Anat: Upper And lower limbs and Head Flashcards
What are the roots of the brachiradialis reflex?
C 5 6 7
What innervated the serratus anterior? What root is it from?
Long thoracic. C5-C7 roots.
Which brachial plexus syndrome affects the PROXIMAL muscles? Arm is addicted extended and flexed hand at wrist?
Erb Duchenne’s Syndrome
Usually seen in difficult shoulder deliveries.
Which brachial plexus syndrome affects the muscles innervated by C8 and T1. Ape hand and claw hand are BOTH seen.
Klumpke’s paralysis
In a long thoracic nerve lesion which border of the scapula is winged? What movement of Te scapula is inhibited?
Vertebral border.
Protraction.
Winging usually due to radical mastectomy, stab wounds and thorax surgery.
What part of the humerus must be injured to result in difficulty in lateral rotation and abduction of the shoulder?
Surgical neck of the humerus. Axillary nerve.
Affecting the deltoid and there’s minor.
What part of the humerus must be injured to result in difficulty extension at the wrist and parenthesia of the skin over the snuff box?
Midshaft fx. Radial nerve lesion.
What wrist bone is commonly affected to result in an ape hand?
Dislocation of the Lunate. Carpal tunnel syndrome affecting median nerve.
What wrist bone is commonly affected to result in an claw hand?
Fx of the hamate. Px will be unable to hold paper in between fingers.
What is the largest branch of the axillary artery? What part is it located in? 1/2/3?
Sub scapular artery in the 3rd part
What kind of fracture results in anterior displacement of the distal end of the radius?
Smith’s.
Posterior displacement is Colls’e fx
What is the common distal attachment of the distal attachment of the quadriceps femoris muscles?
Base of patella and by patellar ligament to tibial tuberosity
What is the common insertion of the iliac us and psoas muscles?
Lesser trochanter of femur.
What is the major arterial supply of the femoral head?
Medial femoral circumflex artery
A fracture of the neck of the femur will result in rotation in which direction?
Lateral.
If dislocation medial rotation.
How many bones do we have?
206
What kind of diarrhrotic joint is the 1st metacarpal?
Saddle
What is the medial border of the axillary?
2nd to the 6th ribs
Serratus anterior muscle
All the rotator cuff muscles insert in the greater tubercle of the humerus EXCEPT:
Subacapularis which inserts in the lesser tubercle of the himerus
The quadrangle dorsal scapular space contains?
Posterior circumflex funeral vessels AND axillary nerve
Triangular space has circumflex scapular vessels.
Which among the anterior compartment arm muscles flexes the forearm at the elbow?
Corachobrachialis
What are the two muscles in the anterior compartment of the forearm are NOT innervated by the median nerve?
Flexor Carpi ulnaris and the medial part of the flexor digitoxin profundus
Name the 3 anterior compartment forearm muscles that DO NOT originate on the medial epicondyle.
The deep group:
flexor digitorum profundus
Pronator quadratus
Flexor policis longus
The brachiradialis muscle located in the psoterior compartment of the forearm is innervated by which nerve?
Radialis nerve.
In a patient with a winged scapula, what action will she have trouble performing?
Raising the IPSILATERAL arm over 90 degrees (above the head). Serratus anterior is unable to move the scapula to enable this motion.
How many bones do we have?
206
What kind of diarrhrotic joint is the 1st metacarpal?
Saddle
What is the medial border of the axillary?
2nd to the 6th ribs
Serratus anterior muscle
All the rotator cuff muscles insert in the greater tubercle of the humerus EXCEPT:
Subacapularis which inserts in the lesser tubercle of the himerus
What do you call a fracture of the 4th and 5th metacarpals?
Boxer’s fracture
What is the only anterior compartment thigh muscle that acts to flex the knee joint?
Sartorius
Name all the contents of Te femoral triangle.
Nerve femoral Artery femoral in sheath Vein femoral in sheath Empty space Lymphatics
All adductor muscles originate and attach where?
Pubis to lines aspera
You are about to perform a femoral vein catheterization. You have felt the pulsations of the femoral artery. Where is the vein located?
Medial to pulsations
What nerve passes through the inguinal canal? What part of the skin does in innervate?
Genitofemoral nerve. Scrotum and groin.
What are the nerve roots of the genitofemoral nerve? And which component supplies the cremaster?
L1 and 2. Cremaster muscle genital branch.
What is the root if the nerve that supplies the lower abdominal wall?
L1. The iliohypogastric nerve.
IM injections to the lower medial quadrant of the gluteus medius or posterior dislocations of the femur may result in?
Sciatic nerve lesions
What is the only 3 gluteal muscles that medially rotate the thigh at the hip joint?
Gluteus medius, minimus and tensor fascias latae.
All others laterally rotate!
A px developed a psoas abscess. On PE you noticed that he had a 1+ patellar tendon reflex on the same side and he had difficulty walking. What nerve is involved?
Femoral nerve.
What is the MOST commonly injured nerve of the pelvis?
Obturator
What are the only 3 posterior compartment muscles that are capable flexing the knee because of their origin at the femur?
Popliteal, plantaris and the femur
After palpating for the popliteal pulsations you wish to puncture the popliteal vein, where will you do it?
Lateral to the pulsations.
Remember: lateral to medial NVA
What is the ONLY muscle stabilizes both the medial and lateral portions of the knee?
Gastrocnemius because is has 2 heads!
What are the 3 most commonly injured structures of the knee joint?
ACL, MCL/ tibial collateral ligament, medial meniscus
What is the keystone bone of the medial longitudinal arch? How about lateral longitudinal arch?
Rounded head of the talus. cuboid.
Most important plantar ligament
Calcaneonavicular joint also called the spring ligament. Supports the arch of the foot.
Brodmann area for Vision? Auditory? Broca's area? Wernicke's area?
Visual 17
Auditory 41 42
Broca’s 44, 45
Wernicke’s 22
What cranial fossa does the accessory meningeal and V3 pass?
Foramen ovale with the lesser petrosal nerve.
What cranial fossa does the superior ophthalmic v. pass?
Superior orbital fissure with CN 3, 4, V1, and 6
What cranial fossa does the middle meningeal artery and meningeal branch of the V3 pass?
Foramen spinosum
What 6 structures pass through the jugular foramen?
Inferior petrosal sinus
Sigmoid sinus
Posterior meningeal artery
CN 9, 10, 11
What artery travels with CN 8 and 7 in the internal acoustic meatus?
Labyrinthine artery
If CN 10 was injured what action would the tongue not be able to perform?
Elevation by the palatoglossus
What 2 veins do the anterior and posterior parts of the retromandibular vein form?
IJV with the common facial v
EJV with the posterior oricular
What pharyngeal arch is phonation from CN 10?
4 and 6
The eye is up and out with CN is damaged?
CN 4
What do you call a circumscribed depression in the skull of a young child?
Pond fx
What is the weakest fossa if the base of the skull?
Middle
2nd most common fx bone of the face?
Zygomatic bibe
Which fx needs prolonged fixation? Maxillary or mandibular?
Mandibular
Which nerve is damaged in forceps delivery?
The facial nerve
Where should a burr hole be placed for the most common kind of extradural hemorrhage?
2.5-4cm above the midpoint of the zygomatic arch.
MC affected anterior division of the middle meningeal artery
Intracranial hemorrhage occurring in an infant is usually from?
Great cerebral veins, straight sinus and inferior sagittal sinus
In blowout fractures:
- Loss of sensation on the skin cheek and gum is due to violation in what structure?
- How about limited upward gaze?
- Injury to the inraorbital nerve, a mandibular branch of V3
- Entrapment of the superior rectus
What ganglion is responsible for the postganglionic part of the direct light reflex?
Ciliary ganglion
In examning the tympanic membrane, the external meatus should be pulled in what direction for:
- Adults
- Childern
- Upward and backward
2. Straight backward backward and downward
How to reduce a dislocated TMJ?
Press downard on lower molar teeth and push backward on the jaw.
In the embryology of the face, what are the 3 processes that must fuse to form the face? The 3 sensory branches of the the fifth cranial nerve, V1 V2 V3 innvervate these.
Frontonasal process
Manibular process
Maxillary process
Facial muscles derive from which arch?
The 2nd
Isolated cleft lip should be operated on at no later than?
2 months
What is an acute infectino of the submandibular fascial space that is usually secondary to dental infection?
Ludwig’s agina
How does one stop torrential hemorrhage from the upper limb?
Exerting downard and backward pressure on the third part of the subclavian artery against the surface of the first rib
Where does one puncture when doing an anterior approach IJV?
On the apex of the triangle formed by the 2 heads of the SCM and the clavicle. Insert needle in a downward direction.
Where does one puncture when doing an an infraclavicular approach subclavian vein catherization?
At the junction of the medial third and latera 2/3 of the clavicle.
The needle is pinted toward the middle of the suprasternal notch
How does one elicit double vision with fourth nerve paralysis?
Ask the patient to look down.
Ectoderm or Entoderm?
- Enamel of teeth
- Lips
- Tongue epithelium
- Ectoderm
- Ectoderm
- Entoderm
At what week should the two parts of the uvula be united?
11th week. Soft palate folds united by 8th week.
Frey’s syndrome presents as?
Persipiration appearing on skin covering the parotid when the patient eats.
Occurs when PS auriculotemporal nerves join the distal end of the great auricular nerve.
Referred pain from frontal sinusitis refers to what part? How bout that of the maxillary sinus?
Forehead, superior orbital nerve
Upper jaw, teeth, inferior orbital nerve
What sinuses do NOT drain into the middle meatus?
Sphenoidal sinus and the posterior group of the ethmoidal sinus
What kind of recurrent laryngeal nerve palsy necessitates tracheostomy?
Bilateral partial section leading to adduction of the vocal cords because abductors are more affected in a partial lesion
What is the BURP maneuver of intubation?
Backward, Upward and rightward pressure on the thyroid to realign the box of the larynx relative to the blade and the glottis.
What is the diameter of the trachea in the child?
0.5 inches
1 inch in the adult
What ligament is cut during a cricothyroidotomy?
The cricothyroid membrane
What is the preferred site for a tracheostomy?
2nd ring of the trachea where you don’t have to cut through the isthmus of the thyroid.
What is the distance from the incisor teeth to the carina?
20cm
15 cm to vocal cords
The pituitary gland originates from what structures?
The rathke’s pouch and the Infundibulum
Inferior thyroid artery is related to which nerve?
Recurrent laryngeal nerve
When does the thyroid gland reach it’s final position?
The 7th week
Where is the most common location of a thyroglossal duct cyst?
midline below the hyoid bone