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MRCS Part B > Anatomy 1 > Flashcards

Anatomy 1 Flashcards

1
Q

What is the normal neck-shaft angle of the femur? Neck anteversion?

A

130 degrees +/- 7 degrees 10 +/-7 degrees of neck anteversion

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2
Q

Vascular supply to hip joint?

A

Medial and lateral femoral circumflex - branches of profunda femoris. Anastomose and pierce joint capsule at base of neck mostly posteriorly Small contribution from artery of ligamentum teres

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3
Q

Why is leg deformed in fracture neck of femur?

A

Shortened, abducted and externally rotated with inability to SLR due to unopposed pull of muscles on lesser trochanter (iliopsoas sartorius etc causes shortening, gluteus maximus obturators and piriformis ie short muscles of gluteal region cause rotation)

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4
Q

What is the definition of a subtrochanteric neck of femur fracture?

A

Below but within 5cm of lesser trochanter

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5
Q

Label these?

A

1 - tibial nerve

2 - common peroneal nerve

3 - sural nerve

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6
Q

Label these parts of popliteal fossa?

A

1 - semitendinosus

2 - semimembranosus

3 - gracilis

4 - gastrocnemius

5 - biceps femoris

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7
Q

What is the deepest structure in the popliteal fossa? What is next most superficial?

A

Polpiteal artery

Popliteal vein just superficial

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8
Q

What are the boundaries of the popliteal fossa?

A

Lateral - biceps femoris above, lateral head of gastrocnemius and plantaris below

Medial - semitendinosus and semimembranosus above, medial head gastrocnemius below

Floor - popliteal surface of femur, popliteus and posterior ligament of knee joint

Roof - superficial and deep fascia

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9
Q

What are the contents of the popliteal fossa?

A

Popliteal artery and vein

Small saphenous vein

Common peroneal nerve

Tibial nerve

Posterior cutaneous nerve of thigh

Genicular branch of obturator nerve

Lymph nodes

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10
Q

Lable this femur bony landmarks?

A
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11
Q

What are the major muscle attachments?

A
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12
Q

What is this and what is its functional purpose?

A

Patella - sesamoid bone contained within tendon of quadriceps that reduces work required to extend the knee joint

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13
Q

Label these?

A

A - vastus medialis

B - Sartorius

C - gracilis

D - gastrocnemius

E - semitendinosus

F - semimembranosus

G - rectus femoris

H - adductor magnus tendon

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14
Q

What is this, where is it and what attaches here?

A

Adductor tubercle on medial condyle of femur

Tendon of adductor magnus inserts here

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15
Q

Label these?

A

A - tibialis anterior

B - peroneus longus

C - long head biceps femoris

D - iliotibial band

E - vastus lateralis

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16
Q

What attaches to 1? Where does it go from and 2? What does it do?

A

ACL

From anterior tibia to lateral intercondylar notch of femur

Prevents tibia sliding anteriorly

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17
Q

What attaches to 2? Where does it go from and to? What is its role?

A

PCL

From posterior tibia to medial intercondylar notch of femur

Prevents tibia sliding posteriorly

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18
Q

What demarcates the femoral neck from the body and what does this continue as?

A

Intertrochanteric crest which continue inferomedially as a spiral line running below lesser trochanter

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19
Q

What does the intertrochanteric line attach to medially?

A

Inferior end of iliofemoral ligament

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20
Q

Where does the synovial membrane of the hip joint stop inferiorly?

A

Intertrochanteric ilne

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21
Q

What muscles attach to greater trochanter of femur?

A

Gluteal muscles

Vastus lateralis more distally

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22
Q

What line runs posteriorly down body of femur? What is its relevance?

A

Linea aspera

Upper-middle linea aspera forms part of origin of attachments of thigh adductors, then spreads out inferiorly to form bony floor of popliteal fossa

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23
Q

Where do vastus intermedius and medialis originate from with respect to each other on femur?

A

Intermedius anterosuperior

Medialis more medial

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24
Q

Besides the circumflex arteries, what else contributes arterial supply to femoral head?

A

Branches from inferior gluteal

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25
Q

What is this? What are its key features?

A

C1 atlas vertebra

Ring with anterior and posterior arches, with lateral bony masses

Transverse processes containing foramen transversarium which transmits the vertebral artery

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26
Q

What structure attaches to X? What is its role?

A

Transverse ligament - holds dens in place

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27
Q

What forms the anterior arch and lateral masses of C1 embryologically?

A

Ossification of vertebral arch

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28
Q

Label this? Where does 1 split into its 2 branches?

A

1 = brachiocephalic trunk - splits into RSCA and RCCA at level of right sternoclavicular joint

2 - left common carotid

3 - left subclavian artery

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29
Q

Which branch of the aortic arch do the phrenic and vagus nerves related closely to? Where do they run?

A

Left subclavian - phrenic continue across anterior surface of pericardium, vagus branches around inferor aspect of aorta and gives off left recurrent laryngeal nerve

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30
Q

Where in the mediastinum is the aortic arch? What level does it become descending aorta?

A

Superior mediastinum

Becomes descending at level of T4

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31
Q

3 things anterior to aortic arch?

A

Thymic remnants

Lungs

Pleura

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32
Q

Label these?

A

1 - right brachiocephalic vein

2 - left brachiocephalic vein

3 - SVC

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33
Q

What feature of the brachiocephalic veins makes it easy to appreciate JVP?

A

Don’t have valves

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34
Q

Where are the brachiocephalic veins in relation to the aortic arch?

A

Anterior

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35
Q

What are the tributaries of the left brachiocephalic vein?

A

Subclavian vein

Internal jugular vein

Thoracic duct

Vertebral vein

Internal thoracic vein

Inferior thyroid vein

Superior intercostal vein

36
Q

Where does the thoracic duct join the venous system?

A

Left brachiocephalic vein at junction of internal jugular and subclavian veins

37
Q

Label this? Which side is it?

A

Left lung

1 - lower left pulmonary vein

2 - oblique fissure

3 - groove for left subclavian artery

4 - left pulmonary artery

5 - upper left pulmonary vein

38
Q

Label the structures in each of these notches?

A

1 - descending aorta

2 - heart

3 - arch of aorta

39
Q
A
40
Q

What structures pass through the superior orbital fissure? 4 nerves 2 vessels

A

CN3 (superior division)

CN4

CN6

Lacrimal nerve

Recurrent meningeal/anastomotic branch of MMA

Superior ophthalmic vein

41
Q

Which structures pass through the optic canal?

A

CN2

Ophthalmic artery

42
Q

What 3 structures pass through the inferior orbital fissure?

A

Maxillary nerve V2

Inferior ophthalmic vein

Zygomatic nerve

43
Q

What is the first branch of the ICA post-cavernous sinus? What are its 6 orbital branches?

A

Ophthalmic artery - lacrimal artery, supraorbital artery, posterior/anterior ethmoidal arteries, medial palpebral artery, frontal artery and dorsal nasal artery

44
Q

What is the first ocular branch of the ophthalmic artery?

A

Central retinal artery

45
Q

What are the 6 ocular branches of the ophthalmic artery?

A

Long and short posterior ciliary arteries

Anterior ciliary artery

Central retinal artery

Superior and inferior muscular arteries

46
Q

Label the carpal bones?

A

1 - scaphoid

2 - trapezium

3 - trapezoid

4 - capitate

5 - hamate

6 - pisiform

7 - triquetrum

8 - lunate

47
Q

What is the significance of the scaphoid blood supply?

A

May be from nutrient foramina in distal segment from carpal vessels in palmar arch, so fractures may compromise blood supply to proximal aspect resulting in AVN

48
Q

Is the hook of hamate palmar or dorsal and what attaches to it?

A

Palmar - flexor retinaculum

49
Q

What type of bone is the pisiform and where is it located?

A

Sesamoid bone situated within tendon of flexor carpi ulnaris

50
Q

What 3 bones of the carpus are stabilised by ligaments only and don’t have tendons attaching to them?

A

First 3 - Scaphoid

Lunate

Triquetrum

51
Q

Label these?

A

1 - peroneus brevis tendon

2 - peroneus tertius muscle

3 - extensor digitorum longus tendon

4 - extensor hallucis longus tendon

5 - extensor hallucis brevis tendon

52
Q

Label these parts of the medial malleolus?

A

1 - flexor retinaculum

2 - tibialis posterior tendon

3 - flexor digitorum longus tendon

4 - flexor hallucis longus tendon

also posterior tibial artery and tibial nerve

53
Q

Label these foot bones?

A

1 - Medial cuneiform

2 - navicular

3 - talus

4 - calcaneum

54
Q

What is this and what does it do? What is its innervation?

A

Tibialis anterior - innervated by deep peroneal nerve L4/5, dorsiflexes ankle and inverts foot

55
Q

What are the 2 arches of the foot?

A

Longitudinal

Transverse

56
Q

Which intertarsal joint is the highest point in the lateral part of the longitudinal arch of the foot?

A

Calcaneocuboid

57
Q

What ankle ligaments do you know?

A

These

58
Q

6 major intrinsic muscles of the foot?

A

Abductor hallucis

Abductor digiti minimi

Adductor hallucis

Flexor digitorum brevis

Flexor hallucis brevis

Extensor digitorum brevis

59
Q

What are the 2 main intrinsic nerves of the foot?

A

Medial and lateral plantar nerves

60
Q

What does the lateral plantar nerve do?

A

Splits to superficial and deep branches to innervate abductor digiti minimi and adductor hallucis

61
Q

What does the medial plantar nerve do?

A

Innervates abductor hallucis, flexor digitorum brevis and flexor hallucis brevis

62
Q

What artery in the foot is a continuation of the anterior tibial artery and what does it do?

A

Dorsalis pedis - gives off arcuate artery then continues as first dorsal metatarsal artery

63
Q

What are the main intrisic arteries of the foot?

A

Medial and lateral plantar arteries

64
Q

Label this? Which kidney is it?

A

Left kidney

1 - gonadal vein

2 - gonadal artery

3 - left renal vein

4 - left renal artery

5 - left ureter

65
Q

What muscle is related posteriorly to the kidneys?

A

Psoas major

66
Q

Roughly between which upper rib and lower vertebral bodies do the kidneys sit? Where are the hila?

A

11th rib

L3

Hilum at L1 (left) and L1/2 (right)

67
Q

What fascia encloses the kidneys and suprarenal gland? What is this derived from?

A

Gerotas fascia

Derived from transversalis fascia

68
Q

What is posterior-anterior in the renal hilum?

A

Ureter posterior

Artery middle

Vein anterior

69
Q

What is the renal papilla?

A

Innermost apex of the renal pyramids

70
Q

What do the renal sinuses contain?

A

Branches of renal artery

Tributaries of renal vein

Major/minor calyces

Fat

71
Q

Label these structures of the anterior neck?

A

A - facial artery

B - EJV

C - IJV

72
Q

What are the 2 major tributaries of the EJV and where does it begin?

A

Posterior division of retromandibular veins

Posterior auricular veins

Begins either within parotid or near angle of mandible

73
Q

What is the main inflow into the IJV?

A

Sigmoid sinus

74
Q

What surface marking would you use to gain access to the IJV for a central line? Where are you aiming? What are the advantages/disadvantages of this approach?

A

Line from ear lobe to medial end of clavicle

Aim needle between sternal and clavicular heads of SCM into the lesser clavicular fossa

Greater risk of pneumothorax but avoids valves lying superior to the bulb of IJV so easier to get guidewires through

75
Q

What structures are superficial to the EJV?

A

Skin

Superficial fascia

Platysma

76
Q

Label these?

A

A - superior thyroid artery

B - vagus nerve

C - inferior thyroid artery

77
Q

Where does the superior thyroid artery come from?

A

External carotid - first part

78
Q

What 4 nuclei give branches to the vagus nerve? Where are they?

A

Dorsal nucles of vagus

Nucleus ambiguus

Solitary nucleus

Spinal trigeminal nucleus

All in medulla

79
Q

Where does the inferior thyroid artery come from?

A

Thyrocervical trunk

80
Q

What are the boundaries of the anterior triangle of the neck?

A

Anterior border of SCM

Lower border of mandible

Anterior midline

81
Q

What are the 3 subtriangles within the anterior triangle of neck? What are they divided by?

A

Muscular triangle

Carotid triangle

Digastric / submandibular triangle

Divided up by digastric and omohyoid

82
Q

What are the contents of the muscular triangle of the neck?

A

Strap muscles

EJV

83
Q

What are the contents of the carotid triangle of the neck?

A

Carotid sheath containig CCA, vagus nerve and IJV

Ansa cervicalis

84
Q

What 4 things are in the submandibular/digastric triangle of the neck?

A

Submandibular gland

Submandibular nodes

Facial vessels

Hypoglossal nerve

85
Q
A

MRCS Part B (25 decks)

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