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Foundation Of Health and Medical Practice > Anatomy > Flashcards

Anatomy Flashcards

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USMLE® Step 1 flashcards
1
Q

Definiton of anterior

A

Towards the front plane of the body

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2
Q

Definition of posterior

A

Towards back plane of the body

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3
Q

Definition of superior

A

Above a region

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4
Q

Definition of inferior

A

Below a region

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5
Q

Definition of medial

A

Towards the centre of the body

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6
Q

Definition of lateral

A

Towards outside of the body

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7
Q

Definition of proximal

A

Towards the joint of the same limb

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8
Q

Definition of distal

A

Away from the joint of the same limb

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9
Q

What is the sagittal plane?

A

It is a vertical cut dividing the body to right and left portions.
Mid sagittal - Cut through the midline of the body
Para sagittal - not cut through the midline

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10
Q

What is the coronal/frontal plane?

A

Vertical line dividing the body into anterior and posterior portions.

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11
Q

What is the transverse/axial plane?

A

Horizontal line dividing the body into superior and inferior portions.

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12
Q

What is the oblique plane?

A

Diagonal line that divides the b body into superior and inferior parts.

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13
Q

What are long bones?

A

Attachment sites for muscles that move the body.

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14
Q

What are flat bones?

A

They protect bones aswell as being attachment sites for muscles.

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15
Q

What is a sesamoid bone?

A

It protects the knee joint (eg.patella).

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16
Q

What are irregular bones?

A

They surround and protect the spinal cord (eg. vertebrae)

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17
Q

What are short bones?

A

Bones that glide over one another (eg. wrist/carpal bones).

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18
Q

What are the skull, vertebral column, ribs and sternum part of?

A

Part of the axial skeleton on the axis of the body.

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19
Q

What parts of the body are part of the appendicular skeleton?

A

The pectoral girdle, pelvic girdle, upper limb, lower limb.

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20
Q

What are joints classified as?

A

Joints are either classified by function or structure.

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21
Q

What is the property of synthroses joints?

A

They are immovable joints.

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22
Q

What is the property of ampiarthroses joints?

A

They are slightly movable joints.

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23
Q

What is the property of diarthroses joints?

A

They are freely movable joints.

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24
Q

What are 3 examples of fibrous joints? (immovable)

A

1) Sutures = Dense fibrous connective tissue only found in skull. Ossifies by middle age to become one bone, called synostoses.
2) Syndesmoses = Bones that are connected by short ligaments to prevent movement.
3) Gomphoses = The socket in which the tooth is embedded and is joined with a periodontal ligament, only found in the mouth.

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25
Q

What are 2 examples of cartilaginous joints? (has a range of mobility)

A

1) Synchondroses = Contains hyaline cartilage, between the first rib and the manubrium of the sternum.

2) Symphyses = Compressible fibrocartilage, functions as a shock absorber between the vertebrae and in the pelvis.
Also in growth plates where bones grow length, these ossify in later age.

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26
Q

What is the structure of a synovial joint?

A

Synovial membrane filled with fluid (joint cavity) between 2 bones.
May have discs of cartilage between the articular surfaces, these are menisci.

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27
Q

What is a pivot joint?

A

When there is rotation around an axis.

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28
Q

Give an example of a hinge joint

A

The elbow

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29
Q

Give an example of a saddle joint

A

At the base of the thumb between the trapezium carpal bone and the first metacarpal bone.

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30
Q

Give an example of a plane joint

A

Between the tarsal bones of the foot, limits the gliding movement of the bone.

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31
Q

What is a condyloid joint and give an example of one

A

It is a synovial joint between convex and concave shaped bones.
An example of this is the radiocarpal joint.

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32
Q

Give an example of a ball and socket joint

A

Hip and shoulder joints

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33
Q

What is a bicondylar joint and give an example of one

A

It is 2 condyloid joints between 2 bones/ellipsoid joints.

An example of this is the knee joint.

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34
Q

Give an example of an ellipsoid joint

A

Between the radius and ulna with the wrist.

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35
Q

What is the opposite of flexion?

A

Extension

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36
Q

What is the opposite of abduction?

A

Adduction

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37
Q

What is an angular movement at joints that moves in a circular motion?

A

Circumduction

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38
Q

In which two directions does rotation at joints occur?

A

Laterally and medially

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39
Q

What is the definition of a somite?

A

It is a repetitive body segment with muscles, blood vessels, nerves and skin strips.
The vertebrae are an example of somites.

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40
Q

How do vertebral somites form?

A

Mesodermal tissue that is distributed along the sides of the neural tube form the skin, skeletal muscle and vertebrae.

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41
Q

What gene controls the formation of somites?

A

Hox genes regulate the body plan along the cranio-caudal axis.
It controls how many and how large each somite is.

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42
Q

What determines the type of segment the somite is

A

Hox proteins (they determine segmental identity but do not form the segments themselves)

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43
Q

Why does the vertebrae shape change dramatically in the spine?

A

The Hox genes have to code for the different weight support and the curvature of the spine.
Different parts of the spine also have different demands of movement.

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44
Q

How many cervical vertebrae are there?

A

7

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45
Q

There are 12 of which vertebrae?

A

Thoracic vertebrae

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46
Q

How many lumbar vertebrae are there?

A

5

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47
Q

How many sacral vertebrae are there?

A

5

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48
Q

What is the name of the stage of development where babies start to carry their head upright on their own?

A

Cervical lordosis

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49
Q

What is the name of the development of the curve in the back?

A

Thoracic kyphosis

if exaggerated this can be a condition that impairs the patient “hunched” posture

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50
Q

What is the name of the stage of development where babies start to walk upright?

A

Lumbar lordosis

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51
Q

What type of kyphosis occur when upright walking develops?

A

Sacrum and coccyx kyphosis

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52
Q

What are the 5 features of organisation of a vertebra?

A

1) Vertebral body
2) Pedicles and lamina, forms vertebral arch from which nervous structure can pass.
3) Articular processes, 2 superior and 2 inferior. They connect two adjacent vertebra together via synovial joints.
4) Transverse processes with lateral muscle attachments.
5) Spinous process at the most anterior part.

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53
Q

Describe the structure of cervical vertebrae

A

Transverse foramen between the transverse process and rib angle only on cervical vertebrae. These allow vertebral artery and vein to pass through.

C1 + 2 are connected to the skull so have a posterior tubercle (C1) and dens (C2).

The spinous process is often bifurcated.

Joint facets are facing the cranium, so can only be seen on the transverse plane.

54
Q

Describe the structure of thoracic vertebrae

A

These vertebrae bear ribs on each side of the vertebra.

Joint facets face the frontal plane so can only be seen on the frontal plane.
There is one joint facet on the rib tubercle which connects to the transverse process of thoracic vertebra.
There is also a joint facet on the head of the rib.

55
Q

Describe the structure of lumbar vertebrae

A

Large and robust.
Can be dorsally wedge shaped.

Joint facets are sagittally orientated.

56
Q

Describe the structure of the sacral vertebrae

A

These vertebrae fuse and become ossified (around age 12).

Connects spine to pelvis via sacroiliac joints.

57
Q

What is the difference between the male and female sacrum?

A

Female sacrum is shorter and wider.

Bone is directed obliquely backward to increase size of pelvic cavity.

58
Q

What is the range of motion for the cervical vertebrae?

A

Flexion, extension, bending laterally, rotation.

It is the most mobile.

59
Q

What is the range of motion of thoracic vertebrae?

A

Only rotation.

Don’t want to compress vertebrae to not able to flex or extend.

60
Q

What is the range of motion of lumbar vertebrae?

A

Mainly flexion and extension, including laterally.

61
Q

What is the cervical plexus?

A

Contains the anterior rami of C1-4. This innervates the neck muscles.
Provides sensory innveration to anterior and lateral neck.

62
Q

What is the brachial plexus?

A

Network of nerves in the shoulder that carries sensory and motor impulses from the spinal cord to the arms and hands.

63
Q

Where do sensory nerves travel in the spinal cord?

A

The posterior root

64
Q

Where do motor nerve impulses travel in the spinal cord?

A

The anterior root

65
Q

Describe the path of a spinal nerve root

A

Spinal nerve root emerges from the medulla and travels to the vertebra foramen.
In the lumbar section of the spine has to travel further as the spinal cord is shorter than the vertebral column. Means the spinal nerves have to make up the difference.

66
Q

What is a dermatome?

A

A signal spinal nerve that carries the sensory innervation for a skin strip of the body surface.

67
Q

What is a myotome?

A

A single spinal nerve that carries motor innervation for a group of skeletal muscles.

68
Q

How many segments of the spinal cord are there?

A

31 segments

69
Q

Which nerve root innervates motor function?

A

The ventral (anterior) root

70
Q

Which nerve root innervates sensory function?

A

The dorsal (posterior) root

71
Q

How do spinal nerves exit the spinal cord?

A

The nerve roots combine on either side to form spinal nerves.
These exit the vertebral canal through the neuroforamina.

72
Q

What can happen if the neuroforamina is compressed?

A

Can result in clinical condition of radiculopathy.

73
Q

How can varicella zoster virus be presented on the body?

A

Reveals as a painful dermatomic area. The virus can be dormant in the dorsal root ganglion and migrates along the spinal nerve. It then affects only the area of skin innervated by that nerve.

74
Q

What is the definition of a plexus?

A

The mixing and redistribution of spinal nerves to form further peripheral nerves.
The higher the vertebral column, the higher the joint is located.

75
Q

Name 3 roles of the lymphatic system?

A

1) Drains excess interstitial fluid. This maintains the fluid balance in the body and prevents the depletion of plasma proteins. Accumulation will cause oedema.
2) Transports dietary lipids - triglycerides - and fat soluble vitamins A, D, E and K. Occurs in the lacteals of small intestines.
3) Carries antigens to lymph nodes.

76
Q

Name the 5 parts of the lymphatic system

A

1) Lymphatic vessels - capillary beds and larger ones.
2) Lymph
3) Diffuse and defined lymphoid tissues - tonsils and Peyer’s patches.
4) Lymphoid organs - thymus, spleen and lymph nodes.
5) Bone marrow

77
Q

Describe the structure of lymphatic vessels

A

Thinner walls than veins, more valves.

This ensures a secure unidirectional flow of lymph.

78
Q

Outline the open system of lymphatic vessels

A

Lymphatic vessels start blind, this means they have a sealed end.
Cell walls overlap, and this creates a one way valve system for fluid that enters the lymph capillaries.

79
Q

Why are lymphatic vessels important?

A

They need to return lost fluid back to the circulatory system.

80
Q

What is important about the functional lymphatic vessels that line the venous draining channels of the brain?

A

They can carry fluid and immune cells from the cerebrospinal fluid, and are connected to deep cervical lymph nodes.
Could be associated with neurodegenerative and neurone inflammatory diseases.

81
Q

What is lymph from the gastro intestinal tract called?

A

Chyle, rich in lipids (triglycerides)

82
Q

What colour does lymph become when it is lipid rich?

A

Opaque white colour.

83
Q

Which blood vessels do the lacteal lymph vessels follow?

A

They follow the superior mesenteric artery.

84
Q

Where are lymphoid tissues usually found?

A

1) GI tract and appendix
2) Urinary tract
3) Reproductive tract
4) Respiratory airways

(Wherever pathogens have a good chance of entering the body.)

85
Q

What is the function of tonsils?

A

Collection of lymphoid tissues, covered by mucous membrane.

Found between the oral cavity and pharynx, and the nasal cavity and pharynx.

86
Q

What happens after puberty to the palatine and nasopharyngeal tonsils?

A

They reach the maximum size in childhood then atrophy after puberty.

87
Q

Why can lymphoid tissue cause deafness or middle ear infection (recurrent otitis media)?

A

Because the lymphoid tissue is close to the auditory tube.

88
Q

Where are the nasopharyngeal tonsils (adenoid) located?

A

Behind nasal cavity, where nose blends into throat.

89
Q

Where are the palatine tonsils located?

A

Near the opening of the oral cavity into the pharynx.

90
Q

Where are the lingual tonsils located?

A

On the posterior surface of the tongue.

91
Q

Describe the structure of Peyer’s patches

A

Located in sub mucosal tissue of ileum containing high levels of IgA secreting cells.

Contains germinal centres with B cell and T cell dependant regions.

A specialised epithelium exists between this patch and the intestine.

92
Q

What are Peyer’s patches function?

A

For the immune response and protection of the gut.

93
Q

Around how many Peyer’s patches are present in humans?

A

100

This number peaks at 15-25 then declines during adulthood.

94
Q

What can excessive growth of Peyer’s patches cause?

A

Telescope gut of small intestine to the large intestine.

95
Q

What is the function of primary lymphoid organs?

A

Generates lymphocytes from stem cells.
Also clones lymphocytes.
They are found in the axis of the body.

96
Q

What is the function of secondary lymphoid organs?

A

They are found in the periphery of the body.

These are the sites where the lymphocytes are activated.

97
Q

What are the primary lymphoid organs?

A

1) Thymus

2) Bone marrow

98
Q

Where is the thymus located?

A

It is located posterior to the sternum, medial to the lungs and superior to the heart.

99
Q

What is the function of the thymus?

A

It is the site where the T cells proliferate and mature.

Mature T cells leave thymus via blood and are carried to the lymph nodes, spleen and lymphoid tissues.

100
Q

Describe the structure of the spleen

A

It is the largest mass of lymphoid tissue in the body.

It is postero lateral to the stomach, under the left dome of the diaphragm.

101
Q

Which artery perfuses the spleen and where does it drain?

A

The splenic artery.

It joins the superior mesenteric vein and drains via the portal vein system.

102
Q

What is splenomegaly?

A

It is when the spleen is enlarged due to an increased work load eg. when there is a disease that needs RBCs to be filtered out of the spleen.
Spleen may be visibly enlarged in the upper quadrant of abdomen.

103
Q

What are symptoms of splenomegaly?

A

Pain in abdomen, chest (when stomach, bladder or bowels are full) and back.

104
Q

List 5 causes of splenomegaly

A

1) Red blood cell diseases eg. sickle cell anaemia
2) Immune hyperplasia - too many lymphocytes eg. mononucleosis, malaria, HIV
3) Bone marrow diseases eg. leukaemia
4) Blood flow disturbances eg. portal hypertension, parasites of liver
5) Blood cancers and cancers of lymphatic system

105
Q

Describe the structure of lymph nodes

A

They are encapsulated collections of lymphoid tissue.

Also are located along lymphatic vessels in groups.

Lymph enters the nodes via afferent vessels the filters through the nodes.

Bean shaped with the hilum. This is where the efferent lymph leaves the node and blood vessels enter and leave.

Has valves so that lymph only goes in one direction.

Contains framework of reticular fibres.

Contains B, T, plama, dendritic cells and macrophages.

106
Q

What is the hilum?

A

A linear, echogenic shadowing structure that contains nodal vessels.
Appears like it is part of the fat around the node.

107
Q

What is the function of the lymph nodes?

A

They act as filters/traps for pathogens.
They are “training camps” for B cells.
They are memory banks for T cell immune responses.
Specialised white blood cells exit the lymph and re circulate the peripheral lymphoid organs.

108
Q

What happens to lymph nodes during lymphadenopathy?

A

The lymph nodes expand during infection.

109
Q

What is the process where cancer cells travel in blood or lymph and establish new tumours?

A

Metastasis

110
Q

How can secondary tumour sites be predicted?

A

The lymph flow through the lymphatic vessels can be followed from the primary tumour site, as this will be the path of metastasis.

111
Q

Outline the TNM staging system

A

T - size of tumour and if it has invaded nearby tissues

N - nearby lymph nodes that are involved

M - distant metastasis

112
Q

Give 2 examples of the TNM staging system in use

A

1) If common iliac nodes are involved in cervical cancer, this defines it as a N1 stage. Linked to overall stage I or II. (high survival rates).

2) If common iliac nodes are involved in bladder cancer, this defines it as M1 stage. Linked to overall stage IV cancer.
(low survival rates).

113
Q

Describe the structure of the bone marrow

A

It is highly vascularised connective tissue in the microscopic spaces between the trabeculae (bands between connective tissue) of spongy bone tissue.
Found in the epiphyses of long bones and flat bone such as the pelvis, vertebrae, ribs, children’s skulls.

114
Q

Define epiphyses

A

The end of a long bone, growing from a shaft.

115
Q

What does bone marrow contain?

A

Contains pluripotent stem cells.

These can differentiate into red and white blood cells.

116
Q

Where does lymph fluid drain into?

A

Ultimately drains into the venous blood circulatory system.

117
Q

Which lymphatic vessel drains into the right jugular and subclavian vein?

A

The right lymphatic duct

118
Q

Which lymphatic vessel drains into the left jugular and subclavian vein?

A

The thoracic duct.

119
Q

What does the pumping in the lymphatic system depend on?

A

It relies on the muscular contraction of the body.

120
Q

Where does the right lymphatic duct collect lymph from?

A

Lymph from the upper right of the torso, right arm, right side of the head and thorax.

121
Q

Where does the thoracic duct collect lymph from?

A

The rest of the body.

It is the largest single vessel for lymph.

122
Q

From where does the thoracic duct run?

A

It runs from the aortic opening in the diaphragm to the root of the neck.

123
Q

What does the thoracic duct specifically rely on for the flow of lymph?

A

Depends on the thoracic pump, the pulsing of thew aorta as well as the movement of the thorax.
This helps to pump lymph against the force of gravity.

124
Q

What are the cistern chyli?

A

Found close to the aortic opening of the diaphragm, at the level of the first lumbar vertebra.
What the thoracic duct starts with.

125
Q

What does the cistern chyli receive lymph vessels from?

A

Receive lymph vessels from the gastrointestinal tract (lacteals) and the lumbar lymphatics.

126
Q

What is primary lymphedema?

A

Results in malformed or absent lymphatic vessels.

127
Q

What is primary lymphedema caused by?

A

Genetic or congenital conditions

128
Q

What are 3 causes for secondary lymphedema?

A

1) Caused by excessive accumulation of interstitial fluid. More fluid being produced than collected.
2) Caused by obstruction of lymphatic vessels eg. infection, parasite infestation, lesions.
3) Caused by lack of skeletal muscle contraction eg. paralysis.

129
Q

What is lymphatic filariasis?

A

Fluid retention

130
Q

What is lymphatic filariasis caused by?

A

Thread like parasitic nematode worms.

It is not clear if swelling is caused by the parasite itself or the immune system’s response to the parasite.

131
Q

What are parasitic nematode worms transmitted by?

A

They are transmitted by mosquito bites.

Adult worms infest the human lymphatic vessels and myth nodes.

Foundation Of Health and Medical Practice (8 decks)

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