Anatomy Flashcards
Name parts of cervical, thoracic and lumbar vertebrae
https://www.getbodysmart.com/skeletal-system-quizzes/cervical-vertebrae-quiz
Divisions of subclavian artery
Vertebral
Internal thoracic
Thoraco dorsal
Cervical
Dorsal scapular
What is the path of the vertebral artery?
1st part of subclavian Posterior to ant scalene To c6 transverse process for amen Up to c2 At c1 horizontal extradural part in occipital triangle Enters spinal canal Joins basilar artery
Most common c spine fracture?
Types and management?
Odontoid peg
Type 1 tip of peg- Miami j
Type 2 waist of peg- high risk of non union- watershed blood supply from vertebral artery
Type 3 extension into c2 body- Miami j
What is the origin of the mental nerve?
V3 and inf alveolar nerve
Muscles of mastication?
Temporalis
Masseter
Lateral- opens jaw
Medial pterygoid- closed jaw
Muscles of the tongue?
Intrinsic- longitudinal, transverse, vertical Extrinsic- genioglossus- cn xii Myoglossus cnxii Hyoglossus cn xii Palatoglossus- cn x
Tongue sensation?
Anterior 2/3
Somatic sensation- lingual of v3
Taste- chords tympani
Post 1/3
Glossopharyngeal
Structures that run through parotid gland?
Cnvii
External carotid a
Retromandibular vein
Lymph nodes
Course of facial nerve?
Pontine medullary junction Through internal auditory meatus To geniculate ganglion Gives off staepedius, greater pertrosal, chorda tympani Stylomastoid foramen To parotid gland
Blood supply of thyroid gland?
Superior thyroid a
Inf thyroid a
Thyroid ima
Sup and middle thyroid being drain to ijv
Inferior thyroid being drains to brachiocephalic vein
Nerve supply of laryngeal muscles?
Recurrently laryngeal to all bar…
Cricothroid muscle- external laryngeal
Sensation above vocal cords is internal laryngeal n
Below is recurrent laryngeal
Recurrent laryngeal nerve palsy symptoms?
External laryngeal?
Hoarseness
High pitched voice
Facial compartments of the neck?
Investing
Pretracheal
Prevertebral
Carotid sheath
Name parts of the rib
Head- 2 articular facets Neck Shaft Tubercle Costal groove
Structures around scalene anterior?
Anterior- subclavian vein and phrenic nerve
Post- subclavian a and brachial plexsus
Thoracic outlet syndrome definition and aetiology and test
Compression of NV bundle going from neck to arm
Anatomical- cervical rib, fibromuscular bands
Traumatic- axillary vein thrombosis, repetitive movements- squash
Costoclavicular space entrapment
Roo’s test- arm. Abducted, ext rotation and flex. Hand flexion. Symptoms recreated
Adsons
Superior mediastinum contents?
Thymus Trachea Thoracic duct Phrenic and vagus nerves Symph chain
Inferior mediastinum contents?
Ant- thymus
Middle- phrenic, pericardium
Post- vagus, thoracic duct, azygous, symph trunk (DATES)
What blood vessel supplies the san and avn?
And what veins drain them?
And what is heart dominance
San- rca/LCX
Avn- RCA/LCX
Veins
Great cardiac- drains lad
Middle cardiac drains pda
Heart dominance- which artery the PDA comes off
What are the impression in the lung hilum?
Right- svc superior
Azygous vein inferior
Left- aortic arch
Heart
Diaphragmatic openings?
Caval- ivc and right phrenic
Oesophageal- oesophageal, vagus nerves, left gastric vessels
Aortic- aorta, thoracic duct, azygous, hemiazygous
Left phrenic pierced diaphragm
Sup epigastric vessels
Symph trunk
Adrenal bloody supply
Superior from inf phrenic
Middle from aorta
Inferior from renal a
Retroperitoneal structures?
Ivc Supra renal glands Aorta and ivc Duodenum- all bar first 2cm Pancreas- all bar tail Ureters Colon ascending and descending Kidneys Esophageus Rectum (upper 2/3)
Layers of scrotum?
Skin Dartos External Cremasteric Internal Tunica vaginalis Tunica albuginea Testes
Lymphatic drainage of scrotum and testis?
Scrotal skin to inguinal
Testis to para aortic
Spermatic cord contents?
Artery to vas
Cremasteric artery
Testicular a
Pampiniform plexuss
Lymphatics
Vas deferens
Genital branch of genitofemoral n
Ilioinguinal n- runs outside canal
Symphathetics
Axillary a divisions
Save the lawyer, screw a patient
Superior thoracic Thoracoacromial Lateral thoracic Subscapular Anterior humeral circumflex Post humeral circumflex
Rotator cuff muscles?
Suprascapular- abduction- greater trochanter
Infrascapular- external rotation gt
Subscaparis- internal rotation- lt
Teres minor adduction + external rotation- gt
Boarders and contents of antecubital fossa?
Lateral epi to medial epi
Brachioradialis
Pronator teres
Contents Median nerve Brachial a Biceps tendon Radial nerve- between brachialis and brachioradialis
Contents of carpal tunnel?
Fpl
Fdp
Median nerve
Fpl
Fcr runs outside
Extensor compartments of the wrist?
Lateral to medial 1-epb and apl 2- ecrl and ecrb 3- epl 4- extensor in incidis + post interosseous n + extensor digitorum 5- edm 6-ecu
Short rotators of the hip?
Piriformis
Gemelli
Obturator
Quadratus femoris
Blood supply of the femoral head?
Retinacular vessels from circumflex femoral a
Interosseous
Ligamentum teres artery
Paths of great and short saphenous veins?
Great drains medial dorsal arch Ant to medial malleolus Posteromedial to patella Through saphenous tunnel? Piercers tensor fascia Lata Joins at saphenofemoral junction- below and lateral to pubic tubercle
Short
Lay margin of dorsal arch
Post to lateral malleolus
Joins popliteal vein
Femoral triangle content boarders floor
Navy + lymphatics
Sartorial inguinal ligament adductor longus
Iliopsoas, pectineus, adductor longus
Femoral canal boarders and content?
Inguinal lig, femoral vein, lacunae ligament medially, pubic rami/pectineus
Empty space- allows for expansion of femoral vein
Cloquet’s lymph node
Boarders of inguinal canal and locations of ring?
Ant- eo
Sup- arching fibres of io and ta
Post- tf
Inferior- inguinal ligament
Deep ring- superior to mid inguinal point
Superficial- above pubic tubercle
Contents of adductor canal?
Sfa Descending genicular arteries Femoral vein Long saphenous n N to Vastus medialis
Popliteal fossa boundaries
Semimembranosus/semitendinosus
Biceps femoris
Gastrocnemius
Contents- deep to superficial
Popliteal a
Popliteal vein
Tibial nerve
Lower limb compartments and nerve and blood supply?
Anterior- tibia ant, ehl, extensor digitorum, peroneus tertius
Deep peroneal and ant tibia artery
Lateral peroneal longus and brevis
Superficial peroneal and peroneal artery
Posterior deep- fdl, fhl, tibialis post, popliteus
Superficial- gastrocnemius, soleus, plantaris
Tibia nerve, post tibial a
Structures posterior to medial malleolus
Tom dick and very nervous Harry
Ant to post
Tibialis post Flexor digitorum Post tibial a Post Tibial vein Tibial nerve Fhl
Ankle ligaments?
Tibular and fibula ant and post
Laterally- talofibular ant and post
Calcaneofibular and bifurcate
Medially deltoid ligament
Superficial tibionavicular and tibicalcaneal log
Deep tibiotalar ant and post
Arches
Long and short plantar reinforce lateral arch
Spring ligament- reinforces medial arch
Cranial fossa and structures passing through
+ cranial fossa boundaries
Ant fossa- frontal, ethmoidal and sphenoid bones
Frontal bone + lesser wings/limbus of sphenoid bone
Middle fossa- sphenoid and temporal bones
Lesser wings/limbus of sphenoid bone anterior to petrous temporal and dorsum sella posteriorly
Post fossa- occipital, temporal bones
Ant- dorsum sella/clivus and petrous temporal bones to squamous occipital bone
Contents of superior orbital fissure?
Inferior orbital?
Cn 3 Cn 4 Cn 6 Cn v1- ophthalmic Ophthalmic vein
Inferior ophthalmic vein
Cnv2- zygomatic n
Infraorbital artery and vein and nerve
Csf
Volume
Secreted by?
Cycle
150-200 mls circulating volume Secreted by choroid plexus Into lateral ventricles Foramen of Munro to 3rd ventricle Slyvius aqueduct to 4th ventricle Magedie and Lusaka to subarachnoid space
Cranial nerve origins ?
Olfactory epithelium cn 1 Retinal epithelium cn 2 Midbrain cn 3/4/5 Pons cn 6/7 Cerebellopontine angle cn 8 Medulla cn 9/10/11/12
Types of spinal cord nerve pathways
Ascending
Spinothalamic- pain and temp
Dorsal columns- fine touch vibration and proprioception
Spinocerebellar- unconscious propioception
Decscending
Corticospinal- skilled and discrete movements
Extrapyramidal system- modulation and regulation of movement
Draw brachial plexus
Contents of carotid sheath
Where does carotid divide?
Cca, vagus, ivc
And a cervicalis
Cn 9.11,12
Splits at c4
Divisions of ica?
Opthalmic a Ant choroidal An cerebral Middle cerebral Post communicating
Describe the parasympathetic nervous system
3, 7,9,10
S2-4
3 to ciliary ganglion
7 to pterygopalatine and submandibular ganglion
9 to otic ganglion
10 to rest of body
location and contents of transpyloric plane?
L1- halfway between pubic symphysis and jugular notch
Contains
Pylorus, neck of pancreas, joining of SMV and splenic vein, SMA, Renal hilum, end of spinal cord, fundus of gallbladder, splenic hilla, cisterna chyli, colonic/hepatic flexure
Surface anatomy of the liver?
5th IC to 10th IC in midclavicular line then to 5th IC
Runs along nipple line
Splenic surface anatomy?
Overlied by ribs 9-11 posteriorly
Aorta paired and unpaired branches?
Paired- phrenic arteries T12 Renal As L1/2 Testicular As L2 Iliac As L4 Lumbar As L1-4 Middle suprarenal As L1
Unpaired Coelia SMA IMA Middle sacral
Surface anatomy of the kidneys?
Right is 12 th rib
Left is 11/12th rib
Function of the spleen?
FISH Filtration of encapsulated organisms (n.menigitidis, s.pneumonia, pneumococcus)/WBC/RBCs/Platelets Immunological (lymphocyte production) Storage of platelets Haemtopoesis in fetus
Portosystemic anastomosis areas?
Bare area of liver Periumbilical area Upper rectum Oesophageal Retroperitoneum
Areas where fluid/pus collects in abdomen?
R and left paracolic gutters R subhepatic space Pelvis Inbetween bowel loops R and left subphrenic spaces
Stomach and pancreas parts?
Stomach- antrum, fundus, pylorus, cardia, body
Pancreas- head, ucinate process, neck, body, tail
Difference between jejunum and ileum
Jejunum more proximal
Bigger and thicker
Longer vasa recta, fewer arcade
Jejunum has thinner mesentry and more arcades
More vascular?
Describe the endocrine and exocrine function of the pancreas?
Exocrine function- acinic cells, produce digestive enzymes
Endocrine- alpha cells- glucagon
Beta cells- insulin
Delta cells- somatostatin (inhibitory hormone of the others)
What is a Meckel’s diverticulum and what is its hernia?
Failure of the obliteration of the Vitelointestinal duct
Littre’s hernia
Rule of 2s, 2% population, 2:1 male to femal, 2 feet from ileocaecal junction, 2 inches in length
What is produced in the adrenals?
Adrenal cortex- GFR ACE
Zona glomerulosa- Aldosterone
Zona fasculata- Cortisol (gluccocorticoids)
Zona reticularis- Androgens
Adrenal medulla- epi/norepi
Order of vessels at renal hila?
Ant to post
Vein
Artery
Ureter (runs posteriorly over psoas major and iliacus
What is the ureter crossed by?
Gonadal vessels
Left side is crossed by left colic A
Right by ileocolic and right colic As
What is the blood supply to the ureter?
Segmental
Superior- Renal
Middle- gonadal and common iliac
Inferior- internal iliac- uterine and superior vesicular
Different positions of the appendix?
Retrocaecal Subcaecal Pelvic Preileal Post ileal
Blood supply and nerve supply of rectum?
Sup rectal A- from IMA
Middle Rectal A from internal iliac
Inferior rectal A from Internal pudendal
Symph from sup hypogastric plexus and lumbar splanchnics
Parasymph from S2,3,4
How many valves are there in the ureter?
Just one- false valve
Detrusor muscle forms muscular sphincter
When contraction of detrusor muscle in closes ureter and prevents back flow
Nerve supply to bladder?
Hypogastric plexus- symph
S2-4 gives parasymph
What makes up the conjoint tendon and lacunar ligament of the inguinal canal?
Conjoint tendon- medial posterior injuinal canal stabiliser- TA and IO
Lacunar lig- medial floor inguinal canal stabliser
What is the nerve supply to EO?
Intercostal N (lower 6) and subcostal N
Why do you get abdominal pain with testicular torsion?
T10 nerve supply- radiation to umbilicus
Nerves at risk in hernia repair?
Ilioinguinal- runs outside of cord but in canal
Sensation loss to anterior scrotum, base of penis and groin
Iliohypogastric- pierces EO medially, sensation to base of pubis
Genital branch of genfem- Loss of cremaster muscle, sensation scrotum
Oesophageal arterial and lymphatic supply?
Segmental!!!
Superior- inferior thyroid artery => deep cervical LNs
Middle- aortic branches=> mediastinal LNs
Inferior- oesophageal branches of left gastric and inf phrenic => left gastric and coeliac nodes
Types of oesophageal hernias?
Congenital- Morganis, Bouchdalek’s
Acquired- sliding (90%) and rolling
Fixed by oesophageal fundoplication
What is Barrett’s oeosphageus?
Chronic GORD
leads to metaplasia of the lower oesophageus and rolling up the Sq cells to replace columnar cells
Premalignany SqCC of oesophageus
Constriction points of the oesophageus?
Arch of aorta
Bronchus- left
Cricoid cartillage
Diaphram
What is the surface A of the GB
The contents of calot’s triangle
And what stiumlates the contraction of the gallbladder?
9th costal margin to lateral edge of the rectus muscle
Tranpyloric plane
Cystic A and Nodes of Lund
CCK- cholecystokinin
Surface A of breast?
2nd to 6th costal cartilage, sternum to mid axillary line
Deep muscle relations of the breasts?
Serratus Ant
Pec major and mine
Rectus
Latissiumus dorsi
Structure of the breast
15-20 lobule per breast, each drain to a lactiferous duct and sinus and join via the nipple
What are Cooper’s ligament?
Suspensory ligaments that extend from the subcutaneous fat to the deep fascia
Malignany infiltration leads to puckering and retraction of the skin
What is the lymphatic drainage of the breast?
75% via axillary LN
Parasternal and post intercostal LNs
Supraclavicular LNs
ContraL breast
What is the nerve and blood supply of the breast?
N- intercostal Nerves 4-6
Blood
Internal thoracic A
Lat thoracic/thoraco acromial branch
Intercostal As
Location of DP and PT?
DP lateral to EHL- between 1 and 2 metatarsal
PT 2-3 cm behind medial malleolus
Where do the peroneal muscles insert?
Peroneus longus-head of fibula to medial cuneiform and 1st metatarsal base
Brevis- onto 5th metatarsal
Tertius- onto 5th metatarsal
Which muscles invert and evert the foot?
Inversion- tib ant and post and EHL
Eversio- peroneal muscles
What attaches to the linea aspera in the thigh?
Lateral ridge- Gleuteal tuberosity- gleuteus maximus/ vastus lateralis
Intermediate ridge- pectineal line- pectineus
Medial ridge- vastus medialis
Adductor magnus
Short head of biceps femoris
Describe the fasciotomy incision for the lower leg?
4 compartment fasciotomy
2 incisions
Anterior and lateral compartments- 2cm ant to fibula from tibial tuberosity to sup to ankle
Post compartments- posteromedial to tibial, tuberisty to 5cm above medial malleolus
Where does popliteal A divide and where does tibioperoneal A divide?
Popliteal A divides at soleus arch in fossa into anterior tibial A and tibioperoneal trunk
TP trunk divides 2-5cm below this into post tibial and peroneal A
How to tell ACL and PCL apart?
ACL is hands in front pockets- post to ant
Lateral post intercondylar notch on femur to medial ant tibial spine
PCL is hands in back pockets
reveres of above
What NVI to be aware of in anteromedial approach to the knee?
Geniculate As
Long saphenous
Saphenous N
What makes up the blood supply to the knee?
An anastomotic mesh of femoral, popliteal and cural As
Sup and inf geniculate As
Middle geniculate- supplies ACL and PCL
What is contained in popliteal fossa?
Superfiscial to deep N- common peroneal and tibial V- popliteal vein A- popliteal A LNs
Floor is knee joint, femur and popliteus
What are the divisions of the axillary A?
1st- Sup thoracic
2nd- Thoracoacromial and Lat thoracic
3rd- Subscapular, ant and post circumflex humeral
Split by pec minor
What is the glenoid labrum?
Fibrocartillage collar of glenoid fossa
What cause shoulder impingement syndrome?
Painful arc from 60-120
Coracoacromial lig- compression of suprascapular lig
Subacromial bursitis
What are the boarders of the quadrangular space and what does it contain?
Humerus, teres minor and major and latissimus dorsi
Contains- post circumflex humeral a, axillary N
Where is the triangular space and its contents?
Teres minor and major and long head of triceps
Cicrumflex scapular A
Where is the triangular interval and its contents?
Triceps long head, teres major and triceps lateral head/humerus
Radial N and profuna brachii artery
What supplies the rhomboids?
Dorsal scapular Nerve- C5
What are the 3 arches of the foot?
Transverse- metatarsal heads, peroneus longus and interossei ligs
Medial- spring lig and tarsal bones and interosseous ligs
Lalteral- long and short plantar ligs and bones
What are the joints of the elbow?
HUmero ulna- trochlea and olecranon
Humero radial- capitelum and radial head
Ulnaradial- radial head and radial notch
What are the flexors of the elbow?
Brachialis, biceps and brachioradialis
What is the contents and boarders of antecubital fossa?
Floor- supinator and brachialis
Roof- bicipital apoN
Lateral- brachioradialis
Medial- pronator teres
Contents
Medial to lateral
Median nerve, brachial a, bicipital tendon, radial nerve
What are the compartments of the forearm?
Volar and dorsal
Volar- superfiscial- FDS, FCR, FCU, PT and PL (from medial epicondyle)
Deep- from forearm- FPL, FDP, PQ
Mobile wad- Brachioradialis and ECRL/B
Dorsal- Superfiscial- ECU and aconeus
Intermediate- EDC and EDM
Deep- APL, EPB, ECU, EPL, EI, supinator
What are the incisions for a forearm fasciotomy?
Volar- along ulna boarder- FCU to medial epi (avoid ulna nerve)- extend to carpal tunnel
Dorsal- lat epicondyle to dorsal mid line
Hand fasciotomy incisions?
10 compartments (7 interossei, hypothenar, thenar and adductor pollicis)
Volar- hypothenar and thenar
Dorsal over 2 and 4th metacarpals
+- carpal tunnel
What is the contents of the carpal tunnel?
FDS, FDP and FPL
Median nerve- medial cuntaneous n of hand has branched off prior
What is the gardners classification of NOF?
1- incomplete NOF
2- complete undisplaced
3- complete, partially displaced
4- fully displaced, complete
What are the ligaments surrounding the hip?
Iliofemoral- strongest- prevents hyperextension of hip joint
Pubofemoral and ischiofemoral
What is the origin and insertion of iliopsoas?
T12-L4
Lesser trochanter
What is the surface A of the sciatic N?
Runs through the greater sciatic notch generally under piriformis
Trace line curved line between 2 points
1/2 way between Ischial tuberosity and PSIS
1/2 way between Ischial tubersoity and >trochanter
What runs through the greater and lesser sciatic notch?
Greater
Suprapiriform- super gleuteal Artery and N and vein
Infrapiriform- sciatic N, inferior glutean VAN, pudendal N, N to piriformis
Lesser
Obturator internus
Pudendal N
Internal pudendal V and A
What muscles attach to the anterior proximal humerus?
Lady between two majors
MEdial to lateral
Teres Major
Lat Dorsi
Pec Major
What muscles insert onto the coracoid?
Pec minor
Coracobrachilais
Short head of biceps
Where to perform LP?
L4/5
Between Iliac crests
What are the spinal columns?
Spinothalamic- pain and temp- decussate at spinal level
Corticospinal- movement and fine control- decussate at in hindbrain
Dorsal columns- sensation and proprioception- high up decussation
Blood supply of spinal column?
Anterior spinal A- from vertebral As and segmentally from aorta, artery of adamzweich
Post spinal A- post inf cerebellar As
What is central cord syndrome?
Hyper extension injuries in elderly
Upper limbs affected more than lower limbs
Good prognosis
Draw Brachial plexus
https://www.physio-pedia.com/index.php?title=Brachial_plexus_injury&veaction=edit§ion=42
What is the origin of lat dorsi?
T7 to L5 spinous process
Adducts, internal rotates and extends arm
Where does the spinal cord terminate?
L1/2 in adults
L3 in kids
Cauda equina carries on to S2 where the dural sac ends
What type of joints are the intervertebral joints?
Type 2 cartillagenous
Like pubic symphsis
Where are most disc prolapses?
L4/5, L5/S1- 95%
What is anterior spinal cord syndrome?
Anterior spinal artery normally affected
Lower limbs worse than upper
Dorsal columns are spared
What structures are at risk during a subclavian line insertion?
Thoracic duct on left
Subclavian a and lung
Phrenic nerves (go over anteriro scalenes)
What is the role of thymus
PLays role from fetus to puberty and then regresseses
Recognises self t cells and eliminates them
What are the atypical ribs?
1,2
10, 11, 12
What is the contents of the inguinal canal?
Spermatic cord
/round ligament
Spermatic cord- 3s
3As- cremasteric, testicular, vas
3Ns- symphatetics, ilioinguinal- runs outside of cord, genital branch
3 others- pampiniform plexus, lymphatics, vas deferens
What is at the mid inguinal point and the mid point of the inguinal canal?
Mid point of the inguinal ligament= deep ring
Mid inguinal point is femoral A
What is the medial aspect of the femoral canal
And what does it contain?
Lacunar lig
LN of cloquet + sapce
Where is the adductor hiatus and what are its boarders?
2/3 of way from ASIS to adductor tubercle Sartorius is roof Adductor magnus is floor Vastus medialis is lateral Magnus/longus is medial
Difference between CN 3 palsy and horner’s?
Key difference is CN3 is parasymph and Horner’s symph interupriton
CN3- eye is down and out, enlarged pupil
Horner’s- miosis, anhidrosis, ptosis and enopthalmos
What enters through the foramen magnum?
Medulla oblongata ANt and post spinal As, vertebral A 3 dural layers Apical dens ligament Tentorium CNXI spinal root
Jugular foramen contents?
Jugular vein
CN9,10,11 (accessory)
ICA branches?
MCA, ACA, posterior communicating, anterior choroidal, opthalmic A
Tongue muscle nerve supply?
All CN12 bar palatoglossus which in CN10
What is the course of the facial nerve?
From pontine medulla junction
To facial canal via internal auditory meatus
Gives off greater petrosal, chorda tympani and n to staepedius
Exits through stylomastoid foramen
Curves to parotid
What exits through superior orbital foramen?
Nerves- CN3,4,6 and V1 (lacrimal and frontal, nasocillary)
V- superior opthalmic vein
A- branches of lacrimal and middle meningeal
What are the layers of the peridcardium?
Fibrous
Serous- parietal and visceral
Which parts of the aortic valve supply the right and left coronary arteries?
Anterior supplies RCA
Left post supplies LCA
What is the venous drainage of the heart?
Coronary sinus reasonable for 2/3 of drainage, enters posterior part of RA
Drains, great, middle, small, oblique and post cardiac veins
1/3 drain directly in to right atrium /other chambers
Cardiac veins/venae cordis (thesbian veins)
Where is the sinoatrial node and what supplies it?
In the right atria christa terminalis
Supplied by RCA in 60% of people and LCA in 40%
What is the course of the phrenic nerves?
C3,4,5
Anterior to scalene anterio, post to subclavain veins
Right runs with IVC
Left runs with aortic arch, crosses anterior over the pericardium
What is the course of the vagus nerves?
RIght post to oesophageuas and run with ICA
Left anterior to oesophageus, runs with ICA
Where does the trachea begin?
C6
What is a bronchopulmonary segment?
Functionally independent bit of lung
Separated by connective tissue
Receives its own AVB
10 in each lung
What is the blood supply to the lung?
Pulmonary As
Bronchial As
What are the branches of the Exeternal carotid A
SLFOPSM superior thyroid artery ascending pharyngeal artery lingual artery facial artery occipital artery posterior auricular artery superficial temporal maxillary
What muscles make up the prevertebral muscles?
Scalens, levator scapulae
splenius capitus
What nerve is at risk in the middle of the post triangle of the neck?
Spinal accessory nerve
Runes from 1/3 down SCM to 2/3 down Trapezius
What bones make up the orbit?
Frontal, maxillary, zygomatic
Lacrimal and ethmoidal
Sphenoid and palatine
What goes through the infra orbial fissure?
CNV2- infraorbital and zygomatic
Inferior opthalmic vein
Pterygopalatine ganglion
What are the clinical signs of an orbital blow out fracture?
Traumatic deformity of floor/medial wall
Enopthalmos
Diplopida
Infraorbital numbness
Orbital emphysema
Location of the parotid gland surface A?
Anterior to tragus to posterior boarder of masseter
to angle of mandible to mastoid process
What runs throug parotid?
Facial N
Retromandibular Vein
ECA- gives off superficial temporal and maxillary
What is Frey’s syndrome?
Iatrogenic damage to auriculotemporal n (provides symph to parotid) unopposed parasymph => gustatory sweating- excessive
What may damage to the zygomatic nerve cause?
CNV2- numbness of zygoma
Paralysis of obicularis oris
Only muscle that can open eye
Dry eye
When do cranial sutures close
Name of condition with fused sutures at birth?
18-24 months
Craniosynothsis
What runs in the foramen lacerum?
ICA
Greater and lesser petrosal nerve- run near by through hiatuses
What is the cavernous sinus and what does it contain?
Drains the opthalmic veins, superfiscial cerebral vein and sphenopalatine sinus as well as danger area of the face
Contains OTOM and CA
CN3
CN4
CN V1 and V2
Carotid artery
Abducens nerve
What does the posterior mediastinum contain and its boundaries?
Ant- pericardium to T5-T12 posteriorly
T4 superiorily to diaphram
Contains DATES Descending aorta Azygous vein Thoracic duct Symphathetics Eosphageus
What is the azygous vein?
Formed by right lumbar and right subcostal veins
Joined by hemiazygous at T8 (left lumbar and left subcostal veins)
And by accessory hemiazygous at T7 (4-8 intercostals)
Drains posterior thorax, trunk and mediastinal viscera
What is the right lymphatic duct?
Drains right head, neck, arm and breast
Thoracic duct does rest
What is the supply of the diagastric muscle?
And other suprahyoid muscles?
Ant- CNV3
Post- CNVII
Stylohyoid (CNVII)
Geniohyoid (C1 via hypoglossal n)
Myohyoid (CNV3)
What are the strap muscles?
Omohyoid, sternothryroid, sternohyoid and thyrohyoid
All bar thyrohyoid (C1) are supplied by cerva ancalis (in wall of carotid sheath)
What nerves are risked damage when operating on submandibular gland?t
Marginal mandibular nerve
Lingual Nerve
Hyoglossus Nerve
The duct runs with hyoglossus
What are the surface landmarks of the lung fissures?
Oblique bilaterally run from 4th thoracic spinous process to 6 costochondral cartillage
Horizontal on right runs from 4th constochnodral cartillage to mid axillarly line of the oblique fissure
What is the sensation supply to the larynx?
Superior to vocal cords- internal laryngeal
Inferior is RLN
Draw the vertebral arteries and branches
https://thoracickey.com/carotid-and-vertebral-artery-intervention/
Where is the most likely place for a circle of willis aneurysm?
ANterior cerebral circulation
What symptoms does a basilar lip Aneurysm cause?
SAH acutely
Bitemporal hemianopia- sits on optic chiasm
What are the divisions of the internal iliac artery?
Anterior trunk- obturator, umbilical (sup vesical), inf vesical, Women- uterine and vaginal, Middle rectal, internal pudendal (inf rectal), lateral sacral, sup gleuteal
Post- Iliolumbar, lateral sacrals, inferior gleuteal
What are the divisions of the lumbar plexus?
I I Get Leftovers On Fridays
Iliohypogastric Ilioinguinal Genitofemoral Lateral cutaneous nerve of the thigh Obturator Femoral
Sacral plexus?
Some Irish Sailor Pesters Polly
Sup Gleuteal Inf Gleuteal Sciatic Post Femoral Cutaneous Pudendal
N to piriformis/obtuartors
What muscles make up the pelvic floor?
Levator ani (pubococcygeus, iliococcygeus, puborectalis) + coccygeus
What supplies IO and TA?
Iliohypogastric and ilioinguinal
What are the boarders of the perineum?
PS to coccyx
Ischial tuberosities
Iscial and pubic rami
Roof is the pelvic floor
What structures are contained in the anal triangle of the perineum?
Pudendal NAV
Anal aperture
Ischioanal fossae
What structures are contained in the urogenital triangle?
Deep perineal pouch- urethra, deep fascia, perineal membrane, vagina
Superfiscial perineal pouch- ischiocavernosa, bulbospongiosa, superfiscial transverse perineal muscle, Bartholin’s gland
What is the perineal body
Sits between anal and urogenital triangle
Where muscles attach
Levator ani Bulbospongiosa Ischiocavernosa Perineal muscles Ext anal sphincter
What are the layers of the scalp?
SCALP Skin Connective tissue deep Epicranial Aponeurosis Loose areolar connective tissue (containing the emissary veins) Perisoteum
Venous drainage of the brain?
Superior and straight (inferior sagittal and great cardiac vein) sinuses drain into the confluence of sinuses
Transverese comes off confluence and anastaomses with superior petrosal sinus to form sigmoid sinus
Greater and less petrosl sinus drain cavernous sinus
Lesser petrosal and sigmoid sinus form IJV
Types of joints and examples?
Fibrous- sutures (skull), gomphoses (teeth), syndesmoses (radio-ulna/tibiafibula)
Immovable
Cartillagenous- 1o- Hyaline cartillage- at diaphases
2o- fibroelastic cartillage- PS and intervertebral joints
Synovial joints- fluid filled joint cavity with fibrous cavity, freely moveable Hinge- elbow Saddle- CMCJ Plane- Subtalar Pivot- C1/C2 Condyloid- Wrist Ball and socket- hip/shoulder
Types of cartillage?
Hyaline- weakest, precursor to bone, contains type 2 collagen Found in growth plates Articular cartillage (subset of hyaline) found in synovial joints
Elastic cartillage- resislient and flexible
Ear, epiglottis and larynx
Fibro-cartillage- strongest, alternating layers of hyaline matrix and dense collagen
Joint capsules, tendon insertions, intervertebral discs
Types of collagen?
Type 1- strongest- majority of body
Type 2- spongy/shock absorbing- hyaline cartillage
Type 3- strong but no tensile, found in granulation tissue- early wound bed collagen
Type 4- Solidifies cellular structures- basement membrane
Kidneys/eyes/ears/skin
What is the blood supply of the diaphram?
Costal portion by subcostal artery and lower 5 intercostal arteries
Inferior phrenic- off abdominal aorta T12
Superior phrenic- off thoracic aorta T11
What are the facial nerve branches after the stylomastoid foramen but before it enters the parotid?
Posterior auricular
N to stylohyoid
N to posterior digastric
What is the clivus?
bone posterior to sella turcica
What makes up the cervical plexus? Where do they emerge?
C1-4
Sensory- all enter the skin at Erb’s point, middle of posterior boarder of SCM
Greater auricular (runs over SCM, parallel to Accessory nerve)
Lesser occipital
Transverse cervical
Supraclavicular
Motor
Phrenic nerve
N to geniohyoid
N to thyrohyoid
Ansa cervicalis- rest of infrahyoid muscles
What runs anterior to anterior scalene?
A- carotid/transverse cervical/suprascapular aa
V- IJV/subclavia
N- vagus/phrenic
LNs
What is the arterial supply to the brain?
ACA/MCA/PCA
Post inf cerebellar a
Ant inf cerebellar
Sup cerebellar a
Where are the motor and somatosensory cortexs found in the brain?
Pre central gyrus- motor
Post central gyrus- sensation
What passes through the foramen lacerum?
ICA and greater/lesser petrosal nerves
What happens at the level C6?
Pharynx to oesophageus
Larynx to trachea
Cricoid cartillage
What are contained in the anterior triangles of the neck?
Sub mental- LNs
Submandibular- gland, LN, facial a, ligual N, hypoglossal N
Carotid triangle- carotid sheath
Muscular- strap muscles, thyroid, trachea, oesophageus
What is contained in the posterior triangle?
LNs External jugular vein, transverse cervical, suprascapular Superfiscial cervical a, suprascapular a Cervical plexus + CNXI Omohyoid
What is the surface anatomy of the CNXI?
Sup 1/3 of scm
middle 1/3 of post triangle
inf 1/3 of trapezius
What is the venous drainage of the danger area of the face?
Deep facial veins to pterygoid plexus to cavernous sinus
What is the intracranial course of CNVI?
Longest intracranial course
Pons to cavernous sinus
to SOF
to LR
What is a d-dimer test measuring?
The breakdown of fibrin
What are the signs of hypovolaemic shock?
Sinus Tachy Hypotension Oliguria Cold Klammy peripheries Slow cap refi Dry mucous membranes and low JVP
Describe the SA of the lung fissures?
Oblique fissures go from T2/3 to 6th rib mid clavicular
Right horizontal goes travels along 4th rib to mid axillarly line meeting oblique fissure
Differences between lung hila?
Both lungs- Pulmonary veins straddle bronchus- infront and below
In right lung- artery is anterior to bronchus
In left lung artery is superior to bronchus
