anatomy Flashcards
what is a collection of nerve cell bodies in the CNS called?
nucleus
what is a collection of nerve cell bodies in the PNS called?
ganglion
where are spinal nerves found?
intervertebral foramina ONLY
myotome
the skeletal muscle supplied with motor innervation from a single spinal nerve
- can be deep to the same or different dermatome
what dermatome is the nipple and umbilicus at?
nipple = T4
umbilicus = T10
which dermatomes cover the upper limb?
C5-T1
which rami are involved in nerve plexuses?
anterior rami from a number of adjacent spinal nerves
-> anterior ONLY
which spinal nerves are involved in the lumbar plexus?
L1-L4
which spinal nerves are involved in the sacral plexus?
L5-S4
which levels have lateral spial horns and why?
T1-L2 - sympathetic outflow
via what do presynaptic parasympathetic axons leave the CNS?
cranial nerves - III, VII, IX + X
+ sacrall spinal nerves (hindgut, pelvis, perineum)
examples - ciliary ganglion, lacrimal gland, vagus nerve (neck-midgut)
what causes symptoms of horners syndrome
compression of cervical parts of sympathetic trunk - impaired sympathetic innervation to head + neck
layers of the sccalp
skin
connective tissue - contains rich anastomotic network
aponeurosis
loose connective tissue
pericranium
which artery lies deep to the pterion in the skull?
middle meningeal artery
pterion = thinnest part of skull
what are the 4 layers of the meninges?
dura mater - tough/fibrous
arachnoid mater - can outpouch into dura venous sinus
subarachnoid space - contains CSF
pia mater - adherent to brain + vesels entering/leaving brain
what is the sensory nerve supply of the dura mater?
CN V
- dura mater enclose the dura venous sinuses
- no space between skull + dura
roof of pituitary
diaphragm sellae
the circle of Willis can be found in what space?
subarachnoid space
–> surrounded by CSF, if bleed will see in CSF
what level do u do a lumbar puncture
L3/L4
extradural haemorrhage location + causes
between bone + dura
ruptured middle meningeal artery -> trauma to pterion
subdural haemorrhage location + causes
separates dura from arachnoid
torn cerebral arteries
-> falls in elderly
subarachnoid haemorrhage location + causes
into CSF of subarachnoid space
ruptured Circle of Willis (“berry”) anneurysm
-> congenital aneurysm
what does compression of the oculomotor nerve by an uncal herniation lead to?
an ipsilateral fixed dilated pupil
(a blown pupil)
intrinsic muscles of the back
maintain back posture, move spine
2 groups -
- erector spinae - superficial
- transversospinalis - deep
attachments of erector spinae
3 muscle groups
- inferiorly -common tendon attaches to sacrum + iliac crest
- superiorly - individual fibres attach to either a rib, tranverse or spinous process
transversospinalis
found within grooves between tranverse + spinous processes
individual muscle fibres attach between:
- vertebra + skull
- vertebra + rib
- 1 vertebra + another
- sacrum + a vertebra
which muscles are responsible for flexion + extension of the spine respectively?
flexion = psoas major + rectus abdominis
extension = erector spinae (if contracts unilaterally - lateral flexion)
where in the spine are there no vertebral discs?
C1-C2 + fused sacrum/coccyx
layers of intervertebral discs
outer fibrous ring = annulus fibrosus
inner SOFT PULP = nucleus pulposus
which vertebra has an odontoid process?
C2 - axis
what level does spinal cord end
L1/L2
-> connus medullaris
when giving epidural anaesthetic at L3/L4, what layers will the needle pass through? vs spinal anaesthetic
supraspinous ligament
interspinous ligament
ligamentum flavum
epidural space (fat + veins)
spinal anaesthetic, as above plus -
- dura mater, arachnoid mater, reaches subarachnoid space containing CSF
anatomy of caudal anaesthesia
local anaesthetic is injected into the sacral hiatus to anaesthetise the sacral spinal nerve roots of the cauda equina
which spinal nerve dermatome innervates the badge patch area?
C5
spinal root levels of femoral nerve
L2, L3, L4
where is the “nerve point” on the neck and why is it important?
just above midpoint of posterior border of SCM
-> sensory nerves of cervical plexus - special care required during biopsy
what is the cutaneous supply to the anatomical snuff box?
cutaneous branches of radial nerve
which spinal levels are important to know for referred pain from the myocardium?
T1+T2
abduction and adduction of the shoulder joint tests which myotomes?
abduction = deltoid, C5
adduction = C7, pec major + lat dorsi
flexion + extension of the elbow joint tests which myotomes?
flexion = C5, C6, biceps brachii
extension = C7, C8, triceps brachii
flexion + extension of the wrist joint tests which myotomes?
flexion = C6, C7, carpal flexors
extension = C7, C8, carpal extensors
flexion + extension of the finger joints tests which myotomes?
flexion = C8, digital flexors
extension = C7, digital extensors
abduction + adduction of the fingers test with myotome?
T1
flexion + extension of the hip joint tests which myotomes?
flexion = L2, L3, psoas major
extension = L5, S1, glute max + hamstrings
flexion + extension of the knee joint tests which myotomes?
flexion = L5, S1, hamstrings
extension = L3, L4, quadriceps
dorsiflexion + plantarlfexion of the ankle joint tests which myotomes?
dorsiflexion = L4, L5, tibialis anterior
plantar flexion = S1, S2, gastrocnemius/soleus
inversion + eversion of the ankle joint tests which myotomes?
inversion = L4, tibialis ant + posterior
eversion = L5, S1, fibularis longus + brevis
does ascending or descending tracts control the reflex muscle contractions?
descending
UMN vs LMN lesion affect on tone
UMN lesion = spasticity
LMN = flaccidity
bicep reflex tests which myotome?
C5 (6)
tricep reflex tests which myotome?
C7
knee reflex tests which myotome?
L4
ankle reflex tests which myotome?
S1
supinator/brachioradialis reflex tests which myotome?
C6
