Anatomy Flashcards
Who is the father of anatomy?
Herophilus
What is fascia?
Fascia is a thin casing of connective tissue that surrounds and holds every organ, blood vessel, bone, nerve fiber, and muscle in place. The tissue provides more than an internal structure; the fascia has nerves that make it almost as sensitive as skin.
Traditionally what are the two divisions of fascia?
- Superficial fascia
- Deep fascia
What are two characteristics of superficial fascia?
-‘Loose’ connective tissue
-Collagen and elastic fibres
What are two characteristics of deep fascia?
- Dense organized connective tissue
- Devoid of adipose tissue
Where is fascia found?
Throughout the body
Three elements (Location, thickness, distribution) between Superficial and deep fascia?
Superficial fascia
-Subcutaneous tissue
-Varies in thickness
-Varies in distribution
Deep fascia
-Deep to the superficial fascia
-Almost everywhere
-Investing fascia / Intermuscular septa
What are the one function of fascia and the seven sections it is active in?
-Packing and insulation
Active in:
-Thermoregulation
-Protective padding
-Support for tissues/organs
-Reduces friction
-Transmits mechanical force
-Proprioceptive feedback
-Myofascial system
Draw fascia and muscle compartments in the leg.
Check-in notion, clinical scenarios of fascia.
What is Compartment Syndrome, what does it affect, and how is it treated?
-Increased pressure caused by swelling of tissue or increase in fluid
-Affects functions of the muscles or nerves in the compartment
-Fasciotomy to relieve pressure in emergency
Where does infection tend to spread within?
Within fascial compartments, or in between fascial compartments
What fascia helps prevent the spread of infection from one compartment to another?
Deep fascia.
What connects the base of the skull to the superior mediastinum?
Cervical fascial planes.
What do nerves allow us to do?
Allow us to sense our environment - both internal and external plus respond appropriately to that environment.
What is the CNS composed of?
-Brain
-Spinal cord
What is the PNS composed of?
-All other nerve tissue not within the CNS
-Spinal Nerves
-Cranial nerves
-Autonomic Nerves
What are the four anatomic nerves?
-organs, smooth muscle, glands
-visceral afferents
-sympathetic nerves
-parasympathetic nerves
What are the two collections of nerve cell bodies?
In the CNS: Nucleus
In the PNS: Ganglion
What are the bundles of axons wrapped with?
Connective tissue
What are the 6 modalities for a single nerve fiber conduction?
Somatic sensory function
Somatic motor function
Special sensory function
Visceral afferent function
Sympathetic function
Parasympathetic function
What is the difference between efferent and afferent?
Efferent: Action potential towards the body wall, body cavity, or organ
Afferent: Actions potential towards the brain.
What is the cortex?
The outermost layer of the cerebral hemispheres
What are the groove and ridges in the brain called?
Sulcus and Gyrus
Tell me the 4 lobes of each cerebral hemisphere
Frontal, temporal, parietal and occipital
How many cranial nerves are there?
12 pairs
What are the 12 Cranial Nerves?
CN I : Olfactory nerve
CN II : Optic nerve
CN III : Oculomotor nerve
CN IV : Trochlear nerve
CN V : Trigeminal nerve
CN VI : Abducent nerve
CN VII : Facial nerve
CN VIII : Vestibulocochlear nerve
CN IX : Glossopharyngeal nerve
CN X : Vagus Nerve
CN XI : Spinal Accessory Nerve
CN XII : Hypoglossal Nerve
What is each of the cranial nerves, sensory or motor?
CN I : Sensory
CN II : Sensory
CN III : Motor
CN IV : Motor
CN V : Both
CN VI : Motor
CN VII : Both
CN VIII : Sensory
CN IX : Both
CN X : Both
CN XI : Motor
CN XII : Motor
Where does each nerve originate from? Draw it
Check.
What nerves go through the anterior cranial fossa?
CN I
What nerves go through the middle cranial fossa?
CN II, CN III, CN IV, CN Va, Vb & Vc, CN VI
What nerves go through the posterior cranial fossa?
CN VII, CN VIII, CN IX, CN XI and CN XII
What foramina does the CN I go through?
Cribriform plate of the ethmoid bone
What foramina does the CN II go through?
Optic canal
What foramina do the CN III, V1 & VI go through?
Superior orbital fissure
What foramina does the CN V2 go through?
Foramen rotundum
What foramina does the CN V3 go through?
Foramen ovale
What foramina do CN VII & VIII go through?
Internal acoustic meatus
What foramina does CN IX, X & XI?
Jugular foramen
What foramina does the CN XII go through?
Hypoglossal canal.
What does the Spinal Cord go through regarding the skull, and what is it protected by?
Foramen magnum and vertebral canal
What are the four segments and 2 enlargements in the spinal cord?
-Cervical, thoracic, lumbar, and sacral/coccygeal.
-Cervical and lumbosacral.
Why does the enlargement happen in the spinal cord?
Due to the limbs, more nerves are required.
What are the numbers of each spinal cord segment, and how do we clinically refer to each one?
Eight cervical - C1-C8
Twelve thoracic - T1-T12
Five lumbar - L1-L5
Five sacral - S1-S5
One coccygeal - Co
What level does the spinal cord end at, and how do we refer to it?
L1/L2 IV disk level– Named conus medullaris.
What is Cauda Equina, and what is it for?
Horsetail, lumbar and sacral spinal nerve roots must descend in the vertebral canal to their respective intervertebral foramina.
Regarding vertebrae, how many are there in each segment, and which ones fuse together?
-33 vertebrae in total
7 cervical
12 thoracic
5 lumbar
5 sacral
-fused to form 1 sacrum
4 coccygeal
-fused to form 1 coccyx
What is the rule for naming the spinal nerves?
- Spinal nerves are named according to the
vertebrae above it- except in the cervical region, where
they are named according to the
vertebrae below it
- except in the cervical region, where
What do the spinal nerves supply?
The soma (Body wall)
Where are the spinal nerves located?
ONLY WITHIN the intervertebral foramina.
What two structures do the intervertebral foramina connect with?
- Structures of the soma via rami
- The spinal cord via roots and rootlets
What do the posterior and anterior rami supply?
-Posterior rami
supply a small posterior strip
-Anterior rami
supply the remainder of the posterior part, the lateral and the anterior parts of the strips, and supply all of the limbs.
What are dermatomes?
Area (strip) of skin supplied by both the anterior and posterior rami of a spinal nerve.
What are the dermatomes for the nipple and umbilicus?
T4 dermatome – nipple
T10 dermatome – umbilicus
What are the four nerve plexuses?
-Cervical Plexus
-Brachial Plexus
-Lumbar Plexus
-Sacral Plexus
Where does the cervical plexus originate, and what does it innerve?
C1-C4 anterior rami
Posterior scalp, neck wall, and diaphragm
Where does the brachial plexus originate, and what does it innerve?
C5-T1 anterior rami
Upper limb
Where does the lumbar plexus originate, and what does it innerve?
L1-L4 anterior rami
Lower limb
Where does the sacral plexus originate, and what does it innerve?
L5-S4 anterior rami
Lower limb, gluteal region and perineum
What is the somatic nervous system?
The somatic nervous system consists of nerves that go to the skin and muscles and is involved in conscious activities.
What are the four sensations sensed by mechanoreceptors in the CNS?
Coarse touch
Fine touch
Vibration
Proprioception
What is sensed by thermoreceptors in between the CNS and PNS?
Temperature
What is sensed by the nociceptors in the PNS?
Pain
What are Spinal reflexes?
Involuntary rapid response which misses out the pathway to the brain.
What is the autonomic nervous system?
It is a component of the peripheral nervous system that regulates involuntary physiologic processes.
What are the two subdivisions of the autonomic nervous system?
Sympathetic and parasympathetic nervous systems.
What does the sympathetic division do to pupils, the heart, lungs, GI tract, liver, adrenal glands, arterioles, and skin?
Pupils - dilate
Heart - rate increases
Lungs - bronchioles dilate
GI tract - motility is reduced
Liver - glucose released into the blood
Adrenal glands - adrenaline/noradrenaline released
Arterioles - dilate (e.g., in skeletal muscle) or constrict (e.g., in the skin). Skin feels cold & looks pale
Skin - hair stands on end & sweat produced
What does the parasympathetic division do to the pupils, the heart, lungs, GI tract, liver, and bladder?
Pupils - constrict
Heart - rate decreases
Lungs - bronchioles constrict
GI tract - motility is increased
Liver - glucose synthesis
Bladder – sphincter relaxes
What is the objective of parasympathetic division?
Return the body to homeostasis and to compliment/oppose the sympathetic system.
At which level do the spinal nerves exit the spinal cord?
T1-L2
By what nerves does the sympathetic outflow travel to reach organs?
Splanchnic nerves.
What structure do only T1 to L2 have, and what are their names?
Lateral horns for cell bodies of the next sympathetic neurons in the chain.
-Paravertebral ganglion of the right sympathetic trunk (the trunk runs parallel to the vertebral column).
In which cranial nerves and via what spinal nerve do ALL parasympathetic axons leave the CNS?
via cranial nerves III, VII, IX & X and sacral spinal nerves
What does the parasympathetic system innervates specifically?
Internal organs
What do the parasympathetic ganglia in the head innervate?
Lacrimal gland and salivary glands.
What does the vagus nerve supply?
Organs of the neck, chest and abdomen as far as the mid-gut
What spinal nerve carries parasympathetic axons to the hindgut, pelvis, and perineum?
Sacral spinal nerves.
What does the sympathetic outflow pass into?
All spinal nerves
-Anterior & posterior rami
-To supply body wall structures (skin, sweat glands, arterioles)
How long do erythrocytes survive?
120 days
The venous blood from the absorptive parts of the GI tract drains into what first?
The liver
What does the liver do in the GI tract?
The liver stores some nutrients, makes other products from them, or returns them into the venous system
It can also metabolise/detoxify potentially harmful substances absorbed from the GI tract
What is tissue fluid, and what does it eventually become?
The excess fluid is left in the tissues and the extracellular spaces.
Once this fluid is taken up by lymphatic vessels, it is called lymph
What is the thoracic duct, and what does it do?
Major lymphatic vessel in the body
Returns lymph to large veins in the root of the neck
What is the thoracic duct, and what does it do?
Major lymphatic vessels in the body
Returns lymph to large veins in the root of the neck
What forms carbonic acid?
Carbon dioxide and water.
What composes the integumentary system, and what is it?
Our skin (integument) is the body’s first line of defense against the external environment.
What four things does the integumentary system provide our body with?
a physical defense against trauma
a waterproof barrier
helps to regulate body temperature
to a degree, protects us against UV radiation
Why could lymph nodes enlarge?
Lymph nodes fighting infection or being infiltrated by spreading cancer usually enlarge and can then be palpated
What is the endocrine system?
The endocrine system consists mainly of several organs called endocrine glands found in various anatomical locations in the body
Where do the glands secrete the hormones?
Capillary blood
What do skeletal muscles do?
-Provides locomotion and it allows us to breathe.
What do skeletal muscles do?
-Provides locomotion, and it allows us to breathe.
What do skeletal muscles do?
-Provides locomotion, and it allows us to breathe.
What is endochondral ossification?
The process in which an initially small, hyaline cartilage version grows and turns into bone (ossifies)
What are the four parts of a bone?
- An epiphysis
- An epiphyseal growth plate.
- Metaphysis.
-Diaphysis, which is found between the two ends.
When does bone growth cease?
When the growth plate of hyaline cartilage finally ossifies.
What are the two elements composing the structure of the bone?
-Outer cortex
dense, strong, heavy
COMPACT (cortical) bone
-Inner medulla
more porous, weaker, lighter
SPONGY (trabecular/cancellous) bone
What could the medulla contain?
Bone marrow
What is the periosteum?
The membrane of blood vessels and nerves that wraps around most of your bones.
What does the patient feel if tearing of the periosteum happens?
It is well-innervated, therefore it results in extreme pain. e.g fractures.
What are the nutrient vessels, and where do they go into?
-artery and vein
-carry blood to/from the medullary cavity
What are three bony features that develop during bone growth?
-Functional (genetic) - best shape for the job
-An adjacent structure applies a force to the developing bone
-An adjacent structure is developing at the same time as the bone
What is the soft callus?
When the clotted blood formed by inflammation is replaced with fibrous tissue and cartilage after a fracture.
What are the three bones that compose the axial skeleton?
- Skull
- Neck
- Bones of the trunk: Chest, abdomen and back.
What are the four bones that compose the appendicular skeleton?
-bones of the pectoral girdle
-bones of the upper limbs
-bones of the pelvic girdle (attaches lower limbs to axial skeleton)
- bones of the lower limbs
What are the bones of the fascial skeleton called?
Viscerocranium
What are the bones of the cranial vault called?
Neurocranium
What are the four bones of the fascial skeleton?
Nasal Bone
Zygomatic bone
Maxilla
Mandible
What are the four curvatures of the vertebral column?
Primary: C1-C7
Secondary: T1 - T12
Primary: L1 - L5
Secondary: S1 - S4
Draw features and functions of a typical vertebra
Check-in notion
How is the intervertebral foramen formed, and what emerges through it?
Form between adjacent vertebrae
Spinal nerves emerge through here
How is the facet joint formed, and what is it affected by?
Between articular processes of 2 adjacent vertebrae
Affected by arthritis
What do all cervical vertebrae have?
All have a foramen in each transverse process, called
transverse foramen
What goes through the transverse foramen?
Passage of vertebral arteries
What is the C1 known as and what is its structure like?
C1 - Atlas
does not have a body or spinous process
it has a posterior arch and an anterior arch instead
What is the C2 known as, and what is its structure like?
C2 - Axis
has an odontoid process
projects superiorly from body
What is the C7 knowns as, and what is so special about it?
Vertebrae prominens, The 7th cervical vertebra (C7) is the largest and most inferior vertebra in the neck region.
Tell me the different groups of ribs and why they are different.
-True ribs (1-7): Attach via cartilage in the sternum
-False ribs (8-10): Attach via common cartilage to the sternum
-Floating ribs (11-12): No attachment to sternum
Tell me the different groups of ribs and why they are different.
-True ribs (1-7): Attach via cartilage in the sternum
-False ribs (8-10): Attach via common cartilage to the sternum
-Floating ribs (11-12): No attachment to the sternum
What is the least likely rib to fracture and why?
The first rib, due to the presence of the clavicle anterior to it.
What could the sharp end of a fractured rib cause?
Potentially pierce and damage the soft tissues, such as: Lung, live and spleen
What composes the pectoral and pelvic girdle?
-Pectoral girdle: 2 scapulae and 2 clavicles
-Pelvic girdle: 2 hip bone and the sacrum
What are the bones of the hand, and what do they compose?
Hand:
Carpal bones (wrist), metacarpals (palm) & phalanges (fingers)
What are the bones of the foot, and what do they compose?
Foot:
Tarsal bones (hindfoot/midfoot), metatarsals (forefoot) & phalanges (forefoot-toes)
What is bone, and what are its four functions?
Hard, connective tissue
Functions include:
- Support & protection of the body’s organs
- Calcium metabolism
-Red blood cell formation
- Attachment for skeletal muscles
What is cartilage, and where can it be found?
- Less rigid than bone
- Located where mobility is required at articulations (joints)
What are the four sensations detected by the sensory receptors of the joint nerves?
Pain
Touch
Temperature
Proprioception
What are articular branches?
The arteries supplying joints arise from large named arteries located near the joint
Define anastomosis and what does it provide?
An anastomosis is where arteries connect with each other without an intervening capillary network
Provides alternative routes for blood to flow to supply the cells distal to arterial occlusion (blockage)
What is the Circle of Willis and what does it prevent?
An arterial anastomosis of the brain.
In the case of the brain, this can help to prevent a cerebrovascular accident (CVA/stroke)
What are alternative routes in an anastomosis, and what is a disadvantage of them?
Known as collateral arteries or collateral circulation
One disadvantage is that collaterals bleed from both sides of a cut, so the hemorrhage can be worse
What are the different types of joints?
Synovial, Cartilaginous and Fibrous
What is the compromise between mobility and stability?
Increased mobility = decreased stability
Decreased mobility = increased stability
What are the two types of fibrous joints?
Syndesmoses: unites bones with fibrous sheet fibrous membrane
Sutures: Between bones of the skull
What are the syndesmoses between the tibia and fibula?
Interosseous membrane
What are fontanelles?
Soft spots on an infant’s head where the bony plates that make up the skull have not yet come together
What are the three fontanelles?
Anterior fontanelles
Posterior fontanelles
Lateral fontanelles
What are the main functions of the fontanelles?
Make the baby’s head smaller for passage through the birth canal also known as molding
What are the two types of cartilaginous joints?
-Primary cartilaginous: Bones joined by hyaline cartilage
-Secondary cartilaginous: Fibrocartilage
Both cartilaginous joints can slip; what are examples of primary and secondary occurrences?
primary – slipped femoral epiphysis
secondary – slipped disc
What could a slipped disc compress?
The spinal cord!!
What is the intervertebral disc composed of? (2)
-Outer fibrous annulus fibrosus
-fibrous ring (fibrocartilage)
-Inner soft nucleus pulposus
- ‘soft center’ (90% water in
newborns)
What are the seven typical features of synovial joints?
- 2 or more bones articulating with each other
- articular surfaces are covered in hyaline ‘articular’ cartilage
- a capsule wraps around the joint
- contains a joint cavity
contains synovial fluid (cushions, nourishes, and lubricates) - supported by ligaments
- associated with skeletal muscles and their tendons
- associated with bursae
prevent friction around joint
extensions of a joint cavity or closed sacs separate from the joint cavity - often have special features
unique features found in different synovial joints e.g., articular disc in TMJ joint
What are the five synovial subtypes, and give a simple definition?
- Pivot: > 45 of “shaking the head” rotation
- Ball & Socket: suitable ranges of multi-axial movement (e.g., circumduction)
- Biaxial: reasonable range of movement in one plane and less in another.
- Hinge: reasonable range of movement in one plane.
- Plane: minimal movement in one plane.
What is the decreasing list order of mobility in the adult? Regarding mobility and stability in joints
Synovial (least stable)>cartilaginous>fibrous
What determines the possible movement?
Shape of articular surface
What permits circumduction of the shoulder?
Shallow socket of the glenoid fossa of the scapula
Define subluxation and dislocation.
-Subluxation: Reduced area of contact between articular surfaces
-Dislocation: Complete loss of contact between articular surfaces
What are common dislocations?
- Craniovertebral joints
- Temporomandibular joints
- Shoulder joints
- Elbow joints
- Hip joints
6 Interpharangeal joints - Pubic symphysis.
- Ankle joints
What kind of joint is the temporomandibular joint, and what is the overall structure like?
Each temporomandibular joint (right and left) is the SYNOVIAL articulation between the mandibular fossa & the articular tubercle of the temporal bone superiorly and the head of the condylar process of the mandible inferiorly.
What are the layers between skin to skeletal muscle?
epidermis (epithelium)
dermis (collagen/ elastic fibers)
superficial fascia (adipose tissue)
deep fascia (fibrous tissue)
skeletal muscle
What are the five skeletal muscle types?
- Circular
- Pennate
- Fusiform
- Quadrate
- Flat with aponeurosis
What is aponeurosis, and what does it attach?
A thin sheath of connective tissue helps connect your muscles to your bones. - A flattened tendon, that attaches muscle to soft tissue.
What two things are ensured by long muscle fibers?
The greater potential range of shortening
The greater potential range of movement produced at joint
What is the function of a skeletal muscle?
Move the origin and insertion closer together during contraction
What do tendons do, where are they found, and are they contractile?
Tendons attach the muscle to bone
Found at either end of the muscle
Non-contractile
What are the three directions of movement regarding the deltoid?
- posterior fibers of deltoid: extension of the shoulder
- middle fibers of deltoid: the abduction of the
- anterior fibers of deltoid: flexion of the shoulder
What are the two kinds of reflexes involving the skeletal muscles?
Stretch reflex
Flexion withdrawal reflex
What is the process of the deep tendon reflex?
A tendon hammer is used to apply a brief, sudden stretch to the muscle via its tendon
The normal reflex response to being stretched is to contract
Reflex contraction results in a brief twitch of the muscle belly or a movement in the normal direction
- reflexes are protective against overstretching
What is the whole route taken by the action potentials called?
The reflex arch
What are the six things which the stretch reflex indicates are functioning normally?
the muscle
its sensory nerve fibers
its motor nerve fibers
the spinal cord connections between the two
the neuromuscular junction
“descending controls” from the brain
What is paralysis?
Muscles without a functioning motor nerve supply, therefore they cannot contract and will have a reduced muscle tone.
What is spasticity?
The muscle has an intact and functioning motor nerve, but the descending controls from the brain are not working.
The muscles would have increased tone.
Define atrophy
Muscle fibres (myocytes) become smaller, reducing the muscle’s bulk and it develops as a result of inactivity
Define hypertrophy
Skeletal muscles enlarges by each individual myocyte enlarging.
Define hyperplasia
Increase in number of myocytes.
What two systems transport fluids throughout the body?
Cardiovascular and lymphatic system
What are the three components of the cardiovascular system?
Arterial system
Heart
Venous system
What are the two circulations of cardiovascular system?
Pulmonary and systemic circulation.
What is the range of a healthy heartbeat?
60 to 100 bpm
What are the three layers of the heart, and what composes each?
- Epicardium: Visceral serous pericardium
- Myocardium: Cardiac muscle layer
- Endocardium: Continuous with endothelium of blood vessels connecting with the heart.
Describe the four steps of the conduction system of the heart
- Electrical impulse starts spontaneously at the SA node
Causing both atria to contract - Travels to AV node at the atrioventricular septum
- Travels down right and left bundles in the interventricular septum
- Spreads out to the myocardium through conducting fibers
Causing both ventricles to contract
Define infarction
Irreversible cell death due to hypoxia (lack of oxygen) caused by loss of arterial blood supply
What are the four parts of the Aorta, and how many branches does each have?
- Ascending Aorta (2 Branches: Left coronary artery and Right coronary artery)
- Arch of the Aorta (3 branches)
- Thoracic Aorta (Numerous)
- Abdominal Aorta (3 unpaired midline branches & several paired, bilateral branches)
What are the branches of the arch of the aorta?
- Branchiocephalic trunk: Right subclavian artery and right carotid artery.
- Left common carotid artery
- Left subclavian artery.
What supplies the pelvis/perineum & the lower limbs?
Common iliac arteries (Bifurcation of abdominal aorta)
External iliac artery: Lower limbs
Internal iliac artery: Pelvis and perineum
What are the six pulses?
Carotid pulse
Femoral artery pulse
Brachial artery pulse
Radial artery pulse
Popliteal artery pulse
Dorsalis pedis artery pulse
What are the three ways in which venous blood is pumped back toward the heart?
Venous valves
Skeletal muscle pump
Venae comitantes (Small veins run in pairs or more with an artery in a sheath. Arterial pulsation pushes venous blood along)
What are the 2 main venous systems?
The hepatic portal venous system
Systemic venous system
In which two structures does the lymph drain?
- Right lymphatic duct drains into the right venous angle.
- Thoracic duct drains lymph into the left venous angle.
