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MRCEM Primary > Anatomy > Flashcards

Anatomy Flashcards

1
Q

What are the borders of the femoral triangle?

A

Superior: Inguinal ligament

Lateral: Medial border of sartorius

Medial: Medial border of adductor lognus

Roof: Fascia lata

Floor: adductor longus, illiopsoas, pectineus

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2
Q

What are contents of the femoral triangle from lateral to medial?

A

Femoral Nerve
Femoral Artery (within sheath)
Femoral Vein (within sheath)
Lymphatics and deep inguinal nodes (within canal)

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3
Q

What are the cerebellar dysfunction signs?

A

Dysdiadokinesia / dysmetria
Ataxia
Nystagmus
Intention tremor
Slurred/ staccato/ scanning speech
HYPOtonia

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4
Q

What is the anatomical course of the abducens nerve?

A
  • Originates in the Pons
  • Travels through the cavernous sinus
  • Runs alongside the internal carotid artery
  • Exits via the superior orbital fissure
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5
Q

Abducens nerve palsy causes which symptom?

A

Horizontal diplopia

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6
Q

What is the anatomical course of the glossopharyngeal nerve

A
  • Originates in the medulla
  • Exits via the jugular foramen
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7
Q

What are the sensory functions of the glossopharyngeal nerve?

A
  • Posterior 1/3 tongue
  • Tonsils
  • Oropharynx
  • Soft palate
  • Middle ear
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8
Q

Is the glossopharyngeal nerve involved in any reflexes? If yes name it

A

Afferent pathway of gag reflex

Afferent pathway of carotid sinus reflex

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9
Q

What are the zones of the prostate and which is most commonly affected by BPH and malignancy?

A

Transitional: surrounds the urethra and affected by BPH leading to urinary symptoms

Central

Peripheral: prone to carcinomatous transformation, it is the area felt on PR examination

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10
Q

What is the lymphatic drainage of the prostate?

A

Internal iliac nodes
+ external iliac nodes
+ presacral nodes

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11
Q

Describe the parts (4) of the testes and their role:

A

Seminiferous tubules: produces spermatozoa

Interstitial tissue: secretes testosterone

Epididymis: collects spermatozoa

Ductus deferens: connects to the epididymis and ejaculatory ducts for transport of spermatozoa

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12
Q

What is the blood supply to the testes?

A

The testicular artery which is a direct branch of the abdominal aorta

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13
Q

What is the lymphatic drainage of the a) testes and b) scrotum

A

Testes: para-aortic lumbar nodes

Scrotum: superficial inguinal nodes

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14
Q

Which muscles are located in the medial compartment of the thigh and what is their function?

A

Adductor longus - hip adduct + medial rotation
Adductor brevis - hip adduct
Adductor Magnus - hip adduct + medial rotation

Obturator externus - hip lateral rotation

Gracillis - adduct hip + flex knee

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15
Q

Which nerve innervates the medial compartment of the thigh (adductors)?

A

Obturator

(Apart from the hamstring portion of the adductor magnus - tibial division of the sciatic nerve)

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16
Q

Where would you test the following dermatomes:
C2
C3
C4
C5
C6
C7
C8
T1
T2

A

C2 - occipital protuberance
C3 - supraclavicular fossa
C4 - acromioclavicular joint
C5 - lateral antecubital fossa
C6 - thumb
C7 - middle finger
C8 - little finger
T1 - medial antecubital fossa
T2 - apex of the axilla

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17
Q

At what spinal level is the conus medularis located?

A

L1/2

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18
Q

Spinal nerves are formed from what individual components?

A

Anterior root (motor)
Posterior root (sensory)

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19
Q

Once leaving the vertebral canal via the intervertebral foramina, spinal nerves divide into what?

A

Posterior rami: provides innervation to intrinsic back muscles

Anterior rami: provides innervation to muscles and skin of the trunk, limbs and visceral organs

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20
Q

What is the arterial supply to the spinal cord and where do they originate?

A

Anterior spinal artery: vertebral arteries

Posterior spinal artery (x2 paired arteries): PICA or vertebral arteries

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21
Q

Which structures are usually damaged in a surgical neck of humerus fracture?

A

Axillary nerve
Posterior humeral circumflex artery

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22
Q

Where is the transverse thoracic plane located and what happens here?

A

T4/T5

  • The aortic arch begins and ends
  • The trachea bifurcates
  • The pulmonary trunk bifurcates
  • The Azygos vein drains into the SVC
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23
Q

What is the anatomical course of the facial nerve?

A
  • Arises in the pons
  • Travels through the internal acoustic meatus in the temporal bone
  • Travels through the facial canal in the temporal bone
  • Exits via the stylomastoid foramen
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24
Q

What is the motor, sensory and autonomic function of the facial nerve

A

MOTOR:
- Facial expression
- Posterior belly of digastric muscle
- Stylohyoid muscle
- Stapedius muscle

SENSORY:
- Taste to anterior 2/3 of the tongue (chorda tympani branch)

AUTONOMIC:
- parasympathetic innervation to lacrimal, salivary and nasal glands

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25
Q

What reflex is the facial nerve involved in?

A

Efferent pathway of corneal blink reflex

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26
Q

What is the sympathetic and parasympathetic supply to the rectum?

A

Sympathetic: Lumbar splanchnic and hypogastric plexus

Parasympathetic: Pelvic splanchnic and hypogastric plexus

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27
Q

What are the nerve roots of the femoral nerve?

A

L2-L4 (arising from the lumbar plexus)

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28
Q

What are the motor functions of the femoral nerve and which muscles does this correlate to?

A

Hip flexors: sartorius, pectineus, iliacus

Knee extensors: quadriceps femoris (vastus lateralis, vastus intermedius, vastus medialis, rectus femoris)

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29
Q

What are the sensory functions of the femoral nerve?

A
  • Anteromedial thigh
  • Medial leg and foot (saphenous)
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30
Q

Describe the sensory innervation (including taste) of the tongue

A

Anterior 2/3 sensation: Lingual (mandibular)

Anterior 2/3 taste: Corda tympani (facial)

Poster1/3 sensation and taste: Glossopharyngeal

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31
Q

What structures are located within the superficial cervical fascia?

A
  • External jugular vein
  • Lymph nodes
  • Platysma muscle
  • Neurovascular supply to the skin
32
Q

What are the layers of the deep cervical fascia and what is contained within each?

A

INVESTING (surrounds the other 3 layers)
- splits to surround trapezius and sternocleidomastoid

PRETRACHEAL
- viscera of the neck: trachea, thyroid, oesophagus

PREVERTEBRAL
- vertebral collumn
- deep muscles of the back

CAROTID SHEATH
- common carotid artery
- internal carotid artery
- internal jugular vein
- vagus nerve

33
Q

Where is the pretracheal space located and what does it connect?

A

Between the investing layer and pretracheal layer

Neck to anterosuperior mediastinum

34
Q

Where is the retropharyngeal space located and what does it connect?

A

Between a section of the pretracheal fascia (buccopharyngeal) and prevertebral fascia

Base of the skull to posterosuperior mediastinum

35
Q

Where is the prevertebral space located and what does it connect?

A

Within a split in the prevertebral fascia

Base of the skull to diaphragm via the posterior mediastinum

36
Q

Describe the function, innervation and distal attachment of the lateral leg muscles

A

FIBULARIS LONGUS
- foot eversion + plantar flexion + arch support
- superficial fibular nerve
- 1st metatarsal and medial cuneiform

FIBULARIS BREVIS
- foot eversion
- superficial fibular nerve
- base of 5th metatarsal

37
Q

What are the main lymph node groups that drain the face?

A

SUBMENTAL
- medial lower lip
- chin

SUBMANDIBULAR
- medial orbit
- nose
- medial cheek
- upper lip and lateral lower lip

PREAURICULAR and PAROTID
- eyelids
- lateral cheek

38
Q

The LEFT optic tract contains fibres from which part of the retina which corresponds to what visual field?

A

Fibres from the left temporal retina and right nasal retina corresponding to the RIGHT visual field

39
Q

Where is the lateral geniculate nucleus located and what happens here?

A

Thalamus

Optic tract fibres synapse

40
Q

In relation to the optic radiations, where are the upper and lower radiations located and how does this correspond to the visual fields?

A

UPPER
- parietal lobe
- inferior visual field

LOWER
- temporal lobe
- superior visual field

41
Q

What is the blood supply to the macular?

A

Posterior cerebral artery + Middle cerebral artery

42
Q

What is the blood supply to the optic nerve?

A

Central retinal artery (branch of ophthalmic)

43
Q

Describe the visual field defect associated with the following:
a) optic nerve
b) optic chiasm
c) optic tract
d) superior optic radiation
e) visual cortex

A

a) ipsilateral visual loss
b) bitemporal hemianopia
c) contralateral homonymous hemianopia
d) contralateral inferior homonymous quadrantinopia
e) contralateral homonymous hemianopia with macular sparing

44
Q

What nerve is involved in the afferent reflex that initiates defecation?

A

Pelvic splanchnic (stimulated by distension of the rectal ampulla)

45
Q

What is the lymphatic draining of the anus?

A

Above pectinate line:
- Internal iliac

Below pectinate line:
- Superficial inguinal -> External iliac

46
Q

What is the nerve supply to the anus?

A

Above pectinate line (autonomic only):
- Inferior hypogastric plexus

Below pectinate line:
- Pudendal (S2-4)

47
Q

What is the blood supply to the uterus?
Where are the vessels located?

A

Uterine artery (internal iliac)
+ uterine branches of ovarian artery

They are located in the broad ligament

48
Q

The spring ligament (foot) connects which 2 bones? What is its role?

A

Calcaneus to navicular

Transmits the weight of the body from the talus to the forefoot + medial arch support

49
Q

Describe the functional unit of the liver

A

The hepatocytes are arranged in to hexagonal shaped lobules

Central: central vein (draining to hepatic vein)

Peripheral points: Portal triad
- portal arteriole (hepatic artery)
- portal venule (portal vein)
- bile duct
- lymphatics
- vagal parasympathetic nerves

50
Q

The femoral artery is a continuation of what main artery?
What does the femoral artery become and where?

A

External iliac

Popliteal artery (just proximal to the knee)

51
Q

Where would you test dermatomes L1-5

A

L1 - upper anterior thigh
L2 - mid anterior thigh
L3 - medial femoral condyle
L4 - medial malleolus
L5 - dorsum of the 3rd MTP joint

52
Q

Where would you test dermatomes S1-5

A

S1 - lateral heal
S2 - popliteal fossa
S3 - ischial tuberosity
S4/5 - perianal area

53
Q

Describe the bifurcations and branches of the popliteal artery

A

Bifurcates in to the anterior and posterior tibial

The anterior tibial eventually becomes the dorsalis pedis

The posterior tibial artery then gives off the circumflex fibular and fibular artery

54
Q

Where would you feel for the posterior tibial artery pulse?

A

Posterior and inferior to the medial malleolus

55
Q

What is the function of the hamstring muscles?

A

All: Flex knee, extend hip

Biceps femoris: hip lateral rotation

Semitendinosus: hip medial rotation

Semimembranosus: hip medial rotation

56
Q

What is the nerve supply to the hamstring muscles?

A

Tibial division of the sciatic nerve (L5-S2)

(Short head of the biceps femoris is supplied by the common fibular division of the sciatic nerve)

57
Q

What is the function of the thymus gland?

A

T-cell maturation

58
Q

What type of joint is the knee?

A

Modified hinge type synovial joint

59
Q

Tibial collateral ligament:
a) attachments
b) function

A

a) medial epicondyle of the femur -> medial tibia
b) stabilise the knee medially

60
Q

Fibular collateral ligament:
a) attachments
b) function

A

a) lateral condyle of the femur -> lateral fibular
b) stabilise the knee laterally

61
Q

Anterior cruciate ligament:
a) attachments
b) function
c) mechanism of injury

A

a) anterior intercondylar region of the tibia -> passes posteriorly -> lateral intercondylar fossa of the femur

b) prevents anterior displacement of the tibia compared to the femur

c) hyperextension or a large force to the back of the knee in partial flexion

62
Q

Posterior cruciate ligament:
a) attachments
b) function
c) mechanism of injury

A

a) posterior intercondylar region of the tibia -> ascends anteriorly -> medial intercondylar fossa of the femur

b) prevents posterior displacement of the tibia compared to the femur

c) hyperflexion or when a large force is applied to the tibia during flexion

63
Q

What is the unhappy triad in knee injuries?

A

Anterior cruciate ligament + medial meniscus + tibial collateral

64
Q

What are the branches of the internal carotid arteries?

A
  • Ophthalmic artery
  • Anterior cerebral artery
  • Middle cerebral artery
  • Anterior communicating artery
  • Posterior communicating artery
  • Anterior choroidal artery
65
Q

Describe the anatomical pathway of the vertebral arteries

A

Arise from the subclavian arteries -> Ascend through the transverse foramina of C6-C1 vertebrae -> Pass through foramen magnum to reach the cranial cavity

66
Q

What are the branches of the vertebral arteries?

A
  • Anterior spinal artery
  • Paired posterior spinal arteries
  • Posterior inferior cerebellar arteries

They then join to form the basilar artery

67
Q

Surface anatomy: The inferior margin of the lung on quiet respiration

A

T10 vertebrae
8th rib (mid axillary)
6th rib (anteriorly)

68
Q

Surface anatomy: Right (and left) oblique fissure

A

T4 vertebrae
5th intercostal space (mid axillary)
6th rib (anteriorly)

69
Q

Surface anatomy: Right horizontal fissure

A

Starting at the sternum it follows the 4th intercostal space until it meets the oblique fissure

70
Q

Which muscles produce inversion of the foot? Which nerves are involved?

A

Tibialis anterior and posterior

  • Deep fibular nerve
  • Tibial nerve
71
Q

Which muscles produce eversion of the foot? Which nerves are involved?

A

Fibularis longus, brevis and tertius

  • Deep fibular nerve
  • Superficial fibular nerve
72
Q

What is the origin of the lateral cutaneous nerve of the thigh?

A

Anterior rami of L2/L3
(part of the lumbar plexus)

73
Q

Describe the anatomical course of the vagus nerve

A
  • Originates in the medulla
  • Exits via the jugular foramen
  • Travels inferiorly within the carotid sheath before branching:

Right:
- passes anteriorly to subclavian artery
(right recurrent laryngeal then hooks back up towards the larynx)
- Reaching the thorax, the posterior vagal trunk is formed

Left:
- passes inferiorly to subclavian artery
- Reaching the thorax, the anterior vagal trunk is formed
(left recurrent laryngeal hooks under the arch of the aorta to ascend)

They both terminate in the abdomen

74
Q

How is the vagus nerve assessed?

A
  • Gag reflex (efferent pathway)
  • Saying ahhh (uvula will move AWAY from the affected side)
  • Cough
75
Q

What forms the anterior and posterior wall of the rectus sheath?

A

Anterior: Aponeurosis of external oblique + half of internal oblique

Posterior: Aponeurosis of half of internal oblique + transversus abdominis

(The aponeurosis of internal oblique splits)

76
Q

Where is the arcuate line located and what happens at this point?
(Abdominal wall muscles)

A

Midway between the umbilicus and pubic symphysis

There is no longer a posterior wall of the rectus sheath (the aponeurosis of all 3 muscles form the anterior wall) so the rectus abdominis is in direct contact with the transversalis fascia

77
Q

What are the contents of the rectus sheath?

A
  • Rectus abdominis
  • Pyramidalis
  • Superior and inferior epigastric nerves
  • Intercostal nerves T7-11
  • 12th thoracic nerve

MRCEM Primary (6 decks)

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