Anatomy Flashcards
Which hormones are released from anterior pituitary ?
GH
TSH
LH & FSH
ACTH
Prolactin
Melanocyte releasing hormone
Which hormones are released from Posterior pituitary ?
Oxytocin
ADH
What is the mneumonic to remember branches of external carotid?
“Some Ancient Lovers Find Old Positions More Stimulating”
What are the branches of the external carotid?
Superior thyroid
Ascending pharyngeal
Lingual
Facial
Occipital
Posterior Auricular
Maxillary
Superficial temporal
What does “face, ear, taste, tear” demonstrate?
Supply of facial nerve:
Muscles of facial expression
Nerve to stapedius
Taste to ant 2/3 of tongue
Parasympathetic fibres to lacrimal and salivary glands
Which foramen is cartilaginous and closed?
Foreman Lacerum
Which formamen does olfactory nerve pass through?
Cribriform foramina
Which nerve and artery pass through optic canal?
Optic nerve
Ophthalmic artery
Which 4 CNs pass through superior orbital fissure?
CN 3, 4, 6 & Ophthalmic division of trigeminal nerve (V1)
Name the foramen which the 3 branches of trigeminal nerve pass through?
V1 - Ophthalmic - Superior orbital fissure
V2 - Maxillary - Foramen Rotundum
V3 - Mandibular - Foramen Ovale
Which foramen transmits the middle meningeal artery?
Foramen spinosum
What is the middle meningeal artery a branch of?
The maxillary artery (which is a branch of the external carotid)
The internal carotid artery passes over the surface of which foramen?
Foramen Lacerum - internal carotid passes over it’s superior aspect
The foramen itself is cartilaginous
Which 2 CNs pass through the internal auditory meatus?
Facial nerve
Vestibulocochlear nerve
Which 3 CNs pass through the Jugular foramen?
CN 9, 10, 11
Glossopharygeal
Vagus
Accessory (the cranial part of accessory nerve)
Which foramen does the hypoglossal nerve pass through?
The hypoglossal canal
What 3 components pass through the Foramen Magnum?
Medulla Oblongata
Vertebral arteries
Spinal part of accessory nerve
Which artery passes through foramen spinosum? What is it a branch of?
Middle Meningeal Artery
A branch of the maxillary artery, which is a terminal branch of external carotid
Name the 4 branches of the basilar artery? (inferior to superior)
Anterior inferior cerebellar arteries
Labrythine arteries
Pontine arteries
Superior cerebellar arteries
Which foramen do the labrythine arteries pass through, with which 2 CNs?
Internal acoustic meatus
alongside the facial nerve and vestibulocochlear nerve
What does the basilar artery bifurcate into?
What do these form?
Left and right posterior cerebral arteries
The posterior part of the circle of willis
Which artery can be decompressed to treat trigeminal neuralgia?
Superior cerebral artery
Branches of which 2 arteries make up the circle of willis?
Internal carotid artery
Vertebral artery
Which 3 muscles does musclocutaneous nerve supply?
Biceps
Coracobrachialis
Brachialis
Which nerve is responsible for supination and extension of the forearm?
Radial nerve
Which nerve is responsible for pronation and flexion of the forearm ?
Median nerve
Which nerve comes off the inferior trunk of brachial plexus (C8-T1)
Ulnar nerve
Which nerve innervates the lateral 2 lumbricals, abductor pollicus brevis, flexor pollicus brevis, opponens pollicus?
median nerve
Which muscles make up the thenar muscles?
Lateral 2 lumbricals
Abductor pollicus brevis
Flexor pollicus brevis
Opponens pollicus
Which nerve innervates all intrinsic muscles of the hand except the thenar muscles?
Deep branch of Ulnar nerve
Compare the muscles of the hand innervated by the ulnar nerve v median nerve?
Ulnar - all intrinsic muscles of the hand except thenar muscles
Median nerve - thenar muscles
(lat 2 lumbricals, abductor pollicus brevis, flexor pollicus brevis, opponens pollicus)
“ABsolutley F**ked”
Which is the only muscle of the hand innervated by the superficial branch of the ulnar nerve?
Palmaris Brevis
Compare the innervation of ABductor pollicus brevis vs ADDuctor pollicus brevis?
ABductor pollicus brevis = Median nerve
ADDuctor pollicus brevis = Ulnar nerve (deep branch)
Which nerve innervates tricep?
Radial nerve
Name 3 nerves affected in erb’s palsy?
Axillary
Musclocutaenous
Suprascapular
Compare which trunks are affected in Erb’s palsy and claw hand (Klumpkes) deformity?
Erb’s palsy - C5, C6
axillary, musculocutaenous, suprascapular
Claw hand (Klumpkes) deformity - C8 - T1
Ulnar nerve
Which nerve most likely to be injured in medial condyle #?
Ulnar nerve (C8-T1)
Damage to which nerve is associated with wrist drop?
Damage to which bone, where, predisposes to its injury?
Radial nerve
Can be damaged in MIDSHAFT humeral #s
Compare nerves affected in surgical neck of humerus #s and humeral mid shaft #s?
Surgical neck of humerus #s - axillary nerve
Humeral mid shaft #s - radial nerve
(Radial wRaps round the humerus)
Name the levels the oesophagus, aorta and vena cava traverse the diaphragm?
T8 - Vena cava
T10 - Oesophagus
T12 - Aorta
What 3 structures contained in the thoracic outlet?
Brachial plexus
Subclavian artery
Subclavian vein
Which nerve roots most commonly affected in thoracic outlet syndrome?
The lower cervical roots (C8-T1)
Ie - ulnar distribution
Which nerve is the cricothyroid supplied by?
The external laryngeal nerve (not recurrent)
Which compartment of the leg is supplied by the deep fibular nerve?
Anterior compartment of the leg
Which artery supplies the anterior compartment of the leg?
Deep tibial (fibular) artery
Name the 4 muscles in the anterior compartment of the lower limb?
Tibialis anterior - strongest dorsiflexor
Extensor Digitorum longus
Extensor hallicus longus
Peroneus tertius
Which nerve innervates the anterior compartment of the lower limb ?
The Deep fibular nerve
Damage to which nerve results in foot drop? (inability to dorsiflex foot)
Damage to common fibular nerve
Describe the nerve roots of the deep fibular nerve?
L4-S2
Compare which muscles form the medial and lateral border of the anatomical snuffbox?
Lateral border - abductor pollicus longus, extensor pollicus brevis
Medial border - extensor pollicus longus
What nerve roots are tested in the ankle reflex?
S1 and S2
Which carpal bone is a sesamoid bone in the tendon of flexor carpi ulnaris?
Pisiform bone
Compare the percentages of blood supplied to the liver by the portal vein and the hepatic artery?
Portal vein supplies 70%
Hepatic artery supplies 30%
What is the most common position for the appendix to lie?
Retroceacal
What nerve is the middle meningeal artery closely associated with?
The auriculotemporal nerve
Can be damaged during surgery, resulting in parasthesia of the affected ear
What is the level of the transpyloric plane?
L1
What is the course of the median nerve relative to the brachial artery in the upper arm?
Lateral to anterior to medial
Which nerve innervates the trapezius muscle?
What action does this have on the scapula ?
Spinal accessory nerve
Retracts scapula and upwardly rotates it
Name the 3 components of the epiploic foramen?
Hepatic artery
Portal vein
Common bile duct
Can be clamped during liver surgery to control bleeding - Pringles manoeuvre
Which nerve is responsible for innervation of the lateral aspect of the flexor digitorum profundus?
What nerve is this a branch of?
Anterior Interosseous nerve
It is a branch of the median nerve
Compare the lateral and medial innervation of the flexor digitorum profundus?
Describe the digits that this distribution covers
Lateral innervation = Anterior interosseous nerve (branch of median nerve). Digits 2-3
Medial innervation = Ulnar nerve. Digits 4-5.
Which nerve innervates all hip adductors?
Orbturator nerve
Compare the superior, middle and inferior adrenal arteries- from which artery do they all branch from?
Superior adrenal arteries - Inferior Phrenic artery
Middle adrenal arteries - aorta
Inferior adrenal arteries - renal arteries
Which nerve is closely associated to the short saphenous vein and can be damaged in surgery?
Sural nerve
Which artery does the gastroduodenal artery arise from?
Common hepatic artery
Compare the innervation of stapedius and tensor tympani muscles?
Stapedius - facial nerve
Tensor Tympani - mandibular branch of the Trigeminal nerve
Damage to innervation to muscle is associated with winged scapula? What is it innervated by?
Serratus anterior
Innervated by long thoracic nerve
Which nerve supplies posterior muscles of the lower limb and is responsible for plantar flexion and inversion?
Tibial nerve
Which nerve supplies anterior and lateral muscles of the lower limb and is responsible for dorsiflexion and eversion?
Common fibular nerve
Compare the tibial nerve with the common fibular nerve.
Ie - innervation and action of the muscles
Tibial nerve - posterior compartment. Plantarflexion and inversion
Common Fibular - anterior and lateral compartments. Dorsiflexion and eversion
Compare the innervations of superficial and deep fibular (peroneal) nerve?
Deep fibular - innervates anterior compartment of leg and 1st web space
Superficial fibular- innervates lateral compartment of leg and sensory innervation to anterolateral leg and dorsal of foot
If trendelenberg’s sign is positive, which side is the hip drop on?
Hip drop on unaffected side
Which nerve is damaged in trendelenbergs positive cases?
Which muscle is therefore affected?
Superior gluteal nerve
Gluteus medius and gluteus minimus
Which artery is contained in the anatomical snuffbox?
Radial artery
Which level does the coeliac axis split from aorta?
Name the 3 branches of coeliac axis?
Branches off aorta at T12
Branches:
Left gastric
Common hepatic
Splenic artery
“Left Hand Side”
Compare the nerves damaged in humeral mid shaft fractures and surgical neck fractures
Surgical neck fractures= axillary nerve
Midshaft fractures = radial nerve
Name the 4 components of the carotid sheath?
Common and internal carotid artery
Internal Jugular vein
Vagus nerve
Describe the muscles and their innervations involved in shoulder ABDuction?
Supraspinatus- shoulder abduction to 15 degrees, innervated by suprascapsular nerve
Deltoid - shoulder abduction >15 degrees, innervated by axillary nerve
Which visual field defect is caused by a lesion at the optic chiasm?
Bitemporal hemianopia
What is the most anteriorly located structure in the lung root?
Phrenic nerve
Compare the location of direct and indirect hernias with respect to the inferior epigastric artery?
direct hernias - medial to IEA
Indirect hernias - lateral to IEA
Describe the medial, lateral and inferior borders of hesselbach’s (inguinal) triangle?
Medial - Rectus abdominus
Lateral - Inferior epigastric Artery
Inferior - inguinal ligament
Which structure is most likely to be encountered in an axillary sentinel LN biopsy?
Intercostobrachial nerve
Name 4 clinical features of Horner’s syndrome?
Ptosis
Miosis
Anhydrosis
Enopthalmos
What visual field defect is seen in pituitary tumours?
Bitemporal hemianopia
Compare the anterior and posterior innervation of the scrotal skin
Anterior - illioinguinal nerve
Posterior - pudendal nerve
Which nerve innervates the web space between 1st and 2nd toe?
Deep fibular nerve
Which muscle is the termination of the adductor canal located in?
Adductor Magnus
Which structure is most at risk during dissection at the saphenofemoral junction?
Deep external pudendal artery
Which region of the male urethra is surrounded entirely by Bucks fascia?
Spongiose part
The membranous part may partially pass through
Name the 2.5 muscles innervated by the anterior interosseous nerve?
Flexor pollicus longus
Pronator quadratus
Flexor digitorum profundus (radial half)
Pneumonic and branches of internal carotid?
“Only Press Carotid Arteries Momentarily”
Ophthalmic
Posterior communicating
Choriodial
Anterior cerebral
Middle cerebral
Which nerve is most often permanently damaged during superficial parotidectomy?
Greater Auricular nerve
Facial nerve paresis can occur, but this is not permanent
What is the sensory nerve supply to the skin overlying the angle of the jaw?
Greater auricular nerve (C2-C3)
It is the only area not innervated by the mandibular branch of trigeminal nerve
Which 2 nerves are responsible for extension of the knee?
Femoral and obturator nerves
What is the lymphatic drainage of the female urethra?
Internal Iliac nodes
What which roots represent the sciatic nerve?
L4 - S3
Name the contents of the rectus sheath?
Pyrimidalis muscle
Rectus Abdominus muscle
Superior Epigastric artery and vein
Inferior epigastric artery and vein
Where does the common fibular nerve bifurcate into the superficial and deep fibular nerves?
At the lateral aspect of the neck of the fibula
This predisposes it to injury
Name the ligament found on the medial side of the ankle?
Deltoid ligament
Name the 3 ligaments found on the lateral ankle?
Anterior talofibular ligament (ATFL)
Posterior talofibular ligament (PTFL)
Calcaneofibular ligament (CFL)
Based on the Danis weber classification, how does level of fibular fracture relate to fracture instability?
The more proximal the fibula fracture, the greater the risk of syndesmotic injury and therefore fracture instability
Which layers does the fluid in a hydrocele collect?
Between visceral and parietal layers of the tunica vaginalis
Which nerve root is most affected by Klumpkes palsy?
How does this present?
C8-T1 - inferior nerve roots
Claw hand, loss of flexors of wrist
Which 2 heart valves are not attached to the chordae tendinae?
Aortic valve and pulmonary valve
Both these valves have 3 cusps
Compare the embryological pouches that the inferior and superior parathyroid is derived from?
Superior parathyroid = fourth pouch
Inferior parathyroid = third pouch
Compare which nerves are related to short saphenous and long saphenous veins?
Which procedure can these nerves be damaged in?
Short saphenous - sural nerve
Long saphenous - saphenous nerve
Nerves can be damaged during vein stripping for varices
Compare the lymphatic drainage above and below the dentate line?
(Transition area in anal canal)
Above dentate line = Internal iliac LNs
Below dentate line = Superficial Inguinal LNs
Which nerve supplies cutaneous sensation to skin over thumb?
Median nerve
Compare the drainage of lymph from the superior and inferior aspect of the vagina?
Superior - internal and external iliacs
Inferior - superficial inguinal lymph nodes
Which artery supplies the SA node?
Right coronary artery
Compare what the left and right gonadal veins drain into?
Right gonadal drain empties directly into vena cava
Left gonadal vein empties into the left renal vein
Describe the relations to the right and left lobe of the liver of the quadrate lobe?
The quadrate lobe is anatomically contained within the right lobe, but is functionally part of the left lobe
What 2 veins combine to form the retromandibular vein?
Maxillary and superficial temporal veins
Which structure separates subclavian artery from subclavian vein?
Anterior scalene muscle
The subclavian vein passes anterior to ant scalene muscle, the subclavian artery passes through the scalene triangle with the brachial plexus
Name the first branch of the abdominal aorta?
Inferior phrenic arteries
The superior phrenic arteries lie in the thorax
Which nerve is closely associated to the brachial artery?
The median nerve
closely associated in the antecubital fossa
What does the brachial artery branch into at the antecubital fossa?
Branches into the radial and ulnar arteries
What is the origin of the superior gluteal artery?
Internal iliac artery
Superior Gluteal artery arises from posterior trunk of IIA,
Inferior Gluteal artery arises from anterior trunk of IIA
Where do the phrenic nerves lie in relation to the hilum of the lungs?
Both right and left phrenic nerves lie anterior to lung roots
Describe the arterial supply of the 3 areas of the rectum?
Superior rectum = Inferior mesenteric artery
Middle rectum = Internal Iliac artery
Inferior rectum = Internal pudendal artery
What is the arterial supply of the lacrimal apparatus?
Opthalmic artery
A branch of internal caroitd
What nerve is at risk during submandibular gland excision?
Lingual nerve
Greater auricular nerve is most commonly damaged in parotidectomy
What artery is the inferior thyroid artery a branch of?
The thyrocervical trunk
The thyrocervical trunk is a branch of the subclavian artery
Compare which artery supplies the bile duct and which supplies the gallbladder?
The bile duct = hepatic artery
The Gallbladder = cystic artery
Damage to hepatic artery in cholecystectomy can cause bile duct strictures
Name the 3 nerves at greatest risk during a carotid endarterectomy?
Hypoglossal nerve
Greater auricular nerve
Superior laryngeal nerve
Name the medial and lateral border of the anatomical snuffbox?
Medial = Extensor pollicis longus
Lateral= Extensor pollicis brevis and abductor pollicis longus
Which nodal region will tumours of the uterus initially spread to?
The Iliac lymph nodes
Which nerve is responsible for the cremasteric reflex?
Genitofemoral nerve
Which nerve passes through the greater and lesser sciatic foramen?
Pudendal nerve
What is the most superficial structure on the parotid?
The facial nerve
Which artery supplies the transverse colon?
Middle colic artery
Which muscle attaches onto the lesser trochanter of the femur?
Psoas major
Which artery supplies the prostate gland?
Inferior vesical artery
How many unpaired branches leave the abdominal aorta to supply the abdominal viscera?
What are they?
3
SMA
IMA
Coeliac axis
Where do all rotator cuff muscles insert into?
All of them insert into the greater tuberosity of the humerus, EXCEPT subscapularis
Subscapularis inserts into the lesser tuberosity of the humerus
Name the surgical approach used to access incarcerated femoral hernias?
McEvedy approach - used for groin incisions
Where does Stensen’s duct open from and where does it open into?
Opens from the parotid gland, enters oral cavity opposite 2nd molar tooth
What muscle is most superficial of the abdominal wall muscles?
External oblique muscle
From anterior to posterior, name the 3 muscles of the abdominal wall?
External oblique
Internal oblique
Transverse abdominus
Which vessel supplies the SA node and AV node?
Right Coronary Artery
Blockage of RCA can cause arrthymias to develop
The anterior interosseus nerve is a branch of which nerve?
What does it supply?
Branch of the median nerve
Supplies motor innervation to deep muscles in anterior compartment of forearm
Flexor pollicus longus
Flexor digitorum profundus
Pronator quadratus
(Finger flexion)
Which foramina does the genital branch of the genitofemoral nerve exit the abdominal cavity?
The deep inguinal ring
Which structure is most at risk of damage during a high anterior resection?
Left ureter
If a renal heamtoma occurs, which structure will contain the haematoma?
Gerotas fascia - it surrounds the kidney
Which structure attaches periosteum to bone?
Sharpey’s fibres
They are strong collagenous fibres and also provide attachment for muscles and tendons
Name the 4 structures passing through the parotid gland?
Facial nerve and branches
External carotid artery
Retromandibular vein
Auriculotemporal nerve
What type of incision is traditionally used for renal transplants?
Rutherford Morrison
Provides extraperitoneal access to iliac vessels
Which nerve supplies the 1st web space of the foot?
Deep peroneal nerve
What is the primary site of venous drainage from the bladder?
Vesicoprostatic venous plexus - can be a site of considerable bleeding in cystectomy
This then drains into the internal iliac vein
Which nerve passes through the quadrangular space near the humeral head?
Axillary nerve
So does the posterior circumflex humeral artery
At which vertebral body does the common carotid bifurcate into the external and internal carotids?
C4
Damage at what vertebral level downwards will result in LMN signs rather than UMN signs?
L1
For lesions below L1, LMN signs will occur
What does the head of the radius articulate with superiorly?
Capitulum of the Humerus
“Capital Radio”
What is the most posterior structure at the hilum of the right kidney?
The Ureter
It would be encountered first in a posterior approach to a nephrectomy
Compare what structures are separated by Denonvillers and Waldeyers fascia?
Denonvillers fascia - separates prostate from rectum
Waldeyer’s Fascia - sperate rectum from sacrum
The thoracic duct drains lymph from the whole body, except…??
What are these areas drained by instead?
The right upper limb, right head and neck and right breast and lung
They are drained by the right lymphatic duct
What surgical incision is used to undergo a Whipple’s procedure?
Rooftop incision
What is Froment’s sign? What does it test for?
Front’s sign = testing grip strength of patients thumb and index finger by asking them to hold a bit of paper and then pulling it
It tests for ulnar nerve palsy in the ADDuctor pollicus muscle
Which structure separates the PCL from the popliteal artery?
The Oblique popliteal ligament
Why is it easy for sepsis to spread in the cranial venous sinuses?
They have no valves
The sinuses are located in the dura mater
What is the cystic artery a branch of?
The right hepatic artery
What artery is most likely to be damaged in an extradural haematoma?
Middle meningeal artery laceration
Name the nerves that provide taste and sensation to the anterior 2/3 of the tongue?
Sensation= facial nerve
Taste = Trigeminal nerve
Which nerve innervates the stylohyoid?
The facial nerve
All other muscles around the hyoid are innervated by trigeminal nerve
Which cranial bone does the Foramen spinosum lie?
Sphenoid bone
When considering ulnar nerve damage, what is the ulnar paradox?
The ulnar nerve paradox - the higher the lesions, the less clawing of the fingers seen clinically
ie - lesion at the elbow will produce less clawing than lesion at the wrist
At what level does the aorta bifurcate into the common iliacs?
L4
What is the mnemonic for remembering radial nerve muscles? What are the muscles?
BEST
Brachioradialis
Extensors
Supinators
Triceps
What sympathetic ganglia should be divided to treat hyperhidrosis of the hands and arms?
DIvide sympathetic ganglia at T2 & T3
“Division of T2&T3 keep the hands sweat free”
The parietal pleura will need to be divided
What CN provides sensation to the posterior 1/3 of tongue?
Glossopharyngeal nerve
Also contributes to gag reflex
Which 3 arteries make up Littles area of the nose?
Facial, Maxillary and ophthalmic arteries
Which branch of the aorta passes anterior to the lower part of the pancreas and may be encountered in a Whipple’s procedure?
Superior Mesenteric Artery
Invasion of this structure into the pancreatic head is a contra-indication to surgery
What level is the lesion in Erb’s Palsy?
C5, C6 nerve lesion
What is the main arterial source of blood supply to the omentum?
Gastroepiploic artery
Where does the scaphoid derive the majority of its blood supply?
Dorsal carpal branch vessels - via retrograde flow
Arises from ulnar artery
Which branch of the brachial plexus is most commonly injured as a result of a crutch palsy?
Radial nerve - results in wrist drop
Ulnar nerve arises from the medial cord so is more protected than radial, which is a branch of the posterior cord
Compare the innervations of the anterior and posterior bellies of the digastric muscle?
Anterior belly = mylohyoid nerve
Posterior belly = facial nerve
What is the correct origin of the pancreas during embryological development?
Ventral and dorsal endodermal outgrowths of the duodenum
In the carpal tunnel, which tendon lies deepest and in closest proximity to the hamate bone?
The tendon of flexor digitorum profundus
Which CN has a long intracranial course and therefore most susceptible to raised ICP?
Which cranial nerve has the longest intracranial course?
Abducens nerve CN6 is most likely to be affected by rasied ICP
CN4 has the longest intracranial course tho
Which nerve is routinely encountered at the superficial inguinal canal during hernia repairs?
Ileoinguinal nerve
Ileoinguinal nerve entrapment may be a cause of neuropathic pain following hernia repair
Compare arterial supply of the cervical and thoracic oesophagus?
Cervical = inferior thyroid artery
Thoracic= direct branches from the thoracic aorta
Where do the common iliac veins fuse with the IVC?
L5
The aorta bifurcates to the common iliac arteries at L4
Compare the insertion sites of flexor digitorum profundus and superficalis?
Flexor digitorum profundus inserts onto the DIP joints
Flexor digitorum superficialis inserts onto the PIP joints
Which nerve gives innervation to anal sphincters and external urethral sphincter?
Pudendal nerve
S2,3,4 keeps shit off the floor
Name the 5 muscles innervated by the deep peroneal (tibial) nerve?
Tibialis anterior
Extensor digitorum longus and extensor digitorum brevis
Extensor hallicus longus
Peroneus tertius
Where are the greatest proportion of musculi pectinati found?
The Right atrium
This gives the anterior walls of right atrium an irregular appearance
From which structure does the inguinal ligament arise?
The external oblique aponeurosis
