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Big Blue Topics > Anatomy > Flashcards

Anatomy Flashcards

1
Q

Dermatomes

A
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2
Q

Pharynx innervation

A

IX: glosopharyngeal

XII: hypoglossal

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3
Q

cartilages of the larynx

A

hyoid

thyroid

cricoid

aretynoid (attached to cricoid and have attached to them the VCs)

epiglottic

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4
Q

Larynx Innervation

A

CN X

  • SLN
  • RLN
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5
Q

SLN

A
  • internal laryngeal branch: pierces thyrohyoid membrane–sensation from epiglottis to vocal cords
  • external laryngeal branch: cricothyroid muscle (tensor of vocal cords)
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6
Q

RLN

A
  • sensation below vocal cords, motor to all laryngeal muscles except cricothyroid
  • bilateral injury–adduction of vocal cords and rapid, severe respiratory obstruction
  • enters larynx psoterior to cricothyroid articulation–blocked by transtracheal approach
  • RLN runs in a groove between trachea and esophagus–blocked by stellate ganglion block
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7
Q

Tracheal Innervation

A

Vagus CN X

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8
Q

Roots of brachial plexus

A

anterior primary divisions C5-8 +T1, with contributions from C4 and T2

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9
Q

Division of brachial plexus

A

Robert Taylor Drinks Cold Beer

Roots

Trunks

Divisions

Cords

Branches

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10
Q

Roots

A

-anterior primary division of C8-T1, emerge from intervebral foramina, fuse above first rib

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11
Q

Trunks

A

-above first rib

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12
Q

Divisions

A

-Each trunk forms anterior and posterior divisions

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13
Q

Cords

A
  • 3 cords: medial, lateral, posterior
  • medial/lateral:flexor surfaces of UE
  • posterior cord: extensor surfaces of UE
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14
Q

Branches-Terminal nerves

A

Lateral/medial cord: lateral/medial head of median

medial cord: ulnar

lateral cord: musculocutaneous

posterior cord: axillary, radial

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15
Q

axillary nerve block

A
  • prevertebral fascia forms axillary perivascular sheath, which envelopes the brachial plexus and axillary artery
  • median nerve: above ax artery
  • ulnar nerve: below ax artery
  • radial nerve: posterior/inferior to artery–needle passes posterior wall of ax artery
  • misses musculocutaneous b/c came off already
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16
Q

interscalene block

A
  • at level C6/cricoid cartilage
  • between anterior and middle scalene muscles
  • brachial plexus and subclavian artery run together
  • needle enters skin posterior to posterior border of sternocleidomastoid muscle behind the EJ
  • anterior scalene is just posterior to the posterior aspect of sternocleidomastoid at the level of the cricoid
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17
Q

supraclavicular block

A
  • enter skin 1-2 cm above midpoint of clavicle and elicit paresthesias as needle advanced toward 1st rib
  • when first rib contacted, needle moved in anteroposterior direction until paresthesias elicited
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18
Q

cutaneous nerves of the hand

A
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19
Q

radial nerve block at elbow

A

-between brachioradialis and biceps tendon

20
Q

radial nerve block at wrist

A
  • nerve is lateral to radial artery
  • NA/N/AN-lateral to medial
  • breaks for flexor carpi radialis and palmaris longus
  • both radial and ulnar located outside
21
Q

ulnar nerve at elbow

A
  • between olecranon and medial epicondyle of humerus
  • usu blocked above elbow to avoid direct nerve trauma
  • loss of all muscles of hand except thenar eminence and 1st/2nd lumbricals
22
Q

ulnar nerve at the wrist

A

-medial to ulnar artery

23
Q

median nerve at the elbow

A

=blocked medial to brachial artery between two heads of pronator teres

24
Q

median nerve supplies

A

-thenar eminence, 1st and 2nd lumbricals

25
Q

median nerve at the wrist

A

-between flexor carpi radialis and palmaris longus

26
Q

injury to nerves

A
  • direct needle or other trauma, or ischemia from positioning
  • supplied by arteries called vasa nerovrum
27
Q

Cutaneous nerves of leg : back

A
28
Q

Cutaneous nerves of leg: front

A
29
Q

nerve supply to LE

A
  • Lumbar plexus: T12, L1, L2, L3,L4-femoral, obturator, lateral femoral cutaneous, ilioinguinal, iliohypogastric, genitofemoral
  • sacral plexus: L4, L5, S1, S2-Sciatic nerve
30
Q

Femoral nerve block

A
  • passes under inguinal ligament, dividing into anteiror and posterior divisions
  • sensory to anteiror and medial thigh and leg
  • sensory to medial ankle (saphenous)
  • NAVL
31
Q

lateral femoral cutaneous nerve

A

-sensory to anterolateral spect of thigh down to knee

32
Q

meralgia paresthetica

A

-compression of lateral femoral cutaneous nerve by inguinal ligament, producing pain, numbness, paresthesia over anterolateral aspect of thigh

33
Q

obturator nerve

A

-adductors of the thigh

34
Q

sciatic nerve

A
  • sacral plexus–>greater sciatic notch–>popliteal region–>divides into tibial and common peroneal nerves
  • sciatic nerve: hammstrings and all msucles of leg and foot
  • sciatic nerve: snesory to front (superficial/deep peroneal), back (posterior tibial), lateral (Sural) ankle
35
Q

sciatic nerve block

A
  • lateral position with hip and knee flexed
  • line drawn between posterior superior iliac spine and greater trochanter
  • at midpoint of this line, a perpendicular (bisecting line) drawn 3 cm downward
  • surgery for sole of foot
  • if surgery involves lE–combine with femoral, obturator or lateral femoral cutaneous nerve
36
Q

superficial peroneal nerve

A
  • line connecting medial and lateral malleolus–place a cuff of anesthesia along it
  • sensory to dorsum of foot and toes except great and 2nd toes
37
Q

deep peroenal nerve

A
  • lateral to ex hallucis longus to great toe
  • flexors of toes and provides sensation between great and second toes
38
Q

sural nerve

A
  • posterior to lateral malleolus
  • sensory to posterolateral leg, lateral foot, 5th toe
39
Q

posterior tibial

A
  • posterior to medial malleolus
  • sensory to sole of foot, plantar surface of foot
40
Q

saphenous nerve

A
  • from femoral nerve
  • anterior to medial malleolus
  • sensory to anteromedial side of leg and medial side of the foot
41
Q

ankle block

A
42
Q

sole of foot innervation

A
43
Q

gasserian ganglion

A
  • a trigeminal nerve block
  • anesthesia to ipsilateral face, cornea, sclera, anterior tongue
  • used for trigeminal neuralgia
  • posterior tongue is covered by CNIX
  • middle cranial fossa, close proximity to dural fold and meckel’s cave containing CSF
  • if needle goes too far, can enter cranial CSF–produce other nerve involvement (facial) or total spinal
44
Q

superficial cervical plexus block

A
  • anterior branches of first 4 cervical nerves
  • superficial at lat border of SCM, blocked with 10 cc 1% lido subq
  • success=horner’s syndrome and hoarsenes (RLN block)
  • complications: phrenic nerve paralysis, subarachnoid block
45
Q

intercostal nerve block

A
  • anterior rami of first 11 Thoracic nerves
  • neurovascular bundle below each rib (VAN–nerve inferior)
46
Q

branches of intercostal nerves

A

1) sympathetic ganglion
2) posterior cutaneous branch–skin and muscle oin paravertebral region
3) lateral cutaneous branch–skin of medial arm for T2–intercostobrachial nerve

Big Blue Topics (25 decks)

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