Anatomy Flashcards
Fractured shaft of humerus - endangered
Axillary nerve
Level spinal cord ends
L1/2
Loss of saddle sensation
Corda equina
Referred pain to ear
Tonsils
Layer of the eye with most refractive power
Cornea
Inability to ad/abduct fingers
T1
Winged scapula due to injury of the…
Long thoracic nerve
Azygous vein drains into…
SVC
Knee reflex
L3/4
Jaw jerk nerve
Trigemnital
Falciform ligament
From the hilum of the liver to the anterior abdominal wall (remnant of the umbilical vein)
Lacteral pectoral nerve
Pectoralis major
Main lymphatic drainage of the leg
Great saphenous vein
Axillary nerve motor supply
Deltoid and teres minor
Transpyloric plane
Superior mesenteric artery origin End of spinal cord Pylorus of stomach Neck of pancreas Origin of portal vein 2nd part of duodenum Sphincter of Oddi Hilum of kidneys Duodenal-jejunal flexure Fundus of gallbladder Tip of 9th costal cartilage Hepatic and splenic flexure
Ankle jerk
L5/S1
Active hyperemia
Increase of blood flow to active tissues in the body
Smooth muscles of arterioles relax in response to local chemical factors
Arterial baroreceptors
Decrease firing to compensate for a sudden loss in arterial BP
Acute inflammation
Leukocytes
Chronic inflammation
Lymphocytes, macrophages, plasma cells
Cricothyroid puncture
Between cricoid and thyroid cartilages (C4-6)Complications: damage to vocal cords (hoarseness) and bleeding
Intercostal catheterisation
Pneumothorax, haemothorax, pleural effusion5th ICS anterior to mid axillary line, or 2nd ICS mid-clavicular line
Lumbar puncture
L3-4 (or below) into the subarachnoid space
Most likely zone of the prostate for carcinoma
Peripheral zone
Most likely zone of the prostate for BPH
Transitional zone
Thyroid surgery
Complications
Bleeding Injury to recurrent laryngeal nerve Hypoparathyroidism Thyrotoxic storm Injury to superior laryngeal nerve Infection Hypothyroidism
Posterior triangle of the neck
Contains the accessory nerve
Apical lung tumour - clinical features
Pain along the inner aspect of the armWasting of intrinsic muscles of the hand Constriction of the pupil
Horner’s syndrome
PAM
Partial ptosis
Anhidrosis
Miosis (constriction of pupil)
Facial nerve - innervations
Motor - stapedius and facial musclesSensory - palate and anterior 2/3 of the tongueParasympathetic - lacrimal gland, submandibular gland, sublingual gland
Traction from an extradural haemorrhage
Nerve endangered
Oculomotor nerve
Compression in the superior orbital fissure above the fibrous ring
Nerve endangered
Oculomotor, trochlear, trigeminal (V1)
Compression within the cavernous sinus
Nerves endangered
AbducensInternal carotid artery
Lateral walls - III, IV, V1, V2
Layers of abdominal wall
Medial to rectus sheath
Above arcuate line
SkinFascia External oblique 1/2 of internal oblique Rectus abdominis 1/2 of internal oblique Transversus abdominis Transversalis fascia Peritoneum
Layers of abdominal wall
Medial to rectus sheath
Bowel arcuate line
Skin Fascia External oblique Internal oblique Transversus abdominis Rectus abdominis Transversalis fascia Peritoneum
Why does the left testis hang lower?
Due to venous drainage - testicular vein drains into the left renal vein on the left side, compared to the IVC on the right side. The left renal vein is smaller than the IVC, so has greater pressure
Large intestine
Histology
Taenia coli
Haustra
Omental appendices
Small intestine
Histology
Smaller in diameter
Consistently peritoneal
Jejunum
Differences from Ileum
More prominent mucosal folds Thicker walls with larger windows Vasa recta Greater diameter More vascular Absorbs protein
Ileum Differences from jejunum
More fat in mesentery
Shorter arcades
More lymphoid
Absorbs B12, fats and bile salts
Foregut
Stomach, gallbladder, pancreas, abdominal part of oesophagus, proximal part of duodenum, liver, spleen
T7-9 - epigastric pain
Supplied by coeliac trunk
Midgut
Appendix, distal part of duodenum, jejunum, ileum, caecum, proximal part of large intestine (until splenic flexure)
T10 - umbilical pain
Supplied by superior mesenteric artery
Hindgut
Above the pelvic pain line - distal part of large intestine, descending colon, sigmoid colon, ureters, testes, ovaries, uterine tubes, bladder above trigone, body of uterus, supravaginal part of cervix
T10-L1 - suprapubic pain
Supplied by inferior mesenteric artery
Sites of portal-systemic anastamosis
Lower end of the oesophagus
Anal canal
Anterior abdominal wall
Posterior abdominal wall
Cauda equina compression - nerve roots
L3-S4
Internal iliac artery
Provides most of the blood supply to the pelvis
Major branch is the pudenal artery
External iliac artery
Gives rise to deep circumflex and inferior epigastric arteries and the femoral artery in the groin
Artery eroded by ulcer in first part of duodenum
Gastroduodenal artery
Artery eroded by ulcer in stomach
Splenic artery
Supply of the right coronary artery
SA node (55% of people) AV node (90% of people) Right atrium Right ventricle (most of) Diaphragmatic part of left ventricle Posterior 1/3 of inter ventricular septum
Supply of the left coronary artery
SA node (45% of people) AV node (10% of people) AV bundle Left atrium Left ventricle (most of) Part of right ventricle Anterior 2/3 of interventricular septum
Sternal angle (Angle of Louis)
2nd costal cartilage IV disc T4/5 Passage of thoracic duct from right to left Aortic arch start and end Tracheal bifurcation End of azygous system into SVC Ligamentum arteriosum Loop of the recurrent laryngeal nerve around aortic arch Superior border of inferior mediastinum
Points where parietal pleura are vulnerable to penetrating injury
Above 1st rib
Right cost-xiphisternal angle (6th rib)
Costovertebral angle (below 12th rib)
Dorsal Scapular Nerve
Rhomboids
Levator scapulae
Long Thoracic Nerve
Serratus anterior
Suprascapular nerve
Supraspinatus
Infraspinatus
Nerve to Subclavius
Subclavius
Lateral pectoral Nerve
1/2 Pectoralis Major
Medial pectoral Nerve
1/2 of pectoralis major
Pectoralis minor
Musculocutaenous Nerve
Biceps brachii
Brachialis
Coracobrachialis
Upper Subscapular nerve
1/2 of subscapularis
Lower subscapular nerve
Teres major
1/2 of subscapularis
Thoracodorsalis nerve (Middle Subscapular Nerve)
Latissimus dorsi
Axillary nerve
Deltoid
Teres minor
Protrusion of the medial border of the scapular. What nerve is injured
Long thoracic nerve
Fracture of the surgical neck of humerus. Best examination to assess neurological status
Sensation over deltoid
Fractured neck of humerous with damage to the axillary nerve. Function that is most likely to be impaired:
Abduction of the shoulder
Nerve and artery in the quadrangular space (humerus)
Axillary nerve and posterior circumflex humeral artery
Fracture of the clavical resulting in injury to the brachial plexus. Which part is likely to be damaged?
Divisions
Fracture of the humerus after a MVA. Results in:
Inability to extend the wrist due to radial nerve injury
Incorect use of crutches resulting in weakness in extension of theforearm and wrist and loss of sensation over the first web space on the dorsum of the hand. Nerve affected
Radial nerve above the point of innervation of the triceps
Apical carcinoma with wasting of the dorsal interossei. This is due to compression of the:
T1 nerve root
Patient has pain and paraesthesia of the thumb, index and middle finger. Nerve most likely affected:
Median nerve
Where the sciatic nerve passes, in relation to the sciatic foramen and piriformis
Through the greater sciatic foramen and inferior to piriformis
Trendelenburg sign - nerve affected
Superior gluteal nerve
Tight below the knee cast compressing the common fibular nerve. Structure most likely affected
Tibialis anterior
Foot drop and inability to evert the foot. Damage to:
Common fibularnerve
Patient presents with altered sensation of the lateral aspect of the foot. Nerve most likely affected:
Sural nerve
Biceps jerk nerve roots
C5, C6
Triceps jerk nerve roots
C7, C8
Brachioradialis jerk
C5, C6
Knee jerk nerve roots
L3, L4
Ankle jerk nerve roots
S1, S2
Erb’s palsy
Waiters tip - stretch/rupture of the upper trunk of the plexusC5,6 paralysis and wasting
Klumpke’s palsy
Claw handUlnar and radial nervesC8, T1
“Ape hand” at wrist
Median nerve
“Hand of benediction” near the elbow
Median nerve
“Ulnar claw” at wrist
Ulnar nerve
“Wrist drop”
Radial nerve
“Foot drop”
Fibular or sciatic nerve
Sciatic Nerve spinal levels
L4-S3
Sciatic Nerve
Innervation
Entire lower leg (besides the medial side) via the tibial and common fibular nerves