Anatomy Flashcards
Three blocks and nerves for FOI
- Anterior tonsillar pillar (at the base): glossopharyngeal (only the tonsillar, lingual, and pharyngeal branches, not the whole nerve)
- Inferior aspect of greater cornu of hyoid bone: INTERNAL branch of the superior laryngeal nerve
- Transtracheal: recurrent laryngeal (spares motor)
Innervation of airway, proximal to distal
- Anterior tongue- trigeminal, mandibular branch (V3)
- Posterior tongue- glossopharyngeal (IX)
- Soft palate- IX
- Oropharynx- IX
- Hypopharynx (oropharynx below level of epiglottis)- internal branch of superior laryngeal nerve (vagus, X)
- Vocal cords- both internal branch of SLN and recurrent laryngeal (X)
- Larynx (blow vocal cords but above trachea)- RL
- Trachea- RL
Superior laryngeal nerve braches
- Internal: sensory to hypopharynx and vocal cords
- External: motor to cricothyroid muscle (elongates cords allowing for higher pitch)
- only motor to cords not supplied by recurrent laryngeal nerve
Recurrent laryngeal nerve
-Unilateral v bilateral blockade
- sensory to underside of vocal cords, larynx and trachea
- motor to glottis (except cricothyroid m. supplied by external branch of SLN)
- unilateral blockade: partial adduction of affect cord, resulting in hoarseness
- bilateral blockade: bilateral partial adduction of vocal cords, resulting in stridor and possible airway obstruction
Muscles of vocal cords
- One abductor: posterior cricoarytenoid
- One tensor: cricothyroid (ext. branch of SLN, only one RL)
- 3 adductors
- Most sensitive indicator for difficult intubation
- Most specific indicator for difficult intubation
- Mallampati class III or IV (also least specific)
- Thyromental distance
Narrowest portion of airway in adults and neonates
Adults: glottis opening
Neonates: cricoid cartilage
RUL broncus takeoff relative to carina
2 cm below carina
Type 1 and type 2 pneumocytes
Type 1
- thin walled epithelial cells
- primarily involved in gas exchange
- cannot differentiate
Type 2
- small cells
- produce surfactant
- differentiate into type 1 pneumocytes
- far more numerous than type 1 pneumocytes
T1-4
- Cardioaccelerator fibers
- travel up through stellate ganglion first before coursing o the heart
- also provide sympathetic innervation to the lungs (bronchodilation)
Heart walls and blood supply
- anteroseptal
- inferoseptal
- inferior
- inferolateral
- anterolateral
- anterior
- anteroseptal: LAD
- inferoseptal: RCA & LAD
- inferior: RCA
- inferolateral: RCA & LCx
- anterolateral: LCx
- anterior: LAD
Aortic Dissection Tissue Layers
-blood penetrates the intimate and creates a false lumen inside the media layer
Subclavian artery and vein anatomy
- vein runs anterior to the artery
- vein courses anterior to the anterior scalene
- artery courses between the anterior and middle scalenes
- both course over (superior to) the 1st rib and enter the thorax
- all central veins are deep to SCM
Spinal Cord Blood Supply
- 1 anterior spinal artery and 2 paired posterior spinal arteries
- superior origins of ASA and PSAs are the vertebral arteries
- upper thorax: ASA mostly supplied from posterior intercostal arteries
- lumbar and sacral cord: ASA supplied by Artery of Adamkiewicz, which arises from a single posterior intercostal artery, usually between T8 and L1 and most often on the left side
Vertebral level at superior aspect of iliac crest
L4
Celiac plexus is at what vertebral level
L1 (just lateral to the aorta)
Musculocutaneous nerve
- which cord of brachial plexus?
- which nerves?
- innervation?
- lateral cord of brachial plexus
- C5, 6, & 7
- sensory to lateral forearm
- missed by axillary block
Relationship of median nerve, brachial artery and radial nerve in AC fossa
- median nerve runs just medial to the brachial artery
- radial nerve runs just lateral to the biceps tendon
Innervation of lower leg
-Sciatic nerve except for the medial leg, which is innervated by the saphenous (femoral nerve branch)
Innervation of interspace between 1st and 2nd toe
Deep peroneal nerve (other webspaces supplied by the superficial peroneal nerve)
