Anatomy Flashcards
What is the origin and insertion of EO, IA and TA?
EO: Ant 1/2 of iliac crest to pubic tubercle
IO: Ant 1/2 of iliac crest, lowermost fibres from lateral 2/3 of inguinal ligament. To pubic crest in conjoint tendon.
TA: Ant 1/2 of iliac crest, lowermost fibres from lateral 1/3 of inguinal ligament. To pubic crest in conjoint tendon.
What are the two main branches of the internal thoracic artery?
Musculophrenic and superior epigastric
Where is the superficial and deep ring?
Deep ring: an out pocketing in transversalis fascia half way between ASIS and pubic tubercle
Superficial ring: Medial opening in EO aponeurosis
What are the boundaries of the inguinal canal?
Floor: inguinal ligament
Roof: IO and TA arching fibres
Anterior wall: EO aponeurosis and IO laterally
Posterior wall: TA fascia and conjoint tendon medially
Where do the 3 layers of fascia around the spermatic cord come from?
1st from fascia transversalis–> internal spermatic fascia
2nd from TA and I0, with some muscle fibres from IO–> Cremasteric fascia
3rd from EO aponeurosis–> external spermatic fascia
What is the difference between a direct and indirect inguinal hernia?
A direct pushes through the posterior wall into the inguinal canal, where as an indirect is a protrusion through the deep ring into the inguinal canal
What is the origin and insertion of psoas major, QL and iliacus?
From vertebral bodies and discs of lumbar vertebrae to the lesser trochanter of femur. Sitting in paravertebral gutter
QL from lower border of 12th rib to posterior half of iliac crest, along tip of transverse processes
Iliac from iliac fossa to form a conjoint tendon with PM
Where do the 3 layers of thoraco lumbar fascia come and then join together? Whats in their compartments? Which two muscles do they anchor?
Anterior from front of transverse process
Middle from tip of transverse process
Posterior from tip of spinous process
Fuse in a line with tip of 12th rib
QL in anterior comp and PM in posterior comp
Anchors TA and IO (EO free edge)
Where do the kidneys sit? What are their dimensions? Where does it blood supply from?
Where do potential accessory renal arteries come from?
From T12-L3 in paravertebral gutters anterior to QL
10x5x2.5 cm
lateral branches from abdo aorta, drains into IVC direct
Accessory arteries from development as the kidneys ascending taking then obliterating blood supply from what ever level they were at.
How long are the ureters? Where would you find them on an x-ray? What 3 places would you find a kidney stone? Where is their blood supply from?
25-30cm, along tip of transverse processes in front of posts major.
Junction of renal pelvis, where tips over pelvic brim, entry into the pelvis
Blood supply just from whatever down its course.
What level of somitomere do somites begin forming?
Number 8, then goes caudally.
Which germ layers initiate and control limb growth? What congenital issue can result?
Mesoderm initiates limb growth
Ectoderm control limb growth forming an apical ectodermal ridge. Can get diplopodia if mechanical disruption.
Can get syndactyly if inefficient apoptosis of webbing
How does anus develop? Which germ layers are involved?
Begins as proctodeum sealed by choacal membrane (ectoderm and endoderm) Urogenital septum (mesoderm) then grows backwards separating allantois and hindgut to form two holes.
Where do pharyngeal pouches develop? What germ layer? What are some examples of structures they go onto form?
Between pharyngeal arches.
Endoderm
Eustachian tubes and thymus.
Which part of which germ layer does the heart come from?
What structure type does the heart begin as and how does it change?
From the splanchnic lateral plate mesoderm. Parts of outflow tract and midline from neural crest
Begins as two tubes that fuse in the midline. It then twists to form 4 chambers.
What is the most common congenital defect organ and an example within in?
Heart defects (1/200), ventricular defect most common (IVS not fully fused)
Where is the GIT rotation axis in development?
Around yolk stalk and superior mesenteric artery
Which germ layer is the kidney from?
What induces the metanephros? What is left of that structure?
- Intermediate mesoderm
- Mesonephros induces metanephros. Mesonephros duct left as wolfing duct–> vas def, epididymis and seminal vesicles
What week do the 3 germ layers form?
When is all major organogenesis complete by?
Week 2-3
Complete by 3 months (1st trimester)
What is the most common form of oesophageal hernia?
Sliding, where it takes part of stomach
What part of the duodenum does the transverse and the mesentery cross?
Transverse: 2nd part
The mesentery: 3rd part
What are the diff between jejunum and ileum in terms of proportion, diameter thickness, mesenteric fat and arteries?
Jejunum 2/5 Less fat in mesentery Larger diameter Thicker walls Less arcades and longer vasa recta
What are the 3 ligaments called that are peritoneal reflections off superior aspect of liver?
coronary ligament running across and right and left triangular ligament either side
Which ligament attaches the liver to the anterior abdominal wall?
Falciform ligament
What is in the port hepatic are where are they in reference to each other?
Portal vein at back.
Hepatic artery to left
Common bile duct to right
Where will you feel an inflamed gall bladder?
Fundas will project between lateral border of rectus abdominus and the costal margin
Which rib is the axis of the spleen along?
Shaft of 10th rib
Which branches of the celiac trunk give the right and left gastric and gastroepiploic arteries?
Right Gastric: Common hepatic
Left gastric: Left gastric
Right gastroepiploic: Superior pancreaticoduodenal
Left gastroepiploic: Splenic
What forms the portal vein?
Superior mesenteric and splenic
Where are some sites of portosystemic anatstamoses? Which systemic vein are they connecting to?
- Abdo oesophaus (via azygous)
- Anterior abdominal wall (via paraumbilical)
- Anus (via inferior rectal vein)
Where is pain referred to in the GIT? (think how it changes in sigmoid)
Via sympathetics:
Foregut T6-T9
Midgut T8-T12
Hindgut (to first half of sigmoid): T12-L2
Hingut (after first half of sigmoid: Via parasympathetics to S2-S4 (as where all hindgut PSN fibres come from)
What does the pre and para aortic lymph nodes drain?
Pre aortic drain the Anterior branches of abdo aorta
Para drain the lateral and posterior branches as well as the pelvis and lower limb.
What 3 things does absorption of an X ray beam in tissues depend on?
- Thickness
- Density
- Atomic number
How can we improve on the natural differences of X ray absorption?
By altering the absorption by inserting a radiographic contrast medium e.g. barium or iodine
What does the dopler effect describe? What does a dopler ultrasound allow you to determine?
A perceived change in frequency of waves when there is movement between the source and observer of wave.
Can determine velocity of blood flow.
How does MRI produce an image?
Uses pulses of altered magnetic field to induce momentary change in magnetism (aligns all the protons that were random) creating a radio wave frequency
What divides the right and left lobes of the liver?
The middle hepatic vein, running from IVC to gall bladder
What is usually the cause of a ventral hernia?
Its usually incisional, so where surgery had been done so area now weak
What is the main stabilising ligament of the sternoclavicular joint?
Costoclavicular ligament
What position is a clavicular fracture likely to occur?
Between lateral 1/3 and medial 2/3
What ligament is the main stabiliser of the acromioclavicular joint?
Coracoclavicular ligament: conoid and trapezoid parts
Which nerve is damaged in a fracture of the following in the humerus:
- Surgical neck
- Mid-shaft
- Supracondylar
Surgical neck: axially
Shaft- Radial
Supracondylar- Median
In which direction and position is the shoulder most prone to dislocation?
Which nerve is endangered?
Anterior inferior direction
When abducted and externally rotated
Axillary nerve
What is cubits valgus and what nerve is endangered?
When the valgus angle goes beyond 15 degrees laterally.
Ulnar nerve in danger.
What direction does the interosseous membrane go in?
Which direction does force go in and what is the ring principle?
Inferiorly anteriorly from radius to ulnar.
Force goes from radius to ulnar.
Ring principle: fracture of radius commonly associated with fracture of ulnar
What can result from a supracondylar fracture of the humerus?
Volkman’s ischaemia from obstuction of brachial artery
In which position is the elbow most stable?
What is the most common dislocation of the elbow?
Extension
Posterior
Where the axis of rotation for pronation/supination?
From head of radius to styloid process of ulna
At the wrist joint what is greater and why?
- Flexion or extension
- Ulnar or radial deviation
What about at intercarpal joint?
Flexion as posterior part of radius projects down further
Ulnar deviation cos of radial styloid process
Opposite at intercarpal joint
What is the differing movements across each digit in the carpometacarpal joints?
Thumb- saddle
2 & 3- immobile
4 & 5- hinge
