Anatomy Flashcards
Duodenal ulcer perforates which artery affected?
Gastroduodenal
What part of the pancreas is most commonly affected by cancer?
Head of pancreas
What is the true obstetric conjugate?
We can’t measure it so instead we palpate the diagonal one instead.
What is the smallest part of the pelvic canal where the baby must go through?
The interspinous distance in the mid pelvis. Typically exceeds 12cm
Pelvic inlet ?
Obstetric or Diagonal conjugate
Where do rectal cancers metastasise?
Below the pectinate line so Superficial inguinal lymph nodes
Where do you do a pudendal block?
Palpate the ischial spine and below that
BPH is the result of enlargement of which lobe?
Median lobe
What is the ligament between the uterine tube and the ovaries
mesosalpinx
Can you cut the Ligament of ovary or the suspensory ligament of the ovary?
The Ligament of the ovary - connects it to the uterus. the suspensory ligament contains blood vessels from the posterior abdominal wall
What provides the passive support of the uterus? And the active support?
Passive - Cardinal Ligament
Active -
Testicular cancer drains to ______ nodes
para-aortic nodes
Cavernous spongiosum contains the urethra - T/F?
T
Bitemporal heminopia from ______ tumour….
Pituitary tumour
Fracture of the Clavicle are most likely to occur ______
middle third
The proximal humerous fractures posteriorly to the surgical neck - this can damage _______
the axillary nerve and posterior circumflex artery
If the coracoclavicular joint is damaged, the clavicle moves ____
upwards
Antero-inferior dislocation of the glenohumeral joint can damage which nerve?
________ Axillary nerve
Damage to the axillary nerve can lead to paralysis of _____ and _____. And loss of sensation at _____
Paralysis of Teres minor and Deltoid muscle. And loss of sensation at patch of shoulder.
What nerve and artery pass through the quadrangular space?
Axillary nerve and Posterior circumflex artery
What are the border’s of the quadrangular space?
Teres major - superior border
Teres minor - inferior border
medially - the long head of the triceps
Laterally - the surgical neck of the humerus
What are the four rotator cuff muscles?
Supraspinatus, Infraspinatus, Subscapularis, Infraspinatus and Teres Minor
The two most superficial muscles of the shoulder are the ____ and ____
trapezoid and the deltoid
The Trapezius has two points of origin - C1-C7 and T1-T12. The superior origin attaches to the vertebral column through the ______-
ligamentum nuchae
Trapezius muscle functions to ___ , _____ and _____
elevate the shoulders (shrug), rotate scapula and extend to reach superiorly
The Trapezius is innervated by the ____
Accessory nerve
The deltoid acts to abduct the arm beyond ______
the initial 15 degrees of the supraspinatus
The Levator Scapulae (deep to the trapezius ) acts to elevate the scapula. It is innervated by ______
Dorsal Scapular nerve
The Rhomboid Minor/Major are innervated by which nerve?
Dorsal Scapular nerve
Damage to the Dorsal Scapular (C4/C5) nerve leads to ______
Winged scapula
The supraspinatus initiates ______
abduction to 15 degrees
The infraspinatus laterally rotates the ________
Humerus
The infraspinatus and spuraspinatus are both innervated by _______
Suprascapular nerve
The Teres minor acts to ________
Laterally rotate the humerus
The teres Major acts to medially rotate and ________ the humerus
Extend the humerus
The teres Major is supplied by the ________
Scapular nerve
The long head of the triceps brachii originates from the infraglenoid tubercle and inserts into the ______
Olecranon
The Suprascapular foramen is formed by the suprascapular notch and the superior transverse scapular ligament - which nerve passes through this space?
Suprascapular nerve
The Triangular interval acts as a passageway between the anterior and posterior compartment of the arm. Which artery and nerve pass through it?
The Radial nerve and Profunda brachii artery
What are the borders of the triangular interval?
Superiorly the teres minor,
laterally the long head of triceps
medially either the humerus or lateral head of triceps (controversial)
If there is sensory loss over the anterior thigh which nerve root is compressed?
L3
If there is sensory loss on the anterior aspect of knee which nerve root is compressed?
L4
if there is sensory loss of dorsum of foot which nerve root is compressed?
L5
If there is sensory loss of posterolateral aspect of leg and lateral aspect of foot which nerve root is compressed?
S1
Sensory innervation to the lateral part of the forearm is by _________ nerve
Musculocutaneous nerve
The musculocutaneous nerve is responsible for __________ and ______
Elbow flexion and supination
Shoulder abduction (deltoid muscle) is supplied by ______
Axillary nerve
Humeral midshaft fracture can damage ______ nerve
Radial
Radial nerve palsy results in …
Wrist drop
Paralysis of thenar muscles and opponens pollicis is due to damage to ______ nerve
median
Loss of pronation of the forearm and weak wrist flexion is due to damage to ______ nerve
Median
Medial epicondyle fracture can damage _____ nerve
Ulnar nerve
Damage to the ulnar nerve can lead to _____ hand
Claw hand
Damage to this nerve results in winged scapula
Long thoracic nerve.
This nerve is injured during sport e.g. following a blow to the ribs. Also possible complication of mastectomy
Long thoracic nerve
Which nerve supplied the Serratus Anterior
Long Thoracic nerve
Erb-Duchenne palsy (Waiter’s tip) is due to damage to ________ trunk of the brachial plexus (C_, C_)
Damage to upper trunk of the brachial plexus (C5, C6)
Which palsy? Arm hangs by the side and is internally rotated with elbow extended
Erb Duchenne Palsy
Klumpke injury is damage to the ______ trunk of the brachial plexus (C_, T_)
Lower trunk of the brachial plexus (C8, T1)
Klumple Injury is commonly associated with ____ syndrome
Horner syndrome
What are the two common nerve injuries associated with Shoulder dystocia?
Klumpke injury and Erb-Duchenne Palsy
The LOAF muscles are affected by Carpel tunnel syndrome (Median nerve palsy) - what are they?
Lateral two lumbricals
Opponens pollis
Abductor pollis brevis
Flexor Pollis brevis
What passes through the triangular interval?
The radial nerve and profunda brachii artery
Quadrangular space syndrome occurs when hypertrophy of the muscle edges of the space impenge on the _____ nerve and lead to weakness of ___ muscle and atrophy of the _______ muscles
Axillary nerve –> weakness of deltoid muscle and atrophy of the teres minor muscle.
Winged scapula happens due to damage to the _______ nerve
Long thoracic nerve
Forearm is flexed by the ______ nerve as it supplies the_________ muscle
Musculocutaneous nerve supplies the biceps brachii muscle
Which nerve pierces and innervates the coracobrachialis muscle?
The musculocutaneous nerve
The axillary artery is divided into three parts by the Pec minor. The first part has one branch which is _____
Superior thoracic artery
The lateral thoracic and thoraco-acromal artery arise as branches from the _____part of the axillary artery and supply the ______
Second part - and supply the breast
The typical site for venous access is the ___________ of the anatomical snuffbox or the antecubital veins the _______
Cephalic vein in the snuffbox or the antecubital veins in the cubital fossa
A rapid decelleration injury can damage the upper thoracic region and cause fracture of the first rib –> this may compromise blood supply to the distal part of the ______ or the first part of the _____. However due to anastamosis the arm is rarely ischaemic.
Distal subclavian artery or first part of the axillary artery
Anterior dislocation of the humeral head may compromise _________ artery resulting in vessel occlusion. ________ may also be damaged.
Axillary artery and brachial plexus may also be damaged.
The Dorsal scapular nerve arises from the ____ root and pierces the ______ muscle to innervate the rhomboid major/minor
C5 root and pierces the scalene muscle to innervate the rhomboid major/minor
The long thoracic nerve originates from C_ to C_ and passes vertically down the neck of the humerus to supply the _______
C5 to C7 and supplies the Serratus anterior
The radial nerve innervates all muscles of the ________ compartment of the arm and forearm
Posterior
The biceps brachii reflex tests nerve root C_ and _____ nerve
C6 and musculocutaenous nerve
The three insertions of the triceps form the tendon and insert into the _____
Olecranon
Biceps brachii test for reflex __
C7
Shaft of the humerus fracture leads to damage to _____ nerve and may cause ___
Damage to Radial nerve and may cause wrist drop
Supracondylar fracture of the humerus can damage which artery?
Brachial artery
Increased pressure in the anterior compartment of the forearm can damage the brachial artery and prevent blood flow tot he deep flexors. This can cause muscle scarring and lead to _________ with flexion deformity of wrists ad fingers
Volkmann’s contracture
The snuffbox is crossed by which artery?
Radial artery
Small muscles of the hand are supplied by __ root
T1
Ulnar nerve palsy results in _____
Claw hand
With an Ulnar nerve lesion the thumb is unable to _____ and hence you get ______ signs – failure to do the paper grasping test
The thumb is unable to adduct and hence you get Froment’s sign
The neck of the femur is mainly supplied by the ______ artery
Medial circumflex artery
In cerebral disease there is an _____ drift and there is slow ____ of the wrist and elbow
Upward drift and slow pronation of the wrist and elbow
A downward drift of the arms may indicate ____ weakness
UMN weakness
A drift with “searching movements” is generally because of loss of _____-
Proprioception
5 causes of fasciculation’s?
Motor neuron disease Motor root compression Peripheral neuropathy Primary myopathy Thyrotoxicosis
Shoulder abduction is done by ____ and ____ muscle with nerve roots (____ and ___ )
Deltoid and supraspinatus muscles. Nerve roots C5 and C6
Shoulder adduction is done by ____ and ____ muscle with nerve roots (____ and ___ )
Pectoral major and latissmus dorsi. Nerve roots C6, C7, C8
Elbow flexion is done by ____ and ____ muscle with nerve roots (____ and ___ )
Biceps and brachialis. Nerve roots C5, C6
Elbow extension is done by _______muscle with nerve roots (____ and ___ )
Triceps brachii - C7, C8
Wrist flexion is done by ____ and ____ muscle with nerve roots (____ and ___ )
Flexor carpi ulnaris and radialis - C6, C7
Wrist extension is done by extensor group muscles with nerve roots (____ and ___ )
nerve root C7 C8
Abduction of fingers is tested by ______ ____ - nerve roots
Abduction of fingers - Dorsal Interossei - C8, T1
Adduction of fingers is tested by ______ ____ - nerve roots
Adduction - Volar Interossei - C8 T1
Brachioradialis Jerk tests - nerve root
C5, C6
The radial nerve is innervated by nerve roots C_ to C_
C5 to C8
Test for radial nerve sensation over ____
Anatomical snuffbox
Median nerve is innervated by nerve roots C_ to T1
C6 to T1
The pen touching test may help determine weakness of ______ which occurs in ____ compression
Adductor Pollicus Brevis in ulnar nerve compression - frogment’s sign
A median nerve lesion in the cubittal fossa can be demonstrated by _______ test
Oschner clasping test
Oschner clasping test is done to test for median nerve and it can indicate loss of ______ which muscle?
Flexor digitorum Sublimis
The palm is or not spared in the median nerve lesions in carpel tunnel syndrome?
Spared!
Do more distal/proximal nerve lesions of the ulnar nerve cause greater deformity (claw hand)?
Distal causes greater claw hand! Paradoxical!
The upper trunk of the brachial plexus supplies muscles in the _____
Shoulder!
The middle trunk of the brachial plexus supplies muscles in the ____ and _____
Triceps and some forearm!
The lower trunk of brachial plexus supplies muscles in ______ and ____
Hands and some forearm!
The Lateral cord leads to formation of _______________ and ________
Musculocutanous nerve and median nerve
The medial cord leads to formation of ____ and ___-
Median nerve and ulnar nerve
The posterior cord leads to formation of ______ and ____
Axillary and radial.
5 Clinical features of cervical rib syndrome?
Weakness and wasting of the small muscles of the hand (claw hand) C8 and T1 sensory loss Unequal radial pulses and BP Subclavian bruits on arm manoevering Palpable cervical rib in the neck
The pelvis is made up of which three bones?
Ischium, Ilium and pubis
The neck of the femur is mainly supplied by which artery? and where does this artery come off from?
Supplied by the medial circumflex artery which comes off the external iliac
__________ fractures of the femur are most likely to lead to avascular necrosis
Intracapsular
The greater sciatic foramen is divided by the ______
piriformis
External and lateral rotation of the hip is done by _____
gluteal maximus
The inferior gluteal nerve (S1,S2) supplies _____ muscle
Gluteal maximus
The piriformis, obturator internus, superior and inferior gemelli and quadratus femoris all act as ______ of the thigh
Lateral rotators of the thigh
The superior gluteal nerve (L4, L5, S1) supplies ______ muscle
Gluteal minimus and gluteal medius
Above the piriformis ( in the greater sciatic foramen) runs the _______ artery and ____ nerve
Superior gluteal artery and nerve
The: Inferior gluteal vessels and nerves The internal pudenal vessels and nerve and sciatic nerve run \_\_\_\_\_ the piriformis in the greater sciatic foramen
Below the piriformis
The obturator artery, obturator vein and obturator nerve run through _____ canal
Obturator
The three borders of the femoral triangle are:
- Inguinal ligament
- Sartorius
- Adductor longus
The inguinal line is from the _____ to the ASIS
Pubic symphysis to ASIS
The inguinal ligament is from the ASIS to ______
ASIS to pubic tubercle
Which is more lateral - the femoral nerve or artery?
Nerve
Match the femoral artery and femoral nerve to their respective locations:
- Midpoint of inguinal ligament
- Mid-inguinal point (Mid point of inguinal line)
- Midpoint of inguinal ligament: femoral nerve
- Midpoint of inguinal line: Femoral artery
The adductor canal is an aponeurotic tunnel in the middle of the thigh extending from the _________ to the opening of the ___________
The adductor canal is an aponeurotic tunnel in the middle of the thigh extending from the femoral triangle to the opening of the adductor magnus
The adductor canal contains…
Femoral artery and femoral vein
Saphenous nerve
Nerve to vastus medialis
Which artery supplies the thigh/femur?
Profundii femoris artery
The hamistrings are which four muscles?
Biceps femoris (long and short head (not often considered), semimebranous and semitendonous
The hamstrings are innervated by division of which nerve?
Sciatic nerve
The four adductors of the thigh are:
The pectineus, adductor longus, adductor brevis and adductor gracilis
The adductors of the thigh (The pectineus, adductor longus, adductor brevis and adductor gracilis) are innervated by _____ nerve
obturator nerve
The pelvis is made up of which three bones?
Ischium, Ilium and pubis
The neck of the femur is mainly supplied by which artery? and where does this artery come off from?
Supplied by the medial circumflex artery which comes off the external iliac
__________ fractures of the femur are most likely to lead to avascular necrosis
Intracapsular
The greater sciatic foramen is divided by the ______
piriformis
External and lateral rotation of the hip is done by _____
gluteal maximus
The inferior gluteal nerve (S1,S2) supplies _____ muscle
Gluteal maximus
The piriformis, obturator internus, superior and inferior gemelli and quadratus femoris all act as ______ of the thigh
Lateral rotators of the thigh
The superior gluteal nerve (L4, L5, S1) supplies ______ muscle
Gluteal minimus and gluteal medius
Above the piriformis ( in the greater sciatic foramen) runs the _______ artery and ____ nerve
Superior gluteal artery and nerve
The: Inferior gluteal vessels and nerves The internal pudenal vessels and nerve and sciatic nerve run \_\_\_\_\_ the piriformis in the greater sciatic foramen
Below the piriformis
The obturator artery, obturator vein and obturator nerve run through _____ canal
Obturator
The three borders of the femoral triangle are:
- Inguinal ligament
- Sartorius
- Adductor longus
The inguinal line is from the _____ to the ASIS
Pubic symphysis to ASIS
The inguinal ligament is from the ASIS to ______
ASIS to pubic tubercle
Which is more lateral - the femoral nerve or artery?
Nerve
Match the femoral artery and femoral nerve to their respective locations:
- Midpoint of inguinal ligament
- Mid-inguinal point (Mid point of inguinal line)
- Midpoint of inguinal ligament: femoral nerve
- Midpoint of inguinal line: Femoral artery
The adductor canal is an aponeurotic tunnel in the middle of the thigh extending from the _________ to the opening of the ___________
The adductor canal is an aponeurotic tunnel in the middle of the thigh extending from the femoral triangle to the opening of the adductor magnus
The adductor canal contains…
Femoral artery and femoral vein
Saphenous nerve
Nerve to vastus medialis
Which artery supplies the thigh/femur?
Profundii femoris artery
The hamistrings are which four muscles?
Biceps femoris (long and short head (not often considered), semimebranous and semitendonous
The hamstrings are innervated by division of which nerve?
Sciatic nerve
The four adductors of the thigh are:
The pectineus, adductor longus, adductor brevis and adductor gracilis
The adductors of the thigh (The pectineus, adductor longus, adductor brevis and adductor gracilis) are innervated by _____ nerve
obturator nerve
The femoral nerve supplies the anterior thigh and is hence repsonsible for ______ of the knee and ____ of the hip
Extension of the knee and flexion of the hip
The anterior thigh muscles are iliopsoas, sartorius and the four quadricep muscles which are
rectus femoris, (lateral + medial + intermedius) Vastalis
The quadriceps are supplied by the _____ division of the femoral nerve
Posterior division
The muscles of the anterior leg are supplied by _______ nerve and they ____ the foot
The common peroneal nerve and they dorsiflex the foot
The pulsation of the __________ artery is often palpable between malleoli and lateral to the extensor hallicus longus
Anterior tibial artery
The fibularis longus and the brevis muscle are supplied by the _________ nerve and they _____ the foot
Superficial fibular nerve and they evert the foot
The two branches of the common peroneal nerve are:
The deep fibular nerve and the superficial fibular nerve
The two posterior muscles of the lower leg are the _____ and ____ and they act to ____ the foot
gastrocnemius and soleus and they act to plantar flex the foot.
The tendons of the gastrocnemius and soleus combine to form the _____ tendon (Achille’s tendon)
Calcaneal
The ________ artery is the longest division of the _______ artery and can be pulsated between the medial malleolus and the calcaneal tendon
Posterior tibial artery - longest division of popliteal artery
The most frequent type of clubfoot is talipes equinovarus - a deformity where the foot is …
Plantarflexed, supinated (inverted) and adducted
The three compartments of the thigh are:
- Posterior
- Medial for adductor
- Anterior.
What are their respective nerve supplies?
- Posterior: sciatic nerve
- medial: obturator
- Anterior: Femoral nerve
Neck of femoral hernia found _____ to pubic tubercle
infrolateral
The knee jerk checks which muscle group and reflex?
The quads - L3,L4
The saphenous nerve extends to supply the skin above the ______
Medial malleolus
The deep fibular nerve is accompanied by the
Anterior tibial artery
The tibial nerve is accompanied by the
Posterior tibial artery
The fibularis longus and brevis are _____ of the foot
Exverters
Exverter - extensor digitorum longus
Ankle jerk tests which nerve and nerve root?
Tibial nerve (extension of sciatic nerve) and nerve root S1
Damage to the tibial nerve causes loss of sensation over the
Sole of the foot
A positive babinski sign is indicative of ____ lesion
UMN lesions
Knock knee is valgus or varus?
VALGA
The ______ nerve is around the fibula and is liable to injury
Common fibular (peroneal) nerve
Unhappy triad of _________
ACL, MCL and Medial Meniscus
Damage to medial or lateral meniscus more common?
Medial
Injections should go in which region of the buttock to avoid which nerve?
In the superolateral region to avoid the sciatic nerve
Trendelenburg test - tests for which nerve?
The Superior gluteal nerves on the standing limb.
Sciatic nerve supplies which muscles?
None in the pelvis, posterior thigh and all of leg
In vaLgus the distal bone goes _____
LATERAL
Referred pain from the heart is through which nerve?
Phrenic nerve
The coronary sinus drains in though the _________ angle of the right atrium
Infero-medial
Mean Arterial pressure =
(1/3 x Pulse Pressure) + Diastolic pressure.
Pulse pressure = Systolic pressure - diastolic pressure
Digoxin can not be used when which electrolyte disturbance?
Hypokalaemia
Alpha 1 Adrenoceptors are found where and do what?
They are found on smooth muscles and if activated cause vasoconstriction, sphincter constriction and mydriasis (Dilation)
Which beta receptor is found in the bronchioles?
Beta 2 - if activated causes constriction.
Out of the 12 - how many true ribs
7
In the intercostal space the neurovascular bundle lies close to the underside of the ribs - in what order do the nerve, vein and artery lie?
And hence which is most easily prone to damage?
They lie in order:
Nerve, artery and then vein (closest to rib)
Hence nerve is least protected.
IVC passes through the diaphragm at which level?
T8
Oesophagus passes through the diaphragm at which level?
T10 - alongside Vagus nerve
Aorta passes through the diaphragm at which level?
T12
The diaphragm is supplied by which nerve?
Phrenic nerve
Which part of the duodenum is the only part that is mobile with mesentery?
First part
The sympathetic nerve supply to the midgut is through which nerves?
Lesser Splanic nerve
The PARAsympathetic nerve supply to the midgut is through which nerves?
Posterior Vagal trunk
The lumbar and Pelvic Splanic nerves provide the Para/Sympathetic supply to Hind gut. Which corresponds to which?
Para - Pelvic Splanic nerve
Symp - Lumbar Splanic nerves
