Anatomy Flashcards
Carpals
“So long to pink, here comes the thumb” (proximal then distal)
Scaphoid, lunate, triquetrium, pisiform
hamate, capitate, trapezoid, trapezium
Radial Nerve motor innervation
Motor: "BEST" Triceps brachii (medial and lateral head) - extend forearm
Deep branch of radial n.:
Brachioradialis (flexes forearm, supinates, pronates)
Extensor carpi radialis longus (extends wrist)
Supinator (supinates)
Posterior interosseous n.:
-Extensor digitorum, extensor pollicis longus + other extensors (extend wrist and digits)
Radial n. sensation
posterior arm
dorsal side of hand
Ulnar N motor innervation
Flexor carpi lunaris - flex and adduct wrist
Flexor digitorum profundus - flex and adduct fingers
Hypothenar m. - control hand and 5th digit
3rd and 4th lumbricals - flex at MCP and extend IP joints
Interosseous - abducts and adducts digits
Adductor pollicis - adducts thumb
Ulnar N. sensation
5th digit and half of 4th digit
medial side of palm and dorsal hand
Median N. motor innervation
Thenar ms: Abductor policies brevis, opponents pollicis, flexor pollicis brevis
Pronator teres and protector quadrates - pronate hand
Flexor carpi radialis and palmaris longus - flex forearm
Flexor digitorum superficial and lateral half of flexor digitorum profundus - flex wrist and digits
Flexor pollicis longus - flexes thumb
1st and 2nd lumbricals - flex MCP joints and extend IP joints
Median N. sensation
Lateral palm
First 3/12 digits and dorsal nailbeds
Musculocutaneous motor innervation
coracobrachialis, biceps, brachial - flex and supinate forearm
Musculocutaneous sensation
lateral side of forearm
Axillary motor innervation
deltoid - abducts shoulder
Long head of triceps - extends forearm
Teres minor - externally rotates arm
Axillary sensation
lateral shoulder
Long thoracic motor innervation
serratus anterior - holds scapula to thorax, abduction beyond 90 degrees
Long thoracic sensory innervation
NONE
Femoral n. motor innervation
psoas, iliaques, pectineus, sartorius - hip flexion
vastus lateralis, vastus intermedis, vastus medialis, rectus femoris - knee extension
Femoral n. sensation
anterior thigh
medial lower leg
Obturator n. motor innervation
adductor magnus, adductor longus, adductor brevis - hip adduction
Gracilis - knee flexion
Obturator n. sensation
medial thigh
Superior gluteal n. motor innervation
tensor fascia latae, gluteus medium, gluteus minimus - hip abduction, medial rotation
Superior gluteal n. sensation
NONE
Inferior gluteal n. motor innervation
gluteus maximus - hip extension and lateral rotation
inferior gluteal n. sensation
NONE
Sciatic nerve motor innervation
biceps femoris (tibial branch), semitendinosus, semimembranosus, adductor magnus - hip extension and knee flexion
Sciatic nerve sensation
posterior thighs and gluteal regions
entire lower leg except medial aspect
Tibial n. motor innervation
tibialis posterior - inversion of foot
gastrocnemius, soles, plantaris - plantar flexion
Popliteus - unlocks knee
Flexor hallucis longus, flexor digitorum longus - toe flexion
Tibial n sensation
sole of foot
back of calf - sural n.
tibial –> sural n. –> Medial and lateral plantar n.
Common fibular n. motor innervation
fibrularis longus, fibularis brevis, short head of biceps femoris
Common fibular n. sensation
lateral lower leg
dorsal side of foot
Deep fibular nerve motor innervation
fibularis tertius - foot eversion
Tibialis anterior, extensor hallucis longus, extensor digitorum longus - foot dorsiflexion
Deep fibular nerve sensation
webbing between 1st and 2nd digits
Diagram arteries of the leg
page 102
Merkel nerve endings
myelinated slowly adapting receptors
static pressure, texture, position sense
skin layers - finger tips
hairy skin and hair follicles
look like melanocytes under microscope
Meissner corpuscles
myelinated, rapidly adaptive receptors
light touch, dynamic changes
fingertips just beneath epidermis - superficial
Ruffini endings
slowly adapting receptors
sense skin stretch, position sense - control of finger position and movement
subcutaneous tissue
spindle shaped
Pacinian (lamellar) corpuscles
myelinated, rapidly adapting
Vibration and dynamic pressure
deeper tissues
onion like under microscope
Free nerve endings - Adelta
myelinated - very fast
sharp prickly pain
cold temp
Epidermis
Free nerve endings - Group C nerve fiber
unmyelinated, slow transmission
ANS - post ganglionic fibers
burning/dull pain - neuropathic
warmth
Peripheral nerve layers
Epineurium - outside, dense connective tissue holding blood vessels
Perineurium- surround nerve fascicles
Endoneurium - surrounds individual nerve fibers
Schwann cells
peripheral n. myelination
glia - support neurons
only myelinated one peripheral axon
saltitory conduction
Layers of GI (lumen to outer)
Mucosa
- lamina propria
- muscular mucosa
Submucosa - contains messier plexus
Muscular externa
- circular m.
- Auerbach (myenteric) plexus
- Longitudinal m.
Serosa
Muscle of esophagus
upper 1/3 sk.m.
middle 1/3 sk.m. and sm.m.
Lower 1/3 sm.m.
Structure of spleen
Has a capsule
Red pulp - RBCs
White pulp (darker) - WBCs, lymphocytes dominate
-has central artery
-PALS (periarterial lymphatic sheath) contains T cells
Marginal zone between the white and red pulp contain APCs
Gastrocolic ligament
greater curvature of stomach to transverse colon
Ligaments cut in splenectomy
- gastrosplenic ligament - greater curvature of stomach to spleen
- splenorenal ligament - spleen to posterior abdominal wall and wall of peritoneal cavity
Gastrohepatic ligament
lesser curvature of stomach to liver
cut through to access lesser sac
Contiguous w/ hepatoduodenal ligament
Hepatoduodenal ligament
contains portal triad
- hepatic A.
- common bile duct
- portal v.
can compress to control bleeding during surgery
Falciform ligament
liver to anterior abdominal wall
Retroperitoneal structures
“A DUCK PEAR”
Adrenal glands Duodenum - parts 2-4 Urethers Colon - ascending and descending Kidneys Pancreas - except tail Aorta and IVC Rectum
Proximal to pectinate line
internal hemorrhoids
- no sensation, not painful, can bleed
- tx: outpt banding
Superior rectal A. off IMA
Venous to superior rectal v.
adenocarcinomas
Distal to pectinate line
External hemorrhoids - very paifnul
squamous cell cancer - HPV 16, 18, 31
Inferior rectal A off internal pudendal a.
Venous –> inferior rectal v –> internal pudendal
Somatic innervation
Portal triad
branches of portal v. hepatic a. - flowing away
bile ductule - flowing toward it
Bile path
bile ductule –>. R/L hepatic duct –> common hepatic duct –> cystic duct –> gallbladder –> common bile duct –> ampula of Vater
Structures transversing diaphragm and vertebral levels
“I 8 ten eggs aat 12”
T8: IVC
T10: esophagus, vagus
T12: aorta, azygous v., thoracic duct
Conducting zone of airway
nose pharynx trachea bronchi bronchiole terminal bronchioles
No gas exchange
Anatomical deadspace
filters, warms, humidifies air
Respiratory zone of airway
alveoli
Alveolar ducts
respiratory bronchioles
Right vs left lung
Right:
3 lobes
MC inhaled or aspirated FB
-right mainstem bronchus wider and more vertical
Left:
2 lobes
lingula
Bronchopulmonary segment
broncush
pulmonary a.
bronchial a.
Arteries are center of segment, venous drainage at periphery
10 in right: 3 upper, 2 middle, 5 lower
8-10 in left: 4-5 in each lobe
Segments separated by layer of connective tissue
-each discrete anatomical and functional unit
can be surgically removed w/o affecting function of other segments
Anatomical vs physiological dead space
anatomical: conducting zone - normal
physiologic: anatomic dead space + pathology in respiratory zone causing no gas exchange
Type 1 pneumocytes
simple squamous epithelial cells
97% surface - walls of alveoli
gas exchange
susceptible to toxic insults, unable to replicate
Type 2 pneumocytes
larger, cuboidal
alveolar septal junction
3% of alveolar surface
secrete surfactant: dipalmitoyl phophotidylcholine
- prevents atelectasis
- decrease surface tension
replicate after lung damage - replace or transform to type I
Uterine layers
Perimetrium - serosal layer
Myometrium - muscle layer
Endometrium - lining
Endometrial layers
Inner --> superficial stratum basalis - does not shed Stratum functionalis 1. stratum spongiosum 2. stratum compactum
Proliferative endometrium
glands straight and tubular
stroma dense
estrogen driven
Secretory endometrium
Glands dilated and tortuous -corkscrew shaped
stroma loos and edematous
progesterone driven
Menstrual endometrium
fragmentation of glands
stroma breaking up
Umbilical cord
two umbilical arteries (deoxygenated blood)
one umbilical vein (oxygenated)
surrounded by wharton’s jelly
Layers of heart
Endocardium
Myocardium
Pericardium
Perfused peri to endo
Glomerular blood flow
Renal a -> hilum -> renal cortex -> glomeruli
Afferent a -> glomerular capillaries within bowman’s capsule -> efferent a.
Glomerular filtration barrier
Capillary endothelium – fenestrated
Basement membrane – charged, prevents protein from leaving capillaries
Podocyte foot processes from bowman’s capsule – visceral layer
Collecting duct system and ureters
Distal end of nephron
-> collecting tubules -> medullary pyramids -> renal pelvis -> ureters
Ureters run retroperitoneally
Join bladder at ureterovesicular junction (UVJ) – common site for renal stone obstruction
Ureters pass under uterine A/vas deferens
“Water under the bridge”
JG cell renin secretion
B1-adrenergic stimulation
Low Na+ in distal convulated tubule
Low pressure in afferent arteriole
