Anatomy Flashcards
The diencephalon is compromised of which structures?
Thalamus + hypothalamus
The diencephalon forms the central core of where?
Cerebrum
Label the attached brain structures
A = Mid-brain
B = Pons
C = Medulla oblongata
The hypothalamus is connected to the pituitary via which structure?
Infundibulium
Label the structures in this saggtal section of the brain
A = Hypothalamus
B = Pituitary Gland
C = Infundibulum
The pituitary fossa lies within which anatomical space?
The sella turcica
The pituitary gland lies immediately inferior / posterior / superior / medial / lateral to the optic chiasm?
Posterior (gland is “just behind” the chiasm)
In bitemporal hemanopia, which ocular vision is lost?
Nasal retina vision
In bitemporal hemanopia, which visual field is lost?
Both temporal fields
The pituitary gland can be surgically accessed via which 2 approaches?
1) Transsphenoidal (via nasal cavity & sphenoid sinus)
2) Transcranial (under the frontal bone)
Label the structures
A = Oral cavity
B = Hard palate
C = Vomer
D = Cribiform plate of ethmoid bone
E = Perpindicular plate of ethmoid bone
Which side of the head is this saggital section facing? Label the structures
Side = lateral wall
A = optic chiasm
B = pituitary gland
C = left superior concha
D = left middle concha
E = left inferior concha
List the paranasal sinuses (4)
1) Maxillary
2) Ethmoidal
3) Sphenoidal
4) Frontal
The sinuses are lined by which type of mucosa?
Respirstory
The transsphenoidal / trans-nasal approach to the pituitary requires fracture of which bones?
Nasal septum, floor/roof of sphenoidal sinuses
Grade these LeFort fractures
A = LeFort 1
B = LeFort 2
C = LeFort 3
Which LeFort fracture can be used in trans-sphenoidal approach to pituitary?
LeFort I
Label these cranial nerves & associated structure (you can do it)
A = CN I
B = CN II
C = CN III
D = CN IV
E = CN V (V1, V2 and V3)
F = CN VI
G = CN VII
H = CN VIII
I = CN IX
J = CN X
K = CN XI
L = CN XII
M = Optic chiasm
The cranial cavity is lined internally with which layer of meninges?
Dura mater
What’s the term for the sheet of dura mater which rests over the cerebellum?
Tentorium cerebelli
What’s the term for the tough sheet of dura mater lying over the pituitary fossa?
Diaphragm sellae
Which sinuses drain most of the blood in the brain? Where do they drain to?
The dural venous sinuses (within the dura) & they drain to the internal jugular veins
Which sinus connects the left and right cavernous sinuses in the brain?
The anterior intercavernous sinus
Label the structures of the pituitary and relations. Which plane is this section in?
A = Pituitary gland lying inferior to the diaghragm sellae
B = Left and right cavernous sinuses
C = Right internal carotid arteries
Plane = frontal
Label the structures in the lateral view of the right cavernous sinus
A = CN III
B = CN IV
C = CN VI
D = CN V
E = Carotid canal in the right temporal bone
F = Right cavernous sinus
G = Pituitary gland
Supply of orbit (opthalmic artery) is a branch of…
Internal carotid artery
The thyroid isthmus is always present, T/F?
False - variation
Describe the arterial blood supply to the thyroid? What are they branches of?
Superior and inferior thyroid artery - branches of the external carotid artery
What’s the “additional” thyroid artery which isn’t always present?
Artery of Ima
List the veins of the thyroid & where do they drain?
Superior and middle (drain into internal jugular) and inferior (drains into braciocephalic veins)
The posterio-medial aspect of the thyroid gland is attached to the thyroid via which ligament?
Berry ligament
List the structures
A = Follicle
B = Follicular cells
C = Colloid (tyrosine containing thyroglobulin)
D = Parafollicular cells (secrete calcitonin)
Iodine is extracted from the blood to the follicular cells across the basolateral / apical membrane?
Basolateral
Which hormone is responsible for production of thyroid hormones?
TPO
Why are vesicles / digestive enzymes required in thyroid hormone synthesis?
They digest the larger precursor hormone to give fT4 and fT3
List the steps of thyroid hormone synthesis (5)
1) Iodine extracted from blood into follicular cell across basolateral membrane
2) Iodine is transorted to colloid reservoir across apical membrane where it can combine with thyroglobulin to make thyroid hormones (via TPO)
3) Colloid undergoes pinocytosis into follicular cells
4) Lyososomes bind to the vesicles and digest the large precusor into T4/T3
5) FT3/FT4 can be released into blood
How do carbimazole and PTU function?
They inhibit fusion of iodine to thyroglobulin tyrosine reisudes, reducing the production of NEW thyroid hormone
What is the more common thyroid hormone?
T4 (90%)
How much more potent is T3 than T4?
10x
Where are the major sites of T4-> T3 conversion?
Liver and kidney
List the 3 major carrier proteins for thyroid hormones
1) Thyroxine binding globulin (70%)
2) Transtheyretin (20%)
3) Albumin (around 5-10%)
Is T3 bound by TTR?
No.
Does TBG bind T3?
Yes, but with 10-20x less affinity than for T4
What effect does tamoxifen have on TBG levels?
Increased
A pyramidal lobe is present in around what % of patients?
44%
The thyroid gland begins development where?
Between the anterior 2/3rds and posterior 1/3rd of tongue (foramen caecum in adults)
The thyroid gland migrates through what?
Thyroglossal duct
The thyroid gland reaches its final position by which week of gestation?
7th
The thyroid gland is present around which vertebral level?
C7
The platysma muscles are innervated by which nerve?
CN VII
Platsyma muscles are part of what group?
“Muscles of facial expression”
Name the fascia types in:
- Purple
- Red
- Green
- Orange
Purple = pretracheal fascia
Red = carotid sheath
Green = investing fascia
Orange = Prevertebral (deep) fascia
The trachea and oesphagus are located within which layer of fascia?
Pre-tracheal
What are contained within the carotid sheaths? (4)
1) Vagus nerve
2) Deep lymph nodes (cervical)
3) Carotid arteries
4) Internal jugular veins
The cervical vertebrae are located within which fascia in the neck?
Prevertebral (deep) fascia
List the structures
A = CN XI (spinal nerve) - supplying SCM & trapezius
B = External jugular vein (within superficial fascia)
C = Anterior jugular vein (drains into external jugular)
D = Sternal head of SCM (manubrium)
E = Clavicular head of SCM (mastoid of temporal bone to clavicle)
F = Trapezius (descending, attaches to spine of scapula to clavicle laterally)
The carotid sheath enters the skull via the…
Jugular foramen
Which nerve runs between the internal jugular & carotid artery?
Vagus
List the arteries
A = Superior thyroid artery
B = External carotid
C = Left common carotid
D = Arch of aorta
E = Inferior Thyroid Artery
F = Subclavian artery
The superior thyroid artery is a branch of which artery?
External carotid
The thyroid drains to which nodes?
Superior deep cervical nodes and the inferior deep cervical lymph nodes - NB also tracheal nodes
Lymph collected from the left side of body returns where
Thoracic duct and then to left venous angle
The vagus nerve passes posterior / anterior to lung hilum?
Posterior (c.f. phrenic which is anterior)
The left vagus nerve hooks under where to become the recurrent laryngeal?
Arch of aorta
The right vagus nerve loops under what to become the recurrent laryngeal?
Right subclavian artery
The subclavian artery and arch of the aorta originate from which structure in the embryo?
4th aortic arch
What are the strap muscles (4)
1) Sternohyoid
2) Omohyoid
3) Sternohyoid
4) Thyrohyoid
List the strap muscles & associated structure
A = Hyoid bone
B = Thyrohyoid
C = Sternothyroid
D = Sternohyoid
E = Omohyoid (superior & inferior belly)
Which lines are used to reduce scarring in thyroid surgery?
Langer’s Lines
Detail the structures shown
A = Right anterior triangle of neck
B = Right posterior triangle of neck
C = Sternal head of SCM
D = Clavicle head of SCM
E = Right external jugular vein
F = Trapezius
Which CNs can be compressed in pituitary tumours?
3, 4, 6
What plane is this MRI in? Identify the structures
Sagittal section.
A = Sella
B = Stalk
C = Sphenoid sinus
Identify the structures
A = Hypothalamus
B = Carotids
C = Chiasm
Which visual field crosses over at the optic chiasm?
Temporal vision (on nasal retina, nasal crosses over)
List the structures
A = strap muscles
B = Internal jugular veins
C = Trachea
D = Common carotids
Can the thyroid be imaged with contrast?
No, it will naturally store iodine
This scintigraphy shows what?
Graves Disease
List the structures shown
A = IVC
B = Aorta
C = Medial branch of adrenal gland
D = Lateral branch of adrenal gland
What’s the diagnosis from this X-ray?
Paget’s Disease (multiple sclerotic and lytic areas where the bone has been destroyed and replaced hastily)
