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anatomy Flashcards

1
Q

Major Branches of Coeliac trunk

A

1) Left Gastric
2) Splenic
3) Common Hepatic

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2
Q

Left Gastric artery course

A

Smallest of the three branches
Ascends across the diaphragm, giving rise to Oesophageal branches.
Then continue anteriorly along the lesser curve of the stomach and then travels backwards and anteriorly to anastomoses with Right Gastric Artery

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3
Q

Splenic Artery Course

A

Arises inferior to LGA.
Travels left towards spleen, running posterior to the stomach and along the superior margin of the pancreas contained in splenorenal ligament. Splits into 5 branches which support segments of the spleen.
1) Left gastroepiploic - supplies greater curvature of the stomach and greater omental parts Anastomoses with right gastroepiploic artery
2) Short gastrics - fundus of stomach
3) Pancreatic branches for body and tail

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4
Q

Common Hepatic Artery course

A 
Travels right superior to duodenum 
Two terminal branches 
1) Proper Hepatic 
- Left and Right hepatic
- Cystic artery off right hepatic
2) Gatroduodenal 
- Right gastroepiploic artery - anastomoses with left
- Superior pancreaticoduodenal (supplies head of pancreas and duodenal) (anterior AND posterior branches present) - anastomoses with inferior pancreaticoduodenal (off SMA)
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5
Q

First Branch of SMA

A

Inferior pancreaticoduodenal artery - inferior head of the pancreas, uncinate process and duodenum

Anastamoses with superior pancreaticoduodenal

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6
Q

SMA gives jejunal and ileal artery supply, what is the difference

A

The jejunal blood supply is characterised by a smaller number of arterial arcades, but longer vasa recta. In contrast, the ileal blood supply is marked by more arterial arcades with shorter vasa recta.

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7
Q

Branches of SMA

comes of L1

A

1) Inferior pancreaticoduodenal branch
Right: 1) Right (Ascening colon) colic, 2) Ileocolic (appendicular) 3)Middle colic (transverse)
Left: Jejunal, ileal,

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8
Q

Branches of Ileocolic

A 
Superior branch (ascending colon and anastomoses with Mid colic) 
Inferior branch (1. Ileal branch, caecal branch, appendicular branch, Colic)
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9
Q

Branches of Right colic

A 
Supplies Asceding colon
Ascending branch (anastomoses with middle colic artery) 
Descending branch (anastomoses with superior ileocolic artery)
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10
Q

Middle colic artery supplies…

A

Proximal 2/3 of Transverse colon

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11
Q

Middle colic artery course

A

Contained within transverse mesocolon ( intraperitoneal

Splits into left and right

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12
Q

Inferior Mesenteric Artery origin and supply

A

L3 level towards left

Vasculises hindgut

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13
Q

Branches of IMA

A

Left Colic
Sigmoid arteries
Superior rectal

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14
Q

Left Colic branches

A

Left colic artery is first branch of IMA - supplies 1/3 of the transverse colon and descending colon.
Travels anterior to psoas major left ureter and left internal spermatic vessels before deviding to ascending and descending
1) Ascending branch
- Crosses left kidney anteriorly, before entering the mesentary of the transverse collon and upper aspect of descending colon
2) Descending branch - moves inferiorly to supply the lower part of the descending colon. Anastamoses with superior sigmoid artery superior sigmoid artery.

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15
Q

Superior rectal artery

A

It descends into the pelvis, crossing the left common iliac artery and vein, bifurcates at S3 level

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16
Q

Superior Gluteal Nerve Roots and course

A

L4, L5, S1.
The superior gluteal nerve leaves the pelvis via the greater sciatic foramen, entering the gluteal region superiorly to the piriformis muscle. Accompanied by SGA and SGV

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17
Q

What are the functions of SGN

A

Sensory - None

Motor - Gluteus Minimus, G.Medius, TFL

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18
Q

Inferior Gluteal Nerve Roots and course

A

L5, S1, S2

leaves the pelvis via the greater sciatic foramen, entering the gluteal region inferiorly to the piriformis muscle.

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19
Q

What are the functions of IGN

A

Motor Functions: Innervates gluteus maximus.

Sensory Functions: None

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20
Q

Sciatic Nerve Roots and course

A

L4-S3
It emerges inferiorly to the piriformis muscle and descends in an inferolateral direction. nerve moves through the gluteal region, it crosses the posterior surface of the superior gemellus, obturator internus, inferior gemellus and quadratus femoris muscles. It then enters the posterior thigh by passing deep to the long head of the biceps femoris.
Within the posterior thigh, the nerve gives rise to branches to the hamstring muscles and adductor magnus. When the sciatic nerve reaches the apex of the popliteal fossa, it terminates by bifurcating into the tibial and common fibular nerves.

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21
Q

Contents of carotid triangle

A 
Common Carotid
External and internal carotid
Internal Jugular Vein
Vagus 
Hypoglossal
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22
Q

Cervical Superfical Fascia

A

Includes Platysma and runs over SCM

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23
Q

Cervical Deep fascial Layer

- Investing

A

Investing deep fascial layer contains SCM and Trapezius muscles

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24
Q

Carotid sheath contents

A

1) Common carotid
2) Internal Carotid
3) Vagus
4) Cervical lymph nodes

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25
Q

Prevertebral fascia

A

Prevertebral encloses the vertebral neck region (including vertebra, spinal cord and assicated muscles)

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26
Q

5 Causes of Thoracic Outlet Syndrome

A

1) Cervical Ribs
2) Scalene muscle hypertrophy
3) Anomalous muscles
4) Fibrous bands
5) Pancoast tumour

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27
Q

Symptoms of TO syndrome

A

1) Numbness and pain along medial arm, forearm and 4th 5th digits (brachial plexus compression)
2) Muscle weakness in the hand
3) Swelling of arm
4) Pallor and coldness

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28
Q

8 branches of External Carotid artery

A

“Some Anatomists Like Freaking Out Poor Medical Students”

1) Superficial Thyroid Artery
2) Acsending Pharyngeal
3) Lingual Artery
4) Facial Artery
5) Occipital Artery
6) Posterior Auricular
7) Maxillary
8) Superfical Temporal

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29
Q

Which CNs pass through Superior Orbital Fissure?

A

CN 3,4, V1, 6 (occulomotor, trochlear, opthal of trigeminal, Abducens)

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30
Q

Which CNs pass through Foramen Rotundum

A

V2 (Maxillary)

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31
Q

Which CNs pass through Foramen Ovale

A

V3 (Mandibular)

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32
Q

Which Structures pass through Foramen Lacerum

A

Deep petrosal nerve

Meningeal artery branches

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33
Q

Which Structures pass through Foramen Spinosum

A

Middle meningeal Artery

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34
Q

Which CNs pass through Internal Acoustic Meatus

A

CN 7, 8 (FACIAL AND VERSTIBULOCOCHOLEAR)

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35
Q

Which CNs pass through Jugular foramen

A

CN IX, X and XI

Glossopharyngeal, vagus and accessory

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36
Q

Which CNs pass Hypoglossal Canal

A

Hypoglossal

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37
Q

Which Structures pass through Foramen Magnum

A

CN XI (accessory)m vertebral and anterior and posterior spinal arteries, and medulla oblongata/spinal cord

38
Q

What is Le Fort 1 fracture

A

Fracture superior to the maxillary alveolar process
Spans body of nasal septum
May involve pytergoid plates

39
Q

What is Le Fort 2 fracture

A

Posterolateral parts of maxillary sinuses
Infraorbital foramina
Lacrimal or ethmoid bones

40
Q

What is Le Fort 3 Fracture

A 
Most superior type.
Horizontal upper mid face
Passes through SOFs
Ethmoid and nasal bones
Greater wings of sphenoid 
Frontozygomatic suture line involvement
41
Q

Describe the course of Sciatic nerve

A

2cm wide, largest nerve in the body.
L4-S3
Travels from the pelvis in to pelvis via greater sciatic notch.
Travels inferior to piriformis
Enters posterior thigh passing deep to long head of biceps.
Bifurcates at the apex of the popliteal fossa at apex to tibial and common fibular

42
Q

Alcock canal syndrome? (hint: cyclists)

A 
Pudendal nerve (S2-S4) eNTRAPMENT 
Supplies sensory and somatic fibres to the external genitalia and surrounding skin and urinary and anal sphincters.
43
Q

Describe the course of Pudendal nerve

A

Forms from S2,3,4 and passes inferior aspect of greater sciatic notch, then crosses sacrospinous ligament and re-enters pelvis through the lesser sciatic foramen.
In the pelvis, it accompanies interal pudendal artery and vein, coursing anterosuperiorly through the pudendal canal (Alcock’s canal)

44
Q

Terminal branches of Pudendal?

A

1) Inferior rectal
2) Perineal
3) Dorsal nerve of penis/clitoris

45
Q

What muscles does perineal nerve supply?

A

Bulbospongiousus
Ischiocavernosus
Levator Ani (Iliococcygeus, pubococcegeus, puborectalis)

46
Q

Where does the rectum begin and how does it differ?

A

Rectum begins at level of S3, it is macroscopically disctinct from the colon with an abscence of taenia coli, haustra and omental appendices

47
Q

Arterial Supply to rectum?

A

1) Superior Rectal (IMA)
2) Middle Rectal (I.Iliac)
3) Inferior rectal (Interal pudendal)

48
Q

Venous drainage of rectum?

Think haemorrhoids

A

Superior, middle and inferior rectal veins
Superior veins empty into the portal venous system
Anastomoses between portal and systemic veins in anal canal

49
Q

Sympathetic nervous supply of the rectum?

A

Lumbar Splanchnic

Superior and inferior hypogastric plexuses

50
Q

Parasympathetic supply of rectum?

A

S2-4 via Pelvic splanchinc nerves and inferior hypogastric plexxuses

51
Q

Lympathic drainage of Rectum?

A

Pararectal lymph noodes which drain into the inferior mesenteric nodes
Lower rectum passes directly to internal iliac lympth nodes

52
Q

Blood supply above and below Dentate line?

A 
Above= Superior Rectal artery from IMA
Below = Inferior rectal - from  INTERNAL PUDENDAL
53
Q

Two Cervix regions?

A

1) Endocervix - Simple columnar epithelium
2) Ectocervix - distal part of cervix which starts at the external os and projects to vagina- stratified squamous non-keratinised epithelium

54
Q

Arterial supply of bladder?

A

Superior Vesical branch of internal iliac

55
Q

Venous drainage of bladder?

A

Vesical venous plexus - emplties into internal iliac veins

56
Q

Bladder reflex Arc

A

Bladder fills with urine, bladder walls stretch, sensory nerves detect stretch and transmit this information to the spinal cord.

2) Interneurons within the spinal cord relay the signal to the parasympathteic efferent
3) Pelvic nerve acts to contract the detrusor

57
Q

Reflex bladder level of transection?

A

Transection above T12

  • Afferent signals from the bladder wall are unable to reach the brain, patient will have no awareness of bladder filling, no descending control over external urethral sphincter
  • Functioning spinal reflex, so parasympathetic initiates detrouser contraction in response to stretch
  • pee constantly
58
Q

Flaccid bladder -

A

Transection below T12
Spinal cord transection at this level will damage the parasympathetic outflow
- bladder fills uncontrollably, overflow incontinence

59
Q

DCML Pathway does?

A

Fine touch
Propriception
Fibres decussate in Medulla oblongata

60
Q

Lesion in DCML?

A

Fibres decussate in Medulla oblongata -

Ipsilateral loss of fine touch, vibration and proprioception

61
Q

Anteriolateral tract/ Spinothalamic tract does?

A

Pain, temperature

62
Q

Lesion in Anteriolateral?

A

Fibres decussate in Spinal tracts

Contralateral loss of pain and temperature sensation.

63
Q

Brown Sequard syndrome

A

Brown-Séquard syndrome refers to a hemisection (one sided lesion) of the spinal cord. This is most often due to traumatic injury, and involves both the anterolateral system and the DCML pathway:
DCML pathway – ipsilateral loss of touch, vibration and proprioception.
Anterolateral system – contralateral loss of pain and temperature sensation.

64
Q

Lesion in Spinocerebellar tracts?

A

Spinocerebellar Tracts
Lesions of the spinocerebellar tracts present with an ipsilateral loss of muscle co-ordination.
However, the spinocerebellar pathways are unlikely to be damaged in isolation – there is likely to be additional injury to the descending motor tracts. This will cause muscle weakness or paralysis, and usually masks the loss of muscle co-ordination.

65
Q

Pyramidal tracts

A

These tracts originate in the cerebral cortex, carrying motor fibres to the spinal cord and brain stem. They are responsible for the voluntary control of the musculature of the body and face.

66
Q

Extrapyramidal tracts

A

tracts originate in the brain stem, carrying motor fibres to the spinal cord. They are responsible for the involuntary and automatic control of all musculature, such as muscle tone, balance, posture and locomotion

67
Q

What is the autonomic control of the pupil?

A

Sympathetic fibres originate from T1 and enter sympathetic chain -> Dilation
Parasymp from post ganglionic fibres from the superior cerbical ganglion

68
Q

Blood supply to the bile duct

A

bile duct has an axial blood supply which is derived from the hepatic artery and from retroduodenal branches of the gastroduodenal artery.

69
Q

Axillary nerve?

A

Terminal branch of the posterior cord of the brachial plexus
Root values C5 and C6
Descends posterior to the axillary artery at the lower border of subscapularis and then passes through quadrangular space with the posterior circumflex humeral vessels
Divides into anterior and posterior branches
Innervates deltoid muscle and small patch of skin over deltoid

70
Q

Where is Cavernous sinus located?

A

Lateral aspect of sphenoid body

71
Q

Where does blood drain from and to cavernous sinus?

A

receives blood from the superior and inferior ophthalmic veins, the middle superficial cerebral veins, and from another dural venous sinus; the sphenoparietal sinus.
Drains to IJV

72
Q

Contents of Cavernous sinus

A

Along with the internal carotid artery, the abducens (VI) nerve crosses the sinus. Several nerves are located within the lateral wall of each sinus; Superior to inferior
oculomotor (III), trochlear (IV), ophthalmic (V1) and maxillary (V2) nerves.

73
Q

How is facial vein related to cavernous sinus?

A

facial vein is connected to cavernous sinus via the superior ophthalmic vein. The facial vein is valveless – blood can reverse direction and flow from the facial vein to the cavernous sinus. This provides a potential pathway by which infection of the face can spread to the venous sinuses.

74
Q

Boundaries of Inguinal canal?

A

Floor
External oblique aponeurosis
Inguinal ligament
Lacunar ligament

Roof
Internal oblique
Transversus abdominis

Anterior wall
External oblique aponeurosis

Posterior wall
Transversalis fascia
Conjoint tendon

Laterally
Internal ring
Transversalis fascia
Fibres of internal oblique

Medially
External ring
Conjoint tendon

75
Q

Boundaries of Hasselback Triangle?

A

Lateral - Inferior epigastric artery
Medially- Rectus Abdominis muscle
Base- Inguinal ligament

76
Q

Nerves of lumbar plexus - 6 nerves

A 
I Twice Get Laid on Fridays 
Iliohypogastric
Ilioinguinal 
Genitofemoral
Lateral femoral cutaneous
Obturator
Femoral

All nerves except Gentitofemoral and Obturator emerge lateral to Psoas muscle

77
Q

Roots of Lumbar plexus nerves?

A

“2 from 1, 2 from 2, 2 from 3”
2 (Iliohypogastric, Ilioinguinal) from L1
2 (Lateral fem and genitofemoral) from L1,L2
2 (Obturator and Femoral) from L2,3,4

78
Q

Lymphatic Drainage of Ureters

A

Upper half - para aortic

Lower half- Common iliac

79
Q

Musculocutaneous Nerve?

A

Branch of lateral cord of brachial plexus

Path
It penetrates the coracobrachialis muscle
Passes obliquely between the biceps brachii and the brachialis to the lateral side of the arm
Above the elbow it pierces the deep fascia lateral to the tendon of the biceps brachii
Continues into the forearm as the lateral cutaneous nerve of the forearm

Innervates
Coracobrachialis
Biceps brachii
Brachialis

80
Q

Structures passing through Foramen Ovale?

A 
"OVALE"
Otic Ganglion 
V3 (Mandibular)
Accessory Meningeal artery
Lesser petrosal nerve
Emissary veins
81
Q

Movements of the elbow joint

A

Extension – triceps brachii and anconeus

Flexion – brachialis, biceps brachii, brachioradialis

82
Q

Extensor Compartment 1

A

Most lateral
Extensor policis brevis
Abductor policis longus

These tendons form lateral aspect of anatomical snuffbox

83
Q

Structures passing through the jugular foramen

A 
Glossopharyngeal nerve
Vagus nerve
Spinal accessory nerve
Inferior petrosal sinus
Sigmoid sinus 
Posterior meningeal artery
84
Q

Foramen Magnum

A

Medulla oblongata
Vertebral arteries
Spinal roots of the spinal accessory nerve (CN XI)

85
Q

Internal acoustic meatus

A

Temporal bone structure
Facial nerve
Vestibulocochlear nerve
Labyrinthine artery

86
Q

Carotid canal contents

A

Internal carotid artery and internal carotid nerve plexus

87
Q

Optic canal

A

Optic nerve and opthalmic artery

88
Q

An 18 year old man undergoes a tonsillectomy for attacks of recurrent acute tonsillitis. Whilst in recovery he develops a post operative haemorrhage. Which of the following vessels is the most likely culprit?

A

arterial supply is from the tonsillar artery, a branch of the facial artery.

external palatine vein lies immediately lateral to the tonsil and if damaged may be a cause of reactionary haemorrhage following tonsillectomy.

89
Q

Where is the Cavernous sinus located?

A

The cavernous sinuses are located within the middle cranial fossa, on either side of the sella turcica of the sphenoid bone

90
Q

Borders of Cavernous sinus?

A

Anterior – superior orbital fissure.
Posterior – petrous part of the temporal bone.
Medial – body of the sphenoid bone.
Lateral – meningeal layer of the dura mater running from the roof to the floor of the middle cranial fossa.
Roof – meningeal layer of the dura mater that attaches to the anterior and middle clinoid processes of the sphenoid bone.
Floor – endosteal layer of dura mater that overlies the base of the greater wing of the sphenoid bone.

91
Q

What is special about cavernous sinus?

A

cavernous sinus is the only site in the body where an artery (internal carotid) passes completely through a venous structure. This is thought to allow for heat exchange between the warm arterial blood and cooler venous circulation.

92
Q

Contents of Cavernous sinus

A

Through the sinus
Internal carotid artery
carotid plexus
Abucens (CN 6)

Lateral wall of sinus
CN 3, 4, 5-1, 5-2

MRCS (14 decks)

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