Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Part A Boards > Anatomy > Flashcards

Anatomy Flashcards

1
Q

Planes of the body

horizontal/transverse
vertical
sagittal
coronal
median
A

in line with the horizon (aka transverse)

right angle to horizontal

top to bottom - separating L and R

vertical plane - separating back and front

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Types of epithelia: SQAMOUS

2 types? Examples of each

A

squamous

simple: lymphatic and blood vessels, pleura, and peritoneum
stratified: skin, esophagus, lower half of the anal canal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Types of epithelia: CUBOIDAL

Examples in the body

A

Bowman’s capsule, convoluted tubules (kidney), thyroid follicles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Types of epithelia: COLUMNAR

3 types? Examples of each

A

columna

simple: lining of the gastrointestinal tract
stratified: uterine tube
pseudostratified: respiratory tract

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Types of epithelia: TRANSITIONAL

Examples in the body

A

ureter, urinary bladder and most of the urethra

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

The body develops from an embryo which at the end of the Week ___ has 2 layers [bilaminar] and at the
end of the Week ___ of gestation has 3 germinal layers [trilaminar]

A

The body develops from an embryo which at the end of the Week 2 has 2 layers [bilaminar] and at the
end of the Week 3 of gestation has 3 germinal layers [trilaminar]

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Endoderm gives rise to… (3)

A

epithelium of the respiratory, GI and GU tract

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Ectoderm gives rise to (4)

A

o epidermis including hair
o retina and lens
o Central Nervous System, Peripheral Nervous System, pia and arachnoid mater
o adrenal medulla

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Mesoderm gives rise to (4)

A

o bones and muscles of the trunk and extremities
o cardiovascular system and most of the genitourinary system
o cartilage and muscle of the respiratory system
o adrenal cortex, dermis of the skin and dura mater of the spinal cord

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Suboccipital Triangle

Boundaries (3):
Roof (1):
Floor (1):
Contents (3):

All of the muscles forming its boundaries are supplied by the ______ ________ of ___.

A

Suboccipital Triangle

Boundaries: rectus capitis posterior major, obliquus capitis superior, obliquus capitis inferior

Roof: deep fascia covered by semispinalis capitis

Floor: posterior arch of C1 and posterior atlanto-occipital membrane

Contents: 3rd part of vertebral artery, suboccipital nerve [CI] and suboccipital veins

All of the muscles forming its boundaries are supplied by the dorsal ramus of C1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Anterior Cervical Triangle

Boundaries:
Roof:
Floor:
Contents:

A

Anterior Cervical Triangle
 Boundaries: anterior midline, inferior ramus of mandible and anterior border of SCM
 Roof: skin, superficial fascia and investing layer of deep cervical fascia
 Contents: carotid, submandibular, submental and muscular triangles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Carotid Triangle

Boundaries:
Roof:
Floor:
Contents:

A

 Boundaries: SCM, posterior belly of digastric and superior belly of omohyoid
 Roof: skin, subcutaneous fascia and investing layer of deep cervical fascia
 Floor: hyoglossus, middle and inferior constrictor muscles
 Contents: CN XI, XII and the carotid sheath containing common carotid artery, external carotid
artery, internal carotid artery, internal jugular vein and CN X; lying anterior to the carotid
sheath are lymph nodes and the ansa cervicalis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Submandibular Triangle [aka digastric triangle]

Boundaries:
Roof:
Floor:
Contents:

A

 Boundaries: posterior and anterior bellies of digastric and inferior ramus of mandible
 Roof: skin, superficial fascia
 Floor: mylohyoid, hyoglossus and part of middle constrictor
 Contents: submandibular gland, nodes, facial vein and artery, hypoglossal and mylohyoid nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Submental Triangle [aka suprahyoid triangle]

Boundaries:
Roof:
Floor:
Contents:

A

 Boundaries: anterior bellies of both digastric and hyoid bone
 Roof: skin, subcutaneous fascia
 Floor: mylohyoid muscles
 Contents: submental lymph nodes and submental veins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Muscular Triangle

Boundaries:
Roof:
Contents:

A

 Boundaries: sternocleidomastoid, superior belly of omohyoid and anterior midline of neck
 Roof: skin and superficial fascia
 Contents: sternohyoid, sternothyroid and thyrohyoid muscles, thyroid, trachea and larynx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Posterior Cervical Triangle

Boundaries:
Roof:
Floor:
Contents:

A

 It is subdivided by inferior belly of omohyoid into the occipital and supraclavicular triangles [2]
 Boundaries: sternocleidomastoid, trapezius and middle third of the clavicle [3]
 Roof: Skin, superficial fascia, platysma and investing layer of deep cervical fascia [4]
 Floor: splenius capitis, levator scapulae, scalenus posterior, medius and anterior [5]
 Contents:
o [6 vessels] subclavian artery, suprascapular, transverse cervical, occipital arteries, the
subclavian and external jugular veins
o [7 nerves] great auricular, lesser occipital, supraclavicular, transverse cervical nerves,
trunks of the brachial plexus and CN XI*

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Triangle of Auscultation

Boundaries:
Roof:
Floor:
Contents:

A

 Boundaries: trapezius, latissimus dorsi and medial border of scapula
 Roof: skin and superficial fascia
 Floor: rhomboid major
 Contents: none

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Lumbar Triangle [of Petit]

Boundaries:
Roof:
Floor:
Contents:

A

 Boundaries: latissimus dorsi, external oblique and iliac crest
 Roof: skin and superficial fascia
 Floor: transverses abdominis
 Contents: none

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Inguinal Triangle [of Hesselbach]

Boundaries:
Roof:
Floor:
Contents:

Direct vs. indirect hernias?

A

o Boundaries: rectus abdominis, inferior epigastric vessels and inguinal ligament
o Inguinal ligament is the infolding of the lower end of the aponeurosis of External oblique
and extends from the Anterior Superior Iliac Spine to the pubic tubercle
 Roof: skin and external oblique aponeurosis
 Floor: transversalis fascia

 Direct hernias pass through Hesselbach’striangle
 Indirect hernias pass through the deep inguinal ring which is a defect in the transversalis fascia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Femoral Triangle [of Scarpa]

Boundaries:
Roof:
Floor:
Contents:

A

 Boundaries: inguinal ligament, medial borders of sartorius and adductor longus*
 Roof: skin, superficial fascia and fascia lata
 Floor: iliopsoas, pectineus and adductor longus*
 Contents: femoral nerve, femoral artery, femoral vein and femoral canal
 The femoral artery, vein and canal lie inside the femoral sheath which is formed from the fascia
related to the transversalis and iliacus muscles
 The femoral nerve lies outside of the femoral sheath

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Thoracic Outlet [aka Superior Thoracic Aperture]

Boundaries:
Roof:
Contents:

A

 Boundaries: T1 vertebra [posterior], 1
st
ribs [lateral] and the manubrium of sternum [anterior]
 Roof: suprapleural membrane [Sibson’s fascia] which extends:
o from the tip of the transverse process of C7
o to the inner aspect of 1st rib
 Contents: trachea, esophagus, thoracic duct, brachiocephalic trunk, left common carotid and left
subclavian arteries, right and left brachiocephalic veins, right and left vagus nerves, phrenic nerves,
right and left sympathetic trunks, T1 of the brachial plexus and the sternohyoid, sternothyroid and
longus coli muscles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Axilla

Boundaries:
Roof:
Floor:
Content (APICAL-lymph nodes groups):

A

 Boundaries: pectoralis major and minor [anterior], subscapularis, teres major and latissimus dorsi
[posterior], upper 4 ribs and serratus anterior [medial] and bicipital groove of the humerus [lateral]
 Roof:
o triangular interval bounded by:
 clavicle [anterior]
 1st rib [medial]
 scapula [posterior]
 Floor:
o skin
o superficial fascia
 Contents: axillary artery and branches, axillary vein and tributaries, cords of the brachial plexus and…

six groups of lymph nodes: 
o  Anterior [pectoral] 
o  Posterior [subscapular] 
o  Infraclavicular 
o  Central 
o  Apical 
o  Lateral [along the axillary vein]
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Triangular Space

Boundaries:
Contents:

A

 Boundaries: teres minor [superior], teres major [inferior], long head of triceps [lateral]
 Contents: circumflex scapular branch of the subscapular artery
 Roof: none
 Floor: none

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Cubital Fossa

Boundaries:
Roof:
Floor:
Content:

A

 Boundaries: pronator teres [medial], brachioradialis [lateral], imaginary line between humeral
epicondyles [superior]
 Roof: skin, superficial fascia containing median cubital vein, deep fascia and the bicipital
aponeurosis
 Floor:
o brachialis [medial]
o supinator muscle [lateral]
 Contents from lateral to medial: radial nerve, tendon of biceps brachii, brachial artery [and its
terminal branches-radial and ulnar] and the median nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Anatomical Snuffbox

Boundaries:
Roof:
Floor:
Content:

A

 Boundaries: tendons of abductor pollicis longus and extensor pollicis brevis [anterior] and tendon of
extensor pollicis longus [posterior]
 Roof: skin, superficial fascia with cephalic vein and superficial branch of the radial nerve
 Floor:
o styloid process of radius
o scaphoid
o trapezium
o base of the 1st metacarpus
 Contents: radial artery and tendons of extensor carpi radialis longus and brevis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Carpal Tunnel

Roof (STOP):
Floor:
Content:

A

 Roof: flexor retinaculum-1”fibroussquareattachedtothefollowingcarpalbones:
o Scaphoid, Trapezium, Os hamate and Pisiform bones [STOP]
 Floor: carpal bones [trapezium, trapezoid, capitate and hamate]
 Contents: the median nerve, tendons of Flexor digitorum superficialis and profundus and tendon of
Flexor pollicis longus [Flexor carpi radialis lies in a separate compartment]
 NB: the superficial palmar branch of the median nerve passes over the retinaculum and therefore is
not compressed allowing for the sensation of the palm to be intact in carpal tunnel syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Guyon’scanal[akaulnartunnel]

Boundaries:
Roof:
Floor:
Content:

A 
  Floor: flexor retinaculum 
  Roof: pisohamate ligament 
  Medial border: pisiform 
  Lateral border: hamate 
  Contents: ulnar nerve and ulnar artery
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Inguinal Canal [of2’s]

Boundaries:
Roof:
Floor:
Content:

A

 Boundaries: external oblique aponeurosis and internal oblique [anterior] with the conjoint tendon
and transversalis fascia [posterior]
 Roof: arching fibers of internal oblique and transversus abdominis
 Floor: inguinal ligament and lacunar ligament medially
 Extent: between the deep and superficial inguinal rings
 Contents:
o ilioinguinal nerve
o spermatic cord in males
o round ligament of uterus in females
 Extent: from the deep ring [above a point midway between the ASIS and pubic tubercle] to the superficial ring [medial to the pubic tubercle and above the pubic crest]

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Femoral Canal

Boundaries:
Roof:
Floor:
Content:

A

 Boundaries: lacunar ligament [medial], inguinal ligament [anterior], femoral vein [lateral] and
pectineus and pectineal ligament [posteriorly]
 Roof: connective tissue
 Contents: lymph node [Cloquet or Rosenmuller], lymphatics and connective tissue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Adductor Canal [SubsartorialorHunter’scanal]

Boundaries:
Content:

A 
  Boundaries:  
o  vastus medialis [anterolateral] 
o  sartorius [medial] 
o  adductor longus [posterior] 
o  magnus [posterior] 
  Contents:  
o  femoral artery 
o  femoral vein 
o  saphenous nerve 
o  nerve to vastus medialis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Popliteal Fossa

Boundaries:
Roof:
Floor:
Content:

A

 Boundaries: biceps femoris [superolateral], semitendinosus and semimembranosus [superomedial],
lateral and medial heads of gastrocnemius [inferolateral and inferomedial]
 Roof: skin, superficial fascia with short saphenous vein and deep fascia
 Floor: lower end of femur, posterior aspect of knee joint, popliteus muscle and fascia
 Contents:
o tibial nerve
o popliteal vein and artery
o common peroneal [fibular] nerve
o nodes
o fat
o the artery is deepest, the tibial nerve is most superficial and the vein is in between

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Tarsal Tunnel

Contents (Tom, Dick, ANd, Harry)

A

 Contents:
o Tibialis posterior tendon
o Flexor Digitorum longus tendon
o posterior tibial Artery, vein and Nerve
o Flexor Hallucis longus tendon
o [Tom, Dick ANd Harry] in that order from anterior t

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Embryology - Heart

The heart develops in the __________in the cephalic region of the developing fetus at Week 3. __________ tissue coalesce to form the right and left ________ tubes which fuse to form the ________heart tube. the _______heart tube folds on itself and develops three dilations-atrial, ventricular and the ______ cordis. the proximal end of the heart tube is formed by the sinus _______the distal end is formed by the truncus ______

A

The heart develops in the mesoderm in the cephalic region of the developing fetus at Week 3. Angioblastic tissue coalesce to form the right and left endocardial tubes which fuse to form the primitive heart tube. the primitive heart tube folds on itself and develops three dilations-atrial, ventricular and the bulbus cordis. the proximal end of the heart tube is formed by the sinus venosus the distal end is formed by the truncus arteriosus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Embryology - Heart

The atrial dilation is divided by a septum _______ in Week 5. Another septum appears to the right of the septum primum called the septum ________. This septum is incomplete inferiorly remaining as the limbus of the fossa _____.

A

the atrial dilation is divided by a septum [septum primum] in the 5th week a hole appears in the upper part of the septum primum-ostium secundum another septum appear to the right of the septum primum called the septum secundum this septum is incomplete inferiorly remaining as the limbus of the fossa ovalis. the ventricular dilation is divided by a septum which goes upwards towards the endocardial
cushions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Embryology - Heart

Truncus arteriosus is divided into two separate tubes-aortic and pulmonary in Week 7 and 8. The two tubes twist on each other to allow the pulmonary ______ to lie anterior to the aorta initially and then posterior there is a connection called the ______ arteriosus in the fetus that allows ___________ blood to be
shunted from the ____pulmonary artery to the arch of the aorta. This ductus closes shortly after birth to form the ligamentum ___________

A

 the truncus arteriosus is divided into two separate tubes-aortic and pulmonary in the 7th and 8th weeks
 the two tubes twist on each other to allow the pulmonary artery to lie anterior to the aorta initially
and then posterior
 there is a connection called the ductus arteriosus in the fetus that allows oxygenated blood to be
shunted from the left pulmonary artery to the arch of the aorta
 this ductus closes shortly after birth to form the ligamentum arteriosum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Embryology - Heart (Congenital anomalies):

VSD - MC congenital heart disease
ASD - MC is a ostium \_\_\_\_\_\_\_\_ defect
Fallot's tetralogy - MC cause of cyanotic heart disease
Patent foramen ovale
Persistent ductus arteriorsus (PDA)

Which of the following are acyanotic?

A

o Ventricular Septal Defect: most common congenital heart disease] (acyanotic)
o Atrial Septal Defect: most common is an ostium secundum defect (acyanotic)
o Fallot’stetralogy: most common congenital cyanotic heart disease
o Patent Foramen Ovale (acyanotic)
o Persistent Ductus Arteriosus (acyanotic)

cyanosis is due to the mixing of arterial blood with deoxygenated blood and occurs in right to left shunts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Fallot’stetralogy is described by what 4 findings?

A

pulmonary stenosis
VSD
R ventricular hypertrophy
over-riding (dextroposition) of the aorta

PS
VSD
RVH
DP of aorta

boot shaped heart! recall that image with the cowboy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Surface markings of the heart

___ right costal cartilage1finger’sbreathfromthesternal edge

___ right costal cartilage 1finger’sbreathfromthesternal edge

___ left costal cartilage 1finger’sbreathfromthesternal edge

___ left intercostal space 7-9 cm from the midsternal line

A

Surface markings of the heart

3rd right costal cartilage1finger’sbreathfromthesternal edge

6th right costal cartilage 1finger’sbreathfromthesternal edge

2nd left costal cartilage 1finger’sbreathfromthesternal edge

5th left intercostal space 7-9 cm from the midsternal line

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Cardiac Chambers

Right heart border is made up of the ?

Inferior heart border is made up of the ?

Left heart border is made of the left ventricle and left _____ of left atrium

A

 Right heart border is made up of the right atrium
 Inferior heart border is made up of the right ventricle
 Left heart border is made of the left ventricle and left auricle of left atrium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Right atrium

2 origins = rough and smooth
Rough part is derived from the ____ ______ which contains the pectinate muscles!
Smooth part is derived from the ______ ______
They are separated by a ridge called _____ _________

A

 it has two origins-from the sinus venosus and from the true atrium
 the rough part is derived from the true atrium
o the rough part of the atrium has the pectinate muscle bundles
 the smooth part is derived from the sinus venosus embryologically
 they are separated by a ridge called the crista terminalis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Right atrium

oval depression on the interatrial septum = ?
limbus of the fossa ovalis is remnant of the septum ________
70% of myocardial venous blood drains into the heart via the coronary _______

A

fossa ovale ( fetal foramen ovalis - the septum primum)

septum secundum

coronary sinus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Left atrium

__ openings carrying _________ blood from the ______

A

4 veins, oxygenated blood, from the lungs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Right ventricle

has large fleshy trabeculae _______ and ________ muscles

septomarginal branch is also known as the _______ _____ which carries majority of the right bundle branch

infundibulum is the smooth ______shaped inlet to the pulmonary _______

A

large fleshy trabeculae carneae and papillary muscles

moderator band

infundibulum is a smooth funnel-shaped inlet to the opening of the pulmonary valves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Left ventricle

has a thick muscular wall with trabeculae _______

divided from the R ventricle by the ?

A

carneae

interventricular septum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Surface Markings of heart valve sound (APTM)

2nd R IC space (1.25 cm from sternum)
2nd L IC space (1.25 cm from sternum)
4th L IC space (1.25 cm from sternum)
5th L IC space (7-9 cm from midsternal line)

A

2R - Aortic (semilunar valves)
2L - Pulmonary (semilunar valves)
4L - Tricuspid (right atrioventricular valve)
5L - Mitral (bicuspid valve or left atrioventricular valve)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Heart Valves

RA to RV
RV to pulmonary trunk
LA to LV
LV to ascending aorta

The valve leaflets are attached to _____ muscles by fibrous cords called the chorda _______ .

A

RA to RV - tricuspid (R AV)
RV to pulmonary trunk - pulmonary (semilunar valves)
LA to LV - mitral (bicuspid or L AV)
LV to ascending aorta - aortic (semilunar valves)

The valve leaflets are attached to papillary muscles by fibrous cords called the chorda tendinae.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Heart

The heart is supplied by two branches that arise from the ______ part of the aorta
o right _______ artery
o left _______ artery

A

 the heart is supplied by two branches that arise from the ascending part of the aorta
o right coronary artery
o left coronary artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Right coronary artery

Originates from the R aortic coronary _____. Runs between the R auricle and pulmonary trunk in the anterior AV sulcus. It is distributed to which (6) locations/branches?

A

sinus

o  RA
o  RV  
o  30% of LA
o  SA node [55% of the population] 
o  AV node [85% of the population]  
o  posterior 1/3 of the IV septum
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Left coronary artery

Originates from the L aortic coronary _____. Runs between L auricle and pulmonary trunk. What are the 3 branches? Where is the blood distributed?

A

o circumflex
o anterior Interventricular [aka left anterior descending]
o left marginal

o LV
o 70% of LA
o anterior 2/3 of the IV septum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Venous Drainage

Coronary sinus drains 70% of venous blood via the follow 4 cardiac veins.

The rest is drained via the _____ cardiac vein which opens into the RA.

A

o great cardiac vein [accompanies the left anterior descending artery]
o small cardiac vein [accompanies the right marginal artery]
o middle cardiac vein [accompanies the posterior interventricular artery]
o oblique cardiac vein

the anterior cardiac vein which opens into the right atrium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Cardiac Conduction System

SA node is located in the upper right ____ near the SVC. It is sympathetically AND parasympathetically innervated by?

AV node is located posteroinferior in the ______ septum

Bundle of HIs is located in the ______ septum (membranous)

R and L bundle branches are located in the muscular part of the IV septem. Bundle branches end at _________ fibers

A

 The Sino-Atrial node is located in the upper right atrium near the opening of SVC. The SA node is innervated by cardiac plexuses with sympathetic fibers from T1-5 and parasympathetic fibers from CN X
 The Atrio-Ventricular node is located in the posteroinferior part of the interatrial septum
 The Bundle of His is located in the membranous part of the interventricular septum
 Right and left bundle branches are located in the muscular part of the interventricular septum
 Bundle branches end as the subendocardial Purkinje fibers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Cardiac Plexuses

Divided into 2 parts: deep and superficial

Superficial plexus has fibers from (2)
Deep plexus has fibers from (3)

A

superficial part receives fibers from:
o superior cervical sympathetic ganglion
o inferior cardiac branch of the vagus

deep plexus receives contributions from the

(1) superior, middle and inferior cervical sympathetic
ganglia
(2) superior and inferior cardiac branches of the vagus
(3) branches from the
recurrent laryngeal nerves from the vagus nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Branches of the thoracic aorta

Just flip and view!

A

Branches of the thoracic aorta
 right and left coronary arteries [from the ascending aorta]
 brachiocephalic trunk [from the arch of aorta]
 left common carotid [from the arch of aorta]
 left subclavian artery [from the arch of aorta]
 3rd to 11th posterior intercostals [from the descending part of thoracic aorta]
 bronchial [from the descending part of thoracic aorta]
 esophageal [from the descending part of thoracic aorta]

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Branches of the abdominal aorta - rules of 4

4 paired _____ arteries

4 paired parietal arteries

4 UNPAIRED _____ arteries

aorta ends at __ by bifurcating into common iliac arteries (origin of internal and external iliac arteries)

A 
  4 paired visceral arteries: 
o  inferior phrenic 
o  middle adrenal 
o  renal 
o  gonadal

 4 paired parietal-1st to 4th
lumbar arteries

 4 unpaired visceral:
o celiac trunk [at the level of T12]
o superior mesenteric [at the level of L1]
o inferior mesenteric [at the level of L3]
o median sacral [at the level of L4]

 aorta ends at L4 by bifurcating into:
o common iliac arteries which then divide into
o internal and external iliac arteries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

Internal Iliac Artery - 9 branches (6 anterior, 3 posterior)

Some Inherit Money, Others Inherit Insanity, Usually. Isn’t Life Silly?

A 
  anterior division [6 branches]:  
o  Superior vesical 
o  Inferior vesical 
o  Middle rectal 
o  Obturator 
o  Inferior gluteal 
o  Internal pudendal  
o  plus the Uterine and vaginal arteries in females

 posterior division [3 branches]:
o Iliolumbar
o Lateral sacral
o Superior gluteal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

External Iliac Artery - 3 branches. Then it continues as the femoral artery…they it branches into what 4 branches.

A

 the external iliac artery has three branches [CID]:
o Cremasteric artery [only in males]
o Inferior epigastric artery
o Deep circumflex artery

 continues as the femoral artery beyond the inguinal ligament with the following branches:
o Superficial external pudendal
o Deep external pudendal
o Superficial circumflex iliac
o Deep femoral with its medial and lateral circumflex branches

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

Femoral artery passes through the _____ canal and becomes which artery?

What does the femoral nerve accompany?

A

adductor

popliteal artery

 the saphenous nerve accompanies the femoral artery in the mid-thigh

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

Popliteal artery bifurcates into what?

What nerve does it accompany?

A

anterior and posterior tibial arteries

posterior tibial then divides into the medial and lateral plantar arteries behind the medial malleolus. Accompanied by posterior tibial nerve

anterior tibial continues into the foot as the dorsalis pedis artery (passing through 1st and 2nd toe). It also accompanies the deep peroneal nerve in the anterior leg compartment. Its branch called the arcuate artery supplies the dorsum of the foot. dorsalis pedis connects with lateral plantar branch of the posterior tibial artery to form the plantar arch

 the popliteal artery accompanies the tibial nerve in the popliteal fossa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

Subclavian Artery

 the ____ subclavian artery comes off of the arch of the aorta
 the ____ subclavian artery comes off of the ______________ trunk
 both pass over the 1st rib behind the Scalenus anterior muscle

A

Subclavian Artery
 the left subclavian artery comes off of the arch of the aorta
 the right subclavian artery comes off of the brachiocephalic trunk
 both pass over the 1st rib behind the Scalenus anterior muscle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

Subclavian artery - 4 branches

A 
internal thoracic
vertebral
thyrocervical trunk (branches are suprascapular, inferior thyroid, transverse cervical)
costocervical trunk (branches are superior intercostal and deep cervical)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

Subclavian artery

Becomes the _______ artery which divides into 3 parts by pectoralis minor. Then it becomes the ________ artery

A

axillary artery

o 1st part [proximal to pectoralis minor]-superior thoracic artery
o 2nd part [beneath pectoralis minor]-thoraco-acromial and lateral thoracic arteries
o 3rd part [distal to pectoralis minor]-subscapular, posterior and anterior circumflex humeral
arteries

brachial artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

Brachial artery

terminates where and then bifurcates into which two arteries?

What nerve does it accompany?

A

cubital fossa at the level of the neck of the radius by
bifurcating into the radial and ulnar arteries

median nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

Radial artery - 4 branches

A 
  the branches of the radial artery include [RCMP]: 
o  Radial recurrent 
o  Carpal 
o  Muscular 
o  superficial Palmar arteries
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

Ulnar artery - 5 branches

What nerve does it accompany?

A

 the branches of the ulnar artery are:
o anterior and posterior ulnar collateral
o common interosseous
o muscular
o anterior and posterior carpal
o deep palmar

ulnar artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

The radial and ulnar arteries form two arches in the palm - what are they?

A

o the superficial palmar arch is the continuation of the ulnar artery
 lies between the palmar aponeurosis and the digital flexor tendons
 it is completed by the superficial palmar branch of the radial artery

o the deep palmar arch is the continuation of the radial artery
 lies between the palmar interossei and the deep digital flexor tendons
 it lies proximal to the superficial palmar arch

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

Pituitary gland

Location?
Covered by a dura called?

Anterior lobe (Rathke’s pouch from ectoderm) produces which 6 hormones?

Posterior lobe STORES but not produce the following 2 hormones?

A

location = sella turcica within sphenoid bone below optic chiasma
fold of dura = diaphragm sellae

Anterior lobe (Rathke’s pouch) = FSH, LH, ACTH, TSH, PRL (prolactin), GH. These hormones (except PRL) are influenced by releasing factors from the hypothalamus.

oxytocin and ADH/vasopressin. Oxytocin is produced by paraventricular nuclei. ADH/vasopressin is produced by supraoptic nuclei in the hypothalamus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

Thyroid gland

Shape? Two sides are connected by the _______.

Consists of ________ cell-lined follicles which secrete _____ from which T_ is developed. Para________ cells are found in between the follicles and these cells secrete _________.

Weighs ___ grams and lies in the ______ cervical triangle (under the cover of SCM and infrahyoid muscles)

The connective tissue wrapping it is continuous with what structure?

Supplied by the 3 following arteries?

A

2 pear shape lobes linked by isthmus

consists of cuboidal cell-lined follicles secrete thyroxin from which T3 is developed

parafollicular cells are found in between the follicles. these cells secrete calcitonin

25 g in the anterior cervical triangle

pre-tracheal layer of deep cervical fascia

o superior thyroid artery from External Carotid Artery (accompanied by the superior laryngeal nerve)
o inferior thyroid artery from the thyrocervical trunk (accompanied by the recurrent laryngeal nerve
o thyroidea ima which occurs in 3-10%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

Parathyroid glands

Contains which two types of cells?

Function of PTH hormone

A

chief cells (secretes PTH) and oxyphils

PTH allows for bone resorption (take Ca out of bone) and into the blood stream

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

Pancreas

T or F: only an exocrine gland.

Islets of Langerhans consists of what 3 cell types and what do each of them secrete?

The main pancreatic duct joins with what duct to open into the ampulla of Vater in the main duodenal papilla in the duodenum? Which sphincter is here?

Blood supply (3)

A

F - endo and exocrine

beta - insulin
alpha - glucagon
delta - somatostatin (aka growth hormone-inhibiting hormone (GHIH))

the main pancreatic duct joins with the common bile duct to open into the ampulla of Vater in the main duodenal papilla into the duodenum. Smooth muscle sphincter of Oddi.

o superior pacreaticodudodenal artery [from the gastoduodenal artery of the celiac trunk]
o inferior pacreaticoduodenal artery [from the superior mesenteric artery]
o great pancreatic artery [from the splenic artery]

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

Adrenal Gland

R gland - smaller and trangular

L gland is semilunar and LARGER

3 structural zones in the CORTEX and the related hormones

The medulla secretes what?

A

o zona Glomerulosa – Mineralocorticoids – Aldosterone [under Renin control]-Salt
o zona Fasciculata – Glucocorticoids [under ATCH control]-Sweet
o zone Reticularis – Sex hormones-Sex

the deeper you go the sweeter the sex gets

the medulla secretes norepinephrine under sympathetic control

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

Embryology of GI anatomy

foregut - gives rise to (3)

midgut - gives rise to (3)

hindgut - gives rise…

A

 esophagus
 stomach
 proximal half of the duodenum-up to major duodenal papilla

 distal half of duodenum
 small intestine
 proximal half of large intestine up to the proximal two thirds of
transverse colon

gives rise to the rest of the large intestine from the distal third of the transverse
colon to the proximal half of the anal canal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

Merkel’s diverticulum (Rule of 2s)

A

o this is an uncommon congenital anomaly
o it occurs in 2% of the population
o it is 2 inches long
o it is located 2 feet proximal to the ileocecal junction
o it may contain 2 types of ectopic tissue-gastric and pancreatic tissue
o it is found 2 times more common in males

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

Regional Topographical Anatomy of the abdomen

o  epigastric
o  right hypochondrium
o  left hypochondrium
o  umbilical
o  right and left flanks
o  right Iliac fossa
o  left Iliac fossa
o  hypogastric
A

o epigastric-stomach, duodenum and pancreas
o right hypochondrium-liver and gallbladder
o left hypochondrium-spleen
o umbilical-small intestine
o right and left flanks-kidneys
o right Iliac fossa-appendix, right ovary and right uterine tube and cecum
o left Iliac fossa-left ovary, left uterine tube and sigmoid colon
o hypogastric [suprapubic]-bladder and uterus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

The dermatomes and underlying parietal peritoneum are innervated by the lower 6 thoracic and

A

o T7-xiphoid level
o T10-umbilical level
o L1-inguinal region

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

Anterior Abdominal Wall - 6 layers.

Innervated by T7-L1 - which nerves?

A

skin
subcutaneous tissue (fatty later and membranous layer)
muscles: external and internal oblique and TA
transversalis fascia
extraperitoneal fat
parietal peritoneum

The anterior abdominal wall is innervated by the lower 5 intercostal nerves [T7-11], the subcostal
nerve [T12], the iliohypogastric and ilioinguinal nerves [L1]

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

Rectus sheath

Contents (3)

A

 Contents of the rectus sheath
o rectus abdominis muscle
o pyramidalis muscle [absent in 15% of the population]
o superior and inferior epigastric arteries and veins which lie below the rectus muscle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

Peritoneum (inner lining of the abdominal cavity)

Parietal layer
Visceral layer

A

o the parietal layer is sensitive to pain and is innervated by the lower intercostal and
subcostal nerves like the anterior abdominal wall

o the visceral layer is not sensitive to pain but sensitive to distension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

Abdominal cavity is divided into two comparments.

A

greater and lesser sacs

 the lesser sac lies behind the stomach and opens into the greater sac via the epiploeic
foramen of Winslow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

Retroperitoneal structures [AC DC PARK AID]

A

retroperitoneal structures [AC DC PARK AID]:

ascending colon, descending colon, pancreas, 
adrenals, 
rectum [lower 2/3], 
kidneys, 
aorta, 
IVC, 
duodenum [2nd to 4th parts]
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

Stomach

J-shaped sac lined by _________ epithelium

3 layers of smooth muscle?
2 notches?
2 attached omentas?
2 sphincters?

Contains 2 main cell types - what do each of then produce?

A

 J-shaped sac lined by columnar epithelium and covered by three layers of smooth muscle-outer
longitudinal, inner circular and innermost oblique
 the stomach has 2 notches-cardiac and angular
 there are 2 curvatures-lesser and greater
 there are 2 attached omenta-greater and lesser
 it is guarded by 2 sphincters-lower esophageal and pyloric

it contains 2 main types of cells-chief cells producing pepsinogen and parietal [oxyntic] cells
which produce hydrochloric acid and Intrinsic Factor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

Duodenum

10-inch C-shaped tube surrounding the head of the pancreas

4 parts

A

o 1st [2”long] – superior part o 2nd [3” long] – descending part (common bile duct opens into here)
o 3rd [4”long] – horizontal part
o 4th [1”long] – ascending part (continuous with jejunum at duodenum-jejunal junction). This junction is secured by the suspensory ligament (of Treitz) which is attached to the R crus of the diaphragm

 the first inch of the first part of the duodenum is intraperitoneal
 the rest of the duodenum is retroperitoneal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

Biliary Tree

Made up of what 6 parts

A

 the biliary tree is made up of the following:
o right and left hepatic ducts join to form the common hepatic duct
o the cystic duct of the gallbladder joins with the common hepatic duct to form the
common bile duct
o the triangle between the cystic duct, common hepatic duct and the liver is known as
Callot’striangleand it contains the cystic artery
o the common bile duct travels in the free edge of the lesser omentum along with the
proper hepatic artery and the portal vein
o the common bile duct passes through the head of the pancreas and is joined by the
main pancreatic duct to open into the second part of the duodenum
o the opening into the duodenum is guarded by the smooth muscle sphincter of Oddi

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

Ileum has numerous ________ aggregates called _____ patches?

A

lymphoid

Peyer’s - [Gut Associated
Lymphoid Tissue]

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

Difference between large vs. small intestine

A

 large intestine has haustra, teniae coli, appendices epiploica and a larger diameter
 small intestine has no haustra, teniae coli or appendices epiploica

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

Colon

4 parts?
Which organ is found with McBurney’s point (2/3 along a line from umbilicus and ASIS)

A

ascending tranverse, descending, sigmoid

its base is located at McBurney’spoint-2/3 along a line from the umbilicus to the ASIS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

Anal Canal

Guarded by two sphincters - one involuntary and the other involuntary

A

o internal circular sphincter which is made up of smooth muscle (involuntary)

o external sphincter [skeletal muscle] which has three parts (voluntary). the external sphincter is supplied by the inferior rectal branch of the pudendal nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

T or F: clavicle is the 1st bone to begin ossification and the last the completely ossify.

T or F: all long bones except the clavicle have intra-cartilaginous ossification

A

T

T

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

T or F: clavicle, flat skull bones and the axial skeleton have intra-membranous ossification

A

T

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

Synarthrosis vs. amphiarthrosis vs. diarthrosis

SADISM

A

S - immobile (fibrous jt)

A - slightly mobile (cartilaginous jt)

D - mobile (synovial jt)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
90
Q

Fibrous joints

3 types

A

 Synostosis [sutural]
 Syndesmosis [interosseous membrane]
 Gomphosis [tooth and tooth socket in the gum]

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
91
Q

Cartilaginous joints

2 types

A

synchondrosis (primary cartilaginous) - growing ends of long bones

symphysis (secondary cartilaginous) - IVD, pubic symphysis, manubriosternal jt)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
92
Q

Synovial joints

  planar  
  ginglymus 
  trochoid 
  condylar 
  sellar 
  spheroidal
A

 planar [gliding] zygapophyseal, acromio-clavicular
 ginglymus [hinge] humero-ulnar
 trochoid [pivot] medial atlanto-axial, proximal radio-ulnar
 condylar [ellipsoid] metacarpophalangeal
 sellar [saddle] 1
st
carpo-metacarpal
 spheroidal [ball and socket] hip and shoulder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
93
Q

T or F: All midline joints are secondary cartilaginous except the median atlanto-axial (atlantodental) jt which is a trochoid synovial jt

A

T

Remember all midline joints are secondary cartilaginous joints EXCEPT the following:
 the median atlanto-axial [atlantodental] joint which is a trochoid synovial joint

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
94
Q

Synovial jts have articular surfaces covered by ______ cartilage except which 3 joints which are fibrocartilage?

A

 the articular surfaces of all synovial joints are covered by hyaline cartilage
o EXCEPT the temporomandibular, sternoclavicular and acromioclavicular joints
 which are covered by fibrocartilage [each of these also have complete or partial
intra-articular discs]

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
95
Q

 the synovial membrane lines the interior of the fibrous joint capsule and the _____________
surfaces of the nearby bones

A

 the synovial membrane lines the interior of the fibrous joint capsule and the non-articular
surfaces of the nearby bones

96
Q

Synovium is made up of _____ cells derived from which embryological layer?

A

 the synovium is made up of plump cells derived from mesoderm

o Type A synoviocytes which are macrophagic cells
o Type B synoviocytes secretes synovial fluid which contains hyaluronic acid and
glycoproteins

97
Q

What is Hilton’s law of innervation of joints?

A

 the nerve which innervates a muscle that acts on a joint, will supply the joint and an area of skin
over the joint

98
Q

Bone is made up of:

(1) Central ______ canals - connected by Volkmann’s canals (supply nutrients and removing waste)
(2) _______ lamella - comprise of lacunae which have the osteocytes (matured osteoblasts)
(3) bone matrix - comprised of which to types of cells?

A

o central Haversian canals
o concentric lamella
o bone mat

 central Haversian canals with blood vessels
o thecanalsareconnectbyVolkmann’scanals
 supplying nutrients and removing waste

concentric lamellae surround the Haversian canals
o the lamellae are comprised of lacunae which the osteocytes
o the lacunae are connected by canaliculi which contain thin cytoplasmic strands
 allowing the osteocytes to communicate with each other

 bone matrix-calcified intercellular material comprised of
o osteoblasts synthesize the matrix [build bone] and later become osteocytes
o osteoclasts reabsorb and remodel bone tissue [clears bone away]

99
Q

_____blasts and blood vessels can be found in the cartilage outer layer called the ____________

A

perichondrium

100
Q

Cartilage is comprised of 95% of what and 5 % of what in lacunae?

A

mainly comprised of [95%] extracellular matrix of gylcosaminoglycans and proteogylcans and few
chondrocytes [5%] in lacunae

chondrocytes arise from chrondroblasts cells

101
Q

T or F: cartilage has no blood supply or nerves

A

T

102
Q

3 types of cartilage

hyaline
elastic
fibrocartilage

A

o Hyaline: most abundant, consisting mainly of Type II collagen fibers covers joint
o Elastic: contains Type II collagen fibers and elastin; found in the larynx
o Fibrocartilage: dense compact Type I collagen fibers; found in intra-articular discs

103
Q

Histological types of muscle:

smooth
skeletal
cardiac

A 
o  smooth 
  no cross striation [hence smooth] 
  spindle-shaped cell 
  central nucleus 
  involuntary

o skeletal
 cross striations
 elongated peripheral nucleus
 voluntary control

 cardiac 
  cross striations 
  branches 
  intercalated discs 
  central nucleus 
  involuntary control
104
Q

Skeletal muscle can be further categorized into what 5 categories?

A

o fusiform
 thick in the middle and tapered at each end: biceps brachii, gastrocnemius

o parallel
 uniform width with parallel fascicles: rectus abdominis and sartorius

o triangular
 fan-shaped with a broad origin and narrow insertion: pectoralis major

o  pennate 
  feather-shaped 
  unipennate: palmar interossei 
  bipennate: rectus femoris and dorsal interossei 
  multipennate: deltoid

o circular
 forms rings around certain body openings: orbicularis oculi and anal sphincter

105
Q

Temporomandibular Joint

Type of joint
Bones involved
Innervation

A

Compound hinge and gliding joint. Articular surfaces are covered by fibrocartilage instead of hyaline like most other synovial joints)

Condyle of the mandible, mandibular fossa and articular eminence of the temporal bone

Auriculotemporal, deep temporal and masseteric branches of CN V3

106
Q

Shoulder [glenohumeral] Joint

Type of joint
Bones involved
Innervation

A

synovial, ball and socket (spheroidal)

Glenoid fossa [deepened by labrum glenoidale] and head of humerus

Axillary and suprascapular nerves

107
Q

Sternoclavicular Joint

Type of joint
Bones involved
Innervation

A

synovial, saddle (sellar) but behaves like a ball and socket (covered with fibrocartilage unlike other synovial joints)

Manubrium of sternum and the medial head of the clavicle

Medial branch of the supraclavicular nerves [C3]

108
Q

Elbow Joint

Type of joint
Bones involved
Innervation

A

synovial, hinge

Lower end of humerus and the head of the radius and trochlea of the ulna

Radial and musculocutaneous nerves

109
Q

Proximal and Distal Radio-ulnar joints

Type of joint
Bones involved
Innervation

A

synovial, pivot (trochoid)

Median, ulnar and radial nerves

110
Q

Wrist Joint

Type of joint
Bones involved
Innervation

A

synovial condyloid (ellipsoid)

Distal end of radius, scaphoid and lunate bones

Radial, median and ulnar nerves

111
Q

1st Carpometacarpal Joint

Type of joint
Bones involved
Innervation

A

synovial, saddle (sellar)

trapezium and 1st metacarpal bones

Radial and median nerves

112
Q

Metacarpophalangeal Joint

Type of joint
Bones involved
Innervation

A

synovial, condyloid [ellipsoid]

Head of metacarpal and base of proximal phalanx

Median, ulnar and radial nerves

113
Q

Good acronym for adduction and abduction of MCP joints

A

Adduction-palmar interossei [PAd]

Abduction-dorsal interossei [DAb]

114
Q

Interphalangeal Joint

Type of joint
Bones involved
Innervation

A

synovial, hinge (ginglymus)

Proximal and middle, and between the middle and distal phalanges

Median, ulnar and radial nerves

115
Q

Hip joint

Type of joint
Bones involved
Innervation

A

synovial, ball and socket (spheroidal)

Acetabulum of os coxae [hip bone] and the head of the femur

Femoral, obturator and nerve to quadratus femoris

116
Q

1 intra-capsular ligament in the hip joint

3 intracapsular ligament in the hip joint

A

one intra-articular ligament:
o round ligament of the head of the femur from the transverse acetabular ligament and
the rim of the nearby acetabular notch to the fovea centralis of the femur. contains the central foveolar artery in children [absent in the adult]

 three extra-articular ligaments:
o iliofemoral ligament from the anterior inferior iliac spine to the root of the femoral neck - prevents hyperextension
o pubofemoral ligament from the superior pubic ramus to lower part of the capsule - prevents hyper-abduction
o ischiofemoral ligament from the ischium to the posterior part of the capsule - prevents hyperextension

117
Q

Knee Joint

Type of joint
Bones involved
Innervation

A

synovial, modified hinge (ginglymus)

Lower end of the femur and the upper end of the tibia

Femoral, tibial and common peroneal nerves

118
Q

Knee Joint

2 intra-articular ligaments

2 extra-articular ligaments

2 intra-articular discs

A

o anterior cruciate ligament
 originates from the anterior part of the intercondylar ridge
 inserted into the posterior side of the medial aspect of the lateral condyle of
the femur; prevents anterior movement of tibia on the femur

o posterior cruciate ligament
 originates from the posterior part of the intercondylar ridge
 inserted into the anterior part of the lateral aspect of the medial condyle of
the femur; prevents posterior movement of tibia on the femur

o medial collateral - thick broad ligament from femur to tibia - attached to the medial meniscus; prevents abduction stress

o lateral collateral - thin narrow ligament from femur to head of fibula; prevents adduction stress

o medial meniscus
 semilunar fibrocartilaginous disc attached to the medial collateral ligament
and to the intercondylar ridge

o lateral meniscus
 nearly circular
 attached to the intercondylar ridge
 not attached to the lateral collateral ligament

119
Q

Ankle Joint

Type of joint
Bones involved
Innervation

A

synovial, hinge

Lower end of the tibia and fibula and the talus

Tibial and deep peroneal nerves

120
Q

Sternocleidomastoid

Origin
Insertion
Innervation
Action

A

Origin Mastoid process and lateral third of superior nuchal line

Insertion Manubrium of sternum and medial third of the clavicle

Innervation Spinal part of CN XI [motor] and ventral rami of C2, C3 [proprioception]

Action Tilts the head towards the shoulder on the same side and rotates the head to the
opposite side

121
Q

Trapezius

Origin
Insertion
Innervation
Action

A

Origin Medial third of superior nuchal line, external occipital protuberance, ligamentum
nuchae, spinous processes of C7 and all thoracic vertebrae

Insertion Lateral third of clavicle, acromion and spine of scapula

Innervation Spinal part of CN XI [motor] and branches of C3 and C4 [proprioception]

Action Shrugs the shoulder, retracts and rotates the scapula

122
Q

Latissimus dorsi

Origin
Insertion
Innervation
Action

A

Origin Thoracolumbar fascia, spinous processes of the lower thoracic and lumbar vertebrae

Insertion Floor of the bicipital groove

Innervation Thoracodorsal nerve [C6, 7, 8]

Action Adducts, extends and medially rotates the arm

123
Q

Levator scapulae

Origin
Insertion
Innervation
Action

A

Origin Transverse processes of C1 and C2 Posterior tubercles of the transverse processes of C3 and C4

Insertion From the superior angle to the root of the spine of the scapula

Innervation Dorsal scapular nerve [C5]

Action Elevates the scapula

124
Q

Scalenus anterior

Origin
Insertion
Innervation
Action

A

Origin Anterior tubercles of the transverse processes of C3, 4, 5 and 6

Insertion Scalene tubercle on the upper inner aspect of the first rib

Innervation Anterior rami of C4, 5 and 6

Action Ipsilateral lateral flexion of the neck

125
Q

Scalenus medius

Origin
Insertion
Innervation
Action

A

Origin Posterior tubercles of the transverse processes of C2 to C6

Insertion Upper aspect of the 1st rib between groove for the subclavian artery and the tubercle

Innervation Anterior rami of C3 to C7

Action Ipsilateral lateral flexion of the neck

126
Q

Serratus anterior

Origin
Insertion
Innervation
Action

A

Origin Lateral aspects of the upper 8 ribs

Insertion Along the medial aspect of the inferior surface of the scapula

Innervation Long Thoracic Nerve [C5, 6 and 7]

Action Draws the scapula forwards and rotates the scapula

127
Q

Deltoid

Origin
Insertion
Innervation
Action

A

Origin Lateral third of clavicle, acromion and spine of the scapula

Insertion Deltoid tubercle of the humerus

Innervation Axillary nerve [C5 and C6]

Action Abducts the arm [15-90 deg], anterior fibers flex and medially rotates the arm. Posterior fibers extend and laterally rotate arm

128
Q

Pectoralis major

Origin
Insertion
Innervation
Action

A

Origin Sternum, upper 6 costal cartilages and medial half of clavicle

Insertion Lateral lip of the bicipital groove

Innervation Medial and lateral pectoral nerves [C5, 6, 7 and C8, T1]

Action Adducts, flex and medially rotates the arm; it also extends the flexed arm

129
Q

Supraspinatus

Origin
Insertion
Innervation
Action

A

Origin Supraspinous fossa of the scapula

Insertion Superior facet of the greater tuberosity of the humerus

Innervation Suprascapular nerve [C5 and C6]

Action Initiates abduction [0-15 deg] of the arm

130
Q

Infraspinatus

Origin
Insertion
Innervation
Action

A

Origin Infraspinous fossa of the scapula

Insertion Middle facet of greater tuberosity of the humerus [just below supraspinatus insertion]

Innervation Suprascapular nerve [C5 and C6]

Action Externally rotates the humerus

131
Q

Teres major

Origin
Insertion
Innervation
Action

A

Origin Oval depression on the lateral aspect of the dorsum of the scapula above the inferior
angle

Insertion Medial lip of the bicipital groove

Innervation Lower subscapular nerve [C5 and 6]

Action Extends, adducts and medially rotates the arm

132
Q

Teres minor

Origin
Insertion
Innervation
Action

A

Origin Middle third of the lateral border of scapula

Insertion Inferior facet of greater tuberosity of humerus [just below infraspinatus insertion]

Innervation Axillary nerve [C5 and C6]

Action Externally rotates the arm

133
Q

Subscapularis

Origin
Insertion
Innervation
Action

A

Origin medial two-thirds of the ventral aspect of the scapula

Insertion Lesser tuberosity of the humerus

Innervation Upper and lower subscapular nerves [C5 and C6]

Action Internally rotates and adducts the arm

134
Q

Biceps brachii

Origin
Insertion
Innervation
Action

A

Origin Coracoid process [short head] and the supraglenoid tubercle [long head]

Insertion Posterior border of the radial tuberosity of the radius

Innervation Musculocutaneous nerve [C5, 6, 7]

Action Flexes and supinates the elbow

135
Q

Triceps

Origin
Insertion
Innervation
Action

A

Origin Infraglenoid tubercle [long head], lateral upper and medial lower parts of the humerus

Insertion Olecranon of the ulna

Innervation Radial nerve [C7 and C8]

Action Extends the forearm and adducts the arm

136
Q

Brachioradialis

Origin
Insertion
Innervation
Action

A

Origin Upper two-thirds of the lateral supracondylar ridge of humerus

Insertion Base of the styloid process of the radius

Innervation Radial nerve [C6 and C7]

Action Flexes the forearm

137
Q

Pronator teres

Origin
Insertion
Innervation
Action

A

Origin Medial epicondyle of the humerus and medial border of the coronoid process of ulna

Insertion Upper part of the radius

Innervation Median nerve [C6 and 7] which passes between the humeral and ulnar heads

Action Pronates the forearm and flexes the elbow

138
Q

Psoas major

Origin
Insertion
Innervation
Action

A

Origin Bodies, intervertebral discs and transverse processes of L1-5

Insertion Lesser trochanter of the femur

Innervation L2, 3 and 4 from the lumbar plexus

Action Flexes the thigh and trunk

139
Q

Gluteus maximus

Origin
Insertion
Innervation
Action

A

Origin Ilium, sacrum, coccyx and sacrotuberous ligament

Insertion Gluteal tuberosity of the femur [25%] and iliotibial band [75%]

Innervation Inferior Gluteal nerve [L5, S1 and S2]

Action Extends and externally rotates the thigh

140
Q

Piriformis

Origin
Insertion
Innervation
Action

A

Origin Pelvic [anterior] surface of sacrum

Insertion Medial aspect of the superior border of the greater trochanter of the femur

Innervation S1 and S2 from the sacral plexus

Action Externally rotates the thigh

141
Q

TFL

Origin
Insertion
Innervation
Action

A

Origin Outer aspect of iliac crest between the iliac tubercle and anterior superior iliac spine

Insertion Iliotibial tract

Innervation Superior Gluteal nerve [L4-S1]

Action Maintains knee extension and abducts the thigh

142
Q

Quadriceps femoris

Origin
Insertion
Innervation
Action

A

Origin AIIS [straight head of rectus femoris], superior rim of acetabulum [reflected head of
rectus femoris] femur [vastus medialis, intermedius and lateralis]

Insertion Tibial tuberosity via the patellar tendon which encloses the patella

Innervation Femoral nerve [posterior divisions of L2, 3 and 4]

Action Extends the knee, stabilizes the patella and flexes the thigh [through the action of rectus
femoris]

143
Q

Tibialis anterior

Origin
Insertion
Innervation
Action

A

Origin Upper half of the lateral aspect of the tibial shaft and interosseous membrane

Insertion Inferomedial aspect of the medial cuneiform and base of 1st metatarsal bone

Innervation Deep Peroneal nerve [L4 and L5]

Action Dorsiflexes and inverts the foot

144
Q

Extensor hallucis longus

Origin
Insertion
Innervation
Action

A

Origin Middle half of anterior aspect of fibula, interosseous membrane

Insertion Base of the dorsal aspect of the distal phalanx of the 1st toe

Innervation Deep peroneal nerve [L5 and S1]

Action Extends the big toe and dorsiflexes of the ankle

145
Q

Peroneus longus

Origin
Insertion
Innervation
Action

A

Origin Lateral tibial condyle, head and upper lateral aspect of fibula

Insertion Inferolateral aspect of the medial cuneiform and base of 1st metatarsal bone

Innervation Superficial Peroneal nerve [L5 and S1]

Action Plantar flexes and everts the foot

146
Q

Gastrocnemius

Origin
Insertion
Innervation
Action

A

Origin Posterior aspects of the medial and lateral femoral condyles

Insertion Posterior aspect of the calcaneus via the calcaneal tendon [Achilles]

Innervation Tibial nerve [S1 and S2]

Action Plantar flexes the ankle

147
Q

Soleus

Origin
Insertion
Innervation
Action

A

Origin Soleal line, middle third of the tibia and upper third of the fibula

Insertion Calcaneal tendon to the posterior surface of the calcaneus

Innervation Tibial nerve [S1 and 2]

Action Plantar flexes the ankle and aids in the venous return from the leg

148
Q

Tibialis posterior

Origin
Insertion
Innervation
Action

A

Origin Interosseous membrane and the upper parts of the tibia and fibula

Insertion Navicular, the three cuneiform bones and the bases of the 2nd to 4th metatarsal
bones

Innervation Tibial nerve [L5 and S1]

Action Plantar flexes and inverts the foot; supports the medial longitudinal arch of the foot

149
Q

Reproductive System

Derived from which of the 3 embryological layers?

Males - SEED
Females - uterus and upper third of the vagina

the primitive testis and ovaries develops from the ____ lying on top of the _______

A

mesoderm. SEED arises from the mesonephric (Wolffian) duct

seminal vesicle
epididymis
ejaculatory duct
ductus deferens

the uterus and upper third of the vagina are developed from the paramesonephric [Mullerian]
duct which runs parallel to the mesonephric duct

the primitive testis/ovaries develops from mesoderm lying on top of the kidney

150
Q

Male Reproductive System

______________ are produced in the seminiferous tubules of the testis

testosterone is secreted by the interstitial cells of _____ which is under the influence of what hormone?

________ is attached to ________ cells in the tubules of the testis

The testis is suspended by the ________ cord in the lower part of the scrotum

Thick fibrous capsule of the testis

7 layers of the testis

A

spermatozoa

Leydig, LH

testosterone, Sertoli cells

spermatic cord

tunica albuginea

o skin
o dartos muscle within Colles fascia [dartos muscle is under sympathetic control]
o external spermatic fascia from the external oblique aponeurosis
o cremasteric muscle and fascia from the internal oblique muscle
o internal spermatic fascia from transversalis fascia
o parietal and visceral layers of tunica vaginalis from the peritoneum

151
Q

Male Reproductive System

Sperm travel to the rete testes into the ______ where they mature

The epididymus continues as ductus _____ where sperm is stored. This is also where the ____ duct merges forming the ejaculatory duct

A

epididymus = mature
ductus deferens = stored
seminal duct –> ejaculatory duct

ejaculatory duct then opens into the posterior part of the prostatic urethra

152
Q

Spermatic cord - rule of 3

Lies in the ______ canal and is made up of…

3 coverings
3 arteries
3 nerves
3 other structures

A

 3 coverings: external spermatic fascia, cremasteric muscle and fascia and internal spermatic
fascia
 3 arteries: testicular, artery to the ductus deferens and cremasteric artery
 3 nerves: testicular nerves, genital branch of the genitofemoral nerve and ilioinguinal nerve [which
actually lies outside of the spermatic cord]
 3 other structures: ductus deferens, pampiniform plexus of veins and testicular lymphatics [drains
to the para-aortic lymph nodes]

153
Q

Penis

Dorsal chambers and inferior chamber that fills up with blood in erection

Blood supply

Innervation

NS system control during erection vs. ejaculation

A 
corpora cavernosa (glans penis is the expanded distal end)
corpus spongiosum  (contains the penile urethra)

internal pudendal artery

pudendal nerve and branches of the pelvic splanchnic nerves - both from S2-S4 (S2, 3, 4 keeps the penis off the floor).

 parasympathetic stimulation is responsible for erection [point] (PP)
 sympathetic stimulation is responsible for ejaculation [shoot] (SS)

154
Q

Uterus

3 components

A normal uterus is ______ and _______

Attached to the ovary by the _____ ligament and to he labia majora by the ____ ligament of the uterus and to the _____ ligament

A

fundus, body, cervix

 the normal uterus is anteverted [angled forwards to the vagina] and anteflexed [body is bent
forwards to cervix]

ovary ligament, round ligament, broad ligament

155
Q

Fallopian (uterine) tubes are long muscular tubes lined by which type of epithelium?

4 parts of the tube

A

ciliated columnar epithelium

o the fimbriated end is funnel-shaped [infundibulum]
o the large ampulla where fertilization occurs
o a long narrow isthmus
o a short intramural part which pass through the cornu [lateral horn] of the uterine cavity

156
Q

Ovary

lies in the ovarian fossa between which two arteries?

attached to which 3 ligaments

Blood supply?

A

external and internal iliac arteries

o posterior aspect of the broad ligament by the mesovarium
o suspensory ligament of the ovary to the pelvic wall; contains ovarian blood vessels
o ligament of the ovary to the uterus

supplied by the ovarian artery, a branch of the abdominal aorta at L2 level

 the right ovarian vein drains into the inferior vena cava
 the left ovarian vein drains into the left renal vein

157
Q

Ox coxae (hip/pelvic bone): ischium + ilium + pubis

Male versus female pelvis

A

the male pelvis is different from the female pelvis in the following ways:

o  heavier with more prominent muscular markings 
o  smaller heart-shaped pelvic inlet 
o  subpubic angle is narrow [45
0
 in the male compared to 85
0 
in the female] 
o  inverted ischial spines 
o  sacrum is more curved
158
Q

Respiratory system

developed as a respiratory diverticulum from the upper end of the _______

Lung buds become what? Then how is lung tissue then further subdivided

Alveoli then develop from the respiratory bronchiole in the _____ trimester

A

foregut

primary bronchi (which then subdivide –> secondary (lobar) —> tertiary/segmental –> terminal bronchiles –> respiratory bronchioles

third

159
Q

Trachea

Begins at the level of C6 and the _____ cartilage then runs to the sternal angle at the level of ___

it is a rigid fibrocartilage tube lined by what type of epithelium?

V-shaped cartilage marks the bifurcation of the trachea called the…

What structure lies behind the trachea?

What is the R vs. L bronchi like?

A

cricoid, T4/5

pseudo-stratified ciliated columnar epithelium

carina

esophagus (air is more important than food)

 the right bronchus is shorter, wider and is more vertical than the left
 the left bronchus is longer, narrower and lies more horizontal

160
Q

Lungs

10 segments of the R lung

8/9 segments of the L lung

Which of the follow are R vs. L lung structures

  • oblique fissure
  • horizontal fissure
  • lingula
  • groove for azygous vein
  • groove for aorta
A

o upper lobe-apical, posterior and anterior
o middle lobe-lateral and medial
o lower lobe-superior, lateral, anterior, medial and posterior basal

o upper lobe-apicoposterior, anterior, superior and inferior lingual
o lower lobe-superior, anterior, lateral and posterior basal

Which of the follow are R vs. L lung structures

  • oblique fissure = L
  • horizontal fissure = R
  • lingula = L
  • groove for azygous vein = R
  • groove for aorta = L
161
Q

Pleura

2 layers & which layer is sensitive to pain

4 parts of the pleura

Superior migration of the lungs are stopped by what membrane?

Upper 6 anterior intercostal (IC) arteries are derived from which branch of the 1st part of the subclavian artery? How about the lower 5?

1st and 2nd posterior IC arteries are derived from?
3rd to 11th posterior IC arteries are derived from?

Venous drainage of pleura goes into which system?

A

outer (parietal) - sensitive to pain and is supplied by intercostal and phrenic nerves
inner (visceral) - insensitive [has autonomic innervation mainly from the vagus]

costal, mediastinal, diaphragmatic, cervical

suprapleural membrane (fibrous and extends from TP of C7 to inner border of 1st rib

internal thoracic artery, musculophrenic branch (of the internal thoracic artery)

costal branch of the costocervical trunk of
the subclavian artery, descending part of the thoracic aorta

azygos venous system

162
Q

Lung lymphatics

A

o pulmonary nodes found in the lung parenchyma
o then to bronchopulmonary nodes located in the hilum of the lung
o then to tracheobronchial nodes located at the bifurcation of the trachea
o into para-tracheal nodes found on either side of the trachea
o finally into the mediastinal lymphatic trunks

163
Q

Azygos Venous system

A

 the azygos vein lies on the right side of the lower eight thoracic vertebrae
 it receives 2nd through to 11th
posterior intercostal and right subcostal veins
 it passes through the diaphragm at T12 along with the aorta and the thoracic duct
 the hemiazygos vein lies on the left
 it receives the left subcostal and the 3 or 4 lower left intercostal veins
 the accessory hemiazygos vein is formed by the 5th to the 8th left intercostal veins
 the hemiazygos and accessory azygos veins may communicate with each other and with the
azygos vein
 1st and 2nd posterior intercostal veins may drain separately or together into the brachiocephalic
veins which are found in the superior division of the mediastinum
 there are many variations of this pattern

164
Q

Diaphragm

Origins and insertion

3 major openings at T8, T10, T12

Innervation

condensation of fascia over the psoas muscle is called the ______ ______ ligament

the ______ ________ ligament is the condensation of fascia over quadratus lumborum

A

o the right crus from the bodies of L1-3
o the left crus from the bodies of L1 and L2
o the lower 6 ribs
o the sternum [posterior aspect of the xiphoid process]

Insertion into the central tendon

o T8-IVC, the right phrenic nerve and pericardiacophrenic vessels
o T10-esophagus and the vagus nerves
o T12-aorta, thoracic duct and azygos vein
o the inferior vena cava passes through the central tendon
o the esophagus passes through the right crus
o the aorta passes between and behind the right and left crura

C3, 4, 5 - keeps the diaphragm alive

medial arcuate ligament

lateral arcuate ligament (lateral, lumborum, LL)

165
Q

Lymph node

Cortex (1)
Medulla (3)

Which types of cells are in each?

A

the cortex is further subdivided into outer and inner layers:
o outer cortex consists of mature B cells organized into the follicles
o these follicles have germinal centers containing activated B [plasma] cells
o inner cortex has mature T cells mainly

the medulla contains lymphocytes, plasma cells and macrophages

166
Q

Spleen

Largest aggregation of lymphoid tissue

Red pulp vs. white pulp

Attached by which two ligaments?

A

 old red blood cells are destroyed in the red pulp
 the white pulp is involved in the immune system

o gastrosplenic ligament which contains the short gastric and left gastroepiploic
arteries and veins
o splenorenal ligament which contains the terminal part of the splenic artery

167
Q

Liver

Largest organ in the body

Attached to the diaphragm via which ligament?

Which cells filter out bacteria?

How many lobes?

Blood supply of the R and L functional lobes of the liver

A

coronary ligament

Kupffer cells

Right, left, quadrate (left), caudate (on belongs to R the other belongs to L)

 right functional lobe is supplied by the right hepatic artery, a branch of the proper hepatic artery
 left functional lobe is supplied by the left hepatic artery

168
Q

Liver

the liver is made up of functional units of _____ lined by ________ and Kupffer cells

the ______ vein provides the liver with 70% of its blood supply and contains nutrients from the gut

Sinusoid venous blood drains into the ______ veins —> 3 hepatic veins —> IVC –> RA

What do the R and L hepatic ducts do?

So what’s the common bile duct? Then which duct does this one connect to leading into the duodenum? (ampulla of Vater + sphincter of Oddi which is activated by CCK)

A

the liver is made up of functional units of sinusoids lined by hepatocytes and Kupffer cells

portal vein (formed by the splenic and superior mesenteric veins - at the area of the head of pancreas)

central vein

 the right and left hepatic ducts join to form the common hepatic duct which then drain bile from the liver and are located in the porta hepatis
which lies between the caudate and quadrate lobes of the liver

common hepatic duct + cystic duct (gallbladder) = common bile duct

main pancreatic duct

169
Q

Thymus

Involved in production of what?

What happens to it over time?

Cortex vs. medulla

A

T-cell production

atrophies into adulthood

 cortex is comprised of immature and maturing T cells
 medulla has lymphocytes and a particular feature found only in the thymus-Hassall’scorpuscles
 Hassal’scorpusclesare oval bodies made up of a central area of degenerated cells surrounded
by concentrically arranged flattened keratinized epithelial cell

170
Q

Skin - epidermis

Composed the: epidermis, dermis, hypodermis (aka. subcutaneous layer). What type of epithelium is the epidermis made out of?

Further subdivisions of the epidermis - CLGiSB

What 4 types of cells can you find in the epidermis?

Epidermis is thickest at which areas of the body?

A

stratified keratinized squamous epithelium

[Californians Like Girls in String Bikinis]
o stratum Corneum
o stratum Lucidum [only found in thick skin e.g. palms and soles]
o stratum Granulosum
o stratum Spinosum produces keratin
o stratus Basale [aka stratum germinativum]

melanocytes (pigment), Langerhan’s cells (immune ID), Merkel (mechanoreceptors), naked nerve endings (nociceptors and heat receptors)

sole and palms

171
Q

Skin - dermis

T or F: the epidermis is anchored to the dermis

2 layers of the dermis

A

papillary - loose CT + fibroblasts + collagen fibers

reticular - mostly collagen and elastic fibers

172
Q

Skin - hypodermis

What cells can you find here?

A

pacinian corpuscles (vibration), Ruffini (joint position sense)

173
Q

Skin

what 3 appendages or structures live in the skin which tumours may arise?

A

hair follicles

sweat glands - eccrine glands + apocrine glands

sebaceous glands (sebum) - found everywhere except soles and palms

174
Q

Sweat glands

eccrine glands
apocrine glands

What are each of them innervated by? And what do they produce?

A

 eccrine which are found all over the body
 these are innervated by cholinergic nerves
 eccrine glands produce water and salts which are excreted
through tiny tubules
 involved in thermoregulation

 apocrine glands are specialized glands found in the axilla, mons pubis
and around the anus
 these are innervated by adrenergic nerves
 apocrine glands are outgrowths of the upper portions of hair
follicles and secrete an oily mixture
 involved in body scent

175
Q

Ribs

Which ones are true? Which ones are false or floating?

A

1-7 - true
8-10 - false (cartilaginous ends meet up with the cartilage of the ribs above them
11 & 12 floating (anterior ends are not connected)

176
Q

Typical ribs: 3-9th

What makes these ribs typical?

A

(1) head
(2) 2 articular demifacets (upper and lower. Upper articulates with the vertebra above. Lower articulates with the same level vertebra)
(3) neck
(4) crest (attachment of superior costotransverse ligament)
(5) smooth oval facet (articulates with the same level vertebra)
(6) rough part (attachment of the lateral costotransverse ligament
(7) angle
(8) shaft
(9) the upper border is smooth and rounded
(10) the lower border is sharp and shelters the costal groove
(11) the costal groove passes along the inferior border of the internal surface
(12) the costal cartilage is the unossified anterior end of the rib
(13) the costal ends articulate with the sternum via synovial joints [2-7]

177
Q

T or F: all of the costosternal joints are synovial joints except the 1st which is primary cartilaginous

A

T

178
Q

Atypical ribs: 1, 2, 10, 11, 12

What makes these ribs typical?

A

 the 1st is an atypical rib because:
o it is the shortest and most curvaceous
o its head has only one articular facet
o the rib has an additional tubercle [for the attachment of scalenus anterior]
o the rib has inner and outer borders and superior and inferior surfaces
o there is no costal groove but there is an extra groove for subclavian artery

o the 2nd rib is atypical because there is a large rough tuberosity near its middle for the attachment of the serratus anterior

 the 10-12th ribs like the 1st rib only possess one facet on the head

179
Q

Intercostal space

3 IC muscles - which direction do they run?

What’s in the neurovascular bundle?

What is it covered by externally and internally?

A

o external with its fibers running downwards and medially [hands-in-the-pocket fashion]
o internal with its fibers running upwards and medially [downwards and backwards]
o innermost with its fibers running upwards and medially [downwards and backwards]

o intercostal Vein which drains into the azygos venous system
o intercostal Artery from the internal thoracic artery and the thoracic aorta
o intercostal Nerve which is the ventral ramus of the thoracic spinal nerve

 it is covered by skin externally and by parietal pleura internally

180
Q

Breast

It is considered a modified _____ sweat gland.

Located in the superficial fascia except which part of it?

glandular tissue is attached to the skin above and the pectoral fascia below by the _________ ligaments [of Cooper] of the breast

glandular tissue opens on to the ________ ducts which are dilated towards the end as the ________ sinuses before opening on to the nipple

A

apocrine

tail of Spence (under the deep fascia of the axilla)

suspensory ligaments of Cooper

lactiferous, lactiferous

181
Q

Breast

Blood supply (3)

Lymphatics: 75% of the breast drains to the anterior (aka. _________) group of axillary nodes. Then the rest drains into the central and apical group of nodes.

A

o lateral thoracic artery
o internal thoracic artery
o 2nd to 4th anterior intercostal arteries

pectoral

182
Q

Mediastinum (space between the lungs)

List some structures that can be found here.

A

o the manubriosternal joint between the manubrium and body of the sternum
o the articulation of the second rib with the sternum
o the bifurcation of the trachea
o the bifurcation of the pulmonary trunk
o the arch of the aorta begins
o the arch of the aorta ends
o the thoracic duct crosses from right to left
o the left recurrent laryngeal nerve passes under the aortic arch

183
Q

Mediastinum

Superior division - TVPASTER

Posterior division - VS DATES

A 
o  Trachea 
o  Vagus nerves 
o  Phrenic nerves 
o  Arch of the aorta and its branches 
o  Superior Vena Cava 
o  Thoracic duct 
o  Esophagus 
o  Remnant of the thymus gland 
o  Vagus nerves 
o  Splanchnic nerves 
o  Descending thoracic aorta and its branches: 
o  Azygos venous system 
o  Thoracic duct 
o  Esophagus 
o  Sympathetic trunks
184
Q

Mediastinum

Inferior division
Anterior division
Middle division

A

 the inferior mediastinum is further subdivided into three compartments:
o middle compartment
o anterior compartment lies between the sternum and the heart
o posterior compartment lies between the heart and the thoracic vertebra

 the anterior compartment contains:
o connective tissue
o lymph nodes
o remnants of the thymus

  the middle compartment contains: 
o  heart 
o  pericardium 
o  roots of the great vessels 
o  phrenic nerves
185
Q

Esophagus

Runs from which levels?

Type of epithelium (3) - inner, middle, outer

A

C6 (cricoid cartilage) to T11 (stomach). Crosses L bronchuus at T5. Passes the diaphragm at T10.

o inner layer - stratified non-keratinized squamous epithelium
o middle layer - submucosa with esophageal glands
o outer layer - two layers of muscle, outer longitudinal and inner circular

186
Q

Esophagus

Characteristics of the upper, middle, and lower third

A

upper: surrounded by skeletal muscle, supplied by inferior thyroid artery, drains into the lower deep cervical lymph nodes
middle: surrounded by both skeletal and smooth muscle, thoracic aorta, drains into mediastinal lymph nodes
lower: both muscle types, supplied by left gastric artery, drains into the L gastric lymph nodes

187
Q

Urinary embryology

Where do each of these arise from?

kidney
ureteric bud
baldder

A

mesoderm
mesonephric duct
endoderm (urogenital sinus)

188
Q

Kidney

bean-shaped __________ organ

these 3 structures are situated in the hilum of the kidney

posterior relations of the kidney include 4 muscles, 3 nerves, 2 vessels and 1 bone:

A

retroperitoneal

o renal vein
o renal artery
o ureter

o 4 muscles-diaphragm, QL, psoas and TA
o 3 nerves-subcostal, iliohypogastric and ilioinguinal nerves
o 2 vessels-subcostal vein and artery
o 1 bone-12th rib

189
Q

Kidney

Artery
Vein

A

renal artery

renal vein (IVC)

R renal vein - shorter and no tributaries

L renal vein - longer and receives the left adrenal vein and left gonadal vein

190
Q

Ureter

Epithelium

Blood supply

A

transitional epithelium

supplied by branches from the renal, gonadal and internal iliac arteries

191
Q

Bladder

 the bladder lies _______ to the prostate in the male
 the bladder lies ________ to the uterus in the female

A

 the bladder lies superior to the prostate in the male

 the bladder lies inferior to the uterus in the female

192
Q

Bladder

Made up on smooth ______ muscle lined by _________ epithelium

Innervation of the…

internal sphincter
external sphincter

A

 the bladder is made up of smooth [detrusor] muscle lined by transitional epithelium

o internal sphincter is comprised of smooth muscle which is relaxed by the pelvic splanchnic nerves [S2, 3 and 4] and is contracted by the sympathetic fibers
o external sphincter is skeletal and is controlled by the pudendal nerve [S2, 3, 4]

193
Q

Urethra

Female vs. male urethra

A

 male urethra is divided into prostatic, membranous and penile parts
 membranous part is the shortest part measuring ½ to ¾ inch
 penile part passes through the corpus spongiosum and opens at the urethral orifice which is
located in the undersurface of the glans of the penis
 bulbourethral glands [of Cowper] in the male lie within the urogenital diaphragm and drain into
the penile part of the urethra
 shorter female urethra lies anterior to the vagina and its opening lies between the clitoris
anteriorly and the vaginal orifice posteriorly

194
Q

Vertebral embryology

Arises from which embryological layer?

The __________ guides the development of the vertebral column and spinal cord, gives rise to the nucleus pulposus of the intervertebral disc, persists as the nucleus pulposus

Condensations of the mesoderm around the notochord are called _________

A

mesoderm

notochord

somites

195
Q

Somites

3 types: sclerotomes, myotomes, dermatomes

A

o sclerotomes from which the vertebrae develop:
o myotomes from which muscle develops:
o dermatomes from which the peripheral nerves develop

196
Q

Sclerotomes - vertebrae

3 primary ossification centers

5 secondary ossification centers

A

primary: centrum (body), R and L halves of the neural arch
secondary: SP, R and L TPs, upper and lower endplates

197
Q

Myotomes - vertebrae

Which types of muscles will arise from these types of myotomes:
somatic
splanchnic
epimere
hypomere
A

 somatic skeletal muscles
 splanchnic smooth muscles
 epimere extensor muscles
 hypomere flexor muscles

198
Q

Typical Vertebra - just flip and read

A

 large weight bearing body anteriorly
 2 pedicles posterolaterally
 2 transverse processes laterally
 2 laminae forming the neural arch
 1 spinous process posteriorly
 superior articular process with its facet facing backwards
 inferior articular process with its facet facing forwards
 pars interarticularis between the superior and inferior articular processes
 vertebral canal behind the body

199
Q

Cervical vertebrae characteristics

A

rectangular body, bifid spinous process, transverse foramina in the transverse process which possess anterior and posterior tubercles

superior articular facets are oriented BUM (backward, upwards, medially)

200
Q

Thoracic vertebrae characteristics

A

heart-shaped body, sloping spinous process, costal facets on body and transverse
process

superior articular facets are oriented BUL (backward, upwards, laterally)

201
Q

Lumbar vertebrae characteristics

A

kidney-shape body, quadrangular spinous process, mammillary and accessory
processes

superior articular facets are oriented BM (backward medially)

202
Q

Which are the 3 atypical cervical vertebrae? Why are they unique?

A

C1 (atlas) - no body, large lateral masses, anterior+posterior arches

C2 (axis) - dens/odontoid process

C7 (vertebra prominens) - v long non-bifid SPs

203
Q

Vertebral Ligaments - where are they and what motions do they limit

ALL
PLL
Supraspinous ligament
Interspinous ligament
Ligamentum flavum
Intertransverse ligament
Alar ligament
Apical ligament
Cruciate ligament
A

ALL - occiput to sacrum, stops hyperEX

PLL - C2 to sacrum, stops hyperFL. Beyond C2, it continues to the tectorial membrane (The tectorial membrane of atlanto-axial joint (occipitoaxial ligaments) is situated within the vertebral canal??))

SSL - connects tips of SPs, stops hyperFL, conitnues as the nuchal ligament upwards and beyond C7

IPL - runs between adjacent SPs, stops posterior translation and FL

LF - adjacent vertebrae, high elasticity, stops FL and buckling during EX

ITL - between adjacent TPs, stops lateral FL

Alar - posterior aspect of dens, inerts into the medial aspect of the condyle of the occiput, limits rotation

apical - apex of dens to the anterior aspect of the foramen magnum, stops FL and EX of C2

cruciates:
 shaped like a cross
 transverse ligament extends from a small medial tubercle [colliculus atlantis] on the
lateral mass of the atlas to the same tubercle on the other side
 superior longitudinal ligament extends from the middle of the transverse ligament to the
anterior lip of the foramen magnum between tectorial membrane and the apical ligament
 inferior longitudinal ligament extends from middle of transverse ligament to body of C2
 limits lateral translation

204
Q

Intervertebral Disc

Outer part (annulus fibrosus, 15-30 concentric laminae, 4-70 deg to vertical)

Inner part (nucleus pulposus)

T or F: discs are thickest in the thoracic spine. Thinnest in the lumbar spine.

A

AF: Type I collagen

NP: Type II collagen, gelatinous

F - vice versa

205
Q

Intervertebral Disc

T or F: only the inner third of the AF is innervated.

T or F: NP has good access to nutrients

2 sources of innnervation

T or F: there are 25 IVDs

A

F - outer layer only

F - no, mostly through diffusion which is facilitated by spinal movements. It is poorly vascularized

posteriorly: sinuvertebral (reccurent meningeal) nerve
laterally: sensory nerves (grey sympathetic rami)

F- 23 IVDs, no disc between C1 and C2.

206
Q

Contents of the IVF (8 items)

DRNASVFL

A 
spinal Nerve
spinal nerve Roots
DRG
spinal Artery
spinal Vein
2-4 Sinuvertebral nerves
Fat
transforaminal Ligaments
207
Q

Spinal canal

Extends from the foramen magnum to where?

Contents (8 items)

A

distal sacrum

spinal cord
spinal nerve roots
dura mater
arachnoid mater
pia mater
CSF
blood vessels
CT
208
Q

Spinal canal

T or F: smallest in the thoracic spine. Largest in the cervical region.

T or F: cervical region of the spinal cord is the MC location for myelopathy

A

 the spinal canal is smallest relatively in the thoracic region and largest in the cervical region
 cervical region of the spinal canal is the most common site for cord compression
[myelopathy] because the spinal cord is widest in this region [C6]

209
Q

Atlanto-Occipital Joint

Type

A

 Type Synovial
 Classification Condylar
 Bones involved Condyle of occipital bone and superior articular facet of C1
 Range of motion Flexion, extension and a little lateral bending and rotation
 Muscles acting Flexion-longus capitis and rectus anterior
Extension-SCM, semispinalis, splenius
Lateral bending-rectus lateralis, SCM and trapezius
 Innervation C1

210
Q

Median Atlanto-Axial [Atlanto-Dental] Joint

Type

A

 Type Synovial
 Classification Pivot
 Bones involved Anterior arch of C1 and the Dens of C2
 Range of motion Rotation
 Muscles acting Rotation-SCM and semispinalis capitis which are countered by the action of
rectus capitis posterior major, obliquus capitis superior and inferior
 Innervation C2

211
Q

Lateral Atlanto-Axial Joint

Type

A

 Type Synovial
 Classification Planar
 Bones involved Lateral masses of C1 and the superior articular facets of C2
 Range of motion Rotation and flexion/extension
 Muscles acting Rotation-SCM and semispinalis capitis against rectus capitis posterior
major, obliquus capitis superior and inferior
 Innervation C2

212
Q

Zygapophyseal [facet] Joint

Type

A

 Type Synovial
 Classification Planar

 Range of motion: depends on the area
cervical facet joint capsules are long and loose:
 allows for greater movement
 especially rotation, flexion and extension
 50% of flexion and extension in the cervical region occurs at the C 0 -C 1 joint
 50% of rotation in the cervical region occurs at C 1 -C 2 joints
Thoracic facets allow primarily for rotation and secondarily flexion
lumbar facet joint capsules are short and tight:
 restricts movements limiting rotation and lateral bending

 Innervation medial branches of the dorsal rami of the corresponding spinal nerve and the nerve below [and perhaps from the one above also]

213
Q

Sacroiliac Joint

Type

A

 Type Compound made up of an anterior synovial joint and posterior syndesmosis
 Classification Reciprocal interlocking planar which allows minimal gliding
 Bones involved Articular surface of the ilium and the auricular aspect of the sacrum
 Range of motion Nutation and counternutation around an axis passing through S2
 Nutation-forward movement of the base of the sacrum [like nodding]
 Counternutation-backward movement of the base of sacrum
 Muscles acting All muscles acting on the lower spine and hip:
mainly erector spinae and psoas major
 Innervation Superior gluteal nerve and branches from S1 and S2

214
Q

Costovertebral Joint

Type

A

 Type Synovial
 Classification Planar
 Bones involved Body of the vertebra and the head of the corresponding rib
 Range of motion Upper 6 joints-pump handle action; lower 6 joints-bucket handle action
 Muscles acting Intercostals and diaphragm
 Innervation Segmental spinal nerve

215
Q

Costotransverse Joint

Type

A

 Type Synovial
 Classification Planar
 Bones involved Tubercle of the rib and the transverse process of the corresponding
vertebra
 Range of motion Upper six costotransverse joints allow rotation and the lower six joints allow for
gliding
 Muscles acting Intercostal and diaphragm
 Innervation Segmental spinal nerve

216
Q

Costochondral joint

Type

A

 Type Primary cartilaginous
 Classification Synchondrosis
 Structures Distal end of the rib and cartilage
 Range of motion None
 Muscles acting Intercostal and diaphragm
 Innervation Segmental spinal nerve

217
Q

Sternochondral joint

Type

A

 Type 1st is a primary cartilaginous and 2nd to 7th are synovial
 Classification Synchondrosis for the 1
st
and planar for the others
 Structures Cartilage and sternum
 Range of motion Pump handle during respiration
 Muscles acting Intercostal
 Innervation Segmental spinal nerve

218
Q

Manubriosternal joint

A

 Type Secondary cartilaginous
 Classification Symphysis
 Bones involved Manubrium and body of sternum
 Range of motion Slight increase and decrease angulation during respiration
 Muscles acting Intercostal
 Innervation Segmental spinal nerve

219
Q

Xiphisternal joint

A

 Type Secondary cartilaginous
 Classification Symphysis, becomes an synostosis after the 40th year
 Bones involved Body of sternum and xiphoid process
 Range of motion very little
 Muscles acting Intercostals, diaphragm and rectus abdominis
 Innervation Segmental spinal nerve

220
Q

Embryology of the spinal cord

Derived from the _______ tube, which is influenced by which nutrient in the __ trimester. And which embryological layer does it arise from?

A

neural tube, folic acid, 1st trimester, ectoderm

221
Q

Neural tube

Starts distal to the 4th pair of somites at the 3rd week of gestation.

dorsal plates differentiates into the _____ neurons

ventral plates differentiates into the _____ neurons

Neural canal becomes the ______ canal of the spinal cord

Which week does the NT close?

A

dorsal = sensory

ventral = motor

central canal

Week 4

222
Q

Tissue at the sides of the neutral tube become the neural ______ cells which give rise to

DAMMMESS

A 
o  Dorsal Root Ganglia 
o  Adrenal medulla 
o  Melanocytes, Microglia and Meninges [arachnoid and pia] 
o  Enteric neurons 
o  Schwann cells 
o  Sympathetic ganglia
223
Q

Spinal cord

foramen magnum to which lumbar segment in adults?

2 areas of enlargement

3 coverings

Dural sac ends at S__

A

L1/2 in adults (conus medullaris)

C6-cervical (brachial plexus)
Lumbosacral region (lumbar plexus)

dura, arachnoid, pia mater

224
Q

3 bundles/funiculi of white matter

A

posterior, anterior, lateral (intermediate)

225
Q

Posterior/Dorsal Columns

3 Modes

2 tracts

A

1) vibration
2) fine touch (2 pt discrimination)
3) joint position sense

o fibers from the lower limb synapse in the nucleus graciLis in the medulla
o fibers from the upper limb synapse in the nucleus cUneatus in the medulla

226
Q

T or F:

 the grey matter is arranged in horns: dorsal [sensory], ventral [motor] and lateral [__________]

 the lateral [intermediolateral] horn is only found in the thoracic part of the spinal cord from T__ to
L___ and represents the region that carries __________fibers

A

 the grey matter is arranged in horns: dorsal [sensory], ventral [motor] and lateral [sympathetic]
 the lateral [intermediolateral] horn is only found in the thoracic part of the spinal cord from T6 to
L1 and represents the region that carries sympathetic fibers

227
Q

Spinal cord

Blood supply (4)

Anteriorly

Posteriorly

A

segmental spinal arteries from the following

ascending cervical
deep cervical
posterior intercostal
lumbar

2/3 anterior = ASA (anterior spinal artery)

1/3 posterior = PSA (posterior spinal artery)

228
Q

UMNL vs. LMNL - in terms of…

Reflexes
Tone
Atrophy
Fasciculations
Babinski sign
A

UMNL

Reflexes - increase + clonus
Tone - spastic
Atrophy - absent
Fasciculations - absent
Babinski sign - present

LMNL

Reflexes - decreased or absent
Tone - flaccid
Atrophy - present
Fasciculations - present
Babinski sign - absent
229
Q

Cells of the CNS

neuroglia - 3 examples + function

microglia - function

A

neuroglia: astrocytes (helps with BBB), ependymal (makes CSF), oligodendrocytes+schwann cells (myelination)
microglia: macrophages of the nervous system (derived from mesoderm and not neuroectoderm like other cells)

230
Q

Frontal

Parietal

Occipital

Temporal

A

 Frontal [thinking and motor function] lies in front of the central sulcus
 Parietal [sensory] lies between the central sulcus and the parieto-occipital fissure
 Occipital [visual] lies behind a line connecting the parieto-occipital fissure and preoccipital notch
 Temporal [hearing, smell and memory] lies onferior to he lateral fissur

231
Q

Sympathetic system

Location of origin
Pre-gang fiber
Post-gang fiber
NT

Parasympathetic system

Location of origin
Pre-gang fiber
Post-gang fiber
NT

A

Sympathetic system

Location of origin: paravertebral
Pre-gang fiber: short
Post-gang fiber: long
NT: NOREPI

Parasympathetic system

Location of origin: intramural
Pre-gang fiber: long
Post-gang fiber: short
NT: Ach

232
Q

 cholinergic [acetylcholine]

 adrenergic [norepinephrine]

All Ach receptors are _________. Except: postganglionic receptors which _________

A

nicotinic

muscarinic (sweat glands

233
Q

Which tissues do not have BOTH sympathetic and parasympathetic innervation? BABAS

A 
blood vessels (symp)
arector pili (symp)
bronchial glands (parasymp)
adrenal medulla (pre-gang symp)
sweat glands (symp)
234
Q

Adrenergic receptors

Two types

A

 All α adrenergic receptor type cause contraction of smooth muscle including the dilator
[radially-arranged fibers] pupillae muscle in the eye

 All β adrenergic receptors are β2 type EXCEPT those that are found in the heart which are β1 (responsible for HR and contraction force)

235
Q

Enteric brain

Walls of intestine

2 major intramural plexuses (symp and parasymp) include…

A

Myenteric plexus of Auerbach (inner circular and outer longitudinal smooth muscle layers of the muscularis externa to regulate peristalsis

Submuscosal plexus of Meissner (secretion of intestinal glands)

Auerbach plexus lies on the Autside and Meissner plexus lies on the inside

236
Q

3 autonomic mediated reflexes

VVS

A

Viscerovisceral reflex - pressure on carotid sinus –> slowing of HR and BP drop

Viscerosomatic reflex - inflation of lung triggers diaphragm to relax (afferent-vagus, effort-phrenic n.)

Somatovisceral reflex - an example is paraspinal muscle spasm triggered by internal disc disruption causing spinal
nerve root irritation which results in visceral dysfunction

Part A Boards (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions