Anatomy Flashcards
What is superficial fascia mainly composed of?
Loose connective tissue and fat
What provides most of the body’s fat storage?
Superficial fascia
True or false - the superficial fascia varies in depth
True
What does superficial fascia carry?
Superficial blood vessels, cutaneous nerves, lymphatics and sweat glands
What is deep fascia mainly composed of?
Dense connective tissue. It is relatively tough and sheet like
What does the deep fascia cover?
Most of the body deep to skin and superficial fascia
Describe the appearance of deep fascia
White, sometimes glistening
Function of the deep fascia
Divides limbs into compartments
What is deep fascia named according to?
The body region it is located in
Deep fascia in the upper limb
Pectoral fascia, deltoid fascia, brachial fascia, anti-brachial fascia
Deep fascia in the lower limb
Fascia lata - thigh
Iliotibial tract
Crural fascia - bottom of leg
Iliotibial tract
Thickened band of fascia lata at the lateral aspect of the thigh
Where does the iliotibial tract insert onto the ilium and tibia
Inserts onto the ilium superiorly and tibia inferiorly
Intermuscular septa
Thickened sheet of fascia
Muscles within a compartment will have __ actions and __ __ nerve supply
Similar, the same
Clinical importance of deep fascia
Contain and direct the spread of infections/tumours, help to stop the muscle bellies from expanding too far during contraction, and help form part of the muscular venous pump, helping pump blood back to the heart against gravity
Where do the basilic and cephalic veins originate?
The dorsal venous network on dorsum of hand
Houseman’s vein
The section of the cephalic vein on the lateral aspect of the distal forearm. Often readily accessible for sitting a cannula
Describe the course of the cephalic vein
Originates in dorsal venous network on dorsum of hand
Runs anteriorly on the midline of the biceps brachii muscle
As it courses proximally it runs through the deltopectoral groove then dives through deep fascia in the deltopectoral triangle to join the axillary vein
Where does the axillary vein become the subclavian vein?
Lateral border of rib 1
True or false: in 20% of people, the median vein of the forearm bifurcates into the median cephalic vein and median basilic vein
True - these people do not usually have a median cubital vein
Medial cubital vein
Connection of cephalic and basilic vein
Describe the course of the basilic vein
Originates in dorsal venous network on dorsum of hand
Runs proximal on the medial aspect of the anterior forearm
It continues proximally before piercing the deep fascia to become the brachial vein at about mid-arm level
Veins in the cubital fossa
Median cephalic vein, median basilic vein, median vein of the forearm
Where does the great saphenous vein arise?
Medial aspect of the dorsal venous arch (from the foot)
Describe the course of the great saphenous vein
Arises from medial aspect of the dorsal venous arch
Travels proximally up medial aspect of limb
Lies immediately anterior to the medial malleolus
Drains into femoral vein, via the femoral triangle
Happens in anterior proximal thigh just distal to the midpoint of the inguinal ligament
True or false - the great saphenous vein gets smaller as it travels proximally?
False - it gets bigger
Where does the great saphenous vein lie in relation to eh patella?
It lies approximately 1 hands breadth medial to the medial aspect of the patella
Where does the small saphenous vein arise?
Lateral aspect of the dorsal venous arch
Describe the course of the small saphenous vein
Arises from lateral aspect of the dorsal venous arch
Travels up the posterior midline of leg
Drains into popliteal vein (posterior to knee)
Describe the course of the deep veins of the upper limb
Superficial and deep palmar venous arches to
Radial and ulnar veins to
Brachial vein to
Axillary vein to
Subclavian which
Meets with internal jugular to make brachiocephalic vein which drains into SVC
Describe the course of the deep veins of the lower limb
Plantar arch to Anterior and posterior tibial veins and fibular vein to Popliteal vein Femoral vein Deep femoral vein comes to femoral vein to External iliac vein Common iliac vein IVC
What causes varicose veins?
Incompetent valves result in reverse flow into superficial veins, causing them to become weak and dilated
Describe the arterial venous pump system
Veins that accompany arteries are called accompanying veins and are surrounded by arteries in a vascular sheath, as the artery expands, the veins are flattened and this helps push venous blood back towards the heart
Describe the arterial supply of the upper limb
Starts with subclavian artery passing under the clavicle
Moving to axillary artery
Down as brachial artery
Gives off deep brachial artery branch
Within the cubical fossa, brachial artery bifurcates to give 2 branches:
o Radial artery (laterally)
o Ulnar artery (medially)
These connect with deep and superficial palmar arches
Branch into metacarpal and digital arteries
How many digital arteries are there per digit?
4
Describe the arterial supply of the lower limb
External iliac artery (from pelvis under inguinal ligament)
Becomes femoral artery (chief arterial supply to lower limb)
Deep femoral artery (profunda femorus) – arterial supply to the thigh via perforator branches
Femoral artery continues inferiorly to become popliteal artery posterior to knee
Branches to become anterior tibial and posterior tibial arteries
Arteries in the foot:
o Dorsalis pedis artery (direct continuation of anterior tibial artery)
o Medial and lateral plantar arteries (bifurcating branches of posterior tibial artery)
o Arcuate artery (dorsal arch artery) and deep plantar arch
o Metatarsal and digital arteries
True or false: digital arteries are end-arteries
True - they are the only blood supply to that area of the body
How can blood loss from from an injury be prevented?
You can apply pressure proximal to the site of injury
Pulse point you can palpate in the neck
Bifurcation of the common carotid artery
Where can you palpate the common carotid artery?
Anterior to the sternocleidomastoid muscle at the level of the upper border of the thyroid cartilage
Pulse points you can palpate in the upper limb
Brachial artery and radial artery
Where can you palpate the brachial artery?
Medial to the biceps tendon in the cubital fossa
Where can you palpate the radial artery?
Lateral to the tendon of flexor carpi radialis
Pulse points you can palpate in the lower limb
Femoral artery, popliteal artery, posterior tibial artery, dorsalis pedis artery
Where can you palpate the femoral artery?
Inferior to the midpoint of the inguinal ligament
Where can you palpate the popliteal artery?
In the popliteal fossa - immediately posterior to knee
Where can you palpate the posterior tibial artery?
Between the posterior border of the medial malleolus and achilles tendon
Where can you palpate the dorsalis pedis artery?
Medial to the tendon of extensor hallucis longus just distal to the ankle joint
True or false: lymphatics generally follow nerves
False - they generally follow veins
Where do superficial lymphatics arise from?
Plexuses in fingers of hands
Where do basilic lymphatics drain into?
Basilic veins drain into cubical lymph nodes then lateral axillary nodes
Where do cephalic lymphatics drain into?
Cephalic veins drain straight up into apical axillary nodes
Where do deep lymphatics of the lower limb drain into?
Lateral axillary lymph nodes
Where do axillary lymph nodes drain into?
Subclavian lymphatics
Where do the great saphenous lymphatics drain into?
Great saphenous tend to pass to the superficial inguinal lymph nodes and then either the external iliac or deep inguinal nodes
Where do the small saphenous lymphatics drain into?
Small saphenous pass to the popliteal fossa nodes then to deep inguinal nodes then to external iliac nodes
Where do the deep lymphatics of the lower limb drain into?
Popliteal lymph nodes
Where do external iliac lymph nodes drain into?
Common iliac lymph nodes and enter lumbar lymphatics
Ischaemia definition
Inadequate oxygenation of cells/tissue/organ due to interruption to blood supply (arterial or venous)
Causes of reduced arterial perfusion pressure
Left ventricular failure
Arterial bleed (injury)
Arterial rupture (aneurysm)
Occlusion of lumen (atherosclerosis: PVD)
Arterial spasm
External compression of arterial supply (tumour, compartment syndrome, crossing legs, inflammation)§
Causes of increased venous drainage pressure
Right (or congestive) heart failure
DVT
External compression e.g. tumour
Steps in how immobility leads to DVT or ulceration
Immobility or venous valve failure → venous insufficiency → deep venous stasis (→ DVT or PE) or superficial microcirculatory deficiencies (very poor blood supply)(→ulceration)
What is venous ulceration a result of?
Blood vessels in the skin being damaged, usually due to increase of venous pressure
Where do most venous ulcerations affect?
The gaiter area - just above the ankle to just below the knee
Where to arterial ulcerations tend to affect?
Foot
Where can a thrombus, broken off from a DVT, occlude?
Small peripheral artery Segmental artery Lobar artery Pulmonary artery Pulmonary trunk
Pathway of DVT in anterior/posterior tibial vein or fibular vein to pulmonary artery
Anterior/posterior tibial vein or fibular vein → Popliteal vein → Femoral vein → External iliac vein → Common iliac vein → Inferior vena cava → Right atrium → Right ventricle → Pulmonary trunk → Left or right pulmonary artery
Type of infarction caused by thrombus blocking a small peripheral artery in the lung
Small wedge infarction
Type of infarction caused by a thrombus blocking a segmental artery in the lung
Bronchopulmonary segment infarction
Type of infarction caused by a thrombus blocking a complete lobar artery
Complete blockage of one lung lobe
Type of infarction cause by a thrombus blocking the whole pulmonary artery
Complete lung
