anatomy Flashcards
Name all the parts of the upper limb.
Axilla Arm Elbow/Cubital fossa Forearm Wrist Hand
Name all the parts of the lower limb.
Inguinal region/groin Thigh Knee/Popliteal fossa Leg Ankle Foot
what is the superficial fascia?
the subcutaneous tissue which consists of loose connective tissue and fat
it varies in depth and contains Superficial blood vessels, cutaneous nerves, lymphatics and sweat glands
what is the deep fascia?
layer of dense connective tissue which covers most of they body deep to skin and superficial fascia and divides the limbs into compartments
relatively tough and sheet like with a white appearance
Give examples of deep fascia tissue in the upper limb and what they lie over.
- Pectoral fascia - pectoral muscles
- Deltoid fascia - deltoid muscles
- Brachial fascia - brachium
- antebrachial fascia - antebrachium
Give examples of deep fascia in the lower limb and what they lie over.
Fascia lata - the thigh
crural fascia - the leg
what is the iliotibial tract?
thickened band of the fascia lata on the lateral aspect
inserts onto the ilium superiorly
inserts onto the tibia inferiorly
what does it mean when the deep fascia is described as “investing” in internal structure?
ii. what is special about deep fascia in the limbs ?
it surrounds deep structures in the body
ii. deep fascia not only invests in muscles but also has intermuscular septa which form fascial compartments. Muscles in the same compartments have the similar actions and same nerve supply. This helps contains infection and tumours and help venous return
What is the arterial supply to the upper limbs?
- subclavian artery ( under the clavicle)
- axillary artery
- brachial artery - gives off deep brachial artery
- brachial artery bifurcates into radial (lateral) and ulnar (medial)
- Deep and superficial palmar arteries in the hand
- Metacarpal and digital arteries ( 4 digital arteries per digit)
what is the arterial supply of the lower limb?
- external iliac artery
- external iliac artery passes under the inguinal ligament to form the femoral artery
- Femoral artery gives rise to the deep femoral artery ( supplies the thigh via perforator branches)
- femoral artery continues artery to the popliteal artery (just posterior to the knee)
- Popliteal branches bifurcates at the popliteal fossa to form anterior tibial and posterior tibial arteries
- anterior tibial artery forms dorsalis pedis artery
- posterior tibial artery bifurcates into medial and lateral plantar arteries
- Arcuate artery ( dorsal arch artery) and deep plantar arch artery
- metatarsal & digital arteries ( remember digital arteries for both fingers and toes are the only blood supply for the digits there are no collaterals)
Name all the sites in the limbs where you can get peripheral pulses?
Neck:
bifurcation of the common carotid artery
Upper limb:
brachial artery
radial artery
Lower limb: femoral artery popliteal artery posterior tibial artery dorsalis pedis artery
Compare the differences between superficial and deep veins?
Superficial
- Run in superficial fascia
- highly variable patterns
- Smaller and thinner in comparison to deep veins
- drain into deep veins
Deep
- Larger and thicker in comparison to superficial
- often occur in neurovascular bundle
- more predictable patterns
- run deep to deep fascia
Where does the cephalic vein rise from
ii. where does it travel through and drain into?
its a superficial vein which arises from the dorsal venous network
ii. the lateral aspect of the upper limb and travels superiorly through the deltopectoral groove and then drains into the axillary vein
where does the basilic vein from arise from?
ii. where does it travel through and drain into?
it is a superficial vein which arises from the dorsal venous network
ii. travels up the medial aspect of the upper limb travels up to mid arm level to drains into the brachial vein?
which vein in the cubital fossa which joins cephalic and the basilic vein?
ii.what is this used for?
median cubital vein
ii.venipuncture
Give some examples of common variants of the the superficial veins in the cubital fossa?
- median cephalic vein
- median basilic vein
- median vein of forearm
8% of patients have no connecting veins in the cubital fossa
where does the great saphenous vein arise from?
ii. where does it travel through and drain into?
It is a superficial vein which arises from the dorsal venous arch
ii. Lying immediately anterior to the medial malleolus of the tibia it travels superiorly in the medial aspect of the lower limb it is also 4 fingers width medial to the medial aspect of the patella. It runs along the saphenous nerve. It ends by piercing the deep fascia of the fascia lata in the region of the femoral triangle and then drains into the femoral vein
where does the small saphenous vein arise from?
ii. where does it travel through and drain into?
the dorsal venous arch on the lateral side
ii. runs up the posterior midline of the leg it drains deep in the popliteal fossa into the popliteal vein which is posterior to the knee
name the most common deep veins.
- Internal jugular vein
- subclavian vein
3, axillary vein
- brachial vein
- brachiocephalic vein
- SVC
- IVC
- radial and ulnar veins
- common and external iliac veins
- femoral vein
- deep femoral vein
- popliteal vein
- fibular vein
- anterior tibial vein
- posterior tibial vein
arches:
planter arch
superficial and deep palmer venous arches
which deep veins are unilateral?
SVC
IVC
where does venous blood flow from and where does it flow to?
Superficial veins into deep veins
perforating veins
what is the role of the musculovenous pump?
pushes blood back towards the heart
what is the role of the venous valves?
ensure unidirectional blood flow against gravity
incompetent valves result in reverse flow into superficial veins
what is the role of arteriovenous pump role?
also pushes blood back towards heart - as artery expands due to contraction of the heart, the veins become flattened which also helps the venous blood move to the heart
where does the superficial lymphatics of the upper limb arise from?
Plexuses in fingers and hand
what do superficial lymphatics of the upper limb follow?
the cephalic or basilic veins
those following the basilic vein will pass and drain into the cubital lymph nodes and then into the lateral axillary nodes
those following the cephalic vein normally drain straight into the apical axillary nodes
what do deep lymphatics of the upper limb follow?
follow the deep veins of the upper limb
they drain into lateral axillary lymph nodes
where do both axillary lymph nodes drain into?
the subclavian lymphatics
what do the superficial lymphatics of the lower limbs follow?
ii. where do they drain into?
follow saphenous veins (great and small)
great saphenous vein: pass into superficial lymph nodes and then into the external iliac or deep inguinal nodes
small: pass into the popliteal lymph nodes then into deep inguinal nodes and then the external iliac nodes
what do the deep lymphatics of the lower limbs follow?
deep veins of the lower limb
they drain into the popliteal lymph nodes and then deep inguinal nodes and then the external iliac nodes
where do the externa iliac nodes drain into?
common iliac nodes and then the lumbar lymphatics
what is ischaemia?
inadequate oxygenation due to an interruption to blood supply
either due to:
- reduced arterial perfusion
- increased venous drainage pressure - back pressure into capillary bed then into the arteriole preventing normal arterial in flow
what are the causes of reduced arterial perfusion?
LVF
arterial bleed
arterial rupture (aneurysm)
occlusion of the lumen ( PVD)
arterial spasm
external compression of arterial supply
what are the causes of increased venous drainage presure?
right cardiac failure
DVT
External compression (tumour)
how does venous ulceration occur?
- venous pressure increases
- damages blood vessels in skin
- skin becomes dry, itchy and inflamed
- cannot heal well due to poor blood supply
- begins to break down
what is the most common site of venous ulcerations?
gaiter area - Skin just proximal to the medial malleolus
if a thrombus breaks, depending on the diameter what can it occlude?
small peripheral artery
segmental artery
lobar artery
pulmonary artery
pulmonary trunk - complete occlusion can occur via a saddle embolus
what can venous stasis cause?
DVT
state how the order of a red blood cell would pass through them when traveling from the lungs to the big toe from top to bottom.
Pulmonary vein
Left side of the heart
Aorta
Abdominal aorta
Common iliac artery
External iliac artery
Femoral artery
Popliteal artery
Dorsalis pedis
state how the following vessels in the order a red blood cell would pass through them when returning to the heart from the big toe. Top to bottom with top being the first.
Deep plantar vein
Great saphenous vein
femoral vein
External iliac vein
Internal iliac vein
Abdominal vena cava
Inferior vena cava
right atrium
Organise the layers of the scalp in order from superficial to deep of the body.
Skin
Loose connective tissue
Connective tissue
Periosteum
Aponeurosis
skin
connective tissue
aponeurosis
loose connective tissue
periosteum
