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Comprehensive Review > Anatomy - Comp Exam > Flashcards

Anatomy - Comp Exam Flashcards

1
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D. Musculocutaneous nerve

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2
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D. Serratus anterior

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3
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B. Scaphoid

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4
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A. Abductor pollicis brevis

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5
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B. Infraspinatus

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6
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E. thoracodorsal nerve.

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7
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A. coronal

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8
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B. cranial caudal and the anterior-posterior axes

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9
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A. True

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10
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B. lungs

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11
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B. left-right or transverse

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12
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A. Simple cuboidal

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13
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D. Simple columnar

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14
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C. Chondroblasts

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15
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B. Osteoclasts

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16
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D. calcaneus

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17
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D. sesamoid

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18
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D. synovial membrane

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19
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B. eccentric

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20
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C. seven

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21
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D. eight

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22
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C. Radial nerve

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23
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C. Radial

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24
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A. Latissimus dorsi

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25
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B. Erector spinae group

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26
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C. Long thoracic

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27
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The sacral promontory is formed by which of the following?

A. The centrum of L1

B. The spinous process of L1

C. The centrum of S1

D. The spinous process of S2

A

C. The centrum of S1

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28
Q

The spinal cord proper ends at which of the following levels?

A. L5/S1

B. S5

C. L2

D. L4

A

C. L2

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29
Q

The vagus nerve passes through the diaphragm at which vertebral level?

A. T6

B . T8

C. T10

D. T12

A

C. T10

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30
Q

The aortic opening of the diaphragm is located at which vertebral level?

A. T6

B. T8

C. T10

D. T12

A

D. T12

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31
Q

Which of the following structures is/are found in both the superior and the inferior mediastinum?

A. Thymus

B. Vagus nerve

C. Heart

D. Trachea

E. Phrenic nerves

A

A. Thymus

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32
Q

The heart is found in which of the following locations?

A. Anterior superior mediastinum

B. Middle superior mediastinum

C. Anterior inferior mediastinum

D. Middle inferior mediastinum

E. Posterior inferior mediastinum

A

D. Middle inferior mediastinum

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33
Q

Which of the following structures would NOT be found in the superior mediastinum?

A. Esophagus

B. Azygos vein

C. Vagus nerve

D. Thymus

E. Trachea

A

B. Azygos vein

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34
Q

Which of the following lobes would not be found in the right lung?

A. Upper (superior)

B. Middle

C. Lower (inferior)

D. Lingula

A

D. Lingula

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35
Q

Remnants of the umbilical arteries are associated with which of the following landmarks on the posterior aspect of the anterior abdominal wall?

A. Falciform ligament

B. Medial umbilical folds

C. Median umbilical folds

D. Lateral umbilical folds

E. Ligamentum teres

A

B. Medial umbilical folds

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36
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A. right

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37
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B. Splenic vein

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38
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C. Ileum

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39
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D. phrenic

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40
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D. Compact bone

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41
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D. White (unilocular) adipose tissue

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42
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A. Anterior border of the trapezius

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43
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A. Trochlea

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44
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C. Infraspinatus

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45
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C. ASIS and pubic tubercle

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46
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C. Wide pubic arch

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47
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A. Pelvic brim

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48
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D. Iscial spine

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49
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D. Piriformis muscle

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50
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C. Coccygeus

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51
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A. Puborectalis

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52
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D. Obturator nerve

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53
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A. Scrotum

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54
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A. Endometrium

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55
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B. Ampulla

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56
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57
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58
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C. 125

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59
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A. Cuboid

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60
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B. Gluteus medius

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61
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B. Hip hyperextension

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62
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B. Obturator

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63
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C. Femoral nerve

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64
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A. Coronary

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65
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B. Popliteus

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66
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A. Popliteal nerve

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67
Q

Describe the superficial posterior compartment of the leg.

A

Leg - Superior Posterior Compartment

  • Cutaneous nerves:
    • Lateral sural cutaneous nerve:
      • From common peroneal (fibular) nerve.
    • Medial sural cutaneous:
      • From tibial nerve.
    • Sural nerve runs with lesser saphenous vein.
  • Muscles:
    • Gastrocnemius
    • Plantaris
    • Soleus
    • Triceps surae
    • Common insertion
  • Nerve supply:
    • Tibial nerve
  • Blood supply:
    • Posterior tibial artery.
    • Peroneal (fibular) artery.
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100
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101
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102
Q

Describe cardiac muscle.

A

Cardiac Muscle

  • Shares characteristics with both skeletal and smooth muscle.
  • Striated and involuntary.
  • Consists of chains of individual cells that are both mononucleated and striated.
  • A major characteristic of cardiac muscle are specialized intercellular junctions called intercalated discs.
103
Q

Describe the arrangement of a sarcomere.

A

Sarcomere Arrangement

  • Myosin and actin fibers are organized into cylindrical units, called sarcomeres, that are aligned end-to-end to form the myofibrils.
  • Sarcomere structure:
    • Z-lines:
      • Separate adjacent sarcomeres in a fibril.
      • Composed of Z-actin.
    • I-bands:
      • Located on either side of the Z-line
      • Make up ends of each sarcomere
      • Composed entirely of actin.
    • A-bands:
      • Located in the middle of the sarcomere between two I-bands.
      • Represents the length of the myosin chains.
      • Composed of actin and myosin.
    • H-band:
      • In the middle of each A-band
      • Composed entirely of myosin
      • Band width changes during contraction.
104
Q

What nerves branch from the posterior cord of the brachial plexus and where do they originate?

A

Nerves of the Posterior Cord of the Brachial Plexus

  • Direct branches:
    • Upper subscapular nerve:
      • C5(6)
      • Subscapularis muscle
    • Thoracodorsal nerve:
      • C6-7
      • Latissimus dorsi muscle
    • Lower subscapular nerve:
      • C(5)6
      • Subscapularis and teres major
  • Terminal branches:
    • Axillary nerve
      • C5-6
      • Motor:
        • deltoid and teres minor
      • Sensory:
        • Skin on arm over deltoid
        • Upper lateral cutaneous nerve
    • Radial nerve:
      • C5-T1
      • Motor:
        • Posterior compartments of arm and forearm.
        • Brachioradialis
      • Sensory:
        • Back of arm, forearm, hand
105
Q

Describe the radial artery, its path and branches in the posterior antebrachium.

A

Posterior Antebrachium - Radial Artery

  • Smallest terminal branch of the brachial artery.
  • Proximally lies deep to brachioradialis.
  • Distally becomes superficial between brachioradialis and flexor carpi radialis.
  • Winds dorsally through anatomical snuff-box.
  • Branches:
    • ​Radial recurrent
    • Dorsal metacarpal and digital arteries
    • First dorsal metacarpal:
      • Princeps pollicis
      • Radialis indicis
  • Pierces first dorsal interosseous muscle
  • After passing through the first dorsal interosseous muscle it gives off the princeps pollicis artery to the thumb.
  • Then renamed the deep palmer arch:
    • ​Gives off the palmer digital arteries.
    • Forms a complete arch across the palm deep to the long extensor tendons.
    • Joins the ulnar artery on the medial side.
  • ​Note that the ulnar artery forms a superficial palmar arch which crosses the palm and joins the radial artery on the lateral aspect of the palm.
106
Q

Describe the bones of the wrist.

A

Wrist - Bones

  • Proximal (lateral to medial):
    • Scaphoid (1)
      • Forms floor of anatomical snuff box.
      • Most commonly fratured wrist bone, usually fractured at “waist” and compromises the radial artery in snuffbox.
      • Fractures may compromise radial artery in snuff box.
      • Articulates with radius.
    • Lunate
      • Articulates with radius.
    • Triquetral (12)
      • Articulates with ulna (via articular (ulnar) disc) during extreme ulnar deviation.
    • Pisiform (11)
      • Sesamoid bone.
      • Forms in tendon of the flexor carpi ulnaris.
  • Distal (lateral to medial):
    • Trapezium (2)
    • Trapezoid (3)
    • Capitate (8)
    • Hamate (10)
107
Q

Describe the anatomical snuff box.

A

Anatomical Snuff Box

  • Tendons of muscles that define the anatomical “snuff-box”:
    • Extensor pollicis longus
      • Dorsal and more medial.
    • Extensor pollicis brevis
      • Palmar border
    • Abductor pollicis longus
      • Runs with extensor pollicis brevis.
  • Components of the snuff box:
    • Scaphoid bone is in the floor.
    • Branches of the radial nerve.
    • Radial artery runs in the floor over the scaphoid bone.
      • Site for radial pulse.
108
Q

What are the deep muscles of the back?

A

Muscles of the Back - Deep

  • True intrinsic muscles of the back.
  • Innervated by dorsal (posterior) rami.
  • 3 groups:
    • Superficial:
      • Splenius capitis
      • Splenius cervicis
    • Intermediate (sacrospinalis system):
      • Iliocostalis
      • Longissimus
      • Spinalis
    • Deep (Transversospinalis system):
      • Semispinalis
      • Multifidus
      • Rotatores
109
Q

Describe the superficial intrinsic muscles of the back.

A

Intrinsic Muscles of Back - Superficial

  • Most superficial muscles of the neck.
  • Make up the spinotransversalis system:
    • Run laterally and upward to attach to transverse processes and skull.
  • Consists of splenius group:
    • 2 parts:
      • Splenius capitis
        • O - spinous processes of C7, T1-4
        • I - Superior nuchal line and mastoid.
      • Splenius cervicis
        • O - Spinous processes of T3-6
        • I - C1-4 transverse processes with levator scapulae.
110
Q

Describe the intermediate intrinsic muscles of the back.

A

Intrinsic Muscles of the Back - Intermediate

  • Make up sacrospinalis system:
    • AKA: erector spinae.
    • These muscles collectively form the erector spinae group.
    • These muscles run longitudinally upward and attach to transverse processes, ribs, and spinous processes.
    • The sacrospinalis system forms three longitudinal bundles:
      • Iliocostalis:
        • Lateral part of erector spinae group.
        • Extends back; keeps erect posture.
        • Components:
          • Lumborum
          • Thoracis
          • Cervicis
        • O - ilium and sacrum.
        • I - most of the ribs.
      • Longissimus:
        • Middle portion of erector spinae group.
        • Components:
          • Thoracis
          • Cervicis
          • Capitis
        • O - transversus processes and sacrum.
        • I - most of the ribs.
      • Spinalis:
        • O - spinous processes of T11-L2
        • I - spinous processes of thoracic and lower cervical vertebrae.
        • Components:
          • Thoracis
          • Cervicis (usually absent)
          • Capitis - part of semispinalis capitis.
111
Q

Describe the deep intrinsic muscles of the back.

A

Intrinsic Muscles of the Back - Deep

  • Make up the transversospinalis system:
  • Covered by sacrospinalis group.
  • Muscles run laterally and insert medially.
  • Muscles run from transverse processes to transverse processes.
  • This group of muscles includes:
    • Semispinalis:
      • Traverse a couple of vertebral levels.
      • Components:
        • Thoracis
        • Cervicis:
          • O - T1-4
          • I - C3-5
          • Largely covered by semispinalis.
        • Capitis:
          • O - T1-6 and C4-7
          • I - between superior and inferior nuchal lines.
    • Multifidus:
      • Thick muscle mass.
      • Best seen in region of sacrum.
      • O - from sacrum and surrounding structures and from transverse processes up to C4.
      • I - on spinous processes C2-L5
      • Traverses 3 segments.
    • Rotatores:
      • Pass from root to transverse process to root of superior spinous process.
      • Long rotatores - spans 2 segments.
      • Short rotatores - spans 1 segment.
    • Intrinsic segmental muscles:
      • Interspinales
      • Intertransversarii
112
Q

Describe the mediastinum.

A

Mediastinum

  • Space between lungs.
  • Superior mediastinum:
    • Separated from inferior by horizontal plane between sternal angle and IV disc T4-T5.
    • Subdivisions:
      • Retrosternal
      • Prevertebral
  • Inferior mediastinum:
    • Subdivisions:
      • Anterior
      • Middle
      • Posterior
114
Q

What folds are found on the posterior surface of the anterior abdominal wall?

A

Folds on Posterior Surface

  • Median umbilical folds:
    • Midline peritoneal fold on inner abdominal wall above bladder.
    • Contains median umbilical ligament.
  • Medial umbilical folds:
    • Paired peritoneal folds on either side of median fold.
    • Contain medial umbilical ligaments:
      • Remnants of umbilical arteries.
  • Lateral umbilical folds:
    • Paired peritoneal folds lateral to medial folds.
    • Contain inferior epigastric vessels.
      • From deep inguinal to arcuate line.
115
Q

Describe the gross anatomy of the liver.

A

Liver - Gross Anatomy

  • Largest visceral organ in body (1/40th of weight).
  • Lies mostly in upper right portion of abdominal cavity.
  • Projects superiorly to xiphisternal junction.
  • Projects inferiorly to midpoint between xiphoid process and umbilicus.
  • Encased in fibrous capsule and covered by visceral peritoneum except:
    • Bare area, in contact with underside of diaphragm.
  • Falciform ligament:
    • Runs to umbilicus.
    • Encloses ligamentum teres.
116
Q

Describe the contents of the mediastinum.

A

Mediastinum - Contents

  • Superior:
    • Retrosternal:
      • Great vessels and branches
      • Thymus
    • Prevertebral:
      • Trachea
      • Esophagus
      • Thoracic duct
      • Sympathetic trunks
      • Vagus nerves
  • Inferior:
    • Anterior:
      • Thymus
      • Fat
      • Lymph nodes
    • Middle:
      • Pericardium
      • Phrenic nerves
      • Pericardiacophrenic artery
      • Heart and great vessels
    • Posterior:
      • Esophagus
      • Thoracic duct
      • Aorta and branches
      • Vagus nerves
      • Sympathetic trunks
      • Azygos system of veins
117
Q

Describe the origin, location and function of the ulnar nerve.

A

Ulnar Nerve

  • Supplies flexor muscles on the ulnar side of the forearm.
  • Starts in anterior brachial compartment:
    • Medial to brachial artery.
    • Runs with superior ulnar collateral artery.
    • Pierces medial intermuscular septum.
    • Enters posterior compartment of the brachium.
    • Passes around the (superficial) medial epicondyle.
    • Passes into forearm between two heads of flexor carpi ulnaris muscle.
118
Q

Describe the elbow complex.

A

Elbow Complex

  • Type of joint:
    • Hinge joint
    • Uniaxial
  • Function:
    • Antebrachium extension and flexion.
    • Antebrachium supination and pronation.
  • Joints of the elbow complex:
    • Humeroulnar joint:
      • Trochlear notch to trochlea
      • Flexion and extension
    • Humeroradial joint:
      • Fovea of head of radius to capitulum
      • Flexion and extension
      • Pronation and supination
      • Superior (radial notch of ulna and annular ligament)
      • Inferior (Ulnar notch of radius, articular disc, head of ulna).
      • Intermediate (Interosseous membrane syndesmosis)
119
Q

Describe the distal end of the humerus.

A

Humerus

120
Q

Identify processes of the scapula.

A

Scapula - Processes

  • Acromion process
  • Glenoid process
    • Articulation with head of humerus
    • Supraglenoid tubercle:
      • Biceps brachii longus tendon
    • Infraglenoid tubercle
      • Triceps longus
121
Q

Identify the features of the anterior aspect of the scapula.

A

Scapula: Anterior

  • Anterior surface:
    • Subscapular fossa
    • Scapular (suprascapular) notch.
  • Coracoid process:
    • Muscle attachments:
      • Biceps brachii brevis
      • Coracobrachialis
      • Pectoralis minor
122
Q

Identify the features of the posterior aspect of the scapula.

A

Scapula: Posterior

  • Crosses ribs 2-7 in anatomical position
  • Posterior surface:
    • Scapular spine
    • Supraspinosous fossa
    • Infraspinous fossa
    • Spinoglenoid notch
    • Medial (vertebral borer)
    • Superior angle
    • Inferior angle
123
Q

Identify the muscle attachements and features from the anterior aspect of the scapula.

A
124
Q

Describe the pelvic boundries.

A

Pelvis - Boundries

  • Pelvic inlet (superior outlet):
    • Sacral promontory.
    • Arcuate lines.
    • Iliopectineal line of pubis.
    • Referred to as pelvic brim.
  • Pelvic outlet:
    • Coccyx
    • Sacrotuberous ligaments.
    • Ischial tuberosities.
    • Ischiopubic rami.
    • Pubic symphysis.
125
Q

Describe the true pelvis vs. the false pelvis.

A

True Pelvis vs. False Pelvis

  • False (greater) pelvis:
    • Expanded area above pelvic brim.
    • Pelvic brim = pelvic inlet.
  • True (lesser) pelvis:
    • Portion of pelvis below pelvic brim (pelvic inlet).
    • Closed below by pelvic diaphragm.
126
Q

Identify:

A
127
Q

Identify:

A
128
Q

Identify:

A
129
Q

Describe the lateral surface of the pelvis.

A

Pelvis - Lateral Surface

  • Acetabular fossa (AF):
    • For articulation with head of femor.
    • Lunate surface.
  • Acetabular notch (AN)
  • Acetabular labrum (AL):
    • Fibrocartilage rim around edge of acetabulum.
  • Obturator foramen (OF):
    • Covered by membrane.
    • Passage for obturator nerve and vessels.
  • Ischial ramus (IR)
  • Pubic rami:
    • Superior (PS)
    • Inferior (PI)
  • Pubic tubercle (PT):
    • Attachment for inguinal ligament.
130
Q

Identify:

A
131
Q

Describe the anterior edge of the pelvis.

A

Pelvis - Anterior Edge

  • Anterior superior iliac spine (ASIS):
    • Attachment of inguinal ligament.
    • Proximal attachment for artorius muscle.
  • Anterior inferior iliac spine (AIIS):
    • Proximal attachment for straight head of rectus femoris.
132
Q

Identify:

A
133
Q

Describe the posterior edge of the pelvis.

A

Pelvis - Posterior Edge

  • Posterior superior iliac spine (PSIS).
  • Posterior inferior iliac spine (PIIS).
  • Greater sciatic notch (GSN):
    • Converted into superior and inferior parts by piriformis muscle.
  • Lesser sciatic notch (LSN).
  • Ischial spine (IS).
  • Ischial tuberosity (IT).
134
Q

Describe the medial surface of the pelvis.

A

Pelvis - Medial Surface

  • Iliac fossa:
    • Attachment surface for iliacus muscle.
  • Arcuate line
  • Auricular surface:
    • Articulates with auricular surface of sacrum.
  • Pubic symphysis.
135
Q

Identify:

A
136
Q

Identify:

A
137
Q

Describe the external iliac a.

A

Pelvic Cavity Vasculature - External Iliac

  • Branches from the common iliac a.
  • Travels lateral to superior pubic ramus.
  • Branches:
    • Deep circumflex iliac a.
    • Inferior epigastric a.
  • Travels deep to inguinal ligament.
  • Becomes femoral a.
138
Q

Describe the internal iliac a.

A

Pelvic Cavity Vasculature - Internal Iliac Artery

  • Branches from the common iliac a.
  • Arises anterior to sacroiliac joint.
  • Travels inferiorly and medially over pelvic brim.
  • Supplies:
    • Pelvic organs and walls.
    • Gluteal muscles.
    • Perineum.
  • 2 divisions:
    • Anterior:
      • Branches:
        • Umbilical a.
        • Obturator a.
        • Inferior vesical a.
        • Uterine a.
        • Internal pudenal a.
        • Inferior gluteal a.
        • Middle rectal a.
        • Vaginal a.
    • Posterior
139
Q

Describe the obturator artery.

A

Pelvic Cavity Vasculature - Obturator Artery

  • Branches from the anterior internal iliac artery.
  • Travels anteriorly and inferiorly along pelvic wall.
  • Exits pelvic cavity through obturator canal in obturator foramen.
  • Supplies:
    • Pelvic muscles
    • Ilium
    • Femoral head
    • Muscles of medial thigh.
140
Q

Describe the autonomic innervation of the pelvic cavity.

A

Pelvic Cavity - Autonomic Innervation

  • Provided by:
    • Pelvic splanchnic nerves
    • Coccygeal plexus
    • Sacral splanchnic nerves
    • Lumbar splanchnic nerves
    • Sacral sympathetic trunk:
      • Paravertebral ganglia:
        • Ganglion impar
        • Superior hypogastric
141
Q

What is the pelvic diaphragm?

A

Pelvic Diaphragm

  • A muscular sheet that covers the pelvic outlet.
  • Forms a muscular sling that supports the pelvic organs.
  • Consists of:
    • Levator ani complex (major constituent)
    • Coccygeus
142
Q

Describe the levator ani.

A

Pelvic Diaphragm - Levator Ani

  • Consists of:
    • Puborectalis:
      • Forms a sling around anorectal junction.
    • Pubococcygeus
    • Iliococcygeus
  • Forms muscular sling supporting pelvic organs.
  • Incomplete anteriorly to allow for passage of the urethra and vagina.
143
Q

Describe the urogentital diaphragm.

A

Urogenital Diaphragm

  • Layer of skeletal muscle between 2 layers of fascia.
    • Penetrated by membranous urethra (male and female) and vagina.
  • Ischioanal (ischiorectal) fossa:
    • Wedge-shaped space between:
      • Anal canal, obturator internus, pelvic diaphragm, skin.
    • Filled with loose connective tissue and fat.
    • Allows expansion of anal canal during defecation and the vagina during child birth.
144
Q

Describe the sciatic foramina.

A

Sciatic Foramina

  • Structures passing through greater sciatic foramen:
    • Piriformis muscle
    • Sciatic nerve
    • Superior/inferior gluteal vessels and nerves.
    • Pudendal nerve
    • Internal pudendal artery/vein.
    • Posterior femoral cutaneous nerve.
    • Nerves to quadratus femoris and obturator internus.
  • Structures passing through lesser sciatic foramen:
    • Tendon of obturator internus.
    • Nerve to obturator internus.
    • Pudendal nerve.
    • Internal pudendal vessels.
145
Q

What nerve innervates the latissimus dorsi?

A

Latissimus Dorsi - Innervation

  • Thoracodorsal nerve (C6-C8)
146
Q

Describe reproductive system homologies.

A

Reproductive System - Homologies

  • External genitalia:
    • Develop embyologically from identical primordia for both male and female.
    • Unpaired genital tubercle:
      • Male: glans penis.
      • Female: clitoris.
    • Paired genital folds:
      • Male: shaft of penis.
      • Female: labia minora.
    • Paired genital swellings:
      • Male: scrotum.
      • Female: labia majora.
  • Internal genitalia:
    • Structures develop from different structures, but both male and femal primordia are present in all embryos regardless of the presence or absence of the Y chromosome.
147
Q

Describe the divisions of the foot.

A

Foot - Divisions

  • Hindfoot:
    • Talus
    • Calcaneus
  • Midfoot:
    • Navicular
    • Cuboid
    • Cuneiforms
  • Forefoot:
    • Metatarsals
    • Phalanges
148
Q

Identify:

A
149
Q

Describe the plantar arches.

A

Foot - Plantar Arches

  • Longitudinal:
    • Medial
    • Lateral
  • Pathologies:
    • Pes cavus
    • Pes planus
  • Support ligaments:
    • Plantar calcaneonavicular (spring):
      • Primary support for medial longitudinal arch.
    • Long plantar:
      • Primary support for lateral longitudinal arch.
  • Support ligaments:
    • Plantar aponeurosis
    • Plantar calcaneocuboid (short plantar)
    • Marginal abductors
  • Other arch support structures:
    • Shapes of bones
    • Peroneus longus
150
Q

What is the trendelenburg test?

A

Trendelenburg Test

  • Evaluates strength of contralateral gluteus medius.
  • Patient stands upright and raises one foot off the ground.
  • Contralateral gluteus medius should lower contralateral hip and raise ipsilateral hip.
  • Needed to clear foot from the ground during swing phase of walking.
151
Q

What are the ligaments of the hip joint?

A

Hip - Ligaments

  • Acetabular labrum
  • Transverse acetabular ligament
  • Fibrous capsule of joint is tight
  • Iliofemoral ligament
  • Pubofemoral ligament
  • Ischiofemoral ligament
  • Ligamentum teres
  • Zona orbicularis
152
Q

Describe the iliofemoral ligament.

A

Hip Joint - Iliofemoral Ligament

  • Strongest and most important ligament of the hip joint.
  • Called the “Y” ligament of Bigelow.
  • Proximal attachment:
    • AIIS
  • Distal attachment:
    • Intertrochanteric line
  • Resists hyperextension of the hip.
153
Q

Describe the pubofemoral ligament.

A

Hip Joint - Pubofemoral Ligament

  • Proximal attachment:
    • Pubis near inferior rim of acetabulum.
  • Distal attachment:
    • Neck of femur above lesser trochanter.
  • Resists hyperextension of the hip.
154
Q

Describe the ischiofemoral ligament.

A

Hip Joint - Ischiofemoral Ligament

  • Proximal attachment:
    • Ischium near posterior rim of acetabulum.
  • Distal attachment:
    • Neck of femur medial to greater trochanter.
  • Resists hyperextension of the hip.
155
Q

Describe the ligamentum teres of the hip joint.

A

Hip Joint - Ligamentum Teres

  • Proximal attachment:
    • Fovea of femoral head.
  • Distal attachment:
    • Transverse acetabular ligament.
  • Supports artery to the head of the femur.
156
Q

Describe the zona orbicularis.

A

Hip Joint - Zona Orbicularis

  • A collar-like ligament around the distal neck of the femur.
157
Q

Describe the facial nerve (CN VII).

A

Facial Nerve (CN VII)

  • The facial nerve is the primary motor nerve to muscles of facial expression.
  • SVM:
    • Supplies muscles of facial expression derived from the second pharyngeal arch (hyoid arch).
    • Cell bodies of these motor neurons are found in the motor nucleus of CN VII.
    • Nerve fibers exit through the stylomastoid foramen.
    • Supply mimetic muscles.
    • Also supply:
      • Stapedius
      • Stylohyoideus
      • Posterior digastric
  • GSS:
    • Carries general sensory fibers.
    • Cell bodies of these sensory neurons are located in the geniculate ganglion.
    • Supply:
      • Part of external ear.
  • SVS:
    • Carries special visceral sensory fibers.
    • Cell bodies of these sensory neurons are located in the geniculate ganglion.
    • Carry taste sensation from anterior two-thirds of tongue and hard and soft palates.
    • Cell bodies of primary sensory neurons are located in geniculate ganglion.
    • Secondary neurons originate from solitary nucleus.
    • Tertiary neurons end in thalamus
  • GVM:
    • Carries general visceral motor (GVM) fibers as part of the parasympathetic system.
    • Cell bodies of preganglionic neurons:
      • Located in superior salivatory nucleus and lacrimal nucleus.
      • Make up the greater petrosal nerve (GPN) and pass through the the pterygoid canal as the nerve of the pterygoid canal (NPC).
    • Cell bodies of postganglionic neurons:
      • Found in submandibular (sublingual) and pterygopalatine ganglia.
      • Use the zygomatic and lacrimal branches of CN V to reach the lacrimal gland.
    • Note that the lingual nerve branch of CN V carries part of the SVS and preganglionic GVM fibers of CN VII.
    • Supplies:
      • Lacrimal gland.
      • Submandibular and sublingual glands.
      • Mucous glands (oral and nasal).
  • Motor branches of the facial nerve include:
    • Temporal
    • Zygomatic
    • Buccal
    • Mandibular
    • Cervical
  • Peculiar branches of the facial nerve split off from inside the petrous part of the temporal bone before the nerve leaves the stylomastoid foramen and carry the parasympathetic part of the facial nerve.
    • Greater petrosal nerve:
      • Merges with deep petrosal nerve carrying sympathetic fibers from around the internal carotid.
      • The two petrosal nerves join to form the nerve of the pterygoid canal.
    • Chorda tympani:
      • Branches from facial nerve inside the petrous portion of the temporal bone.
      • Emerges into the rear of the middle-ear cavity and runs along the inner surface of the eardrum.
      • Joins lingual nerve of V3.
158
Q

Describe the hypaxial muscle organization in neck.

A

Neck - Hypaxial Muscle Organization

  • Hypaxial muscles in neck are innervated by ventral rami of spinal nerves (as elsewhere).
  • Groups:
    • Rectus cervicis series (rectus abdominis equivalents):
      • Infrahyoid muscles:
        • Deep:
          • Sternothyroid
          • Thyrohyoid
        • Superficial:
          • Sternohyoid
          • Omohyoid
    • Geniohyoid:
      • Forms incomplete floor of mouth.
    • Scalene muscles (intercostal muscle/abdominal oblique equivalents):
      • Anterior scalene:
        • Transverse processes of C3-C6 → first rib.
      • Middle scalene:
        • Transverse processes of C5-C7 → first rib.
      • Posterior scalene:
        • Transverse processes of C5-C7 → second rib.
      • Levator scapulae (separate slip from serratus layer):
        • Upper three or four cervical transverse processes → upper medial corner of scapula.
      • Prevertebral muscles (no obvious equivalents elsewhere in body):
        • Lateral and anterior intertransversarri:
          • Rectus capitis lateralis
          • Rectus capitis anterior
        • Longer prevertebral muscles:
          • Longus capitis
          • Longus colli
159
Q

Describe the characteristics and branches of the cervical plexus.

A

Cervical Plexus

  • From ventral rami of C1-4.
  • Runs partly with hypoglossal nerve (CN XII).
  • Sensory branches:
    • Great auricular (C2-3)
    • Lesser occipital (C2(3)):
      • Ventral ramus of C2.
    • Greater occipital - dorsal ramus of C2.
    • Transverse cervical (C2-3)
    • Supraclavicular (C3-4)
  • Motor branches:
    • To prevertebral muscles:
      • Rectus capitis anterior
      • Rectus capitis lateralis
      • Longus capitis and coli
    • To levatorscapulae muscle (C3-4).
    • To scalene muscles.
    • Ansa cervicalis:
      • Supplies infrahyoid muscles.
      • Except thyrohyoid.
    • Phrenic nerve (C3,4,5)
  • Nerve to geniohyoid:
    • C1 via hypoglossal nerve.
  • Nerve to thyrohyoid.
  • Superior and inferior limbs:
    • Omohyoid
    • Sternothyroid
    • Sternohyoid
160
Q

Describe the femoral triangle, its borders and contents.

A

Femoral Triangle

  • Borders:
    • Medial border of sartorius muscle.
    • Lateral border of adductor longus muscle.
    • Inguinal ligament:
      • From ASIS to pubic tubercle.
  • Contents (lateral to medial):
    • Femoral nerve (not in femoral sheath).
    • Femoral artery (in femoral sheath).
    • Femoral vein (in femoral sheath).
    • Lymphatics (in femoral sheath in femoral canal).
  • Floor:
    • Iliopsoas muscle.
    • Pectineus muscle.
    • Adductor longus muscle.
  • Cutaneous innervation:
    • Femoral cutaneous nerves:
      • Lateral
      • Intermediate
      • Medial
      • Posterior
161
Q

Describe the landmarks of the skull.

A

Bones of Skull - Landmarks

  • Sutures:
    • Sagittal = sag
    • Lambdoidal = lam
    • Coronal = cor
    • Frontal = fr
  • Fontanelles:
    • Anterior = ant
    • Posterior = post
    • Posterolateral = pl
    • Anterolateral = al
  • Nasion
  • Pterion
  • Inion
  • Asterion
  • Glabella
162
Q

Describe the suboccipital triangle muscles.

A

Suboccipital Triangle Muscles

  • Obliquus capitis superior:
    • Weak extensor of the neck.
  • Obliquus capitis inferior:
    • Strong rotator of atlas.
  • Rectus capitis posterior major:
    • Extension of vertebral column.
  • Rectus capitis posterior minor:
    • Extension of vertebral column.
163
Q

Describe the floor and roof of the suboccipital triangle.

A

Suboccipital Triangle - Floor and Roof

  • Floor:
    • Posterior atlanto-occipital membrane.
  • Roof:
    • Semispinalis capitis muscle.
164
Q

Describe the nervous and vascular contents of the suboccipital triangle.

A

Suboccipital Triangle - Nervous and Vascular Contents

  • Suboccipital nerve:
    • Dorsal ramus of C1.
    • No sensory function and no dorsal root.
    • Motor to muscles of suboccipital triangle.
  • Greater occipital nerve:
    • Dorsal ramus of C2.
    • Sensory to back of skull.
  • Third occipital nerve:
    • Dorsal ramus of C3
  • Vertebral artery
165
Q

Describe the dural sinuses.

A

Dural Sinuses

  • Dural venous sinuses are endothelial-lined spaces between the periosteal and meningeal layers of the dura.
  • Include:
    • Superior sagittal sinus:
      • Lies along superior margin of falx cerebri.
      • Begins at crista galli and ends at occipital protuberance.
    • Inferior sagittal sinus:
      • Lies along inferior margin of falx cerebri.
      • Ends in straight sinus.
    • Straight sinus:
      • Lies at intersection of falx cerebri and tentorium cerebelli.
      • Formed at intersection of inferior sagittal sinus with great cerebral vein.
      • Joins confluence of sinuses.
    • Confluence of sinuses:
      • Common confluence of superior sagittal sinus, transverse sinuses, and straight sinus.
    • Transverse:
      • Begins at confluence of sinuses
      • Extends along edges of tentorium cerebelli.
      • Right receives blood from
        superior sagittal sinus.
      • Left (dominant) receives
        blood from straight sinus.
    • Sigmoid:
      • Continuations on either side of straight sinus.
      • “S”-shaped.
      • End at jugular foramina.
      • Become internal jugular veins.
    • Cavernous:
      • Large venous plexus on each side of sella turcica.
    • Superior petrosal:
      • Run on either side from cavernous sinus to junction of transverse and sigmoid sinus.
    • Inferior petrosal:
      • Run on either side from cavernous sinus to junction of sigmoid sinus and internal jugular vein.
    • Sphenoparietal
    • Basilar venous plexus
166
Q

Describe the spleen.

A

Abdominal Viscera - Spleen

  • Largest lymphatic organ.
  • Develops in dorsal mesentery of stomach:
    • Not an embryological derivative of gut tube.
  • Location:
    • Lies against diaphragm in left hypochondriac region, along the long axis of ribs 9-11.
  • Ligaments of the spleen:
    • Gastrosplenic (gastrolienal) ligament:
      • Attaches spleen to stomach.
      • Contains:
        • Left gastroepiploic artery and vein.
        • Short gastric arteries and veins.
    • Phrenicosplenic (phrenicolienal) liganent:
      • Attaches spleen to diaphragm.
    • Lienorenal ligament:
      • Attaches spleen to left kidney.
  • Vascular supply of the spleen:
    • Splenic artery via 4 branches:
      • Superior polar
      • Superior middle
      • Inferior middle
      • Inferior polar
  • Impressions of the spleen:
    • Stomach
    • Large intestine
    • Kidney

Comprehensive Review (7 decks)

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