anatomy everything else Flashcards
paralysis of the lower lip is damage of what nerve
marginal mandibular branch of CNVII
what are the pleural reflections
abrupt lines along which the PARIETAL pleura change direction as it passes from one wall to the other
what are the 3 pleural reflections
sternal
costal
vertebral/diaphragmatic
where are the pleural reflections at the sternal line on the right and the left
right - level of 6th costal cartilage
left - level of 4th costal cartilage
how do the vagus nerves enter the superior mediastinum
posterior to their respective sternoclavicular joint and braciocephalic veins
describe the route of the right vagus nerve in the mediastinum
Runs posteriorinferiorly through the superior mediastinum on the right side of the trachea
Passes posterior to the right brachiocephalic vein, SVC and root of right lung
divides into branches to contribute to the right pulmonary plexus
what happens the right vagus nerve after it has contributed to the right pulmonary plexus
leaves as a single nerve
passes to the oesophagus to contribute to the oesophageal plexus
also contributes to the cardiac plexus
how does the left phrenic nerve enter the superior mediastinum
between the subclavian artery and brachiocephalic vein
describe the route of the right phrenic nerve
passes along the RIGHT side of the right brachiocephalic vein, SVC, pericardium of right atrium
passes ANTERIOR to the root of the right lung
descends on the right side of the IVC to the diaphragm
what are subarachnoid cisterns
openings in the subarachnoid space
created by separation of the arachnoid and pia mater
contain CSF and soft tissue structures that anchor the brain
what is the largest subarachnoid cistern
cerebellomedullary
receives CSF from 4th ventricle
location of the ambient subarachnoid cistern
on the lateral aspect of the midbrain
continuous posteriorly with the quadrageminal cistern
where is the Chiasmatic subarachnoid cistern
inferior and anterior to the optic chiasm
which cistern contains parts of the great cerebral vein
Quadrigeminal cistern
name the 5 subarachnoid cisterns
Cerebellomedullary (largest)
Pontocerebellar
Chiasmatic
Quadrigeminal (contains great cerebral vein)
Ambient
examples of hyaline cartilage
costal
nasal
tracheobronchial
laryngeal
articular cartilage of typical synovial joints
epiphyseal growth plates
what type of cartilage is hyaline cartilage
found at joint surfaces
a pearly bluish colour with firm consistency and considerable collagen
no nerves or blood vessels
covered by a fibrous membrane called perichondrium
examples of fibrocartilage
knee menisci
intervertbral discs
glenoid labrum
articular surface of clavicle
In relation to bone what is the periostium
a thick layer of vascular fibrous tissue that covers the outer surface of the bone
nutrition of the bone depends on the integrity of the periostiums blood vessels
does not cover articulating surfaces of the bone
what is cancellous bone capable of
rearrangement in response to strain
it is spongy bone
describe and give and example of secondary cartilaginous joints
strong, slightly moveable joints
united by fibrocartilage
eg intervertebral discs
myotome for plantar flexion
S1/S2
shoulder abduction myotome
C5
myotome elbow extension
C6/C7
myotome of opponens pollicis
T1 (small C8 component)
what is a direct connection of the vestibular nucleus
vestibulospinal tract
foot inversion myotome
L4, L5
knee flexion myotome
L5 S1
shoulder adduction and medial rotation myotome
C6 C7 C8
myotome for great toe extension
L5
upper limb pronation myotome
C7 C8
upper limb supination myotome
C6
wrist flexion myotome
C7
wrist extension myotome
C6
what nerve supplies general sensation of anterior 2/3 of tongue
lingual nerve of CNV3
cell bodies in the trigeminal ganglion
what nerve supplies taste for the anterior 2/3 of tongue
chorda tympani nerve from CNVII
cell bodies in the geniculate ganglion
elbow flexion myotome
C5/C6
elbow extension myotome
C6/C7
what structures pass through the clavipectoral fascia/costocoracoid membrane
lymphatics - in
cephalic vein - in
thoracoacromial artery - out
lateral pectoral nerve - out
contents of the lesser sciatic foramen
(PINT)
Pudendal nerve
Internal pudendal artery and vein
Nerve to obturator internus muscle
Tendon of obturator internus
according to Hiltons law which nerves supply the hip joint
femoral
obturator
nerve to quadratus femoris
superior gluteal
regarding cerebral circulation what is the largest vessel
middle cerebral artery
regarding cerebral circulation where are congenital aneurysms commonly found
on the anterior cerebral and anterior communicating artery
the dorsal column pathways synapse where ?
Gracile and cuneate nuclei
end inthe lower part of the medulla
what do the dorsal column pathways do
ascending fibres concerned with light/discriminative touch, vibration sense, proprioception, sense of fullness in the bladder and rectum
where is the medulla
it is in the posterior cranial fossa
part of the brainstem between pons and spinal cord
what is the blood supply of the medulla
vertebral and basilar arteries
posterior inferior cerebellar artery
what cranial nerves come from the medulla
9 10 and 12
what do the spinocerebellar tracts convey
unconcious proprioceptive information from cord to cerebellum
what are the 3 structures/tracts that control posture and movement
vestibulo-spinal tract
lateral reticulo - spinal
spino - cerebellar
what action of the eye does superior rectus cause
adducts, elevates and medially rotates the eye ball
what happens to the eye with combined action of superior rectus and inferior oblique
vertical upward movement
regarding cerebral blood supply what does the territory of the anterior cerebral artery control
contralateral leg
micturition
defacation
regarding cerebral blood supply what does the territory of the middle cerebral artery control
motor and sensory are of opposite side except lower limb.
speech and auditory area
regarding cerebral blood supply what does the territory of the posterior cerebral artery control
visual area for the field of vision on the opposite side
where does the midbrain lie and what is its blood supply
posterior cranial fossa
posterior cerebral and superior cerebellar arteries
which muscle controls vocal cord abduction in the larynx
posterior criocoarytenoid
where does the internal jugular vein lie in relation to the sternocleidomastoid muscle
It runs deep to the two heads of sternocleidomastoid
what nerves do the gag reflex
Glossopharyngeal nerve for afferent,
vagus nerve for efferent
what lies in the stylomastoid foramen
facial nerve
stylomastoid artery
it is the termination of the facial canal
muscle contents of the posterior triangle
splenius capitus
levator scapulae
middle scalene
posteror scalene
arteries in the posterior triangle
lateral branches of the thyrocervical trunk
subclavian 3rd part
suprascapular
cervicodorsal trunk
superficial cervical artery
dorsal scapular artery
veins in the posterior triangle
external jugular vein
subclavian vein
nerves in the posterior triangle of the neck
spinal accessory
roots of the brachial plexus
suprascapular
roots of cervical plexus
superior and inferior root of ansa cervicalis
cutaneous branch of cervical plexus
great auricular
transverse cervical
supraclicular
phrenic
acessory phrenic
branches of the opthalmic nerve (CNV1)
lacrimal
supraorbital
supratrochlear
infratrochlear
external nasal
in cerebral blood flow where does the great cerebral vein drain
with the inferior sagittal sinus forms the straight sinus
drains into the transverse sinuses
where do the cerebral veins lie
subarachnoid space
what opens into the inferior meatus
nasolacrimal duct
While transversing the temporal bone within the facial canal, CN VII gives rise to following nerves?
Greater petrosal nerve
chorda tympani nerve
Nerve to stapedius
The alar ligaments connect which of structures
Dens to foramen magnum
regarding the right coronary artery what % supplies the SA nod and the AV node
SA node 60%
AV node 80%
where does the right coronary artery arise from
the right aortic sinus
what does the internal thoracic artery supply
directly supplies the superior 6 intercostal spaces
describe the course of the internal thoracic artery
arises at the root of the neck
descends into the thorax posterior to the clavicle and 1st costal cartilage
descends 1cm lateral to the border of the sternum
gives off 2 anterior intercostal arteries in each intercostal space
has 12 branches
what is the internal thoracic artery a branch of
branch of the first part of the subclavian
landmarks of the oesophagus
begins at the lower border of the cricoid cartilage at C6
passes through the diaphragm at level T10
ends at the cardiac orifice at T11
where is the oesophagus the its narrowest
at the commencement at the cricopharyngeal sphincter
where does the trachea start
at the level of the cricoid cartilage below C6
how many bronchopulmonary segments are in each lung
10 bronchopulmonary segments
where does aspirated material tend to lodge in the lung
apical segment of the right lower lobe
where do the bronchial veins drain into on the left and the right?
accessory hemiazygous vein on the left
azygos vein on the right
in the chest wall where does the neurovascular bundle lie
between the internal intercostal and innermost intercostal muscles
In relation to the lung roots/hilum where do the vagus nerves run
behind the lung root
In relation to the lung roots/hilum where do the phrenic nerves run
in front of the lung root closer to the pericardium
referred pancreatic pain is felt where
T6 to T10
which lymph nodes drain the testes and ovaries
para aortic nodes
what drains into the superficial inguinal lymph
lower limb
inferolateral quadrant of the trunk
gluteal region
superficial perineal structures
what is the lymphatic drainage of the colon
via superior and inferior mesenteric lymph
how long is the male urethra
19.5-22cm
where is the narrowest part of the male urethra
at the external meatus
in the male urethra where is the spongy urethre
within the corpus spongiosum of the penis
what is the tough fibrous outer surface of the testes
the tunica albuginea
what is the surface of each testis
visceral layer of tunica vaginalis
where do the renal arteries originate
L1
what is the surface marking of the abdominal aorta
just above the transpyloric plane to a point just below and to the left of the umbilicus
what is the position of the appendix
retrocaecal position in the absence of disease
opens onto the caecum 2cm below the ileocaecal valve
in the anal canal superior to the pectinate line where does the lymph drain
internal iliac lymph nodes
in the anal canal inferior to the pectinate line where does the lymph drain
superficial inguinal lymph nodes
what structures pass through the transpyloric plane
9th costal cartilage
fundus of the gallbaldder
lower border of the first lumbar vertebra
spinal cord ends at the conus medullaris
pylorus
head neck and body of pacnreas
SMA
splenic vein
hilum of each kidney
superior pancreaticoduodenal vein drains into
splenic vein
inferior pancreaticoduodenal vein drains into?
SMA
what is the arterial blood supply of the stomach
left and right gastric arteries
six short gastric arteries
left and right gastroepiploic arteries
anatomical landmark of the cardia of stomach
midline at the level of T11
what is the length of the duodenum
25cm
what anatomical level does the duodenum lie
L1 to L4
what is the first branch of the abdominal aorta
inferior phrenic arteries
what is the main vessel supplying the body of the pancreas
splenic artery
what is the blood supply to the head of the pancreas
superior pancreaticoduodenal artery
what are the ureters crossed over by
vas deferens
gonadal vessels
ductus deferens
testicular/ovarian vessels
what do the ureters cross over
genitofemoral nerve
sacroiliac joint at the bifurcation of the iliac vessels
on top of the psoas muscle
Which bones form the borders of the anterior fontanelle in an infant
2 frontals
2 parietals
A lumbar puncture needle passes through which correct series of layers to get CSF
Skin, subcutaneous tissue,
supraspinous ligament,
interspinous ligament,
ligamentum flavum,
dura,
arachnoid
how much CSF is produced daily
500-550ml
where is the main site of absorption of CSF
arachnoid granulations
what is the weight of the brain
1400g
in its CSF water bath is 50g
how does the CSF communicate between the 3rd and 4th ventricle
via the cerebral aqueduct
which is the first bone to ossify
clavicle
but also is the last to completely ossify
describe the course of the first part of the duodenum
runs to the right upwards and BACKWARDS from the pylorus
describe the course of the second part of the duodenum
covered in front by peritoneum
crossed by the attachment of the transverse mesocolon
curves downwards over the hilum of the right kidney
describe the course of the third part of the duodenum
curves forward from the right paravertebral gutter over the slope of the right psoas muscle
passes over the forwardly projecting inferior vena cava and aorta
reaches the left psoas muscle
describe the fourth part of the duodenum
ascends to the left of the aorta to lie on the left psoas muscle
reaches the lower border of the pancreas
cerebrospinal fluid is produced by the choroid plexuses which are found where
in the lateral, third and fourth ventricles
with regards to CSF, what do the lateral ventricles consist of and what do they drain into
consist of a body and anterior, posterior and inferior horns
each ventricle drains into 3rd ventricle through interventicular foramina
CSF in the 4th ventricle drains into what
into the subarachnoid space via the foramen of Magendis and two lateral foramens of Luschka
what is the lumbar plexus formed from
nerves from the anterior to the lumbar transverse process
anterior rami of L1 to L4
what are the branches of the lumbar plexus
Femoral L2-L4
Obturator L2-L4
Lumbosacral trunk L4 L5
Ilioinguinal and iliohypogastric L1
Genitofemoral L1 L2
Lateral cutaneous nerve of the thigh L2 L3
Accessory obturator L3 L4
what covers the sacroiliac joint
covered by articular cartilage at the joint surface
branches of aorta running superior to inferior
Inferior phrenic
coeliac
suprarenal
SMA
renal
gonadal
IMA
median scaral
landmarks of the abdominal aorta
T12 to L4
what are the 5 layers of the scalp
SCALP
Skin
Connective tissue
Aponeurosis with muscles
Loose areolar tissue
Pericranium
In the scalp where do blood vessels and nerves run
in the second layer
what is the blood supply of the scalp
external and internal carotid
external; occipital, posterior auricular and superficial temporal
internal; supratrochelar and supraorbial
what is the blood supply of the spinal cord
a single anterior and 2 posterior spinal arteries
ASA formed from the vertebral artery
PSA formed from the posterior inferior cerebellar and vertebral artery
in the superior mediastinum what are the layers anterior to posterior
Lymphoid system - thymus
Blood vascular system
Respiratory system - trachea
Alimentary system - oesophagus
Lymph vascular system
what does the right coronary artery suppy
right atrium
right ventricle
diaphragmatic surface of the left ventricle
posterior 1/3 of interventricular septum
SA node 60%
AV node 80%
what are the 5 arteries that supply anterior part of the nasal septum (kiesselbach’s area)
Anterior ethmoidal artery (opthalmic a)
Posterior ethmoidal a ( opthalmic a)
Sphenopalatine a (maxillary a)
Greater palatine a ( maxiallry a)
Septal branch of the superior labial artery from the facial a
at what level does the aortic arch become the descending aorta
level of T4
definition of medial plane
vertical plane passing longitudinally through the body
divides the body into right and left halves
passes through the body at right angles to the frontal plane
definition of sagittal plane
vertical plane passing through the body parallel to median plane
what is heterotopic bone
bone formation in tissues where they are not normally found
define capitulum
small round articular head
define condyle
roudned knuckle like articular head
define facet
smooth flat area usually covered with cartilage
Superior oblique eye movements
Abduct
Depress
medially rotate
Eye movements of Inferior oblique
Abduct
elevate
laterally rotate
eye movements of superior rectus
Adduct
Elevate
medially rotate
eye movements of inferior rectus
Adduct
Depress
Laterally rotate
anatomical landmark of the mitral valve
posterior to the sternum at level of 4th costal cartilage
what fascia encloses the retropharyngeal space anteriorly
Buccopharnygeal fascia
what fascia encloses the retropharyngeal space posteriorly
deep cervical fascia
At the level of which intercostal cartilage does the superior vena cava (SVC) drain into the right atrium
3rd costal cartilage
The internal thoracic artery is a branch of what
Subclavian artery
The intercostals increase the volume of the thorax in which dimension
anterior-posterior
Which lobe of the brain is responsible for processing sense of smell
temporal lobe
A patient is unable to remove a food bolus from their cheek. Which nerve is likely damaged
facial
weakness/paralysis to buccinator or obicularis
what is the hypoglossal nerve responsible for
motor supply to intrinsic and extrinsic muscles of the tongue
what carries sensory supply of the epigastric region
Visceral afferent fibres synapsing in the T7-T8 sensory ganglia in spinal cord
Patients with gastric ulcers will experience pain from gastric mucosa irritation. This is interpreted centrally via afferent fibres from which nerve?
Visceral afferent fibres synapsing in the T7-8 sensory ganglia in spinal cord
What structure makes up the lateral border of the deep inguinal ring
transversalis fascia
Which is primarily responsible for the peripheral sensory supply to the diaphragm?
Intercostal nerves
what is the main sensory supply to the diaphragm
phrenic nerve
an example of a secondary cartilaginous joint?
intervertebral disc
A middle-aged man presents to the emergency department with left-sided flank pain and is found to have a ureteric calculus. Nerve fibres carry afferent supply from the ureter to which vertebral level?
T11-T12
An 80-year-old lady with atrial fibrillation presents with acute abdominal pain. Which part of the vasculature of the bowel is most likely to be compromised?
jejunum
A patient with acute necrotizing pancreatitis develops intra-abdominal bleeding. Which artery is the likely source?
splenic artery
The straight sinus is formed by
inferior sagittal sinus and great cerebral veins
A patient is stabbed in the anterior chest to the left of the sternum. Which structure is most likely damaged?
right ventricle
Which cell is responsible for myelin formation in the CNS?
oligodendrytes
In testicular torsion, which structure is affected first?
venous drainage
What branch from the internal iliac supplies the psoas and quadratus lumborum?
Iliolumbar artery
The primary motor centre is found in which lobe?
Frontal
Where does the right bronchial artery generally arise from?
Right 3rd posterior intercostal artery
Which portion of the urethra is most likely to be damaged with insertion of an indwelling urinary catheter?
Intermediate part
Which part of the pelvis is least likely to be fractured in trauma?
body of the ileum
