anatomy exam 1 Flashcards
how does regional anatomy organize the body?
by major segments or parts
how does systemic anatomy organize the body?
focuses on the body’s organ systems
what types of anatomy does clinical anatomy include?
regional and systemic anatomy (to describe function)
describe anatomical position
head (eyes) and toes directed anteriorly
arms adjacent to the sides with palms facing forward
lower limbs close together with feet parallel
how does the median plane divide the body?
divides the body into two halves
how does the sagittal plane divide the body?
divides the half into two other halves
how does the frontal (coronal) divide the body?
divides the body into front and back halves
how does the transverse plane divide the body?
divides body into superior and inferior parts
what are the four terms of laterality (and what do they mean)?
bilateral - both sides
unilateral - on one side
ipsilateral - same side
contralateral - opposite sides
what two components make up the central nervous system?
brain and spina cord
what connects the spinal cord to the brain?
brain stem (medulla oblongata and pons)
what is contained within gray matter in the spinal cord?
neuron cell bodies
what types of signals come into the dorsal root / dorsal horn?
sensory / afferent signals
what types of signals come out of the ventral horn?
motor / efferent signals
what is the outermost layer of meninges?
dura mater
what is the middle layer of meninges?
arachnoid mater
what is the inner most layer of meninges?
pia mater (adhered to tissue of spinal cord)
what is the order of spaces and meninges around the spinal cord? (outer to inner)
epidural space
dura mater
subdural space (potential space)
arachnoid mater
subarachnoid space (CSF found here)
pia mater
what are denticulate ligaments made up of and what is their clinical significance?
paired extensions of pia mater than attach to the arachnoid and dura mater (run between ventral and dorsal rootlets of the spinal cord)
helps to prevent lateral shifting of the spinal cord within the dural sac
what can be found within the epidural space?
adipose tissue, internal vertebral plexus
what can be found within the subarachnoid space?
spinal veins and arteries, cerebrospinal fluid, arachnoid trabeculae
what levels of the spinal cord makeup the cervical enlargement and what does it give rise to?
C5-T1
cervical plexus and brachial plexus
what levels of the spinal cord makeup the lumbar enlargement and what does it give rise to?
L1-S2
lumbar plexus and sacral plexus
how many spinal nerves are there within each segment of the spinal cord? (bilateral, paired)
cervical (8)
thoracic (12)
lumbar (5)
sacral (5)
coccygeal (1)
another term for conus medullaris (which level does it usually end at)?
terminal end of spinal cord
usually around L1-L2
significance of filum terminale (internum / externum)
extensions of pia mater that anchor the spinal cord inferiorly in dura sac (function is same way as denticulate ligaments)
significance of lumbar cistern
enlargement of subarachnoid space from L2-S2 (CSF pools here)
significance of cauda equina
L2-S5 spinal nerve roots (forms as a result of differential growth of spinal cord and vertebral column)
segmental spinal arteries arise from: (subclavian aa)
vertebral aa
ascending cervical aa
deep cervical aa
segmental spinal arteries arise from: (descending aorta)
posterior intercostal aa
lumbar aa
segmental spinal arteries arise from: (internal iliac aa)
lateral sacral aa
what artery does the anterior spinal artery arise from?
(located in subarachnoid space along spinal cord)
vertebral aa
what artery does the paired posterior spinal aa arise from?
(located in subarachnoid space along spinal cord)
vertebral aa or cerebellar aa
what types of arteries do segmental arteries give rise to and where do they go?
radicular - anterior and posterior
medullary - anterior
what is the largest of the segmental medullary arteries?
artery of ademkiewicz (supplies lower spinal cord)
order of venous drainage of spinal cord
anterior / posterior spinal veins
anterior / posterior medullary veins and radicular veins
internal vertebral venous plexus
segmental veins
other major systemic routes of venous drainage
what is a significance difference of veins within the internal vertebral venous plexus compared to veins found in other parts of the body?
these veins DO NOT have valves
clinical significance of internal vertebral venous plexus
cancer metastases (has many connections to systemic venous circulation)
what are the two sensory (afferent) tracts and what kind of stimulus do they perceive? (lateral and posterior)
dorsal columns - fine touch and proprioception
spinothalamic pathway - lateral - pain and temperature and anterior - touch and pressure
where do ascending tracts (sensory pathways) originate and where do they travel to? (
originate - peripheral body
travel to - primary sensory cortex
where do descending tracts (motor pathways) originate and where do they travel to?
originate - cerebral cortex and brainstem
travel to - muscle
what is the motor (efferent) tract? (lateral and anterior)
corticospinal tract (somatic motor - voluntary movement)
lateral - 85-90% to limbs
anterior - 10-15% to trunk
what does the peripheral nervous consist of?
cranial nerves, spinal nerves, and ganglia
what direction does sensory innervation get to the body?
brings information to the CNS from the environment
what direction does motor innervation come from the body?
sends instructions from the CNS to muscle and glands
where are the parts of a motor neuron located?
(one axon)
cell body - CNS
axon - comes out as part of a spinal nerve
where are the parts of a sensory neuron located?
(bipolar - two axons)
cell body - found outside of CNS, in ganglion
axon branches into peripheral tissue to pick up information and other branch goes to CNS to relay information
what does somatic innervation concern? (voluntary)
body wall (skeletal muscle or skin)
what does visceral innervation concern? (involuntary)
internal organs (innervation of the heart)
different types of:
body wall (somatic)
internal organs (visceral)
somatic sensory (skin)
somatic motor (skeletal muscle)
visceral sensory (brain regulation of internal organ function)
visceral motor (heart, digestive system)
what is the target tissue of somatic motor innervation and is it voluntary or involuntary control?
target tissue - skeletal muscle
voluntary control
ONE neuron connects the CNS to the target muscle
how does somatic sensory innervation carry sensory information and is perceived consciously or unconsciousy?
carries sensory information from skin and musculoskeletal system
perceived consciously
ONE neuron connects site of stimulus to CNS
examples of somatic sensory stimuli
pain from cutting, tearing, crushing, inflammation, burning
temperature
touch
pressure
vibration
THINK STIMULI THAT CAN BE FELT BY SKIN
importance of notochord
fiber of tissue that is important in regulating development of surrounding tissues (control segmentation)
importance of paraxial mesoderm
columns of tissue along either side of notochord that segments and becomes somite pairs (gives rise to bone, skeletal muscle, dermis - below the head)
what does dermamyotome give rise to?
population of somites that gives rise to dermis and muscle
what does sclerotome give rise to?
gives rise to axial skeleton (becomes bone)
what does exaxial dermamytomes give rise to?
all intrinsic (deep) back muscles and dermis that covers them
what does hypaxial dermamytomes give rise to?
all other skeletal muscle and dermis below the neck, including the limbs
what rami supples epaxial dermamytomes?
dorsal rami
what rami supples hypaxial dermamytomes?
ventral rami
what is the target tissue of visceral motor innervation and are they under conscious or unconscious control?
target tissue - smooth muscle, cardiac muscle, glands
under unconscious control (involuntary)
TWO neurons connect the CNS to target tissue
what are visceral structures located within the body wall?
sweat glands, arrector pili muscles, smooth muscle in skin and vessel walls
what types of innervation do most internal organs receive?
both sympathetic and parasympathetics
what type of innervation do most visceral structures in the body wall receive?
sympathetic innervation only
another term for sympathetic
fight or flight
another term for parasympathetic
rest and digest
where is parasympathetic outflow located in a spinal cord?
craniosacral (cranial nerves 3, 7, 9, 10 and S2-S4)
where is sympathetic outflow located in a spinal cord?
thoracolumbar (T1-L2)
relative length of pre/post ganglionic axons in sympathetic pathways
ganglia located roughly halfway between CNS and target (pre/ post ganglionic axons about same length)
relative length of pre/post ganglionic axons in parasympathetic pathways
long preganglionic axons enter organ before it find the short postganglionic axon
what does the vagus nerve supply?
parasympathetics to pharynx, larynx, all thoracic organs, and organs of the upper abdomen
what supplies parasympathetics to the lower abdomen and pelvis?
pelvic splanchnic nerves (preganglionic)
where are sympathetic preganglionic cell bodies located within the spinal cord?
lateral horn (gray matter)
sympathetic innervation to VENTRAL body wall
lateral horn
ventral root / rami
down white communicans (preganglionic)
synapse in paravertebral ganglion
up gray communicans (postganglionic)
out ventral rami towards hypaxial dermatome
sympathetic innervation to dorsal body wall
lateral horn
ventral root / rami
down white communicans (preganglionic)
synapse in paravertebral ganglion
up gray communicans (postganglionic)
backtrack to dorsal rami towards expaxial dermatome
sympathetic innervation for thoracic organs
lateral horn
ventral root / rami
down white communicans (preganglionic)
synapse in paravertebral ganglion
postganglionic (splanchnic nerve) extends to organ
NOTE - never use gray ramus as part of pathway
sympathetic innervation for abdominal and pelvic organs
lateral horn
ventral root / rami
down white communicans (preganglionic)
DO NOT synapse in paravertebral ganglion
elongated preganglionic axon extends through diaphragm
SYNAPSE in prevertebral ganglion (close to organ)
innervates organ
parasympathetic innervation to thoracic and upper abdominal organs
vagus nerve extends and synapses within organ wall
preganglionic cell bodies - CNS
postganglionic cell bodies - organ wall
parasympathetic innervation to lower abdominal and pelvic organs
lateral horn
ventral root / ramus
becomes pelvic splanchnic nerve
(all preganglionic)
what are the two types of visceral sensory innervation?
visceral pain - pain from internal organs
visceral afferents - visceral sensory other than pain
how is visceral pain described?
dull, diffuse, poorly localized
what can cause visceral pain?
ischemia, prolonged smooth muscle contraction, distention
how do visceral pain axons for the thorax and abdomen send signals back to the body?
follow sympathetic pathways backward (no matter how complicated) as far as spinal nerve proper then pass through the dorsal root (cell bodies found in dorsal root ganglia)
how do visceral pain axons from the pelvis send signals back to the body?
follow parasympathetic pathways backward to spinal nerve proper and then pass through dorsal root (cell bodies found in dorsal root ganglia)
how are visceral afferents (other than pain) carried back to body to be perceived?
from thorax and abdomen - carried by vagus nerve
lower abdomen and pelvis - pelvic splanchnic nerves
what part of the skeleton is made up of the cranium, mandible, spine, ribs, and sternum?
axial skeleton
what are the two main roles of the vertebral column?
protect the spinal cord and transfer loads (allow movement of body)
how many vertebrae are there in the 5 different segments of the spine?
cervical (n=7)
thoracic (n=12)
lumbar (n=5)
sacral (n=5)
coccyx (n=3/4)
what segments of the vertebral column make up the the primary curvatures?
thoracic and sacral
what are segments of the vertebral column make up the the secondary curvatures?
cervical and lumbar
what segments of the spinal cord are convex?
thoracic and sacral
what segments of the spinal cord are concave?
cervical and lumbar
what are the 5 palpable skeletal landmarks and points of reference for the back and spinal column?
cervicothoracic junction (C7)
scapular spine (T3)
inferior scapular angle (T7)
12th rib (T12) - last set of floating ribs
iliac crest (L4) - supracristal line
what are the relative degrees of flexion and extension within the cervical spine?
flexion - 45-50 degrees
extension - 85 degrees
what is the degree of axial rotation within the cervical spine?
90 degrees
what is the degree of lateral flexion within the cervical spine?
40 degrees
what artery does the vertebral arteries give rise to that can be impinged on during rotational movement and cause vertigo / dizziness, syncope, and visual disturbance?
basilar artery
what is the relationship between flexion and extension within the thoracic and lumbar regions?
thoracic - flexion and extension is relatively limited (articular facets flat and against each other)
lumbar - flexion and extension are relatively free (articular facets are turned slightly lateral)
what is the relationship between lateral flexion and bending within the thoracic and lumbar regions?
thoracic - lateral flexion and bending is somewhat limited (articular processes and ligaments)
lumbar - lateral flexion and bending is somewhat minimal in lumbar region
what type of movement is an important aspect of human bipedal locomotion?
axial rotation
what helps to promote rotation in the thoracic region?
orientation of articular processes
NOTE - attachment of ribs somewhat limited the range of rotation that would be possible
NOTE - trunk rotation in the lumbar region is relatively limited due to shape and orientation of lumbar articular processes
general anatomical features of typical vertebral segments (see picture in notes)
vertebral body - weight bearing parts of vertebrae
vertebral arch - made of up pedicle and lamina
inferior / superior articular process
transverse process
spinous process
which vertebrae within the vertebral column does NOT have a vertebral body?
atlas (C1)
which vertebrae within the vertebral column has the dens?
axis (C2)
NOTE - dens of C2 used to be the body of C1
what segment of vertebrae have a bifid spinous process and what does it accomodate?
cervical vertebrae (7) and nuchal ligament
what segment of vertebrae have demi-facets and the vertebral bodies resemble a heart shape?
thoracic vertebrae (12)
what segment of vertebrae are under the greatest amount of strain because they transmit weight to the pelvis (have the largest vertebral body)?
lumbar vertebrae (5)
what segment of vertebrae is comprised of 5 fused vertebrae, provides strength and stability to the pelvis, and serves as sites of attachment for ligaments that hold the sacrum and pelvis together posteriorly?
sacrum (5)
what part of the sacrum tends to correspond to the center of gravity?
promontory (articulates with L5 vertebrae)
name the parts of the thoracolumbar fascia (tendon sheet)
anterior layer
middle layer
posterior layer
what are the two components of intervertebral discs?
nucleus pulposus - jelly like spongy middle (remnant of notochord)
annulus fibrosus - fibrous tough outer layer that provides joint connection between vertebral bodies
where are intervertebral discs the thickest and thinnest?
thickest - lumbar region (where they bear the most weight)
thinnest - cervical region
ligaments of the vertebral column to know (see picture in notes)
nuchal ligament (cervical region). -attaches to bifid spinous process
supraspinous ligament
interspinous ligaments
ligamentum flava (has a lot of collagen - yellow color)
intertransverse ligaments
anterior longitudinal ligament
posterior longitudinal ligament
describe kyphosis (hyperkyphois) and what it can result from
- abnormal or exaggerated thoracic curvature (convexity)
- can result from developmental abnormalities, trauma, or degenerative disease
describe lordosis (hyperlordosis) and what it can result from
- abnormal or exaggerated lumbar curvature (concavity)
- associated with congenital abnormalities, musculoskeletal problems, degenerative disease
describe scoliosis and what it can result from
- abnormal or exaggerated lateral curvature of spine
- can be congenital, neuromuscular, or idiopathic in origin
NOTE - usually manifests in thoracic region
describe what a herniated intervertebral disc is and what it can result from
- weakened spot where nucleus pulposus can burst and rupture and thus compress spinal nerves
NOTE - usually occurs in lumbar region and in posterolateral direction
notes on thoracic region disc herniation
- usually a result of wear and tear (disc degeneration)
- sudden and forceful twisting of the mid-back region
- other conditions that predispose individual such as abnormal kyphosis
notes on lumbar region disc herniation
- lumbar region bears the most weight
- frequent bending, twisting, and improper lifting increases load on tendons that reinforce this region as well as intervertebral discs
- acute or sudden injury
describe spondylolisthesis and what it can result from
- anterior / central displacement of one vertebrae on adjacent
- common progression from spondylolysis (fracture of posterior aspect of vertebrae), can also be congenital
in what direction do intrinsic back muscles run?
run longitudinally
what area that is used clinically to hear breathing sounds is made up by the lateral border of trapezius and the superior border of latissimus dorsi?
triangle of auscultation
what area of clinical significance is prone to herniation due to a slight weakening in the lateral abdominal wall?
lumbar triangle
are extrinsic back muscles hypaxial or expaxial and what are they innervated by (dorsal or ventral rami)?
hypaxial
ventral rami of spinal nerves
NOTE - trapezius is innervated by cranial nerve 11
are intrinsic back muscles hypaxial or expaxial and what are they innervated by (dorsal or ventral rami)?
epaxial
dorsal rami of spinal nerves
NOTE- have a lot of proprioception function
extrinsic back muscles - HYPAXIAL and VENTRAL RAMI
trapezius
latissimus dorsi
levator scapulae
rhomboid minor
rhomboid major
serratus posterior superior
serratus posterior inferior
intrinsic back muscles - EPAXIAL and DORSAL RAMI
erector spinae group
- iliocostalis
- longissimus
- spinalis
transversospinalis group
- multifidus
- semispinalis
- rotatores
what three muscles make up the erector spinae group (superficial to deep)?
ilocostalis
longissimus
spinalis
what three muscles make up the transversospinalis group (superficial to deep)?
semispinalis
multifidus
rotatores
what rami innervates the intrinsic back muscles and skin of the back?
dorsal ramus
what rami innervates extrinsic back muscles, anterior / lateral trunk, and limbs…. makes up the cervical and brachial plexus and intercostal nerves?
ventral rami
what group of back muscles moves the shoulder and arm (extrinsic or intrinsic)?
extrinsic back muscles
where does trapezius receive its motor and sensory innervation from?
motor - spinal accessory nerve (CN11)
sensory - cervical plexus (C3 and C4)
where does latissimus dorsi receive its motor and sensory innervation from?
motor and sensory - thoracodorsal nerve (brachial plexus)
where does levator scapulae receive its motor and sensory innervation from?
motor and sensory - cervical plexus (C3 and C4)
where does rhomboid minor receive its motor and sensory innervation from?
motor and sensory - branchial plexus (dorsal scapular nerve)
where does rhomboid major receive its motor and sensory innervation from?
motor and sensory - branchial plexus (dorsal scapular nerve)
where does serratus posterior superior receive its motor innervation from?
intercostal nerve branches
where does serratus posterior inferior receive its motor innervation from?
intercostal nerve branches
what muscle connects from vertebral column out to scapula and clavicle (axial skeleton to shoulder)
trapezius
what muscle originates on vertebral column and thoracolumbar fascia… coming around and attaching to humerus?
latissimus dorsi
what three muscles connect from scapula to vertebral column?
levator scapulae
rhomboid minor
rhomboid major
where do extrinsic back muscles (posterior axioappendicular muscles) attach?
attach to scapula and humerus (upper arm bone) to the spine and/or ribs (axial skeleton)
what group of muscles move the vertebral column (extrinsic or intrinsic)?
intrinsic back muscles
what area does capitis denote?
connection to cranium
what area does cervicis denote?
connection to cervical vertebrae
what area does thoracis denote?
connectio to thoracic region
what area does lumborum denote?
connection to lumbar region
in what areas does the splenius muscle exist?
capitus and cervicis
in what areas does the iliocostalis muscle exist?
cervicis, thoracis, and lumborum
in what areas does the longissimus muscle exist?
capitus, cervicis, and thoracis
in what areas does the spinalis muscle exist?
cervicis and thoracis
in what areas does the multifidus muscle exist?
expands entire vertebral column
what are the two parts of the rotatores muscle (bi-fid muscle)?
brevis and longus
in what areas does the semispinalis muscle exist?
capitus and cervicus
what group of muscles functions to extend the trunk when working bilaterally and laterally flexes the trunk when active unilaterally?
erector spinae group
where does iliocostalis have attachments?
attaches to sacrum / ilium and ribs
where does longissimus have attachments?
has rib attachments and can extend to cranial region
where does spinalis have attachments?
inserts and originates in spinous processes
what muscle that is a part of the transversospinalis group skips 2 or more levels?
multifidus
what muscle that is a part of the transversospinalis group skips 2 levels?
rotatores longus
what muscle that is a part of the transversospinalis group skips 1 level?
rotatores brevis
