Anatomy Exam 2 Flashcards

1
Q

superficial veins of upper limb

A

basillic- runs medially
cephalic- runs laterally
drain into axillary vein
connected by median cubital

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2
Q

lymphatics of axilla

A

humeral, pectoral, subscapular, central, apical

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3
Q

arteries of upper limb

A

subclavian artery arises from brachiocephalic trunk on right and directly from arch of the aorta

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4
Q

what does the subclavian artery become and when

A

becomes axillary artery at lateral border of 1st rib

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5
Q

first axillary artery branch

A

superior thoracic artery

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6
Q

second axillary artery branch

A

thoraco-acromial trunk
lateral thoracic artery

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7
Q

what does the thoraco-acromial trunk branch into

A

acromial, clavicular, deltoid, and pectoral branches

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8
Q

third axillary artery branch

A

subscapular artery
anterior humeral circumflex a.
posterior humeral circumflex a.

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9
Q

what does the subscapular artery branch into

A

thoracodorsal artery and circumflex scapular artery

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10
Q

musculocutaneous nerve

A

formed from lateral cord
c5-c7 ventral rami contributions
pierces through coracobrachialis m
major nerve of anterior arm
continues as lateral cutaneous nerve
innervates skin of lateral forearm

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11
Q

ulnar nerve

A

formed from medial cord
C8-T1 ventral rami contributions
located medial to brachial artery in arm
innervates nothing in arm
runs behind medial epicondyle
major nerve of hand

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12
Q

median nerve

A

Formed from 1/2 lateral cord and 1/2 medial cord
C6-T1 ventral rami contributions
passes medial to arm muscles
lateral to brachial artery proximally
distally crosses medial side of brachial artery
innervates nothing in arm
major nerve of anterior forearm

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13
Q

axillary nerve

A

formed from posterior cord
C5-C6 ventral rami contributions
circles behind humerus in quadrangular space with posterior circumflex humeral artery
inn. deltoid and teres minor

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14
Q

radial nerve

A

formed from posterior cord
C5-T1 ventral rami
passes posterior to humerus, travels with profunda brachii artery in radial groove, pair seen in triangular space
gives off cutaneous branches:
inferior lateral cutaneous nerve of arm
posterior cutaneous n of forearm
major nerve of posterior arm and forearm

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15
Q

dorsal scapular n

A

C5
passes posteriorly to reach and travel along the medial border of scapula
levator scapulae and rhomboids

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16
Q

long thoracic n

A

C5-C7
passes vertically down neck, through the axillary inlet, and down medial wall of axilla
runs with lateral thoracic artery
lies on superficial aspect of serratus anterior muscle
serratus anterior

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17
Q

suprascapular n

A

C5-C6
passes laterally through the posterior triangle of neck and through suprascapular notch/foramen to enter the posterior scapular region
supraspinatus
infraspinatus

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18
Q

N to subclavius

A

C5-C6
passes anteroinferiorly over the subclavian artery and vein
subclavius

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19
Q

lateral pectoral n

A

C5-C7
branches from lateral cord
pec major

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20
Q

medial pectoral n

A

C8-T1
branches from medial cord
pec major and minor

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21
Q

upper subscapular n

A

C5-C6
first branch off posterior
passes posteriorly to directly innervate subscapularis and teres major

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22
Q

thoracodorsal n

A

C6-C8
second branch posterior cord
runs inferolaterally along posterior axillary wall
close to thoracodorsal artery
from back to humerus

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23
Q

lower subscapular n

A

C5-C6
third branch off posterior
runs inferolaterally deep to subscapular a
innervates teres major and subscapularis

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24
Q

medial brachial cutaneous n

A

C8-T1
sensory to medial arm
second branch off medial cord
runs along medial side of axillary and branchial veins

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25
Q

medial antebrachial cutaneous n

A

C8-T1
sensory to medial forearm
third branch off medial cord
initially runs with ulnar nerve but pierces deep fascia with basilic vein and enters subcutaneous tissue

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26
Q

thoracic outlet syndrome

A

compression of subclavian artery and vein or brachial plexus
most commonly affects nerves
causes: trauma, anatomical defects, tumor, poor posture, pregnancy, repetitive arm mvmts

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27
Q

injury to upper plexus

A

C5-C6
result from excessive increase in angle between neck and shoulder
see effects in shoulder

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28
Q

injury to lower plexus

A

C8-T1
may occur when upper limb suddenly pulled superiorly
see effects in hand

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29
Q

2 compartments of arm muscles

A

anterior: flexors
posterior: extensors

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30
Q

biceps brachii

A

Origin: short head- coracoid process of scapula
long head: supraglenoid tubercle of scapula
Insertion: radial tuberosity and fascia of forearm via bicipital aponeurosis
Inn: musculocutaneous n
Action: supinates flexed forearm, flexes forearm when supine, short head resists dislocation

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31
Q

brachialis

A

Origin: distal half of anterior humerus
Insertion: coronoid process and ulnar tuberosity
Inn: musculocutaneous and radial n
Action: flexes forearm in all positions

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32
Q

coracobrachialis

A

Origin: coracoid process of scapula
Insertion: middle third of medial surface of humerus
Inn: musculocutaneous n
Action: flexes, adducts, and resists dislocation

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33
Q

triceps brachii

A

Origin: long head: infraglenoid tubercle of humerus
lateral head: posterior surface of humerus superior to radial groove
medial head: posterior surface of humerus inferior to radial groove
Insertion: olecranon process of ulna and fascia of forearm
Inn: radial n
Action: chief extensor of forearm, long head resists dislocation

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34
Q

anconeus muscle

A

triceps little helper
inn: radial n
actions: assists triceps in forearm extension, stabilizes elbow joint, may abduct during pronation

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35
Q

what action does C5 test

A

shoulder abduction

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36
Q

what action does C6 test

A

elbow flexion
testing biceps tendon

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37
Q

what action does C7 test

A

elbow extension
testing triceps tendon

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38
Q

the axillary artery becomes what and where

A

brachial artery at inferior border of teres major

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39
Q

what does the brachial artery branch into

A

radial and ulnar arteries

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40
Q

what are the branches of the brachial artery

A
  1. profunda brachii a
    - radial collateral a
    - middle collateral a
  2. humeral nutrient a
  3. superior ulnar collateral a
  4. inferior ulna collateral a
  5. radial a
  6. ulnar artery
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41
Q

trapezius

A

Origin: nuchal ligament and spinous processes
Insertion: lateral 1/3 of clavicle, acromion, and spine of scapula
Inn: accessory n
Action: elevates, depresses, retracts, rotates glenoid cavity superiorly

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42
Q

latissimus dorsi

A

Origin: spinous processes, iliac crest, ribs
Insertion: bicipital groove
Inn: thoracodorsal n
Action: adducts, medially rotates, and extends humerus; pulls body toward arms during climbin

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43
Q

levator scapula

A

Origin: transverse processes of cervical spine
Insertion: superior portion of medial border of scapula
Inn: dorsal scapular n
Action: elevates scapula, rotates glenoid cavity inferiorly by rotating scapula

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44
Q

rhomboids (major and minor)

A

Origin: minor: nuchal ligament
major: spinous processes of thoracic spine
Insertion: minor: medial border of scapula
major: medial border of scapula
Inn: dorsal scapular n.
Action: retract scapula, rotate glenoid cavity inferiorly, fix scapula to thoracic wall

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45
Q

triangle of auscultation

A

latissimus dorsi, trapezius, rhomboid major
floor: 6th intercostal
respiratory sounds

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46
Q

lumbar triangle

A

iliac crest, lat, external oblique
floor: internal oblique
lumbar herniation

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47
Q

serratus posterior superior

A

action: elevates ribs

48
Q

serratus posterior inferior

A

action: depresses ribs

49
Q

splenius capitus

A

Origin: spinus processes
Insertion: mastoid process
Inn: dorsal rami of spinal n
Action: rotate head ipsilaterally and laterally flexes neck, extends head and neck

50
Q

splenius cervicis

A

Origin: spinous processes of cervical and thoracic spine
Insertion: transverse processes of cervical spine
Inn: dorsal rami of spinal n
Action: rotate head ipsilaterally, laterally flexes neck, extends head and neck

51
Q

erector spinae (iliocostalis, longissimus, spinalis)

A

Origin: sacrum, ilium crest
Insertion: ribs
Inn: dorsal rami of spinal n
Action: extends vertebral column and head when back flexed and controls movement via eccentric contraction, laterally flexes vertebral column

52
Q

semispinalis capitus, semispinalis cervicis, semispinalis thoracis

A

Origin: transverse processes of cervical and thoracic spine
Insertion: occipital bone
Inn: dorsal rami
Action: extend head, cervical and thoracic regions of vertebral column, rotates contralaterally

53
Q

multifidus

A

Origin: PSIS of ilium
Insertion: SP of vertebrae
Inn: dorsal rami
Action: stabilizes vertebrae, involved in lower back pain

54
Q

rotatores

A

Origin: TP of vertebrae
Insertion: lamina and TP or spine
Inn: dorsal rami
Action: rotate, stabilize, and extend spine

55
Q

interspinales

A

aid in extension and rotation

56
Q

intertransversarii

A

aid in lateral flexion, stabilization

57
Q

levatores costarum

A

elevates ribs, assists with respiration and lateral flexion

58
Q

suboccipital triangle

A

rectus capitus posterior major, rectus capitus posterior minor, obliquus capitus inferior, obliquus capitus superior
contains suboccipital nerve and vertebral a
Actions:
Rectus capitus posterior major and minor: extension and rotation of head
Obliquus capitus superior: extension and lateral flexion
Obliquus capitus inferior: rotation of head

59
Q

craniovertebral joint

A

atlanto-occipital
atlanto-axial

60
Q

joints of articular processes

A

zygopophysial

61
Q

joints of vertebral bodies

A

uncovertebral
intervertebral

62
Q

intervertebral joints

A

symphysis joints
contain annulus fibrosus and nucleus pulposus

63
Q

what causes a herniated nucleus pulposus

A

portion of nucleus pulposus is pushed through weakened portion of annulus fibrosis
most common L4-L5 and L5-T1, no PLL or ALL

64
Q

Ligamenta flava

A

connect adjacent laminae of vertebra
Action: limits flexion

65
Q

anterior longitudinal ligament

A

Action: prevents hyperextension

66
Q

posterior longitudinal ligament

A

prevents hyperflexion

67
Q

nuchal ligament

A

resists flexion

68
Q

supraspinous ligament

A

connects tips of spinous processes
Action: limits hyperflexion

69
Q

interspinous ligament

A

Connects adjacent spinous processes
Action: limits hyperflexion

70
Q

what causes whiplash

A

muscle injury of neck due to sudden hyperextension and possible hyperflexion as head rebounds
possible stretching or tearing of ALL
possible facet jumping (pedicles) or locking of cervical vertebrae due to arch dislocation

71
Q

what happens with illegal face blocking

A

hyperextension and likely injure posterior portions of vertebrae
T11/T12 most common non-cervical break; going from an area of mobility to non-mobility

72
Q

epidural space

A

contains fat and blood vessels
outermost space

73
Q

dura mater

A

most external meninge
fuses with epineurium that surrounds the spinal nerves

74
Q

subdural space

A

separates dura mater from arachnoid mater
potential space, very small, sometimes fuses with dura mater

75
Q

arachnoid mater

A

deep to dura mater and subdural space

76
Q

subarachnoid space

A

between arachnoid mater and pia mater
real space, filled with CSF

77
Q

pia mater

A

adheres directly to spinal cord
forms lateral extensions called denticulates that anchor spinal cord to dura mater

78
Q

what do ventral roots contain

A

motor axons

79
Q

what do dorsal roots contain

A

sensory axons

80
Q

where do anterior and posterior roots unite to become spinal nerve

A

in intervertebral foramen

81
Q

what is the arterial supply of scapula

A

segmental arteries coming off aorta that pass through intervertebral foramen

82
Q

how many longitudinal arteries supply spinal cord

A

3; 1 anterior, 2 posterior

83
Q

how many veins supply spinal cord

A

6; 3 anterior, 3 posterior

84
Q

conus medularis

A

tapering inferior end of spinal cord
ends between T12-L3 usually L1
termination of spinal cord

85
Q

cauda equina

A

bundle of nerve roots running inferior to spinal cord
where stick the needle in and roots move out of way

86
Q

filum terminale

A

thin strand of pia mater that helps anchor conus medullaris to coccyx
tethers spinal cord inferiorly

87
Q

where do you do a lumbar puncture

A

L4-L5 in subarachnoid space

88
Q

where do you do an epidural

A

L4-L5 in epidural space; fat filled to hold analgesic

89
Q

what is a laminectomy used for and what is a potential after effect of it

A

used to release pressure in IV discs
could cause bony outgrowth

90
Q

deltoid

A

Origin: lateral 1/3 clavicle, acromion, spine of scapula
Insertion: deltoid tuberosity
Inn: axillary nerve
Action: abduction past first 15 degrees

91
Q

teres major

A

lats major helper
Origin: posterior surface of inferior angle of scapula
Insertion: medial lip of bicipital groove
Inn: lower subscapular n
Action: adducts and medially rotates arm

92
Q

supraspinatus

A

delts super helper
Origin: supraspinous fossa of scapula
Insertion: superior facet of greater tubercle
Inn: suprascapular n
Action: assists delt with abduction- does first 15 degrees

93
Q

infraspinatus

A

Origin: infraspinous fossa of scapula
Insertion: middle facet of greater tubercle
Inn: suprascapular n
Action: laterally rotates arm

94
Q

teres minor

A

Origin: middle part of lateral border of scapula
Insertion: inferior facet of greater tubercle
Inn: axillary n
Action: laterally rotates arm

95
Q

subscapularis

A

Origin: subscapular fossa of scapula
Insertion: lesser tubercle
Inn: upper and lower subscapular n
Action: medially rotates

96
Q

what causes rotator cuff injuries

A

repeated abduction and flexion causes wear on tendons as they rub on the acromion and coracoacromial ligament
tendon of supraspinatus is most vulnerable
weakest inferiorly because incomplete inferiorly

97
Q

what rotator cuff dislocation is most common

A

anterior humeral dislocation

98
Q

pec major

A

Origin: sternocostal head and clavicular head
Insertion: bicipital groove
Inn: lateral and medial pectoralis n
Action: adducts, medially rotates humerus, draws scapula inferiorly and anteriorly
clavicular head flexes while sternocostal head extends humerus from a flexed position

99
Q

pec minor

A

Origin: ribs 3-5
Insertion: coracoid process of scapula
Inn: medial pectoral nerve
Action: stabilizes scapular by drawing it inferiorly and anteriorly against thoracic wall
important in respirations

100
Q

subclavius

A

Origin: junction of 1st rib and costal cartilage
Insertion: inferior surface of clavicle
Inn: nerve to subclavius
Action: depresses and anchors clavicle

101
Q

serratus anterior

A

Origin: lateral part of ribs 1-8
Insertion: medial border of scapula
Inn: long thoracic n
Action: protract, rotate, and hold scapula against thoracic wall

102
Q

what causes paralysis of serratus anterior

A

injury to long thoracic nerve

103
Q

characteristic of someone with an injury to their long thoracic n

A

winged appearance
scapula moves away from thoracic wall

104
Q

quadrangular space

A

teres minor, teres major, triceps brachii long head, shaft of humerus

105
Q

what does the quadrangular space contain

A

axillary nerve and posterior circumflex humeral artery

106
Q

triangular space

A

teres major, teres minor, triceps brachii long head

107
Q

what does the triangular space contain

A

circumflex scapular artery

108
Q

what is the blood supply of the scapula

A

arteries interconnecting around scapula forming an anastomosis
allows for blood supply even in the event of a gradual blockage

109
Q

flow of milk in breast

A

produced in alveoli
moves to lactiferous ducts
moved to lactiferous sinuses before being expelled out the nipple with the let down reflex

110
Q

what nerve innervates the breasts

A

anterior and lateral cutaneous branches of 4th-6th intercostal n

111
Q

what arteries provide blood to the breasts

A

lateral thoracic, posterior intercostal, medial mammary branches, internal intercostal

112
Q

where does most of the breast drain

A

via pectoral, central, and apical axillary nodes to subclavian lymph trunk

113
Q

where do medial breasts drain

A

parasternal nodes

114
Q

where does the subclavian lymph trunk drain into the venous system

A

subclavian and internal jugular junction

115
Q

direction of lymphatic flow in breast

A

pectoral, humeral, and subscapular nodes drain into central nodes
central node drains into axillary node
axillary node drains into supraclavicular node which drains into right or left venous angle

116
Q

what are the signs of breast cancer

A

skin dimpling, nipple retraction and deviation, abnormal contours, edema of skin

117
Q

what causes herpes zoster

A

viral disease of spinal ganglia
reactivation of varicella zoster or chickenpox virus
causes sharp burning pain in dermatome, skin becomes red, and possible muscle weakness in same myotome