anatomy final LOs

Question 1

anatomical snuffbox

Answer 1

• boundaries
  
  • dorsal: extensor pollicis longus (EPL)
    
    • 3rd extensor compartment
  • volar: abductor pollicis longus (APL) and extensor pollicis brevis (EPB)
    
    • 1st extensor compartment
• contens
  
  • scaphoid bone of wrist is floor of anatomical snuff box: most commonly fractured bone in wrist

Question 2

cerebral arterial circle

Answer 2

• vertebral arteries
  
  • anterior spinal artery
  • posterior inferior cerebellar arteries (PICA)
• basilar artery
  
  • anterior inferior cerebellar arteries (AICA)
  • pontine arteries
• superior cerebellar arteries

components of CAC

• posterior cerebral arteries (PCA)
• posterior communicating arteries
• internal carotid arteries
• middle cerebral arteries (MCA)
• anterior cerebral arteries (ACA)
• anterior communicating arteries

Question 3

blood flow through chambers and valves of heart

Answer 3

• SVC/IVC
• right atrium
  
  • tricuspid/right atrioventricular valve
• right ventricle
  
  • pulmonary semilunar valve
  • pulmonary trunk
  • pulmonary arteries
• lungs
  
  • pulmonary veins
• left atrium
  
  • left atrioventricular/mitral valve
• left ventricle
  
  • ascending aorta/aortic arch

Question 4

branching of coronary arteries on heart surface

Answer 4

• right coronary artery
  
  • SA nodal
  • atrial rami
  • right marginal branch
  • posterior interventricular branch
• left coronary artery
  
  • anterior interventricular branch
  • atrial rami
  • left marginal branch (left anterior descending)
  • circumflex branch

Question 5

dural venous sinus drainage

Answer 5

• superior and inferior sagittal sinuses connected by straight sinus
  
  • great cerebral vein
• transverse sinus to sigmoid sinus through jugular foramen to internal jugular vein
  
  • pterygoid plexus through emmissaries to cavernous sinus
  • opthalmics to cavnerous sinus through jugular foramen through superior and inferior petrosal sinuses

Question 6

clinically relevant sites on dermatome maps

Answer 6

• C5: deltoid tuberosity
• C6: thumb
• C8: pinky
• T1: median aspect forearm
• T4: nipple
• T6: skin over xiphoid
• T10: umbilicus
• L4: big toe
• S1: pinky toe

Question 7

lower extremity cutaneous nerve fields

Answer 7

• perforating cutaenous: middle butt
• lateral femoral cutaneous: lateral thigh
• posterior cutaneous of thigh: posterior thigh
• obturator: distal medial thigh
• saphenous: medial leg
• sural/klateral sural: lateral leg
• sural/superficial fibular: lateral foot
• deep fibular: flipflop area between big and second toes

Question 8

cutaneous nerve fields of face

Answer 8

• apex of skull to lower eyelid, top of nose: trigeminal, ophthalmic
  
  • supra-orbital, supratrochlear, infratrochlear, lacrimal, external nasal
• temporal region, cheek bones, sides of nose, upper lip: trigeminal, maxillary
  
  • zygomatico-temporal, zygomaticofacial, infra-orbital
• front of ear, sides of face, jaw line: trigeminal, mandibular
  
  • auriculotemporal, buccal, mental
• sides of neck, psoterior ear: anterior rami great auricular (C2, C3)
• back of head: greater occipital (C3)

Question 9

meningeal coverings of the central nervous system

Answer 9

• dura mater: infolding creates falx cerebri
  
  • periosteal: against the skull
  • meningeal: divides cerebellum
• arachnoid mater
• pia mater: bonded to CNS

Question 10

genu valgum

Answer 10

• “coxa vara”
• knock-knee
• decreased level angle of inclination (<125)

Question 11

genu varum

Answer 11

• coxa valga
• increased angle of inclination (>125)
• bow-legged

Question 12

anteversion

Answer 12

• increased angle of torsion
• pigion toed

Question 13

retroversion

Answer 13

• decreased angle of torsion
• duck feet

Question 14

autonomic ganglion

Answer 14

• oculomotor: ciliary ganglion
• facial: pterygopalatine, submandibular
• glossopharyngeal: otic
• vagus: neurons in/near viscera

Question 15

oculomotor autonomic innervation

Answer 15

• ciliary ganglion
• ciliary bodies/muscle (lens accomodation)
• sphincter pupillae of iris (constriction)

Question 16

facial autonomic innervation

Answer 16

• pterygopalatine, submandibular (cry, snot, spit)
• lacrimal mucosa glands of nasal cavity, paranasal sinuses
• roof of mouth, soft palate, nasopharynx
• submandibular and sublingual glands

Question 17

glossopharyngeal autonomic innervation

Answer 17

• otic
• parotid gland

Question 18

vagus autonomic innervation

Answer 18

• neurons in/near viscera
• smooth muscle viscera up to splenic flexure

Question 19

thoracolumbar fascia

Answer 19

• psoas major, iliacus, transverse abdominus, internal/external oblique, latissimus dorsi
• anterior layer
  
  • quadratus lumborum
• middle layer
  
  • erector spinae
• posterior layer

Question 20

glenohumeral joint dislocation

Answer 20

• anterior (95%)
• inferior joint capsule not reinforced by rotator cuff or ligaments
  
  • vulnerable when arm is in abduction

Question 21

radial head dislocation

Answer 21

• Nurse Maid’s Elbow
  
  • pediatric
• radial head subluxation from annular ligament

Question 22

hip and femoral head dislocation

Answer 22

• posterior dislocation outnumbers anterior dislocation 9:1
• most often in motor vehicle accidents from pressure on distal femur
• injures posterior acetabulum/labrum and (most critically) sciatic nerves

Question 23

intervertebral disc herniation

Answer 23

• nucleus pulposus leaks from anulus fibrosus posterolaterally
  
  • generally affects nerve below the herniation
• can cause Trendelenburg gait if affecting superior gluteal nerve (L4, L5, S1)

Question 24

surface anatomy of right lung

Answer 24

• 3 lobes
  
  • superior, middle, inferior
• 2 fissures
  
  • horizontal, oblique
• pulmonary arteries anterior to primary bronchus

Question 25

surface anatomy of left lung

Answer 25

* 2 lobes * superior, inferior * 1 fissure * oblique * lingula * pulmonary arteries superior to primary bronchus

Question 26

layers of the heart

Answer 26

* fibrous pericardium, parietal pericardium, visceral pericardium (epicardium), myocardium, endocardium * parietal + visceral = serous pericardium * epicardium + myocardium + endocardium = heart

Question 27

surface features of heart

Answer 27

* right auricle on right atrium * coronary sulcus running under right atrium * right ventricle * left auricle on left atrium * coronary sinus in coronary sulcus under left atrium * left ventricle * anterior interventricular sulcus * cardiac apex * pulmonary arteries (2) and veins (4) on posterior inferior to aortic arch

Question 28

right atrium internal features

Answer 28

* interatrial septum * fossa ovalis * valved orifice of IVC and coronary sinus (drains heart surface) * crista terminalis (wherepectinate meets interatrial septum) * pectinate muscle (rough)

Question 29

right ventricle internal features

Answer 29

* right AV valve/tricuspid * chordae tendineae * anterior papillary muscles * 3: anterior, posterior, septal * septomarginal trabeculae * trabeculae carneae (rugated) * supraventricular crest * conus arteriosus * pulmonary trunk

Question 30

left atrium and ventricle internal features

Answer 30

* left atrium * valve of foramen ovale * interatrial septum * pectinate septum * left ventricle * mitral valve (left AV) * papillary muscles * 2: anterior, posterior * trabeculae carneae

Question 31

remnants of fetal circulation

Answer 31

* ligamentum arteriosum: ductus arteriosus in fetal circulation * shunts blood from pulmonary trunk to arch of aorta * fossa ovalis: foramen ovale in fetal circulation * blood from right to left atrium