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Phase 1 > Anatomy - Introduction > Flashcards

Anatomy - Introduction Flashcards

1
Q

What are the 2 parts of the skeleton?

A
  • Axial - brain, thoracic cavity + spine - Appendicular - upper + lower limbs
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2
Q

What is the anatomical position?

A
  • Straight back with head and eyes facing forwards - Eyes by the side with forearms and hands facing forwards
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3
Q

What are the anatomical planes?

A
  • Sagittal - Left and right (imagine archer) - Coronal (frontal) - Front and back (anterior and posterior) - Axial (transverse) - Superior and inferior - Oblique = any diagonal section
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4
Q

What do medial and lateral mean?

A
  • Medial = closer - Lateral = further, e.g. humerus lateral to rib cage
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5
Q

What do anterior and posterior mean?

A
  • Anterior = front - Posterior = back, e.g. heart posterior to rib cage
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6
Q

What do superficial and deep mean?

A
  • Superficial = closer to skin - Deep = further from skin, e.g. rib cage superficial to heart
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7
Q

What do proximal and distal mean?

A
  • Proximal = towards where the limb attaches to the body - Distal = away from where the limb attaches to the body. ONLY USED TO DESCRIBE 2 POINTS ON THE SAME LIMB.
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8
Q

What do ipsilateral and contralateral mean?

A
  • Ipsilateral = same side - Contralateral = opposite side
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9
Q

What do supine and prone mean?

A

Both are variations of the anatomical position. - Supine = Person laying on back - Prone = Person laying on front

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10
Q

What is a joint? What are the 3 types of joint?

A

A joint is a connection between 2 or more bones, irrespective of whether movement can occur. 3 types (fibrous, cartilaginous and synovial)

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11
Q

What is a fibrous joint?

A

Bones in a fibrous joint are unified by fibrous tissue. No joint cavity. Movement depends on length of fibrous fibres.

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12
Q

What is a cartilaginous joint? What are the two types?

A

Bones are united by cartilage. No joint cavity. - Primary = united by hyaline cartilage, some flexibility - Secondary = bones covered by a layer of hyaline cartilage + united by fibrocartilage = strength

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13
Q

What is a synovial joint?

A
  • Bones in synovial joint united by joint capsule enclosing a joint cavity. - Joint capsule composed of outer fibrous layer and inner synovial membrane - Bones are covered by articulate cartilage - Joint cavity contains synovial fluid = offers more movement
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14
Q

What are the different types of synovial joint?

A
  • Plane = 2 flat surfaces, one direction - Hinge = Flexion and extension only - Condyloid = 2 directions - Saddle = articulate surfaces are convex and concave, 2 directions but wider range than condyloid - Ball and socket = multiple axes of movement - Pivot = rotation around central axis
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15
Q

What are the 3 bones that make up the knee joint?

A

Femur, patella and tibia. Knee joint = synovial hinge joint

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16
Q

Which cartilaginous disk is used to increase contact between the femur and tibia?

A

Meniscus. Femur = condyla + tibia = flat

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17
Q

Which four ligaments support the knee joint?

A

Lateral and medial collateral ligaments (either side). 2 cruciate ligaments deep within.

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18
Q

What are the lateral and medial collateral ligaments?

A
  • Medial collateral = within joint capsule, so tear = bleeding within - Lateral collateral = outside joint capsule, so tear = bleeding outside - Both stabilise femur + tibia, still knee joint from coming apart
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19
Q

What are the cruciate ligaments?

A
  • Anterior cruciate ligament = anterior aspect of tibia to posterior aspect of femur - Posterior cruciate ligament = posterior aspect of tibia to anterior aspect of femur, so cross over each other - Stop the forwards and backwards movement of knees
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20
Q

What are the three types of muscle?

A
  • Cardiac = heart and unique, e.g. doesn’t tire easily. Involuntary - Smooth = involuntary, controlled by autonomic nervous system. Concerned with bodily functions, e.g. digestion and blood pressure control - Skeletal = conscious control, function is to move skeleton. Has 2 or more attachments to bony skeleton. Origin = muscle that moves least when contracted, insertion = other end
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21
Q

What are the different types of muscle structures?

A
  • Strap = fibres parallel + long - Fusiform = similar time strap (parallel) but larger muscle bulk (muscle belly) - Fan = parallel fibres but flat - Circular = allow closing and opening, e.g. eye muscles - Pennate = fibres contract at an angle to direction of action of muscle = allows more fibres = more power. Uni, bi (two angles) and multi (many angles)
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22
Q

Will the strap or pennate expend more energy?

A

Strap as longer, so contracts across whole length. Bipennate = lots of power.

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23
Q

What controls skeletal muscles?

A

Nerves. Without a nervous supply, skeletal muscle cells won’t contract

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24
Q

What do these terms mean: - Flexion - Extension - Synergists - Antagonists - Abduction - Adduction - Circumduction - Pronation - Supination - Oppsition - Protraction - Retraction - Lateral Flexion - Inversion - Eversion

A
  • to bend - to extend - group of muscles that act together to create joint movement - opposite of synergists - movement away from midline - movement towards midline - hand traces a circle - palm faces posteriorly (down) - palm faces anteriorly (up) - thumb can touch little finger - move forwards, e.g. jaw - move backwards - upper body bends over to the side - sole of foot faces inwards - sole of foot faces outwards
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25
Q

What are the similarities between the upper and lower limb?

A

Develop in same way, so similar arrangements: - Large bone (femur and humerus) - Two parallel bones distally (tibia-fibula lower, radius-ulna upper) - Ball and socket joints (shoulder and hip)

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26
Q

Why is the shoulder easier to dislocate than the hip?

A

Ligaments play smaller role in shoulder, hip surrounded by ‘screw-like’ formation of ligaments that increases stability. Hip joint also connects over a larger area

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27
Q

Why is there greater dexterity in the hand and forearm?

A
  • Radius and ulna articulate more freely, tibia + fibula fixed together to provide stable joint for ankle - Majority of muscles found in forearm, majority of muscles found in foot
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28
Q

What is the spine made up of?

A

7 cervical, 12 thoracic, 5 lumbar, 5 sacral vertebra (fused to form sacrum) + 4 further vertebrae fused together to form coccyx

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29
Q

What unique features do the 1st and 2nd cervical vertebrae have that relates to their function?

A
  • C1 (atlas) supports weight of skull, has articular surface on superior (skull) and inferior (C2) - Atlas has no body as attaches to C2 to form odontoid peg - sits behind anterior arch of atlas and held in position by cruciate ligament - odontoid peg can rotate considerably
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30
Q

What features does C5 contain to make it ‘typical’ of other cervical vertebrae?

A

3 foramin (holes) - one for spinal cord and two vertebral arteries which lie in transverse process. The spinous process (end bit) is bifid except for C7.

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31
Q

What features do thoracic vertebrae have?

A

Singe foramina for spinal cord and longer spinal processes with have single point

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32
Q

What features do lumbar vertebrae have?

A

Bigger as support more body weight

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33
Q

Through which types of joint do vertebrae articulate with each other by?

A

Secondary cartilaginous and synovial

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34
Q

Where are the secondary cartilaginous and synovial joints found?

A
  • Secondary cartilaginous between vertebral bodies + responsible for slipped disc. - Synovial between articular processes
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35
Q

What happens if the articular cartilage wears away?

A

Osteoarthritis occurs

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36
Q

What is the role of the sacrum?

A

Transmits weight of body to pelvis. Have massive transverse processes to allow firm attachment to pelvis

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37
Q

Anatomically, how is the nervous system divided?

A
  • Central nervous system = brain and spinal cord - Peripheral nervous system = 12 pairs of cranial nerves (from brain) + 31 pairs of spinal nerves (from spinal cord)
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38
Q

Functionally, how is the nervous system divided?

A
  • Somatic = controls voluntary activities - Autonomic = controls involuntary activities
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39
Q

Which two parts make up the autonomic nervous system?

A
  • Sympathetic = prepares body for emergencies - Parasympathetic = creates state of rest
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40
Q

Which 3 parts make up the brain?

A
  • Cerebral hemispheres - Brainstem = midbrain, pons and medulla - Cerebellum
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41
Q

What are the surface structures of the cerebral hemisphere?

A

Temporal, frontal, parietal + occipital lobe

42
Q

What are the deep structures of the cerebral hemisphere?

A

Basal ganglia, thalamus, internal capsule etc.

43
Q

What are the folds and valleys of the cerebral hemisphere called?

A
  • Folds = gyri - Valleys = sulci
44
Q

What separates the frontal and parietal lobes?

A

Central sulcus

45
Q

If we slice the brain, surface is grey matter but inside is mainly white matter? What makes up grey and white matter?

A
  • Grey matter = nerve cells - White matter = nerve fibres covered in myelin
46
Q

What is the role of the brain stem?

A

Automatic functions. Transmits signals from brain to body and vice versa

47
Q

What is the function of the meningeal layers (layers between skull and brain)?

A
  • Protect the brain - Provide framework for blood supply - Enclose the fluid filled subarachnoid space
48
Q

What are the 3 meningeal layers?

A
  • Dura - Arachnoid - Pia
49
Q

Which two layers does the dura consist of?

A

Periosteal layer + meningeal layer

50
Q

What are the 3 spaces between the layers?

A
  • Extradural (outside of dura) = potential, so only exists in pathology - Subdural (between dura and arachnoid) = potential - Subarachnoid (between arachnoid and pia) = exists in healthy humans and filled with cerebrospinal fluid (CSF)
51
Q

What is CSF?

A

Cerebrospinal fluid. Provides nutrients to brain and helps maintain balance of extra cellular fluid. Protects brain.

52
Q

What are the 4 ventricles of the brain?

A
  • Right and left lateral (in cerebral hemisphere) - Third (midbrain) - Fourth (in front of cerebellum)
53
Q

How is CSF absorbed into the venous system?

A

CSF flows from lateral ventricles - 3rd - 4th - subarachnoid space , then absorbed

54
Q

Which 4 arteries supply blood to the brain?

A
  • 2 internal carotid arteries - 2vertebral arteries
55
Q

What is the Circle of Willis?

A

Circle of Willis = ring of blood vessels formed at base of brain. 6 major branches.

56
Q

What are the 12 cranial nerves?

A
  • I Olfcatory = smell (sensory) - II Optic = sight (sensory) - III Oculomotor = movement of eye (motor). Autonomic to pupil and lens - IV Trochlear = movement of eye (motor) - V Trigeminal = chewing muscles (motor). Sensory from face, nose + oral cavity - VI Abducens = lateral (outward) movement of eye (motor) - VII Facial = facial expression (motor), taste (sensory) + autonomic to salivary glands - VIII Vestibulocochlear = balance and hearing (sensory) - IX Glossopharyngeal = tongue and pharynx (sensory). Autonomic to salivary glands - X Vagus = autonomic motor to thoracic and abdominal organs. Autonomic sensory from thoracic and abdominal organs - XI Accessory = head, shoulders, pharynx, larynx and soft palate - XII Hypoglossal = motor to tongue
57
Q

How are the cranial nerves clinically examined?

A
  • I Olfactory = close one nostril and smell different odours. Repeat. - II Optic Nerve = test visual acuity using Snellen’s charts. Test coloured vision using pseudo-isochromatic plates. Test visual fields with either confrontation test or perimeter. Ophthalmoscopy essential to visualise optic disc - III Oculometer, IV Trochlear and VI Abducens = each eye separately and simultaneously, ask patient to follow ‘H’-shaped movement - V Trigeminal = sensory: test all sensory modalities of 3 main branches. Motor: ask patient to clench teeth - VII Facial = ask patient to shut eyes as tight as possible, then raise eyebrows, smile and whistle. Also taste sensation on anterior 2/3 of tongue - VIII Vestibulocochlear = whisper in each ear and ask patient to repeat. Use vibrating tuning fork to perform Rinne and Webber tests - IX Glossopharyngeal and X Vagus = tickle back of pharynx. IX sensory, note if reflex contraction occurs, X motor, ‘gag’ reflex - XI accessory = ask patient to shrug shoulder against resistance (Trapezius). Ask patient to turn head on each side against resistance (Sternocleidomastoid) - XII hypoglossal = ask patient to put tongue out as far as possible - straight or deviated to one side?
58
Q

What are the two rows of nerve fibres that the spinal cord gives off?

A
  • Dorsal root fibres = enter spinal cord (sensory) - Ventral root fibres = leave spinal cord (motor) - Fibres from single spinal segment join to form dorsal/ventral root - pass through inter-vertebral formina between vertebrae
59
Q

How is the spinal nerve formed?

A

Dorsal and ventral roots join together at inter-vertebral foramen

60
Q

What is a spinal cord segment? What is it made up of?

A
  • Spinal cord segment = area of spinal cord from which pair of spinal nerves emerge - 31 pairs: 8 cervical, 12 thoracic, 5 lumbar, 5 sacral + 1 coccygeal
61
Q

How do the spinal nerves leave the spinal canal?

A
  • First 7 pass through foramina above corresponding cervical vertebrae - 8th spinal nerve passes below 7th cervical vertebrae - All others pass below corresponding vertebrae
62
Q

What is a dermatome?

A

An area of skin that receives a sensory nerve supply from a single root of the spinal cord

63
Q

How can we find out which spinal nerves are diseased?

A

We can find sensory abnormalities: - Clavicle = Cervical 4 - Nipples = Thoracic 5 - Umbilicus = Thoracic 10 - Inguinal region = Thoracic 12 - Middle finger = Cervical 7 - Patella = Lumbar 3 - Big toe = Lumbar 5 - Fifth toe = Sacral 1 - Perianal region = Sacral 5 -

64
Q

What is a myotome?

A

A group of muscles supplied by the same spinal root. Patient is asked to perform movement to assess, e.g. C5 = deltoid, so hands to the sky

65
Q

What is the brachial plexus?

A

Due to complexity of limbs, peripheral nerves often need a mix of spinal segments. Mixing of segments achieved by brachial plexus.

66
Q

What is the brachial plexus made up of?

A

C5-8 + T1. Example of damage: damage to T1 nerve root results in paralysis of small muscles in hand + sensory deficit in medial aspect of arm

67
Q

Where does the sympathetic division emerge from?

A

Emerges from spinal cord in thoracic areas and terminates around L2-3

68
Q

Where does the parasympathetic division emerge from?

A

Neurons begin at cranial nerves (specifically oculomotor, facial) and S2-4 of spinal cord

69
Q

How does the sympathetic nervous system leave the CNS?

A
  • Preganglionic axons pass out of cell bodies found at intermediolateral column (T1 - L2) - Moves through anterior root to join spinal nerve - Travels to paravertebral ganglion - 4 possible outcomes at paravertebral ganglion
70
Q

What are the 4 possible outcomes at the paravertebral ganglion?

A
  • Synapse at level it entered paravertebral ganglion and post ganglionic axon leaves via grey ramus to supply target organs - Move up and down sympathetic trunk and synapse at another paravertebral ganglion - Synapse at level it entered paravertebral ganglion, and postganglionic axon leaves the paravertebral ganglia NOT via grey ramus = occurs in thorax - Preganglionic nerve does not synapse at paravertebral ganglia - instead, leaves NOT via grey ramus and synapses at a prevertebral ganglion = occurs in abdomen and pelvis
71
Q

What is the difference between sympathetic and parasympathetic ganglia?

A

Parasympathetic ganglia, where preganglionic neurons synapse, closer to target organ

72
Q

What is the thyroid cartilage made up of?

A

Two halves that meet in middle at laryngeal prominence (Adam’s Apple). Cricoid cartilage below thyroid cartilage, surrounds start of trachea. Between thyroid and crycoid = cricothyroid membrane, where we can make an emergency cricothyrotomy for upper airway obstruction

73
Q

How do you determine the location of specific ribs?

A

12 rib pairs. Palpate sternal notch + move down sternum until ridge is felt (Angle of Louis). Second rib is felt when you move laterally from the Angle of Louis. As you move down, depression are felt in between ribs = intercostal spaces. 4th rib is generally by nipple in males, horizontal fissure of right lung runs along this cartilage

74
Q

Which structure lines up with T4/T5?

A

Sternal angle (Angle of Louis) anteriorly lines nicely with T4/T5 vertebral level

75
Q

What are the two vertical lines that can be drawn?

A

One vertically from midpoint of clavicle = midclavicular line. One from midpoint of axilla (armpit) = midaxillary line

76
Q

Where is the heart contraction best felt?

A

Left side where midclavicular line crosses 5th intercostal space (apex of heart)

77
Q

Where do we listen to the 4 heart sounds?

A
  • Aortic valve = 2nd intercostal space on right
  • Pulmonary valve = 2nd intercostal space on left
  • Mitral valve = apex (5th intercostal space in line with middle of clavicle)
  • Tricuspid valve = 5th intercostal space on right
78
Q

Where does the oblique fissure start and finish?

A

Lungs have a number of lobes separated by fissures. Oblique fissures start at 4th rib at back and end at 6th costal cartilage at front

79
Q

Where is the horizontal fissure?

A

At the 4th costal cartilage

80
Q

What is the role of the trachea and bronchi?

A

Transmit air from the larynx to the alveoli so that gas exchange can take place. The remaining gas (after exchange) is exhaled back up the bronchial tree and trachea to allow for elimination of CO2.

81
Q

How are solid particles removed when air is inhaled?

A

Trapped in mucous lining of nasal passage + bronchial tree and then transported to oral cavity for ingestion by cilia

82
Q

What lines the trachea and bronchi?

A

Smooth muscle and cartilage. Muscle contracts, airway becomes narrow (bronchoconstriction), reduces volume of air in lungs when asleep, so reduces effort needed to breathe = useful

83
Q

How many lobes to the right and left lung have? How is blood supplied and drained?

A
  • Right = 3 (upper, middle + lower)
  • Left = 2 (upper + lower)
  • Arterial supply = bronchial and pulmonary arteries
  • Venous drainage = bronchial and pulmonary veins
84
Q

What is the pleura?

A

Parietal pleura = serous membrane that covers inner surface of chest wall. Comes into contact with visceral pleura (covers lungs). Space between forms pleural cavity that contains a very thin layer of serous fluid

85
Q

What is the requirement for air to be drawn into the lung?

A

Pressure in alveoli must be lower than pressure at the nostril (atmospheric pressure). In order to inhale, thorax must be able to become a larger volume - this creates a pressure below atmospheric which sucks air into the lungs

86
Q

What is the pump handle and bucket handle mechanism?

A

Anterior ends of rib move upwards + lateral parts move outwards. Imagine lifting a bucket handle. This increases the thoracic volume. Imagine lifting a pump handle to represent sternum movement

87
Q

Where are the intercostal muscles?

A

In the intercostal spaces between ribs. Ribs are connected by 3 layers of intercostal muscles.

88
Q

What is abdominal breathing?

A
  • Diaphragm moves down due to muscle contraction. This creates a negative pressure in the thorax + air drawn into lungs
  • Blood also drawn into thorax to aid venous return to right atrium
  • Breathing due to action of diaphragm = abdominal breathing
89
Q

What is thoracic breathing?

A

During exercise, increased gas exchange. Action of intercostal muscles will pull ribs closer together. First rib is relatively fixed, so other ribs pulled upwards increasing lateral + anterior-posterior diameters of chest = thoracic breathing

90
Q

Is muscle contraction required in expiration?

A

No, it’s a passive process. No muscular contraction from diaphragm or intercostal muscles

91
Q

What are the 4 chambers of the heart?

A
92
Q

Describe the pathway of blood, beginning with the right atrium.

A
  • Right atrium receives deoxygenated blood from superior + inferior vena cavae and coronary sinus
  • Blood passes through tricuspid valve into right ventricle
  • RV pumps blood out through pulmonary valve into pulmonary artery which takes blood to lungs
  • Oxygenated blood returns from lungs in pulmonary veins and goes to left atrium
  • Blood passes through mitral valve to enter left ventricle which then pumps blood out of heart through aortic valve into aorta to supply the body
93
Q

What are the anterior and inferior surfaces of the heart called?

A
  • Anterior = sternocostal surface as faces sternum + ribs (costae)
  • Inferior = diaphragmatic surface as sits on diaphragm
94
Q

Which fibroserous sac is the heart contained within? What is its role?

A

Pericardium. Consists of two layers (fibrous pericardium and serous pericardium). Pericardium allows unrestricted contraction of heart while ensuring the heart is tethered in place. Also limits how much heart can fill

95
Q

Which two arteries supply blood to the heart?

A

Right and left coronary arteries. Arise from the aorta.

96
Q

When do the coronary arteries fill?

A

Can’t fill in systole as blood within coronary artery can’t pass into muscle as would be going up a pressure gradient (impossible). In diastole (relaxation of heart), pressure within ventricles = low but pressure in coronary arteries = high, so blood flows in coronary arteries to supply heart. Systole is for blood flow to other body parts.

97
Q

If the contraction time is fairly fixed, how is the heart rate increased?

A

Decrease diastole time, so less time for blood flow in the coronary arteries to supply oxygen to the myocardium

98
Q

What do the spikes on an electrocardiogram (ECG) represent?

A

Ventricle contraction. When a muscle contracts, ions cross the cell membrane. Any movement of a charged particle is electrical.

In relaxation, the wave is longer, as ions are pumped back to restore the activation potential within the cells.

99
Q

In a plain chest radiograph, what appears white and black?

A
  • Dense structures absorb most of the X-rays + appear white
  • Air absorbs none of the X-rays + appears black
100
Q
A

Phase 1 (17 decks)

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