Anatomy Unit 2 Flashcards
<p>the body of a vertebrae is made of what?</p>
<p>primarily spongy bone, helps with shock absorption</p>
<p>the edges (epiphyseal rim) are smooth compact bone</p>
<p>what forms the boundaries of the vertebral foramen?</p>
<p>body + veterbral arch</p>
<p>what forms the vertebral arch?</p>
<p>pedicles + lamina</p>
<p>what dopedicles do?</p>
<p>attach to vert body, form roof and floor of intervertebral foramena</p>
<p>what are lamina?</p>
<p>connect the pedicles and each other, form the posterior arch</p>
<p>what forms the vertebral canal?</p>
<p>lined up vertebral foramena</p>
<p>what forms intervetebral foramen?</p>
<ol> <li>Floor: Sup vert notch of pedicle</li> <li>Roof: inf vert notch of pedicle</li> <li>Post: lamina/zygapophyseal joint</li> <li>Ant: body/intervertebral disk</li></ol>
<p>what do the intervertebral foramen contain?</p>
<p>spinal nerves</p>
<p>how many processes are there on a typical vertebrae?</p>
<p>7</p>
<p>what are the 7 vertebral processes?</p>
<ol> <li>spinous (1),</li> <li>transverse processes (2),</li> <li>superior articular processes (2),</li> <li>inferior articular processes (2)</li></ol>
<p>what is the angle between transverse and spinous processes called? why?</p>
<p>Gutter, a lot of posterior muscles run through this space</p>
<p>what articulations form the zygapophysial joints?</p>
<p>superior and inferior articular processes</p>
<p>what is the orientation of the zygapophysial joints?</p>
<ol> <li>C: transverse</li> <li>T: oblique coronal</li> <li>L: (S) sagittal</li> <li>L: (I) coronal</li></ol>
<p>how many articulations does a typical vertebrae have?</p>
<p>6--between each vertebrae x2--zygapophyseal joint R/L x2</p>
<p>cervical discs size</p>
<p>large disc with small vertebral bodies</p>
<p>advantages of cervical disc/vertebrae size</p>
<p>allows for more movement</p>
<p>what movements can occurs at cervical zygapophyseal joints?</p>
<p>flex/extension; abd/adduct; rotation</p>
<p>6 identifying features of cervical vertebrae</p>
<p>1). transverse foramen</p>
<p>2). A/P tubercles</p>
<p>3). grooves for spinal nerves</p>
<p>4). uncinate processes</p>
<p>5). bifid spinous processes (C3-6)</p>
<p>6). vertebra prominens</p>
<p>where are the A/P turbercles of cervical vertebae located?</p>
<p>at ends of transverse processes provide muscle attachments for levator scapulae and scalene muscles</p>
<p>(There is a P tubercle in place of a spinous process at C1)</p>
<p>where are the grooves for spinal nerves located in cervical vertebrae?</p>
<p>in a sulcus between A/P turbecles of transverse processes</p>
<p>which cervical vertebrae has bifid spinous processes?</p>
<p>C3-C6</p>
<p>what is an uncinate process?</p>
<p>elevated S epiphyseal rim ant and lat.</p>
<p>allows free flex/ext but restricts abd/adduction</p>
<p>what limits abd/adduction at cervical vertebae</p>
<p>uncovertebral joints</p>
<p>What are uncovertebral joints?</p>
<p>exist between uncinate process of cervical vertebra and epiphyseal rim of vertebral body above</p>
what passes through the Cerv transverse foramen
vertebral arteries and veins
T/F: the atlas (C1) has a vertebral body?
FALSE
what type of joint is the atlanto-occipital joint?
condyloid
T/F: the posterior atlanto-occipital membrane is a continuation of ligamentum flavum
TRUE
what does the atlas (C1) have in place of a body?
anterior arch connecting pedicles anteriorly
what do the lateral masses of C1 do?
transmit weight from head to C2, contain sup/inf articular processes
unique feature of the axis (C2)
dens (odontoid process)
which T vert do not have paired S/I costal facets?
T1, 10, 11, 12
Zygophyseal joints are stabilized by what accessory ligaments?
- ligamenta flava
- interspinous ligaments
- supraspinous ligaments
- nuchual ligament
- intertransverse ligaments
What does the ligamenta flava do?
interconnects adjacent laminae
they are elastic ligaments that limit flexion
how are the articular processes (zygapophyseal joints) oriented in T vert?
coronally
what movement is restricted at zygapophyseal joints in T vert?
Flex/ext
what limits ab/adduction at T vert?
rib articulations
where do ribs articulate with vertebrae?
Ribs 2-9: body of S/I vert and transverse process of inf vert
how are the S/I articulations (zygapophyseal joints) oriented in L vert?
S: sagittal
I: coronal
unique orientation of L5
body is higher A than P creating the lumbosacral angle
what 2 surfaces of the sacrum articulate with the hips?
1). sacral tuberosity
2). auricular surface
what type of joint does the pelvis and sacral tuberosity make?
fibrous, syndesmosis joint
what type of joint does the pelvis and auricular surface make?
planar, synovial joint
functional role of the coccyx
anchors the pelvic diaphragm, regulates pressure in the pelvic cavity
components of intervertebral disc
anulus fibrosis, nucleus pulposus
how is the annulus fibrosis arranged?
- outer ring of fibrocartilage of disk arranged in concentric lamellae attached to the epiphyseal rim of the vertebra above and vertebra below to hold them together.
- Twists to allow some rotation.
- All designed to keep the nucleus pulposus in the center
anterior longitudinal ligament
runs from C1 and Occipital bone to pelvic surface of sacrum; limits vert column ext
posterior longitudinal ligament
weaker; runs from C2 to sacrum through the vertebral canal; limits vert hyperflexion
what are symphysis?
a type of cartilaginous joint
atlanto-occipital articulation
occipital condyles with superior articular processes of C1
what is the sacral canal?
continuation of vertebral canal; it houses the cuada equina
what is the role of the A/P sacral foramena
serve as openings for dorsal and ventral rami of spinal nerves
where does the sacrum articulate with L5?
L5 inferior articular process with superior articular process of sacrum
what is the sacral promontory?
projection of S1 into the pelvic cavity
Name the crests on the sacrum
- median sacral crest
- intermediate sacral crest
- lateral sacral crest
what forms the median sacral crest?
fused spinous processes on the dorsal surface
what forms the intermediate sacral crest?
fused articular processes of sacral vertebrae on the dorsal surface
What forms the lateral sacral crest?
fused transverse processes of sacral vertebae on dorsal surface
how does the sacrum articulate with the coccyx?
sacral cornu with the cornue of the coccyx
How many articulations form the atlanto-axial joint? Name them.
- 2 lateral atlantoaxial apophysel joints
- median atlantoaxial joint = pivot joint
what is the median atlantoaxial joint comprised of?
- synovial articulation between dens of C2 with anterior arch of C1
- synovial articulation between dens of C2 with cartilage of the transverse ligament
Name the ligaments of the Atlanto-axial joint
- transverse ligament of the atlas
- longitudinal bands
- cruciate ligament (transverse + longitudinal bands)
- alar ligaments
- tectoral membrane
What is the role of the alar ligaments at the atlanto-axial joint?
connect dens to lateral foramen magnum
what is the role of the spinal curvatures?
- shock absorption
- flexibility
- balance in upright posture
what is the venous supply of the vertebral column?
- anterior and posterior external vertebral plexus
- anterior and posterior internal vertebral plexus
- basivertebral vein
what does the basivertebral vein do?
drains blood from vertebral body into anterior external and internal plexus
What is the neural supply of the vertebral column?
- recurrent meningeal nerve
- articular branchs from medial branches from posterior rami
what does the recurrent meningeal nerve do?
supplies dura mater, periosteum, ligaments, disks, and blood vessels of vertebrae with sensory and sympathetic innervations
How many bones are there in the skull?
8
What are the 8 bones of the skull?
1). frontal
2). ethmoid
3). sphenoid
4). occipital
5). temporal (2)
6). parietal (2)
what are the 3 regions of the skull?
1). roof (calvaria)
2). floor (base)
3). occiput (back)
how many bones make up the viscerocranium (facial bones)
15
what are the 15 bones in the viscerocranium?
- mandible, ethmoid, vomer, maxillae (2),
- inferior nasal conchae (2),
- zygomatic (2),
- palatines (2),
- nasals (2),
- lacrimal (2)
Which bones make up the orbit?
1). frontal,
2). ethmoid,
3). Lacrimal
4). Sphenoid
5). Zygomatic
6). Palatine
7). Maxilla
roof of orbit
orbital plate of frontal bone
medial wall of orbit
ethmoid and lacrimal bones
posterior wall of orbit
Sphenoid bone
lateral wall of orbit
Zygomatic bone
floor of orbit
palatine and maxilla bones
what bone does the optic canal pass through?
sphenoid
what bone is referred to as the keystone bone of the cranial cavity?
Sphenoid bone
what is found in the sella turcica?
pituitary gland
where is the pituitary gland?
sella turcica of the sphenoid bone
what passes through the superior orbital fissure?
CN 3, 4, 6, and CN V1
what is CN V1?
ophthalmic nerve of CN 5 (trigeminal nerve)
name the nerves that pass through the superior orbital fissure
- occulomotor,
- trochlear,
- trigeminal (ophthalmic branch),
- abducens
what passes through the foramen rotundum?
CN V2 (trigeminal - maxillary branch)
what passes through the foramen ovale?
CN V3 (trigeminal - mandibular branch)
what passes through the foramen magnum?
1). spinal cord and brain-stem,
2). vertebral arteries,
3). CN 11 comes into the skull this way
where is the jugular foramen?
posterior cranial fossa between occipital and temporal bone
what goes through the jugular foramen?
1). internal jugular vein,
2). CN 9
3). CN 10,
4). CN 11 (exits here)
name the nerves that pass through the jugular foramen
1). Glossopharyngeal,
2). Vagus,
3). Spinal Accessory
what attaches at the temporal styloid process?
pharynx and larynx
temporomandibular joint articulation
mandibular fossa, head of the mandible,
what passes through the stylomastoid foramen?
CN 7 (exiting)
what passes through the internal acoustic foramen (meatus)
CN 7 (exiting) and 8
name the nerves passing through the internal acoustic foramen
Facial and vestibulocochlear
mental protuberance is commonly called the _____
Chin
where is the inferior orbital fissure?
posteriolateral aspect of maxilla in the orbit
what passes through the inferior orbital fissure?
CN V2 branch and zygomatic nerve off of V2
what forms the piriform aperture?
nasal and maxilla bone
what composite structure do the nasal and maxilla bone form?
piriform apeture
what forms the roof of the nasal cavity?
ethmoid bone
what forms the lateral wall of the nasal cavity?
1). ethmoid S/I conchae,
2). palatine perp plate,
3). inferior nasal conchae,
4). maxilla
what forms the floor of the nasal cavity?
1). maxilla palatine plate,
2). palatine bones
what forms the medial wall (nasal septum) of the nasal cavity?
1). vomer,
2). ethmoid perp plate,
3). septal cartilage
what forms the anterior cranial fossa?
frontal, ethmoid, and sphenoid bones
what forms the middle cranial fossa?
sphenoid and temporal bones
what forms the posterior cranial fossa?
- occipital
- sphenoid
- temporal bones
what forms the superior and inferior temporal lines?
- temporal,
- parietal,
- frontal,
- zygomatic bones
what forms the zygomatic arch?
- zygomatic process of temporal bone
- temporal process of zygomatic bone
coronal suture
separates frontal and parietal
sagittal suture
separates right and left parietal
lambdoid suture
separates occipital from parietal
occipitomastoid suture
separates occipital from temporal
squamous (parietomastoid) suture
separates temporal from parietal
lambda
intersection of lambdoid and sagittal sutures
bregma
intersection of sagittal and coronal sutures
pterion
"H" shaped intersection of coronal, squamous, and sphenoid bone
vertex
most superior point of calvaria on sagittal suture
asterion
junction of lambdoid, occipitomastoid, and squamous
TMJ joint type
synovial; modified hinge
unique feature of TMJ hinge
divided into superior and inferior articular cavities each with its own set of movements
TMJ ligaments
- lateral ligament,
- stylomandibular ligament,
- sphenomandibular ligament
what does the lateral TMJ ligament prevent?
posterior dislocation
what does the stylomandibular ligament prevent?
downward dislocation
what does the sphenomandibular ligament prevent?
downward dislocation
what movements occurs at the TMJ joint?
- protrusion/retrusion,
- elevation/depression,
- ab-/adduction
what movements occur in the superior articular cavity of the TMJ joint?
protrusion/retrusion
what movements occur in the inferior articular cavity of the TMJ joint?
elevation/depression, ab-/adduction
what are the composite structures within the skull?
- orbit,
- nasal cavity,
- hard and soft palate,
- S/I temporal lines,
- A/M/P cranial fossa,
- zygomatic arch,
- piriform aperture,
- cranial cavity
Name the landmarks on the frontal bone
- glabella: medially located projecting part of forehead
- nasion (bridge of nose)
- supraorbital margin
How does dura mater attach to the ethmoid?
via the crista galli
A fracture of the temporal bone will lead to bleeding from what artery?
medial meningeal artery, passes through the foramen spinosum
What bones in the cranium have sinuses?
- Frontal
- Ethmoid
- Sphenoid
- Maxilla
the carotid canal passes through what bone?
temporal
what passes through the carotid canal?
- internal carotid artery
- sympathetic plexus
what attaches to the soft palate?
uvula, it will flip up to cover the nasal cavity when you swallow
what is the function of the S/M/I conchae?
direct, clean, filter, humidfy air
what features of the sphenoid does CN 2 pass through?
optic canals and prechiasmatic sulcus
what is another name for the external occipital protuberance?
inion
what does the external acoustic meatus pass through?
petris part of the temporal bone
what forms the infraorbital margin?
Maxillae and zygomatic bones
how does the internal carotid artery enter the skull?
foramen lacerum
Muscles of mastication
1). Temporalis
2). Masseter
3). Lateral pterygoid
4). Medial pterygoid
what innervates all of the muscles of mastication?
trigeminal nerve
Temporalis prox attachment
floor of temporal fossa, deep surface of temporal fascia
Temporalis distal attachment
coronoid process of mandible
Temporalis innervation
Trigeminal (V3)
Temporalis action
1). elevate mandible
2). close jaw post
3). horizontal fibers retract jaw
Masseter prox attachment
zygomatic bone and zygomatic arch
Masseter distal attachment
lateral surface of ramus of mandible
Masseter innervation
Trigeminal (V3)
Masseter action
1). elevate mandible
2). minimal protrusion of manidble
Lateral pterygoid prox attachment
1). crest of greater wing of sphenoid
2). lateral pterygoid plate
Lateral pterygoid distal attachment
S: TMJ joint capsule
I: mandible
Lateral pterygoid innervation
Trigeminal (V3)
Lateral pterygoid action
Bi: protract mandible, depress chin
Uni: swings jaw toward contralateral side
Medial pterygoid prox attachment
1). medial surface of lateral pterygoid plate
2). tuberosity of maxilla
Medial pterygoid distal attachment
medial surface of ramus of mandible, inf to mandibular foramen
Medial pterygoid innervation
Trigeminal (V3)
Medial pterygoid action
1). synergistic to masseter in mandibular elevation
2). protrusion
3). uni move produces small grinding movements
how many muscles of the scalp contribute to facial movement?
2
what 2 muscles of the scalp contribute to facial movement?
1). Occipitofrontalis,
2). Epicranial aponeurosis
how many muscles of the mouth, lips, and cheek contribute to facial expression?
9
What muscles of the mouth, lips, and cheeks contribute to facial expression?
1). Orbicularis oris
2). Buccinator
3). Depressor anguli oris
4). Levator anguli oris
5). Depressor labii inferioris
6). levator labii superioris
7). Zygomaticus major
8). Zygomaticus minor
9). Platysma
orbital and nasal opening muscles
1). Orbicularis Oculi
2). Nasalis
What innervates all the muscles of facial expression?
CN 7 (facial nerve)
what facial muscle is responsible for frowning?
depressor anguli oris
what facial muscle is responsible for smiling?
Zygomaticus Major
what facial muscle allows you to grin/grimmace?
Levator anguli oris
what muscle closes the mouth?
Orbicularis oris
what is the function/role of the Buccinator?
synergist with the tongue to form a bolus
what facial muscle allows a pouty expression?
Depressor labii inferioris
what eye muscle is responsible for a soft close of the eye lids?
Orbicularis Occuli (Palpebral)
what eye muscle is responsible for a hard close?
Orbicularis Occuli (Orbital)
2 Fascial Compartments of the Neck
1). Superficial Cervical Fascia
2). Deep Cervical Fascia
what is in the superficial cervical fascia compartment?
hypodermis, cutaneous nerves, blood and lymph vessels, fat and platysma
what are the 3 general layers of the Deep Cervical Fascia?
1). Investing layer
2). Peritracheal layer
3). Prevertebral layer
what is in the investing layer?
SCM and trapezius
what is in the peritracheal layer?
trachea, esophagus, thyroid glands, and infrahyoid muscles
what is the peritracheal layer?
middle layer of deep cervical fascia, forms a CT tube from hyoid to thoracic inlet
what is the prevertebral layer?
deep layer of deep cervical fascia; forms a CT tube around C vert column and muscles
what is in the prevertebral layer?
- longus colli
- longus capitis
- scalenes
- posterior deep cervical muscles
- sympathetic chain ganglia
what other compartments/spaces are found in the neck?
carotid sheaths, retropharyngeal space and Alar fascia
what is in the carotid sheaths?
carotid arteries, jugular veins, vagus nerves, and lymphatics
what is the retropharyngeal space?
space between pretracheal and prevertebral fascia
what is the purpose of the retropharyngeal space?
slick surface to allow for movement of organs, increase ROM
what is the purpose of the alar fascia?
interconnects carotid sheaths, subdivides retropharyngeal space
superficial muscles of the neck
1). Platysma
2). Sternocleidomastoid
3). Trapezius
Suprahyoid muscles
1). Mylohoid
2). Geniohyoid
3). Stylohoid
4). Digastric
Mylohoid origin
mandible and raphe
Mylohoid insertion
hyoid
Mylohoid innervation
CN5
Geniohyoid origin
mandible
Geniohyoid insertion
hyoid
Geniohyoid innervation
cervical plexus
Stylohyoid origin
temporal bone/styloid process
Stylohyoid insertion
hyoid
Stylohoid innervation
CN 7
Anterior digastric origin
mandible
Anterior digastric insertion
hyoid sling
Posterior digastric origin
temporal/mastoid
Posterior digastric insertion
hyoid sling
Anterior digastic innervation
CN 5
Posterior digastric innervation
CN 7
main action of all suprahyoid muscles?
elevate the larynx
Infrahyoid muscles
1) Sternohyoid
2). Omohyoid
3). Sternothyroid
4). Thyrohyoid
Sternohyoid prox attachment
sternum
Sternohyoid distal attachment
Hyoid
Sternohyoid innervation
cervical plexus
Sternohyoid action
depress larynx
Omohyoid prox attachment
S: clavicle sling
I: scapula/notch
Omohyoid distal attachment
S: hyoid
I: clavicle sling
what connects the S and I belly of the omohyoid?
intermediate tendon at clavicular sling
Omohyoid innervation
cervical plexus
Omohyoid main action
depress larynx
Sternothyroid prox attachment
sternum
Sternothyroid distal attachment
larynx/thyroid cartilage
Sternothyroid innervation
cervical plexus
Sternothyroid main action
depress larynx
Thyrohyoid prox attachment
larynx thyroid cartilage
Thyrohyoid distal attachment
hyoid
Thyrohyoid innervation
cervical plexus
Thyrohyoid main action
depress larynx
Innervation of all infrahyoid muscles?
cervical plexus
Main action of all infrahyoid muscles?
depress larynx for swallowing and sound modification
Deep muscles of neck
1). Longus coli (S/I/),
2). Longus capitis,
3). Rectus Capitis Anterior,
4). Rectus capitis lateralis,
5). A/M/P Scalene
Superior longus coli prox attachment
bodies of upper C vert
Superior longus coli distal attachment
transverse process of middle C vert
Inferior longus coli prox attachment
transverse process of middle C vert
Inferior longus coli distal attachment
bodies of inferior C Vert and super T vert
S/I longus coli action
Bi: flex
Uni: ab-/adduction; rotation
S/I longus coli innervation
cervical plexus
Longus capitis prox attachment
skull/occipital
Longus capitis distal attachment
transverse processes of middle C vert
Longus capitis innervation
cervical plexus
Longus capitis action
Bi: flex
Uni: ab-/adduction; rotation
Rectus capitis ant prox attachment
skull/occipital
Rectus capitis ant distal attachment
anteriolateral mass of C1
Rectus capitis ant innervation
cervical plexus
Rectus capitis ant action
Bi: flex
Uni: ab-/adduction; rotation
Rectus capitis lateralis prox attachment
skull/occiptal
Rectus capitis lateralis distal attachment
transverse process C1
Rectus capitis lateralis innervation
cervical plexus
Rectus capitis lateralis action
mostly proprioception (will also flex, ab-/adduct, rotate). Very important for monitoring head position
T/F: the rectus capitis lateralis can be considered a sensory organ?
TRUE
Anterior scalene prox attachment
transverse p. middle C vert
Anterior scalene distal attachment
rib 1
Middle scalene prox attachment
transverse p middle C vert
middle scalene distal attachment
rib 1
Posterior scalene prox attachment
transverse p. middle C vert
Posterior scalene distal attachment
rib 2
A/M/P scalene innervation
cervical plexus
A/M/P scalene action
Bi: flex
Uni: ab-/adduct; rotate
*lift rib cage for inspiration
All the deep muscles of neck perform what actions?
Bi: flex
Uni: ab-/adduction; rotation
Muscles of pharynx
1). S/M/I pharyngeal constrictors
2). palatopharyngeal
3). salpingopharyngeus
4). stylopharyngeus
S/M/I pharyngeal constrictors origin
- ant/lat skull,
- hyoid,
- larynx and trachea
S/M/I pharyngeal constrictors insertion
- post skull
- raphe
- larynx
S/M/I pharyngeal constrictors action
constrict/squeeze walls of pharynx - reflexively during swallowing
S/M/I pharyngeal constrictors innervation
CN 10
Palatopharyngeal origin
palate
Palatopharyngeal insertion
pharynx
Palatopharyngeal innervation
CN 10
Palatopharyngeal action
elevate/shorten/widen pharynx
Salpingopharyngeus origin to insertion
Eustachian tube to pharynx
Salpingopharyngeus innervation
CN 10
Salpingopharyngeus action
elevate/shorten/widen pharynx
stylopharyngeus origin to insertion
styloid process to pharynx
stylopharyngeus innervation
CN 9
stylopharyngeus action
elevate/shorten/widen pharynx
what does the common carotid branch off of?
R: brachiocephalic
L: aortic arch
what is it called when the common carotid splits?
carotid bifurcation
Divisions of carotid bifurcation?
Internal and External Caroitd
internal carotid destination?
brain and circle of Willis
what is located within the Internal Carotid artery?
carotid sinus andcarotid body
what does the carotid sinus sense?
Blood pressure via baroreceptors
what does the carotid body sense?
pH, CO2 via chemoreceptors
External Carotid artery destination?
soft structures of superficial head, supply the upper neck, surface and head
branches of Subclavian artery
1). Vertebral arteries,
2). Thyrocervical trunk,
3). Costocervical trunk
4). Internal thoracic artery
Vertebral arteries destination
brain (travel through cervical transverse foramen and then through the foramen magnum
Thyrocervical trunk destinations
1). muscles at base of neck, scapula,
2). thyroid
3). cervical structure
Costocervical trunk destinations
1). ribs
2). cervical structures
Internal thoracic artery destination
anterior rib cage
venous supply of the neck and skull
Jugular veins (internal, external and anterior)
what does the internal jugular vein do?
drains blood from brain
what does the external jugular vein do?
drains superficial structures of the head
what does the anterior jugular vein do?
empties into external jugular vein at base of neck to give jugular venous arch
Vagus nerve structural destinations
tongue, pharynx, thorax, and abdomen
branches of Vagus nerve
1). right recurrent laryngeal
2). left recurrent laryngeal
3). cardiac branches
4). pharyngeal branches
Right recurrent laryngeal branch
loops around R subclavian artery to trachea, esophagus and muscles of larynx
Left recurrent laryngeal branch
loops around aortic arch to trachea, esophagus, and muscles of larynx
Cardiac branches of the vagus nerve feed into what?
cardiac plexus of heart
what forms the Cervical Plexus?
ventral rami C1-C4 unit to form loops
Cervical Plexus branches
1). Ansa cervicalis
2). Phrenic nerves
3). Sensory nerves
Sensory nerves off of cervical plexus
1). lesser occipital n (C2)
2). great auricular n (C2, 3)
3). transverse cervical n (C3, 4)
4). supraclavicular n (C3, 4)
what are the sympathetic trunks
groups of neurons from upper Thoracic lateral horn of spinal cord, extend along either side of Vert column from sacrum to base of skull
3 cervical ganglia
1. superior ganglion
2. middle ganglion
3. inferior ganglion
superior cervical ganglion form what post-ganglionic nerves?
1). superior cervical cardiac nerve to cardiac plexus
2). arterial branches
3). internal carotid (sympathetic) plexus
thyroid gland location
anterior neck at C5-T1
thyroid gland function
secretes T3 and T4 hormone (metabolism) and calcitonin
what does calcitonin do?
stimulates CA storage, decreased blood Ca, and increases bone absorption of Ca
Hyperthyroid hormones result
Addison's disease
thyroid gland vasculature
superior branches of external carotid artery and inferior branches of subclavian artery
thyroid gland innervation
cervical sympathetic ganglia
parathyroid gland location
4 glands located on posterior thyroid
parathyroid gland function
secretes PTH
what does PTH do?
increase blood Ca, can decrease bone density (no PTH is fatal)
parathyroid vasculature
inferior thyroid artery branching from subclavian
parathyroid innervation
cervical sympathetic ganglia
larynx location
connects pharynx to trachea at C3-C6 level
Larynx function
sound production, prevents compression/closure of airway during swallowing
Laryngeal skeleton
9 pieces of cartilage
9 laryngeal cartilage pieces
1). thyroid cartilage (2)
2). cricoid cartilage
3). arytenoids cartilage (2)
4). vocal ligaments (2)
5). epiglottis 6). glottis
what forms the Adam's apple?
anterior fused section of the thyroid cartilage
significance of thyroid cartilage movement
protraction and retraction of thyroid important to sound modulation
cricoid cartilage connection to trachea
cricotracheal ligament
what forms the vocal fold?
arytenoid cartilage attached to vocal ligaments
where are the vocal ligaments?
extend from mid-line of thyroid cartilage anteriorly to arytenoids cartilage posteriorly; connect to cricoid by conus elasicus
epiglottis location
inferior end attached to ant thyroid cartilage, attached to arytenoids by aryepiglotic ligament
intrinsic laryngeal muscles innervation
CN 10
laryngeal blood vessles
superior branches from external carotid artery inferior branches from subclavian artery
trachea location
mid-line of neck from C6 (larynx) to T4-5 (sternal angle)
T/F: tracheal cartilage is open posterioly?
TRUE
terminus of trachea
Carina -- splits into bronchi -- where cough reflex originates
location of pharynx
base of cranium to base of cricoid cartilage
pharynx function
passageway for food and air (swallowing), connects oral and nasal cavities to trachea
subdivisions of pharynx
nasopharynx, oropharynx, laryngopharynx
nasopharynx location
from nasal cavity to soft palate; contains tonsils
oropharynx location
from soft palate to base of tongue; contains tonsils
laryngopharynx location
from superior epiglottis to esophagus
blood vessels of pharynx
arteries = branches of external carotid pharyngeal venous plexus
nerves to pharnyx
1). vagus to all muscles (except stylopharyngeus)
2). glossopharyngeal (stylopharyngeus)
Posterior triangle of neck
lateral cervical region
boundaries of post triangle of neck
- ant - SCM
- post - trap
- inf - clavicle
post triangle of neck blood vessels contents
- suprascapular artery,
- subclavian artery,
- external jugular vein,
- subclavian vein,
- brachiocephalic vein
post triangle of neck nerve contents
- CN 11
- cutaneous nerves of cervical plexus
cutaneous nerves of cervical plexus
1). great auricular n.
2). lesser occipital n.
3). transverse cervical n.
4). supraclavicular n.
5). brachial plexus
Anterior triangle boundaries
- ant - median line of neck
- post - SCM
- sup - mandible
sub-divisions of anterior triangle
- submental triangle
- submandibular triangle
- carotid triangle
- muscular triangle
submental triangle boundaries
1). inf - body of hyoid
2). right lat - right ant belly of digastric muscle
3). left lat - left ant belly of digastric muscle
submental triangle contents
lymph nodes and small veins
floor of submental triangle
mylohyoid, expect to find CN V3 here
submandibular triangle boundaries
1). sup - inferior border of mandible
2). ant - ant belly of digastric
3). posterior - post belly of digastric and stylohyoid
submandibular triangle contents
- submandibular salivary gland,
- CN 12,
- CN 5 branch,
- branches of external carotid to face,
- facial artery and vein,
- submental artery
carotid triangle boundaries
1). sup - post belly digastric along w/stylohyoid
2). inf med - sup belly of omohyoid
3). inf lat - SCM
contents of carotid triangle
- pulse site,
- thyroid,
- common cartoid branching to in/ex carotid,
- carotid body,
- internal jugular vein and branches,
- CN 11,
- CN 12,
- ansa cervicalis,
- CN 10,
- sympathetic plexus
branches of external carotid
- ascending pharyngeal artery,
- occipital artery,
- facial artery,
- superior thyroid artery
muscular triangle boundaries
1). med - medial plane of neck
2). sup lat - sup belly of omohyoid
3). inf lat - SCM
Muscular triangle contents
- thyroid gland,
- parathyroid glands,
- larynx,
- trachea,
- esophagus,
- ant jugular vein,
- communicating veins,
- recurrent laryngeal nerve
what fascia compartment is located in the muscular triangle?
peritracheal
which subdivision of the anterior triangle is not paired?
submental triangle
which subdivisions of the anterior triangle are paired?
1). Submandibular
2). Carotid
3). Muscular
which ribs are true ribs?
1-7
what determines a true rib?
attaches directly to sternum via costal cartilage
which ribs are false indirectly attached ribs?
8-10
which ribs are false floating ribs?
11-12
ribs are what type of bone?
curved flat bones
heads of ribs 2-9 articulation
Sup facet: vertebral body aboveInf facet: vertebral body belowCrest - projection between articular facets
what is found in the costal groove?
intercostal blood vessels, nerve, and muscles
what part of the rib forms the costochondral joint?
cup for the costal cartilage
T2-T9 articulate with ribs where?
bilaterally demifacets on sup/inf surfaces
plane of articular processes allows T vert to do what?
rotate and ab-/adduct but not FL/EX
joint type for manubrium and 1st rib
synchondrosis
Costovertebral joint type
articulations are planar but overall joint is condyloid
Costovertebral joint, # of articulations
typically 3 (ribs 2-9)
Costovertebral joint ligaments
1). strong capsule 2). intra-articular ligament 3). radiate ligament
collective movements at the Costovertebral joints?
pump/bucket handle -- each articulation rotates a little which collectively elevates/depresses the sternum
how many articulations does a costotransverse joint have?
1 articulation per rib
where does the costotransverse joint articulate?
transverse process of the inferior vertebrae
Costotransverse joint type
planar
ribs 1-6 costotransverse joints
slightly convex (rib) with concave (transverse process) -- allow rotation = pump handle
ribs 7-10 costrotransverse joints
flat planar - allow gliding = bucket handle
Costotransverse joint ligaments
weak capsule, lateral and superior costotransverse ligaments
Sternocostal joints
1). rib 1 - synchondrosis 2). ribs 2-10 have costochondral and sternochondral joints
costochondral joint type
synchondrosis (rib to cartilage)
sternochondral joint type
synovial planer (cartilage to sternum)
sternochondral joint rib 1
syncondrosis
sternochondral joint ribs 2-10
synovial planar/gliding
superior aperture borders
1). post - T1 body2). lat - rib 13). ant - manubrium
superior aperture contents
esophagus, trachea, nerves (vagus, sympathetic trunk, cervical plexus), blood vessels (carotids, subclavian, vertebral, jugular)
inferior aperture borders
1). post - T12 body 2). lat post - 11 & 12 ribs 3). lat ant - costal cartilage ribs 7-10 4). ant - xiphosternal joint
what is the inferior aperture covered by?
respiratory diaphragm
inferior aperture contents
esophagus, nerves (vagus, sympathetic chain), blood vessels (inf vena cava, descending aorta), internal thoracic arteries
what are the internal thoracic arteries called as they pass the diaphragm?
superior epigastric arteries
subdivisions of thoracic cavity
R/L Pleural cavity, mediastium
what is in the mediastium?
pericardial cavity, esophagus, trachea, great vessels, nerves
Muscles of the thoracic cavity
1). Serratus posterior (S/I)
2). Levator Costarum
3). External intercostals
4). Internal intercostals
5). innermost intercostals
6). subcostal
7). transversus thoracis
Serratus posterior superior, origin
S: spinous processes C7-T3
Serratus posterior superior, insertion
ribs 2-4
Serratus posterior superior, innervation
intercostal nerves
Serratus posterior superior, action
proprioception for respiration control
Serratus posterior inferior origin
spinous processes T11-L2
Serratus posterior inferior insertion
ribs 9-12
Serratus posterior inferior, innervation
intercostal nerve
serratus posterior inferior, action
proprioception for respiration control
Levator costarum origin
transverse processes of C7-T11
Levator costarum insertion
rib below
Levator costarum innervation
dorsal rami
Levator costarum action
elevate ribs for inspiration
external intercostals origin
superior rib
external intercostals insertion
inferior rib
external intercostals innervation
intercostal nerve
external intercostals action
elevate adjacent rib for inspiration
internal intercostals origin
inferior rib
internal intercostals insertion
superior rib
internal intercostals innervation
intercostal nerve
internal intercostals action
depress adjacent rib for expiration
innermost intercostals origin
inferior rib
innermost intercostal insertion
superior rib
innermost intercostal innervation
intercostal nerve
innermost intercostal action
depress adjacent rib expiration
subcostal origin
inferior rib
subcostal insertion
superior rib 2 or 3 above
subcostal innervation
intercostal nerve
subcostal action
depress ribs for expiration
transversus thoracis origin
sternum
transversus thoracis insertion
costal cartilage
transversus thoracis innervation
intercostal nerve
transversus thoracis action
proprioception for respiration control
ventral rami T1-11
intercostal nerve
what are the intercostal nerves further divided to?
S/I collateral branches and Lat/Ant cutaneous
ventral rami T12
subcostal nerve
sympathetic chain ganglia
connected to ventral rami by rami communicants; located on either side of vertebral bodies forming thoracic vertebral column
blood supply to Ant and Ant/lat thoracic wall
R/L subclavian arteries -> internal thoracic artery -> ant intercostals arteries -> ant and lat intercostals spaces of ribs 1-10
blood supply to post and post/lat thoracic wall
descending abdominal aorta -> paired post intercostal arteries -> post and post/lat intercostals spaces of ribs 4-11
Anterior intercostal veins
internal thoracic veins -> brachiocephalic vein
posterior intercostals veins
azygos/hemiazygos system -> superior vena cava
lymph flow
blood plasma -> capillary filtration -> ECF -> lymph capillary -> lymph fluid -> lymph vessel -> lymph nodes -> lymph trunk -> lymph duct
2 lymph ducts
Right Lymphatic Duct and Thoracic Duct
what does the Right lymphatic duct drain?
right side of head, arm, and thorax
what does the Thoracic duct drain?
left side head, arm, thorax, and entire abdomen, pelvis, legs
structural components of the mammary gland
1). glandular tissue
2). lactiferous ducts/sinus
3). nipple
4). areola
5). fat
6) retro-mammary space
7). pectoralis fascia
8). suspensory (Cooper's) ligaments
anterior arterial blood flow to the mammary glands
anterior intercostal -> medial mammary branches
axillary arterial blood flow to the mammary glands
axillary artery -> lateral thoracic and thoracoacromial -> lateral breast
posterior arterial blood flow to the mammary glands
posterior intercostals artery -> deep structures
mediastinum
area between pleural cavities
what is inside the mediastinum?
heart and pericardium
contents outside the pericardium
1). thymus
2). veins
3). arteries
4). nerves
5). trachea and primary bronchi
6). esophagus
7). thoracic duct
which veins are found in the mediastinum outside the pericardium?
1). R/L brachiocephalic
2). superior vena cava
3). azygos veins
which arteries are found in the mediastinum outside the pericardium?
1). aortic arch/descending aorta/ branches to thoracic structures
2). pulmonary truck with R/L pulmonary artery branches
3). brachiocephalic trunk
4). left carotid
5). left subclavian
which nerves are found in the mediastinum outside the pericardium?
1). vagus & recurrent laryngeal branches > esophageal plexus
2). phrenic
3). cardiac plexus (sympathetic & parasympathetic)
4). sympathetic chain ganglia
layers of the pericardium
1). fibrous pericardium
2). serous pericardium
3). visceral pericardium
what is the fibrous pericardium
outer layer of pericardium; suspends the heart in loose CT of mediastinum, protects it from over filling
what is the serous pericardium?
serous membrane forming the inner lining of pericardium (parietal pericardium)
what is the visceral pericardium?
serous membrane forming the outer covering of the heart (epicardium)
what is the orientation of the heart?
oblique, off center with 2/3 on L of mid-sagitall plane
venous supply to the right atria
1). Superior vena cava - blood from head, arms and thorax
2). inferior vena cava - blood from abdomen, pelvis, and legs
3). coronary sinus - blood from heart myocardium
valve between R atria and ventricle
R atrioventricular (AV) valve = tricuspid valve
left AV valve
bicuspid/mitral valve
valve between R atria and pulmonary trunk
pulmonary semilunar valve
valve between L ventricle and aorta
aortic semilunar valve
layers of the heart wall
1). epicardium
2). myocardium
3). endocardium
what is the endocardium?
simple squamous epithelial lining of the heart chambers
what attaches to AV valve flaps and close valves
chorde tendenae and papillary muscles
what do the trabeculae carneae do?
muscular ridges found on the inner surface of both ventricles
where are the pectinate muscles?
ridges found on the inner surface on both atria
where are the auricles?
R/L pouches attached to the R/L atria
what is the fibrous skeleton of the heart?
dense CT associated with the bases of the 4 valves. Acts as an insulator to electrically isolate atria from ventricles to create 2 heart pumps
where does the right coronary artery branch to?
1). SA node
2). base of heart
3). posterior R/L ventricles and IVC
4). AV node
where does the left coronary artery branch to?
1). SA node (40%)
2). Ant R and L ventricles and IVS
3). post surface
4). left border
5). post R and L ventricles and IVC (30%)
where do the R/L coronary arteries run?
in AV sulcus
how does the right coronary artery get to the Post R/L ventricles and IVC?
via posterior interventricular
how does the right coronary artery get to the base of the heart?
right marginal
how does the left coronary artery get to the Ant R/L ventricles and IVS?
via anterior interventricular artery = left anterior descending artery
how does the left coronary artery get to the posterior surface of the heart?
via circumflex artery
how does the left coronary artery get to the left border of the heart?
via marginal artery
where do the veins of the heart drain?
into great cardiac vein (left coronary sulcus) -> coronary sinus -> right atria
how does the left coronary artery run to the ant R/L ventricles and IVS?
via anterior inter ventricular artery and left anterior descending artery
how does the left coronary artery branch to the posterior surface of the heart?
via circumflex artery
how does the left coronary artery run to the left border of the heart?
via the marginal artery
how does the left coronary artery branch to the post R/L ventricles and IVC?
via posterior inter-ventricular artery
how does the R coronary artery branch to the base of the heart?
via right marginal artery
how does the R coronary artery branch to the posterior R/L ventricles and IVC?
via posterior inter-ventricular artery
T/F: the fibrous pericardium is continuous with the serous pericardium
TRUE
What is the intrinsic pathway for coronary innervation?
SA node (pacemaker) -> internodal fibers -> AV node (delay) -> AV bundle of HIS -> bundle branches -> Purkinje fibers
what is found in the hilum of the lungs?
- pulmonary arteries and veins
- bronchial arteries and veins
- primary (main) bronchus
- lymphatics
- nerves
- pulmonary ligament
what is the pulmonary ligament?
fold of viseral and parietal pleura connecting lungs to mediastinum
what portion of the airway has thick walls with no gas exchange?
the conducting portion
name the structures in the conducting portion of the airway
- Oral and nasal cavities
- Pharynx
- Larynx
- Trachea
- Primary bronchi
- Secondary bronchi (to lobes)
- Tertiary bonchi (segmental, ~10 per lung)
- Bronchioles
- Terminal bronchioles
what portion of the airway is responsible for gas exchange?
Respiratory portion
Name the structures in the respiratory portion of the airway
- Respiratory bronchioles (lubulues)
- Alveolar duct
- Alveolar sac
- Alveoli
superior surface of abdomen
diaphragm (domed to 4th intercostals space)
inferior surface of abdomen
pelvic inlet (superior pelvic apeture)
anterolateral surface of abdomen
muscular wall
posterior surface of abdomen
lumber vertebrae
what lines the abdominal cavity?
Peritoneum
what is visceral peritoneum?
serous membrane covering abdominal organs
what is parietal peritoneum?
serous membrane lining cavity
what is the peritoneal cavity?
fluid filled space in abdomen
what is the mesentery?
continuation of visceral and parietal peritoneum that attaches organ to body wall
what planes create the abdominal quadrants?
Transumbilicial plane (S/I halves)
Median plane (R/L halves)
what is in the right upper quadrant?
1). R lobe of liver
2). gallbladder
3). Stomach: pylorus
4). Pancreas head
5). R kidney
what is in the right lower quadrant?
1). Cecum
2). Appendix
3). Most of ileum
4). R Ovary, Uterine tube
5). R ureter & spermatic cord
what is in the left upper quadrant?
1). Liver L lobe
2). spleen
3). stomach
4). Jejunum & prox ileum
5). Pancreas: body and tail
what is in the left lower quadrant?
1). Sigmoid colon
2). Descending colon: Inf part
3). L ovary & uterine tube
4). L ureter & spermatic cord
anterior peripheral attachment of the diaphragm
xiphoid process
lateral peripheral attachment of the diaphragm
costal cartilage and ribs 5-10
posterior peripheral attachment of the diaphragm
L1-3 vertebrae and floating ribs
Deep attachment of the diaphragm
central tendon
