anatomy yr 1 Flashcards
whats the other term for superior vs inferior
rostral vs caudal
whats the other term for anterior vs posterior
ventral vs dorsal
what are the 2 divisions of the skelenton
axial
- skull
- vertebral column
- ribs
- sternum
appendicular
- lower limb
- upper limbs
2 types of joints
synovial
- bones moving against each other
- has an articular cavity
- produces synovial fluid
solid
- no joint space just connective tissue between
- for support not movemetn
types of synovial joints and and example of where they’re found
pivot joint - Between C1 and C2 vertebrae Hinge joint - Elbow Saddle joint - Between trapezium carpal bone and 1st metacarpal bone Plane joint - Between tarsal bones Condyloid joint - Between radius and carpal bones of wrist Ball-and-socket joint - Hip joint
types of solid joints - and they’re subtypes
Fibrous
- Syndesmosis
- Gomphosis
- Sutures
Cartilaginous
- Synchondrosis
- Symphysis
tendons vs ligaments
tendons - muscle to bones
ligaments - bone to bone
anatomical terms for movements
flexion vs extension abduction vs adduction circumduction rotation supination vs pronation inversion vs eversion
types of imaging and what they’re primarily used for
radiography with contrast media
- contrast media > barium or iodine compounds, absorb x-rays more than soft tissue
- visualise sift tissue
computerised tomography (CT scans)
- x-rays > tube rotates around body = transverse plane image
- visualise bony structures
magnetic resonance imaging (MRI)
- no x-rays
- uses radiowaves - from hydrogen nuclei
- sim. CT = planar image
- better than CT for soft tissue eg heart, brain
Ultrasound
- doesn’t use x-rays
- records reflection of ultrasonic waves
- visualise pregnancy, internal organs, blood vessels
divisions of vertebrae
33 in total
- 7 cervical
- 12 thoracic
- 5 lumbar
- 5 sacrum
- 4 coccyx
what are the 2 vertebral column curvatures
Primary – foetal
- Thoracic and sacral
- Concave anteriorly
- Differing height of anterior and posterior parts of vertebrae
Secondary – after birth
- Cervical and lumbar
- Concave posterior
- Postnatal changes in intervertebral discs
what is the purpose of vertebral column curvatures
- shock absorption
- weight distribution
clinical curvatures
Kyphosis – increases curvature of thoracic region
Scoliosis – lateral curvature
Lordosis –increased curvature of lumbar or cervical region
features of a typical vertebrae
Body
- Weight bearing, shock absorbing
Vertebral arch (neural arch) - Completes vertebral foramen o 2 pedicles o 2 laminae o 4 articular processes o 3 non-articular processes 2 transverse, 1 spinous
components of vertebral disc
annulus fibrosis
- fibrotic cartilage
nucleus pulposus
- gelatinous central mass
specialisation and name of the C1 vertebrae
Atlas
- No body or spinous process
- Anterior arch
- Posterior arch
- Superior articular surface
- Inferior articular surface
specialisation and name of the C2 vertebrae
Axis
- Rounded superior articular facets
- Dens (odontoid process)
C1 and C2 joints
- Atlanto-axial joint
o C1/C2
o Rotation
o Dens (odontoid process - Atlanto-occipital joint
o C1/ Occipital Bone
o ‘nodding’
variation between cervical, thoracic and lumbar vertebrae
Cervical - Sloped from anterior to posterior - Zygaphophysial joint in all Thoracic - ‘vertical’ Lumbar - ‘wrapped’
types of movement of the vertebral column
- Lateral flexion
- Lateral extension
- Rotation of head and neck
- Rotation of upper trunk
- Extension
- Flexion
what are the general functions of the muscles of the back
intrinsic
- movement and support of vertebral column
Extrinsic
- movement of limbs
- have a superficial and deep layer
trapezius
Attachments
o Thoracic vertebrae, cervical region, occipital bone to clavicle and scapula
Actions o Sup/ inf fibres Superior rotation of scapula o Middle fibres Retract scapula o Superior fibres Elevate o Inferior fibres Depress
Latissimus Dorsi
- Attachments
o Lower thoracic vertebrae, thoracolumbar fascia, iliac crest, inferior ribs to humerus - Actions
o Extend, adduct, medially rotate shoulder
Rhomboids
- Attachments
o Spinous processes to medial border of scapula - Actions
o Retraction. Inferior rotation of scapula
Levator Scapulae
- Attachments
o C1-4, to medial superior scapula - Actions
o Elevation and inferior rotation of scapula
name the extrinsic muscles of the back
trapezius
rhomboids
levator scapulae
name the erector spinae muscles, where they attach and their function
iliocostalis
longissimus
spinalis
attach from base of skull to the lower back
for posture and movement of the spine
SUPERFICIAL
name the transversospinals, where they attach and their function
semispinalis
multifidus
rotatores
attach from transverse process to superior spinous process
for extending the vertebral column
DEEP
what are the 3 bones of the pelvic bone and describe what they look like/ where they are
ilium - the big boi fan shaped one at the top
ischium - the wee skinny legend at the outside
pubis - the wee boi in the middle
what are the other bones of the pelvis other than the pelvic bone and how were they formed
sacrum
- formed by fusion of 5 sacral vertebrae
coccyx
- formed by 3-5 fused coccygeal vertebrae
joints of the pelvis
lumbosacral joint
o between the sacrum and sacrum
pelvic inlet
o the circle
pubic symphysis
o where the 2 pubis bones meet at the bottom
- sacrococcygeal joint
- sacro-iliac joint
what are the bones that make the pelvic inlet
sacrum
ilium
pelvis
pubic symphysis
what are the bones that make the pelvis outlet
coccyx
the ischial tuberositiesthe pubis symphysis
describe the differences between the pelvic inlet and outlet
The pelvic inlet is oval being widest transversely, the pelvic mid-cavity is circular, while the outlet is oval being widest anteroposteriorly.
pelvic dimorphism
Obturator foramen
- male – large and ovoid
- female – small and triangular
sub-pubic angle
- male – smaller
- female – larger
pelvic inlet shape
- male – heart shaped, narrow
- female – circular, elliptical, wide
true pelvis
- male – small
- female – shallow and spacious
pelvic viscera
bladder
urethra
reproductive system
GI system - rectum, anus
male peritoneum in pelvis
rectovesical pouch
- between bladder and rectum
female peritoneum in pelvis
recto-uterine pouch (pouch of douglas)
- vesico-uterine pouch
- broad ligament
female reproductive tract
- The ovary
- Corpus luteum
- Uterine tubes
o Conduct ovum from ovary to uterine cavity
o Usual site of fertilization - Uterus
what are the 4 parts of the uterine tubes
Infundibulum
Ampulla
Isthmus
Uterine part
what are the layers of the uterine wall
Endometrium
o Innermost mucosal layer, thickens and becomes rich in blood vessels and glands
Myometrium
o Middle, muscular layer (smooth muscle)
o Thickest layer of tissue in uterine wall
Perimetrium
o Outermost layer
o Part of visceral peritoneum
male reproductive system
- Rectum
- Anal canal
- Urinary bladder
- Urethra
- Prostate
- Seminal gland
- Ejaculatory duct
- Testis
- Epidymis
- Ductus deferens
- Penis
testes
- Ductus (vas) deferens o Transport spermatozoa to ejaculatory duct - Epididymis o Sperm storage and maturation - Testis o Produce spermatozoa
what are the types of cells lining the seminiferous tubules
- Germ cells (sperm in various stages of development)
- Sertoli cells (supporting cells)
- Leydig cells (endocrine function) > adrogens
urethra pathway
- Begins at base of bladder -> ends in external opening in perineum
- Paths of urethra differ between male and female
muscles of the pelvis
- Coccygeus
- Levator ani
- Piriformis
- Obturator internus
Pelvic diaphragm -> coccygeus + levitator ani
pelvic perineum
- Diamond-shaped shallow compartment bounded by pelvic outlet
- Separated from pelvic cavity by fascia covering inferior aspect of pelvic diaphragm
Divided into 2 triangles - Urogenital triangle (above)
- Anal triangle (below)
anal triangle contents
- Contains anus, external anal sphincter
- Extends superiorly to pelvic diaphragm
- Filled laterally with ischional fat
urogenital triangle
- Inferior fascia of pelvic diaphragm
- Perineal membrane
- Perineal fascia
muscles associated with genitals
- ischiocavernous
- bulbospongiosus
gonadal blood supply - the order of the blood vessels the blood travels through
abdominal aorta
common iliac
internal iliac
external iliac
- gonadal arteries arise from abdominal aorta
female blood supply
- where do the arteries arise and whats the flow
- Uterine arteries arise from internal iliac arteries
- Ascending uterine arteries and ovarian arteries bifurcate into ovarian and tubal branches
- Arteries supplying superior part of vagina derive from uterine arteries
- Arteries supplying mid/ inf vagina derive from vaginal/internal pudendal arteries
male blood supply
- Inf vesical – branches to bladder, ureter, seminal vesicles and prostate
- Middle rectal artery – rectum
- Internal pudendal artery – main artery of the perineum including penis
nerve supply to the pelvis
pudendal nerve
bones of the neurocranium
- Frontal
- Parietal
- occipital
- temporal
- sphenoid
- ethmoid
bones of the viscerocranium
- frontal
- nasal
- maxilla
- zygomatic
- mandible
sutures of the cranium and and describe where they are
frontal/ coronal
- the big boi horizontally at the front
lamboid
- between occipital bone
- the wee boi horizontally at the back
- he a bit bent do
sagittal
- big boi right down the middle he longgggg
landmarks of sutures
lambda
o lamboid and sagittal sutures meet here
bregma
o coronal and sagittal sutures meet
pterion
o H shaped formation of sutures on the side of the calvarium
temporomandibular joint
- Hinge connecting the jaw to the temporal bone
- Joint capsule
- Articular disc
- Hinge and gliding
o Allows for movement up, down and side to side
o For speech, talking, chewing and yawn etc
coverings of the brain
meninges
- dura
- arachnoid
- pia
what are the 3 cranial fossa? what do they look like and what do they contain
Anterior > most shallow and superior – lies over the nasal and orbital cavities
- Cribiform plate
Middle > butterfly shaped depression of the skull base
- Optic canal
- Superior orbital fissure
- Foramen rotundum
- Foramen ovale
- Foramen spinosum
- Foramen lacerum
Posterior > most deep – accommodates the brainstem and cerebellum
- Internal acoustic meatus
- Hypoglossal canal
- Jugular foramen
- Foramen magnum
middle crania fossa foramina of the skull
Cribiform Plate - CNI – olfactory Optic canal - Optic nerve Superior orbital fissure - CNIII, CNIV, CNV, Foramen Rotundum - CNV (2) Foramen ovale - CNV (3) Foramen spinosum - Middle meningeal artery Foramen lacerum/ carotid canal - Internal carotid artery
posterior cranial fossa foramina
- Internal acoustic meatus o CNVII and CNVIII - Jugular foramen o Internal jugular vein, CNIX, X, XI - Hypoglossal canal o CNXII - Foramen Magnum o Spinal cord, vertebral arteries
the ear structures from external to internal
- Tympanic membrane
- Auditory ossicles
- Tympanic cavity
- Vestibulocochlear organ
- Cochlea
- Semicircular canals
muscles of facial expression and examples of them
Bone - skin Allow skin to move independently of underlying structures Eg… - Orbicularis occuli - Orbicularis oris - Buccinator - Platysma
muscles of mastication
bone – bone movement of TMJ 4 bilateral muscles - Temporalis - Masseter - Medial pterygoid - Lateral pterygoid
sternocleidomastoid
- Long muscles connect the sternum, clavicle and mastoid process of the temporal bone
- Used to turn and nod the neck
trapezius
- Large surface muscle that extends longitudinally from the occipital bone to the lower thoracic vertebrae of the spine and laterally to the spine of the scapula
- Moves scapula and supports the arms
the 2 triangles of the neck and their boundaries
Posterior triangle boundaries
- SCM
- Trapezius
- Clavicle
Anterior triangle boundaries
- SCM
- Mandible
- Median plane of neck
what are the key structures contained within each neck triangle
Posterior (deep) - Roots of brachial plexus - Subclavian artery + vein Anterior - Salivary glands - Lymph nodes - Hypoglossal nerve - Carotid sheaths and contents - Thyroid gland
what are the openings of the head and neck
- optic canal
- superior orbital fissure
the contents of the nasal cavity
- Nares
- Choanae
- Conchae
- Paranasal sinuses
the paranasal sinuses
- Frontal
- Maxillary
- Sphenoid
- Ethmoid air cells
oral cavity boundaries
- Hard palate
- Soft palate
- Lips
- Tongue
- Muscles of the mouth floor
- Cheeks
- Oropharynx
teeth
- Incisors – thin cutting edge – 4+4
- Canines – one prominent cone – 2+2
- Premolars – 2 cusps – 4+4
- Molars 3+ cusps – 6+6
palantine tonsils
- Palatoglossal arch
- Palatopharyngeal arch
divisions of the pharynx and larynx
Pharynx - Nasopharynx - Oropharynx - Laryngopharynx Larynx - Cartilage skeleton - Vocal cords - Surface landmarks
blood supply to the head and neck
Paired Common Carotid Arteries
- Branch of brachiocephalic trunk on right and arch of aorta on left
Paired vertebral arteries
- Branch of subclavian artery on both sides
the mediastinum
- Central compartment of thoracic cavity
- Between pleural sacs
- 5 divisions
o Superior, inferior, anterior, middle, posterior
pericardium - what is it, where is it
- Fibroserous fluid filled sac
- Surrounds heart muscle and great vessels
- Lies within middle mediastinum
what are the 2 layers of the pericardium and describe them
Fibrous (outer layer)
o Tough connective tissue
o Inextensible
o Central tendon of diaphragm
Serous (inner layer) o Single sheet epithelial cells o Parietal layer o Pericardial cavity (fluid filled) o Visceral layer (epicardium)
Function of the pericardium
- Fixation within mediastinum
- Prevents over filling of the heart
- Lubrication
- Protection from infection
innervation of the pericardium
- Phrenic nerve (C3, 4 and 5)
- Referred pain
pericardial sinuses
Transverse pericardial sinus
o Lies between arterial outflow (posteriorly) and venous inflow (anteriorly)
o Coronary artery bypass grafting
Oblique pericardial sinus
o Blind end passageway
o Reflection of pericardium onto pulmonary veins
clinical relevance of the pericardium
Cardiac tamponade
o Inextensible fibrous layer
Pericarditis
o Inflammation from bacterial infection or infarction
Coronary artery bypass grafting
o Ligation of arteries
o Transverse pericardial sinus
what layers of the pericardium do the pericardial sinuses lie between
the visceral and parietal layers of the serous pericardium
surfaces of the heart
- anterior (sternocostal) - R. ventricle
- posterior (base) - L. atrium
- inferior (diaphragmatic) - L. and R. ventricles
- R. Pulmonary - R. atrium
- L. pulmonary - L. ventricle
borders of the heart
right border - right atrium
inferior border - left and right ventricles
left border - left ventricles and part of L. atrium
superior border - L & R Atria, Great Vessels
external heart sulci
- Grooves created by internal divisions
o Coronary sulcus
o Anterior and posterior interventricular sulci
heart wall
- Endocardium
- Subendocardial layer
- Myocardium
- Subepicardial layer
- Epicardium (visceral pericardium)
endocardium
- Innermost layer
- Lines cavities and valves
- Loose connective tissue and simple squamous epithelium
- Regulates contractions
- Role in development
subendocardial layer
- Joins endocardium and myocardium
- Loose layer of connective tissue
- Contains neurovasculature of heart conducting system
myocardium
- Cardiac muscle (involuntary striated muscle)
- Cardiac contractions
subepicardial layer
- Joins myocardium with epicardium
epicardium
- Outermost layer of the heart
- Visceral layer of pericardium
- Connective tissue and fat
o Secretes lubricating fluid - Lined by simple squamous epithelial cells ~(outermost surface)
right atrium
- Receives blood from superior and inferior vena cava, coronary veins
- Right auricle
- 2 distinct parts divided by crista terminalis (sinus vernarum and atrium proper)
- Coronary sinus (between IVC and right atrioventricular orifice)
interatrial septum
- Muscular wall separating atria
- Oval depression on septal wall of RA ‘fossa ovalis’
right ventricle
- Receives blood from RA
- Pumps blood to pulmonary artery via pulmonary orifice
- Triangular shape
- Anterior heart border
- Inflow and outflow portions
- Separated by supraventricular crest
right ventricle - inflow portion
- Trabeculae carnae ‘sponge like’ o Ridges o Bridges o Pillars (papillary muscle) - Papillary muscle base attached to ventricle - Chordae tendineae - Cusps of tricuspid valve
right ventricle - outflow portion
- Superior ventricle leading to pulmonary artery
- Derived from embryonic bulbus cordis
- Smooth walls
- No trabeculae carnae
left atrium
- Receives blood from pulmonary veins
- Forms posterior border (base) of heart
- Left auricle
left ventricle
- Receives blood from left atrium
- Forms apex of heart
- Left and inferior heart borders
- Inflow and outflow portions
left ventricles inflow and outflow portions contents
inflow
- trabeculae carnae
- 2 papillary muscles
- cordae tendineae attach cusps of mitral valve
outflow
- aortic vestibule
- smooth walls
- derived from bulbus cordis
heart valves
- Ensure blood flows in one direction
- Connective tissue and lined in endocardium
- 4 valves
o 2 atrioventricular
o 2 semilunar
atrioventricular valves
- Close at start of systole (first heart sound)
- Valves are supported by chordae tendinae
tricuspid
- guards right atrioventricular orifice
- 3 cusps
- 3 supporting papillary muscles
mitral
- guards left atrioventricular
- 2 cusps
- 2 supporting papillary muscles
semilunar valves
- Close at the start of diastole (2nd heart sound)
- Found between ventricles and corresponding outflow tracts
- Sinuses
- Lunule (thickened free edge)
- Nodule (widest area)
what are the 2 semilunar valves and describe them
pulmonary valve
- guards pulmonary orifice
- 3 cusps
aortic valve
- guards aortic orifice (L. ventricle and ascending aorta)
- 3 cusps
- left and right coronary aortic sinuses
heart sounds - what valves are responsible
First heart sound - Tricuspid valve - Mitral valve Second heart sound - Aortic valve - Pulmonary valve
coronary artery supply to the heart
- Vessels that supply and drain the heart
- 2 main arteries
o Right and left coronary arteries - Left coronary artery
o Left anterior descending artery
o Left marginal artery
o Left circumflex artery - Right coronary artery
o Right marginal artery
o Posterior interventricular artery (85%)
venous drainage of the heart
- Venous drainage of the myocardium
- 5 tributaries
o Great cardiac v.
o Small cardiac v.
o Middle cardiac v.
o Left marginal v.
o Left posterior ventricular v. - Converge at coronary sinus
- Drain into RA between atrioventricular orifice and orifice of IVC
the great vessels to and from the heart
Carrying blood away from the heart - Pulmonary arteries - Aorta Carrying blood towards the heart the g - Pulmonary veins - Superior vena cava - Inferior vena cava
cardiac conduction system
- Initiate and co-ordinate contraction of myocardium
- Comprised of
o Sinoatrial node (pacemaker)
o Atrioventricular node
o Atrioventricular bundle (of His)
o Right and left bundle branches
o Purkinje fibres
the thoracic aorta what does it give arise to
Ascending aorta
o L and R coronary arteries
Arch of the aorta
o Brachiocephalic trunk
o Left common carotid a.
o Left subclavian a.
how does the brachiocephalic trunk divide
- Brachiocephalic trunk divides into right CC and SC
- Paired common carotid arteries supply head and neck
o Divide at C3/4 into internal and external carotid arteies - Paired subclavian arteries supply upper limbs, head and neck
thoracic aorta - what’s it’s positions and what branches come off it
Descending
- Loops back over hilum of left lung into the posterior mediastinum
Descending aorta has branches that supply…
- Lungs > bronchial x 3
- Rib cage > post. Intercostal x 9
- Oesophagus > oesophageal x 2
- Variable branches to pericardium, diaphragm, and other mediastinal structures
what forms the intercostal arteries
- Posterior intercostal arteries
o Descending thoracic aorta - Anterior intercostal arteries
o L&R internal thoracic arteries
superior vena cava - what forms it, what vessel does it receive and where does it deliver blood
- Formed by unification of brachiocephalic veins
- Receives azygos vein
- Carries deoxygenated blood back to right atrium
brachiocephalic veins - what are they formed by, what do they do, and which one is longer
- Formed by unification of subclavian and internal jugular veins on each side (draining blood from upper limbs and head and neck respectively)
- Left brachiocephalic vein longer than right brachiocephalic vein
azygous venous system - where does it receive blood from, what does it form a link between, what does it drain into, what doe sit contain
- Receives blood from posterior thoracic wall, bronchi, and mediastinal viscera
- Forms a link between IVC and SVC
- Drains into the SVC
Contains… - Azygos vein
- Hemiazygos vein
- Accessory hemiazygos vein
aortic hiatus and what happens to the abdominal aorta past this point
- At T1 the thoracic aorta passes through the diaphragm to enter the abdomen and becomes the abdominal aorta
- The abdominal aorta passes from T12->L4 where it bifurcates into 2 terminal branches
o L and R common iliac arteries
what are the 3 major midline, unpaired abdominal aorta branches
o Coeliac trunk (T12)
o Superior mesenteric A. (L1)
o Inferior mesenteric A (L3)
what are the several paired abdominal aorta branches
o Renal A. (kidneys)
o Gonadal A. (testes/ovaries)
o Lumbar A. (vertebra and muscles)
o Inferior Phrenic A. (diaphragm)
coeliac trunk branches and where does it supply
- Supplies the foregut, liver, spleen and pancreas
o Common hepatic artery
o Splenic artery
o Left gastric artery
superior mesenteric artery branches and where does it supply
Supplies the midgut and pancreas via-
- Middle colic A.
- Right colic A.
- Ileocolic A.
- Jejunal and ileal A.s
inferior mesenteric artery branches and where does it supply
Supplies the hindgut via-
- Left colic A.
- Sigmoid A.
- Superior Rectal A.
inferior vena cava - hows it formed, where does it pass through the diaphragm, where does it carry blood to
- Formed by unification of L&R common iliac veins (L5)
- Passes through diaphragm at T8 (caval foramen)
- Carries deoxygenated blood back to right atrium)
vena cava - what veins does it receive and what veins does it give rise to
- Receives renal veins (kidneys)
- Receives right gonadal vein and right suprarenal vein (ovary/ testis and adrenal gland)
- Receives hepatic veins (liver)
- Gives rise to azygos vein
- Doesn’t directly receive veins from intestines, spleen, pancreas or gall bladder
o Hepatic portal venous system
hepatic portal vein - whats it formed by, whats its route
- Formed by unification of splenic and superior mesenteric vein
- Also joined by inferior mesenteric vein
- After passing through liver, blood returns to IVC via hepatic veins
great vessels of the pelvis
- Common iliac arteries branch into external and internal iliac arteries at the pelvic brim (in front of the sacroiliac joints)
- External iliac arteries pass around pelvic brim before passing under inguinal ligament and into lower limb (femoral artery)
- Internal iliac arteries and their branches supply the pelvis
internal iliac arteries
- Supply most pelvic organs and perineum
- Subtle gender differences in branching pattern
- Can be subdivided into anterior/ posterior divisions and visceral/ parietal branches
branches of the aortic arch
Brachiocephalic trunk - Right common carotid - Right Subclavian a. Left Common Carotid a. Left Subclavian a.
arterial supply of head and neck
Common Carotid a. - External carotid a. - Internal carotid a. Subclavian a. - Vertebral a.
at what level to the common carotids bifurcate
Common carotids ascend neck bifurcating at C4 (margin of thyroid cartilage)
within carotid triangle…
external carotid branches and where does it terminate
8 Branches… - Superior thyroid a. - Lingual a. - Facial a. - Ascending pharyngeal a. - Occipital a. - Posterior auricular a. - Superficial temporal a. - Maxillary a. Terminates in the parotid gland
carotid sinus
- Dilated segments of common and internal carotid a.
- Detection and regulation of blood pressure
internal carotids - what do they supply and what are they a part of
- Supplies brain, eyes and forehead
- Forms part of circle of willis
vertebral artery - what does it arise from, what does it ascend through and what route does it enter the brain
- Arise from subclavian a.
- Ascend through the transverse foramina of c spine
- Enter foramen magnum and converge
- Supply the brain via the ‘circle of willis’
venous drainage of the head and neck - what vessels are involved
Internal jugular (drains brain and skull) o Combines with subclavian v. to form brachiocephalic v.
External jugular (drains face and scalp) o Empties into subclavian v.
Anterior Jugular (drains anterior neck) o Empties into subclavian v.
carotid sheath - location and contents
Paired structures found on either side of the anterior neck
Contents… o Common carotid a. o Internal jugular v. o Vagus nerve o Cervical lymph nodes
arterial supply to the upper limb
Subclavian a.
- becomes axillary a. at lateral margin of first rib
- Passes through the axilla
- At the inferior margin of Teres Major it becomes Brachial a.
Profunda brachii a.
Brachial a.
Radial a.
Ulnar a.
what veins drain the upper limb
- cephalic vein
- basilic vein
- median cubital vein
arterial supply to the lower limb
- external iliac artery
- femoral artery
- deep artery of thigh
- popliteal artery
- posterior and anterior tibial artery
- fibular artery
- posterior tibial artery
- dorsalis pedis artery
at what point does the femoral artery become the popliteal artery
when it passes posteriorly through the adductor hiatus
venous drainage of the lower limb
- femoral vein
- popliteal vein
- great and small saphenous veins
- dorsal venous arch
histology of blood vessels
Tunica intima
- Endothelial cells, connective tissue
Tunica media
- Smooth muscle cells and collagen (thickest part)
Tunica adventitia
- Thin connective tissue layer, contains lymphatics, nerves and blood vessels
pulses
Radial - Lateral wrist Brachial - Medial to biceps tendon Femoral - Mid-inguinal point Popliteal - Popliteal fossa Anterior tibia - Lateral edge of medial malleolus Dorsalis pedis - Dorsum of foot
functions of the chest wall
- Respiration
- Protection
- Muscle attachments
the thoracic cavity major spaces
- Heart with coverings (pericardium – pericardial cavity) + the major vessels
- Lungs with coverings (pleura – pleural cavities)
superior thoracic aperture
- Upper opening of the thorax
- ‘thoracic inlet’
- Formed by the first thoracic vertebra behind, the upper margin of the sternum in front and the first rib on either side
inferior thoracic aperture
- Lower opening of thorax
- ‘Thoracic outlet’
- Formed by…
o twelfth thoracic vertebra behind
o by the eleventh and twelfth ribs, in front
o by the cartilages of the tenth, ninth, eighth and seventh ribs at each sides
o form the subcostal angle
components of the chest wall
- thoracic vertebrae
- ribs
- sternum
o manubrium, body, xiphoid process - intercostal spaces
o intercostal muscles
typical rib features
head neck tubercle angle internal surface costal groove external surface costal cartilage
categorisation of ribs
True Ribs - ribs 1-7 - articulate with sternum. Via own costal cartilage False ribs - ribs 8-10 - articulate with sternum via costal cartilage of rib above Floating ribs - ribs 11 and 12 - do not articulate with sternum
what are the 2 muscles of the chest
Pectoralis major
- muscle at the chest
- beneath the breast
- thick, fan-shaped muscle
Pectoralis Minor
- thin triangular muscle
- upper part of the chest beneath the pectoralis major
serratus anterior muscles
- Originates from surface of the 1st- 8th ribs at the side of the chest
- Inserts along the entire anterior length of the medial border of the scapula
- Pulls the scapula forward around the thorax
intercostal muscles
- Run between the ribs
- Help form and move the chest wall
- Involved in mechanical aspects of breathing
- Help to expand and shrink the chest cavity for breathing
movements of the chest wall during inhalation
internal intercostals relax and external intercostal muscles contract…
- chest expands
- diaphragm contracts pulling down
- ribcage is pulled upwards and outwards
- lung volume increases and air pressure inside decreases so air rushes in
what are the characteristic movements of the chest
Bucket handle movement
- during inspiration the transverse diameter of the thorax is increased by the ribs swinging outward – bucket-handle rib motion
Pump handle movement
- contraction of external intercostals raises the lateral part of the ribs
- causing a bucket handle motion that increases the transverse diameter of the thorax
- vertebrosternal ribs follow this movement
o raises sternum and inc. the anterior-posterior dimensions of the thorax
diaphragm openings
- inferior vena cava – T8
- Oesophagus – T10
- Aorta – T12
trachea
- C-shaped hyaline cartilage rings
- Bifurcates into right and left main bronchus at TIV/TV
- Carina > hook-shaped tracheal rings
- Trachealis muscle
bronchial tree - the 2 bronchi
Right main bronchus - Wider - Vertical - Shorter - Divides into 3 Left main bronchus - Long - More horizontal - Thin - Divides into 2
the pathway of air
- Traches
- Main bronchus > PRIMARY
- Lobar bronchi > SECONDARY
- (3R, 2L)
- segmental bronchi > TERTIARY
- conducting bronchioles
- respiratory bronchioles
- alveoli
- alveolar ducts
- alveolar sacs
alveoli
- microscopic air cells
- gas exchange
- 150-300 mill
- Single layer of epithelial cells and elastic fibres line the walls of each one
o Allow them to stretch/ contract during breathing - Surrounded by a network of capillaries for gas exchange
- Coated in a thin film of pulmonary surfactant
o Prevents alveoli from collapsing
what are the external features of the left and right lung
Right lobe - Superior - Middle - Inferior o Oblique fissure o Horizontal fissure
Left Lobe - Superior - Inferior o Oblique fissure o Lingula
right medial surface - root structures and impressions
Hilum
- Where important structures enter/ exit each lung
Root structures
- Pulmonary arteries (purple)
- Pulmonary veins (orange)
- Bronchus (green)
Impressions (the blue arrtows)
- Superior vena cava
- Inferior vena cava
- Oesophagus
- Azygos vein
left medial surface - root structures and impressions
- Smaller than right lung Hilum - Where structures enter/ exit Root structures - Pulmonary arteries - Pulmonary veins - Bronchus Impressions - Heart - Aortic arch - Thoracic aorta - Oesophagus - Left subclavian artery
hilum
Main structures entering the hilum - Primary bronchi - Pulmonary arteries (deoxygenated blood) Main structures exiitng the hilum - Pulmonary veins (oxygenated blood) Other structures - Bronchial arteries and veins - Lymph vessels - Efferent and afferent autonomic nerves
what are the 2 laters and sub-layers of pleura
- PARIETAL PLEURA o Costal o Mediastinal o Diaphragmatic o Cervical
- VISCERAL PLEURA
o Adheres to walls of lung
o Covering surface of each lobe
describe what happens when lung ruptures
- Rupture of a lung allows entry of air into pleural cavity
- Surface tension adhering visceral to parietal pleura breaks = lung collapses
- Won’t affect the other lung
costodiaphragmatic recess
- Between costal pleura and diaphragmatic pleura
- Clinically important
mediastinum divisions
- Separates the pleural cavities
- Divided into 2 parts
o Superior mediastinum
o Inferior mediastinum
Anterior
Middle
Posterior
mediastinum contents
- Aorta
- Heart
- Azygous vein
- Trachea
- Main bronchi
- Oesophagus
- Vagus nerves
- Phrenic nerves
- Thoracic ducts
innervation of the lung pleura
- Parietal pleura > somatic innervation
- Costal pleura > intercostal nerves
- Mediastinal pleura > phrenic nerves
- Diaphragmatic pleura
o Phrenic nerves to domes
o Lower 5 intercostal nerves to periphery - Visceral pleura > autonmic innervation
innervation to mediastinum
- Vagus nerve
o Parasympathetic supply to all organs and thorax - Phrenic nerve
o Motor and sensory to diaphragm
what is the vomer bone
the small thin bone separating the 2 nasal cavities in humans
what is the nasal septum
The nasal septum separates the left and right airways of the nasal cavity, dividing the two nostrils. It is depressed by the depressor septi nasi muscle
what is the ethmoid bone
It is situated at the roof of the nasal cavity, and between the two orbital cavities. It contributes to the medial wall of the orbit and forms part of the anterior cranial fossa, where it separates the nasal cavity (inferiorly) from the cranial cavity (superiorly).
what are the conchae - turbinate
- any of the scrolled spongy bones of the nasal passages in vertebrates.
- In humans, the conchae divide the nasal airway into 4 groove-like air passages,
- responsible for forcing inhaled air to flow in a steady, regular pattern around the largest possible surface area of nasal mucosa.
what are the meatus
passage or opening
- three meatuses (passages) through the skull’s nasal cavity: the superior meatus (meatus nasi superior), middle meatus (meatus nasi medius), and inferior meatus (meatus nasi inferior).
name the paranasal sinuses
frontal
ethmoid
maxillary
sphenoidal
nasal cavity communicating structures
Pharyngotympanic tube (eustachian tube)
- connects nasal cavity to the middle ear
Nasolacrimal duct (tear duct)
- connects lacrimal sac to nasal cavity
what are the parts of the pharynx
Nasopharynx - choanae > soft palate Oropharynx - posterior opening of oral cavity > epiglottis Laryngopharynx - laryngeal inlet > oesophagus Soft palate “flutter valve” Pharyngotympanic tube opens into nasopharynx
constrictor muscles of the pharynx
- pharyngeal tubercle
- superior constrictor
- middle constrictor
- inferior constrictor
- stylopharyngeus
- pharyngeal raphe
- oesophagus
what are the longitudinal muscles of the pharynx
Move pharyngeal wall up and over bolus of food being moved through the pharynx
- salpingopharyngeus
- palatopharyngeus
- stylopharyngeus
the pharynx innervation
- pharyngeal branch of vagus nerve (X)
- glossopharyngeal nerve (IX) to stylopharyngeus
what are the cartilaginous structures within the larynx
o thyroid cartilage T o cricoid cartilage C o arytenoid cartilage x 2 A o Epiglottis E - T, C and A are HYALINE cartilage - E is ELASTIC FIBROCARTILAGE
what does the epiglottis do
Closes over entrance to the larynx to stop food/ liquid entering during swallowing
the larynx structure - what membrane and what ligaments
Thyrohyoid membrane
- Tough fibro-elastic ligament
- Superior margin of thyroid cartilage > hyoid bone
Cricotracheal ligament
- Lower border of cricoid cartilage > upper border of 1st tracheal cartilage
- Fibrous membrane between tracheal cartilage
Cricothyroid Ligament
- Cricoid cartilage > thyroid and arytenoid cartilages
- Free upper margin = vocal ligament
muscles of the larynx
Cricothyroid muscle
- Lengthens vocal folds
- External laryngeal nerve (branch of the superior laryngeal nerve)
Posterior cricoarytenoid muscles
- Primary abductors of vocal folds (open vocal folds)
- Recurrent laryngeal nerve
Lateral cricoarytenoid muscles
- Adductors of vocal folds (close the vocal folds)
- Recurrent laryngeal nerve
innervation of the larynx
Sensory above vocal folds - L & R superior laryngeal nerves (internal branch) Sensory below vocal folds - L & R recurrent laryngeal nerves All motor innervation - L & R recurrent laryngeal nerves Except cricothyroid - L & R superior laryngeal nerves (external branch)
the trachea
- Continuous with the larynx
- Walls are held open by C-shaped rings of hyaline cartilage
o Incomplete posteriorly to allow food to travel down the oesophagus
histology of the upper respiratory tract in general
- Most of the upper respiratory tract is covered in pseudostratified columnar ciliated epithelium (“respiratory epithelium”)
- Goblet Cells (G) – produce mucus to trap foreign particles
- Cilia ( C) – beat to transport mucus out of the respiratory system
trachea histology
- Respiratory epithelium
- Cartilage ring (c )
- Trachealis muscle (T)
- Mucosa (M)
- Longitudinal muscle (L)
primary bronchiole histology
- Respiratory epithelium (RE)
- Cartilage (c )
- Mucous/ serous glands (G)
- Elastic lamina propria (LP)
- Smooth muscle (M)
- Ciliated epithelial cells (CC)
bronchiole histology
- <1mm lumen
- Pseudostratified ciliated columnar epithelium > ciliated columnar epithelium
- NO glands
- NO cartilage
- Smooth muscle (M)
alveoli histology
- Simple squamous epithelium
- Alveolus (A)
- Alveolar duct (AD)
- Alveolar sac (AS)
- Bronchiole (R)
- Type I pneumocyte (P1)
- Type II pneuomocyte (P2)
- Capillary (C)
- Red blood cell (RBC)
attachments of the shoulder and what kind of joint is it
Attachment between the trunk and the upper limb - Proximally – pectoral girdle o Scapula + clavicle - Distally – humerus Synovial joint – ball and socket joint
describe the structure and articulation of the scapula
- Complex bone
- Suspended by soft tissues
- Directly articulated with humerus – glenohumeral joint
- Articulates with trunk via clavicle only
- Triangular – 3 angles, 3 borders
- 3 fossae for muscle attachment
state the attachments and, ends and surfaces of the clavicle
- Relatively simple bone
- Only bony attachment between trunk and upper limb
- 2 ends
o Medial, or ‘sternal’
o Lateral, or ‘acromial’ - 2 surfaces – superior + inferior
describe the structure, and surfaces of the proximal humerus
- Long bone of the arm
- Rounded head
- Neck
o Anatomical
o Surgical - Irregular surfaces for muscle attachment
o Tubercle from ‘tuber’ – swelling
describe the joint between the scapula and clavicle - what kind, functions etc
- Synovial joint between acromion and lateral end of clavicle
- Bound together by ligaments
- For stability
- Several small groups…
o Named for features they connect
o Eg. Coraco-acromial ligament
glenohumeral joint - what is it formed by, what muscles support it, how does it facilitate movement
- Glenoid fossa of scapula and head of humerus
- Primarily supported by musculature
o Rotator cuff, deltoid - Facilitates high degree of movement
- Capsule has ‘free’ tissue to aid movement
what are the movements of the shoulder?
Broad range of movements o Flexion/ extension o Abduction/ adduction o Medial (internal) rotation/ lateral (external) rotation o Circumduction
Second set of associated movements increases range of motion - Scapular movements o Elevation/ depression o Protraction/ retraction o rotation
the hip - function, attachments, what type of joint
- articulation between the trunk and the lower limb
- major biomechanical structure
o transfers weight of body to lower limb
o facilitates bipedal locomotion - proximally > pelvic girdle
- Distally > proximal femur
- Synovial ball-and-socket joint
what is the pelvic girdle - what joints does it contain
- Tightly bound complex – ‘hip bones’ and sacrum
o ‘hip bones’ = innominate or ‘os coxa” - Three joints within the pelvic girdle
o 2x sacroiliac joints
o Pubic symphysis - Only one innominate is directly involved in each hip joint
whats the innominate
- Oddly shaped bone
- Formed from 3 separate bones in childhood
o Ilium
o Ischium
o Pubis - Fuse together in teenage years
- Retain independent identity in adulthood
describe the proximal femur - where does it join, describe the ends
- Longest (and strongest) bone in body
- Bony support for the thigh
- Joins the hip joint superiorly to knee joint inferiorly
- Similarities to humerus
- Elongated proximal end
- Flattened, widened distal end
the hip joint - what type of joint, what does it join together, what ligaments are involved, whats it functions
- Synovial ball and socket
- Tight articulation between the acetabulum and head of femur
o Structures grow together during childhood
o Bone stability high - Reinforced by ligaments
o Extrascapular
o Intrascapular - Designed to reduce force needed to stand upright
- Support weakest when flexed and medially rotated
movements of the hip
- Similar no. to the shoulder
- Mobility greatly reduced
- Preferential selection for stability instead
- Movements include
o Flexion/ extension
o Abduction/ adduction
o Medial/ lateral rotation
o Circumduction
the elbow - what does it join together, what different joints does it contain
- Articulation between the arm and forearm
- Complex arrangement
o Contains 3 separate joints - Proximal – distal humerus
- Distal
o Ulna (medial)
o Radius (lateral) - Synovial joint
- Hinge
the distal humerus - describe it’s shape, what are its articular surfaces, how many depressions does it have
- Broad, flattened articular region
- 2 articular surfaces
o Trochlea – for ulna
o Capitulum – for radius - 3 depressions to allow bones to ‘tuck in’ together
bones of the forearm
Ulna – medial
o Longer with relatively thin diaphysis
o Expanded proximal and at elbow
Radius – lateral
o Shorter and broader
o Cylindrical proximally
o Expanded distal end at wrist
the elbow joint - what kind of joint, and what are the 3 joint and where are these joints located
- Synovial hinge – limited movement
- 3 joints at ‘elbow’
o Humerus – ulna (‘main’ elbow articulation)
o Humerus – radius
o Radius – ulna (proximal radio-ulnar joint) - Stabilised by bony articulation
- Ligaments provide additional support
what are the movements at the elbow
- Movements are simple o Flexion o Extension - Approx. 140 degrees motion - Minimal hyperextension o Movement restricted by olecranon process
movements at the radioulnar joints
- Proximal and distal radioulnar joints
- Supported by ligaments
- Radius and ulna connected by interosseous membrane
- Facilitates ‘twisting’ movements
- Pronation/ supnation
o Crossing radius over ulna
what are the bones in the hand
- 3 stes of bones o Proximally – 8 carpal bones o Centrally – 5 metacarpal bones o Distally – 14 phalanges Arranged in 3 rows - Complex set of joints and movements
the wrist joint - what bones does it join, what type of joint
- Between radius and 2 carpals proximally
o Scaphoid
o Lunate - Synovial ellipsoid joint
- Supported by ligaments and surrounding muscles
wrist movements
- highly mobile
- complex range of movements
- flexion/ extension
- abduction/ adduction
- circumduction
the knee - what parts of the leg does it join, what bones articulate here, what kind of joint
- Articulation between the thigh and leg
- 3 bones articulate here
o Proximal – distal femur
o Centrally – patella (sesamoid)
o Distal – tibia - The fibula in the leg does not form part of knee joint
- Modified hinge joint
the distal femur
- Broad, flattened articular region
- Approximately triangular in shape
- Articular condyle forms ‘V’ shape
o Medial and lateral condyles
o Small notch anteriorly for patella
what are the 2 bones of the lower leg - describe them
- Tibia – medial o Broad, robust bone o Flattened proximal surface o Triangular cross-section - Fibula – lateral o Very long and thin o Irregularly shaped o Does not articulate as part of the knee
the knee joint - what kind of joint, what ligaments are involved
- Synovial hinge – limited movement
- Modified hinge
o Also permits rotational movements - Supported extensively by ligaments
o Collateral ligaments
o Cruciate ligaments
o Menisci
movements of the knee
- Primary movements are simple o Flexion o Extension - Approx.. 130 – 150 degrees motion - Patella facilitates movement o Alters line of action of thigh muscles
whats the purpose of knee ‘lock’ and describe the actions that facilitate this
- Increases stability
- Reduces energy required to remain upright
- 2 descriptions
o Medial rotation of femur on tibia
o Lateral rotation of tibia on femur - Some active rotation also possible during knee flexion
bones in the foot
- Similar to hand o 7 tarsals o 5 metatarsals o 14 phalanges Same no. and dist. As hand
the ankle - what joints are involved, what ligaments are involved
- ‘colloquial’ ankle – 3 separate group of joints
o Talocrural joint – anatomical ankle
o Subtalar joint
o Transverse tarsal joints - Permit different types of movements
- Held together by medial and lateral collateral ligaments
the ankle movements - what joints permit what movements
Talocrural Joint - Hinge joint - Flexion/ extension only - Plantarflexion/ dorsiflexion Subtalar and transverse tarsal joints - ‘twisting’ movements of foot - Inversion and eversion No rotation
musculature of the limbs - how are muscles organised and why are they organised like this
- Joints of the limbs each have unique requirements
- One movement = one muscle is impractical and inefficient
- A complex range of muscle are present in each limb
- Each indiv. Muscle may
o Contribute to a number of separate movements
o Affect movements across multiple joints
o Work in combination with others to produce movements
compartmentalisation - what does each compartment tell us
- Simplifying concept
- Indiv. Muscles are arranged in groups
- Each grup has a similar set of properties
o Position in body
o Type of movement initiated
o Innervation
o Blood supply
compartments in practice - how many compartments in upper and lower limbs
- Each limb segment contains a number of diff. compartments
o Girdles and extremities are a little unique due to complex movement - Upper limb segments – 2 compartments
- Lower limb segments – 3 compartments
upper limb compartments in arm and forearm - what action does each compartment facilitate
Arm
- Anterior > flexion of elbow
- Posterior > extension of elbow
Forearm
- Anterior > flexion of wrist
- Posterior > extension of wrist
lower limb compartments in thigh and leg - what action does each compartment facilitate
Thigh - Anterior > flexion of hip, extension of knee - Posterior > extension of hip, flexion of knee - Medial > adduction of hip Leg - Anterior > dorsiflexion of foot - Posterior > plantarflexion of foot - Lateral > eversion of foot
shoulder - what kind of joint,, what does this joint articulate, what supporting structures are involved
Shoulder = glenohumeral joint
- Articulation between head of humerus and glenoid fossa
- Projections over the joint provide anchor points for supporting structures
o Coracoid process
o Acromion
glenohumeral joint - what provides stability for this joint
o Bones
o Ligaments
o Muscles (rotator cuff)
o Tendons
ligaments involved in the shoulder
- Multi-axial, synovial ball and socket joint
- Main supporting ligaments
o Glenohumeral ligaments
o Coracohumeral ligament
o Transverse humeral ligament
o Coracoacromial ligament
glenoid labrum - where and function
- Intracapsular structure lining margin of glenoid cavity
- Improves joint fit
- Triangular fibrocartilage
muscles in the rotator cuff and what are their functions
4 muscles…
- Subscapularis > medial rotation
- Supraspinatus > abduction
- Infraspinatus > lateral rotation
- Teres Minor > Lateral rotation
deltoid - what are the different fibres and what movements do these diff. fibres facilitate, what is its origin, insertion and innervation
- Multiple fibre directions produce different actions
o Anterior = flexion and medial rotation
o Posterior = extension
o Middle = abduction - Origin = lateral 1/3 clavicle and scapula
- Insertion = deltoid tuberosity
- Innervation = axillary nerve
pectoralis major - describe it’s shape, actions, origin, insertion, innervation
- Large fan-shaped muscle on anterior chest wall
- Actions (on humerus)
o Flexion
o Adduction
o Internal rotation - Origin = clavicle and sternum
- Insertion = intertubercular groove
- Innervation = medial and lateral pectoral
trapezius - describe its shape, actions, origin, insertion, innervation
- Large, superficial muscle of the back
- Actions (on scapula)
o Elevation
o Depression
o Rotation
o Retraction - Origin = occipital bone, C7 – T12 vertebrae
- Insertion = lateral 1/3 clavicle, scapula
- Innervation = accessory nerve
anterior compartment of arm - what muscles, and what innervation
- Consists of… o Biceps brachii Long head Short head o Brachialis o Coracobrachialis - Innervation o Musculocutaneous nerve
posterior compartment of the arm - what muscles, and what innervation
- Compromised of one muscle o Triceps brachi Long head Medial head Lateral head - Innervation o Radial nerve
what are the ligaments of the elbow
- The fibrous membrane of the joint capsule is thickened on the medial and lateral aspects to form COLLATERAL LIGAMENTS
- The ANNULAR LIGAMENT helps maintain contact of the radial head with the radial notch and CAPITULUM during PRONATION AND SUPNATION
what are the pronators and supnators at the elbow
Pronation and supination occur at the proximal and distal radio-ulnar joints - Supinators o Biceps brachii o Supinator - Pronators o Pronator teres o Pronator quadratus
posterior and anterior compartments of the forearm - are the muscles in each extensors or flexors and what is their nerve supply
Anterior compartment - Flexors o Common origin = medial epicondyle - Primary nerve supply = Median (incl. some ulnar) Posterior compartment - Extensors o Common origin = lateral epicondyle - Nerve supply = radial
anterior compartment of the forearm - muscle layers
3 layers of muscles
- Superficial layer = 4 muscles
- Intermediate layer = 1 muscle
- Deep layer = 3 muscles
carpal tunnel - what does it contain, what makes up its floor and roof
- Osseo-fibrous tunnel
- Compact space containing:
o 9 tendons
o Median nerve - Floor = carpal arch
- Roof = flexor retinaculum
arterial blood supply to the upper limb - what arteries, what’s it’s origin and termination
- Common vessel that changes in size and name based on region
- Main divisions
o Subclavian
o Axillary
o Brachial
o Radial
o Ulnar
o Palmar arches - Origin = arch of aorta
- Termination = palmar arches in the hand
subclavian artery - what are it’s 2 origins, where does it terminate and what divides it
- Major paired arteries
- Different origins depending on side
o Right side – arises at bifurcation of innominate artery
o Left side – arises directly from the arch of the aorta - Both sides terminate at lateral border of 1st rib, becoming the axillary artery
- Divided into 3 parts by anterior scalene muscle
axillary artery - what’s it’s journey and landmarks and what divides it
- Continuous with the subclavian artery
- Runs through axilla
- Runs from lateral border of 1st rib to inferior border of teres major
- Divided into 3 parts by pectoralis minor muscle
brachial artery - what’s it’s pathway and where does it bifurcate
- Continuation of the axillary artery beyond teres major
- Closely related to the median nerve
- Bifurcates into the radial and ulnar arteries around the neck of the radius
radial artery - where does it arise, where does it run through, where does it terminate
- arises from brachial artery around neck of radius
- runs through the anatomical snuffbox
- terminates in hand contributing to palmar arches
o primarily to the deep palmar arch
what 2 arteries are useful for finding the pulse
brachial and radial
ulnar artery - where does it arise, where does it terminate
- arises from brachial artery around neck of radius
- larger than the radial artery
- terminates in hand contributing to palmar arches, primarily to superficial palmar arch
- not easily palpable
palmar arches
- superficial and deep branches of the radial and ulnar arteries give rise to the arches
venous drainage of the arm
- deep veins follow the arteries
- superficial veins drain into a dorsal venous network on back of hand
- cephalic vein drains lateral side of forearm to axillary vein via median cubital vein
- basilic drains median side of forearm to axillary vein
brachial plexus - where does it arise, what is it
- complex nerve bundle innervating the upper limb
- arises from anterior rami of spinal nerves C5-T1
- highly organised plexus
musculocutaneous nerve - what is it a branch of, what does it pierce, what muscles does it pass between, where does it terminate
- a large terminal branch of the lateral cord
- pierces coracobrachialis
- passes between biceps and brachialis
- innervates all 3 (BBC)
- Terminates as the lateral cutaneous nerve pf the forearm
median nerve - what’s it derived from, what does it innervate, passes through carpal tunnel
- Large nerve derived of anterior cords
- Primary innervator of flexor compartment of forearm
- Passes through carpal tunnel
- Wide motor and sensory dist. In the hand
ulnar nerve - what does it derive from, where does it travel, what does it innervate
- Derived primarily from medial cord
- Courses medially within the arm and forearm
- Passes posterior to medial epicondyle
- Innervates 1 ½ muscles within forearm
- Primary innervator within the hand
axillary nerve - what’s it a branch of, what does it pass through, what does it innervate
- A branch of the posterior cord
- Passes through quadrangular space
- Innervates deltoid and teres minor muscles
- Provides sensory innervation to patch on lateral arm
radial nerve - where does it arise, where does it run through, what does it innervate
- Largest nerve of brachial plexus
- Arises as the terminal branch of the posterior cord
- Runs within the spiral groove of the arm
- Provides motor and sensory innervation to all post. Compartments of the upper limb
hip joint - whats the other name for this joint and what bones is it made up of
acetabulofemoral joint
- ischium
- ilium
- pubis
what is the articular surface of the hip joint
acetabulum
centre of gravity - what ligament is involved
- The iliofemoral ligament is tight during standing
- No muscles are required to keep your hip stable
- So you can stand for a long time
muscles in the hip - flexors, extensors, abductors, adductors, lateral rotators
Flexors
- Iliopsoas (Ant.)
- Pectineus (med.)
- Sartorios (ant.)
- Rectus femoris (ant.)
Extensors - Hamstring - Biceps femoris (long and short head) - Semitendinosus - semimembranosus Gluteus maximus
Abductors
- gluteus Medius
- gluteus minimus
Adductors
- adductor longus
- gracilis
- adductor brevis
- adductor magnus
Lateral rotators
- piriformis
- quadratus femoris
- gemelli (sup. An inf.)
- obturator internus
what are the femoral triangle boundaries
- superior border > inguinal ligament
- medial border > medial border of adductor longus
- lateral border > medial border of sartorius
what are the femoral triangle contents
- femoral nerve
- lymphatics in femoral canal
- femoral artery
- femoral vein
bones in the knee region
- femur
- tibia
- fubula
- patella
bones involved in the knee joint
- femur
- tibia
- patella
bones involved in the tibiofibular joint
- tibia
- fibula
patella - what facets foes it have, what kind of bone is it
- medial and lateral facets
- apex
o example of a sesamoid bone (bone formed within tendon)
the knee joint - what kind of joint, what movements
- synovial modified hinge joint
- mainly flexion/ extension
- also slight rotation for ‘locking’
extra-capsular ligaments of the knee joint
Joint capsule is reinforced by extracapsular ligaments - medial (tibial) collateral ligament o flat o part of joint capsule - Lateral (fibular) collateral ligament o Cord-like o Separate to capsule
These ligaments tighten in knee extension, loosen in flexion
intracapsular ligaments of the knee joint
Anterior cruciate ligament
- Prevents anterior tibial translation
Posterior cruciate ligaments
- Prevents posterior tibial translation
fibrocartilaginous menisci of the knee joint
- Medial meniscus
- Lateral meniscus
anterior compartment of the thigh - what movement and what muscles
- Mainly extension o Quadriceps femoris Vastus medialis Vastus intermedius Vastis lateralis Rectus femoris o Sartorius
posterior compartment of the thigh - what movement and what muscles
- Flexion and ‘unlocking’ o Hamstrings Biceps femoris Semimembranosus Semitendinosus o Gastrocnemius
(unlocking – lateral rotation of femur on tibia)
- Popliteus
ankle joint - whats its other name, what ligaments stabilise it, what bones are involved
- talocrucial joint
- JOINT IS STABILISED BY MEDIAL AND LATERAL LIGAMENTS
bones involved - fibula, tibia, talus
movements at the ankle and stability of the ankle
MOVEMENTS AT THE ANKLE JOINT
True Hinge Joint
- Dorsiflexion
- Plantarflexion
Movements of eversion and inversion do NOT take place at the ankle joint
- They occur between tarsal bones in the foot
STABILITY OF THE ANKLE
- Shape of the bones at the ankle joint mean that it is far more stable in dorsiflexion than in plantarflexion
what muscles move the ankle and their associated movements
Plantarflexion
- Plantaris
- Soleus
- Gastrocnemius
Dorsiflexion
- Tibialis anterior
innervation of the lower limb - what plexus and what vertebrae does this plexus arise from, what 3 major nerves arise from this plexus, branches of one of these nerves
Lumbosacral Plexus > T12-S3/4
3 Major nerves originating from lumbosacral plexus
- Femoral
- Sciatic
- Obturator
Sciatic nerve branches in popliteal fossa into
- Tibial nerve
- Common fibular (peroneal) nerve
blood supply to the lower limb - pathway of blood
Common iliac artery > external iliac artery > femoral artery
Femoral artery passes through the adductor hiatus > popliteal artery
Popliteal artery > anterior and posterior tibial arteries
Anterior tibial artery > dorsalis pedis
Posterior tibial artery > fibular artery, circumflex fibular artery
