AP HEAD NECK AND TORSO Flashcards
How many bones in human body
206
Why do kids have more bones than adults
Because some bones fuse during development
What are the two parts of the skeleton
Axial Skeleton
Appendicular Skeleton
What are the basic types of bones
- long
- short
- flat
- irregular
- sesamoid
Where are sutures located
In joints between bones of the skull
Describe long bones
Are greater in length than in width Consist of shaft and extremities (end) slight surged for strength and distribute stress Mostly compact bone in the diaphysis Commonly spongy bone in the epiphyses
What are examples of long bones
Femur, tibia, humerus, ulna, radius
Describe short bones
Nearly equal in length and width
Consist of spongy bone tissue except at surface
Surface is a thin layer of compact bone tissue
Examples of short bones
Carpal bones of the wrist
Remember PISIFORM is a sesamoid bone
Describe flat bones
Generally thin
Consist of two parallel plates of compact bone enclosing a layer of spongy bone
Provide protection
Areas for muscle attachment
Examples of flat bones
Cranial bones, sternum, ribs, scapulae
Describe sesamoid bones
Develop in certain tendons that have considerable friction, tension.
Protect tendons from excessive wear and tear
-may change direction of pull of a tendon
Example of sesamoid bones
Patella,
Sesamoid
Describe sutural bones
NOT THE SAME AS SUTURES
Classified by location not shape
Call bones that are located in sutures between cranial bones
Formed due to additional ossification centers in or near sutures
Describe irregular bones
Complies shapes that prevent grouping them into typical bone groups
-vary in the amount of spongy and compact bones
Examples of irregular bones
Vertebrae, hip bones, calcaneus
What are processes
Projections or outgrowths
Either help form joints or serve as attachment points for connective tissue
What parts of bone allow for passage of soft tissue and participate in joints
Depressions and openings
What is the difference between the origin and the insertion of muscles
Origin: is the on the bone that does not move when the muscle shortens/ contracts
(Normally proximal)
Insertion: is the bone that moves with contraction
How do we name muscles
Patterns of fascicles Size Shape Action Number of origins Location
What are the 7 fascicle arrangements of muscles
Unipennate Bipennate Multipennate Triangular Circular Fusiform Parallel
Describe parallel fascicles
Fascicles are parallel to the longitudinal axis of the muscle
terminate at either end in flat tendons
describe fusifrom fascicle formation
Fascicles nearly parallel to the longitudinal axis of muscle
terminate in flat tendons where diameter is less that at the belly
This of processes as….
Muscle attachment points
What is a fossa
A shallow depression in a bone
What is a Foramen
A hole
What is a meatus
A tube like opening
What is a condyle
Large, round protuberance at the end of a bone
What is a facet
Smoot flat articular surface
What is a crest
Prominent ridge or elongated projection
What is a line/línea
A long narrow ridge or border, less prominent than a crest
What is a spinous process
Sharpe slender projection
What is a trochanter
Very large projection
What is tubercle
Small, rounded projection
What is a tuberosity
Large, rounded, usually roughened projection
Describe circular fascicles
Aka sphincters
fascicles in concentric circular arrangements
Describe triangular fascicles
Convergent
Fascicles that spread over a broad area, and converge at a thick central tendon give the muscle a triangular appearance
Describe Unipennate fascicles
Are short in relation to total muscle length, and are arranged on only on side of the tendon
Describe Bipennate fascicles
Are arranged on both sides of centrally positions tendons which extend nearly the entire length of the muscle
Describe multipennate fascicles
Attach obliquely from many direction to several tendons, which in turn extend nearly the entire length of the muscle
What does rectus mean
Parallel to midline
Define transfers
Perpendicular to midline
Define oblique
Diagonal to midline
Define maximums
Means largest
Define medius
Means intermediate
Define minimus
Means smallest
Define longus
means long
Define brevis
Means short
Define latissimus
Means Widest
Define longissimus
Means longest
Define magnus
Means Large
Define Major
Means Larger
Define minor
Means smaller
Define Vastus
Means huge
Define Deltoid shape
Triangular
Define trapezius shape
Trapezoidal
Define serratus shape
Saw-toothed
Describe rhomboid shape
Diamond shaped
Describe orbicularis shape
Circular
Describe pectinate shape
Comblike
Define piriformis shape
Pear shaped
Describe platys shape
Flat
Describe quadratus shape
Square shaped, four sided
Describe gracilis shape
Slender
Describe flexor action
Decreases a joint angle
Describe extensor action
Increase a joint angle
Describe abducter action
Moves AWAY from midline
Describe adductor action
moves a bone CLOSER to midline
Levator action
Raises or elevates a body part
Depressor action
Lowers or depresses a body part
Supinator action
Turns Palm anteriorly
Pronator action
Turns palm posteriorly
Sphincter action
Decreases the size on an opening
Tensor action
Makes a body part rigid
Rotator action
Rotates a bone around its longitudinal axis
What is bicep origin number
2
What is triceps origin number
3
What is quadriceps origin number
4
What is the prime mover
The agonist
Contracts to cause the desired action
What is the antagonist
Stretches and yields to prime mover
Describe a synergistic
Contract to stabilize nearby joints
What are fixations
Stabilize the origin of the prime mover
What is Hilton’s law
Is the observation that a nerve that innervates a joint also told to innervate the muscles that move the joint, and the skin that covers the attachments of those muscles
What fact does Hiltons Law arise from
Embryological development
What is entrapment neuropathy
Physical compression or irritation of major nerve trunks and peripheral nerves, producing distant nerve pain
Entrapment Neuropathy of the upper limbs
Neck
Should
Elbow
Wrist
Entrapment Nueropathy of the neck
Thoracic outlet syndrome
Entrapment Nueropathy of the shoulder
Supra clavicular neuritis
Entrapment Neuropathy of the elbow
Ulnar neuritis
Median Neuritis
Radial neuritis
Entrapment neuropathy of the lower limbs
Hip
Leg
Foot
Entrapment neuropathy of the hip
Piriformis syndrome
Entrapment Neuropathy of the leg
Compartment syndrome
Entrapment neuropathy of the foot
Tarsal tunnel syndrome.
Medial plantar neuritis
Digital neuritis
Deep Fibular neuritis
S/S of Entrapment neuropathy
Symptoms: Tingling, pain
Followed by accompanied reduced sensation of complete numbness
Signs: muscle weakness, associated atrophy
What are the two main circulatory routes
Systemic and pulmonary
Where do all systemic arteries Branch from
AORTA
What are the four branches of the AORTA
Ascending,
ARCH
Thoracic
Abdominal
What are venae comitantes
Viens that accompany arteries
are often dedicated as single vessels, but in fact they tend to be multiple vessels
Have the same name as the corresponding artery
How is venous blood warmed as it travels back to the heart
By venae comitantes
Define Myotome
All the muscles or parts of muscles receiving innervation from one spinal nerve
What does it mean to be “recurrent”
That its “running in a reverse” direction
How do the venae comitantes play a role in the arteriovenous pump
Veins stretch and flatten as the artery expands during contraction of the heart… milking blood through the veins
What are the layer of the SCALP
Superficial to Deep
S-Skin C-Connective Tissue A-Aponerousis L-Loose Connective Tissue P- Pericranium
What are the two connective tissues of the scalp
Subcutaneous/ Hypodermis
And
Loose CT
(danger space of loose areolar CT)
What three layers of the skin of the scalp are connected and move as a single unit
SKIN
CONNECTIVE TISSUE
APONEUROSIS
What area of the scalp can fill with pus, or blood due to infection
The loose CT area
Aka the DANGER AREA
How many bones are in the skull
22
What are the two parts of the skull
Neurocranium and facial skeleton
What is the neurocranium
Cranial Vault or Brain Box
Encompasses the brain, cranial meninges, cranial nerves, and associated structures
What composes the Facial Skeleton
Anterior part of the skull containing the orbits, nasal cavities, maxilla (upper jaw), mandible (lower jaw).
What is the facial skeleton also called
Viscerocranium or Splanchnocranium
What are the bones of the neurocranium
Frontal bone (1) Parietal Bones (2) Temporal Bones (2) Occipital Bone (1) Sphenoid Bone (1) Ethmoid Bone (1) *8 total*
How are the bones of the neurocranium connected
Most are largely flat, curved bones united by fibrous interlocking sutures
What is the space within the neurocranium called
Cranial Vault
What are the two parts of the cranial vault
Calvaria and Basicranium
What is the calvaria
Aka the skullcap
Is the dome like roof of the cranium, made up of the superior portions of the frontal bone, occipital bone, and parietal bones
What is the basicranium,
AKA cranial base
Is the floor of the cranium, basically comprising the occipital, sphenoid,
Petrous portion of the temporal bone,
Vomer, palatines, and a portion of the maxillae
What is the function of the 8 cranial bones
- protect the brain and house the ear ossicles
- provide muscle attachments for the jaw, neck, and facial muscles
What is the function of the facial bones
-protect delicate sense organs
Like smell, taste, vision
-support entrances to digestive and respiratory systems
What are the 8 cranial bones
the same bones as the neurocranium
Frontal Parietal (2) Temporal (2) Occipital Sphenoid And ethmoid
What does the frontal bone form
Forehead Roof of orbits Anterior cranial floor Suborbital Margin Frontal Sinus
When does the frontal suture close
By age 6.
What is the frontal suture called before its closed
Metopic suture
What does the parietal bone form
Sides and roof of cranial cavity
What does the temporal bones from
Zygonatic process froms part of arch External auditory meatus Mastoid process Styloid process Stylomastoid Foramen Mandíbula fossa Petrous portion Caryatid Foramen Jugular Foramen
What CN is associated with the stylomastoid Foramen of the temporal bone
CN VII
What CN is associated with the petrous portion of the temporal bone
CN VIII
What does the occipital bone form
Foramen Magnum
Occipital condyles
External occipital protuberance attachment of ligamentum nuchae
Superior and inferior unchallenged lines
What is the keystone bone and why is it called that
The sphenoid bone
Because it articulates with all other cranial bones
Where is the sphenoid bone located and what does it compose
In the middle part of the base of the skull
Composes ptygoid processes that are attachment sites for jaw muscles
What do the greater wings of the sphenoid bone form
The anteriolateral floor of the cranium and the lateral part of the skull
Describe the body of the sphenoid
Is a cable like portion holding the sphenoid sinuses
What do the lesser wings of the sphenoid form
Part of the orbit of the eye and part of the cranium floor
What are the pterygoid processes
Attachment points from muscles that move the mandible
lateral and medial pterygoid muscles on each side
What is the passageway for CN III, IV, VI and CNV1
Superior orbital fissure of the sphenoid bone
Where does CN V2 pass through
Forman rotundum of the sphenoid bone
Where does CN V3 transmit through
The Foramen Ovale of the Sphenoid Bone
What does teh sella turcica of the sphenoid bone hold
The Pituitary gland
What is the central depression of the sphenoid bone called,,,
The hypophyseal fossa
What does the ethmoid bone form
Forms portion of cranial floor
Medial wall of the orbit
Superior portion of the nasal septum
And most of the superior walls of the nasal cavity
Which bone is a major supporting structure of the nasal cavity
The ethmoid bone
What does the cristales galli of the ethmoid bone attach
Attaches to the falx cerebri
Celebrating L and R cerebral hemispheres
Where does CN I pass through
The olfactory for amine of the ethmoid bone
What do the lateral masses of the ethmoid bone contain
Lateral masses
What is the perpendicular plate of the ethmoid bone
The upper part of the sandal septum
What are the turbinates
Portion of the ethmoid bones
Made from the superior and middle nasal conchae
What are the functions of the superior and middle nasal conchae
Increase vascular surface to warm passing air
Causes inhaled air to swirl and impact mucus (Filters air)
Superior conchae house the olfactory receptors
What are the 14 Facial Bones
Nasal (2) Maxillae (2) Zygomatic (2) Mandible (1) Lacrimal (2) Palatine (2) Inf.. Nasal Conchae (2) Vomer (1)
What do the alveolar processes of the maxillae and mandible
A sockets for teeth
What structures do the maxillary bones make up
Floor of the orbit Floor of the nasal cavity Hard palate Maxillary sinus Alveolar processes of the upper teeth
What do the zygomatic bones make up
Cheekbones
Lateral walls of the orbit
Combines with the termporal bone for the zygomatic arch
What structures arrise from the lacrimal bones
Medial wall of the orbit
Lacrimal fossa houses the lacrimal sac
What is another name for the inferior nasal concha
Turbinate
What are the three portions of the mandible
Body, angle, and the rami
What are the two Foramen of the mandible
The mandibular and mental Foramen
What are the two processes of the mandible
Alveolar and the coronoid processes
What structures does the palatine bone make up
The back end of the hard palate and a part of the orbit
Where is the vomer
Posterior part of the nasal septum
What three things comprise the nasal septum
Vomer
Perpendicular plate of the ethmoid
Septal cartilage
What are the 7 bones that make up the orbits
- Maxillary
- Frontal
- zygomatic
- ethmoid
- lacrimal
- sphenoid
- palatine
What 5 important Foramina are associated with each orbit
- optic foramen
- superior orbital fissure
- inf. Orbital fissure
- supraorbital foramen
- lacrimal fossa
What two bones make the roof of the orbit
Frontal and sphenoid
What makes the lateral wall of the orbit
Zygomatic bone and sphenoid
What make the orbital floor
Maxilla, zygomatic, and palatine bones
What makes the medial wall of the orbit
Maxilla, lacrimal, ethmoid and sphenoid bones
What are the 4 sutures of primary importance
- Coronal
- Sagittal
- lambdoidal
- squamous
Where is the sagittal suture
Along the sagittal plane, combines the two parietal bones
Where is the lambdoid suture
Posterior
Unites the parietal and occipital bones
Where is the coronal suture
Along the frontal plane
Unites frontal with both parietal bones
Where is the squamous suture
Unites each parietal bone to the temporal bone
Located laterally
What are the 4 fontanels
Anterior
Posterior
Anteriolaterals
Posterolaterals
What are the two major functions of fontanels
Enable the fetal skull to pass through the birth canal
Permit rapid growth of the brain during infancy
What are the paranasal sinuses
Cavities in bones of the skull that communicate with the nasal cavity
- lined with mucous membranes
- serve to lighten the weight of the skull
- are resonating chambers for speech
What are the cranial bones that contain the paranasal sinuses
Frontal, sphenoid, ethmoid, and maxillae
What are the four paranasal sinuses
Frontal sinus
Ethmoid Sinus
Sphenoidal Sinus
Maxillary Sinus
What are the 3 muscles that move the mandible
Masseter, termporalis, and pterygoids
What CN innervates movement of the maxillae
CN V3
What are the movements and correlated muscles of the mandible
Protracts and elevates
Aka biting
(Temporalis and Masseter)
Retracts
(Temporalis)
What is the only muscle that depresses the mandible
Lateral pterygoid
What two muscles move the jaw side to side for mastication
Lateral and medial pterygoid
What are the two points of origin for the occipitofronatalis
Occipital belly: occipital bone
Frontal belly: galea aponeurotica
What are the two insertion points for the occiputofrontalis
Occipital belly: galea aponeurotica
Frontal belly: fascia and skin superior to the eye and nose
What is the action and innervation of the Occipitofrontalis
Elevated eyebrows and wrinkles the skin of the forehead
(look surprised)
Innervation CN VII
What is the origin of the Zygomaticus major and minor
Zygomatic bone
What is the insertion points of the Zygomatic Major and Minor
Major: skin at the angle of the mouth and orbicularis oris
Minor: Upper Lip
What is the action and innervation of the Zygomaticus Major and Minor
Action-
Major: draws angle of mouth superiorly and laterally (smiling)
Minor: elevated the upper lip, exposing the maxillary teeth
Innervation: CN VII
(zygomatic and bucal branch)
What is the Insertion of the lavator labii superioris
In the skin at angle of mouth and orbicularis oris
What is the action and innervation of the Levator labii superioris
Raises upper lip
Innervation CN VII
Zygomatic Branch
What is the insertion site of the depressor labii inferioris
In the skin of lower lip
What is the action and innervation of the depressor labii inferioris
Depresses Lower Lip
Innervation CN VII
Mandibular Branch
What is the insertion site of the depressor ánguli oris
In the angle of the mouth
What is the action and innervation of depressor anguli oris
Draws the mouth laterally and inferiorly ( frowning )
Innervation: CN VII
Mandibular branch
What is the origin of the orbicularis oris
Muscle fibers surrounding the opening of the mouth
What is the insertion side of the orbicularis oris
Skin at the corner of the mouth
What is the action and innervations of the orbicularis oris
Action: Closes and protrudes lips
Compresses lips against teeth,
Shapes lips during speech
(Monkey face)
Innervation: CN VII
(Bucal Branch)
What is the insertion site of the Buccinator
Orbicularis Oris
What is the action and innervation of the buccinator
Presses cheeks against teeth and lips, whistling, sucking,
Draws corner of the mouth laterally
Assists in mastication by keeping food in between teeth.
Innervation: CN VII
(Bucal Branch)
Where is the insertion site of the risorius
In the skin at the angle of the mouth
What is the action and innervation of the risorius
draws the angle of the mouth laterally, as in grimacing
Innervation: CNVII
bucal branch
What is the insertion site of the mentalis
In the skin of the chin
What is the action and innervation of the mentalis
Elevated and protrudes the lower lip and pulls the skin of the chin
(Pouting)
Innervation: mandibular branch
What is the insertion site of the platysma
Mandible, muscle around angle of the mouth, and skin of the lower face
What is the action and innervation of the platysma
Draws outer part of lower lip inferiorly and posteriorly,
(Pouting)
Depresses the mandible
Innervation: CN VII
(Cervical Branch)
What is the insertion site of orbicularis oculi
Circular path around the orbit
What is the action and innervation of the orbicularis oculi
Closes and squints eye
(Orbital part)
Depresses upper eyelid
Elevated lower eyelid
Innervation: CN VII
(Temporal branch and Zygomatic Branch)
Is the Levator palperbrae a muscle of facial expression
NO
It opens the eye
Innervation CN III but does not contribute to facial expression
Where is the insertion site of corrugator supercilii
Skin of the eyebrow
What are the actions and innervations of the corrugator supercilii
Action: draws the eyebrow inferiorly and medically
(Frowning)
Wrinkles the skin of the forehead vertically
Innervation: CN VII
(Temporal branch)
Where is the origin and the insertion site of the sternocleiodmastoid
Origin: Sternum and clavicle
Insertion: onto mastoid process of the temporal bone
What is the action and innervation of sternocleidmastoid
Action: contraction of both flexes the cervical verebrae
(Shin toward the manubrium)
And Thrusts chin forward
(Keeps head level)
Contraction of only one, laterally flexes the neck and rotates the face in opposite direction
Innervation: CN XI
What is the scalene Muscle Group
- Attach cervical vertebrae to uppermost ribs
- Flex, laterally flex and rotate the head
- participate in forced respiration
- innervated by Cervical Spinal Nerves C3-C8
What two muscle groups are innervated by CN XI
Sternocliodmastoid and the Trapezius
What are the two groups of muscles associated with the anterior aspect of the neck
Suprahyoid and Infrahyoid Muscles
What do the suprahyoid and infrahyoid do….
Stabilize the hyoid bone
Allowing it to be a firm base on which the tongue can move
Describe the shape and specifics of the Hyoid Bone
U-shaped bone
articulates with no other bone in your body
Has a horizontal body and paired projections
(The greater and lesser horns)
Suspended by a ligament from the skull
**supports the tongue and provides attachment for tongue, neck, and pharyngeal muscle
What are the four suprahyoid muscles
Digastric
Stylohyoid
Mylohyoid
Geniohyoid
What is the general function of the suprahyoid muscle group
They elevate the hyoid bone, the floor of the oral cavity, and tongue during swallowing
What are the 4 muscles of the infrahyoid muscles
Omohyoid
Sternhyoid
Strenothyroid
Thyrohyoid
What is the general function of the infrahyoid muscle group
Depress the hyoid bone and move the larynx during swallowing and speech
define the suboccipital region
-Upper back of the neck-
Is the triangular area inferior to the occipital region of the head
What are the 4 muscles of teh subocciptial region
Rectus cavities posterior
(Major and Minor)
Obliquus Capitis
(Inferior and superior)
External carotid arteries supply …
Structures external to the skull as branches of maxillary and superficial temporal branches
What do the Internal carotid arteries supply
Circle of Willis
Eyeballs and brain
How do the internal carotid arteries enter the cranial cavity
Through the carotid canals in the petrous part of the temporal bones
The verterbral arteries passs through the,,.
Foramen magnum
Circle of Willis
Connects the posterior and anterior blood supplies to the brain by connection the branches of the basilar artery with branches of the internal carotid arteries
What makes up the circle of Willis
The vertebral arteries become the basilar arteries, and communicates with anterior and 2 posterior communicating arteries
Where do dural venous sinuses drain to
The internal jugular vein
Where is the thoracic duct
Is the L lymphatic duct located at the junction of the left internal jugular and left subclavian veins
Where is the R lymphatic duct
At the junction of the R internal jugular and right subclavian veins
Which cranial bone contains the carotid foramen
Temporal Bone
What are the dermatomes of the face
Face: CN V
C2: Occipital Protuberance
C3: Gentleman’s collar
What comprises the cervical plexus
The ventral rami of spinal nerves C1-C5
What does the greater occipital nerve supply
The back of the head and protuberance
What does the lesser occipital nerve supply
Posterior to the ear
What does the great auricular nerve supply
Goes from the lobe of the ear and runs along the mandible (jaw line)
What are the nerves of dermatome C2
Greater Occiptial
The great auricular and lesser occipital is part of the
Cervical plexus
What does the cervical plexus supply
Supplies the skin, muscles of the head and neck and the PHRENIC NERVES
What causes occipital neuralgias
When the greater occipital nerve gets entrapped at the obliquus capitis inferior muscle
Causes Pain in the back of the head
What muscle does the greater occipital nerve emerge from beneath
The obliquus capitis inferior muscle
What is the only moveable joint of the head
Temporal Joint
TMJ
The mandible articulates with the temporal bone to from the….
Temporomandibular Joint
What is TMJ syndrome
Dysfunction to varying degrees of the TMJ joint.
What are the muscles of the TMJ
Temporal
Masseter
Lateral pteygoid
Medial ptyergoid
What kind of joint in the TMJ
A hinge joint
In the TMJ the head of the mandible fits into the
Mandibular fossa
What disk and tubercle is in the TMJ
Articular tubercle
Articular Disk
What are the subsections of the posterior triangle of the neck
Occipital triangle and the subclavian triangle
What are the important features of the occipital triangle
TheCN XI
Occipital artery
And the cervical plexus
What are the important feartures of the subclavian triangle
The subclavian artery and vein
What are the subdivisions of the anterior triangle
Submandibular
Submental
Muscular triangle
Carotid Triangle
What is in the submental triangle
The submental lymph nodes
Hyoid bone
What is in the submandibular triangle
The facial artery and the facial vein
Along with the submandibular lymph nodes and glands
What is in the carotid triangle
Common carotid artery Internal and external carotid arteries Internal jugular vein Vagus nerve And parts of the thyroid And parts of the larynx
What is the vagus nerve also called
A transient nerve
What is in the muscular nerves
It’s bellow the hyoid
And contains infra hyoid muscles
Contains parts of the thyroid
Parathyroid and trachea and larynx
What are 2 transient nerves in the neck
Vagus and Phrenic Nerves
How many bones are in the vertebral column
26
7-12-5-5-4
What are the 4 natural curves of the vertebrae
Cervical
Lumbar
Thoracic
Sacral
What curves are formed during fetal development
Thoracic and Sacral Curves
When is the cervical curve formed
When infants begin to raise their head at around 4 months
When in the lumbar curve formed
When infants begin to sit up and walk around 1 year old
What is kyphosis
Humpback
Is abnormal increase in the thoracic curve
What is dowagers hump
A colloquial name for kyphosis in older women caused by wedge fxs of the thoracic vertebrae resulting from osteoporosis
What is lordosis
Sway back
Characterized by an anterior rotation of the pelvis at the hip producing an abnormal increase in the lumbar curvature
Associated with weakened trunk musculature.
What can cause lordosis
Late pregnancy due to gravity
Obesity
What is scoliosis
Curved back
Characterized by an abnormal lateral curve that is accompanied by a rotation of the vertebrae
The spinous processes turn TOWARD the cavity of the abnormal curvature.
What is the most common deformity of the vertebral column in pubertal girls?
Scoliosis
How many processes are on a typical vertebrae
7 :
2 transverse
1 spinous
4 articular
What makes up the vertebral arch
The pedicle and the lamina
What makes the intervertebral foramina
2 vertebral notches together
What is the first cervical vertebra called
The atlas
What is the 2nd cervical vertebra called
Axis
What is the 7th cervical vertebra called
Vertebra prominens
What are typical cervical vertebral like
Smaller bodies
Larger canal
Have bifid processes
Shorter with transerves foramen for vertebral arteries
The transverse foramina transmits the
Vertebral arteries
What are the two craniovertebral joints in the cervical region
The Atlanta-occipital joint and atlanoaxial joint
Synovial Joints
In the cervical region, a ring of bone, has superior facets for occipital condyles
Atlas C1
In the cervical region, dens or odontological process is body of atlas
Axis C2
What is the tectorial membrane
A strong superior continuation of the posterior longitudinal ligament
What is the hangman’s fx
Is the common name given to a fracture of both pedicles of the C2 vertebrae
What are specific characteristics of thoracic vertebrae
Articulate with the ribs
Have larger and stronger bodies
Have facet joints for connecting ribs.
Describe rib articulation with the spinal vertebrae
Tubercle of the rib articulates with the transverse process of the vertebrae
The head of the rib articulates with the vertebral bodies
What is specific about lumbar vertebrae
Are the strongest and largest of the vertebral column
Have short thick spinous and transverse processes
How many bones form the sacrum
5 bones fused
What is the foundation of the pelvic girdle
The sacrum
What are the median, medial, and lateral sacral crest
Median- are fused rudimentary spinous processes
Medial- fused articular processes
Lateral- tips of transverse processes of fused sacral vertebrae
How many bones fuse to form the coccyx
4
At what age does the coccyx finish fusing
Generally by age 30
What are coccygeal cornua
Rudimentary articular processes
What is the medical importance of the sacral and coccygeal cornu
Important landmarks for caudal anesthesia
Local anesthetic injected into sacral canal at the sacral hiatus and coccygeal nerves.
Describe a intervertebral disk
Fibrocartilage ring with a pulpy center
What causes herniated intervertebral discs
Flexion of the vertebral column pushes the nucleus pulposus posteriorly toward the thinnest part of the annulus fibrosis
If degeneration of the posterior longitudinal ligament and wearing of the anulus have occurred, what can happen in intervertebral disk herniation
The nucleus pospusus may herniate into the vertebral canal and compress on the spinal cord or the nerve roots of the cuadra equina
What can forcible hyper flexion of the neck cause
May rupture the intervertebral disk without fx the vertebral body
What are the most common ruptures intervertebral disks?
C5/C6 and C6/C7
Which would compress the nerves of C6 or C7 respectively
What can hyperextension of the neck cause
May stretch of tear the anterior longitudinal ligament
Whiplash
what is a zygapophyseal joint
Facet joints
-plane synovial joints between superior and inferior articular processes of adjacent vertebrae
What do accessory ligaments in a zygapophysial joint do
Unite the laminae, the transverse processes, and the spinous processes to help stabilize the joint
What can injury or disease of the zygapophysial joint cause
They are closes associated with spinal nerves, so osteoarthritis in the joint causes pain and distribution patterns along the dermatomes of the affected spinal nerve along with spasms of the associated myotomes
What is foraminal stenosis
Narrowing of one of more spinal formamina
Commonly at C5/6 and C6/7 in the neck and L3/4, L4/5, and L5/S1 in the low back
S/s;
Associated with back or neck pain with sciatica or branchialgia
Where and what is the anterior longitudinal ligament
Strong, broad fibrous band that covers and connects anterior aspects of vertebral bodies and intervertebral disks
The anterior longitudinal ligament extends from
Atlas to the sacrum
What is the function of the anterior longitudinal ligament
Maintains stability of the joints between vertebral bodies, and helps prevent hyperextension of the vertebral column
What is the Posterior Longitudinal ligament
A ligament that runs within the vertebral canal along the posterior aspect of the verterbral bodies
-is narrower and weaker that the anterior longitudinal ligament
What is the function of the posterior longitudinal ligament
Helps to prevent hyper flexion of the vertebral coló un and herniation or posterior protrusion of the vertebral disks
What is the ligamenta Flava
Are broad, yellow elastic fibrous tissue that join adjacent laminae of verterbral arches
What is the function of the ligamenta flava
To prevent separation of the vertebral lamina, to arrest abrupt flexion of the vertebral colómn, and help prevent injury to vertebral disks
What is the supraspinous ligament
Is the most posterior connection on the spinous process
-joins the tips of the spinous processes on C7 through the sacrum
What is the ligamentum nuchae
A thickening of the supraspinous ligament in the neck spanning from C7 to the occipital protuberance
What is the artery that is related around each vertebra
The segmental artery
What are the two Venus plexuses the spinal cord
The anterior and posterior vertebral venous plexus
What are the attributes of ribs 1-7
Called true ribs
Have costal cartilage
And attach directly to the sternum
What is the attribute of the 1st rib
Has the sharpest curvature
Articulates with the manubrium at a point below the clavicle
What is the attribute of the second rib
Attaches at the eternal angle
What is the attribute of ribs 3-7
Sternal coastal articulations are direct to the body of the sternum
What are the vertbrochondral ribs
Ribs 8-10
Aka False Ribs
- Do not have direct articulation with the sternum
- Indirectly articúlate with the sternum by joining with the costal cartilage of rib 7
What is the costal arch
Is the arrangement of costal cartilages that provide for the indirect articulation of ribs 8-9-10
What are the attributes of ribs 11 and 12
Have no anterior articulation with the sternum
Are called floating ribs
Are also false ribs
What is the head of a rib
Has either one articulating facet with articulated with the facet of the body of the corresponding vertebrae
Or
Has two articulating facets which articulate with the Demi facets of the bodies of adjacent vertebrae as well as the intervertebral disk
What is the tubercle of the rib
The site of articulation of the rib with the transverse process of posterior vertebrae of the same number
What is the neck of the rib
Attaches to the head of the bid to the body of the rib
What is the sternal extremity of a rib
Is the site of costochondral articulation of the rib to its cartilage
What is the costal groove of the rib
Begins near the tubercle on the body of the rib and provides some protection for the Intercostal nerve and vessels
What is the costal angle of the ribs
Is a abrupt change in the curvature of the shaft of the rib
Describe the sternum
Is a flat, elongated bone in the middle of the anterior portion of the thoracic cage Approx 5-6 inches in length Consists of 3 parts -manubrium -body -Xiphoid process
What is the jugular notch of the sternum
Lies just between the clavicles, and is the most superior landmark of the sternum
What is the sternoclavicular notch of the sternum
Is the point of articulation of the sternal extremity of the clavicle with with manubrium
What is the sternal angle of the sternum
- at the junction of the manubrium and the body of the sternum
- is the location of the cartilaginous articulation of the second pair of ribs
What kind of joint is the xiphisternal joint
And synchonrosis
-progressively fusses as we age, later becoming a synostosis in older persons
What is costochondritis
Inflamation of the junctions where the upper rib joins with the cartilage that holds them to the sternum
Usually goes away on its own.
Cause unknown
what are extrinsic back muscles
Superficial group of muscles that produce control of limb movements
-intermediate group of muscles that are involved in respiration
What are intrinsic back muscles
True back muscles
Specifically act on the vertebral column producing its movements and maintaining posture
Name the superficial back muscles
-Trapezius
-Levator scapulae
-Rhomboideus
(Major) (Minor)
-Latissimus dorsi
Name the intrinsic muscles of the back
- Erector spinae
- Transversospinal muscles
What are the three muscles that make up the erector spinae group
Spinallis (medial)
Longissimus (intermediate)
Illiocostalis (lateral)
Describe the erector spinae group
Origin is sacrum and illiac crest
Externos throughout the lenght of the back
Controls flexion and lateral bending
What are the muscles that make up the transversospinal group
Rotatores (rotate)
Multifidus (my)
Semispinalis (spine)
What are nerves innervate the transverospinalis
Dorsal rami of spinal nerves
What are thoracoappendicular muscles
- Anterior thoracic muscles or axial muscles that produce and control limb movements
- generally considered upper limb muscles
What are the muscles that assist in breathing
Diaphragm
Scalenes
Intercostals
Some thoracoappendicular muscles
Name the anterior thoracoappendicular muscles
Pectoralis Major and Minor
Subclavius
Serratus anterior
What are the posterior thoracoappendicular muscles
Latissimus dorsi
How many layers are there to intercostal muscles
3 layers Outer layer-external intercostal Middle layer-internal intercostal Innermost layer- Transversus thoracis -subcostal muscles -innermost Intercostal muscles
Intercostal muscles are _____ innervated by ________intrecostal nerves
ALL
Segmental
Origin/ insertion/ function of the external intercostal muscles
Travels obliquely downward from the inferior border of the rib above to the superior border of the bib below
- Elevates the rib cage.
- muscle of inspiration
Origin/insertion/ function of the internal intercostal muscles
Originate from the superior border of the rib below and insert on the inferior border of the rib above
-oriented at right angels to the external intercostal muscle
- depress the rib cage
- muscles of forced expiration
Where are the transverse thoracic muscles
Originate from the sternum and insert on the cartilages of the ribs
What are the two muscle groups of the innermost layer of the rib cage
Subcostal and innermost intercostal
Subcostal muscle group
Muscles bridge two intercostal spaces and “probably” elevate the ribs
-no test question-
Innermost intercostal muscle group
Muscles bridge an intercostal space and are “probably” muscles of expiration
-no test question-
Upon leaving the intervertebral foramina the spinal nerves divide into
Posterior and anterior primary rami
The anterior rami of the thoracic spinal nerves form the
Intercostal nerves
The posterior rami of the thoracic spinal nerves ….
Pass posteriorly to supply the joint, muscles, and skin of the back in the thoracic region .
What spinal nerves supply the dermatomes of the anterior thorax
The dorsal roots of spinal nerves C5 and T1-T6
Dermatome landmark for C5
Jugular notch and clavicles
Dermatome landmark for T1
Inferior to C5, continues down the anterior portion of the arms
Landmark for T4
Nipples
Dermatome Landmark for T7
Xiphoid process
Dermatome landmark for T10
umbillicus
What is the most superior dermatome of the back that does not supply the upper limbs
T1
Where is the mediastinum located
Between the two pulmonary cavities
What is in the glandular plane of the superior mediastinum
Thyroid
Thymus
Lymph glands
What is in the venous plane of the superior mediastinum
Left and right brachiocephalic vein
Superior vena cava
Arch of the azygos vein
What does the arterial nervous plane of the superior mediastinum contain
Aortic arch and its branches -brachiocephalic -left common carotid -left subclavian And the vagus and phrenic nerve
What is in the visceral nervous plane of the Superior mediastinum
Trachea
Esophagus
Branch of the vagus nerve
(Innervates the larynx, pharynx, and sensory for bronchial tree below the volcano chords)
What is in the lymphatic plane of the Superior mediastinum
-Thorcic duct
(Main duct for most of the lymphatic)
(Terminates at the left junction of the subclavian and jugular veins)
What is in the anterior mediastinum
Connective tissue and fat
Few blood vessels and lymph
Sometimes the lower end of the thymus
What is the only thing in the middle mediastinum
The pericardium surrounding the heart
What is in the posterior mediastinum
Thoracic aorta, duct Lymph nodes Azygos and hemiazygos Esophagus and esophagus plexus Thoracic sympathetic trunk and splanchic nerves
What are the three flat muscles of te abdominal wall
External oblique
Internal Oblique
And the transverse abdominal
What are the two vertical muscles of the abdominal wall
Rectus abdominal And pyramidalis (sometimes absent)
What forms the rectus sheath of the abdomen
Flat muscles have an anterior and medial aponeuroses which collectively forms the rectus sheath
What are the arteries of the anteriolateral wall
The superior and inferior Epigastric arteries
Describe the superior epigastric artery
Artery is a continuation of the internal thoracic artery
It enter the recutus sheath and provides blood to the rectus abdominus
Abdominal Aorta
Runs anterior to the vertebral column
-has parietal and visceral branch’s
What are the three branches of the celiac trunk
The common hepatic, splenic, ande left gastric branches
The left gastric feeds
The stomach and esophagus
What does the superior Mesenteric artery feed
Pancreas, duodenum, jejuni, ileum, ascending colon, and transverse colon
Where does the infer. Mesenteric supply
The transverse and desecening colon, sigmoid colon, and rectum
