Block 1 - Anatomy - Miscellaneous Flashcards
Identify the surface anatomy for the:
superior nuchal line,
external occipital protuberance,
and vertebra prominens (C7).
Identify the following surface anatomy:
Root of spine of scapula,
Inferior angle of scapula,
iliac crest,
posterior superior iliac spine
What vertebra protrudes and creates the vertebra prominens?
C7
What vertebra is at the level of the inferior angle of the scapula?
T7
Can the T12 be seen on the surface anatomy of the back? How can its level be identified?
No; halfway between the inferior angle of the scapula and the iliac crest
What vertebral level is at the iliac crest?
L4
What vertebral level is at the posterior superior iliac spine?
S2
What surface landmarks can be used to identify the C7, T7, T12, L4, and S2 vertebrae?
C7 - vertebra prominens
T7 - Inferior angle of scapula
T12 - midway between T7 and L4
L4 - iliac crest
S2 - PSIS
Identify the atlas (C1).
Identify the axis (C2).
Identify the dens (odontoid process).
Identify the alar ligaments.
Identify the clivus of the occipital bone.
Identify the superior longitudinal bond of the cruciate ligament.
Identify the atlantooccipital joint capsule.
Identify the atlantoaxial joint capsule.
Identify the atlas (C1).
The axis (C2)
The dens (odontoid process)
The alar ligaments
The clivus of the occipital bone
The superior longitudinal bond of the cruciate ligament
The atlantooccipital joint capsule
The atlantoaxial joint capsule
Identify the following main structures common to vertebra at the cervical, thoracic, and lumbar levels:
body,
lamina,
pedicle,
transverse process,
spinous process,
vertebral foramen,
superior and inferior articular facets.
How many cervical vertebrae are there?
How many thoracic vertebrae are there?
How many lumbar vertebrae are there?
How many sacral vertebrae are there (fused)?
How many coccygeal vertebrae are there (fused)?
C - 7
T - 12
L - 5
S - 5 (fused)
C - 4 (fused)
What osteology is unique to the cervical vertebrae?
Transverse foramina
(and a bifurcation in the spinous process)
What osteology is unique to the thoracic vertebrae?
Superior and transverse costal facets
Identify the median sacral crest.
Identify the coccyx.
Identify the dorsal foramen.
Identify the sacral horn. What is another name for this structure?
Superior articular facet
Identify the ala.
Identify the sacral canal
Identify the sacral hiatus.
Median sacral crest.
Coccyx
Dorsal foramen.
Superior articular facet (sacral horn)
The ala
Sacral canal
Sacral hiatus
What are the two main joints where vertebrae interact?
Intervertebral joints (intervertebral discs);
facet joints
What is another name for the intervertebral facet joints?
Zygapophyseal joints
What is a zygapophyseal joint?
The joint connecting vertebrae at the facets
(facet joints)
What foramen exists in all vertebral levels?
What foramina exists in only the cervical vertebrae?
Vertebral foramen;
transverse foramina
What are the intervertebral foramina?
What are these spaces called?
Intervertebral foramina
What vertebra is usually in line with the spine of the scapula?
T3
What surface landmark can be used to identify vertebra T3?
The spine of the scapula
Identify an example of a superior costal facet.
(thoracic vertebrae)
Identify an example of a superior articular facet.
(thoracic vertebrae)
Identify an example of a superior and inferior articular facet.
(thoracic vertebrae)
Describe the location of a demi costal facet and transverse costal facet.
(thoracic vertebrae)
The only features unique to thoracic vertebrae are the costal facets. These include the demifacets and transverse facets.
Which two facets make up the demifacets?
The superior and inferior costal facets
What is an identifiable feature of longissimus that differentiates it from spinalis or iliocostalis?
Long tendons extending posteriorly
Which erector spinae muscles attach to the ribs?
Only iliocostalis
What artery and nerve supply the trapezius?
The transverse cervical artery;
cranial nerve XI (spinal accessory nerve)
What artery and nerve supply the latissimus dorsi?
The thoracodorsal artery;
thoracodorsal nerve
What artery and nerve supply the rhomboid major, rhomboid minor, and levator scapulae?
The dorsal scapular artery;
dorsal scapular nerve
What nerves supply the serratus posterior superior?
T2- T5 (anterior ramus)
What nerves supply the serratus posterior inferior?
T9 - T12 (anterior rami)
What nerves supply the erector spinae?
C1 - L4 (posterior rami)
Are the erector spinae, splenius cervicis, splenius capitis, semispinalis, and multifidus innervated by spinal ventral or dorsal rami?
Dorsal (posterior)
Which back muscles are innervated by spinal dorsal rami? (posterior)
The erector spinae, splenius cervicis, splenius capitis, semispinalis, and multifidus
What is the action of the latissimus dorsi?
Extension and abduction of shoulder
What is the action of the rhomboid major and minor?
Retract the scapula
What is the action of the levator scapulae?
To elevate the scapula
What is the action of the serratus posterior superior? What is the action of the serratus posterior inferior?
Elevate the ribs;
depress the ribs
What is the action of the erector spinae?
Extend vertebrae;
lateral flexion
What is the action of the splenius cervicis and splenius capitis?
Extend and rotate neck
What is the action of the semispinalis?
To extend the neck and head
What is the action of the multifidus?
To extend the spine
What is the action of the trapezius?
Retract scapula;
shoulder elevation;
cervical spine extension and lateral flexion;
What three structures make up the border of the triangle of auscultation?
Trapezius (medial),
medial scapular border (lateral)
latissimus dorsi (inferior),
Identify the dura mater.
Identify the dorsal root ganglia.
Identify the posterior roots.
Identify the visible cauda equina.
What is the order of branching of the spinal cord to the root ganglia?
Spinal cord >
rootlet (ventral or dorsal) >
root >
root ganglion
(> spinal nerve > rami (ventral or dorsal))
What is the order of branching of the root ganglia to the rami (ventral or dorsal)?
(Spinal cord > rootlet (ventral or dorsal) > root >)
Root ganglion >
spinal nerve >
rami (ventral or dorsal)
Identify the dorsal roots. What are they made of?
Rootlets
Identify the denticulate ligaments.
Identify a ventral root.
Will the subarachnoid mater be visible upon slitting the dura mater of the spinal cord?
No, it lies flush with the dura and is invisible to the naked eye.
Where does the pia mater lie?
Flush with the spinal cord.
When does the spinal cord usually end as the cona medullaris?
L1 - L2
Identify structure 1.
Vertebral body
Identify structure 2.
Spinous process
Identify structure 3.
Ligamentum flavum
Identify structure 4.
Spinal cord
Identify structure 5.
Dorsal nerve rootlets
Identify structure 6.
CSF in subarachnoid space
Identify structures 1-3.
- vertebral body (marrow)
- spinous process
- Ligamentum flavum
Identify structures 4-6.
- spinal cord
- dorsal nerve rootlets
- CSF in subarachnoid space
What is structure 1?
L5
What is structure 2?
L2 spinous process
What is structure 3?
L2-L3 intervertebral disk
Which of the following is L5?
1
Which of the following is the L2 spinous process?
2
Which of the following is the L2-L3 intervertebral disk?
3
What is 1 in this T2-weighted MRI?
Cona medullaris (between L1 and L2)
What is 2 in this T2-weighted MRI?
The cauda equina
What is 3 in this T2-weighted MRI?
Cerebrospinal fluid
Which vertebra is 1?
How can you tell?
L1;
note the steep angle difference between L5 and the top of S1
Are bones dark or light on a normal MRI?
And marrow?
Dark; gray
Are bones dark or light on T1-weighted MRI?
And marrow?
Dark;
gray
What body tissues are brightly defined in a T1 image?
Fat
What body tissues are brightly defined in a T2 image?
Fat and water
Name the three sections of the sternum.
Manubrium, body, xiphoid process
What is the depression in the superior, midline portion of the manubrium called?
Jugular notch
Name the depressions on either side of the jugular notch of the manubrium?
Clavicular notches
What joint binds the xiphoid process to the body of the sternum?
The xiphisternal joint
What binds the body of the sternum to the manubrium?
Manubriosternal junction
(the sternal angle)
Which ribs directly contact the sternum through their costal cartilage? Where on the sternum?
(i.e. which ribs are true ribs?)
1 - 7
What is the order of milk flow from production to ejection at the nipple?
Mammary glands > lactiferous ducts > lactiferous sinuses > final duct
What is the difference between a lactiferous sinus and a lactiferous duct?
Sinuses are distal enlargements of the ducts as they lead to the final duct for milk ejection.
However, they both carry milk from the mammary glands to ejection.
Describe the general anatomy of the breast.
The external intercostals are angled in what direction?
To what abdominal muscle group is this similar?
Inferiomedial direction
(down and towards the sternum);
external abdominal oblique
The internal intercostals are angled in what direction?
To what abdominal muscle group is this similar?
Inferiolateral direction
(down and out);
internal abdominal oblique
In what direction are the innermost intercostals angled?
In order to be tagged in the lab, where would the pin be placed?
The internal intercostals;
the posterior side of the rib cage
From superior to inferior, what order of vein, artery, and nerve are found in each costal groove?
Vein
Artery
Nerve
The VAN bundle (vein, artery, and nerve) in each costal groove is found between which two muscle layers?
Internal and innermost intercostals
In what space are the intercostal vessels found?
The costal grooves
The lingula is on which lobe of which lung?
The superior lobe of the left lung
The right pulmonary artery is _____ to the right bronchus.
Anterior
(RALS)
The left pulmonary artery is _____ to the left bronchus.
Superior
(RALS)
The right lung is __ lobes.
The left lung is __ lobes.
Both lungs have a(n) _______ fissue.
Only the ____ lung has a ______ fissure.
3;
2;
oblique;
right, horizontal
Identify the costal surface.
Identify the mediastinal surface.
Identify the diaphragmatic surface.
Identify the apices.
Which lung has a cardiac notch?
The left
What are the superficial muscles of the back?
Trapezius, latissimus dorsi, rhomboid major, rhomboid minor, levator scapulae
What are the intermediate muscles of the back?
Serratus posterior superior and inferior
What are the deep muscles of the back?
The erector spinae (spinalis, longissimus, iliocostalis),
the transversospinales (multifidus, semispinalis, rotators)
What nerve and artery are found on the underside of the trapezius?
What other muscle is innervated by this nerve?
Spinal accessory nerve (CN XI);
transverse cervical artery;
sternocleidomastoid
What nerve and artery are found on the underside of the rhomboid major?
What other muscles are innervated by this nerve?
Dorsal scapular nerve and artery;
rhomboid minor, levator scapulae
What nerve and artery are found on the latissimus dorsi?
The thoracodorsal nerve and thoracodorsal artery
What nerve and artery are found on the serratus anterior?
Long thoracic nerve;
lateral thoracic artery
What nerves and artery are found on the underside of the pectoralis major?
Which of these nerves also supplies the pectoralis minor?
Lateral and medial pectoral nerves,
pectoral branch of thoracoacromial trunk;
medial pectoral nerve (Medial does More)
What neck muscle lies directly below the trapezius and directly above the semispinalis capitis?
The splenius capitis
What neck muscles lie below the semispinalis capitis?
The suboccipitals (rectus capitis posterior major and minor, obliquus capitis superior and inferior)
What three superficial nerves supply the occiput (from medial to lateral)?
What deep nerve supplies the suboccipital muscles?
Third occipital n., greater occipital n., lesser occipital n.;
suboccipital n.
What artery branches from the external carotid artery to supply the superficial occiput?
The occipital a.
What paired artery lines the internal edges of the anterior thoracic cage and gives rise to the anterior intercostal arteries?
What two arteries will this artery become as it descends inferiorly towards the superficial abdomen?
The internal thoracic a.;
the musculophrenic a. (lateral) and superior epigastic a (medial).
What are the four branches of the thoracoacromial trunk?
This trunk is a branch of what artery?
Clavicular, acromial, deltoid, and pectoral
(cadavers are dead people);
the axillary a.
Between what two structures can the thoracic duct be found?
The azygous v. and esophagus
What is the term for the branch of the upper outer breast quadrant that extends into the axilla?
The tail of Spence
What three muscles make up the intercostal muscles?
Describe their fiber orientations.
External intercostals - same orientation as the external abdominal oblique
internal intercostals - same orientation as the internal abdominal oblique
innermost intercostals - same orientation as the internal abdominal oblique
What thoracic cage muscle connects the ribs and sternum?
What muscle group is found on the interior posterior thoracic wall?
Thoracis transversus;
subcostales
Where can intercostal veins be found?
Within the costal grooves
(superior to the intercostal arteries and nerves)
What is the name of the muscular ring surrounding the fossa ovalis?
The limbus fossa ovalis
After the left recurrent laryngeal nerve branches off the left vagus nerve, where does the vagus go?
It descends along the anterior esophagus and combines with the right vagus nerve (lining the posterior esophagus) to form the esophageal plexus
What two nerves descend out of the esophageal plexus?
Where are they both heading?
The anterior and posterior vagal trunk;
to innervate both the foregut and midgut
What structure is made up of preganglionic nerve fibers and connects ventral rami to the sympathetic ganglia?
What structure is made up of postganglionic nerve fibers and connects ventral rami to the sympathetic ganglia?
White rami communicantes (lateral);
gray rami communicantes (medial)
What structure of the right ventricle connects the interventricular septum to the anterior papillary muscle?
The moderator band (septomarginal trabeculae)
What cardiac vein follows the LAD a. and part of the circumflex a.?
What cardiac vein follows the acute marginal a. of the RCA?
What cardiac vein follows the PDA?
Great cardiac v.;
small cardiac v.;
middle cardiac v.
(He’s a great lad;
small people are marginalized;
middleschoolers love PDA)
Where does the coronary sinus drain?
The posteroinferior right atrium
(medial to the opening of the IVC)
What coronary vessel supplies the SA node?
The sinu-atrial nodal branch of the RCA
What are the internal muscular ridges of the atria called?
What are the internal muscular ridges of the ventricles called?
Pectinate;
trabeculae carnae
What are the three cusps of the pulmonary valve?
What are the three cusps of the aortic valve?
Left, anterior, right
left, posterior, right
What vein drains the left posteroinferior thoracic cage?
What vein drains the left posterosuperior thoracic cage?
What vein drains the right thoracic cage?
The hemiazygous v.;
the accessory v. of the hemiazygous;
the azygous v.
Where does the azygous v. drain?
The SVC
What structure runs in the deltopectoral groove?
The cephalic v.
What three nerves descend from the posterior thoracic cage to innervate the abdomen?
The greater, lesser, and least splanchnic nerves
What structure makes up the base of the pulmonary trunk (a remnant of the bulbus cordis)?
The conus arteriosus (infundibulum)
What artery branches off the RCA soon after the sinu-atrial nodal branch to supply the conus arteriosus?
The artery of the conus
What small pia mater projections anchor the spinal cord in place within the spinal column?
Denticulate ligaments
What three structures border the triangle of auscultation?
The latissimus dorsi,
the trapezius,
the medial border of the scapula
What three structures border the lumbar triangle of Petit?
What structure lies deep to this space?
The external abdominal oblique,
the latissimus dorsi,
the iliac crest;
the internal abdominal oblique
What ridge runs between the SA and AV nodes?
Where is it found?
The crista terminalis;
lining the right atrial wall near the groove between the SVC and IVC
Where is the left pulmonary artery in relation to the left main bronchus in the left pulmonary hilum?
Superior
(RALS)
Where is the right pulmonary artery in relation to the right main bronchus in the right pulmonary hilum?
Anterior
(RALS)
Lactiferous ducts lead to enlarged spaces called ______________ _______ that feed into the nipple.
lactiferous sinuses
Where does the thoracic duct drain into the venous system?
The junction of the left internal jugular v. and left subclavian v.
(i.e. the start of the left brachiocephalic v.)
What three major drains drain into the SVC?
Right brachiocephalic v.,
left brachiocephalic v.,
azygous v.
Into what major vein do the hemiazygous and accessory hemizaygous cross the body at midline to drain?
What structures are these three veins draining?
The azygous;
the intercostal arteries
What artery branches off the circumflex to aid in supplying the lateral left ventricle?
What artery branches off the LAD a. to aid in supplying the anterior wall of the left ventricle?
The left marginal a.;
the diagonal a. of the LAD a.
What vessels run alongside the phrenic nerves?
The pericardiacophrenic vessels
