clinical anatomy And Physiology Flashcards
what and Where is the patella? What holds it in place?
- Sesamoid bone that sits at the patellofemoral groove
- held in place by quadricep tendon on top & patellar tendon on the bottom (attached to tibia at tibial tuberosity)
How is the femur held to the tibia and fibula? What are their functions
- Center: anterior and posterior cruciate ligament in the center and
- Around: meniscus (cartilage acting as shock absorber）
- inner lateral of knee: medial collateral ligament holding femur and tibia
- Outer lateral of knee: lateral collateral ligament holding femur and fibula
Describe the structure of thyroid gland? What anatomical location & compartment is it in?
- 2 lobes connected by isthmus at C5-T1
- cricoid of larynx and superior ring of trachea
- visceral compartment of the pretracheal fascia
What does pretracheal layer of the neck consist of?
- Visceral: Thyroid gland, esophagus, trachea
- Muscle: infrahyoid muscles: sternothyroid, omohyoid, sternohyoid
- Recurrent laryngeal (branch of vagus nerve) runs through pretracheal layer to innervate the larynx
What is the pathway of recurrent laryngeal nerves? What is the clinical relevance in terms of thyroid surgery?
- Travels down with vagus nerve then loop around right subclavian artery and aortic arch then travel inside pretracheal layer (between trachea and esophagus in the tracheoesophageal groove) to supply larynx
- Runs close in proximity of thyroid gland (beneath-> behind), damage of this nerve could cause hoarse voice
What are the anatomical relations closest to furthest of the thyroid gland? (anteriorly, laterally, medially)
- Anteriorly: infrahyoid muscles (sternothyroid-> sternohyoid in middle & omohyoid on side)
- posterolaterally: carotid sheath (common carotid artery, internal jugular vein, vagus nerve, deep cervical lymph nodes)
- Medially: trachea, larynx, esophagus, recurrent laryngeal nerve
What is the arterial supply to the thyroid gland?
- Superior thyroid artery (first branch of external carotid artery)
- Inferior thyroid artery (branch of thyrocervical trunk from subclavian artery)
- Thyroid ima artery (10% of people, from brachiocephalic trunk)
- reminder: aorta-> (brachiocephalic -> right common carotid & right subclavian), left common carotid, left subclavian
What is the venous supply of the thyroid gland?
- Superior, middle thyroid veins (branched from internal jugular vein)
- Inferior thyroid vein (brachiocephalic)
- reminder: Superior vena cava-> brachiocephalic vein-> internal jugular vein, subclavian vein
What are the carpal bones? Name them from radial (thumb) to ulnar (pink) side
- Proximal row: scaphoid, lunate, triquetrum, pisiforms
- Distal row: Trapezium, trapezoid, capitate, hamate
what are the features if lunate, scaphoid bone
lunate: crescent bone w/ concave surface
scaphoid: if fractured cause pain in anatomical snuffbox
How is the carpal tunnel formed? What is inside the carpal tunnel?
- Arch made by the carpal bones + flexor retinaculum
- Median nerve, flexor pollicis longus,
- 4x flexor digitorum producus, 4x flexor digitorum superficialis
What muscles are in the thenar eminence of the hand? Which nerve supplies it? What is the clinical relevance?
- Opponens pollicis, abductor pollicis brevis, flexor pollicis brevis
- Median nerve: wasting of these muscles in carpal tunnel syndrome
What muscles are in the hypothenar eminence of the hand? Which nerve supplies it? What is the clinical relevance?
- Opponens digiti minimi (deep), abductor digiti minimi, flexor digiti minimi brevis
- Ulnar nerve: wasting of these muscles in cubital tunnel syndrome
What is the function of lumbricals? What are they attached to? What is the nerve supply?
- 4 muscles in the palmar aspect of hand in charge of MCP flexion & interphalangeal extension
- Attached to the 4 flexor digitorum profundus tendons (muscle attached to ulna) on the radial side (side close to thumb)
- median nerve supplies index & middle, ulnar nerve supplies ring & pinky
What is the kiesselbach plexus? What arteries does this area contain?
- Region of nasal septum where blood vessel come together, damage leads to epistaxis
- Anterior and posterior ethmoidal artery
- Septal branch of superior labial artery
- Sphenopalatine artery and greater palatine artery
Where do the anterior and posterior ethmoid artery of the kiesselbach plexus come and enter from?
- Both from ophthalmic artery of internal carotid
- enter to the nasal septum via anterior and posterior ethmoid foramen
Where do the sphenopalatine and greater palatine artery of the kiesselbach plexus come and enter from?
- Both from maxillary artery of external carotid.
- Sphenopalatine artery enter from sphenopalatine foramen
- Greater palatine artery enters through greater palatine foramen then incisive canal
what type of connective tissue and gland does the external ear have? what is the external ear canal surrounded by
- Have elastic cartilage in lateral ⅓
- Surrounded by external acoustic meatus of temperal bone
- Contain ceruminous glands that produce ear wax
What is the tympanic membrane? Describe the components of it
- Separates external and middle ear
- Contain pars tensa (thick/ dense irregular connective tissue) and pars flaccida (thin loose connective tissue, easy to injure)
- Attached to malleus and tensor tympani (can be seen otoscopy)
What is the nerve supply for tympanic membranes?
internal: glossopharyngeal nerve
External wall: mandibular V3 and vagus
What are the components of the middle ear/ tympanic cavity?
- Bones: malleus, incus, stapes connected by synovial joints
- window: oval (enclosed by stapes), round (entrance to cochlea, covered by membrane)
- Muscles: Tensor tympani, stapedius
- nerves: tympanic nerve, stapedius nerve
What are the nerves supplying the middle ear/ tympanic cavity?
- Glossopharyngeal (CN IX): tympanic branch forming tympanic plexus (supply middle ear, internal surface of tympanic membrane, eustachian tube)
- Facial (CN V): stapedius nerve
(tympanic chorade only pass through)
Where and what is the eustachian tube? What are the different portions of this tube?
connection between tympanic cavity and nasopharynx to equalize air pressure
Osseous portion-> cartilaginous portion-> pharyngeal opening
What are the components of the bony labyrinth in the inner ear? Can you describe them
- Cochlear: shell shaped spiral encircling modiolus (bony core), round window
- Vestibule: oval window that communicates /w stapes, contain 2 organs (utricle and saccule)
- Semilunar canals: superior, lateral, posterior semilunar duct (right angles to each other)
What is the general pathway and branches of glossopharyngeal nerve
- From Oblongata medulla goes out at jugular foramen
- Tympanic branch-> tympanic plexus-> lesser petrosal nerve
- Stylopharyngeus branch (somatic motor, muscle)
- carotid sinus nerve (runs w. Carotid, sensory for bp & O2)
- pharyngeal branch-> lingual branch-> tonsillar branch
What does tympanic branch of glossopharyngeal nerve innervate
- Tympanic plexus (motor): middle ear, internal tympanic membrane, eustachian tube
- Lesser Petrosal (parasympathetic/ secretomotor), Goes through otic ganglion, innervate Parotid gland
What does the pharyngeal, lingual, tonsillar branch of glossopharyngeal nerve innervate?
- Pharyngeal: mucosa of oropharynx- stimulates gag reflex (absent if damaged)
- Lingual: posterior ⅓ of tongue (taste)
- tonsillar : palatine tonsils
Where is the aqueous humor produced?
Energy dependent process in the epithelial layer of the ciliary body (posterior chamber of the eye)
What is the pathway for aqueous humor drainage?
- Epithelial process of ciliary body in posterior chamber
- Pass through trabecular meshwork in the iridocorneal angle
- drain to scleral venous sinus
What is the function and content of aqueous humor for the eyes?
- Specialized fluid that nourishes lens and cornea
- Provide oxygen and metabolites and contains bicarbonate
- High ascorbate, powerful antioxidant
What is the function of bicarbonate in aqueous humor?
anaerobic glycolysis: Buffers the H+ produced by the cornea and lens
