Exam 1 Flashcards
Anterior vs Posterior view
- ant = front
-post = back
3 Anatomical Planes
- median - plane longitudinally through the body (split the balls)
-sagittal - planes parallel to median plane (cut the shoulders) - coronal - vertical planes passing through the body and right angles to median plane
Superficial vs intermediate vs deep
- superficial - nearer to surface
- intermediate - between superficial and deep
- deep - farther from surface
Medial vs Lateral
- medial - nearer to median plane (the pinky is on the medial side of the hand)
- lateral - farther from median plane ( thumb is on the lateral side of the hand)
Posterior (dorsal) vs anterior (ventral)
-posterior - nearer to back (heel is posterior to the toes)
- anterior - nearer to the front (toes are anterior to the ankle)
Inferior (caudal) vs superior (cranial)
- inferior - nearer to feet (stomach is inferior to the heart)
- superior - nearer to head (heart is superior to the head)
Proximal vs Distal
- distal - farther from trunk or point of origin
- proximal - nearer to trunk
Dorsal vs Palmar
- dorsal - top of hand/foot
-palmar - palm side of hand/foot
Ipsilateral vs Contralateral
Those on the same side of the body are referred to as ipsilateral, whereas those on different sides of the body are referred to as contralateral.
Flexion vs Extension
-Extension - opening of the joint, increasing angle
-Flexion - closing of the joint , decreasing angle
Abduction vs Adduction
-Abduction - moving limbs away from midline
- Adduction - moving limbs towards midline
Circumduction
Arm and leg circles
Opposition
Touching thumb to other fingers
Protrusion vs retrusion
Protrusion involves a movement going straight ahead or forward. Retrusion is the opposite and involves going backwards.
Elevation vs Depression
-elevation - rising jaw
- depression - lowering jaw
Eversion vs inversion
-inversion - sole of foot towards the body midline
-eversion - sole of foot away from midline
Pronation vs supination
When your palm or forearm faces up, it’s supinated. When your palm or forearm faces down, it’s pronated
Standard position of patient imaging
as we face the image our right side is the patients left side and our left side is the patients right side
Radiolucent
structures that permit the passage of the x-rays, tissues that are less dense, causing the representative areas appear black on the exposed film. Air permits easy passage of x-rays, less dense, therefore appears black on film. (Black air on xray)
Radiopaque/Radiodense
structures that do not permit the passage of x-rays, tissues that are very dense, causing the representative areas to appear light or white on exposed film. Bone does not permit passage of x-rays, very dense tissue therefore appears white on film. Soft tissue is the intermediate, some x-rays pass and some are blocked causing the areas to appear gray. (White bone on x-ray)
4 Types of Radiographic Densities
- Gas = black
- Fat = gray/black
- Water = gray
- Bone (metal) = white
radiographic image rule
- to reduce the undesirable effect of magnification is to have the part of greatest interest closest to the film
-most common x-ray practice is post-ant
Computer Tomography (CT)
abdomen with contrast, Axial (gives radiologic exposure, x-rays, to patient)
Magnetic Resonance Imaging (MRI)
no radiologic exposure-Arm, Axial Puts the body in a strong magnetic pole system
Ultrasound
allows health-care professionals to visualize structures, in real-time, superficial to deep by recording ultrasonic sound waves reflecting off the tissues
Reading an MRI or CT Transverse Section Image
-Film is in standard position for viewing as previously discussed for plain (x-ray) films for right and left of the film.
-When viewing cross-sections (transverse) images, imagine that you, the health-care professional, are situated at the “foot-end of the bed” looking up towards the head-end of the patient. This is how you look at the film or monitor
Oogenesis vs spermatogenesis
1 viable oocyte (finite resource) and 4 viable sperms (easily replenished)
Nondisjunction
failure of homologous chromosomes
to separate, resulting in some gametes with extra
chromosomes, and others with not enough
Week 1 of development
- ovulation
- fertilization (day 1)
- cleavage
- implantation into superior-posterior wall of uterus (implantation = pregnancy)
Highlights:
* Zygote divides into morula, a ball of ~16-32 cells
* Blastocyst develops
– Embryoblast (inner) -> the future embryo
– Trophoblast (outer)-> embryonic contribution to placenta
* Begin implantation into endometrium
* Trophoblast divides into:
– Syncytiotrophoblast -> invades endometrium
– Cytotrophoblast -> contributes cells to syncytiotrophoblast
& to future placenta
Week 2 of development
- Embryoblast differentiates into bilaminar disc (hypoblast and epiblast)
- Cavities change & new ones appear:
– Amniotic cavity forms within epiblast
– Blastocyst cavity -> exocoelomic cavity -> primary umbilical vesicle
– Secondary umbilical vesicle forms
– Extra-embryonic coelom -> chorionic cavity
– Chorionic cavity:
houses the embryo, amniotic sac, & (secondary) umbilical vesicle - Primordial uteroplacental circulation will start to develop
Early Nutrition: Yolk Sacs
-In Embryo: earliest directly from endometrium. Then, blood/nutrient supply
provided by Yolk Sac (Umbilical Vesicles) from ~week 2- latest week 12.
-Connected to gut tube via vitelline duct (aka: Omphalomesenteric duct or
yolk stalk ). ~12 wks Yolk Sac resorbed into primordial gut tube
Early Utero-Placental
Circulation
-begins week 2
-Lacunar network will be replaced by
placenta
-Maternal placental contributions:
Decidual cells (from within
endometrium)
-Embryonic placental contribution:
Primary chorionic villa from
cytotrophoblas
-During weeks 4-12 placenta continues to mature & takes over
embryo/fetal nourishment by ~week 12 to 42+ weeks)
-Oxygen, nutrients
delivered to embryo/fetus via
Umbilical Vein
Circulation: Highlights (note there will be overlap)
- Early days: embryo nourished by endometrium and Yolk Sac (umbilical vesicles)
- Early Week 2: lacunar network forms between mother & embryo
- Later Week 2: Formation of placenta
-maternal contribution: decidual cells of endometrium
-embryonic contribution: chorionic villa of cytotrophoblast - Weeks 4-12: Maturation of placenta & placental barrier
-umbilical vein: delivers oxygen & nutrients to embryo/fetus
-umbilical arteries: transport wastes and CO2 away from embryo/fetus
Placental barrier ensures most RBCs don’t mix between mother and fetus
(but not 100% effective)
Week 3 of development
-Gastrulation
-Bilaminar -> Trilaminar disc
-Begins with primitive streak
-All three layers from epiblast!
Trilaminar Disc: derivatives
-Ectoderm (and neuroectoderm): epidermis, nervous
system, retina
-Mesoderm : muscles, connective tissue, bones, dermis
* paraxial (somites); intermediate (UG tract); lateral (body
walls)
* Notochord
-Endoderm: epithelial lining of respiratory & GI systems
The notocord
- Rod of mesoderm
- Defines embryo’s midline
(axis) - Signals ectoderm to start
neurulation - Basis of axial skeleton
- Remains as nucleus
pulposus (intervertebral
disc)
Neurulation
-Neural Tube -> Central Nervous System
-Neural Crest -> Peripheral Nervous System cells, facial bones…
and more!
-Clinical correlates:
-Spina Bifida:
Failure of the caudal neuropore to close
properly during the 1st month of pregnancy
-Anencephaly:
-Failure of the rostral neuropore to close
properly during the 1st month of pregnancy
Late week 3 with the lateral mesoderm
-Somatopleure -> Becomes body walls
-Splanchnopleure -> Becomes the gut wall
-Intra-embryonic coelom -> Body cavities
Week 4 Folding
-Folding of lateral walls
-makes visible remnant on pregnant belly : Linea Nigra. This line develops during pregnancy due to hormonal changes. It actually
represents the resultant “seam” of lateral folding during the mother’s/surrogate’s own
embryological development.
-Clinical Correlates: Folding “Failures””
Gastroschisis and Ectocardia
Week 4 Paraxial Mesoderm :
-Somites
Each somite forms 3 segments:
1. Sclerotome
vertebrae and ribs (affected by spina bifida)
2. Myotome
muscle mass w/ spinal nerve
3. Dermatome
dermis layers of skin w/ spinal nerve
Week 3-4 Highlights
Bilaminar disc develops into a trilaminar disc via
gastrulation
– Embryonic ectoderm, endoderm, & mesoderm (all from epiblast)
* Notochord forms and signals ectoderm to begin neurulation
– Neural tube becomes CNS & Neural crest cells become part of PNS
(and other structures)
* Lateral mesoderm divides via coelomic vesicles
– Somatopleura (somatic mesoderm + ectoderm) -> body wall
– Splanchnopleura (splanchnic mesoderm + endoderm) -> gut walls
– Intra-embryonic coelom -> future body cavities (e.g., where your
abdominal organs will be located)
* Paraxial mesoderm organizes into somites. (week 4)
– Somites organize into sclerotomes, myotomes, and dermatomes
Vertebral Column: Overview
-C1-7
-T1-12
-L1-5
-S1-5
-Co1-4
Cervical Vertebrae
C1-7
Thoracic Vertebrae
T1-12
Lumbar Vertebrae
L1-5
Abnormal Curvatures of the spine
Kyphosis, lordosis, scoliosis
Superficial Back Joints
-Acromioclavicular Joint:
-relatively weak plane joint with limited
mobility
-some rotation of the acromion process
occurs here accompanied by
movement
-Sternoclavicular Joint:
mobile saddle joint surrounded by strong
ligaments
all scapular motion is accompanied by
movement
-Glenohumeral Joint:
-extremely mobile and relatively
weak
-motion at this joint is often
accompanied by motion at the
sternoclavicular and
acromioclav
Scapular Movements
elevation, depression, protraction, retraction, inferior rotation, superior rotation
Fascia
Superficial Fascia:
* Subcutaneous tissue
* Primarily adipose tissue
* Varies in thickness
Deep Fascia:
* Dense connective tissue layer
* Lies deep to superficial fascia
Investing Fascia:
* Extensions of deep fascia surrounding
muscles & neurovascular bundles
Extrinsic Back Muscles
-Superficial Extrinsic mm
* Move upper limb
-Deep Extrinsic mm
* Accessory mm of respiration
Trapezius
-Origins = midline:
occipital bone, nuchal lig, cervical & thoracic spinous
processes
-Insertions = upper limb:
Scapular spine, acromion process, 1/3 of clavicle
-Actions = varies by fibers:
Elevate & depress scapula
Retract scapula
Superiorly rotate scapula
Extend/laterally flex neck
-Innervation =
Accessory n (CN XI)
* Exits via jugular foramen
* Innervates Trapezius &
Sternocleidomastoid mm
* Runs with transverse cervical arter
Latissimus dorsi
-Origins = midline:
Spinous processes of lower thoracic verts,
thoracolumbar fascia
-Insertions = upper limb:
Anterior humerus (intertubercular sulcus)
*Note: wraps medially and around to front of arm
-Actions =
ADDucts, extends, & medially rotates arm
Can also attach to inferior angle of scapula and
assist with scapular movements (retraction,
inferior rotation
Levator Scapulae
-Origins = midline:
Transverse processes of C1-C4
-Insertions = upper limb:
Superior part of medial border of scapula
-Actions =
Elevates & inferiorly
rotates scapula
Assist with neck
extension
Rhomboids
-Rhomboid minor
O: Spinous processes of C7-T1
I: med border scapula, @ spine
-Rhomboid major
O: Spinous processes of T2-T5
I: med border scapula, inf to
spine
Actions
Retract & elevate scapula, inf
rotation
Deep Extrinsic Back Muscles
“Intermediate” muscle layer
-Serratus Posterior Superior
O: spinous processes of C7-T3
I: superior borders ribs 2-5
A: elevates ribs
-Serratus Posterior Inferior
O: spinous processes of T11-L2
I: inferior borders or ribs 8-12
A: depresses ribs
-Both are accessory muscles of respiration &
important in proprioception
-Innervation:
intercostal nerves (ventral primary rami)
SPS
SPI
R’s
Cutaneous Innervation
-Cutaneous nerves (and vessels) pierce muscles on way to
skin at regular intervals.
-Correspond to dermatomes (segmental pattern from
development, representing a single spinal nerve level).
