Exam 1 Flashcards
What are the three main types of joints and their subtypes?
Fibrous (suture, schindylesis, syndesmoses, gomphoses)
Cartilaginous (synchondroses aka hyaline, symphases aka fibrocartilage)
Synovial (planar, hinge/ginglymus, pivot/trochoid, condyloid, saddle/seller, ball and socket)
What is a pennate muscle?
Muscle fibers next to tendon (unipennate, bipennate, multipennate)
What is a fusiform muscle?
Wide in the middle, tapered at the ends. Can have multiple heads (bicipital, tricipital, quadracipital)
What is a digastric muscle?
Two muscle bellies separated by central tendon
What is a multiventral muscle?
Muscle broken up by tendonous inscriptions (ex: 6 pack)
What is a multicaudal muscle?
Multiple tails/tendons (ex: multiple tendons in hand going to different digits)
What is lymph?
Surplus tissue fluid that is taken into lymphoid vessels and dumped back into venous circulation.
What is a collection of cell bodies called in the CNS vs PNS?
CNS - nucleus
PNS - ganglion
What are the cells of the blood brain barrier?
Astrocytes
What are the cells that myelinate axons in the CNS and PNS?
CNS - oligodendroglia
PNS - Neurolemma/Schwann cells
What are the phagocytes in the CNS?
Microglia
What are the cells that produce CSF?
Ependymal cells
What are the three types of cartilage?
Hyaline (nose), fibrocartilage (fibers/tough), elastic (ears)
What does aponeurosis mean?
Flat sheet of tendon
What are the layers in arteries and veins?
(Valve cusps in veins)
- Endothelium (inside)
- Subendothelium
- Basement membrane
- Elastic lamina
- Tunica media
- Tunica adventia (outside)
What is a Jefferson fracture?
Fracture of both arches of the atlas from a blow to the top of the head. Also known as a burst fracture. Usually will not injure spinal cord.
What is a Hangman’s fracture?
Fracture of the vertebral arch due to hyperextension of the head on the neck.
What is an odontoid fracture?
Fracture of the dens/odontoid process on the axis due to a horizontal blow to the head. The transverse L. breaks it and holds it away from blood supply.
What makes the cervical vertebrae unique?
“Bifed” spinous process, large triangular vertebral foramen, transverse foramen within the transverse processes, anterior/posterior tubercles on transverse processes, costotransverse bar between tubercles
What makes the thoracic vertebrae unique?
Small, round vertebral foramen, “heart”-shaped vertebral body, well-pronounced lamina, large/inferiorly directed spinous processes, superior/inferior/transverse costal facets for rib articulation
What makes the lumbar vertebrae unique?
Large, oval vertebral foramen, long/slender transverse processes, “hatchet”-shaped spinous processes, “kidney”-shaped vertebral body, mammillary process on superior articulating process, accessory process on transverse process
What happens with Spina Bifida Occulta?
Lamina does not completely close off to protect spinal cord, can be differing degrees of severity
What is the difference between spondylosis, spondylolysis, and spondylolisthesis?
Spondylosis- degeneration of vertebral disc
Spondylolysis - fracture of the arch
Spondylolisthesis - fracture and displacement of the vertebra
What is a tubercle?
A bony bump
What are the two types of joints at the atlantoaxial joint?
Trochoid/pivot joint at the dens
Planar synovial joint further out
What is the difference between intervertebral joint and zygapophyseal jiont?
Intervertebral joint is a symphysis (cartilagenous) joint between vertebral bodies
Zygapophyseal joint is a planar synovial joint between articular processes
Describe vertebral disc herniation
Happens when the nucleus pulposus comes through the annulus fibrosis and impinges on a nerve between the anterior longitudinal ligament and posterior longitudinal ligament because there is less support there
Which sections of the spine does the second number rule apply to and why?
Cervical and lumbar spine. C-spine has 8 nerves for 7 vertebrate, so second numbered vertebrae corresponds with nerve number. In L-spine the nerves come out above the discs so the next nerve down is what is impinged.
What is in layer 1 of back muscles?
Trapezius M. and Latissimus Dorsi M.
Where does the Trapezius M. originate and insert?
Skull (superior nuchal line) down the T-spine spinous processes to scapular spine (and some to clavicle)
Where does the Latissimus Dorsi M. originate and insert?
Ilium and sacrum up to mid T-spine on spinous processes to front of proximal humerus
What innervates the Trapezius M.?
Spinal accessory N. - CN XI
What innervates the Latissimus Dorsi M.?
Thoracodorsal N.
What is in layer 2 of back muscles?
Levator Scapulae M., Rhomboid Minor M., and Rhomboid Major M.
Where does the Levator Scapulae M. originate and insert?
C-spine transverse processes to medial border of scapula above the scapular spine
Where does the Rhomboid Minor M. originate and insert?
C-spine/T-spine junction to medial border of scapula at scapular spine
Where does the Rhomboid Major M. originate and insert?
Upper T-spine to medial border of scapula below scapular spine
What innervates the Levator Scapulae M.?
Dorsal scapular N.
What innervates the Rhomboid Major M.?
Dorsal scapular N.
What innervates the Rhomboid Minor M.?
Dorsal scapular N.
What is in layer 3 of back muscles?
Serratus Posterior Superior M. and Serratus Posterior Inferior M.
Where does the Serratus Posterior Superior M. originate and insert?
C-spine/upper T-spine down and out to ribs
Where does the Serratus Posterior Inferior M. originate and insert?
Lower T-spine/upper L-spine up and out to ribs
What innervates the Serratus Posterior Superior M.?
Intercostal N.
What innervates the Serratus Posterior Inferior M.?
Anterior rami
What is in layer 4 of back muscles?
Splenius Capitis M. and Splenius Cervicis M.
Where does the Splenius Capitis M. originate and insert?
Lower C-spine/upper T-spine to skull
Where does the Splenius Cervicis M. originate and insert?
Upper T-spine to upper C-spine
What innervates the Splenius Capitis M.?
Posterior rami
What innervates the Splenius Cervicis M.?
Posterior rami
What is in layer 5 of back muscles?
Erector Spinae M. (Iliocostalis M, Longissimus M, and Spinalis M.)
Break down the Iliocostalis M. into its groups
Iliocostalis Lumborum M., Iliocostalis Thoracis M., and Iliocostalis Cervicis M.
Break down the Longissimus M. into its groups
Longissimus Thoracis M., Longissimus Cervicis M., and Longissimus Capitis M.
Break down the Spinalis M. into its groups
Spinalis Thoracis M., Spinalis Cervicis M., and Spinalis Capitis M. (won’t see spinalis cervicis m or spinalis capitis m in lab)
Where do the Iliocostalis Ms. originate and insert?
Iliocostalis Lumborum M: sacrum/ilium to ribs
Iliocostalis Thoracis M: ribs to ribs
Iliocostalis Cervicis M: ribs to C-spine
Where do the Longissimus Ms. originate and insert?
Longissimus Thoracis M.: sacrum to ribs
Longissimus Cervicis M: ribs to C-spine
Longissimus Capitis M: ribs to skull
Where do the Spinalis Ms. originate and insert?
Spinous processes to spinous processes of upper L-spine to upper T-spine
What innervates the Erector Spinae Ms.?
Posterior rami
What is in layer 6 of back muscles?
Transversospinalis M. (Rotatores Brevis M., Rotatores Longus M., Multifidus M., Semispinalis M.)
Where does the Rotatores Brevis M. originate and insert?
Transverse process of one vertebrae to spinous process of 1 vertebrae up
Where does the Rotatores Longus M. originate and insert?
Transverse process of one vertebrae to spinous process of 2 vertebrae up
Where does the Multifidus M. originate and insert?
Transverse process of one vertebrae to spinous process of 3-4 vertebrae up
Where does the Semispinalis M. originate and insert?
Transverse process of one vertebrae to spinous process of 5-6 vertebrae up
What innervates the Transversospinalis Ms.?
Posterior rami
What muscles are between neighboring spinous processes?
Interspinalis Ms.
What muscles are between neighboring transverse processes?
Intertransversearii Ms.
What muscles go from transverse processes to ribs?
Levator Costarum Brevis M. (one up) and Levator Costarum Longus M. (more than one up)
What muscles make up the suboccipital triangle?
Rectus Capitis Major M., Obliquus Capitis Superior M., an Obliquus Capitis Inferior M. The Rectus Capitis Minor M. is medial to the triangle but does not make up the triangle.
What are the 8 source arteries for paraspinal arteries?
Vertebral A., Ascending Cervial A., Deep Cervical A., Posterior Intercostal A., Subcostal A., Lumbar A., Iliolumbar A., and Lateral Sacral A.
What are the paraspinal arteries?
Periosteal branch (to periosteum/vertebral body) Equitorial branch (wraps around and goes directly into vertebral body) Spinal branch (goes into vertebral canal), branches into anterior/posterior vertebral branch and radicular arteries OR segmental medullary arteries
What is the difference between radicular arteries and segmental medullary arteries?
Radicular arteries supply roots and rootlets but do not feed into spinal arteries. Segmental medullary arteries do feed into spinal arteries
What are the components of the spinal meninges?
Dura mater - outermost layer
Arachnoid mater - next layer, anchored by arachnoid trabeculae
Dura-arachnoid interface
Subarachnoid space - filled with CSF
Pia mater - directly on neural tissue, extends out into denticulate ligaments
What are the relevant posterior rami?
Suboccipital nerve (C1) Greater occipital nerve (C2) Least occipital nerve (C3) Superior cluneal nerves (L1-L3) Middle cluneal nerves (S1-S3)
What happens with C1-C3 injury?
No function below head, need respirator
What happens with C4-5 injury?
No function of limbs, can breathe
What happens with C6-7 injury?
Loss of hand and variable upper limb function
What happens with T1-T9 injury?
Lower limb paralysis
What happens with T10-L1 injury?
Some thigh muscle function
What happens with L2-L3 injury?
Most lower limb functions present
What type of joint is the sternoclavicular joint?
Saddle/seller joint that is biaxial
What type of joint is the acromioclavicular joint?
Planar synovial
What type of joint is the elbow joint?
Hinge/ginglymus joint that is uniaxial
What type of joint is the radioulnar joint?
Pivot joint at proximal and distal ends, and fibrous syndesmosis in the middle w/ interosseous membrane
What type of joint is the radiocarpal joint?
Condyloid joint that is biaxial
What type of joint is the intercarpal joint?
Planar synovial
What type of joint is the midcarpal joint?
Saddle/seller but surrounded by planar joints so unable to move like saddle joint
What type of joint is the carpometacarpal joint?
Planar synovial except thumb is saddle
What type of joint is the intermetacarpal joint?
Planar synovial
What type of joint is the metacarpophalangeal joint?
Condyloid joint that is biaxial
What artery supplies blood to the spinal cord?
The Spinal A.
Subclavian A. –> Vertebral A. –> Spinal A.
How many anterior vs posterior spinal arteries are there?
Two posterior spinal arteries and one anterior spinal artery
What artery supplies the Trapezius M?
The Transverse Cervical A.
Subclavian A. –> Transverse Cervical A.
What artery supplies the Rhomboid Major M?
The Dorsal Scapular A.
Subclavian A. –> Dorsal Scapular A.
What artery supplies the Rhomboid Minor M?
The Dorsal Scapular A.
Subclavian A. –> Dorsal Scapular A.
What artery supplies the Levator Scapulae M?
The Dorsal Scapular A.
Subclavian A. –> Dorsal Scapular A.
What artery supplies the Latissimus Dorsi M?
The Thoracodorsal A.
What is the order of arteries that come off the subclaivan A?
Vertebral A, Internal Thoracic A, Thyrocervical Trunk, Costocervical Trunk, Dorsal Scapular A
What is the order of layers that you go through for a lumbar puncture?
Skin - fat - thoracolumbar aponeurosis - supraspinous L - interspinous L - ligamentum flavum (pop) - epidural space - intervertebral venous plexus - dura mater - arachnoid mater - subarachnoid space (CSF)
What happens at the end of the spinal cord?
Spinal cord - medullary cone - filum terminale interum (pia mater) - filum terminale externum (added layer of dura mater)
What do the posterior rami of spinal nerves branch into?
Medial branch and lateral branch. Medial branches off into articular branch, muscular branch, and cutaneous branch. Lateral branches off into muscular and cutaneous
What is the order of arteries that comes off the axillary A?
Superior Thoracic A, Thoracoacromial Trunk, Lateral Thoracic A, Subscapular A, Anterior Circumflex Humeral A, Posterior Circumflex Humeral A
What makes up the humeral condyle?
Capitulum and Trochlea
What are the three fossas at the distal end of the humerus?
Coranoid fossa (lateral side of anterior side), radial fossa (medial side of anterior side), and olecranon fossa (posterior side)
Which bone of the upper extremity has its “head” at the distal end?
The ulna
What are the 8 carpal bones?
Scaphoid, Lunate, Triquetrum, Pisiform, Hamate, Capitate, Trapezoid, Trapezium
Which metacarpal has a styloid process?
The base of the 3rd metacarpal
What is the singular and plural for our fingers?
Phalanx vs phalanges
Which joints have fibrous articular discs?
Sternoclavicular, acromiclavicular, and radiocarpal joints
What type of cartilage is in the glenohumeral joint?
A glenoid labrum
What ligament is between clavicles?
Interclavicular ligament
What ligament holds the clavicle to the sternum?
Anterior sternoclavicular ligament
What ligaments are involved in the acromioclavicular joint?
Conoid ligament and trapezoid ligament (which make up the coracoclavicular ligament) and the acromioclavicular ligament
What ligaments are involved in the glenohumeral joint?
Coracoacromial ligament, coracohumeral ligament, and transverse humeral ligament
What ligaments are on the lateral side of the elbow joint?
Lateral/radial collateral ligament of the elbow
What ligamens are on the medial side of the elbow joint?
Posterior band ligament, oblique band ligament, anterior band ligament which all make up the ulnar collateral ligament
What ligament holds the radial head to the ulna?
The annular ligament of the radial head
What makes up the coracoacromial arch?
The acromion, the coracoacromial ligament, and the coracoid process
What is the difference between bull rider’s thumb and and skier’s thumb?
Bull rider’s thumb is a laxity of the lateral collateral ligament of the 1st metacarpophylangeal joint. Skier’s thumb is a laxity of both the medial collateral ligament and the lateral collateral ligament of the 1st metacarpophylangeal joint.
What causes Dupuytren contracture?
When palmar aponeurosis gets too dense
Where does fertilization occur?
Ampula of the uterine tube
How long does fertilization take?
Can take up to 24 hours
When does cleavage begin?
~30 hours after fertilization
What happens on day 3 after fertilization?
Morula is formed
What happens on day 4 after fertilization?
Morula enters into body of uterus
What happens on day 5 after fertilization?
Inner cell mass is formed (embryoblast), blastocyst cavity formed surrounded by trophoblast. Zona pellucida begins breakdown
What happens on day 6 after fertilization?
Implantation. Cytotrophoblast formation/division to become placenta and syncytiotrophoblast erosion into endometrium/hCG release
What is the trophoblast?
Releases early pregnancy factor to prevent rejection (immunosuppressant protein)
What is the cytotrophoblast?
Comes from trophoblast, stem cell layer of the placenta. Mitotically active to form placenta
What is the syncytiotrophoblast?
Comes from the cytotrophoblast, secretes proteolytic enzymes to erode into endometrium for implantation. Also secretes hCG = initial pregnancy signal.
What is unique about the cells of the syncytiotrophoblast?
Multinuclear and no cell membrane
What happens to the sperm before it can fertilize an egg?
Capacitation - removal of glycoprotein coat from plasma membrane of sperm. Takes ~7 hours.
What happens as the sperm passes through the corona radiata?
It releases hyaluronidase from the acrosome and releases tubal mucosal proteins
What happens as the sperm penetrates the zona pellucida?
It releases esterases, ACROSIN, and neuraminidase causing the zona reaction to block polyspermy.
What happens during the zona reaction?
Confirmational change in zona pellucida to freeze meshwork and stop other sperm
What happens after the sperm penetrates the zona pellucida and causes the zona reaction to happen?
Fusion of plasma membranes of egg and sperm. Head and tail of sperm enter, leaves behind mitochondria
What happens after the head and tail of the sperm enter the egg?
Second meiotic division completes and the male pronucleus forms to fuse with the female pronucleus
What are the results of fertilization?
Completion of 2nd meiotic division, restoration of diploid # of chromosomes, determination of chromosomal sex, metabolic activation, initiation of cleavage
What does the inner cell mass give rise to?
Epiblast and hypoblast
What does the epiblast form?
The ectoderm, amnion, and amniotic cavitiy
What does the hypoblast form?
Extraembryonic endoderm - prechordal plate, primary/secondary yolk sac (umbilical vesicle), and extraembryonic mesoderm
What does the extraembryonic mesoderm give rise to?
Extraembryonic coelom, extraembryonic somatic mesoderm, and extraembryonic splanchnic mesoderm
What is the extraembryonic coelom?
Hollow cavity outside of embryo
What is the extraembryonic somatic mesoderm?
Lines the inside of the trophoblast and covers the amnion
What is the extraembryonic splanchnic mesoderm?
Lines the outside of the secondary yolk sac (and the remains of the primary)
What does the extraembryonic somatic mesoderm give rise to?
Connecting stalk and chorion
What does the extraembryonic splanchnic mesoderm give rise to?
Primitive blood
What is the connecting stalk?
Precursor to umbilical cord
What is the chorion?
Layer of placenta
How long does implantation take?
~ 4 days: day 6-10
What happens in week 3 after fertilization?
Gastrulation & neurulation
What is gastrulation?
Formation of the 3 primary germ layers
What will give rise to the mouth?
The prechordal plate –> oropharyngeal membrane
What will give rise to the digestive/urinary tract emptying?
Cloacal membrane
What happens to the hypoblast during the primitive streak formation?
The epiblast cells invaginate and migrate down to replace the hypoblast cells and become the definitive endoderm. Epiblast cells continue to migrate down to form the mesoderm.
What causes a sacrococcygeal teratoma?
Persistance of the primitive streak (tissues from all 3 germ layers present)
What causes an oropharyngeal teratoma?
Abnormal migration of primordial germ cells
Where does the notochord come from?
Extends from primitive node anterior to prechordal plate. The primitive pit forms and the notochordal process fuses with the endoderm to form a notochordal plate. The notochordal cells then round up and form the notochord.
What are the functions of the notochord?
Template for vertebral column and induces neural plate formation (SHH)
What is a chordoma?
Remnants of notochord, agressive neoplasm of bone
What is the allantois?
Endodermal tissue that is template for umbilical arteries and veins. Becomes urachus
What 3 types of mesoderm are there?
Paraxial, intermediate, and lateral plate
What does paraxial mesoderm give rise to?
Somites - Muscle, skeleton, dermis
What does intermediate mesoderm give rise to?
Urogenital - Kidneys and gonads
What does lateral plate mesoderm give rise to?
Connective tissue - Blood, lymph, mesenteries, cardiovascular
What does the endoderm give rise to?
Trachea, lungs, GI tract, bladder, thyroid gland, tonsils
What does the mesoderm give rise to?
Gonads, kidneys, blood, spleen, muscles
What does the ectoderm give rise to?
Skin, hair, pituitary gland, eyes, CNS