Exam 4 Regional Anatomy; Vascularization Head & Neck; Axial Skeleton Flashcards
1
Q
What are the arteries that furnish blood to the brain? (They are paired)
A
- Vertebral Arteries
- Internal Carotid Arteries
2
Q
How many vertebrae are in each of the vertebral regions?
A
Cervical-- 7 Thoracic-- 12 Lumbar-- 5 Sacrum-- 5 fused Coccyx-- 4 fused
3
Q
What are the four normal vertebral curves?
A
- Cervical & Lumbar (Anteriorly convex curves)
- Thoracic & Sacral (Anteriorly concave curves)
4
Q
Intervertebral discs are found where?
A
2nd Cervical (axis) to sacrum
5
Q
What is characterized by an abnormal increase in the thoracic curvature?
A
Kyphosis
6
Q
Kyphosis may results from what?
A
Erosion of the anterior part of one or more vertebrae (demineralization resulting from osteoporosis)
7
Q
What is characterized by an anterior rotation of the pelvis at the hip joints producing an abnormal increase in lumbar curvature?
A
Lordosis
8
Q
What are some associated causes of Lordosis?
A
- Weakened trunk musculature
- Late pregnancy
- Obestity
9
Q
What is characterized by an abnormal lateral curvature that is accompanied by rotation of the vertebrae?
A
Scoliosis
10
Q
Which abnormal curvature is the most common deformity in pubertal girls?
A
Scoliosis
11
Q
This abnormal curvature has the spinous processes turn toward the cavity of the abnormal curvature and the ribs protrude when bending over?
A
Scoliosis
12
Q
What are the different structural parts of a vertebra?
A
Vertebral processes
Vertebral Arch
Vertebral Body
13
Q
What is the name of the cervical vertebra that supports the skull and is the first cervical vertebra?
A
Atlas
14
Q
Which cervical vertebra allows for side-to-side rotation of the head?
A
Axis
15
Q
What transmits the vertebral arteries?
A
Transverse Foramina
16
Q
What are the two craniovertebral joints?
A
Atlanto-occipital Joint- (Atlas & Occipital Bone)
Atlantoaxial Joint- (Atlas & Axis)
17
Q
What type of joint are the craniovertebral joints?
A
Synovial Joint
18
Q
This is a ring of bone & has the superior facets for the occipital condyles?
A
Atlas
19
Q
This cervical vertebra has the dens (odontoid) process as the body?
A
Axis
20
Q
What is the name of the strong ligament extending between right & left tubercles of C1 & holds the dens of C2 against the anterior arch of C1, forming the posterior wall of a socket for the dens?
A
Transverse Ligament
21
Q
The Thoracic aorta supplies branches to what?
A
Pericardium Esophagus Bronchi Diaphragm Intercostal Chest Muscles Mammary Gland Skin Vertebrae Spinal Cord
22
Q
What are the paired arteries that supply blood to the brain?
A
Vertebral Arteries
Internal Carotid Arteries
23
Q
The vertebral arteries are direct branches of what?
A
Subclavian arteries
24
Q
What foramina do the Vertebral arteries travel through heading toward the brain and pass through to get to the brain?
A
Travel: Transverse Foramina of the cervical vertebrae
Pass: Foramen Magnum
25
What do the vertebral arteries unit to form on the inferior posterior part of the brain?
Basilar Artery (single) on ventral surface of the pons
26
What arteries are branches of the common carotid artery and enter the skull through the carotid foramen (Carotid Canal)?
Internal Carotid Arteries
27
The Internal Carotid Arteries & External Carotid Arteries are branches of what?
Common carotid arteries (right & left sides)
28
The internal carotid arteries travel to inferior anterior surface of the brain and contribute to what?
Formation of CIRCLE OF WILLIS
| -Supply blood to eyeballs & brain
29
The external carotid arteries supply blood to what structures?
Structures of the external skull as branches of maxillary & superficial temporal branches
30
What is the most important anastomosis in the body that connects posterior & anterior blood supplies to the brain?
Arterial Circle of Willis
31
What vessels make connections in the Circle of Willis?
Basilar Artery (formed from united vertebral arteries) interconnect with branches of the internal carotid arteries
32
What is the importance of the anastomosis called the Arterial Circle of Willis?
- Control of blood supply to brain when pressure varies in one or more major artery
- Alternate pathways if blockage or occlusion
33
Name the foramina and what portion of which bone the internal carotid arteries pass through to get to the cranial cavity?
Carotid Foramina (Carotid Canals) in the petrous part of the temporal bones
34
What vessels drain the head and neck?
External Jugular Vein
| Internal Jugular Vein
35
What vessel do the External & Internal Jugular veins take blood to?
Superior Vena Cava
36
Where does the Dural Venous Sinuses empty into?
Internal Jugular Vein
37
Name the groups of Lymph nodes found on the head and neck?
```
Parotid
Occipital
Retroauricular (Mastoid)
Deep Cervical
Superficial Cervical
Submental (anterior, inferior mandible)
Submandibular (posterior to submental)
```
38
The thoracic duct drains lymph into venous blood at what junction?
Left Internal Jugular & Left Subclavian Veins
39
The Right Lymphatic Duct drains lymph into venous blood at what junction?
Right Internal Jugular & Right Subclavian Veins
40
What Plexus is formed from the ventral rami of spinal nerves C1-C5?
Cervical Plexus
41
The cervical plexus supplies nerve innervation of what areas?
Skin & Muscles of the Head, Neck, & Upper Shoulders
42
What other significant nerve arises from the C3-C5 portion of the Cervical plexus? Innervates what?
Phrenic Nerve
| Innervates the Diaphragm
43
What nerve branch arising from the Cervical Plexus provides cutaneous innervation of skin of the neck & scalp posterosuperior to the auricle?
Lesser Occipital Nerve
44
What nerve branch arising from the cervical plexus provides cutaneous innervation of skin over the parotid gland, mastoid process, auricle, & area of skin from angle of the mandible to mastoid process (Posterioinferior part of face & inferior part of the auricle)?
Great Auricular Nerve
45
What nerve is a branch of the dorsal primary ramus of spinal nerve C2, not part of the Cervical plexus?
Greater Occipital Nerve
46
Where does the Greater Occipital Nerve arise from & emerges beneath what muscle?
Between vertebrae C1 & C2, emerges beneath obliquus capitis inferior muscle
47
The greater occipital nerve passes through what muscles after it emerges beneath obiquus capitis inferior?
Semispinalis Capitis & Trapezius Muscles
48
What does the Greater Occipital Nerve supply?
Skin along posterior scalp to the vertex
49
Disorders of the Greater Occipital Nerve may cause what? & is brought on (due to) by what reason?
Occipital Neuralgias
| -Entrapped at the obliquus capitis inferior muscle
50
What nerve supplies the skin covering the anterior cervical region?
Transverse Cervical Nerve
51
Which nerves supply the skin over the shoulder?
Supraclavicular Nerves
52
Which nerve provides motor innervation of the infrahyoid muscles, Omohyoid, Sternohyoid, Sternothyroid?
Ansa Cervicalis
53
Which nerve provides motor innervation of the infrahyoid muscle, Thyrohyoid?
Hypoglossal Nerve (CN-XII)
54
Which muscles are the TMJ Muscles?
Temporal
Masseter
Lateral Pterygoid
Medial Pterygoid
55
Which triangle has the occipital triangle and Subclavian triangle in it?
Posterior Triangle
56
What separates the occipital triangle from the subclavian triangle?
Omohyoid (inferior belly portion)
57
What important structures lie within the Occipital Triangle?
- Occipital Artery (for which triangle is named)
- Accessory Nerve (CN-XI)
- Cervical Plexus
58
The Subclavian Triangle contains what important structures?
Subclavian Artery & Vein (for which triangle is named)
59
What other name may the Subclavian Triangle be called?
Supraclavicular Triangle
60
Name the subdivisions of the Anterior Triangle?
Submandibular Triangle
Carotid Triangle
Submental Triangle
Muscular Triangle
61
Which triangle is bounded inferiorly by the body of the hyoid bone, laterally by right & left anterior bellies of digastric muscles & the floor is the two mylohyoid muscles?
Submental Triangle
62
What is contained in the submental triangle?
Submental Lymph Nodes
63
The Submandibular Triangle is the glandular area between what?
Inferior border of mandible & anterior & posterior bellies of the digastric muscle
64
What other name may the Submandibular Triangle be called?
Digastric Triangle
65
What structure nearly fills the Submandibular Triangle?
Submandibular gland
66
What other structures are contained in the Submandibular Triangle?
Facial Artery
| Facial Vein
67
The Carotid Triangle is a vascular area bounded by what structures?
Superior belly of the omohyoid
Posterior belly of Digastric
Anterior border sternocleidomastoid
68
What important structures are contained in the Carotid triangle?
Common Carotid (pulse auscultated or palpated here)
- Internal & External Carotid Arteries
- Internal Jugular Vein
- Vagus Nerve
- Thyroid Gland
- Larynx
69
The pulse can be auscultated or palpated by compressing it against what?
Transverse processes of cervical vertebrae
70
The common carotid divides into the internal & external carotid arteries at what level?
Superior border of the thyroid cartilage
71
What deeper structures lie within the Carotid Triangle?
Middle Cervical Sympathetic Ganglion
Recurrent Laryngeal nerve
Thyroid branches of inferior thyroid artery
72
The muscular triangle is bounded by what?
Superior belly of omohyoid muscle
Anterior border of sternocleidomastoid
Median plane of the neck
73
What is contained in the muscular triangle?
Infrahyoid muscles
| Viscera of the neck (Thyroid & Parathyroid Glands)
74
What deeper structures lie within the Muscular Triangle?
Trachea
Larynx
Thyroid Gland
75
Nerves that "just pass through" an area on their way to innervate a more distal body part are called?
Transient Nerves
76
Name two transient nerves within the neck?
```
Vagus Nerve (CN-X)
Phrenic Nerve
```
77
Which nerve accompanies the carotid artery & internal jugular vein in the neck on its way to the thorax & abdomen?
Vagus Nerve (CN-X)
78
Branches of the Vagus Nerve are found in which triangles?
Carotid Triangle
| Submandibular Triangle
79
The phrenic nerve transits along what as it heads to innervate the thoracic diaphragm?
Anterior Scalene Muscle
80
The most inferior functional intervertebral disc is between?
L5 & S1
81
No intervertebral disc is found between?
C1 & C2
82
Which primary vertebral Curve is formed during fetal development?
Thoracic (Anteriorly Concave Curve)
| Sacral Curve
83
Which secondary Vertebral curve forms when a child begins to hold their head erect?
Cervical Curve
84
Which secondary Vertebral curve forms when a child begins to walk?
Lumbar Curve
85
All curves of the spine are fully developed by what age?
10
86
What portion of the vertebrae are the weight bearing portion?
Body of the vertebrae
87
The vertebral arch has what structures of the vertebrae?
Pedicles
| Laminae
88
What are the seven processes found on a vertebrae?
Transverse -2
Spinous -1
Articular -4
89
All the vertebral foramina together form what?
Spinal Canal
90
What is formed from two vertebral notches together?
Intervertebral Foramina
91
The seventh cervical vertebrae is called what?
Vertebra Prominens
92
The Cervical Vertebrae C3-C6 structural characteristics?
Smaller Body
Larger Spinal Canal
Transverse processes: shorter
Transverse foramen for vertebral artery
93
The spinous processes of C2 to C6 are often structurally different in what way?
bifid (split in the middle making two)
94
What membrane is the strong superior continuation of the posterior longitudinal ligament across the central atlantoaxial joint through the foramen magnum to the central floor of the cranial cavity?
Tectorial Membrane
95
A hangman's fracture is the colloquial name given to a fracture of what?
Both Pedicles of C2 (Axis)
96
What causes a hangman's fracture?
Forcible hyperextension of the head (Large axial load onto C2)
97
Which vertebrae articulate with the ribs?
12 Thoracic Vertebrae
98
What are some structural characteristics of the thoracic vertebrae?
Larger & stronger Body
Longer Transverse Process
Longer Spinous Process
Facets or demifacets on body for head of rib
Facets on transverse Processes for tubercle of rib
99
The Tubercle of the rib articulates with which portion of the thoracic vertebrae?
Transverse Process
100
The thoracic vertebral body articulates with what portion of the rib?
Head of the rib
101
What are the largest and strongest vertebrae in the vertebral column?
Lumbar Vertebrae (5 Lumbar vertebrae)
102
Which vertebrae have short thick spinous processes and transverse processes?
Lumbar Vertebrae
103
Which vertebrae are fused by age 30 and serve as a strong foundation for the pelvic girdle?
Sacrum (5 fused)
104
What area of the Sacrum is covered with hyaline cartilage and is the site of the synovial part of the sacroiliac joint? (named derived from resemblance to an ear)
Auricular Surface
105
The continuation of the vertebral canal in the sacrum is called what and contains what?
Sacral Canal
| Nerve Roots of Cauda Equina
106
What is formed from the fused rudimentary spinous processes of the Sacrum?
Median Sacral Crest
107
What is formed from the fused articular processes of the Sacrum?
Medial (Intermediate) Crest
108
What is formed from the fused tips of the transverse processes of the sacral vertebrae?
Lateral Sacral Crest
109
What is formed due to the absence of spinous processes and associated laminae on S5 and sometimes S4
Sacral hiatus
110
This is the inferior articular process of S5 and is a helpful guide to the location of the sacral hiatus?
Sacral Cornu
111
What portion of the vertebrae is formed from the fusion of 4 bone generally by age 30 and is the remnant of the skeleton of the embryonic tail?
Coccyx
112
What are the rudimentary articular processes of the Coccyx called?
Coccygeal Cornu
113
What landmarks on the Sacrum and Coccyx are used to place an Epidural or Caudal block?
Sacral & Coccygeal Cornu
114
An epidural or caudal block provides anesthesia to what area?
Regions innervated by the sacral and Coccygeal nerves (Approx. waist to knees)
115
What permits various movements of the vertebral column, absorbs vertical shock between vertebrae and is a Fibrocartilagenous ring (Anulus Fibrosus) with a pulpy center (Nucleus Pulposus)?
Intervertebral Discs
116
What accounts in part for a loss of height during old age?
Nuclei Pulposi lose turgor and thin due to dehydration and degeneration
117
What occurs to the intervertebral disc with flexion of the vertebral column?
Nucleus Pulposus: Pushed posteriorly toward thinnest part of annulus fibrosus
118
What may occur with degeneration of the posterior longitudinal ligament and wearing of the annulus?
Nucleus pulposus may herniate into the vertebral canal
| Compress spinal cord or nerve roots
119
What is the most commonly ruptured intervertebral disc?
C5/C6 (compresses spinal nerve roots C6) &
| C6/C7 (compresses spinal nerve roots C7)
120
Intervertebral disc protrusion within the cervical spine may cause what symptoms?
Pain in Neck, Shoulder, arm, & hand
121
Hyperextension of the neck may result in what injury?
stretch or tearing of Anterior Longitudinal Ligament
122
What is a common cause of hyperextension injuries of the neck?
Rear-end collision (Whiplash)
123
What is the name of the plane synovial joint between the superior and inferior articular processes (vertebral arches) of adjacent vertebrae?
Zygapophysial joint (facet joint)
124
Zygapophysial joints are surrounded by what? These are especially thin and loose in the cervical region
Articular Capsule (Thin and loose)
125
The Zygapophysial joints permit what?
Gliding Movements between vertebrae
126
What purpose do Accessory ligaments of the vertebrae serve?
- Unite the laminae, transverse processes, spinous processes
| - Help stabilize the joints
127
If Zygapophysial joints are diseased (osteoarthritis) or injured what may occur?
- Joint is close to intervertebral foramina and spinal nerves may be affected
- Pain distribution along dermatomes and spasm in muscles derived from associated myotomes
128
What ligament is a broad fibrous band that covers and connect the anterior aspect of vertebral bodies and intervertebral discs and extends from the atlas to the sacrum?
Anterior longitudinal ligament
129
The anterior longitudinal ligament serves what purpose?
- Stability of joint between vertebra
| - Prevent hyperextension of vertebral column
130
What ligament runs within the vertebral canal along posterior aspect of the vertebral bodies and is supplied with nociceptive nerve endings?
Posterior Longitudinal Ligament
131
The posterior longitudinal ligament serves what purpose?
- Prevent Hyperflexion of vertebral column
| - Herniation or posterior protrusion of discs
132
What Ligament is a broad, yellow elastic fibrous tissue that joins laminae of adjacent vertebral arches?
Ligamenta Flava
133
The Ligamenta Flava serves what purpose?
- Prevent separation of vertebral lamina
- Arrest abrupt flexion of vertebral column
- Help prevent injury to intervertebral discs
134
What ligament joins the tips of the spinous processes from C7 to the sacrum?
Supraspinous Ligament
135
This is the thickening of the supraspinous ligament in the neck, extending from C7 to the occipital protuberance?
Ligamentum Nuchae
136
What provides the blood supply to the vertebrae?
A segmental artery
137
Spinal arteries enter the Intervertebral foramina and divide to provide blood to what?
Dorsal & ventral roots of spinal nerves & coverings
138
Spinal veins form what to provide venous drainage of the vertebral column?
- Anterior vertebral venous plexus (Internal & external)
| - Posterior vertebral venous plexus (internal & external)
139
What vertebral veins are large & tortuous and are in the substance of the vertebral bodies?
Basivertebral veins
140
What veins accompany the spinal nerve through the intervertebral foramina and receive blood from the spinal cord and vertebral plexuses?
Intervertebral veins
141
The Anterior Internal Plexus and Posterior Internal Plexus together form what venous plexuses?
Internal vertebral (Epidural) Plexus
142
What is the clinical significance of the vertebral venous plexus being a valve-less system?
Transmit cancer metastases to distant locations that do not lie in the normal venous pathway. i.e. Brain but not the lungs
143
The bony thorax is formed by?
Thoracic portion of vertebral column
12 pairs of ribs w/costal cartilages
sternum
144
What function does the bony thorax serve?
Protect: Heart, Lungs, Liver, Spleen, etc..
Attachment for muscles of respiration
Produce red bone marrow
145
Name the openings of the Bony thorax?
- Superior Thoracic aperture (bounded by first pair of ribs & sternum)
- Inferior Thoracic Aperture (Closed by the diaphragm)
146
The vertebrosternal ribs are comprised of what?
Ribs 1-7
Costal Cartilage
Attach directly to sternum
147
Which rib has the sharpest curvature and articulates with the manubrium inferior to the clavicle?
First Rib
148
Which ribs have sternal costal articulations direct to the body of the sternum?
3-7
149
The second rib articulates with what?
Junction of Manubrium and body of the sternum
150
Which ribs are considered "true ribs"?
1-7
151
Ribs 8-10 indirectly articulate with the sternum by joining the costal cartilage of rib 7, these ribs called?
Vertebrochondral ribs
152
Ribs 8-10 are also termed what due to the indirect articulation with the sternum?
False ribs
153
What is formed by the arrangement of costal cartilages that provide for the indirect articulation of ribs 8-10?
Costal Arch
154
These ribs are also false ribs and have no articulation with the sternum or any anterior articulation?
Ribs 11 & 12
155
Ribs 11 and 12 are also known as?
"Floating ribs"
156
What the is name of the joint that articulates between the xiphoid process and body of the sternum and is a synchondrosis?
Xiphisternal joint
157
What type of joints are formed between ribs 6-9?
Synovial joints (Synovial plane joints)
