Final 2.0 Flashcards
Be able to list all the structures that pass through the FORAMEN ROTUNDUM
Trigeminal V2- Maxillary branch
NO ARTERIES OR VEINS
Be able to list all the structures that pass through the FORAMEN OVALE
Trigeminal V3 -Mandibular branch;
lesser petrosal nerve= branch of CN 9
emissary veins
Accessory meningeal artery
Be able to list all the structures that pass through the JUGULAR FORAMEN
Glossopharyngeal IX,
Vagus X,
Accessory Spinal XI,
internal jugular vein and sigmoid sinuses
meningeal branches of ascending pharyngeal and occipital arteries
Be able to list all the structures that pass through the FORAMEN SPINOSUM
Middle Meningeal Artery
meningeal branch of mandibular nerve- V3
Be able to list all the structures that pass through the SUPERIOR ORBITAL FISSURE
Oculomotor III,
Trochlear IV,
Abducens VI,
Trigeminal V1 - opthalamic division branches
- lacrimal n
- frontal n.
- nasociliary n.
ophthalmic vein
sympathetic nerve fibers
Sensory VS Motor VS Both
Some Say Money Matters But my Brother Says Big Brains Matter More
CN1 - Nerve - S/M/B - path/innervation - lesion (tried to combine questions)
Olfactory- 1
info= Sensory
superior nasal cavity-> olfactory bulb-> olfactory tract -> brain
passes through cribriform plate and
innervates nasal epithelium of superior nasal cavity -
Lesion: shearing at cribriform plate causes loss of smell (anosmia)
CN 2 - Nerve - S/M/B - path/innervation - lesion (tried to combine questions)
Optic
Sensory
exits via the optic canal
innervates the retina
lesion= blindness
CN 3 - Nerve - S/M/B - path/innervation - lesion (tried to combine questions)
Oculomotor
Motor
through cavernous sinus exits via superior orbital fissure
innervates -
- superior/middle/inferior rectus,
- inferior oblique,
- levator palpebrae
lesion- diplopia, ptosis, strabismus
CN 4 - Nerve - S/M/B - path/innervation - lesion (tried to combine questions)
Trochlear
Motor
through cavernous sinus exits via superior orbital fissure
innervates superior oblique
Lesion- diplopia, ptosis?, strabismus
paralysis of superior oblique= inferior/lateral mvmt of eye
CN 5 - Nerve - S/M/B - path- branches - lesion (tried to combine questions)
V1- sensory - ophthalmic division exits via superior orbital fissure
V2 - sensory - maxillary division exits foramen rotundum then through the infraorbital foramen
- two branches
1. zygomatic
2. infraorbital n. (goes through infraorbital foramen)
V3 - sensory/motor - mandibular nerve exits via foramen ovale through the infratemporal fossa
branches
1. ariculotemporal
2. long bucal n.
3. lingual n.
4. inferior alveolar nerve -> goes through mental foramen= mental n.
LESION: Trigeminal neuralgia (hurts like a b), weakness with muscles of mastication
CN 6 - Nerve - S/M/B - path/innervation - lesion (tried to combine questions)
Abducens
Motor
through cavernous sinus exits via superior orbital fissure,
innervates lateral rectus
Lesion: lateral rectus paralyzed, eye drifts medially, diplopia and strabismus
CN 7- Nerve - S/M/B - path/innervation - lesion (tried to combine questions)
Facial nerve
Both
exits via internal acoustic meatus and exits stylomastoid foramen,
innervates anterior ⅔ tongue, muscles of facial expression
Lesion: Bell’s Palsy, loss of taste from anterior two-thirds
CN 8 - Nerve - S/M/B - path/innervation - lesion (tried to combine questions)
Acoustic/Vestibulocochlear
Sensory
exits via the internal acoustic meatus and stays
innervates: hearing and equilibrium (middle ear)
Lesion: loss of hearing, vertigo = world spinning
CN 9 - Nerve - S/M/B - path/innervation - lesion (tried to combine questions)
Glossopharyngeal
Both
exits via the jugular foramen,
Innervates posterior 1/3 tongue (taste and sensory), pharynx, parotid gland, stylopharyngeus muscle, carotid sinus and carotid bodies, sensory info for tympanic membrane
Lesion: dysphagia, impaired sensation posterior ⅓ of tongue palate and pharynx, absent gag reflex
CN 10 - Nerve - S/M/B - path/innervation- lesion (tried to combine questions)
Vagus
Both
Exits: down jugular foramen and follows carotid sheath through neck into thorax,
Innervates: heart, respiratory smooth muscle, abdominal viscera, muscles of larynx
laryngeal palsy (if damaged before it gives off recurrent laryngeal)
Lesion: dysphasia, dysphonia, problems with palate and pharynx paralysis, problems with esophageal motility, problems with parasympathetic nervous system
DEATH IF CUT BOTH
CN 11 - Nerve - S/M/B - path/innervation - lesion (tried to combine questions)
Spinal accessory
Motor
enters foramen magnum, exits jugular foramen,
Innervates: SCM & trapezius
Lesion: paralysis of SCM, inability to shrug shoulders or turn head against resistance; torticollis (twisting of neck causing head to rotate/tilt)
CN 12 - Nerve - S/M/B - path/function - lesion (tried to combine questions)
Hypoglossal
Motor
exits via hypoglossal canal,
Innervates tongue
Lesion: partial paralysis of tongue & dysphagia
Know the pathway of cerebrospinal fluid from its creation to its absorption.
Cerebrospinal fluid is made in the choroid plexus WHICH ARE IN FLOORS OF BOTH LATERAL VENTRICLE, ROOF OF 3RD VENTRICLE AND SOME 4TH VENTRICLE
Travels through interventricular foramina-> Enters 3rd ventricle
Travels through cerebral aqueduct/aqueduct of Sylvius-> Enters 4th ventricle
Travels through lateral apertures-> medial aperture->
Fills subarachnoid space and bathes external brain/ spinal cord
Is reabsorbed by the arachnoid villi at the SUPERIOR SAGITTAL SINUS which shuttles the CSF to the venous blood in the dural venous sinuses.
Be able to define myotome, sclerotome, and dermatome
Myotome - muscles served by a single spinal nerve root
Sclerotome - any of the paired block-like segments of the mesoderm alongside the neural tube - vertebrae and ribs innervated by a single nerve root
Dermatome - any area of skin in which sensory nerves derive from a single spinal nerve root
Hip Flexors
You get to Flex TRIPS if you get a good GPAA
Tensor fasciae latae, Rectus femoris, Iliacus, Psoas, Sartorius,
Gracilis
Pectineus,
Adductor brevis,
Adductor magnus,
Hip Extensors
Biceps femoris, Gluteus maximus, Adductor magnus Semitendinosus (superficial) Semimembranosus (deep to semitendinosus)
Extend your shoe By Getting A Shoe Stretcher
Hip ABDuctors
gluteus medius,
gluteus minimus,
tensor fascia latae
same as medial rotators
Hip ADDuctors
Adductor longus, Adductor brevis, Adductor magnus, Gracilis, Pectineus,
Add A GAP
Internal rotators of the hip (medial rotation)
gluteus medius,
gluteus minimus,
tensor fascia latae
same as hip ABDuctors
External Rotators of the hip (lateral rotation)
Quadratus femoris, Gluteus maximus muscle Obturator externus, Piriformis, Gemelli, Obturator internus,
Quit Getting Overwhelmed, Please Get On it…
lol a little negative when I thought of this one
7 bones that make the orbit of the eye
Sphenoid, Frontal, Zygomatic, Lacrimal, Ethmoid, Maxilla, Palatine
So Far Zeus Lacks Eternal Maximal Power
Chambers of the Inner Ear
Scala vestibuli - perilymph
Separated by REISSNER’S MEMBRANE (vestibular membrane)
Scala media- bounds the cochlear duct - endolymph
Separated by BASILAR MEMBRANE
Scala tympani - perilymph
Membranes of the Inner Ear
Vestibular membrane (reissner’s membrane)- separates scala vestibuli from cochlear duct
Tectorial membrane- forms covering over cochlea
- SUPERIOR TO BASILAR
Basilar membrane- supports/anchors cochlea
- ORGAN OF CORTI SITS ON BASILAR
innervation of both the internal and external anal sphincters including the spinal segments that give rise to that innervation
Internal anal sphincter - innervated by the autonomic nervous system- visceral
- parasympathetic = S2-4
- Sympathetic= T12-L2
NO PAIN
External anal sphincter - innervated by the pudendal nerve (S2-S4) - somatic
PAIN
Know where fertilization typically occurs.
ampulla of the uterine tube
Know how culdocentesis works, how it is performed, and why.
Culdocentesis checks for abnormal fluid in the space posterior to the vagina.
Via posterior vaginal fornix and up in uterorectal pouch.
Culdocentesis is used to detect hemoperitoneum (blood in the peritoneum) following blunt abdominal trauma.
- usually caused by rupture of the uterine tube in a tubal pregnancy
Pelvic inlet shapes
Gynecoid - Round shaped= most common
Android - Heart shaped
Platypelloid - oval transverse diameter larger
Anthropoid -oval with A-> P diameter larger
Pelvic Angles male vs female pubic angle
obturator foramen for males vs females
Female >80 degrees
Male <70
obturator foramen males= round
females= oval
measure aperture
Diagonal Aperture (measured by placing the tip of the middle finger at the sacral promontory and noting the point on the hand that contacts the pubic symphysis)
only one that can be measured
Know the retroperitoneal organs
SAD PUCKER
Suprarenal glands (adrenal glands)
Aorta and inferior vena cava
Duodenum (2nd and 3rd part only)
Pancreas
Ureters and Urinary Bladder
Colon (ascending and descending large intestine) -note: transverse colon is NOT retroperitoneal
Kidneys
Esophagus
Rectum
Know the arterial supply to and from the organs of digestion.
-Celiac Trunk (foregut) → Left Gastric Artery, Splenic Artery, Common Hepatic Artery
foregut= esophagus, stomach, proximal duodenum
-Superior Mesenteric (midgut)
midgut= distal duodenum through proximal 2/3 transverse colon
-Inferior Mesenteric (hindgut)
hindgut= distal 1/3 transverse colon through superior portion of anal canal
Know the chambers and valves of the heart.
Chambers=
- R atrium
- L atrium
- R ventricle
- L ventricle
valves:
- tricuspid / right AV valve= R atrium / R ventricle
- pulmonary= R ventricle / pulmonary trunk
- mitral / bicuspid / left AV valve= L atrium/L ventricle
- Aortic valve= L ventricle / ascending aorta
Know the arterial supply to the heart chamber by chamber - Left Side
Left Coronary Artery: divides into the Circumflex and Left Anterior Descending (Anterior Interventricular Artery)
Circumflex= left atrium and side & back of left ventricle
LAD= front & bottom of left ventricle and the front of the septum
Know the arterial supply to the heart chamber by chamber - Right Side
Right Coronary Artery: supplied the right atrium & ventricle and the bottom of the left ventricle and the back of the septum
SA Node: fed by right coronary artery (60%)
AV Node: fed by right coronary artery
Know the muscles of the rotator cuff and their actions.
- “SITS” functions to stabilize the glenohumeral joint by compressing the humeral head against the glenoid (all C5,C6)
- Supraspinatus - Abduction at the shoulder
- Infraspinatus - Lateral Rotator arm + aids in extension of the arm at shoulder
- Teres Minor - Lateral Rotator + assists in adduction /extension of the arm at should joint
- Subscapularis - Medial Rotator at shoulder joint
Know positions of the following female structures: uterus, vagina, broad ligament, round ligament, ovarian ligament, mesovarium, mesosalpinx, myometrium
Round ligament connects the front of the uterus to the groin region (abdominal wall)-> inguinal canal.- help keep uterus anteverted
uterus= superior/inferior ish to the bladder- anteverted position
vagina= posterior to bladder
broad ligament = double layered fold enveloping pelvic organs
mesovarium= portion of broad ligament of uterus that suspends ovaries
mesosalpinx= mesentery of uterine tubes
mesometrium= messentery of uterus
ovarian ligament= ovary to the lateral aspect of uterus
Know the vascular supply to and from the gonads - Arterial
Males: abdominal aorta to right and left testicular arteries
Female: abdominal aorta to right and left ovarian arteries
uterus is via the uterine artery of common iliac artery
Know the vascular supply to and from the gonads - Venous
Male: inferior vena cava to right testicular vein; left drains into left renal vein first then IVC
Female:
Right side= R ovarian vein-> IVC
left side= L ovarian vein-> L renal vein -> IVC
Understand which muscles move the ribs - Inspiration
Levator Costarum: Elevate the ribs in inspiration
External Intercostal: Elevate the ribs during forced inspiration
Understand which muscles move the ribs - Expiration
Internal Intercostal: Depress the Ribs/Forced Expiration
Understand how the ribs move during breathing
Anterior Aspect of Ribs (sternal ends) and sternum: Pump Handle Motion
Lateral Aspect of Ribs: Bucket Handle Motion
when this happens A-> P diamter increases
Know the boundaries/borders of the following pelvic structures: Pelvic Inlet
Pelvic inlet: also called pelvic brim
the ala and sacral promontory, AND Right and left linea terminalis - arcuate line, - pectineal line (pecten pubis) - pubic crest and - pubic symphysis
Know the boundaries/borders of the following pelvic structures: Perineum
Perineum: roof - pelvic diaphragm, floor - fascia and skin, anteriorly - pubic symphysis, posteriorly - coccyx, laterally - ischiopubic rami and sacrotuberous ligament
Know the boundaries/borders of the following pelvic structures: urogenital triangle
Urogenital triangle:
the anterior half of the diamond shaped perineum;
defined by the pubis symphysis anterioly
ischial tuberosities anterolaterally;
anterolateral borders are ischiopubic rami
posterior border is transverse perineal muscles
Know the boundaries/borders of the following pelvic structures: Anal Triangle
Anal triangle: formed on both sides by the internal margins of the sacrotuberous ligaments, anterioly by the perineal membrane and inferiorly by the coccyx, superior roof is the levator ani muscles
??
Know the boundaries/borders of the following pelvic structures: Ischiorectal fossa
Ischiorectal fossa: roof - levator ani muscles, floor - deep transverse perineal fossa, medial wall - external anal sphincters and levator ani, lateral wall - ischial tuberosity, obturator internus muscle and obturator fascia????
Know the glands present in the duodenum and what they produce.
Brunner’s glands - secrete a bicarbonate rich (alkaline) solution to help neutralize the acidic stomach chyme entering the duodenum - BICARB
pancreas and duodenum secrete bile, lipase, and amylase into duodenum (descending part) via the major duodenal papilla (hepatopancreatic ampulla)
Know the glands present in the stomach and what they produce.
Parietal cells - secrete HCl and intrinsic factor
Chief cells - secrete pepsinogen
Enteroendocrine cells (G-Cells)- secrete gastrin
Goblet cells - secrete mucus
Know the glands present in the pancreas and what they produce.
Exocrine glands - Acinar cells secrete digestive enzymes (pancreatic lipase, amylase, tripsinogen and bicarbonate) into pancreatic duct
Endocrine glands - Islet of Langerhans (beta and alpha): secretes hormones (insulin - beta cells and glucagon - alpha cells) into the bloodstream
Know the vascular supply to the thyroid gland - Arterial
Superior Thyroid Artery: branch off anterior branch of external carotid artery; runs antero-inferior to infrahyoid muscle
Inferior Thyroid Artery: largest branch off the thyrocervical trunk
Know the vascular supply to the thyroid gland. - Venous
Venous drainage is formed by the superior, middle and inferior thyroid veins which make a thyroid plexus.
Superior and middle veins drain into the internal jugular, and the inferior vein drains into the brachiocephalic trunk.
Know the location and placement of the hyoid bone.
Anterior part of the neck at the level of the C3 vertebra in the angle between the mandible (just below the mandible; mandible protrudes more anterior to the hyoid) and the thyroid cartilage.
Know the ligaments of the knee and leg.
ACL PCL Medial Meniscus Lateral Meniscus Medial Collateral Lateral Collateral Transverse Patellar Ligament
Know the innervation of the forearm extensors
radial nerve
Injury= can’t move =wrist drop
Know the general fates of the 3 layers of the trilaminar disk - Ectoderm
epithelial cells (epidermis) and all neural tissues
Know the general fates of the 3 layers of the trilaminar disk - Endoderm
innermost germ layer; develops into the linings of the digestive tract and much of the respiratory system; certain organs including the colon, stomach, small intestine, lungs, liver, thyroid and pancreas
Know the general fates of the 3 layers of the trilaminar disk - Mesoderm
middle germ layer; develops into muscles, and much of the circulatory, reproductive, and excretory systems
Know how sympathetic pathways reach structures in the abdomen or pelvis.
Thoraco- abdominal nerves:
- T7-T11
- T7-T9 lateral + anterior cutaneous branches
- most abundant
Subcostal nerve:
- T12
- >Anterior and lateral branch
- >Right below umbilicus
Iliohypogastric (superior) and ilio- inguinal nerves (inferior):
- L1
- Inguinal region
what joints make up the pelvis (pelvic girdle)
sacro iliac joint
pubic symphysis
lumbosacral joint
sacrococcygeal joint
What makes up the sacro iliac joint
- synovial joint with limited mobility
anteriorly= synovial
posteriorly= syndesmosis= fibrous connective tissue - sacral cartilage= hyaline cartilage
- iliac cartilage= fibrocartilage
general info regarding sacro iliac joint
supports weight of upper body/ transmits weight to hips and thus lower limbs
what makes up the pubic symphysis
Pubic symphysis - secondary cartilaginous joint: fibrocartilage
consists of fibrocartilage discs
- discs wider in women
- helps form pubic arch
what makes up the lumbosacral joint
Lumbosacral - symphysis: fibrocartilage
it is Lf-S1 with intervertebral disc to form this joint
what makes up the sacrococcygeal joint
Sacrococcygeal - secondary cartilagenous joint = fibrocartilage symphysis (amphiarthrotic)
joins the coccyx to the sacrum
what is route of the following to the heart
superior messenteric vein
inferior messenteric vein
superior messenteric-> hepatic portal vein-> central vein-> IVC
inferior messenteric-> splenic vein-> hepatic portal vein
azygous drains posterior thoracoabdominal wall
what are the 3 layers of the tilaminar disk
Ectoderm –
Mesoderm –
Endoderm –
what is the fate of the ectoderm
becomes epithelial cells (epidermis) and neural tissues
what is the fate of the mesoderm
Mesoderm – everything in between - bones, muscles, limbs
- > Intermediate becomes kidney and gonads
- > Lateral - splanchnic (circulatory system), somatic (body cavity, pelvis, limb bones), extra embryonic
- > paraxial (somite) mesoderm= head and somite
- > somite becomes sclertome (cartilage), syndotome (tendons), myotome (skeletal muscle), endothelial cells, dermatome (dermis/skeletal muscle)
what is the fate of the endoderm
Endoderm – tissues and organs associated with mucus membranes
