Final Exam Learning Objectives Flashcards
What neurovasculature structures are susceptible to injury at the surgical neck of the humerus?
Posterior humeral circumflex a.
Axillary n.
(Quadrangular space: teres minor, teres major, long head triceps, shaft of humerus)
What neurovasculature structures are susceptible to injury at the radial groove?
Profunda brachii a.
Radial n.
What neurovasculature structures are susceptible to injury at the distal humeral shaft?
Median n.
Brachial a.
What neurovasculature structures are susceptible to injury at the medial epicondyle of the humerus?
Sup/inf ulnar collateral aa.
Ulnar n.
Basilic v.
What neurovasculature structures are susceptible to injury with a posterior hip dislocation?
Sciatic n.
What neurovasculature structures are susceptible to injury at the head of the fibula?
Common fibular n.
Describe the boundaries of the anatomical snuff box and its contents.
Boundaries:
Extensor pollicis longus
Abductor pollicis longus*
Extensor pollicis brevis*
Contents:
- cephalic v.
- radial a.
- superficial br. radial n.
- scaphoid bone
Describe the components of the cerebral arterial circle.
Posterior cerebral a. Posterior communicating a. Internal carotid a. Anterior cerebral a. Anterior communicating a.
Name the location of the coronary arteries and their branches relative to surface features of the heart.
Anterior interventricular sulcus
- anterior interventricular a.
- great cardiac v.
Posterior interventricular sulcus
- posterior interventricular a.
- middle cardiac v.
Left atrioventricular sulcus
- circumflex br. of left coronary a.
Right margin to right atrioventricular sulcus
- right marginal a.
- small cardiac v.
Identify the clinically relevant sites on dermatome maps of the extremities. (segmental innervation)
Deltoid tuberosity: C5 thumb: C6 index finger: C7 pinky finger: C8 Medial aspect of forearm: T1 Nipple: T4 Xiphoid process: T6 Umbilicus: T10 Great toe: L4 5th toe: S1 Heel: S2
Cutaneous nerve innervation, CN V1
opthalmic
Front 1/2 of head, upper eyelids, bridge of nose
Cutaneous nerve innervation, CN V2
maxillary
Anterior 1/3 temporal bone, cheeks, upper lip, sides of nose
Cutaneous nerve innervation, CN V3
mandibular
middle 1/3 temporal bone, anterior half ear, lower lip, chin
Cutaneous nerve innervation, great auricular n.
area below ear, posterior half of ear
Cutaneous nerve innervation, lesser occipital n.
posterior 1/3 temporal bone, area directly behind ear
Cutaneous nerve innervation, greater occipital n.
posterior portion of head and neck
Lateral femoral cutaneous n.
lumbar plexus
lateral aspect thigh
saphenous n.
femoral n.
medial leg
perforating cutaneous n.
sacral plexus (posterior div)
medial buttock
posterior cutaneous n. of thigh
sacral plexus (ant/post div)
buttock and uppermost medial and posterior thigh
sural n.
tibial n.
lateral leg and foot
lateral sural n.
common fibular n.
lateral aspect leg
Describe the shape of the articular surfaces (convex or concave) of bones participating in joints of the upper extremity.
Clavicle is convex superior to inferior
Manubrium is concave superior to inferior
Clavicle is concave anterior to posterior
Manubrium is convex anterior to posterior
Explain the meningeal coverings of the central nervous system.
Dura mater - Periosteal - Meningeal Arachnoid mater - arachnoid filaments Pia mater - adhered to brain and spinal cord - filum terminale
Describe the anatomical basis of mild deformities of the lower extremity: knock knees
Genu valgus/coxa vara:
Shorter extremity
Distal femur angled more medially
More strain on neck of femur
Describe the anatomical basis of mild deformities of the lower extremity: bow-legged
Genu varus/coxa valga:
- longer extremity
- distal femur angled more laterally
- more strain on head of femur
Describe the anatomical basis of mild deformities of the lower extremity: duck feet
Retroversion
- decreased angle of torsion
Describe the anatomical basis of mild deformities of the lower extremity: pigeon toes
Anteversion
- increased angle of torsion
Iris and ciliary bodies
Oculomotor - V1
Pre-para
Ciliary ganglion
Ciliary bodies (accommodation), sphincter pupillae of iris (constriction)
Pterygopalatine ganglion
Facial - VII
Pre-para
Lacrimal gland - “CRY”
“SNOT”
Submandibular ganglion
Facial - VII
Pre-para
submandibular gland - “SPIT”
sublingual gland - “SPIT”
Otic ganglion
Glossopharyngeal - IX
Pre-para
parotid gland - “SPIT”
Vagal trunk
Vagus - X
Pre-para
visceral thorax and abdomen
Describe the organization of the thoracolumbar fascia.
3 layers at lumbar level
- Posterior: posterior to erector spinae and transversospinales
- Middle: posterior to quadratus lumborum
- Anterior: anterior to quadratus lumborum
Name the most common directions of joint dislocation: shoulder joint dislocation.
- 95% are anterior dislocations (inf dislocated, then head of humerus moves anteriorly)
- vulnerable to dislocation when arm is in abducted position (downward force)
- inferior joint capsule not reinforced by rotator cuff muscles or ligaments
Name the most common directions of joint dislocation: hip joint dislocation.
- Posterior dislocation outnumbers anterior 9:1
- most common MOI: MVA
- may injure acetabulum, labrum, and SCIATIC NERVE
Name the most common directions of joint dislocation: radial head dislocation.
Nurse maid’s elbow
- distraction force pulls radial head out from annular ligament
- caused by hanging/lifting from forearm, wrist, or hand
- muscles pull radial head superiorly
- most common in 3-5 y/o (radial head is not fully ossified)
Describe the process of intervertebral disc herniation.
Breakdown of anulus fibrosus
Extrusion of nucleus pulposus
Most commonly extrudes in posterolateral direction
Enters intervertebral foramen
PLL blocks excursion only in posterior direction
Compresses spinal nerve (typically a level below herniation)
Describe the surface anatomy of the lungs.
RALS
- right pulmonary artery anterior to primary bronchus
- left pulmonary artery superior to primary bronchus
Right lung:
- 3 lobes: superior, middle, inferior
- 2 fissures: horizontal and oblique
Left lung:
- 2 lobes: superior, inferior
- 1 fissure: oblique
- lingula
Explain what structures are remnants of fetal blood supply.
Ligamentum arteriosum: b/t pulmonary trunk and arch of aorta
Fossa ovalis: b/t left and right atria
