First Term Material Flashcards
Anatomical planes
flat surface that passes through the body to provide a frame of reference in 3D, includes frontal plane (coronal), transverse (horizontal) plane and saggital (medial) plane
Frontal plane
(coronal plane) divides the body into anterior and posterior portions
Transverse plane
(horizontal plane) divides the body into superior and inferior portions
Saggital plane
(medial plane) divides the body into right and left segments
Front of the body terminology
ventral or anterior
Back of the body terminology
dorsal or posterior
What does cranial refer to?
superior
What does caudal refer to?
inferior
Proximal
closer to the origin
Distal
further away from the origin
4 body tissues
epithelia, nervous tissue, muscle tissue and connective tissue
Epithelia
in general, is classified based on cell morphology and number of layers
Nervous tissue
main component of the brain, spinal cord and nerves
Muscle tissue
contractile tissue controlled either voluntarily (skeletal muscle) or involuntarily (cardiac and smooth muscles)
Connective tissue
tissue that connects, supports, binds or separates other tissues or organs
Types of Connective tissue
(1) proper connective tissue - can be loose tissue functioning as a binding tissue (ex. adipose tissue) or it can be dense tissue that resists mechanical stress (ex. ligaments, tendons and deep fascia)
(2) blood - transports medium for respiratory gases, nutrients and wastes
(3) bone - supports and protects organs, attachment site for muscles
(4) cartilage - provides cushion and support (ex. hyaline cartilage covering ends of bones and fibrocartilage between intervertebral discs)
Fascia
type of connective tissue, it can be (1) superficial fascia also known as the hypodermis (below the dermis), contains adipose (loose connective tissue), fat storage, passageway for nerves and blood vessels (2) deep fascia found between adjacent muscles, no fat, dense proper connective tissue, creates compartments, surrounds individual and groups of muscles and large nerves and vessels, reduces friction during muscle contractions
Joints
articulations or sites where two or more bones meet, provides stability and / or mobility to the skeleton
Classification of joints
(1) functional - immovable, slightly movable or freely movable joints
(2) structural - fibrous, cartilaginous or synovial joint
Fibrous joint
connected by dense regular connective tissue, lacks a joint cavity
Types of fibrous joints
(1) sutures - located between skull bones, immovable
(2) syndesmoses - connected by ligaments, movement range depends on length (ligaments of fibula and tibia)
(3) gomphoses - peg-in-socket joint for root of tooth
Cartilaginous joint
bones united by cartilage, lack a joint cavity
Types of cartilaginous joints
(1) synchondroses - hyaline cartilage, immovable
(2) symphyses - fibrocartilage, slightly movable
Synovial Joint
fluid-filled joint cavity, contains synovial fluid, classified according to degree of movement and shape
Classifying synovial joint based off degrees of movement
(1) non-axial movement - gliding does not involve rotation around an axis (plane joint - ex. intercarpal joint)
(2) uni-axial movement - movement around a single axis (hinge joint - ex. elbow) (pivot joint - ex. proximal radioulnar joint in forearm)
(3) bi-axial movement - movement around two axes (condyloid joint - ex. metacarpophalangeal joint) (saddle joint - ex. carpometacarpal joint at thumb), includes flexion extension abduction and adduction
(4) multi-axial movement - movement around multiple axis (ball and socket joint - ex. shoulder), flexion, extension, abduction, adduction and rotation in all planes
Human skeleton
consists of 206 bones including the axial skeleton (80) and the appendicular skeleton (126)
Axial skeleton consists of …
skull, vertebral column, ribs, sternum
Appendicular skeleton consists of …
upper and lower limbs, shoulder girdle (attaches the upper limb to the trunk) and the pelvic girdle (attaches the lower limb to the trunk)
Girdle
attaches the bone of the appendicular skeleton to the bones of the axial skeleton
Surfaces that form joints
(1) head - bony expansion on a narrow neck
(2) facet - smooth articular surface
(3) condyle - rounded articular projection
Projections that are sites of muscle and ligament attachments
(1) process - any bony prominence
(2) tubercle - small rounded projection
(3) tuberosity - larger rounded projection (can be rough)
(4) spine - sharp slender projection
(5) crest - narrow ridge
(6) line - narrow ridge, less prominent than crest
Depressions and openings of the bones
(1) fossa - shallow depression
(2) notch - indentation on edge of structure (looks like a bit out)
(3) foramen - round / oval opening through bone
Development of vertebrate from birth
fetus only has one curvature, at birth humans have a primary thoracic and sacral curves formed, once you become a child, you develop secondary cervical and lumbar curves, development of the curvatures are important for stability and holding up the head with increasing mass
Scoliosis
abnormal lateral curvature (spine curved away from midline)
Kyphosis
exaggerated thoracic curvature
Lordosis
exaggerated lumbar curvature
Anatomy of the vertebral column
7 cervical, 12 thoracic, 5 lumbar, 1 sacral (5 bones fused together) and 1 coccyx bones (4 fused together)
Pedicle
base of the superior and inferior articular processes
Cervical vertebrae
(C1-C7), bifid spinous process (shorter) (appearance is like a dolphin fin), transverse process on each side contains a foramen in them
Axis and Atlas
axis (C2) - has a projection known as the dens and this articulates with the atlas (C1), it is a large projection that goes up and articulates with the atlas
Injury to the atlas (C1)
vertical compressive force - force from skull onto the atlas, coming from above onto the skull causing a Jefferson fracture (burst), can occur from diving into shallow water, drives the base of the atlas and the posterior and anterior portions of the atlas detach
Injury to the axis (C2)
hyperextension of the head and neck can cause of traumatic spondylosis of C2 in a Hangman’s fracture, neck is in place and the head is forcefully extended, involves breaking between the inferior and superior articular processes of C2
Thoracic vertebrae
(T1-T12), the spinous processes are exaggerated (much longer), principle responsibility is interacting with the ribs, articulates with the ribs
Thoracic vertebrae and the ribs - articulation
ribs touch the spine in 3 locations - touching two vertebrae and a transverse costal facet, the transverse vertebrae contain a superior and inferior demifacet on each vertebrae and these are known as the superior costal facet and inferior costal facet, the head of the rib articulates with the inferior costal facet of the superior vertebra and the superior costal facet of the inferior vertebra, 3rd point of contact is the tubercle of the rib articulates with the transverse costal facet of the transverse process of the inferior vertebra
Costal groove
ribs offer protection for vessels that run in the costal groove (located on the lower inside of each rib)
Costal cartilage
attaches bone of the ribs to the sternum
Sternum
manubrium, the body of the sternum and the xiphoid process
Manubrium articulates with …
the first rib
True ribs
have their own costal cartilage connecting them to the sternum, ribs 1-7
False ribs
use the costal cartilage of the first 7 true ribs to reach the sternum, 8-12
Floating ribs
do not actually make contact with the sternum, not directly attached, ribs 11-12
Articulation point between axial and appendicular skeleton
is between the clavicle and the manubrium of the sternum
Shoulder girdle consists of …
clavicle and the scapula
Two joints of the shoulder girdle …
sterno-clavicular joint and the acromio-clavicular joint
Landmarks of the scapula
(1) acromion - highest point of the scapula, points out towards the should is on the dorsal scapula
(2) suprascapular notch - wedge cute away appearance, at the top of the scapula
(3) spine - divides the scapula into two fossas, the supraspinous fossa and the infraspinous fossa
Bicipital groove also known as
intertubercular groove
Parts of the more proximal humerus
head, neck, greater tubercle (more posterior) and lesser tubercle (more anterior) near the neck of the humerus, bicipital groove (or intertubercular groove) runs between the greater and lesser tubercle down the lateral humerus, where it meets up with the deltoid tuberosity, on the posterior shaft of the humerus is the radial groove
Parts of the more distal humerus
medial and later epicondyles, between the medial and lateral epicondyles posteriorly is the olecranon fossa, and anteriorly is the coronoid fossa, between the olecranon fossa and the coronoid fossa is the trochlea
Ulna plays a larger role in …
the elbow joint movement, but little in hand movement, therefore has a larger proximal end and a smaller distal end
Radius plays a larger role in …
wrist movement and little in elbow movement therefore has a larger distal end and a smaller proximal end
Head of the radius and the head of the ulna are …
opposite to one another, at the proximal radioulnar joint (near the elbow), the head of the radius articulates with the ulna in a pivot joint, and at the distal radioulnar joint (near the wrist) where the head of the ulna articulates with the radius
Ulna landmarks
olecranon is the more superior surface at the top, and coronoid process is the bottom of the trochlear notch, the radial notch is inferior to the trochlear notch on the posterior ulna and the ulna tuberosity is on the medial superior shaft, the styloid process of the ulna is at the distal end lateral to the head of the ulna
Radius landmarks
head and neck at proximal end, radius tubercle on the medial side, styloid process on the lateral distal end and ulnar notch (for the head of the ulna) at the medial distal end, dorsal tubercle is on the posterior distal end of the radius
Radius and ulna held together by
interosseous membrane
Falling on an outstretched arm
the radius head becomes more proximal when fractured (goes backward) when you fall on an outstretched arm, only the radius is fractured through this injury because it’s taking all of the pressure and force from the wrist, the ulna is often protected as its more proximal and inside articulating with the radius
Type of joint - sternoclavicular joint
bi-axial, saddle joint
Type of joint - acromioclavicular joint
non-axial, plane joint
Venue comitantes
deep veins are often paired with arteries, this pairing is known as venue comitantes
Veins of the brachium (and just above)
subclavian vein passes first rib and then becomes axillary vein which branches off to form the cephalic vein and then further down branches off to the anterior and posterior circumflex humeral veins and at about teres major the axillary vein becomes the basilic vein and the brachial vein … basilic vein runs medially down the arm and cephalic runs laterally down the arm and the median cubital vein connects the two in the cubital fossa
Zygapophyseal joint
also known as facet joint - where the inferior and superior facets come together of the vertebral column
damage to the anterior longitudinal ligament
extreme hyperextension
damage to the supraspinous ligament
hyperflexion
ligamentum flava
connects laminae of adjacent vertebrae
pars interarticularis
piece between articulations, located between inferior and superior articular processes of the facet joint
spondylolysis
spine divide common at L4/L5 due to repeated stress fractures caused by hyperextension (ex. gymnastics), excessive hyperextension
spondylolisthesis
spine slips forward, facet joint is no longer able to hold vertebrae in place against force of bodyweight, if compromised, it can slip
enlargements of the spinal cord
braids of nerves leaving at the region at cervical and lumbar because nerves leave to upper and lower limbs at these points
Vertebral column ends at …
L2, but nerve roots continue lower
Filum terminale
fibrous terminal filament, runs from the end of the spinal cord to the coccyx
Pairs of cervical spinal nerves
8 pairs, but only 7 cervical vertebrae because the cervical nerves exit above the corresponding vertebra, but there is an eighth one below C7
Spinal nerves leaving vertebra (other than cervical region)
they exit below the corresponding vertebra
How many pairs of spinal nerves are there?
31 pairs - 8 cervical, 12 thoracic, 5 lumbar, 5 sacral and 1 coccyx
Meninges
3 connective tisse membranes that protect the CNS and blood vessels, including dura mater (more external), arachnoid mater (middle layer) and the pia mater (right on the outside of the spinal cord)
denticulate ligament
pair, one on each side and it is an extension of the meninges - lateral expansion of the pia mater
white matter
region outside of the grey matter (spinal cord), myelinated area of the cells axons, myelinated
Epidural space
above the dura - child bearing
Subdural space
below the dura - only potential space (becomes a space if there is bleeding of the spinal cord or there is trauma)
subarachnoid space
below the arachnoid meninge - lumbar puncture (spinal tap), contains cerebrospinal fluid which acts as a cushion for the CNS, nourishes brain and spinal cord
Mixed spinal nerve
has both motor and sensory roots
grey matter
unmyelinated
Peripheral nervous system
ventral (motor) and dorsal (sensory) roots
Voluntary Muscle / Motor of the spinal cord
ventral horn of spinal cord –> ventral root –> mixed spinal cord –> ventral OR dorsal ramus (branch) –> muscle
(may also have its own nerve that goes from the ventral or dorsal ramus to its own nerve and then to the muscle)
Sensory Innervation of the spinal cord
sensory receptor –> ventral OR dorsal ramus (branch) –> mixed spinal nerve –> dorsal root ganglion (neuronal cell body) –> dorsal root –> dorsal horn of spinal cord
(if it is skin of the anterior side of the body it starts from the ventral ramus and then to the mixed spinal nerve and then continues through dorsal root)
Sympathetic trunk ganglion
swelling of the synapse location going from pre into the ganglion to fire and then going to the post ganglion
lateral horn
autonomic nervous system output, motor coming out, goes down ventral root of thoracolumbar region, communicating branch is myelinated (white matter)
deltopectoral triangle
between the pectoralis major and the deltoid and this is where the cephalic vein comes through
Why is the clavicle’s inferior side rough
because it attaches to the subclavius muscle there
Waiter’s tip position
upper injury caused by head / neck movement, damage to C5 and C6 roots, cannot abduct (axillary nerve cannot innervate deltoid), laterally rotate (axillary nerve cannot innervate teres minor) or supinate (musculocutaneous nerve cannot innervate biceps brachii, therefore arm is in position of adduction, medial rotation and pronation (arm facing backwards to normal anatomical position)
Claw hand
caused by excessive upward pull of limb, damage to C8 and T1, ulnar nerve cannot fire and median nerve is weakened, therefore cannot make full fist because flexor digitorum profundus, flexor digitorum superficialis, flexor carpi ulnaris, flexor carpi radialis cannot be fired effectively
Ape hand
thumb hardly moves, cannot perform abduction and opposition because recurrent branch of median nerve does not function, can still flex thumb because flexor palmaris longus from anterior interosseous nerve has higher innervate than carpal tunnel
Wrist drop
being unable to extend your wrist, damage to extensor digitorum
bicipital aponeurosis
sheath that hold contents of the anterior arm
triangular space of the brachium
superior boundary - teres minor, inferior boundary = major and lateral = triceps long head, circumflex scapular artery
Quadrangular space
triceps long head is the medial border, humerus is the lateral border and inferior and superior are teres minor and teres major, this is where axillary nerve and the posterior circumflex humeral artery
Triangular interval
moving triceps laterally, teres major, humerus and long head of triceps make up this space and this is where the profunda brachii artery comes out as well as the radial nerve (on top of the radial groove of the posterior humerus)
Ligaments of the sternoclavicular joint
anterior and posterior sternoclavicular ligament, costoclavicular ligament and the interclavicular ligament
Ligaments of the acromioclavicular joint
acromioclavicular ligament and the coracoclavicular ligaments including the trapezoid ligament and the conoid ligament
Subluxation of the shoulder joint
partial dislocation, occurs from an indirect force to the shoulder, still more muscles to maintain the integrity of the shoulder / scapula, only acromioclavicular ligament it torn
Dislocation of the shoulder joint
full dislocation, occurs from direct force on the shoulder, trapezoid and conoid ligaments are fractured (coracoclavicular ligaments) as well as the acromioclavicular ligament
Ligaments of the glenohumeral joint
coracohumeral ligament - does not bend with the joint capsule, prevents superior dissolution of the humerus (strengthens superior portion) and the glenohumeral ligaments - superior, middle and inferior ligaments resists hyperextension of the head of the humerus
Dislocation of the humerus damages …
the axillary nerve causing weakness abducting fully and loss of sensation over the shoulder
Weakest and thinnest band of the elbow joint ligaments
oblique band between ulna and humerus
Supination vs. pronation
supination is the active uncrossing and pronation is the crossing of the radius and ulna bones
Tommy John surgery
taking tendons of the contralateral limb to replace the ulnar collateral ligament, replacement surgery, tendon graph, important to tighten the joint of the elbow
motor deficits of carpal tunnel
recurrent branch of median nerve is not functional therefore cannot abduct or oppose the thumb, but can flex because flexor pollicis longus is innervated by anterior interosseous nerve of the median nerve higher up, median nerve is crushed under extensor retinaculum of the wrist
Sensory innervation of the median nerve of the hand
anterior surface of the thumb and digits 2-4.5 and the posterior surface of digits 2-4.5
Sensory innervation of the ulnar nerve of the hand
posterior and anterior surface of digits 4.5 and 5
Sensory innervation of the radial nerve of the hand
posterior surface of the thumb and lower digits 2 and 3
Sensory innervation of the palmar branch of the medial nerve
palm by the thumb and half way up to digits 2 and 3, this is spared during carpal tunnel because the palmar branch of the medial nerve goes about the extensor retinaculum
Stuff box of the wrist
made by the tendons of the extensor pollicis longus and extensor pollicis brevis, scaphoid and trapezium bones of the carpals form the floor
