Gross Anatomy- Assessment 1 Flashcards
where do intrinsic back muscles come from?
epimere of somite
where do extrinsic back muscles come from?
hypomere of somite
how are vertebra formed?
caudal and cranial aspects of somites fuse
muscles come out of the somites as well
what makes intrinsic back muscles intrinsic? what is the innervation?
attach to the spinal column only and primary movers of spinal column
primary posterior rami
what makes extrinsic back muscles extrinsic? what is the innervation?
attach to spinal column and upper limb and move the upper limb
primary anterior rami
Name the intrinsic back muscles
erector spinae - iliocostal (lateral) -logissimus (middle) -spinalis (medial) transversospinalis muscles - semispinalis -rotatores -multifidus splenius
boarders of the suboccipital triangle
medial- rectus capitis superior major
- rectus capitis superior minor is medial to it
lateral- obliquus capitis superior
inferior- obliquus capitis inferior
what innervates the muscles in the suboccipital triangle?
suboccipital nerve- dorsal ramus of C1
what is special about the vertebral artery?
atherosclerosis can result in dizziness
what arteries and nerves are involved in the suboccipital triangle?
suboccipital nerve- dorsal ramus of C1- inside triangle
greater occipital nerve- dorsal ramus if C2- passes inferior to the triangle, goes to skin
vertebral artery- inside the triangle
where is the suboccipital triangle?
centered over the posterior arch of the atlas
where is the lesser occipital nerve?
comes out medially to sternocleidomastoid muscle and then travels posterior to it up into the head
where is the occipital artery?
comes out lateral to nuchal ligament at superior nuchal line of the skull
what are the boarders of the triangle of auscultation?
medial- trapezius
lateral inferior- latissimus dorsi
lateral superior- fascia of scapular muscles
what is spin bifida occulta?
incomplete formation of the mural arch, lamina does not reach spinous process
hair tuft above misformed vertebra
prevented by folic acid
what travels through the transverse foramen?
vertebral artery
which spinal level has transverse foramen?
cervical
which vertebra is the dens on?
C2 axis
which vertebra supports the skull?
C1 atlas
articular facets in the thoracic region allow for which kind of bending?
lateral bending- facets face anteriorly (inferior) and posteriorly (superior)
articular facets in the lumbar region allow for which kind of bending?
flexion and extension- facets face medially (superior) and laterally (inferior)
unique features of cervical vertebra
small vertebral bodies
short, bifid spinous processes
large triangular vertebral foramen
transverse foramen
unique features of thoracic vertebra
heart shaped vertebral bodies
long, posteriorly angled spinous processes
round vertebral foramen
costal facets
unique features of lumbar vertebra
large, kidney shaped vertebral bodies
short, hatchet shaped spinous processes
triangular vertebral foramen
what are the primary curvatures? when do they develop?
thoracic and sacral
concave anteriorly
develop during fetal life
what are the secondary curvatures? when do they develop?
cervical and lumbar
concave anteriorly
develop when baby lifts head (cervical) and stands (lumbar)
what is the purpose of the curvatures?
maintain balance
increase resistance and strength for weight bearing
reduce weight on vertebral column
what is kyphosis
exaggerated thoracic curvature do to erosion of anterior aspect of vertebral bodies
what is lordosis
exaggerated lumbar curvature due to weakened trunk muscles
what is scoliosis
laterally bent spin
causes asymmetrically intrinsic back muscle weakness and rib hump
leg height differences
what are epiphyseal rims?
outside part of vertebral bodies where the annulus fibrosis connects
anterior longitudinal ligament- location and purpose
anterior aspect of vertebral bodies
resists extension
posterior longitudinal ligament- location and purpose
posterior aspect of vertebral bodies
resists flexion
diamond shaped- wider at discs
ligamentum flavum- location and purpose
anterior lamina
limits flexion
used to guide spinal taps
where is the interspinous ligament
between spinous processes
where is the superspinous ligament
on top of spinous processes
what is the cervical enlargement of the spinal cord
thickening of the spinal cord between C4-T1 for upper limb innervation
what is the lumbar enlargement of the spinal cord
thickening of the spinal cord between T11-L1
what is the conus medlars? where is it?
inferior tapering of the spinal cord around L2
what is the caudal equina?
horse’s tail, nerve roots extending from the spinal cord and run past where the spinal cord ends
what does the filum terminale do? where is it?
anchors the inferior end of the spinal cord and the meninges
starts at tip of conus medlars and inserts into coccyx
where does the dural sac end?
S2
Spinal cord rule of 2
spinal cord ends- L2
dural sac ends- S2
filum terminale anchors at Co2
3 layers of spinal meninges?
dura mater- outer, tough layer
arachnoid mater- thin, spider-web-like layer attached to dura mater
pia mater- thin, avascular layer on top of spinal cord
spaces in spinal canal?
epidural space- outside dura, veins and fat
subdural space- between dura and arachnoid mater
subarachnoid space- between arachnoid and pia mater, contains CSF and blood vessels
which spinal canal space is abnormal?
subdural space
what are the denticulate ligaments?
saw/tooth like extensions of the pia mater that anchor the spinal cord to the dural sac
what is the lumbar cistern?
between L2 and S2
dilation of the subarachnoid space where CSF pools
communicates with brain CSF
where spinal tap/lumbar punctures are performed
in which space is a spinal anesthetic given?
epidural
organization of the spinal cord arterial supply
anterior artery- anterior 2/3
2 posterior arteries- posterior 1/3
segmental medullary arteries- enter via the roots and supplement the main spinal arteries at the enlargements
radicular arteries- supplies the roots, anterior and poster sections
blood supply to cervical spine
vertebral arteries supply spinal and medullary arteries
where are the vertebral arteries?
run through transverse foramen on cervical vertebra
blood supply to thoracic spine
intercostal arteries supply medullary arteries
blood supply to lumbar spine
lumbar arteries supply medullar arteries
blood supply to sacral spine
sacral arteries supply medullary arteries
what is the most important artery that supplies the spinal cord? what does it supply?
major anterior segmental medullary artery of Adamkiewicz
supplies the lumbar enlargement and comes from the lumbar artery
what happens of the adamkiewicz artery is compromised?
lower limb paralysis
what is unique about the spinal veins? why is it important?
no valves, cancer can metastasize to the brain through them, specifically prostate
what venous root supplies the metastasis pathway?
internal vertebral (epidural) venous plexus
what is the venous drainage of the spinal cord?
internal veterbral plexus
external vertebral plexus
anterior spinal vein
posterior spinal vein
what do the recurrent meningeal nerves supply?
dura mater
periosteum of vertebrae
outer annulus fibrosis
posterior longitudinal ligament
where do the recurrent meningeal nerves come from? how do they get to their target?
spinal nerves
go back into vertebral canal via inter vertebral foramen
what muscles are in the rotator cuff?
supraspinatus
infraspinatus
teres minor
subscapularis
what is the function of the rotator cuff?
protect and stabilize the glenohumeral joint
what passes through/deep to the quadrangular space?
axillary nerve and posterior circumflex humeral artery pass through it
where is the quadrangular space?
medial to humerus, lateral to triangular space on lateral scapula
what are the boarders of the quadrangular space?
lateral- lateral head of triceps brachii (surgical neck of humerus)
superior- teres minor
medial- long head of triceps brachii
inferior- teres major
what passes through/deep to the triangular space?
circumflex scapular artery passes deep to it
where is the triangular space?
medial to the quadrangular space on lateral scapula
what are the boarders of the triangular space?
lateral- long head of triceps brachii
superior- teres minor
inferior- teres major
where is the cephalic vein?
in the deltopectoral triangle- very superficial between the anterior deltoid and pectorals major muscles
where are the supra scapular nerve and artery?
deep to the supraspinatus and the infraspinatus
Arm goes over the bridge, navy goes under the bridge
suprascapular artery passes over the superior transverse scapular ligament
suprascapular nerve goes under it
where is the circumflex scapular artery?
deep to triangular space
where is the posterior humeral circumflex artery?
traveling through the quadrangular space with the axillary nerve
where is the axillary nerve?
traveling through the quadrangular space with the posterior circumflex humeral artery
where is the suprascapular artery?
travels down to scapula over the superior transverse scapular ligament and superior to scapula
where is the suprascaupular nerve?
travels down to scapula under the superior transverse scapular ligament and superior to scapula
where is the greater occipital nerve?
passes inferior to the suboccipital triangle and goes out to the skin
where is the suboccipital nerve?
passes through the suboccipital triangle
where is the dorsal scapular artery?
travels anterior to the levator scapulae and down medially to the scapula with the dorsal scapular nerve
where is the transverse cervical artery?
branch of subclavian and then branches into deep and superficial branches
what is the dorsal scapular artery a branch of?
subclavian or the transverse cervical artery
what is the dorsal scapular artery called if it branches off of the transverse cervical artery?
deep branch of the transverse cervical artery
where is the dorsal scapular nerve?
travels anterior to the levator scapulae and down medially to the scapula with the dorsal scapular artery
what is the drainage path of the cephalic vein?
cephalic–>axillary–>subclavian–>brachiocephalic–>superior vena cava
what is the cephalic vein clinically used for?
catheters and pic lines
what is the drainage path of the basilic vein?
basilic–>axilary–>subclavian
where is the basilica vein?
medial side of anterior arm
where is the median cubital vein?
in the cubital fossa running transversely between the cephalic and basilc veins
where is the olecranon fossa?
posterior humerus hole between the epicondyles
where is the trochlea?
posterior humerus lateral thing below the olecranon fossa
where are the supracondylar ridges?
distal medial and lateral aspects of the humerus
what is the apex boundary of the axilla?
neck entrance between first rib and clavicle
what is the base of the axilla?
skin and fascia between the arm and thorax
what is the posterior wall of axilla?
scapula and subscapularis, trees major, and latissimus dorsi muscles
what is the anterior wall of the axilla?
pectoral major and minor muscles
what is the medial wall of the axilla?
thoracic wall and serratus anterior muscle attachments
what is the lateral wall of the axilla?
intertubercular groove of the humerus
what are the boundaries of the posterior axillary fold?
trees major and pectoralis intersection
what are the boundaries of the anterior axillary fold?
pectorals major crossing into arm
what structures are in the axillary region?
cephalic vein, axillary vein, axillary artery, brachial plexus
what is a neuromuscular bundle?
arteries, veins, nerves, and lymph vessels bundled together in loose connective tissue sheaths
where does the axillary artery come from? where does it start? where does it end?
subclavian artery turns into the axillary artery after the first rib
the axillary artery turns into the brachial artery around the lateral boarder of the scapula
what are the boarders of the 3 sections of the axillary artery?
section 1- first rib to superior pectoralis minor boarder
section 2- under pectoralis minor
section 3- inferior pectoralis minor boarder to lateral scapular boarder
what are the branches of the axillary artery?
superior thoracic thoraco-acromial lateral thoracic subscapular anteiror humeral circumflex posterior humeral circumflex
sixties teens love sex and pot
pneumonic for branches of axillary artery
branches of the thoraco-acromial artery
clavicular branch
acromial branch
deltoid branch
pectoral branch
cadavers are dead people
pneumonic for branches of thoraco-acromial artery
branches of the sub scapular branch
scapular circumflex
thoracodorsal
sex leads to STDs
pneumonic for subscapular branch
what is collateral circulation? why is it bad?
loops between multiple branches of major arteries to provide circulation in both directions
it is bad if there is a bleed in it because blood is coming form both directions
which arteries form the collateral circulation of the scapula?
scapular circumflex and suprascapular arteries
what muscles does the collateral circulation of the scapula supply?
infraspinatus and supraspinatus
what does the posterior circumflex humeral artery supply?
deltoid
teres major
teres minor
long head of biceps bracii
what does the lateral thoracic artery supply?
pectoralis major
pectoralis minor
serratus anterior
what are the posterior shoulder muscles?
supraspinatus infraspinatus latissimus dorsi deltoid trees major teres minor long head of triceps brachii
what are the anterior shoulder muscles?
pectoralis major
pectoralis minor
serratus anterior
what are the branches of the subclavian artery?
dorsal scapular
transverse cervical
what does the dorsal scapular artery supply?
rhomboid major and minor
what does the transverse cervical artery supply?
levator scapulae
trapezius
what spinal roots are in the brachial plexus?
C5-T1
real trainers drink cold nitwit juice
order of the brachial plexus pieces
roots, trunks, divisions, cords, nerves
my aunty raped my uncle
brachial plexus terminal nerves musculocutaneous axillary radial median ulnar
ULTRA
nerves off of the posterior cord of the brachial plexus upper scapular thoracodorsal lower scapular radial axillary (switch T/L and R/A)
M nerves
nerves off of the medial cord
medial pectoral
medial brachial cutaneous
medial antebrachial cutaneous
S nerves
nerves off of the superior trunk of the brachial plexus
suprascapular
subclavious
nerves off of C5 of brachial plexus
dorsal scapular long thoracic (combines with others)
nerves off of lateral cord of brachial plexus
lateral pectoralis
what does the median nerve come from?
lateral root of lateral cord
medial root of medial cord
what muscle groups are in the anterior arm compartment? what nerve innervates them?
shoulder and elbow flexors
musculocutaneous nerve
what muscle groups are in the posterior arm compartment? what nerve innervates them?
shoulder and elbow extensors
radial nerve
what does the dorsal scapular nerve supply?
levator scapula
rhomboid major
rhomboid minor
what does the supra scapular nerve supply?
supraspinatus
infraspinatus
what does the thoracodorsal nerve supply?
latissimus dorsi
what does the axillary nerve supply?
teres minor
deltoid
what does the lower sub scapular nerve supply?
subscapularis
teres major
what does the upper sub scapular nerve supply?
subscapularis
what does the long thoracic nerve supply?
serratus anterior
what happens if the long thoracic nerve is compromised?
winged scapula- serratus anterior is no longer holding the scapula against the thoracic wall
what muscles are in the anterior arm compartment?
coracobrachialis
biceps bracii
brachialis
what muscles are in the posterior arm compartment?
triceps bracii
where is the pectoral branch of the thoracoacromial artery?
goes between the pectoralis major and minor muscles
largest branch of the thoracoacromial artery
where is the deltoid branch of the thoracoacromial artery?
in the deltopectoral groove with the cephalic vein
where is the acromial branch of the thoracoacromial artery?
superior to coracoid process and goes toward acromion
where is the clavicular branch of the thoracoacromial artery?
superior and medial towards the subclavius muscle and sternoclavicular joint
where is the lateral thoracic artery?
lateral boarder of the pectoralis minor muscle
where is the axillary vein?
with the axillary artery
what are the boarders of the cubital fossa?
distal- medial/lateral epicondyles
medial- pronator teres
lateral- brachioradialis
floor- brachialis, supinator
what structures pass through the cubital fossa?
radial nerve brachial artery brachial recurrent artery median nerve ulnar artery radial artery
where does the ulnar nerve go near the cubital fossa?
around near medial epicondyl
what muscles are involved in forearm pronation and supination?
pronator teres
pronator quadratus
supinator
where are the forearm pronators/supinators?
very deep, right on bone under all the flexors and extensors and their ligaments
where at a joint are blood vessels and nerves more protected?
inside the joint
what is the difference between pronation/supination and rotation?
pronation/supination involves 2 bones crossing over one another
rotation does not
what muscle does the median nerve go through?
pronator teres
where is the long thoracic nerve?
superficial to the serratus anterior muscles- very injury prone
what muscles originate at the common extensor tendon?
extensor digitorum
extensor digiti minimi
extensor carpi ulnaris
extensor carpi radialis
what is tennis elbow?
inflammation of the common extensor tendon
what innervates the forearm extensors?
radial nerve or its branches
where does the deep radial artery of the arm (profunda brachia) branch from and travel?
branches from brachial artery inferior to teres minor and travels posterior to humerus and down through the radial groove with the radial nerve
what is the order of structures in the cubital fossa?
lateral- biceps tendon
middle- brachial artery
medial- median nerve
what is the positioning of structures in the cubital fossa relative to the bicipital aponeurosis?
brachial artery and median nerve are deep
superficial veins are superficial
where is the medial head of the triceps brachii?
deep to lateral and long heads
what passes through the anatomical snuff box?
radial artery
what does the median nerve innervate?
most of the flexors and the pronators
what does the radial nerve innervate?
extensors, supinators, brachiradialis
what does the ulnar nerve innervate?
flexor carpi ulnaris
flexor digitrum profundus (part)
what innervates most of the posterior forearm muscles?
radial nerve
what innervates most of the anterior forearm muscles?
median nerve
what innervates the rest of the forearm muscles that are not innervated by the median nerve?
ulnar nerve (2)
what are the movements of digits 2-5?
flexion/extension
abduction, adduction
what are the movements of the thumb?
flexion/extension
abduction/adduction
opposition/reposition
order of the superficial extensors (lateral to medial)
carpi radialis longus carpi radialis brevis digitorum digiti minimi carpi ulnaris
what are the boarders of the anatomical snuff box?
extensor pollicis longus and brevis
what is the order of the posterior intermediate muscles? (lateral to medial)
abductor pollicis longus
extensor pollicis longus
what is the order of the posterior deep muscles? (lateral to medial)
extensor pollicis brevis
extensor indicis
what do the carpi radialis muscles do in addition to their prefix word?
abduct wrist
what do the carpi ulnaris muscles do in addition to their prefix word?
adduct wrist
what is the order of the superficial flexors lateral to medial?
carpi radialis
palmaris longus
carpi ulnaris
what is the order of the intermediate flexors lateral to medial?
digitorum superficialis
what is the order of the deep flexors lateral to medial?
pollicis longus
digitorum profundus
which muscles originate at the common flexor tendon?
pronator teres flexor carpi radialis palmaris longus flexor carpi ulnaris flexor digitorum superficialis
what muscle attaches at the anterior oblique line of the radius?
flexor digitorum superficialis
what structures pass under the tendinous arch of the forearm?
ulnar artery
median nerve
carpal bones
scaphoid lunate triquetrum pisiform trapezium trapezoid capitalte hamate
scared lovers try positions that they can’t handle
ANTERIOR
lateral to medial, proximal to distal
triquetrum, trapezium, trapezoid (q, zium, zoid)
which carpals have special features? what are they?
hamate- hook of hamate on anterior view
pisiform is anterior to the triquetrum
scaphoid- tubercle of scaphoid
trapezium- tubercle of trapezium
what structures pass through the carpal tunnel?
flexor digitorum profundus
flexor digitorum superficialis
flexor pollicis longus
median nerve
where do the ulnar nerve and artery pass at the wrist?
medial anterior to the carpal tunnel (anterior to hamate)
where does the radial artery pass?
lateral posterior to trapezium
what ligament forms the carpal tunnel?
flexor retinaculum
where is the scaphoid?
most lateral of the proximal row
where is the lunate?
middle of proximal row
where is the traquetrum?
most medial of proximal row
where is the pisiform?
most medial of proximal row anterior to traquetrum
where is the trapezium?
most lateral of the distal row
where is the trapezoid?
second lateral of distal row
where is the capitate?
second medial of distal row
where is the hamate?
most medial of distal row
what innervates the skin of the hand? where does it pass through?
branches of the median nerve that pass anteriorly to the flexor retinaculum
what are symptoms of carpal tunnel syndrome?
compression of median nerve causing hypesthesia or parethesia and weakened grip, allows for passive grip if flexor muscle function is compromised
which flexor muscle tendon is the V in the digits?
flexor digitorum superficialis
which flexor muscle tendon is the I in the digits?
flexor digitorum profundus
where are the lumbricals?
between the flexor digitorum profundus ligaments in the central compartment
what is the order of the superficial palm muscles? lateral to medial
abductor pollicis brevis
pamlaris brevis
what is the order of the intermediate palm muscles? lateral to medial
opponens pollicis
flexor pollicis brevis
flexor digiti minimi brevis
abductor digiti minimi
what is the order of the deep palm muscles? lateral to medial
adductor pollicis
opponens digiti minimi
where are the interosseous muscles?
between the metacarpals, deep to the lumbricals
what are the arterial arches in the hand?
superficial palmar arterial arch
deep palmer arterial arch
what arterial branches to to the digits?
common palmar digit arteries
proper palmar digit arteries
what combines to form the superficial palmar arterial arch?
superficial branch of radial artery
ulnar artery
what supplies the deep palmar arch?
radial artery and deep palmar branch of ulnar artery
what are the thenar muscles?
opponens pollicis
abductor pollicis brevis
flexor pollicis brevis
what are the hypothenar muscles?
abductor digiti minimi
opponens digiti minimi
flexor digiti minimi brevis
what do the palmar interosseous muscles do?
adduct digits
what do the dorsal interosseous muscles do?
abduct digits
what are dermatomes?
regions of sensory innervation corresponding to nerve roots
what are myotomes?
regions of motor innervation corresponding to spinal nerve roots
what is the difference between cutaneous innervation the and dermatome?
cutaneous is for the actual nerves off of the brachial plexus
dermatomes are the original spinal nerve roots
what innervates the top of the shoulder?
supraclavicular
what innervates the lateral side of the shoulder?
axillary
what innervates the medial side of the arm?
medial cutaneous of the arm
what innervates the lateral lower arm?
radial
what innervates the medial forearm and the middle of the arm?
medial cutaneous of the forearm
what innervates the lateral side of forearm?
musculocutaneous
what innervates the pinky and half of the ring finger?
ulnar nerve
what innervates the rest of the fingers?
median nerve
what nerve roots go to what part of the hand?
C6- thumb
C7- palm, digits 2,3
C8- lateral part of digit 4, 5
T1- none
what is pronator syndrome?
median nerve entrapment in the pronator teres
NOT carpal tunnel
symptoms worse with repetitive motions
have symptoms proximal to carpal tunnel (forearm weakness)
Reflex pneumonic
One Two tie your shoe- ankle reflex (L1 and L2)
Three Four kick the door- knee extension (L3 and L4)
Five Six- pick up sticks- biceps reflex (C5 C6)
Seven Eight- lay them straight- triceps reflex (C7 and C8)
what nerve is the biceps reflex testing?
musculocutaneous
what nerve is the triceps reflex testing?
radial nerve
what nerve is the brachioradialis reflex testing?
radial nerve
where is the brachiradialis reflex done?
near styloid process of radius
what is hyporeflexia?
weaked reflex response
what is areflexia?
no reflex response
what do hyporeflexia and areflexia indicate?
damage to: skeletal muscles, dorsal/ventral nerve roots, spinal nerves, spinal cord, brain
what is hyperreflexia and what does it indicate?
exaggerated response, indicates higher up brain issues or spinal cord compression
midshaft humerus fracture injures what nerve?
radial nerve- radial nerve sits in radial groove along posterior humerus right against the bone
what results from a radial nerve injury?
weakness in medial head of triceps, defects in forearm extensors, supinator, and brachioradialis (posterior forearm muscles)
what is the presentation for a radial artery injury?
wrist drop- lack of flexion
avulsion injury where the head is thrown back from the shoulder injures what nerve?
upper trunk of brachial plexus
what results from an injury to the upper trunk of brachial plexus?
loss of radial nerve- forearm extensors
preservation of:
median nerve- C7-T1 forearm flexors and pronators
ulnar nerve- flexor carpi ulnaris and flexor digitorum profundus
thoracodorsal- lanissimus dorsi
medial pectoral nerve-
what is waiters tip (pronated hand, shoulder adducted, forearm flex, claw grip) indicative of?
brachial plexus upper trunk injury
what results from an ulnar nerve injury?
hypothenar group muscle atrophy
what is claw grip indicative of?
ulnar nerve injury
can’t extend digits 4 or 5
what is benediction hand indicative of?
can’t flex digits 1-3
median nerve injury
when should you suspect restricted blood flow?
weak pulse
normal reflex and nerve conduction test
what is the most common shoulder dislocation?
anterior dislocation
what is sensory deficit over the shoulder and failure to abduct > 15 degrees indicative of?
axillary nerve damage second to anterior shoulder dislocation
falling on outstretched hand causes what type of fracture?
colles fracture- distal radius fracture which causes secondary fracture of the styloid process of the ulna due to brachioradialis displacement of the bone
what is the most commonly fractured carpal?
scaphoid
what is a complication of a scaphoid fracture?
necrosis of anterior scaphoid due to lack of blood supply because the fracture compromised artery
what is the hook of hamate attachment for?
flexor retinaculum
flexor digiti minimi brevis
opponens digiti minimi
what do pseudo unipolar do? where are they?
sensory
in the posterior roots
what do multipolar neurons do?
motor
in the anterior roots
what does the posterior horn look like?
skinny, top of the butterfly, next do the DRG
what does the anterior horn look like?
fat, bottom of the butterfly
where do primary posterior rami go?
intrinsic back muscles and skin over them
where is the vasonervorum?
blood supply to the epinerium of nerves
which levels are segmented nerves?
T2-T12
which cranial nerve does not originate from the brain? where does it go?
accessory nerve (CN XI) innervates the trapezius and sternocladomastoid
what is a dorsal rhizotomy?
cut the posterior root of spinal nerve to relieve chronic pain
where are bipolar neurons?
special senses- vision and smell
where do pseudo unipolar neurons synapse?
dorsal/posterior horn
where do multipolar neurons originate from?
ventral/anterior horn
where do multipolar presynaptic cell bodies of the parasympathetic nervous system arise?
ventral horn of cranial and lumbosaccral
where do multipolar presynaptic cell bodies of the sympathetic nervous system arise?
interomediolateral (IML) column of T1-L2 (aka lateral horn)
where do visceral motor neurons go?
cardiac muscle, smooth muscle, glands
how many neurons are involved in visceral sensory?
1- single pseudo unipolar neuron with cell body in the DRG
how many neurons are involved in the autonomic motor system?
2- presynaptic in the spinal cord and postsynaptic in a ganglia
where do presynaptic sympathetic neuron synapse?
sympathetic chain ganglia right outside of spinal cord
what are the options once a presynaptic sympathetic neuron gets into the sympathetic chain ganglia?
synapse and exit
go up/down a level and synapse and exit
where are the sympathetic chain ganglia?
run from magnum foramen to tip of coccyx
where do cranial nerves exit?
skull foramina
where do spinal nerves exit?
intervertebral foramina
what is the entrance to the sympathetic chain ganglia?
white rami communicants ONLY found in T1-L2
what is the exit to the sympathetic chain ganglia?
gray rami communicans in entire spinal cord
what spinal roots are in the cervical plexus?
C1-C4
what spinal roots are in the brachial plexus?
C5-T1
what spinal roots are in the lumbar plexus?
L1-L4
what spinal roots are in the thoracic plexus?
None- no plexus here, they are segmental
what spinal roots are in the sacral plexus?
L4-S4
difference between sympathetic and parasympathetic neuron lengths
sympathetic- short pre, long post
parasympathetic- long pre, short post
what NTs does the autonomic nervous system use?
sympathetic post- NE (sweat glands ACh)
parasympathetic post- ACh
both pre- ACH
what is the function of the sympathetic nervous system?
fight or flight
what is the function of the parasympathetic nervous system?
rest and relax
what do the cephalic arterial rami do?
go to periarterial plexuses of carotid arteries to get to the head for distribution there
what do the parietal branches of the sympathetic trunk do?
vasomotion
sudomotion- sweat glands
pilomotion- goosebumps
What is Horner’s syndrome? what are the symptoms?
loss of sympathetic control of head symnptoms: ptosis- eyelid drooping miosis- constrictued pupil anhydrosis- can't sweat erythema- loss of vasoconstriction
cranial component of parasympathetic nervous system gets what body parts?
head down to colic flexure
sacral component of parasympathetic nervous system gets what body parts?
GI tract distal to the colic flexure
what is a morula?
solid ball of cells with a protective outer layer formed via mitotic divisions formed as the zygote travels down uterine tube
what is and what are the parts of a blastocyst?
hollow ball of cells
inner cell mass- clump of cells inside
trophoblast- outer cell layer
blastocele- fluid filled compartment
what part of the embryo becomes the human?
inner cell mass
what does the trophoblast become?
extra embryonic tissues
what is the space between the trophoblast and the epiblast?
amniotic cavity
what does the epiblast become?
embryo
what is the layer of cells of the inner cell mass toward the amniotic cavity?
epiblast
what is the layer of cells of the inner cell mass toward the blastocoele?
hypoblast
what does the hypoblast become?
yolk sac
what is the primitive streak?
thickening of epiblast cell layer on blastodisc
what is a blastodisc?
epiblast and hypoblast layers
what order does epiblast cell migration occur it?
cranially first, then caudally
what is mesenchyme?
moving mesoderm
what is derived from the ectoderm?
skin and nervous tissue (including adrenal medulla)
what is derived from the endoderm?
lining of gut tubes
what is derived from the mesoderm?
everything else that is not skin, nervous tissue, or lining of tubes
what are the structures/areas that are formed during epiblast migration?
prechordal plate- area superior to primative pit
notochord- between prechordal plate and primitive pit
buchoforengial membrane- cranial area with no mesoderm
cloacal membrane- caudal area with no mesoderm
what does the buchoforengial membrane become?
mouth
what does the cloacal membrane become?
anus
what is caudal dysgenesis?
caudal end of embryo fails to develop- levels of severity
what is sirenomelia?
most severe form of caudal dysgenesis, complete lack of caudal structures
what is the nucleus pulpous derived from?
notochord
what are the vertebra and meninges derived from?
mesoderm surrounding the notochord
what determines the body axes?
primative node
what is reversal of laterality sequences?
defect in primitive node determination of body axes- results in body structures on the wrong side of the body
what is situs inverses?
complete flip of body organs from normal (heart points right)
what does the paraxial mesoderm give rise to?
somites
what does the intermediate mesoderm give rise to?
urogenetial system
what does the lateral mesoderm give rise to?
space of future body cavities
what does the neural crest form?
peripheral nervous system
in what order does the neural tube close in?
starts in cervical and works out
anterior closes before posterior
what is anancephaly?
brain doesn’t form because anterior aspect of neural tube did not close
what is rachischisis?
caudal region of neural tube doesn’t close
what is spina bifida cystia?
failure of meninges or vertebra to form
different degrees of severity
what is meningocele?
form of spina bifida that the vertebra don’t form and meninges leak out
what is myelomeningocele?
form of spina bifida that the vertebra and meninges don’t form and spinal cord leaks out
what is spina bifida occulta?
mildes form of spina bifida- vertebra don’t form but nothing leaks out
patients have no clinical signs except hair tuft over missing vertebra
what is encephalocele?
herniation of meninges with brain matter
what are the regions of somites that form from the paraxial mesoderm? what do they form
sclerotome- ventral/medial- bone forming cells
epimere- dorsomedial- intrinsic back muscles
hypomere- dorsolateral- muscles of body wall and extremities
dermatome- dorsal- dermis
how is fetal age determined?
counting somites
when does the yolk sac disappear?
after embryo folding
what does the dorsal part of the lateral mesoderm become?
skeletal muscle
what does the splanchic part of the lateral mesoderm become?
visceral layer and smooth muscle
what does the celome become?
body cavities
how do limb buds form?
lateral projections develop an apical ectodermal ridge that induces th mesoderm in the limb buds to differentiate into bone, muscle, and connective tissue
what is meromelia?
minimal limb formation
what is amelia?
no limb formation
what is micomelia?
shortened limb formation
what is phocomelia?
abnormal limb formation
what is brachydactyly?
shortening of digits
what is syndactyly?
fusion of digits
what is polydactyly?
extra digits
