Gross Anatomy- Assessment 1 Flashcards
1
Q
where do intrinsic back muscles come from?
A
epimere of somite
2
Q
where do extrinsic back muscles come from?
A
hypomere of somite
3
Q
how are vertebra formed?
A
caudal and cranial aspects of somites fuse
muscles come out of the somites as well
4
Q
what makes intrinsic back muscles intrinsic? what is the innervation?
A
attach to the spinal column only and primary movers of spinal column
primary posterior rami
5
Q
what makes extrinsic back muscles extrinsic? what is the innervation?
A
attach to spinal column and upper limb and move the upper limb
primary anterior rami
6
Q
Name the intrinsic back muscles
A
erector spinae - iliocostal (lateral) -logissimus (middle) -spinalis (medial) transversospinalis muscles - semispinalis -rotatores -multifidus splenius
7
Q
boarders of the suboccipital triangle
A
medial- rectus capitis superior major
- rectus capitis superior minor is medial to it
lateral- obliquus capitis superior
inferior- obliquus capitis inferior
8
Q
what innervates the muscles in the suboccipital triangle?
A
suboccipital nerve- dorsal ramus of C1
9
Q
what is special about the vertebral artery?
A
atherosclerosis can result in dizziness
10
Q
what arteries and nerves are involved in the suboccipital triangle?
A
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
11
Q
where is the suboccipital triangle?
A
centered over the posterior arch of the atlas
12
Q
where is the lesser occipital nerve?
A
comes out medially to sternocleidomastoid muscle and then travels posterior to it up into the head
13
Q
where is the occipital artery?
A
comes out lateral to nuchal ligament at superior nuchal line of the skull
14
Q
what are the boarders of the triangle of auscultation?
A
medial- trapezius
lateral inferior- latissimus dorsi
lateral superior- fascia of scapular muscles
15
Q
what is spin bifida occulta?
A
incomplete formation of the mural arch, lamina does not reach spinous process
hair tuft above misformed vertebra
prevented by folic acid
16
Q
what travels through the transverse foramen?
A
vertebral artery
17
Q
which spinal level has transverse foramen?
A
cervical
18
Q
which vertebra is the dens on?
A
C2 axis
19
Q
which vertebra supports the skull?
A
C1 atlas
20
Q
articular facets in the thoracic region allow for which kind of bending?
A
lateral bending- facets face anteriorly (inferior) and posteriorly (superior)
21
Q
articular facets in the lumbar region allow for which kind of bending?
A
flexion and extension- facets face medially (superior) and laterally (inferior)
22
Q
unique features of cervical vertebra
A
small vertebral bodies
short, bifid spinous processes
large triangular vertebral foramen
transverse foramen
23
Q
unique features of thoracic vertebra
A
heart shaped vertebral bodies
long, posteriorly angled spinous processes
round vertebral foramen
costal facets
24
Q
unique features of lumbar vertebra
A
large, kidney shaped vertebral bodies
short, hatchet shaped spinous processes
triangular vertebral foramen
25
what are the primary curvatures? when do they develop?
thoracic and sacral
concave anteriorly
develop during fetal life
26
what are the secondary curvatures? when do they develop?
cervical and lumbar
concave anteriorly
develop when baby lifts head (cervical) and stands (lumbar)
27
what is the purpose of the curvatures?
maintain balance
increase resistance and strength for weight bearing
reduce weight on vertebral column
28
what is kyphosis
exaggerated thoracic curvature do to erosion of anterior aspect of vertebral bodies
29
what is lordosis
exaggerated lumbar curvature due to weakened trunk muscles
30
what is scoliosis
laterally bent spin
causes asymmetrically intrinsic back muscle weakness and rib hump
leg height differences
31
what are epiphyseal rims?
outside part of vertebral bodies where the annulus fibrosis connects
32
anterior longitudinal ligament- location and purpose
anterior aspect of vertebral bodies
| resists extension
33
posterior longitudinal ligament- location and purpose
posterior aspect of vertebral bodies
resists flexion
diamond shaped- wider at discs
34
ligamentum flavum- location and purpose
anterior lamina
limits flexion
used to guide spinal taps
35
where is the interspinous ligament
between spinous processes
36
where is the superspinous ligament
on top of spinous processes
37
what is the cervical enlargement of the spinal cord
thickening of the spinal cord between C4-T1 for upper limb innervation
38
what is the lumbar enlargement of the spinal cord
thickening of the spinal cord between T11-L1
39
what is the conus medlars? where is it?
inferior tapering of the spinal cord around L2
40
what is the caudal equina?
horse's tail, nerve roots extending from the spinal cord and run past where the spinal cord ends
41
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
42
where does the dural sac end?
S2
43
Spinal cord rule of 2
spinal cord ends- L2
dural sac ends- S2
filum terminale anchors at Co2
44
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
45
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
46
which spinal canal space is abnormal?
subdural space
47
what are the denticulate ligaments?
saw/tooth like extensions of the pia mater that anchor the spinal cord to the dural sac
48
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
49
in which space is a spinal anesthetic given?
epidural
50
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
51
blood supply to cervical spine
vertebral arteries supply spinal and medullary arteries
52
where are the vertebral arteries?
run through transverse foramen on cervical vertebra
53
blood supply to thoracic spine
intercostal arteries supply medullary arteries
54
blood supply to lumbar spine
lumbar arteries supply medullar arteries
55
blood supply to sacral spine
sacral arteries supply medullary arteries
56
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
57
what happens of the adamkiewicz artery is compromised?
lower limb paralysis
58
what is unique about the spinal veins? why is it important?
no valves, cancer can metastasize to the brain through them, specifically prostate
59
what venous root supplies the metastasis pathway?
internal vertebral (epidural) venous plexus
60
what is the venous drainage of the spinal cord?
internal veterbral plexus
external vertebral plexus
anterior spinal vein
posterior spinal vein
61
what do the recurrent meningeal nerves supply?
dura mater
periosteum of vertebrae
outer annulus fibrosis
posterior longitudinal ligament
62
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
63
what muscles are in the rotator cuff?
supraspinatus
infraspinatus
teres minor
subscapularis
64
what is the function of the rotator cuff?
protect and stabilize the glenohumeral joint
65
what passes through/deep to the quadrangular space?
axillary nerve and posterior circumflex humeral artery pass through it
66
where is the quadrangular space?
medial to humerus, lateral to triangular space on lateral scapula
67
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
68
what passes through/deep to the triangular space?
circumflex scapular artery passes deep to it
69
where is the triangular space?
medial to the quadrangular space on lateral scapula
70
what are the boarders of the triangular space?
lateral- long head of triceps brachii
superior- teres minor
inferior- teres major
71
where is the cephalic vein?
in the deltopectoral triangle- very superficial between the anterior deltoid and pectorals major muscles
72
where are the supra scapular nerve and artery?
deep to the supraspinatus and the infraspinatus
73
Arm goes over the bridge, navy goes under the bridge
suprascapular artery passes over the superior transverse scapular ligament
suprascapular nerve goes under it
74
where is the circumflex scapular artery?
deep to triangular space
75
where is the posterior humeral circumflex artery?
traveling through the quadrangular space with the axillary nerve
76
where is the axillary nerve?
traveling through the quadrangular space with the posterior circumflex humeral artery
77
where is the suprascapular artery?
travels down to scapula over the superior transverse scapular ligament and superior to scapula
78
where is the suprascaupular nerve?
travels down to scapula under the superior transverse scapular ligament and superior to scapula
79
where is the greater occipital nerve?
passes inferior to the suboccipital triangle and goes out to the skin
80
where is the suboccipital nerve?
passes through the suboccipital triangle
81
where is the dorsal scapular artery?
travels anterior to the levator scapulae and down medially to the scapula with the dorsal scapular nerve
82
where is the transverse cervical artery?
branch of subclavian and then branches into deep and superficial branches
83
what is the dorsal scapular artery a branch of?
subclavian or the transverse cervical artery
84
what is the dorsal scapular artery called if it branches off of the transverse cervical artery?
deep branch of the transverse cervical artery
85
where is the dorsal scapular nerve?
travels anterior to the levator scapulae and down medially to the scapula with the dorsal scapular artery
86
what is the drainage path of the cephalic vein?
cephalic-->axillary-->subclavian-->brachiocephalic-->superior vena cava
87
what is the cephalic vein clinically used for?
catheters and pic lines
88
what is the drainage path of the basilic vein?
basilic-->axilary-->subclavian
89
where is the basilica vein?
medial side of anterior arm
90
where is the median cubital vein?
in the cubital fossa running transversely between the cephalic and basilc veins
91
where is the olecranon fossa?
posterior humerus hole between the epicondyles
92
where is the trochlea?
posterior humerus lateral thing below the olecranon fossa
93
where are the supracondylar ridges?
distal medial and lateral aspects of the humerus
94
what is the apex boundary of the axilla?
neck entrance between first rib and clavicle
95
what is the base of the axilla?
skin and fascia between the arm and thorax
96
what is the posterior wall of axilla?
scapula and subscapularis, trees major, and latissimus dorsi muscles
97
what is the anterior wall of the axilla?
pectoral major and minor muscles
98
what is the medial wall of the axilla?
thoracic wall and serratus anterior muscle attachments
99
what is the lateral wall of the axilla?
intertubercular groove of the humerus
100
what are the boundaries of the posterior axillary fold?
trees major and pectoralis intersection
101
what are the boundaries of the anterior axillary fold?
pectorals major crossing into arm
102
what structures are in the axillary region?
cephalic vein, axillary vein, axillary artery, brachial plexus
103
what is a neuromuscular bundle?
arteries, veins, nerves, and lymph vessels bundled together in loose connective tissue sheaths
104
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
105
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
106
what are the branches of the axillary artery?
```
superior thoracic
thoraco-acromial
lateral thoracic
subscapular
anteiror humeral circumflex
posterior humeral circumflex
```
107
sixties teens love sex and pot
pneumonic for branches of axillary artery
108
branches of the thoraco-acromial artery
clavicular branch
acromial branch
deltoid branch
pectoral branch
109
cadavers are dead people
pneumonic for branches of thoraco-acromial artery
110
branches of the sub scapular branch
scapular circumflex
| thoracodorsal
111
sex leads to STDs
pneumonic for subscapular branch
112
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
113
which arteries form the collateral circulation of the scapula?
scapular circumflex and suprascapular arteries
114
what muscles does the collateral circulation of the scapula supply?
infraspinatus and supraspinatus
115
what does the posterior circumflex humeral artery supply?
deltoid
teres major
teres minor
long head of biceps bracii
116
what does the lateral thoracic artery supply?
pectoralis major
pectoralis minor
serratus anterior
117
what are the posterior shoulder muscles?
```
supraspinatus
infraspinatus
latissimus dorsi
deltoid
trees major
teres minor
long head of triceps brachii
```
118
what are the anterior shoulder muscles?
pectoralis major
pectoralis minor
serratus anterior
119
what are the branches of the subclavian artery?
dorsal scapular
| transverse cervical
120
what does the dorsal scapular artery supply?
rhomboid major and minor
121
what does the transverse cervical artery supply?
levator scapulae
| trapezius
122
what spinal roots are in the brachial plexus?
C5-T1
123
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order of the brachial plexus pieces
| roots, trunks, divisions, cords, nerves
124
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```
brachial plexus terminal nerves
musculocutaneous
axillary
radial
median
ulnar
```
125
ULTRA
```
nerves off of the posterior cord of the brachial plexus
upper scapular
thoracodorsal
lower scapular
radial
axillary
(switch T/L and R/A)
```
126
M nerves
nerves off of the medial cord
medial pectoral
medial brachial cutaneous
medial antebrachial cutaneous
127
S nerves
nerves off of the superior trunk of the brachial plexus
suprascapular
subclavious
128
nerves off of C5 of brachial plexus
```
dorsal scapular
long thoracic (combines with others)
```
129
nerves off of lateral cord of brachial plexus
lateral pectoralis
130
what does the median nerve come from?
lateral root of lateral cord
| medial root of medial cord
131
what muscle groups are in the anterior arm compartment? what nerve innervates them?
shoulder and elbow flexors
| musculocutaneous nerve
132
what muscle groups are in the posterior arm compartment? what nerve innervates them?
shoulder and elbow extensors
| radial nerve
133
what does the dorsal scapular nerve supply?
levator scapula
rhomboid major
rhomboid minor
134
what does the supra scapular nerve supply?
supraspinatus
| infraspinatus
135
what does the thoracodorsal nerve supply?
latissimus dorsi
136
what does the axillary nerve supply?
teres minor
| deltoid
137
what does the lower sub scapular nerve supply?
subscapularis
| teres major
138
what does the upper sub scapular nerve supply?
subscapularis
139
what does the long thoracic nerve supply?
serratus anterior
140
what happens if the long thoracic nerve is compromised?
winged scapula- serratus anterior is no longer holding the scapula against the thoracic wall
141
what muscles are in the anterior arm compartment?
coracobrachialis
biceps bracii
brachialis
142
what muscles are in the posterior arm compartment?
triceps bracii
143
where is the pectoral branch of the thoracoacromial artery?
goes between the pectoralis major and minor muscles
| largest branch of the thoracoacromial artery
144
where is the deltoid branch of the thoracoacromial artery?
in the deltopectoral groove with the cephalic vein
145
where is the acromial branch of the thoracoacromial artery?
superior to coracoid process and goes toward acromion
146
where is the clavicular branch of the thoracoacromial artery?
superior and medial towards the subclavius muscle and sternoclavicular joint
147
where is the lateral thoracic artery?
lateral boarder of the pectoralis minor muscle
148
where is the axillary vein?
with the axillary artery
149
what are the boarders of the cubital fossa?
distal- medial/lateral epicondyles
medial- pronator teres
lateral- brachioradialis
floor- brachialis, supinator
150
what structures pass through the cubital fossa?
```
radial nerve
brachial artery
brachial recurrent artery
median nerve
ulnar artery
radial artery
```
151
where does the ulnar nerve go near the cubital fossa?
around near medial epicondyl
152
what muscles are involved in forearm pronation and supination?
pronator teres
pronator quadratus
supinator
153
where are the forearm pronators/supinators?
very deep, right on bone under all the flexors and extensors and their ligaments
154
where at a joint are blood vessels and nerves more protected?
inside the joint
155
what is the difference between pronation/supination and rotation?
pronation/supination involves 2 bones crossing over one another
rotation does not
156
what muscle does the median nerve go through?
pronator teres
157
where is the long thoracic nerve?
superficial to the serratus anterior muscles- very injury prone
158
what muscles originate at the common extensor tendon?
extensor digitorum
extensor digiti minimi
extensor carpi ulnaris
extensor carpi radialis
159
what is tennis elbow?
inflammation of the common extensor tendon
160
what innervates the forearm extensors?
radial nerve or its branches
161
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
162
what is the order of structures in the cubital fossa?
lateral- biceps tendon
middle- brachial artery
medial- median nerve
163
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
164
where is the medial head of the triceps brachii?
deep to lateral and long heads
165
what passes through the anatomical snuff box?
radial artery
166
what does the median nerve innervate?
most of the flexors and the pronators
167
what does the radial nerve innervate?
extensors, supinators, brachiradialis
168
what does the ulnar nerve innervate?
flexor carpi ulnaris
| flexor digitrum profundus (part)
169
what innervates most of the posterior forearm muscles?
radial nerve
170
what innervates most of the anterior forearm muscles?
median nerve
171
what innervates the rest of the forearm muscles that are not innervated by the median nerve?
ulnar nerve (2)
172
what are the movements of digits 2-5?
flexion/extension
| abduction, adduction
173
what are the movements of the thumb?
flexion/extension
abduction/adduction
opposition/reposition
174
order of the superficial extensors (lateral to medial)
```
carpi radialis longus
carpi radialis brevis
digitorum
digiti minimi
carpi ulnaris
```
175
what are the boarders of the anatomical snuff box?
extensor pollicis longus and brevis
176
what is the order of the posterior intermediate muscles? (lateral to medial)
abductor pollicis longus
| extensor pollicis longus
177
what is the order of the posterior deep muscles? (lateral to medial)
extensor pollicis brevis
| extensor indicis
178
what do the carpi radialis muscles do in addition to their prefix word?
abduct wrist
179
what do the carpi ulnaris muscles do in addition to their prefix word?
adduct wrist
180
what is the order of the superficial flexors lateral to medial?
carpi radialis
palmaris longus
carpi ulnaris
181
what is the order of the intermediate flexors lateral to medial?
digitorum superficialis
182
what is the order of the deep flexors lateral to medial?
pollicis longus
| digitorum profundus
183
which muscles originate at the common flexor tendon?
```
pronator teres
flexor carpi radialis
palmaris longus
flexor carpi ulnaris
flexor digitorum superficialis
```
184
what muscle attaches at the anterior oblique line of the radius?
flexor digitorum superficialis
185
what structures pass under the tendinous arch of the forearm?
ulnar artery
| median nerve
186
carpal bones
```
scaphoid
lunate
triquetrum
pisiform
trapezium
trapezoid
capitalte
hamate
```
187
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ANTERIOR
lateral to medial, proximal to distal
triquetrum, trapezium, trapezoid (q, zium, zoid)
188
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
189
what structures pass through the carpal tunnel?
flexor digitorum profundus
flexor digitorum superficialis
flexor pollicis longus
median nerve
190
where do the ulnar nerve and artery pass at the wrist?
medial anterior to the carpal tunnel (anterior to hamate)
191
where does the radial artery pass?
lateral posterior to trapezium
192
what ligament forms the carpal tunnel?
flexor retinaculum
193
where is the scaphoid?
most lateral of the proximal row
194
where is the lunate?
middle of proximal row
195
where is the traquetrum?
most medial of proximal row
196
where is the pisiform?
most medial of proximal row anterior to traquetrum
197
where is the trapezium?
most lateral of the distal row
198
where is the trapezoid?
second lateral of distal row
199
where is the capitate?
second medial of distal row
200
where is the hamate?
most medial of distal row
201
what innervates the skin of the hand? where does it pass through?
branches of the median nerve that pass anteriorly to the flexor retinaculum
202
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
203
which flexor muscle tendon is the V in the digits?
flexor digitorum superficialis
204
which flexor muscle tendon is the I in the digits?
flexor digitorum profundus
205
where are the lumbricals?
between the flexor digitorum profundus ligaments in the central compartment
206
what is the order of the superficial palm muscles? lateral to medial
abductor pollicis brevis
| pamlaris brevis
207
what is the order of the intermediate palm muscles? lateral to medial
opponens pollicis
flexor pollicis brevis
flexor digiti minimi brevis
abductor digiti minimi
208
what is the order of the deep palm muscles? lateral to medial
adductor pollicis
| opponens digiti minimi
209
where are the interosseous muscles?
between the metacarpals, deep to the lumbricals
210
what are the arterial arches in the hand?
superficial palmar arterial arch
| deep palmer arterial arch
211
what arterial branches to to the digits?
common palmar digit arteries
| proper palmar digit arteries
212
what combines to form the superficial palmar arterial arch?
superficial branch of radial artery
| ulnar artery
213
what supplies the deep palmar arch?
radial artery and deep palmar branch of ulnar artery
214
what are the thenar muscles?
opponens pollicis
abductor pollicis brevis
flexor pollicis brevis
215
what are the hypothenar muscles?
abductor digiti minimi
opponens digiti minimi
flexor digiti minimi brevis
216
what do the palmar interosseous muscles do?
adduct digits
217
what do the dorsal interosseous muscles do?
abduct digits
218
what are dermatomes?
regions of sensory innervation corresponding to nerve roots
219
what are myotomes?
regions of motor innervation corresponding to spinal nerve roots
220
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
221
what innervates the top of the shoulder?
supraclavicular
222
what innervates the lateral side of the shoulder?
axillary
223
what innervates the medial side of the arm?
medial cutaneous of the arm
224
what innervates the lateral lower arm?
radial
225
what innervates the medial forearm and the middle of the arm?
medial cutaneous of the forearm
226
what innervates the lateral side of forearm?
musculocutaneous
227
what innervates the pinky and half of the ring finger?
ulnar nerve
228
what innervates the rest of the fingers?
median nerve
229
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
230
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)
231
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)
232
what nerve is the biceps reflex testing?
musculocutaneous
233
what nerve is the triceps reflex testing?
radial nerve
234
what nerve is the brachioradialis reflex testing?
radial nerve
235
where is the brachiradialis reflex done?
near styloid process of radius
236
what is hyporeflexia?
weaked reflex response
237
what is areflexia?
no reflex response
238
what do hyporeflexia and areflexia indicate?
damage to: skeletal muscles, dorsal/ventral nerve roots, spinal nerves, spinal cord, brain
239
what is hyperreflexia and what does it indicate?
exaggerated response, indicates higher up brain issues or spinal cord compression
240
midshaft humerus fracture injures what nerve?
radial nerve- radial nerve sits in radial groove along posterior humerus right against the bone
241
what results from a radial nerve injury?
weakness in medial head of triceps, defects in forearm extensors, supinator, and brachioradialis (posterior forearm muscles)
242
what is the presentation for a radial artery injury?
wrist drop- lack of flexion
243
avulsion injury where the head is thrown back from the shoulder injures what nerve?
upper trunk of brachial plexus
244
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-
245
what is waiters tip (pronated hand, shoulder adducted, forearm flex, claw grip) indicative of?
brachial plexus upper trunk injury
246
what results from an ulnar nerve injury?
hypothenar group muscle atrophy
247
what is claw grip indicative of?
ulnar nerve injury
| can't extend digits 4 or 5
248
what is benediction hand indicative of?
can't flex digits 1-3
| median nerve injury
249
when should you suspect restricted blood flow?
weak pulse
| normal reflex and nerve conduction test
250
what is the most common shoulder dislocation?
anterior dislocation
251
what is sensory deficit over the shoulder and failure to abduct > 15 degrees indicative of?
axillary nerve damage second to anterior shoulder dislocation
252
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
253
what is the most commonly fractured carpal?
scaphoid
254
what is a complication of a scaphoid fracture?
necrosis of anterior scaphoid due to lack of blood supply because the fracture compromised artery
255
what is the hook of hamate attachment for?
flexor retinaculum
flexor digiti minimi brevis
opponens digiti minimi
256
what do pseudo unipolar do? where are they?
sensory
| in the posterior roots
257
what do multipolar neurons do?
motor
| in the anterior roots
258
what does the posterior horn look like?
skinny, top of the butterfly, next do the DRG
259
what does the anterior horn look like?
fat, bottom of the butterfly
260
where do primary posterior rami go?
intrinsic back muscles and skin over them
261
where is the vasonervorum?
blood supply to the epinerium of nerves
262
which levels are segmented nerves?
T2-T12
263
which cranial nerve does not originate from the brain? where does it go?
accessory nerve (CN XI) innervates the trapezius and sternocladomastoid
264
what is a dorsal rhizotomy?
cut the posterior root of spinal nerve to relieve chronic pain
265
where are bipolar neurons?
special senses- vision and smell
266
where do pseudo unipolar neurons synapse?
dorsal/posterior horn
267
where do multipolar neurons originate from?
ventral/anterior horn
268
where do multipolar presynaptic cell bodies of the parasympathetic nervous system arise?
ventral horn of cranial and lumbosaccral
269
where do multipolar presynaptic cell bodies of the sympathetic nervous system arise?
interomediolateral (IML) column of T1-L2 (aka lateral horn)
270
where do visceral motor neurons go?
cardiac muscle, smooth muscle, glands
271
how many neurons are involved in visceral sensory?
1- single pseudo unipolar neuron with cell body in the DRG
272
how many neurons are involved in the autonomic motor system?
2- presynaptic in the spinal cord and postsynaptic in a ganglia
273
where do presynaptic sympathetic neuron synapse?
sympathetic chain ganglia right outside of spinal cord
274
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
275
where are the sympathetic chain ganglia?
run from magnum foramen to tip of coccyx
276
where do cranial nerves exit?
skull foramina
277
where do spinal nerves exit?
intervertebral foramina
278
what is the entrance to the sympathetic chain ganglia?
white rami communicants ONLY found in T1-L2
279
what is the exit to the sympathetic chain ganglia?
gray rami communicans in entire spinal cord
280
what spinal roots are in the cervical plexus?
C1-C4
281
what spinal roots are in the brachial plexus?
C5-T1
282
what spinal roots are in the lumbar plexus?
L1-L4
283
what spinal roots are in the thoracic plexus?
None- no plexus here, they are segmental
284
what spinal roots are in the sacral plexus?
L4-S4
285
difference between sympathetic and parasympathetic neuron lengths
sympathetic- short pre, long post
| parasympathetic- long pre, short post
286
what NTs does the autonomic nervous system use?
sympathetic post- NE (sweat glands ACh)
parasympathetic post- ACh
both pre- ACH
287
what is the function of the sympathetic nervous system?
fight or flight
288
what is the function of the parasympathetic nervous system?
rest and relax
289
what do the cephalic arterial rami do?
go to periarterial plexuses of carotid arteries to get to the head for distribution there
290
what do the parietal branches of the sympathetic trunk do?
vasomotion
sudomotion- sweat glands
pilomotion- goosebumps
291
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
```
292
cranial component of parasympathetic nervous system gets what body parts?
head down to colic flexure
293
sacral component of parasympathetic nervous system gets what body parts?
GI tract distal to the colic flexure
294
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
295
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
296
what part of the embryo becomes the human?
inner cell mass
297
what does the trophoblast become?
extra embryonic tissues
298
what is the space between the trophoblast and the epiblast?
amniotic cavity
299
what does the epiblast become?
embryo
300
what is the layer of cells of the inner cell mass toward the amniotic cavity?
epiblast
301
what is the layer of cells of the inner cell mass toward the blastocoele?
hypoblast
302
what does the hypoblast become?
yolk sac
303
what is the primitive streak?
thickening of epiblast cell layer on blastodisc
304
what is a blastodisc?
epiblast and hypoblast layers
305
what order does epiblast cell migration occur it?
cranially first, then caudally
306
what is mesenchyme?
moving mesoderm
307
what is derived from the ectoderm?
skin and nervous tissue (including adrenal medulla)
308
what is derived from the endoderm?
lining of gut tubes
309
what is derived from the mesoderm?
everything else that is not skin, nervous tissue, or lining of tubes
310
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
311
what does the buchoforengial membrane become?
mouth
312
what does the cloacal membrane become?
anus
313
what is caudal dysgenesis?
caudal end of embryo fails to develop- levels of severity
314
what is sirenomelia?
most severe form of caudal dysgenesis, complete lack of caudal structures
315
what is the nucleus pulpous derived from?
notochord
316
what are the vertebra and meninges derived from?
mesoderm surrounding the notochord
317
what determines the body axes?
primative node
318
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
319
what is situs inverses?
complete flip of body organs from normal (heart points right)
320
what does the paraxial mesoderm give rise to?
somites
321
what does the intermediate mesoderm give rise to?
urogenetial system
322
what does the lateral mesoderm give rise to?
space of future body cavities
323
what does the neural crest form?
peripheral nervous system
324
in what order does the neural tube close in?
starts in cervical and works out
| anterior closes before posterior
325
what is anancephaly?
brain doesn't form because anterior aspect of neural tube did not close
326
what is rachischisis?
caudal region of neural tube doesn't close
327
what is spina bifida cystia?
failure of meninges or vertebra to form
| different degrees of severity
328
what is meningocele?
form of spina bifida that the vertebra don't form and meninges leak out
329
what is myelomeningocele?
form of spina bifida that the vertebra and meninges don't form and spinal cord leaks out
330
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
331
what is encephalocele?
herniation of meninges with brain matter
332
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
333
how is fetal age determined?
counting somites
334
when does the yolk sac disappear?
after embryo folding
335
what does the dorsal part of the lateral mesoderm become?
skeletal muscle
336
what does the splanchic part of the lateral mesoderm become?
visceral layer and smooth muscle
337
what does the celome become?
body cavities
338
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
339
what is meromelia?
minimal limb formation
340
what is amelia?
no limb formation
341
what is micomelia?
shortened limb formation
342
what is phocomelia?
abnormal limb formation
343
what is brachydactyly?
shortening of digits
344
what is syndactyly?
fusion of digits
345
what is polydactyly?
extra digits
