gross anatomy spine Flashcards
what is located in the visceral anterior compartment of the neck
thyroid gland, parathyroid gland, where respiratory and digestive tracts begin
what is located in the visceral neurovascular compartments of the neck (2 lateral)
common carotid artery, IJV, vagus nerve
what is located in the vertebral posterior compartment of the neck
cervical vertebrae and associated muscles
where does air pass through when our mouth is empty
nasal cavity to nasopharynx or oral cavity to oropharynx
where does air pass through when our mouth is full
larynx to trachea to tongue which blocks oropharynx
when we swallow where does the food and air pass through
oral cavity to oropharynx to esophagus to laryngopharynx
what closes in the mouth/throat to block food from going down the trachea
epiglottis
what is the difference between thyroid cartilage and circoid cartilage
thyroid is large and superior, circoid is inferior and circles the airway
what is the purpose of the pharynx
connect oral and nasal cavities to the larynx and esophagus
what are the 3 parts of the pharynx and what is their role
nasopharynx: superior constrictor
oropharynx: middle constrictor
laryngopharynx: inferior constrictor
what is the role of the auricle
capture sound
where does the aucostic meatus end
tympanic membrane
what do the middle ear ossicles transfer sound from
tympanic membrane to inner ear
stimulating what part of the ear may influence the vagus nerve
inner ear
what are the 2 branches of the brachiocephalic
r common carotid and r subclavian
what are the 2 branches of l common carotid
internal and external carotid
what is the primary blood supply to the face
external carotid artery
where is the left subclavian artery found
above first rib, below clavicle
where do the vertebral arteries pass
transverse foramen of cervical vertebrae
where does the internal jugular vein return blood to the heart from
face and cranium
where does the external jugular vein return blood to the
cervical spine
what is the passage of veins from distal to proximal
internal and external jugular, subclavian, brachiocephalic, superior vena cava
what do carotid sinus do
mechanoreceptors that monitor changes to blood pressure
what is carotid sinus innervated by
CN 9
what do carotid body monitor
chemoreceptors, change in blood chemistry
what is carotid body innervated by
CN9 &10
what are the triangles of the neck split by
SCM
anterior triangle contents and borders
A=midline
p=SCM
s=mandible
posterior triangle contents and borders
A=SCM P=trap I=middle 1/3 clavicle S=occiput
anterior triangle CN
7, 10, 11, 12
anterior triangle muscles
submental, submandibular
anterior triangle nodes
thyroid, parathyroid, lymph
anterior triangle vasculature
common carotid artery, IJV
posterior triangle muscles
occipital, omoclavicular, subtriangles, omohyoid, scalene, levator scapula, splenius capitis
CN posterior triangle
11, cervical plexus, phrenic nerve, brachial plexus trunks
posterior triangle vasculature
external jugular vein, subclavian artery, subclavian vein
nerves of cervical plexus
anterior rami (C1-C4)
lesser occipital (C2)
greater auricular (C2-C3)
transverse cervical (C2-C3)
supraclavicular (C3-C4)
cutaneus sensation anterior face/head
trigeminal and facial
posterior head cutaneus sensation
greater occiput, third occipital
lateral/inferior head neck cutaneus sensation
lesser occipital, greater auricular
what does a plexus mean
starts next to the spinal cord and combines into branches to innervate
what are the roots of brachial plexus
C5-T1
what are the trunks of brachial plexus
superior, middle, inferior
what are the divisions of brachial plexus
anterior and posterior; makes an X b/w C6-C7 and a Z b/w C7-C8
what are the cords of brachial plexus
lateral, posterior, medial
what are the terminal nerve branches of brachial plexus
musculocutaneus, axillary, radial, median, ulnar
what nerve roots is each nerve innvervated by
MC: C5-C7
axillary: C5-T1
radial: C5-T1
median: C5-T1
ulnar: C8-T1
brachial plexus branches of nerve roots
dorsal scapular
phrenic
long thoracic
brachial plexus branches of lateral cord
lateral pectoral, musculocutaneus, lateral cutaneus, median nerve
brachial plexus branches of trunks
suprascapular, nerve to subclavius **both coming off of superior trunk
brachial plexus branches of median nerve
medial pectoral, median cutaneus of arm, median cutaneus of forearm, ulnar nerve, median nerve
brachial plexus branches of posterior cord
suprascapular nerve, thoracodorsal, inferior suprascapular, axillary, radial
what is the main nerve for mastication
trigeminal
what are the 3 branches of trigeminal nerve
opthalmic (V1), maxillary (V2), mandibular (V3)
what branch of the trigeminal nerve has some motor function
mandibular (V3)
what landmark divides the branches of the facial nerve
parotid gland
what are the pre-parotid branches of the facial nerve
posterior auricular, digastric
what are the post-parotid branches of the facial nerve
temporal, zygomatic, buccal, marginal mandibular, cervical
muscles of facial expression
orbicularis occuli, occipitofronalis, procerus, hasalis, zygomaticus major and minor, buccinator, levator labril superioris, orbicularis oris, mentalis, platysma
what are the suboccipital muscles
rectus capitis posterior minor, rectus capitis posterior major, obliquus capitis superior and obliquus capitis inferior
what do the obliquus muscles do
keep head in correct position “right” on the body
posterior neck muscle layers
superficial: trapezius
intermediate: splenius capitis and cervicis
deep: spemispinalis capitis: extension and CL rotation of head/neck
what are the muscles of the lateral neck
SCM, scalenes
what muscle usually compensates for neck flexors
SCM
what muscle is very active for chest breathers
scalenes
what muscles attach to the first rib and pass through the brachial plexus
anterior scalenes
what muscle attaches to the second rib and has an extension component
posterior scalene
what are the anterior deep neck flexors
longus capitis, longus colli, rectus capitis lateralis, rectus capitis anterior
what is the anatomical location of anterior deep neck flexors
posterior to esophagus and trachea, anterior to vertebral bodies
4 suprahyoid muscles
digrastric, stylohyoid, geniohyoid, mylonhyoid
what do the suprahyoid muscles assist with
elevation, swallow, chew, speech
what are the infrahyoid muscles
sternothyroid, circothyroid, thyrohyoid, omohyoid
what do the infrahyoid muscles do
assist with depression
c1 vertebrae palpation
no vertebral body so harder, articulates with occpitial condyles
c2 vertebrae palpation
large dens, articlulates with anterior arch of C1, includes transverse ligament
C3-C7 palpation
short vertebral bodies and spinous processes
if the alar ligament is found to have a problem, is it a medical emergency
no it is not
what does the joint b/c C1 and C2 promote
rotation b/c planar joint and no disc b/w
what does the joint between the skull and C1 promote
flexion and extension
what is found in the anterior cranial cavity
frontal bone, ethmoid bone, sphenoid bone
what is found in the middle cranial cavity region
sphenoid bone, temporal bone, parietal bone
what cavity are the pituitary glands found
middle cranial cavity
what is found in the posterior cranial cavity
temporal, parietal, occipital bones
where is the foramen magnum found in the cranial cavities
posterior cranial cavity
what does the foramen magnum do
attaches the spinal cord to the brainstem
4 ligaments of the upper cervical spine
transverse ligament atlas, apical, alar, cruciform
what motion does alar ligament limit
rotation
what does apical ligament help with
sagittal plane stability
does the hyoid bone articulate with other bones
no it is surrounded by muscles and soft tissue
borders of hyoid bone
S: floor of oral cavity
I: larynx
P: pharynx
where do suboccipitals insert
occiput at superior nuchal line
how many bones does the skull have not including ear. bones
22
what type of joint is TMJ
synovial
what kind of pts does Dr Mckinnon often work with that relates to the spine
brain tumor
where did Dr Orton go with his wife for the weekend
Quebec City
where did Dr Mckinnon go for a wedding last week and got sick
Dominican republic
how can you determine if the nerve issue is a peripheral nerve or myotome
first test the myotome motion, if it is weak, test the peripheral nerve in a different way. if both are weak, it’s likely a peripheral nerve issue. if the myotome motion is the most weak, it’s likely a myotome issue
what is the acronym to remember order of brachial plexus as it moves distal
real therapists drink cold beer
what is the acryonym to remember order of nerve branches found superior to inferior on brachial plexus
marmu
what are some important bony landmarks coordinating with vertebrae
xiphoid process: T6
costal margin ribs: T3
umbilicis: T10
what does the intercostal nerve do
provide motor and sensory innervation for ribs
how many parts does the diaphragm have
L & R
what does the recurrent laryngeal nerve do
loop under aorta to the throat for vocal cords, has L and R sides
what are 3 nerves of the digestive system
greater splanchic, lesser splanchic, least splanchnic
where does indigestion take place b/c there’s not really anywhere else for the acid to go
esophagus
what happens to bronchioles, HR, and force of contraction during sympathetic response
dilate, increase, increase
what happens to bronchioles, HR, and force of contraction during vagus response
constrict, decrease, decrease
what artery flows into the intercostal space
R & L internal thoracic
how do the superior ribs with respiration
pump handle motion (superior and anterior)
how do the inferior ribs move with respiration
bucket handle motion (superior and lateral)
what pec muscle is associated with TOS
pec minor
which intercostals are used for exhalation and inspiration
internal , external
what muscle is on the posterior aspect of the anterior wall
transverse thoracic
where does the aorta pass through the diaphragm
posterior, the esophagus and IVC pass through here
2 symphysis joints of ribs
manubriosternal and xiphiseral
synovial joints of ribs
costovertebral, costotransverse, interchondral, sternocostal
what synovial joint can be displaced by trauma or surgery
superior costotransverse
where is interchondral joint found
b/w false ribs
what kind of joint is 1st rib
fibrocartilaginous, the others are sternocostal joints
what rib is at the level of the sternal angle
rib 2
where does costal cartilage travel
anteriorly and attaches to the sternum
identify which ribs are true, false, floating
1-7 true
8-10 false
11-12 floating
what does a floating rib mean
no direct attachment with sternum
are superior or inferior ribs more stable
superior b/c articulate with manubrium… inferior articulate w/ diaphragm
describe the thoracic vertebrae in comparison with other regions
less mobility and more stability here b/c attach to ribs
what may cause a change in the pleural cavities
infection, trauma, swelling, fluid
what are the 2 pleural cavities
parietal: superficial
visceral: deep
what’s included in the superior thoracic aperture
T1 vertebra, manubrium, medial margins of rib 1
what’s included in the inferior thoracic aperture
T12 vertebra, ribs 11 and 12, rib 7-10, ziphoid process, esophagus, aorta, IVC
what helps create more space in the diaphragm for blood to flow
esophageal hiatus and aortic hiatus
what are 3 functions of the thorax
breath, protect, conduit
what’s found in the posterior, anterior, lateral regions of the thorax
P: 12 vertebrae and IVD
A: sternum, manubrium, body of sternum, xiphoid process
L: 3 layers of flat muscles (intercostals)
how do you determine names of cervical vertebrae and nerve roots
C8 to T, name of nerve root is below the number of vertebrae
C1 to C7, name of nerve root is the same as vertebrae
ex) C8 nerve root is with C7 vertebrae b/c there are 8 cervical nerve roots and only 7 vertebrae
what is the function of thoracolumbar fascia
anchor muscles to increase stability
what are the 3 segmentum cervical muscles
levatores costarium, interspinales, intertransversarri
what are the 3 transversospindle muscles
semispinalis, mulfidus, rotatores
what are the 3 erector spinae muscles
illiocostalis, longissimus, spinalis
how to tell the difference b/w erector spinae muscles depending on where you are on the spine
illiocostalis: most lateral and greatest muscle belly inferior
longissimus: intermediate: greatest muscle belly thoracic area
spinalis: most medial, largest muscle belly superior
what are the 2 spinotransversales muscles
splenus capitis, splenus cervicis
what do intermediate thoracic muscles do
attach to ribs and serve respiratory function
what are 2 intermediate thoracic muscles
serratus posterior superior and serratus posterior inferior
what is the position of facet joints in the spine
cervical: slopped A to P
thoracic: vertical shape
lumbar: wrapped more
where do pelvic floor muscles attach
coccyx
where does illium articulate with spine
sacrum
which segment of the spine can withstand the largest load and has larger vertebral bodies compared to the others
lumbar spine
which segment of the spine is most stable
thoracic
what segment of the spine will demifacets be found
thoracic
what is a demifacet
where ribs articualte with 2 vertebral segments
where is the vertebral canal most narrow
thoracic spine
what are the vertebrae associated w/ each segment
C1-C2 (upper C)
C3-C7 (lower C)
T1-T12
L1-L5
what is the dens
fulcrum that allows for rotation at upper cervical spine
what is the function of the transverse ligament
prevent compression of the spinal cord
what is the function of the alar ligament
attach the dens and atlas, prevent 2 vertebrae from moving too far away from each other
which vertebra is called atlas and which is axis
C1 (Atlas), C2 (Axis)
what motion is most important at the C2 vertebra
rotation
what is the uncinate process
part of the lower C spine, where superior segment sits
which spinal segment has the largest transverse processes
thoracic b/c have to attach to ribs
what kind of joint is IVD
symphysis: nucleus pulposus is more fluid and needs nutrients, annulus fibrosis is rigid outer layer
what is the function of the vertebral body
embrace the load/force
what part of the vertebral body absorbs more force
anterior part
what is the function of lamina, pedicle, foramen transversarium
-base of transverse process to spinous process
-bridge of transverse process to vertebral body
-hole in transverse process where vertebral arteries pass through
t/f all parts of the spine move in the same direction at the same time
totally false. the spine moves in segments and the segments have different shapes
functions of the spine
support against gravity, move, protect spinal cord
what kind of curve does each segment have
C: secondary: convex in the anterior direction
T: primary: convex in the posterior direction
L: secondary: convex in the anterior direction
S/C: primary: convex in the posterior direction
how many vertebrae do the sacrum and coccyx have
5 (sacrum), 3 or 4 depending on the person, FUSED (coccyx)
what is the articulation at the TMJ
mandibular fossa of temporal bone + condylar process of mandible
what kind of joint is TMJ
true synovial, has a disc
does the superior part of the TMJ slide or spin
slide/translate
does the inferior part of the TMJ slide or spin
spin
what is the disc of TMJ made of
fibrocartilage disc, is good for repeated forces like chewing so it’s important
what do protrusion and retrusion of TMJ mean
push bottom teeth forward
pull bottom teeth backward
for TMJ kinematics spin what part of TMJ should you look at to see how it moves
chin/anterior mandible
for depression of TMJ what has to happen
mandibular condyle translate anteriorly and spin to allow for opening, THEN superior portion translates anteriorly
for elevation of TMJ what has to happen
superior portion translates posteriorly, THEN inferior portion spins anteriorly
what are the muscles involved with depression of TMJ
digastric, LATERAL pterygoid, suprahyoid muscles
normal ROM TMJ depression
40-50 mm, 20-35 mm necessary for function
what is the arthokinematic motion of TMJ depression
first part: posterior rotation/spin
second part: anterior glide
muscles for TMJ elevation
temporalis, masseter, medial pterygoid
arthrokinematic for TMJ elevation
first part: posterior glide of upper compartment
second part: anterior spin of lower compartment
muscles for TMJ protrusion
lateral and medial pterygoid
normal ROM TMJ protrusion
7 mm
arthrokinematic TMJ protrusion
anterior glide superior compartment
muscles for TMJ retrusion
temporalis, suprahyoid muscles
TMJ retrusion normal ROM
3-4 mm
arthrokinematic TMJ retrusion
posterior glide superior compartment
muscles for ipsilateral lateral deviation TMJ
masseter and temporalis
normal ROM lateral deviation TMJ
10-15 mm
arthrokinematic ispilateral lateral deviation
ipsilateral rotation in transverse plane
muscles for contralateral lateral deviation TMJ
medial and lateral pterygoids
arthrokinematic contralateral lateral deviation
anterior glide in upper compartment
what does TMJ open packed mean
no contact of teeth, tongue in resting position
what do lateral and medial collateral disc ligaments do
attach to medial and lateral poles of mandibular condyle, prevent frontal plane mvmt
what does lateral ligament of TMJ do
support laterally to resist posterior displacement, prevent excessive elevation of condyle into skull
what does stylomandibular ligament do
resist opening for excessive protrusion
what does sphenomandibular ligament do
support medially to TMJ and resist opening, most painful after prolonged mouth opening
what is the primary passive support of mandible
sphenomandibular ligament
compare temporalis and masseter articulations
t: connect temporal fossa to mandible
m: connect zygomatic bone to mandible
compare temporalis and masseter functions
both do elevation of mandible and ipsilateral lateral excursion of mandible. temporalis also does retraction of mandible
compare medial and lateral pterygoid function and innervation
-lateral: depression of mandible, protrusion mandible
-medial: elevation mandible
-both: contralateral lateral excursion of mandible and innervated by mandibular branch of CN 5
compare medial and lateral pterygoid origin and insertion
lateral upper: infratemporal fossa
lateral lower: pterygoid process
lateral insertion: TMJ capsule, TMJ disc, mandible
medial deep: pterygoid process
medial superficial: maxilla
medial insertion: mandible
trigeminal neuralgia
problem w/ chewing, caused by CN 5
bell’s palsy
problem w/ facial expression, CN 7
post surgical sensory issues of face/jaw
CN 5 or 7
where is the spinal cord the thickest
brachial plexus and lumbar regions
what vertebra does the spinal cord end
L2
why is the thoracic spine so stable
attaches to ribs and has many ligaments to it
what part of the spine is built to withstand force
vertebral bodies
blood flow through the heart
chambers of heart
lung anatomy
