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PAM Semester 1 > Gross Anatomy Week 1 > Flashcards

Gross Anatomy Week 1 Flashcards

1
Q

Which of the following nerves is deep to the transverse carpal ligament?

A. Radial
B. Musculocutaneous
C. Interosseous
D. Median

A

D. Median

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2
Q

List the bones of the wrist

A

Carpals (8 Bones)

Proximal
some lovers try positions

Distal
that they can’t handle

Proximal
Scaphoid - Lunate - Triquetrium - Pisisform

Distal
Trapezium - Trapezoid - Capitate - Hamate

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3
Q

Which bone receives the blood supply from distal to proximal?

A. Hamate
B. Lunate
C. Scaphoid
D. Trapezium

A

C. Scaphoid

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4
Q

Triceps deep tendon reflex (DTR) is diminished. Which of the following myotomes will be affected

A. Elbow flexion
B. Shoulder abduction
C. Wrist extension
D. Finger adduction

A

C. Wrist extension

C7 Myotome

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5
Q

Which of the following rotator cuff muscels externally rotates the shoulder joint?

A. Supraspinatus
B. Infraspinatus
C. Teres Minor
D. Subscapularis

A

B. Infraspinatus

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6
Q

What space does a lumbar puncture obtain CSF from?

A. Choroid plexus
B. Epidural
C. Subdural
D. Subarachnoid

A

D. Subarachnoid

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7
Q

Which of the following signs or symptoms would present from a deep scalp laceration?

A. Neck Abcess
B. Cellulits aof the forehead
C. Exopthalamus
D. Periorbital swelling

A

D. Periorbital swelling

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8
Q

What space do you inject drugs into the CSF at?

A. Choroid plexus
B. Epidural
C. Subdural
D. Subarachnoid

A

B. Epidural

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9
Q

Occular muscles for eye look in medially or inward?

A

Medial rectus

eyes look inward

look left with right eye or right with left eye
Crosseyed

Cranial nerve 3

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10
Q

Occular muscles for laterally or outwards

A

Lateral rectus

Eyes look outward or laterally

look left with left eye, look right with right eye

Cranial nerve 6

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11
Q

Occular muscles for looking down and in (down nose) (down and medially)

A

Superior Oblique

Obliques are opposite

Look down and in (medially)

look down and left with right eye or down and right with left eye
Crosseyed

Cranial nerve 4

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12
Q

Occular muscles for up and inwards (up & medially)

A

Inferior oblique

Obliques are opposite

Look up and in (medially)

look up and left with right eye or up and right with left eye
Crosseyed

Cranial nerve 3

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13
Q

Occular muscles for looking down and outwards (laterally)

A

Inferior rectus

Look down and outwards (laterally)

look down and left with left eye, look down and right with right eye

Cranial nerve 3

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14
Q

Occular muscles for looking up and outwards (laterally)

A

Superior rectus

Look up and outwards (laterally)

look up and left with left eye, look up and right with right eye

Cranial nerve 3

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15
Q

Cranial nerves for eye movements with muscles

A

3, 4, 6
Occularmotor
Trochlear
Abducens

SO4, LR6, Rest are 3

Obliques are opposite directions

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16
Q

What can pathology in the cavernous sinus effect

A

CN III, IV, V1, V2, V3

Extra ocular motion
Vision
Pupilary response

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17
Q

Cranial Nerve I

A

Number = 1
Name = Olfactory Nerve
Motor / Sensory = Sensory

Origin / Termination = Epithelium / Bulbs
Cranial exit = Foramina of cribriform plate of ethmoid bone
Brainstem location = Cortex / Midbrain / Olfactory Bulbs
Function = Transmits olfaction (smell) to the brain
(special sensory)

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18
Q

Cranial Nerve II

A

Number = 2
Name = Optic
Motor / Sensory = Sensory

Origin / Termination = Retina (ganglion cells)
Cranial exit = Optic Canal
Brainstem location = Retina / Midbrain
Function = Vision from Retina
(special sensory)
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19
Q

Cranial Nerve III

A

Number = 3
Name = Occulomotor
Motor / Sensory = Motor

Origin / Termination = Nucleus of CN III (edinger westphal)
Cranial exit = Superior Orbital Fissure
Brainstem location = Midbrain
Function = Pupil Constriction, Accomodation, Eye movement

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20
Q

Cranial Nerve IV

A

Number = 4
Name = Trochlear
Motor / Sensory = Motor

Origin / Termination = Nucleus of CN IV
Cranial exit = Superior Orbital Fissure
Brainstem location = Midbrain
Function = Inferior Oblique (looks down and in

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21
Q

Cranial Nerve V (V1)

A

Number = 5
Opthalmic Division
Name = Trigeminal
Motor / Sensory = Both (sensory)

Origin / Termination = Trigeminal ganglion / spinal principle and mesecephalic nucleus of CN V
Cranial exit = Superior Orbital Fissure
Brainstem location = Pons
Function = Sensation from cornea, skin of forehead, nasal cavity and more

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22
Q

Cranial Nerve VI

A

Number = 6
Name = Abducens
Motor / Sensory = Motor

Origin / Termination = Nucleus of CN VI
Cranial exit = Superior Orbital Fissure
Brainstem location = Pons/Medulla
Function = Lateral gaze, Lateral rectus motor

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23
Q

Cranial Nerve VII

A

Number = 7
Name = Facial
Motor / Sensory = Both

Origin / Termination = Nucleus of CN VII
Cranial exit = Stylomasoid foramen
Brainstem location = Pons/Medulla
Function = facial expression

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24
Q

Cranial Nerve VIII

A

Number = 8
Name = Vestibular-Cochlear
Motor / Sensory = Sensory

Origin / Termination = Vestibular nuclei / Cochlear nuclei
Cranial exit = Internal acoustic meatus
Brainstem location = Pons/Medulla
Function = hearin, head position, balance

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25
Cranial Nerve IX
Number = 9 Name = Glossalpharyngeal Motor / Sensory = Both Origin / Termination = Nuclei of soilatry/ambiguus/trigeminal Cranial exit = Jugular Foramen Brainstem location = Medulla Function =Swallow, saliva, taste
26
Cranial Nerve X
Number = 10 Name = Vagus Motor / Sensory = Both Origin / Termination = Nuclei of soilatry/ambiguus/trigeminal Cranial exit = Jugular Foramen Brainstem location = Medulla Function = Taste, cardiac, Digestion,
27
Cranial Nerve XI
Number = 11 Name = Spinal Accessory Motor / Sensory = Motor Origin / Termination = accessory nucleus of spinal cord Cranial exit = Jugular foramen Brainstem location = Medulla / spinal cord Function = Motor muscles sternocleidomastoid, trapezius
28
Cranial Nerve XII
Number = 12 Name = Hypoglossal Motor / Sensory = Motor Origin / Termination = Nucleus of CN XII Cranial exit = Hypoglossal canal Brainstem location = Medulla Function = Motor muscles of tongue
29
Cranial Nerve V (V2)
Number = 5 V2 Maxillary Division Name = Trigeminal Motor / Sensory = Both (sensory) Origin / Termination = Trigeminal ganglion / spinal principle and mesecephalic nucleus of CN V Cranial exit = Foramen Rotundum Brainstem location = Pons Function = Sensation of upper lip, mucosa of nose, maxillary sinuses, palate
30
Cranial Nerve V (V3)
Number = 5 Mandibular division Name = Trigeminal Motor / Sensory = Both Origin / Termination = Trigeminal ganglion / spinal principle and mesecephalic nucleus of CN V and Motor nucleus of CN V Cranial exit = Foramen Ovale Brainstem location = Pons Function = Muscles of mastication, sensation over mandibleTMJ, side of head etc.
31
Promary headache types
Migraine Tension Trigeminal autonomic cephalalgias (cluster)
32
Horner syndrome
Horner syndrome = Nerve interruption, can result from stroke, small pupil, drooping Eyelid
33
Trigeminal neuralgia
Trigeminal neuralgia = chronic, over 50 in women, pain in face
34
Upper Motor Neuron vs Lower Motor Neuron | eyebrows
Raise eye brows If both raise, it is upper motor neuron problem (Stroke) Involves brain If only one raises, it is a lower motor neuron problem (bells palsy) involves brain
35
Bells palsey (UMN vs LMN)
Lower motor neuron problem ipsilateral problem Problem is on the same side This involves the Nerve, not the brain
36
Stroke (UMN vs LMN)
Upper motor neuron problem Crosses hemispheres Oppostie side problem This involves the brain, not the nerve
37
Location of LMN problem | Lower Motor Neuron
``` Anterior horn to The affected organ system (end plate) This is ipsilateral side Lose motor on ipsilateral side Affects the entire side of face Only one eye brow moves ```
38
Location of UMN problem | Upper Motor Neuron
Affects the lower face Contralateral side Both eyebrows move
39
What cranial nerve inervates the parotid gland
CN IX glossalpharyngeal salvary juices swallowing
40
What cranial nerve can get cut in thyroid disease and cause permanent hoarseness
Vagus Nerve | CN X
41
What cranial nerve gives taste and sensation in back of throat
Vagus | CN X
42
What cranial nerve gives taste in the back 3rd (posterior 3rd) of tongue
Glossalpharyngeal | CN IX
43
What cranial nerve gives taste for front 2/3s (anterior 2/3s) of tongue
Facial | CN VII
44
Tongue Cranial nerves Posterior 1/3
Posterior 1/3 = Taste and sensation = Glossalpharyngeal CN IX Motor = Hypoglossal CN XII
45
Tongue Cranial nerves Anterior 2/3
Anterior 2/3 = Taste = Facial CN VII Sensation = Trigeminal 3 CN V3 Motor = Hypoglossal CN XII
46
What cranial nerve is motor in the back 3rd (posterior 3rd) of tongue
Motor = Hypoglossal CN XII
47
What cranial nerve gives sensation in the back 3rd (posterior 3rd) of tongue
sensation = Glossalpharyngeal CN IX
48
What cranial nerve is motor for front 2/3s (anterior 2/3s) of tongue
Motor = Hypoglossal CN XII
49
What cranial nerve gives sensation for front 2/3s (anterior 2/3s) of tongue
Sensation = Trigeminal 3 CN V3
50
Saying Ah tests which Cranial Nerve A. Vagus B. Hypoglossal C. Trigeminal V3 D. Facial
A. Vagus
51
The OD has a loss of all visual fields. Where is the defect? A. Optic tract B. Lateral geniculate nucleus C. Optic nerve D. Optic radiations
C. Optic Nerve
52
Patient has a Cranial nerve VI lesion. Which of the following is affected? A. Visual acuity B. Facial sensation C. Hearing D. Convergence
D. Convergence
53
Where is the lesion for teh Old man with the stroke symptoms (both eyebrows raise, lip droop. A. Middle cerebral artery B. Facial nerve C. Trigeminal Nerve D. Internal carotid artery
A. Middle cerebral artery
54
The effernet pupilary response is controlle by which nerve? A. CN II B. CN III C. CN V1 D. CN IV
B. CN III
55
Efferent
Motor Nerves | Outgoing
56
Afferent
Sensory Nerves | In coming
57
What are the cranial nerves responsible for pupil constriciotn and dialation
Incoming (afferent) light = CN II Optic nerve Sensory ``` Pupil constriction (efferent) = CN III oculomotor Motor ``` ``` Pupil Dialation (efferent) = CN V1 Trigeminal 1 Motor ```
58
Lower Motor Neuron Attributes
``` Loss of muscle tone Same sided weakness Flaccidity atrophy tendon reflexes impaired or gone fasciculations ``` From anterior horn to the effector plate
59
Upper Motor Neuron Attributes
Chorea Dystonia Athetosis increased muscle tone, reflexes rigidity spacticity Babinsky ``` Brain cross over (opposite side) ```
60
Bulbocavernosa reflex
Squeeze clitoris or penis and anus contracts
61
DTR Deep tendon reflexes
Biceps C5/C6 Brachioradialis C6 Triceps C7 Distal Finger Flexors C8 Patellar L4 Ankle Jerk S1 Jaw Jerk CN V
62
Basillar skul fracture symptoms
Raccoon eyes (periorbital eccymosis) Battle signs (Postauricular eccymosis) Hemotympanum CSF otorrhea
63
Pterion
The pterion is the region where the frontal, parietal, temporal, and sphenoid bones join together. It is located on the side of the skull, just behind the temple.
64
Scalp infection can result in what
Periorbital swelling
65
What do we worry about in a Pterion fracture
Middle meningeal artery tearing | Which can lead to epidural hematoma
66
Layers of meninges from deep to superficial
``` Pia Subarachnoid space Arachnoid space Subdural space Dura ```
67
Where does CSF go into the venus system
Archnoid granulations
68
Three ways to have hydrocephalus
Back up of CSF (communicating or non communicating) Choroid plexus over production Arachnoid granulation isn't reabsorbing CSF and putting it into the venus space
69
What feeds almost the entire dura
Middle meningeal artery
70
What is faux cerebri
Dura that seperates the brain into left and right hemispheres
71
What is the tentorium cerebelli (tentorium)
Seperates the cerebellum from the crebrum
72
superior sagital sinus
runs down the top center of skull a venous sinus of dura mater Main reabsorption site of CSF
73
What is the danger area of the scalp for infection and laceration
Loose areola tissue Infection in this layer can pass into the cranial cavity through emissary veins, which pass through parietal foramina in the calvaria and reach intracranial structures such as the meninges.
74
Epidural hematoma cause
Test question Tear of middle meningeal artery CT w/o contrast Blood is white ``` Acute process (Rapid, abrupt bleeding) Lens like shape (Swelling out of scalp) ``` Is there midline shift?
75
Subarachnoid hemorrhage cause
Active bleeding from within that Is white on CT (diffuse white blood on the CT) see blood in all different spaces Caused by aneurysm that gives out Ventricles are black Blood is white Acute onset
76
Subdural hematoma Cause
Bridging veins torn Ventricles are black (white is new blood) Balloon shape layering bleeding under balloon Venous bleed, slower
77
CSF Purpose
Protection, waste removal, nutrient transport
78
Differnece in communicating and non communicating (CSF)
In communicating, there is no blockage. Every thing is open and flowing. All ventricles will be dialated In non communicating, there is a blockage somwhere. one or more ventricels are dialated while others are not.
79
What is Normal pressure hydrocephalus a cause of
Normal pressure hydrocephalus is reversible cause of dementia
80
Which sinues can you palpate
Frontal sinuses (can palpate) Ethmoid sinuses (cannot palpate) ``` Sphenoid sinuses (cannot palpate) behind ethmoid ``` Maxillary sinuses (can palpate)
81
What sinus is behind the sphenoid sinus
cavernous sinus
82
Best way to image sinuses
Sinus CT Scan
83
cavitating
the layer of the sinus now has fluid behind it and is expanding and is pressuring the eyeball
84
Nerves in and around cavernous sinus
``` CN III oculomotor CN IV trochlear CN VI abducens CN V1 Trigeminal opthalmic CN V2 Trigeminal maxillary ``` internal carotid surounds the pituitary
85
How far does nuchal ligament go
c1 - c7
86
What is most posterior ligament in cervical spine
Nuchal
87
List ligaments in cervical spine from anterior to posterior
``` Anterior longitudinal Posterior longitudinal ligamentum flavum interspinal ligament Nuchal ligament ```
88
What makes the popo on a lumbar puncture
Punching through the ligamentum flavum
89
Where does the nerve exit on each cervical vertebrae
Nerve exits above each vertebrae C1 nerve root is above C1 reason we have C8 nerve but no C8 vertebrae
90
Where does the nerve exit on each vertebrae other than cervical
Below the vertebrae | T1 nerve root exits below T1, between T1 and T2
91
What view on x ray allows us to see the nerve exit
Oblique view
92
Where does the spinal cord usually terminate
L1 or L2 | Cauda equina
93
MRI T1 vs T2
T1 fluid is not white | T2 fluid is white
94
What attaches the upper limb to the axial skeleton
Sternoclavicular joint
95
Shoulder Joint
Glenohumeral joint glenoid is shallow socket Because of its freedom of movement and instability, the glenohumeral joint is commonly dislocated by direct or indirect injury. Most common downward (inferior) direction
96
Rotator cuff muscles
SITS ``` Suprapinatous (abductor) Infraspinatus (external rotators) Teres minor (external rotators) (Superior to major) Subscapularis (internal rotation) ```
97
Rotator Cuff Muscles | Subscapularis
Large flat muscle on anterior (inside) of scapula | internal rotation
98
Rotator Cuff Muscles | Infraspinatus
Large muscle on posterior of flat portion of scapula, sits below spine of scapula, above teres minor (external rotators)
99
Rotator Cuff Muscles | Teres minor
sits on the bottom margin posterior of scapula under inferior to the infraspinatus (external rotators) (Superior to major)
100
Rotator Cuff Muscles | Suprapinatous
Sits above the spine of the scapula at the top of the scapula on the posterior side (abductor)
101
Injectionsite in shoulder
Subacromial bursa
102
groove of superior humerous
long head of biceps runs through groove of humerous and attaches to the superior portion of the glenoid
103
Short head of bicep attaches to
Short head of bicep attaches to the coracoid process
104
Long head of bicep attaches to
Long head of bicep attaches to transverse humeral ligament
105
What does volar mean
Dorsal | Typically used for forearm
106
What does the radial nerve innervate
All muscles of the posterior compartment of arm and forearm
107
What does the ulnar nerve innervate
flexor carpi ulnaris and ulnar half of the flexor digitorum profundus in the forearm the hypothenar and interosseous muscles of the hand the lumbricals to digits 3 and 4 and 1½ thenar muscles (adductor pollicis and the deep head of the flexor pollicis brevis).
108
What does the median nerve innervate
muscles of the anterior compartment of the forearm (with 1½ exceptions that are innervated by the ulnar nerve) the lumbricals to digits 2 and 3 and the intrinsic muscles of the thumb (thenar muscles).
109
What does the musculocutaneous nerve innervate
all the muscles of the anterior compartment of the arm.
110
Dermatome C5
Upper arm (lateral)
111
Dermatome C6
Trigger finger thumb lateral forearm
112
Dermatome C7
Middle finger
113
Dermatome C8
Pinkie finger | Ring finger
114
Dermatome T1
medial forearm
115
Dermatome T2
Medial upper arm | axilla
116
Phrenic Nerve
Diaphragm | C3,4,5 keeps the diaphragm alive
117
Brachial plexus nerves
C5 -T1 C5, C6, C7, C8, T1
118
Myotome Elbow flexion
C5/C6
119
Myotome Elbow extension
C6/C7
120
Myotome Wrist Flexion
C6/C7
121
Myotome Wrist extension
C6/C7
122
Myotome Finger Flexion
C7/C8
123
Myotome Finger extension
C7/C8
124
Myotome Shoulder Flexion
C5
125
Myotome Shoulder extension
C6/C7/C8
126
Myotome C5/C6
Elbow flexion
127
Myotome C7/C8
Finger flexion/extension | wrist pronation
128
Myotome C6/C7
Wrist extension/flexion | Elbow extension
129
Myotome wrist supination
C6
130
Myotome wrist pronation
C7/C8
131
Lines of demarcation of brachial plexus
First rib and teres major
132
Brachial Plexus C5
Musculocutaneous Axillary Radial
133
Brachial Plexus C6
Musculocutaneous Axillary Median Radial
134
Brachial Plexus C7
Musculocutaneous Median Radial
135
Brachial Plexus C8
Median Radial Ulnar
136
Brachial Plexus T1
Median Radial Ulnar
137
Brachial Plexus Musculocutaneous Nerve
C5 C6 C7
138
Brachial Plexus Axillary Nerve
C5 | C6
139
Brachial Plexus Median Nerve
C6 C7 C8 T1
140
Brachial Plexus Radial Nerve
``` C5 C6 C7 C8 T1 ``` ALL
141
Brachial Plexus Ulnar Nerve
C8 | T1
142
What runs between the scalene muscles
Brachial plexus nerves
143
Where does the subclavian artery become the axillary artery
At the outer border of the first rib
144
Where does the axillary artery become the brachial artery
as it crosses teres major
145
What are the 3 forearm compartments
Volar Mobile Dorsal
146
Contents of Volar Compartment
ulnar nerve median nerve superficial branch of the radial nerve anterior interosseous nerve ulnar artery radial artery anterior interosseous artery ``` Muscles = flexor of hands and wrist, including policis longus flexor digitorum superficialis flexor carpi radialis flexor pollicis longus flexor digitorum profundus flexor carpi ulnaris ```
147
Contents of the Mobile Compartment
AKA mobile WAD Muscles= extensor carpi radialis brevis longus muscles brachioradialis
148
Contents of the Dorsal Compartment
Posterior interosseous artery (PIA), posterior interosseous nerve ``` Muscles= finger extensors and the long thumb abductor abductor pollicis longus extensor digiti minimi extensor carpi ulnaris extensor pollicis longus extensor digitorum communis ```
149
Volkmanns Contracture
Failure to recognize compartment syndrome | Volar
150
Compartment syndrome
supracondylar fx, radial fx, crush injury
151
What is TFCC
Pad between the ulna and triquetrum
152
What articulates with 1st metacarpal (thumb)
Trapezium
153
What tendon does only 50% of population have
Palmaris longus
154
What is radial artery lateral to
Flexor Carpi radialis tendon
155
What is cut in carpal tunnel surgery
Transverse carpal ligament
156
Hand compartments
``` Thenar = thumb side Hypothenar = pinkie side Central = middle palmar side ```
157
Where does the musculocutaneous nerve terminate
about the elbow

PAM Semester 1 (16 decks)

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