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Silas Phase 1 Medicine > IMMS Anatomy > Flashcards

IMMS Anatomy Flashcards

1
Q

What is the sagital plane?

A

vertical plane passing through midline of body, divides into right and left

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2
Q

What are the coronal planes?

A

divide body into anterior and posterior

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3
Q

What is the parasagital plane?

A

Runs parallel to sagital plane but to one side

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4
Q

What is the axial plane?

A

Divides the body into superior and inferior

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5
Q

Name the relative positioning terminology?

A
  • Superior(above) and Inferior(below)
    • Lateral(further from the sagittal plane) and Medial (closer to sagittal plane)
    • Superficial (closer to surface) and deep(further from surface)
    • Anterior (closer to front of the body) and Posterior(closer to back of body)
    • Proximal(closer to starting point) and Distal (further from the starting point)
    • Ipsilateral(same side of body) and Contralateral (the opposite side of the body)
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6
Q

Describe fibrous joints?

A

Bones in a fibrous joint are united by fibrous tissue, there is no joint cavity. The amount of movement depends on the length of the fibrous fibres. For example, the sutures of the cranium are fibrous joints with essentially no movement between them. In contrast, the interosseous membrane between the radius and ulna of the forearm forms a partially movable fibrous joint.

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7
Q

Describe cartilagenous joints?

A

The bones in a cartilaginous joint are united by cartilage, there is no joint cavity.

1. In primary cartilaginous joints the bones are united solely by hyaline cartilage which provides some flexibility e.g. attachment of the ribs to the sternum.
2. In secondary cartilaginous joints the bones are covered with a layer of hyaline cartilage and then united by fibrocartilage which provides strength e.g. the joints between vertebral bodies.
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8
Q

Describe synovial joints?

A

The bones in a synovial joint are united by a joint capsule enclosing a joint cavity. The joint capsule is composed of an outer fibrous layer and an inner serous synovial membrane. The joint cavity is a potential space which contains lubricating synovial fluid. The bones are covered by articular cartilage. Synovial joints allow free movement between the bones they join. The majority of limb joints are synovial.

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9
Q

What are the six types of synovial joints and give an example for each?

A

Ball and Socket (hip joint), Hinge(elbow), Condyloid (Metacarpophalengeal joints of fingers), Saddle (Carpometacarpal joint of thumb) , Plane (Acromioclavicular joint), Pivot (Atlanto-axial joint of cervical spine)

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10
Q

What are the features of a ball and socket joint?

A

• Spherical and concave articular surfaces
• Multiple axes of movement
Permits flexion, extension, abduction, adduction, circumduction, and rotation

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11
Q

What are the features of a hinge joint?

A

Permits flexion and extension only

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12
Q

What are the features of a condyloid joint?

A
  • Similar to saddle joints with movement in two axes but one is usually restricted
    • Permits flexion, extension, abduction, adduction and circumduction
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13
Q

What are the features of a plane joint?

A
  • Articular surfaces are flat
    • Joint capsules are tight
    • Slide movement in planes of articular surfaces
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14
Q

What are the features of a saddle joint?

A
  • Articular surfaces are convex and concave
    • Two axes of movement
    • Permits flexion, extension, abduction, adduction, and circumduction
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15
Q

What are the features of a pivot joint?

A

Rotation around a central axis

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16
Q

Name the ligaments affected by medial and lateral movement of the knee joint?

A

• A lateral force applied to the knee will open out the medial angle of the knee and could strain or tear the Medial Collateral Ligament (A). A medial force applied to the knee could open out the lateral angle of the knee and strain or tear the Lateral Collateral Ligament. These bands of fibrous connective tissue stabilise the femur and tibia in the coronal plane

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17
Q

What anatomical feature provides shock absorption in the knee?

A

protection comes in the form of two discs of fibrocartilage; the medial and lateral menisci, that helps with shock absorption. The articulating surfaces are covered with hyaline cartilage which allows smooth movements

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18
Q

Which ligaments prevent/reduce movement in the sagital plane?

A

• There are a further two ligaments inside the knee joint that prevent excessive movements in the sagittal plane. The anterior cruciate ligament (ACL) attaches the posterior aspect of the lateral condyle of the femur and to the anterior part of the tibial plateau. Because of its position, it prevents excessive forward movements of the tibia in relation to the femur. The posterior cruciate ligament (PCL) arises from the posterior tibial plateau and attaches to the anterior part of the medial condyle of the femur. The PCL prevents excessive movements of the femur anteriorly in relation to the tibia (or the tibia posteriorly in relation to the femur)

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19
Q

Name the three histological types of muscle?

A

Skeletal, cardiac, smooth

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20
Q

Name the 7 types of muscle structures

A

Fusiform, parallel, unipennate, bipennate, multipennate, circular, convergent

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21
Q

Define Flexion?

A

Flex is a verb meaning to bend. For any joint if the joint becomes more bent this is flexion. For example bending the knee or finger or wrist. Flexion of the back is bending forwards.

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22
Q

Define Extension?

A

For each joint this is the opposite of flexion, the joint is moved to a less bent (more straight) position.

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23
Q

Define Rotation?

A

Where the angle between two bones does not change but the axis of one of the bones rotates relative to the other. Eg. Turning the head to look sideways is rotation at the atlanto-axial joint, the humerus can be rotated relative to the shoulder.

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24
Q

Define Abduction?

A

Movement away from the midline; for the arms this is movement away from the body and for the legs movement away from the opposite leg. For fingers it is movement away from the middle finger and for the toes movement away from the second toe

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25
Define Adduction?
The opposite of abduction. Moving the limbs towards the midline or moving the fingers and toes closer together.
26
Define Lateral flexion?
This is a movement of the trunk which takes place at the intervertebral discs, the upper body bends over to the side, it also occurs in the neck.
27
Define supination?
Rotation of the forearm bones so that the palm of the hand faces anteriorly
28
Define pronation?
Rotation of the forearm bones so that the palm of the hand faces posteriorly
29
Define protraction?
to move forwards, such as the jaw moving forwards at the temporomandibular joints or the scapula gliding anteriorly
30
Define retraction?
to move backwards, such as the jaw moving backwards at the temporomandibular joints or the scapula gliding more posteriorly
31
Define Opposition?
this is a special movement of the thumb where the thumb is rotated to allow the palm of the thumb to meet the palm of the little finger; the thumb opposes the little finger.
32
Define inversion?
The sole of the foot faces inwards towards the other foot
33
Define eversion?
movement of the foot where the sole of the foot is made to face outwards
34
How many vertebrae make up the spine and how are they divided?
The spine is made up of seven cervical, twelve thoracic, five lumbar and five sacral vertebra
35
What is unusual about the C1 and C2?
The atlas has no vertebral body, this has fused with the axis below to form the odontoid peg. The odontoid peg sits just behind the anterior arch of the atlas and is held in this position by the cruciate ligament. The odontoid peg can rotate considerably within the atlas and this accounts for almost all of the rotation of the head on the neck.
36
What is a typical cervical verterbrae structure?
The fifth cervical vertebra is ‘typical’ for the other cervical vertebra. The cervical vertebra all have three foramina (holes); one for the spinal cord and two for the vertebral arteries which lie in the transverse processes. The spinous process are bifid except on the seventh cervical vertebra.
37
What is a typical thoracic verterbrae structure?
The thoracic vertebra only have a single foramina for the spinal cord and have longer spinous processes which have a single point. There are synovial joints for the heads and tubercle of the ribs on the body and transverse processes of the vertebra.
38
What types of joints are present in the verterbrae?
Vertebrae articulate with each other through two distinct types of joint, secondary cartilaginous and synovial. The secondary cartilaginous joint is between the vertebral bodies, the intervertebral disc, and is responsible for a ‘slipped disc’ should it become displaced.
39
Anatomically, how is the nervous system divided?
1) Central nervous system consisting of the brain and spinal cord 2) Peripheral nervous system consisting of 12 pairs of cranial nerves (which arise directly from the brain) and 31 pairs of spinal nerves (which arise from the spinal cord).
40
Functionally, how is the nervous system divided?
A) Somatic nervous system, which control voluntary activities ‘Motor’ control of skeletal muscles ‘Sensations’ which reach consciousness B) Autonomic nervous system, controls involuntary activities ‘Motor’ to glands, blood vessels, heart etc. ‘Sensory’ blood pressure, CO2 in blood, how full is duodenum? etc. The Autonomic nervous system is further divided into two opposing parts B1, Sympathetic, prepares the body for emergencies B2, Parasympathetic, creates a state of rest and facilitates digestion
41
What components make up the brain?
The brain consists of the: 1. Cerebral hemispheres 2. Brainstem - midbrain, pons and medulla 3. Cerebellum
42
How are the cerebral hemispheres divided?
The cerebral hemispheres are divided into surface and deep structures. On the surface there are frontal, parietal, temporal and occipital lobes and deep within the brain structures such as the basal ganglia, thalamus and internal capsule etc. The surface of the cerebral hemispheres are thrown into folds called gyri which are separated by valleys called sulci
43
What separates the frontal and parietal lobes?
The frontal and parietal lobes are separated by the Running across the central sulcus
44
what is the motor cortex and where does it lie?
In front of the central sulcus is a gyrus which controls muscles of the opposite side of the body; the motor cortex. Behind the central sulcus is the corresponding sensory gyrus, it also corresponds to the opposite side of the body. Damage to these parts of the cortex will lead to a predictable pattern of motor and sensory loss on the opposite of the body.
45
What is grey matter?
Grey matter is where all the processing (thinking) takes place and white mater transmits the information from one place to another
46
What is the role of the brain stem?
The brain stem is mainly concerned with transmitting signals from the brain to the body (motor) and from the body to the brain (sensory). Whilst there are some small areas which have cell bodies it is predominantly white matter.
47
What is the role of the cerebellum?
The cerebellum is a specialised area of the brain which has no conscious input but uses sensory information form the body to refine the motor instruction which the brain sends to the muscles.
48
What are the menigeal layers?
Dura, arachnoid, pia
49
What are the layers of the dura?
The periosteal layer and the meningeal layer
50
What are the potential spaces in the menigeal layers?
1. Outside of the dura (the extradural or epi-dural space) - this is a potential space and does not exist in the absence of pathology 2. Between the dura and the arachnoid (the subdural space) - again, this does not exist in the absence of pathology. 3. Between the arachnoid and the pia mater (the subarachnoid space) - this space exists in healthy individuals and is filled with cerebrospinal fluid (CSF)
51
What is CSF?
CSF is a clear fluid which provides nutrients to the brain and helps to maintain the balance of extracellular fluid. It protects the brain by providing a cushion against trauma and prevents delicate nervous and vascular structures from becoming compressed against the internal surface of the skull. It is produced by tissue called choroid plexus which is found within the ventricles of the brain.
52
What are the ventricles in the brain?
There are four, interconnected ventricles: 1. Right and left lateral ventricles 2. Third ventricle 3. Fourth ventricle The lateral ventricles lie within the cerebral hemispheres, one on either side. The third ventricle lies in the midbrain The fourth ventricle lies behind the pons and medulla and in front of the cerebellum.
53
What is the pathway of CSF?
Cerebrospinal fluid flows from the lateral ventricles → 3rd ventricle → cerebral aqueduct → fourth ventricle → subarachnoid space. From the subarachnoid space the CSF is absorbed into the venous sinuses and the venous system
54
Which arteries supply the brain?
Two internal carotid arteries and two vertebral arteries supply blood to the brain.
55
What are the key vessels of the circle of Willis?
Need to be able to identify Vertebral arteries, Internal carotids, Basilar artery Posterior cerebral Anterior cerebral, Middle cerebral arteries
56
Name the 12 cranial nerves?
Olfactory, Optic, Occulomotor, Trochlear, Trigeminal, Abducens, Facial, Vestibulocochlear, Glossopharyngeal, Vagus, Accessory, Hypoglossal
57
What is the function of the olfactory nerve?
Sensory-smell
58
What is the function of the optic nerve?
Sensory-Sight
59
What is the function of the Occulomotor nerve?
Motor- eye movement, Autonomic to the pupil
60
What is the function of the trochlear nerve?
Motor- movement of the eye
61
What is the function of the trigeminal nerve?
Sensory from the face, nose and oral cavity | Motor-Chewing muscles
62
What is the function of the abducens nerve?
Motor, lateral (outward) movement of the eye
63
What is the function of the facial nerve?
Motor of facial expression, Sensory (taste) Autonomic to salivary glands
64
What is the function of the vestibulocochlear nerve?
Sensory-balance and hearing
65
What is the function of the glossopharyngeal nerve?
Sensory from the tongue and pharynx, Autonomic to salivary glands
66
What is the function of the Vagus nerve?
Autonomic motor to thoracic and abdominal organs, autonomic sensory from thoracic and abdominal organs
67
What is the function of the accessory nerve?
Motor to head, shoulders, pharynx, larynx, and soft palate
68
What is the function of the hypoglossal nerve?
Motor to tongue
69
Name the 9 Dermatomes and the corresponding Spinal nerves?
Clavicle C4/5 Nipples T5 Umbilicus T10 Inguinal Region T12 Middle Finger C7 Patella L3 Big Toe L5 Fifth Toe S1 Perianal Region S5
70
Name the myotomes and the corresponding spinal nerve?
Deltoid C5 Biceps C6 Triceps C7 Grip C8 Finger abduction T1 Psoas L1 Adductors L2 Quadriceps L3 Dorsiflexors and invertors L4 Long extensors and evertors L5 Long Flexors S1 Bladder S2, S3, S4
71
Define Dermatome
A Dermatome is an area of skin which receives a sensory nerve supply from a single root of the spinal cord (although the nerve fibres may travel through different peripheral nerves). By finding sensory abnormalities in the dermatomes we can work out which spinal nerve is diseased.
72
Define Myotome
A myotome is a group of muscles supplied by the same spinal root. Just like dermatomes, because some nerves have mixed spinal roots, the pattern of muscles supplied by a spinal root is different to the pattern of muscles supplied by a single peripheral nerve. To assess the motor function of a myotome (or a nerve) the patient is asked to perform the movement of the relevant group of muscles against gravity and then against resistance applied by the doctor.
73
Where spinal nerves mix?
This mixing of the spinal nerves is achieved in a plexus. There are cervical, brachial, lumbar and sacral plexuses supplying the upper and lower limbs. The brachial plexus is the most complex, the upper limb being more complex than the lower limb. The spinal nerves supplying the plexus are from the fifth to eighth cervical segments (C5-C8) and the first thoracic segment (T1).
74
What is the function of the sympathetic nervous system?
The sympathetic system prepares the body for ‘emergencies’ or the four F’s; Fight, fright, flight and frolic. The heart rate increases, there is peripheral vasoconstriction (you go white with fear), blood pressure increases, respiratory rate increases, the bowel is suppressed and sphincters closed. Hair stands on end and, in preparation for heat production from vigorous exercise, you sweat. The sympathetic division emerges from the spinal cord in the thoracic and lumbar areas (or ‘thoracolumbar’ outflow), terminating around L2-3.
75
What is the function of the parasympathetic nervous system?
The parasympathetic system prepares the body for rest and sleep. The heart and respiratory rate falls, bowel and glandular activity increases and the sphincters relax, blood pressure falls and you feel sleepy. Vessels in the erectile tissue dilate causing penile erection. parasympathetic division has craniosacral ’outflow’, meaning that the neurons begin at the cranial nerves (specifically the oculomotor nerve, facial nerve, glossopharyngeal nerve and vagus nerve) and sacral (S2-S4) spinal cord.
76
What is the pathway of the sympathetic nervous system?
1. Preganglionic axons pass out of cell bodies found at the intermediolateral column (found laterally in the grey matter of the spinal column between T1-L2; aka. lateral horn). 2. Moves through the anterior root to join the spinal nerve 3. Travels to the paravertebral ganglion via the white ramus (white as preganglionic fibres are myelinated) 4. At the paravertebral ganglion, there are 4 possible outcomes (all 4 possibilities are drawn in the diagram using the same preganglionic axon, however in reality there will all be different nerves). a. Synapse at the level it entered the paravertebral ganglion, and postganglionic axon leaves via the grey ramus (as postganglionic axons are unmyelinated) via either the posterior or anterior ramus to supply its target organs b. Move up and down the sympathetic trunk and synapse at another paravertebral ganglion c. Synapse at the level it entered the paravertebral ganglion, and postganglionic axon leaves the paravertebral ganglia NOT via the grey ramus. This nerve is called a splanchnic nerve (as doesn’t pass through the grey ramus). This occurs in the thorax d. The preganglionic nerve does not synapse at the paravertebral ganglia. Instead it moves out of the ganglia NOT via the grey ramus (hence becomes a splanchnic nerve) and synapses at a prevertebral ganglion. This occurs in the abdomen and pelvis.
77
What is the pathway of the parasympathetic nervous system
The parasympathetic nervous system is connected to the central nervous system through the third, seventh, ninth and tenth cranial nerves and the second, third and fourth sacral nerves. The sacral nerve fibres pass out of the spinal nerves to form the Pelvic splanchnic nerves which pass to the hind gut and the pelvic organs. Fibres in the cranial nerves pass with those nerves to the organs which they innervate. The parasympathetic ganglion where these preganglionic neurons synapse will be close to the organ of innervation. This differs from the sympathetic nervous system, where synapses between pre- and post-ganglionic efferent nerves in general occur at ganglia that are farther away from the target organ
78
What is the name for the for the peak at which the two halves of the thyroid cartilage meet?
The Laryngeal Prominence
79
What cartilage lies below the thyroid cartilage?
The cricoid cartilage
80
What is the name of the depression between the cricoid cartilage and the thyroid cartilage?
The cricothyroid membrane
81
How many pairs of ribs do we have?
12
82
What is the other name for the jugular notch?
The suprasternal notch
83
What is the Angle of Louis?
The Sternal Angle
84
Where does the costal cartilage of the second rib articulate with the sternum?
The sternal angle
85
In males, what is a good surface marking for the fourth intercostal space?
The nipple
86
What is happening at T4/5?
The sternal angle anteriorly lines nicely with the T4/T5 vertebral level. This is of significance because at this point the trachea bifurcates (splits) and the arch of aorta ends as the thoracic aorta begins
87
What is the midaxillary line?
The midaxillary line runs vertically through the middle of the axilla under the armpit
88
What are the surface markings for the oblique fissure of the lungs?
On both sides the oblique fissures start at the 4th rib at the back, travel deep to the 5th rib and end at the 6th costal cartilage at the front.
89
What is the second fissure in the right lung?
On the right there is a horizontal fissure, at the level of the 4th costal cartilage, which separates the upper lobe from the middle lobe of the right lung
90
What is the inferior extent of the lungs?
• The inferior extent of the lungs is at the 6th rib anteriorly, the 8th rib laterally and the 10th rib posteriorly
91
What is the costo-diaphragmatic recess?
The pleura extends below the lungs and forms the costo-diaphragmatic recesses. The recess extends to the 8th rib anteriorly, the 10th laterally and the 12th posteriorly. This recess is needed for the lungs to expand into during deep inspiration.
92
Why is the lung at risk from a neck stabbing?
lung extends above the clavicle into the base of the neck, and is at risk from stab wounds in the neck.

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