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Phase 1 finale > Landmarks > Flashcards

Landmarks Flashcards

1
Q

Which spinal nerves do the Ansa cervicalis arise from?

What does it innervate?

A

It is a neural loop arising from (C1-C3 spinal nerves)

It innervates the infrahyoid muscles except for thyrohyoid

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2
Q

Where does the cervical plexus arise from?

A

From spinal nerve C1 - C4

Sensory fibres carry proprioceptive info.
Motor fibres innervate the diaphragm

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3
Q

Where do the phrenic nerves arise?

What do they innervate?

What can cause related referred pain?

A

Spinal nerves C3-C5
They innervate the diaphragm

Spinal cord segments C3-C5 also receive somatic sensory information from the skin over the shoulder. Therefore, gallbladder pathology involving the diaphragm may also be felt in the right shoulder

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4
Q

Which spinal nerves innervate the skin of the thoracic wall?

A

T1-T12

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5
Q

What fibres innervate the skeletal muscles of the thoracic wall?

A

Somatic motor fibres (T1-T12) - intercostal nerves

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6
Q

What spinal nerves give rise to the cardiopulmonary splanchnic nerves?

A

T1-T5

(Visceral and somatic sensory from the heart, skin of chest wall, neck and arm)- T1-T5

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7
Q

Where do preganglionic sympathetic fibres exit the spinal cord?

A

Spinal nerves T1-L2/L3

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8
Q

What is the level of the sternal angle?

A

T4

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9
Q

At what level is the mediastinum divided into superior and inferior compartments?

A

Anteriorly- sternal angle
Posteriorly- T4-T5 spinal cord segments

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10
Q

At what level does the trachea bifurcate?

A

at the junction between T4-T5

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11
Q

Where do the greater splanchnic nerves arise?

A

Spinal nerves T5-T9

epigastric pain suggests foregut pathology as T5-T9 innervates the foregut

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12
Q

Where do the thoraco-abdominal nerves arise from and what do they innervate?

A

Continuation of the intercostal nerves (T7-T11)
They supply the skin and muscles of the thoracic wall, intercostal muscles and anterolateral abdominal wall

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13
Q

Innervation of the anterolateral abdominal wall

Where do each of the nerves arise from?

A

External oblique (1&2), internal oblique (1,2,3), transversus abdominis, (1,2,3) rectus abdominis (1)

Innervation: 1) Thoracoabdominal nerves (T7-T11), 2) subcostal nerve (T12), 3) iliohypogastric and ilioinguinal (L1)

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14
Q

Where does the oesophagus pass through the oesophageal hiatus?

What is it continuous with here?

A

It passes through the oesophageal hiatus at T10 (diaphragm) - it is continuous with the cardia of the stomach here

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15
Q

Where do the lesser splanchnic nerves originate?

A

Spinal nerve T10-T11
umbilical region pain suggests midgut pathology

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16
Q

Where does the aorta pass through the diaphragm?

A

T12

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17
Q

Where do the least splanchnic nerves originate?

A

T12 - They innervate the hindgut

Pain in the suprapubic region could be an indication of hindgut pathology (as dermatome T12 also innervates the suprapubic region)

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18
Q

Where does the subcostal nerve arise and what does it innervate?

A

T12 spinal nerve

Provides motor supply to the rectus abdominis, intercostal muscles and anterior abdominal wall muscles

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19
Q

Where does the celiac trunk leave the abdominal aorta?

A

T12

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20
Q

Just take note of where the pain fibres supplying the ureters originate

A

T12-L2

So pain caused by kidney stones are referred to and felt in the T12-L2 dermatomes

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21
Q

Where do the lumbar splanchnic nerves arise from?

A

Spinal nerves L1-L2

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22
Q

Where do the azygos system of veins arise?

A

In the abdomen at the level of L1/L2

23
Q

Where do the iliohypogastric and ilioinguinal nerves arise and what do they innervate?

A

Motor innervation of the transversus abdominis and internal oblique muscles

They arise at level of L1

24
Q

At what level does the superior mesenteric artery leave the aorta?

A

L1

25
Q

At what level does the pancreas lie?

A

Pancreas lies horizontally at L1, on the posterior abdominal wall

26
Q

What level is the conus medullaris?

A

L1
The terminal end of the spinal cord

27
Q

What is cauda equina syndrome?

A

When there is compression of nerve roots below the conus medullaris - usually caused by disc prolapse at L4/L5 or L5/S1

28
Q

Where does the lumbar plexus arise from? What are the nerves and which spinal nerves do they arise from?

A

L1-L4

Femoral nerve - L2-L4
Obturator nerve- L2-L4
Iliohypogastric and Ilioinguinal nerve- L1

(Genitofemoral L1,L2) (lateral cutaneous nerve of thigh, L2,L3)

29
Q

What level is the transumbilical plane

A

L3

30
Q

How can the transpyloric plane be drawn?

A
  • Horizontal line passing through the tips of the right and left 9th costal cartilage, transecting the pylorus of the stomach, the gallbladder, the pancreas and hila of the kidneys
    L1-L3
  • Also lies in between the pubic symphysis and manubrium
31
Q

How can the intercristal plane be drawn?

A

A horizontal line between the highest points of the right and left iliac crests (used to guide lumbar puncture)

32
Q

At what level does the inferior mesenteric artery leave the aorta?

A

L3

33
Q

What is the highest point of the iliac crest?
What procedure is performed here? Which layer?

A

Interval between L3-L4
Lumbar puncture is done here in the subarachnoid space in L3-L4 interspace

34
Q

Which spinal nerves does the sciatic nerve arise from?

A

L4-S3

35
Q

At what level does the abdominal aorta bifurcate? What does it bifurcate into?

A

L4
Into the left and right common iliac arteries

36
Q

At what level does the inferior vena cava form? What is it formed by?

A

L5
Formed by the union of the left and right common iliac veins

37
Q

What can be found to arise from S2-S4?

A
  • Parasympathetic pelvic splanchnic nerves
  • Somatic pudendal nerve
  • Dorsal nerve of penis (supplies penis)- branch of pudendal nerve
  • Sacral plexus (supplies lower limb) S2-S4 but receives contribution from L4-L5
38
Q

What happens at the 1,2,3,4 part of the duodenum?

A

1st part- the bile duct, gastroduodenal artery and hepatic portal vein lie posterior

2nd part- major duodenal papilla

3rd part- superior mesenteric artery lies anterior

4th part- meets jejunum at duodenojejunal flexure

39
Q

Dermatome for C4

A

Upper shoulder

40
Q

Dermatome for C5

A

C5 - lateral side of the anterior and posterior aspects of the arm

Test- upper lateral arm

41
Q

Dermatome for C6
How would you test?

A

C6 - lateral side of the anterior and posterior aspects of the forearm, the lateral sides of the anterior and posterior aspects of the palm, and the anterior and posterior surfaces of the thumb and index fingers

Test- Thumb

42
Q

Dermatome for C7

A

C7- the anterior and posterior surfaces of the middle finger and middle of palm (3rd metacarpal)

Test- middle finger

43
Q

Dermatome for C8

A

C8 - the medial side of the anterior and posterior surfaces of the forearm and palm, the anterior and posterior surfaces of the fourth and fifth fingers

Test- medial border of hand

44
Q

Dermatome for T1

A

T1 - the medial side of the anterior and posterior surfaces of the arm

Test- medial border of the arm

45
Q

Dermatome for L1

A

L1- Region over inguinal ligament

Test- region over inguinal ligament

46
Q

Dermatome for L2

A

L2- Upper half of anterior thigh

Test- upper anterior thigh

47
Q

Dermatome for L3

A

L3- Lower anterior thigh and medial aspect of the knee

Test- medial aspect of the knee

48
Q

Dermatome for L4

A

L4- From the anterior surface of the lower limb, lateral aspect of lower thigh, knee and upper leg, the dermatome extends obliquely, inferiorly and medially to cover the anterior knee, anteromedial leg, dorsum of the medial aspect of the foot and skin over dorsum and plantar surface of the big toe

Test- Anteromedial leg

49
Q

Dermatome for L5, test?

A

L5- On the anterior surface of the lower limb. Laterally - the lower ⅔ of the leg, excluding skin over the lateral ankle. Extends obliquely to cover the dorsum of the middle of the foot and the dorsum of toes 2-4. Also covers the plantar surface of the corresponding area.
Posteriorly- vertical strip of skin laterally, extending from the buttock of the upper leg

Test- Anteriorlateral leg

50
Q

Dermatome for S1

A

S1- posteriorly, a vertical strip of skin in the middle of the thigh extending over the lateral part of the posterior leg. The lateral aspect of the ankle, the lateral aspect of the dorsum and sole of the foot. Skin over dorsum and plantar aspect of little toe.

Test- 5th digit (toe)

51
Q

Dermatome for S2

A

S2- posteriorly, vertical strip of skin over the medial thigh and leg, extending onto the medial aspect of the sole of the foot, excluding the plantar surface of big toe.

52
Q

Horizontal fissure of lung level

A

Rib 4

53
Q

Inferior border of lungs landmark

A

6 anteriorly (mid clavicular line), 8 laterally (mid axillary line), 10 (vertebral column)

54
Q

Oblique fissure of lung level

A

Rib 4 posteriorly, 5 laterally, 6 anteriorly

Phase 1 finale (16 decks)

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