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lecom ms1 gross anatomy > LECOM MS1 Gross Anatomy--Initial Quiz > Flashcards

LECOM MS1 Gross Anatomy--Initial Quiz Flashcards

1
Q

What types of structures does technically anatomy include

A

macroscopic and microscopic

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2
Q

When used by itself, anatomy typically refers to which structures

A

macroscopic

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3
Q

Microscopic anatomy is also called what

A

histology

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4
Q

The term anatomy is derived from the Greek word “temnein” which means

A

to cut

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5
Q

What two approaches can anatomy be studied

A

regional approach

systemic approach

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6
Q

What is the regional approach to studying anatomy

A

Each region of the body is studied separately and all aspects of that region are studied at the same time (example all structures of thorax studied at same time)

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7
Q

What is the systemic approach to studying anatomy

A

Each system of the body is studied and followed throughout the entire body

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8
Q

What is the anatomical position

A

the standard reference position of the body used to describe the location of structures

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9
Q

Describe the positions of the hands, feet, body, face, mouth, facial expression in the anatomical position

A
  • Person is standing upright with feet together, toes point forward
  • Hands are by the side with palms forward with the fingers straight and together. Thumb pad turned 90 degrees to pads of fingers
  • Face looking forward, mouth closed
  • Neutral facial expression, eyes open and focused on something in the distance
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10
Q

In the anatomical position, the bone under the eye aligns with what

A

the opening of the ear

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11
Q

How many major groups of planes pass through he body in the anatomical position

A

3

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12
Q

What are the 3 major groups of planes in the anatomical position

A

Coronal
Sagittal
Transverse

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13
Q

What orientation is the coronal plane

A

Oriented vertically

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14
Q

What does the coronal plane divide the body into

A

posterior and anterior parts

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15
Q

What orientation is the sagittal plane

A

Orientated vertically, but at 90 degree angles to the coronal plane

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16
Q

What does the sagittal plane divide the body into

A

left and right parts

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17
Q

What is the plane that passes through the center of the body dividing the body into equal left and right parts called

A

median sagittal plane

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18
Q

What is the orientation of the transverse plane

A

Horizontal

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19
Q

What are two other names for the transverse plane

A

Horizontal plane or axial plane

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20
Q

What does the transverse plane divide the body into

A

superior and inferior parts

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21
Q

What are the three major pairs of terms used to describe the location of structures relative to other structures or the body as a whole

A

anterior (ventral) vs. posterior (dorsal)
superior vs. inferior
Medial vs. lateral

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22
Q

What does the terms anterior and posterior mean

A

anterior: towards the front
posterior: towards the back

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23
Q

What do the terms medial and lateral mean

A

Medial: more towards the median sagittal plane
Lateral: more towards the sides of the body

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24
Q

What do the terms superior vs inferior mean

A

describe structures in reference to the vertical axis of the body
Superior: higher
Inferior: lower

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25
Q

What do the terms proximal and distal mean

A

Used with reference to being closer (proximal) or farther (distal) from a structure’s origin

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26
Q

What do the terms caudal and cranial mean

A

Cranial: towards the head
Caudal: toward the tail
Occasionally used in place of superior and inferior

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27
Q

When is the term rostral used

A

particularly in the head

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28
Q

What does the term rostral mean

A

to describe the position of a structure in reference to the nose

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29
Q

What do the terms superficial and deep mean

A

Superficial: closer to skin
Deep: farther from skin
Used to describe the relative position of two structures with respect to the surface of the body

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30
Q

What is another name for plain radiography

A

Xray

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31
Q

What are xrays

A

photons

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32
Q

What are photons

A

a type of electromagnetic radiation

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33
Q

What are xrays generated from

A

complex x-ray tube (type of cathode ray tube)

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34
Q

After xrays are generate from a cathode ray tube, what happens

A

x-rays are collimated (directed through lead-lined shutters to stop them from fanning out) to the appropriate areas

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35
Q

What happens to xrays as they pass through the body

A

They are attenuated (reduced in energy)

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36
Q

What causes xrays to attenuate

A

as they pass through the tissues

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37
Q

After passing through the tissues, what occurs to the xrays

A

they interact with the xray film to form an image

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38
Q

How much does air attenuate xrays

A

very little (film is exposed to most amount of xrays)

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39
Q

How much does fat attenuate xrays

A

more than air but less than water

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40
Q

How much does bone attenuate xrays

A

the most (film is exposed to the least amount of xrays)

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41
Q

Differneces in attenuation result in what

A

differences in levels of exposure of the film

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42
Q

On xray, how does bone appear

A

white

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43
Q

On xray, how does air appear

A

dark

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44
Q

What is barium sulfate (structure)

A

nontoxic, an insoluble salt, relatively high density

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45
Q

What is used to demonstrate the bowel lumen in xray

A

barium sulfate suspension

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46
Q

What is also common with using a contrast agent in xrays

A

adding air to the suspension

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47
Q

How is air added to a contrast agent suspension

A

“fizzing” granules or directly instilling air into the body

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48
Q

What is a double contrast study

A

air and barium contrast

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49
Q

What contrast agent is used for injections

A

Iodine

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50
Q

Why is iodine good structurally

A

high atomic mass

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51
Q

Why is iodine good from a patient stand point

A

it is naturally excreted by the urinary system

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52
Q

Why are intravenous contrast agents good

A

help visualize arteries and veins and also the urinary system

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53
Q

What is the urinary system xray with contrast called

A

Intravenous urography

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54
Q

What makes angiography difficult

A

difficult to appreciate the contrast agent in the vessels through the overlying bony structures

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55
Q

What technique is used to circumvent the difficulty in an angiography

A

subtraction angiography

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56
Q

How is subtraction angiography performed

A

1 or 2 images are obtained before the injection of contrast media. Images are inverted to create a “negative image”. Images obtained after injection of the contrast media. The negative image is added to the positive post contrast image to create a solitary image of contrast only. (bones and soft tissues were subtracted.

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57
Q

What is ultrasound

A

series of high frequency sound wave

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58
Q

What produces the very high frequency sound waves for an US

A

piezoelectric materials

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59
Q

What can the piezoelectric material also do after producing the sound waves

A

receive these sound waves back

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60
Q

Traditionally, US is used for what

A

assessing the abdomen and the fetus in pregnant women

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61
Q

US can also be used to asses what

A

eyes, neck, soft tissues, and peripheral musculoskeletal system, stomach, esophagus, duodenum, transvaginal, transrectal

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62
Q

Doppler US enables determination of what

A

its direction, flow, and velocity within a vessel

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63
Q

How do US tell direction

A

the degree of frequency shift determines whether the object is moving away from or toward the probe and its speed

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64
Q

What does CT stand for

A

computed tomography

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65
Q

Simply describe what a CT scan does

A

obtain images of the body in slices in the axial plane

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66
Q

How are CT scans obtained

A

patient lies on a bed and an X-ray tube passes around the body. Computer transforms the images

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67
Q

What does MRI stand for

A

magnetic resonance imaging

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68
Q

What is the process of MRI dependent upon

A

free protons in the hydrogen nuclei in molecules of water

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69
Q

Why is the hydrogen proton ideal for MRI

A

water is found in almost all biological tissues

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70
Q

Protons within a patient’s hydrogen nuclei should be regarded as what

A

small bar magnets randomly orientated in space

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71
Q

During an MRI, the patient is placed in what

A

a strong magnetic field

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72
Q

During an MRI, placing the patient in a strong magnetic field does what

A

align the small bar magnets

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73
Q

What is passed through the patient during an MRI

A

pulse of radiowaves

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74
Q

As radiowaves are passed through a patient during an MRI, what happens

A

the small bar magnets are deflected

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75
Q

What occurs after the small bar magnets are deflected

A

they return to their aligned position and emit small radio pulses

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76
Q

How is a signal produced in an MRI

A

the frequency and strength of the emitted pulses and the time it takes for the protons to return to their pre-excited state results in a signal

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77
Q

Signals from protons during an MRI then do what

A

are analyzed by a computer

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78
Q

How can different properties of protons be assessed during an MRI

A

by changing the sequence of pulses to which the protons are subjected

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79
Q

What are the different properties of protons called in an MRI

A

the “weighting” of the scan

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80
Q

What are the two weightings of an MRI

A

T1-weighted images

T2- weighted images

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81
Q

From the clinical point of view, what do T1 images show

A

dark fluid and bright fat (ex: cerebrospinal fluid is dark)

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82
Q

From the clinical point of view, what do T2 images show

A

bright signal from fluid and an intermediated signal from fat (ex cerebrospinal fluid is white)

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83
Q

What does Nuclear medicine imaging involves

A

gamma rays

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84
Q

What are gamma rays

A

a type of electromagnetic radiation

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85
Q

What is the important difference between gamma rays and x-rays

A

gamma rays are produced from within the nucleus of an atom when an unstable nucleus decays, whereas x-rays are produced by bombarding an atom with electrons

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86
Q

For an area to visualized with nuclear medicine imaging, what must the patient have

A

a gamma ray emitter

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87
Q

What are properties of a gamma ray emitter

A

a reasonable half life
an easily measurable gamma ray
energy deposition is as low a dose as possible in the patients tissues

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88
Q

What is the time length for a reasonable half life

A

6-24 hours

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89
Q

What is the most commonly used radionuclide (radioisotope)

A

technitium-99m

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90
Q

What is technitium-99m usually injected as

A

technitium salt or combined with other complex molecules

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91
Q

What is technitium-99m bound to to allow assessment of the skeleton

A

methylene diphosphonate (MDP)

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92
Q

What does MDP and technitium-99m together form and do

A

radiopharmaceutical that specifically binds to the bone

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93
Q

How are images obtained in nuclear medicine imaging

A

via a gamma camera

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94
Q

What causes the imaging in nuclear medicine imaging

A

the level on how the radiopharmaceutical is absorbed, distributed, metabolized, and excreted by the body after injection

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95
Q

What does PET stand for

A

positron emission tomography

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96
Q

What does PET detect

A

positron emitting radionuclides

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97
Q

What is a positron

A

anti-electron

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98
Q

What is an anti-electron

A

positively charged particle of antimatter

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99
Q

Where are positrons emitted from

A

the decay of proton rich radionuclides

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100
Q

Most of the radionuclides are made where

A

cyclotron

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101
Q

What is a characteristic of these radionuclides

A

they have extremely short half lives

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102
Q

What is the most commonly used PET radionuclide

A

Fluorode-oxyglucose (FDG) labeled with Fluorine-18

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103
Q

What is fluorine-18

A

positron emitter

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104
Q

What in the body takes up fluorode-oxyglucose with fluorine-18

A

any tissue that is taking up glucose

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105
Q

What does the tissue uptake of this radionuclide on a PET mean

A

any resulting localized high concentration of this molecule compared to the background emission is a “hot spot”

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106
Q

What are PETs commonly used for from a clinical aspect

A

detection of cancer and the assessment of its treatment and recurrence

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107
Q

What is the most commonly obtained form of imaging

A

plain radiography (x-rays)

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108
Q

How far away is the xray tube from the film at standard (excluding chest radiographs)

A

1 meter

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109
Q

In plain radiography, where is the patient’s body area of question placed

A

on the xray film

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110
Q

When describing subject placement for radiography, the part closest to the xray tube is referred to as

A

anterior

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111
Q

When describing subject placement for radiography, the part closest to the xray film is referred to as

A

posterior

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112
Q

When viewing an xray, the right side of the patient is seen where

A

on the left (vice versa)

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113
Q

The observer views the patient in an xray image as looking at what

A

the patient in the anatomical position

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114
Q

What is one of the most commonly requested plain radiographs

A

chest xray

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115
Q

How is the patient situated during a chest xray

A

patient is erect and placed posterioanteriorly (occasionally obtained anterioposterior position when patient too ill too stand)

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116
Q

A good quality chest xray will demonstrate what

A

lungs, cardiomediastinal contour, diaphragm, ribs, and peripheral soft tissues

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117
Q

How are plane abdominal xrays obtained (position of pt)

A

AP supine position

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118
Q

What is an exception to obtaining a plain abdominal xray in the AP supine position

A

Small Bowel obstruction suspected

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119
Q

When SBO is suspected, how is a plain abdominal xray obtained

A

erect position

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120
Q

CT images are viewed how

A

Obtained in axial plane and viewed from below looking upwards

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121
Q

What side of the patient is on the left side of the screen in a CT

A

the right

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122
Q

The uppermost border of the image in a CT is what

A

anterior

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123
Q

What is the great advantage of a CT scan

A

ability to extend and compress the gray scale to visualize the bones, soft tissues, and visceral organs

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124
Q

MRI contrast agents typically contain what

A

paramagnetic substances

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125
Q

What are typical MRI paramagnetic substances

A

gadolinium and manganese

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126
Q

What makes MRI and US ideal imaging studies

A

do not impart significant risk to the patient

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127
Q

What is the modality for imaging in assessing a fetus

A

US

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128
Q

What is the relationship between cost and imaging

A

the more complex, the more expensive

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129
Q

What is the order in least to greatest exposure dose of radiation for imaging methods

A 
chest radiograph 
abdomen radiograph
intravenous urography
CT scan of head
CT scan of abdomen and pelvis
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130
Q

What is the dose and duration of background exposure for chest radiograph

A

0.02 and 3 days

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131
Q

What is the dose and duration of background exposure for abdomen radiograph

A

1.0 and 6 months

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132
Q

What is the dose and duration of background exposure for intravenous urography

A

2.5 and 14 months

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133
Q

What is the dose and duration of background exposure for CT scan of head

A

2.3 and 1 year

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134
Q

What is the dose and duration of background exposure for CT of abdomen and pelvis

A

10.0 and 4.5 years

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135
Q

The skeleton can be divided into how many subgroups

A

two

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136
Q

What are the two subgroups of a skeleton

A

axial skeleton

appendicular skeleton

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137
Q

What does the axial skeleton consist of

A

bones of skull, vertebral columns, ribs and sternum

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138
Q

What does the appendicular skeleton consist of

A

bones of the upper and lower limbs

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139
Q

What is the skeletal system composed of

A

cartilage and bone

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140
Q

What is cartilage

A

avascular form of connective tissue

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141
Q

What is cartilage composed of

A

extracellular fibers embedded in a matrix that contains cells localized in small cavitites

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142
Q

Depending on the type of cartilage, how does the cartilage composition change

A

the amount and kind of extracellular fibers

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143
Q

In heavy weight bearing areas or areas prone to pulling forces, how is the cartilage composition different

A

more cartilage

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144
Q

Cartilage in heavy weight bearing areas is almost what..

A

inextensible

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145
Q

In areas that have less weight bearing demand and stress, how is the cartilage composition different

A

more elastic fibers, fewer collagen fibers

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146
Q

What are the 3 functions of cartilage

A
  • support soft tissues
  • provide a smooth, gliding surface for bone articulations at joints
  • enable the development and growth of long bones
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147
Q

What are the 3 types of cartilage

A
  • hyaline
  • elastic
  • fibrocartilage
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148
Q

What is hyaline cartilage composition

A

matrix contains a moderate amount of collagen fibers

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149
Q

What is elastic cartilage composition

A

matrix contains collagen fibers along with a large number of elastic fibers

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150
Q

What is fibrocartilage composition

A

matrix contains a limited number of cells and ground substance amidst a substantial amount of collagen fibers

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151
Q

What is an example of hyaline cartilage

A

articular surfaces of bones

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152
Q

What is an example of elastic cartilage

A

external ear

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153
Q

What is an example of fibrocartilage

A

intervertebral disks

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154
Q

Which of the 3 types of cartilage is most common

A

hyaline

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155
Q

Does cartilage have blood vessels

A

no

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156
Q

How is cartilage nourished

A

by diffusion

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157
Q

Does cartilage have lymphatics

A

no

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158
Q

Does cartilage have nerves

A

no

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159
Q

What is bone

A

calcified connective tissue

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160
Q

Is bone living or nonliving

A

living

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161
Q

What does bone consist of

A

intercellular calcified matrix, collagen fibers, and several types of cells within the matrix

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162
Q

What are the 5 functions of bone

A
  1. supportive structures for the body
  2. protectors of vital organs
  3. reservoirs of calcium and phosphorus
  4. levers on which muscles act to produce movement
  5. containers for blood-producing cells
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163
Q

What are the two types of bones

A

compact and spongy

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164
Q

What type of bone is compact bone

A

dense bone

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165
Q

What structures do compact bone form

A

outer shell of all bones (surrounds spongy bone)

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166
Q

What does spongy bone consist of

A

spicules of bone enclosing cavities containing blood-forming cells

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167
Q

What is another name for blood forming cells

A

marrow

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168
Q

How are bones classified

A

by shape

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169
Q

What are the 5 shapes of bones

A 
long bones
short bones
flat bones
irregular bones
sesamoid bones
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170
Q

What shape do long bones have

A

tubular

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171
Q

What is an example of a long bone

A

humerus and femur

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172
Q

What shape do short bones have

A

cuboidal

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173
Q

What is an example of short bones

A

bones of wrist and ankle

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174
Q

What shape do flat bones have

A

two compact bone plates separated by spongy bone

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175
Q

What is an example of flat bones

A

skull

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176
Q

What is classified as an irregular bone

A

bones with various shapes

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177
Q

What are examples of irregular bones

A

bones of the face

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178
Q

What shape do sesamoid bones have

A

round or oval

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179
Q

What is an example of sesamoid bones

A

bones that develop in the tendons

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180
Q

Do bones have blood vessels

A

yes

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181
Q

Do bones have nerves

A

yes

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182
Q

Generally, how many nutrient arteries per bone

A

1

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183
Q

Where does the nutrient artery enter the bone

A

the internal cavity of the bone

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184
Q

What areas does the nutrient artery supply

A

the marrow, spongy bone, and inner layers of compact bone

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185
Q

All bones are covered externally by what

A

a fibrous connective tissue membrane

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186
Q

What is the name of the fibrous connective tissue membrane called that covers bones

A

periosteum

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187
Q

What areas does periosteum not cover bones

A

area of a joint where articular cartilage is present

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188
Q

What is the unique function of periosteum

A

forming new bone

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189
Q

What supplies the periosteum with nutrients

A

blood vessels

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190
Q

Will a bone stripped of its periosteum survive

A

no

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191
Q

The branches of the blood vessels that supply the periosteum also supply what

A

extend to the outer surface of the compact bone

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192
Q

Most of the nerves that pass into the internal cavity are what type of fibers

A

vasomotor fibers

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193
Q

What do the vasomotor fibers do

A

regulate blood flow

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194
Q

Does bone have sensory nerve fibers

A

yes

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195
Q

How many sensory nerve fibers do bone have

A

very few

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196
Q

Does periosteum have sensory nerve fibers

A

yes

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197
Q

How many sensory nerve fibers does the periosteum have

A

a lot

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198
Q

Because the periosteum has a lot of sensory nerve fibers results in what

A

very sensitive to any type of injury

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199
Q

Where do all bones come from in development

A

mesenchyme

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200
Q

What are the two ways bones develop from the mesenchyme

A

intramembranous ossification

endochondral ossification

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201
Q

What is intramembranous ossification

A

mesenchymal models of bones undergo ossification

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202
Q

What is endochondral ossification

A

cartilaginous models of bones form from mesenchyme and undergo ossification

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203
Q

In western countries, when does skeletal maturity occur

A

between ages of 20 and 25

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204
Q

Skeletal maturity is impacted by what factors

A

genetic factors and disease states

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205
Q

How can bone age be determined

A

image the nondominant hand (typically left) and compare to series of standard radiographs

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206
Q

In disease states of malnutrition and hypothyroidism, what occurs

A

bone maturity may be slow

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207
Q

In a healthy individual, the bone age accurately represents what

A

the true age of the patient

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208
Q

How many types of bone marrow are there

A

2

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209
Q

What are the two types of bone marrow

A

red and yellow

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210
Q

What is another name for red bone marrow

A

myeloid tissue

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211
Q

What arises from the red bone marrow

A

red blood cells, platelets, most white blood cells

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212
Q

What arises from the yellow bone marrow

A

a few white blood cells

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213
Q

What also composes the yellow bone marrow

A

large fat globules

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214
Q

From birth, most of the marrow is what kind

A

red

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215
Q

As a person ages, what occurs to the marrow

A

red is converted to yellow

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216
Q

Where is yellow bone marrow formed typically

A

in the medulla of the lone and flat bones

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217
Q

How many types of stem cells compose bone marrow

A

2

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218
Q

What are the two types of stem cells in bone marrow

A

hemopoietic

mesenchymal

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219
Q

What do hemopoietic stem cells give rise to

A

WBC, RBC, and platelets

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220
Q

What do mesenchymal stem cells give rise to

A

differentiate into structures that form bone, cartilage, and muscle

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221
Q

What causes fractures in bones

A

abnormal load or stress, diseases that lead to poor quality bone

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222
Q

In growing children, where can fractures occur

A

across the growth plate or across the shaft

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223
Q

Shaft fractures in growing children result in what

A

partial cortical disruption

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224
Q

What is the term for shaft fractures in growing children

A

greenstick fractures

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225
Q

After a fracture has occurred, what happens next

A

the healing process

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226
Q

What is the first step in the healing process for a bone fracture

A

clot forms between fracture margins into which new vessels can grow

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227
Q

After a clot forms between the fracture, what is the next step in the healing process for a bone fracture

A

a jelly-like matrix is formed and further migration of collagen producing cells occurs

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228
Q

What occurs on the soft collagen framework after it is formed

A

osteoblasts produce calcium hydroxyapatite and forms insoluble crystals

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229
Q

After insoluble crystals are formed by osteoblasts, what occurs

A

bone matrix is laid down

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230
Q

As more bone is produced, what can be visualized after a fracture

A

a callus across the fracture site

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231
Q

Treatment of fractures require what

A

reduction in fracture line

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232
Q

What can reduce the fracture line

A

cast (plaster of paris)

internal or external fixation with screws and rods

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233
Q

What is avascular necrosis

A

cellular death of bone resulting from a temporary or permanent loss of blood supply to that bone

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234
Q

When can avascular necrosis occur

A

variety of medical conditions

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235
Q

What is a typical site for avascular necrosis

A

fracture across the femoral neck in an elderly patient

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236
Q

What is the treatment for avascular necrosis in the femoral head

A

replace the femoral head with a prosthesis

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237
Q

What is osteoporosis

A

a disease where the bone mineral density is significantly reduced

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238
Q

What does osteoporosis cause the bone to be more prone to

A

fractures

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239
Q

Where do osteoporitic fractures typically occur

A

femoral necks, the vertebra, and wrists

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240
Q

Osteoporosis typically occurs more likely in what patients

A

postmenopausal women

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241
Q

What four factors predispose bones to osteoporosis

A

poor diet
steroid usage
smoking
premature ovarian failure

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242
Q

What is treatment for osteoporosis

A

remove underlying factors

prevent further bone loss with drug treatment

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243
Q

When are the two stages of intense bone growth

A

between 7-10 years

puberty

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244
Q

What are intense bone growth stages associated with

A

increased cellular activity around the growth plate and the metaphyseal region

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245
Q

As a result of increased cellular activity in bone growth, what renders the metaphyseal region and growth plate more vulnerable to

A

injuries

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246
Q

What is a joint

A

a site where two skeletal elements come together

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247
Q

How many categories of joints are there

A

2

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248
Q

What are the 2 categories of joints

A

synovial and solid joints

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249
Q

What are synovial joints

A

skeletal elements are separated by a cavity

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250
Q

What are solid joints

A

no cavity and the component are held together by connective tissue

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251
Q

How are joints supplied with blood vessels and nerves

A

branches from blood vessels and nerves that innervated muscles

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252
Q

What are the characteristic features of synovial joints

A
  • a layer of cartilage covers the articulating surfaces
  • presence of a joint capsule
  • presence of additional structures within the area enclosed by the joint capsule
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253
Q

What type of cartilage usually covers the articulating surfaces in joints

A

hyaline cartilage

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254
Q

What does a joint capsule in synovial joints consist of

A

an inner synovial membrane and an outer fibrous membrane

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255
Q

The synovial membrane of the joint capsule attaches to what

A

margins of the joint surfaces at the interface between the cartilage and bone

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256
Q

What does the synovial membrane of the joint capsule encolse

A

articular cavity

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257
Q

Does the synovial membrane have blood vessels

A

yes, it is highly vascular

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258
Q

What does the synovial membrane produce

A

synovial fluid

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259
Q

What is the function of synovial fluid

A

it perculates into the articular cavity and lubricates the articulating surfaces

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260
Q

What structure of the synovial membrane forms outside of joints

A

closed sacs of synovial membrane

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261
Q

What are these closed sacs of synovial membrane called

A

synovial bursae or tendon sheaths

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262
Q

Where do synovial bursae occur typically

A

between structures such as tendons and bone, tendons and joints, or skin and bone

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263
Q

What is the function of synovial bursae

A

reduce the friction of one structure moving over the other

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264
Q

Where do tendon sheaths form

A

surround tendons

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265
Q

What is the function of tendon sheaths

A

reduce friction

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266
Q

What composes the fibrous membrane

A

dense connective tissue

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267
Q

Where does the fibrous membrane form

A

surround the joint

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268
Q

What is the function of the fibrous membrane in a synovial joint

A

stabilize the joint

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269
Q

What may occur to parts of the fibrous membrane in a synovial joint

A

it may thicken

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270
Q

Thickened fibrous membrane in a synovial joint forms what

A

ligaments

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271
Q

What are types of additional features that may be within the area enclosed by the capsule or synovial membrane

A

articular discs, fat pads, and tendons

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272
Q

What is the function of articular discs

A

absorb compression forces, adjust to changes in the contours of joint surfaces, increase the range of movements

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273
Q

Where do fat pads typically occur

A

between the synovial membrane and the capsule

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274
Q

What is the function of the fat pad

A

move into and out of region as joint contours change during movement

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275
Q

How are synovial joints described

A

based on shape and movement

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276
Q

Based on shapes, how can synovial joints be described

A 
plane (flat)
hinge
pivot
bicondylar (two sets of contact points)
condylar (ellipsoid)
saddle
ball and socket
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277
Q

Based on movement, how can synovial joints be described

A

uniaxial
biaxial
multi axial

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278
Q

What are uniaxial joints

A

movement in one plane

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279
Q

What are biaxial joints

A

movement in two planes

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280
Q

What are multi axial joints

A

movement in three planes

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281
Q

Hinge joints are typically what type of joint movement wise

A

uniaxial

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282
Q

Ball and socket joints are typically what type of joint movement wise

A

multi axial

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283
Q

What function do plane joints allow

A

sliding or gliding movement when one bone moves across the surface of another

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284
Q

What is an example of a plane joint

A

acromioclavicular joint

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285
Q

What function do hinge joints allow

A

permit flexion and extension

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286
Q

What is an example of a hinge joint

A

elbow

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287
Q

How many axis do plane joints use

A

1

288
Q

What function do pivot joints permit

A

rotation

289
Q

Pivot joints allow movement around how many axis

A

1

290
Q

This one axis in a pivot joint allow movement how

A

longitudinally along the shaft of the bone

291
Q

What is an example of a pivot joint

A

atlanto-axial joint

292
Q

How many axis do bicondylar joints allow movement around

A

2 (limited in the second direction)

293
Q

What is an example of a bicondylar joint

A

knee

294
Q

How are bicondylar joints formed

A

two convex condyles that articulate with concave or flat surfaces

295
Q

Condylar joints allow movement around how many axis

A

2

296
Q

What type of axis are condylar joints

A

two axes that are at right angles to each other

297
Q

What function do condylar joints allow

A

flexion, extenstion, abduction, adduction, and circumduction

298
Q

What is an example of condylar joint

A

wrist joint

299
Q

How many axes for saddle joints

A

2 axis

300
Q

What type of axes are saddle joints able to move

A

two axes that are at right angles to each other

301
Q

What gives saddle joints their shape

A

the articular surfaces are saddle shaped

302
Q

What do saddle joints permit

A

flexion, extension, abduction, adduction, and circumduction

303
Q

What is an example of a saddle shaped joint

A

carpometacarpal joint of the thumb

304
Q

How many axes do ball and socket joints allow movement

A

multiple

305
Q

What do ball and socket joints permit

A

flexion, extension, abduction, adduction, circumduction, and rotation

306
Q

What is an example of ball and socket joints

A

hip joint

307
Q

What are solid joints are connections between skeletal elements where adjacent surfaces are linked together by what

A

fibrous connective tissue or cartilage

308
Q

What type of cartilage usually would link solid joints

A

fibrocartilage

309
Q

How is the movement in solid joints different than in synovial joints

A

more restricted

310
Q

What are the 3 types of fibrous joints

A

sutures, gomphoses and syndesmoses

311
Q

Where do sutures occur

A

only in the skull

312
Q

What are suture joints

A

adjacent bones are linked by a thin layer of connective tissue

313
Q

What is the name of the connective tissue that links at suture joints

A

sutural ligament

314
Q

Where do gomphoses occur

A

only between the teeth and adjacent bones

315
Q

What are gomphoses

A

joint, where short collagen tissue fibers in the periodontal ligament run between the root of the tooth and the bony socket

316
Q

What are syndesmoses

A

joints in which two adjacent bones are linked by a ligament

317
Q

What are the two different types of solid joints

A

fibrous joints and cartilaginous joints

318
Q

What are the two types cartilaginous joints

A

synchondroses and symphyses

319
Q

Where do synchondroses occur

A

two ossification centers in a developing bone remain separated by a layer of cartilage

320
Q

What do synchondroses allow for

A

bone growth

321
Q

What eventually occurs to synchondroses

A

eventually become completely ossified

322
Q

Where do symphyses occur

A

most occur in the midline, where two separate bones are interconnected by cartilage

323
Q

What are two examples of symphyses

A 
pubic symphysis (between the two pelvic bones)
intervertebral discs between adjacent vertebrae
324
Q

What are two other names for degenerative joint disease

A

osteoarthritis or osteoarthrosis

325
Q

What is osteoarthritis related to

A

aging

326
Q

What is typically seen structurally in osteoarthritis

A

decrease in water and proteoglycan content within the cartilage

327
Q

What occurs to the cartilage in osteoarthritis

A

cartilage becomes more fragile and more susceptible to mechanical disruption

328
Q

As the cartilage wears, what occurs to the bones

A

becomes fissured and thickens
synovial fluid may be forced into cracks and form cysts
reactive juxta articular bony nodules are formed

329
Q

What is another name for juxta-articular bony nodules

A

osteophytes

330
Q

How many PCP visits does osteoarthritis account for in US

A

one quarter of PCP visits

331
Q

What is the etiology of osteoarthritis

A

unclear, but can occur secondary to other joint diseases and infection

332
Q

What are treatments for osteoarthritis

A

weight reduction, proper exercise, anti-inflammatory drugs, joint replacement

333
Q

What is arthroscopy

A

the technique of visualizing the inside of a joint using a small telescope placed in a tiny incision in the skin

334
Q

Where is arthroscopy most often performed on the body

A

knee, shoulder, ankle, hip joints, elbow, wrist

335
Q

What are three advantages of arthroscopy

A

performed through small incisions
patients recover quicker
only requires a light or regional anesthetic

336
Q

What is the largest organ of the body

A

skin

337
Q

What two things does the skin consist of

A

epidermis and dermis

338
Q

What is the epidermis/ composition

A

the outer cellular layer of stratified squamous epithelium

339
Q

Does the epidermis have blood vesels

A

no its avascular

340
Q

How thick is the epidermis

A

varies in thickness

341
Q

What is the dermis/ compostion

A

dense bed of connective tissue

342
Q

Does the dermis have blood vessels

A

yes

343
Q

What are the functions of the skin (3 things)

A

mechanical and permeability barrier
sensory and thermoregulatory organ
initiate immune responses

344
Q

What is fascia

A

connective tissue containing varying amounts of fat

345
Q

What are functions of fascia

A

separate, support, and interconnect organs and structures
enable movement of one structure relative to another
allow the transit of vessels and nerves from one area to another

346
Q

What are the two general categories of fascia

A

superficial and deep

347
Q

What is another name for superficial fascia

A

subcutaneous

348
Q

Where does superficial fascia lie

A

just deep to the dermis and is attached to the dermis of the skin

349
Q

What is the composition of the superficial fascia

A

loose connective tissue containing a large amount of fat

350
Q

What is the thickness of the superficial fascia

A

varies

351
Q

What two ways does the superficial fascia vary

A

between people and between areas of the body

352
Q

What does the superficial fascia allow for

A

movement of the skin over deeper areas of the body

353
Q

What does the superficial fascia acts as

A

conduit for vessels and nerves coursing to and from the skin

354
Q

What does the superficial fascia serve as

A

an energy (fat) reservoir

355
Q

What does deep fascia consist of

A

dense, organized connective tissue

356
Q

Where is deep fascia located

A

outer layer attached to deep surface of superficial fascia

357
Q

What does deep fascia form

A

thin fibrous covering over most of the deeper region of the body

358
Q

What do inward extensions of the deep fascia form

A

intermuscular septa

359
Q

What do the intermuscular septa of the deep fascia do

A

compartmentalize groups of muscles with similar functions and innervations

360
Q

The deep fascia has other extensions (other than intermuscular septa) that do what

A

surround individual muscles and groups of vessels and nerves

361
Q

What do these other extensions form

A

an investing fascia

362
Q

What is it called when deep fascia forms around some joints and thickens

A

retinacula

363
Q

What do fascial retinacula do

A

hold tendons in place and prevent them from bowing during movements at the joints

364
Q

Where else is deep fascia found other than joints and below subcutaneous fascia

A

lining the abdominal cavity

365
Q

What is another name for the fascia lining the abdominal cavity

A

parietal peritoneum

366
Q

what is the name of the fascia that covers the deep surface of the muscles of the abdominal wall

A

transversalis fascia

367
Q

What is the layer of fascia called that separated the membrane lining the abdominal cavity from the fascia covering the deep surface of the muscles of the abdominal wall

A

extraperitoneal fascia

368
Q

What is a similar layer of fascia to the extraperitoneal fascia in the thorax termed

A

endothoracic fascia

369
Q

What is fascia

A

thin band of tissue that surrounds muscles, bones, organs, nerves, and blood vessels

370
Q

Do fascias have blood vessels

A

yes

371
Q

Clinically how are fascias important

A

often limit the spread of infection and malignant disease

372
Q

What are the three types of muscle in the body

A

skeletal, smooth, cardiac

373
Q

How is muscle characterized

A

controlled voluntarily or involuntarily
striated or smooth
associated with body wall or with organs and blood vessels

374
Q

What is a term to describe location near body wall

A

somatic

375
Q

What is a term to describe location near organs and blood vessels

A

visceral

376
Q

What muscle forms the majority of muscle tissue in the body

A

skeletal

377
Q

What is the structure of muscle tissue

A

parallel bundles of long, multinucleated fibers with transverse stripes

378
Q

What is the function of muscle tissue

A

powerful contractions to move bones and other structures
provides support
gives form to the body

379
Q

What type of nerves innervate muscle tissue

A

somatic and branchial motor nerves

380
Q

How are individual skeletal muscles named by

A

shape, attachments, function, position, fiber orientation

381
Q

Where is cardiac muscle found

A

only in walls of the heart and in some large vessels close to where they join the heart

382
Q

What is the structure of cardiac muscle

A

branching network of individual cells linked electrically and mechanically to work as a unit

383
Q

Is cardiac muscle striated

A

yes

384
Q

In comparison to skeletal muscle, compare cardiac muscles contractions

A

less powerful

385
Q

What type of nerves innervate cardiac muscle

A

visceral motor nerves

386
Q

Does smooth muscles have striations

A

no

387
Q

What is the structure of smooth muscle

A

elongated or spindle shaped fibers

388
Q

What type of contractions do smooth muscle produce

A

slow and sustained contractions

389
Q

Where is smooth muscle found

A

walls of blood vessels, hair follicles in skin, eyeball, wall of various structures of GI, respiratory, GU, and urogenital systems

390
Q

What type of nerves innervate smooth muscle

A

visceral motor nerves

391
Q

What is muscle paralysis

A

inability to move a specific muscle or muscle group

392
Q

What may cause muscle paralysis

A

abnormalities in the brain, spinal cord, and nerves supplying the muscles, drugs that affect neurotransmitters, stroke, trauma, poliomyelitis, iatrogenic factors

393
Q

What will muscle paralysis produce in the long run

A

secondary muscle wasting and overall atrophy of the region

394
Q

What are two effects of using anesthesia in relationship to muscle paralysis

A

enter the region of the body with agonistic and antagonistic patient muscle response

prevents the patient from breathing

395
Q

What is muscle atrophy

A

wasting disorder of the muscle

396
Q

what can cause muscle atrophy

A

nerve damage and disuse

397
Q

What are muscle strains related to

A

sudden exertion and muscle disruption

398
Q

How do muscle injuries and strains tend to occur

A

in specific muscle groups

399
Q

What does the cardiovascular system consist of

A

the heart and the blood vessels

400
Q

What is the function of the heart

A

pump blood throughout the body

401
Q

What is the function of the blood vessels

A

closed network of tubes that transport the blood

402
Q

How many types of blood vessels are there

A

3

403
Q

What are the three types of blood vessels

A

arteries
veins
capillaries

404
Q

What are arteries

A

vessels that transport blood away from the heart

405
Q

What are veins

A

vessels that transport blood towards the heart

406
Q

What are capillaries

A

vessels that connect the arteries and veins and are where oxygen, nutrients, and wastes are exchanged in the tissues

407
Q

Which of the three blood vessels is the smallest

A

capillaries

408
Q

Walls of blood vessels consist of how many layers (tunics)

A

3

409
Q

What are the three layers of blood vessels

A

tunica externa
tunica media
tunica intima

410
Q

What is another name for the tunica externa

A

adventitia

411
Q

What is the tunica externa

A

outer connective tissue layer

412
Q

What is the tunica media

A

middle smooth muscle layer

413
Q

Other than smooth muscle, what else may the tunica media contain

A

elastic fibers in medium and large arteries

414
Q

What is the tunica intima

A

inner endothelial lining of the blood vessels

415
Q

Arteries can be divided into how many subclasses

A

3

416
Q

How are arteries divided into the 3 subclasses

A

according to the variable amounts of smooth muscle and elastic fibers contributing to the thickness of the tunica media,
overall size of vessel,
and function of vessel

417
Q

What do large elastic arteries contain structurally

A

substantial amounts of elastic fibers in the tunica media

418
Q

What do large elastic arteries allow for

A

a constant flow of blood during diastole

419
Q

What do the increased elastic fibers in large elastic arteries allow for

A

expansion and recoil during the normal cardiac cycle

420
Q

What are examples of large elastic arteries

A

aorta, brachiocephalic trunk, left common carotid, left subclavian artery, pulmonary trunk

421
Q

What is the structure of medium muscular arteries

A

tunica media contains mostly smooth muscle fibers

422
Q

What is allowed for due to the structure of medium muscular arteries

A

vessels regulate their diameter and control the flow of blood to different parts of the body

423
Q

What are examples of medium muscular arteries

A

most of the named arteries (femoral, axillary, radial)

424
Q

What is the function of small arteries and arterioles

A

control the filling of the capillaries and contribute directly to the arterial pressure in the vascular system

425
Q

How many classes are veins divided into

A

3

426
Q

What are the 3 classes of veins

A

large veins
small and medium veins
venules

427
Q

What are the 3 classes of arteries

A

large elastic
medium muscular
small arteries and arterioles

428
Q

What is the structure of large veins

A

contain some smooth muscle in the tunica media, but thickest layer is the tunica externa

429
Q

What are examples of large veins

A

superior vena cava, inferior vena cava, portal vein

430
Q

What is the structure of small and medium veins

A

contain small amounts of smooth muscle and the thickest layer is the tunica externa

431
Q

What are examples of small and medium veins

A

superficial veins in the upper and lower limbs and deeper veins of the leg and forearm

432
Q

What are the smallest veins

A

venules

433
Q

What is the function of venules

A

drain the capillaries

434
Q

Structurally, how are veins different from arteries

A

the walls of veins are thin
luminal diameters of veins are large
often are multiple veins closely associated with arteries in peripheral regions
valves are often present in veins

435
Q

What wall of the veins is specifically different

A

tunica media

436
Q

Where are valves in veins typically present

A

in veins inferior to the level of the heart

437
Q

What are valves in veins

A

paired cusps that facilitate blood flow toward the heart

438
Q

What is atherosclerosis affect

A

the arteries

439
Q

What is atheroscleriss

A

chronic inflammatory reaction in the walls of the arteries with deposition of cholesterol and fatty proteins

440
Q

What can result because of the chronic inflammatory reaction and fatty deposits in atherosclerosis

A

secondary calcification, reduction in the diameter of the vessels, impeded distal flow

441
Q

What is the importance of atherosclerosis and its effects depends upon what

A

which vessel it is occuring in

442
Q

What are varicose veins

A

tortuous dilated veins

443
Q

where do varicose veins typically occur

A

in the legs

444
Q

What causes varicose veins to form

A

valves in veins become damaged allowing blood to pass in opposite direction resulting in increased volume and pressure, thus dilation and tortuosity of the superficial veins

445
Q

What do lymphatic vessels collect

A

fluid lost from vascular capillary beds during nutrient exchange processes

446
Q

What do lymphatic vessels do with the fluid they collect

A

deliver it back to the venous side of the vascular system

447
Q

What is also included in the interstitial fluid that drains into the lymphatic capillaries

A

pathogens, cells of the lymphocytic system, cell products (like hormones) and cell debris

448
Q

In the small intestin, certain fats absorbed are processed into what by the intestinal epithelium

A

chylomicrons

449
Q

What are chylomicros

A

protein coated lipid droplets

450
Q

Chylomicrons go where

A

drain into the lymphatic capillaries in small intestine

451
Q

What are the lymphatic capillaries in the small intestine knows as

A

lacteals

452
Q

The lymphatic system function related to the gut is what

A

major route of transport for fat absorbed by the gut

453
Q

What color is the fluid of the lymphatic system is typically what

A

clear

454
Q

What is the name of the fluid of the lymphatic system

A

lymph

455
Q

The color of the fluid from small intestine is what color

A

opaque and milky

456
Q

Why is the fluid color milky from the small intestine

A

due to chylomicrons

457
Q

What is the name of the fluid from the small intestine called

A

chyle

458
Q

Where are there not lymphatic vessels

A

brain
bone marrow
avascular tissues (epithelia and cartilage)

459
Q

Movement of lymph through vessels is generated how

A

mainly by indirect action of adjacent structures (contraction of skeletal muscles and pulses in arteris)

460
Q

How is unidirectional flow maintained in lymphatic vessels

A

valves

461
Q

What are lymph nodes

A

small encapsulated structures that interrupt the course of lymphatic cessels

462
Q

What is the size of lymph nodes

A

0.1-2.5 cm long

463
Q

What do lymph nodes contain

A

elements of the body’s defence system

like macrophages and lymphocyte clusters

464
Q

What is the function of lymph nodes

A

elaborate filters that trap and phagocytose particulate matter in the lymph that perculates through them

defect and defend against foreign antigens that were also carried by lymph

465
Q

Where do cells that metastasize from primary tumors typically grow secondarily

A

lymph nodes

466
Q

What characteristics occur to a lymph node that has cancer

A

enlarge or undergo certain physical changes (become “hard” or “tender”

467
Q

What three areas are high risk sites for the entry of foreign pathogens

A

digestive system, body’s surface, respirtory system

468
Q

What is located at these high risk sites for foreign pathogen entry

A

clusters and increased abundance of lymph nodes

469
Q

Where are lymph nodes abundant and accessible to palpation

A

axilla, groin, femoral region, and neck

470
Q

Deep sites of more abundant lymph nodes are where

A

trachea, bronchi, aorta and its branches in the abdomen

471
Q

Are deep sites of lymph nodes palpable

A

no

472
Q

All lymphatic vessels coalesce to form what

A

larger trunks or ducts

473
Q

What do larger trunks or ducts of lymphatic vessels do

A

drain into the venous system at sites in the neck

474
Q

Where in the neck do larger trunks or ducts of lymphatic vessels drain

A

internal jugular veins join the subclavian veins to form teh brachiocephalic veins

475
Q

Lymph that drains into the right side of the neck comes from what areas of the body

A

right side of head and neck
right upper limb
right side of thorax
right side of upper and more superficial region of the abdominal wall

476
Q

Lymph that drains into veins on the left side of the neck come from what areas of the body

A

All other regions of the body not mentioned for draining into the right side of the neck

477
Q

What structure do lymph nodes have

A

internal honeycomb of reticular connective tissue

478
Q

What is the internal honeycomb of reticular connective tissue of lymph nodes filled with

A

lymphocytes

479
Q

What is the function of lymphocytes within lymph nodes

A

act on bacteria, viruses, other bodily cells to destroy them

480
Q

When a lymph node is “active” in fighting off something, what occurs

A

rapid cell turnover and production of local inflammatory mediators

481
Q

As a result of increased cell turnover and production of local inflammatory mediators, what occurs to the lymph node

A

enlarges and becomes tender

482
Q

In systemic illnesses, what may occur to lymph nodes

A

diffusely enlarged or local groups enlarge

483
Q

What are two ways to separate the nervous system

A

structure and function

484
Q

Structurally, how can the nervous system be divided

A

central nervous system and peripheral nervous system

485
Q

Functionally, the nervous system can be divided into what

A

somatic and visceral parts

486
Q

What is the CNS composed of

A

brain and spinal cord

487
Q

Where do the brain and spinal cord develop from

A

the neural tube in the embryo

488
Q

What is the PNS composed of

A

all nervous structures outside the CNS that connect the CNS to the body

489
Q

Where do elements of the PNS develop from

A

neural crest cells and as outgrowths of the CNS

490
Q

PNS consists of what

A

spinal and cranial nerves
visceral nerves and plexuses
enteric system

491
Q

What are the parts of the brain divided into

A

cerebral hemispheres
the cerebellum
the brainstem

492
Q

The cerebral hemispheres consist of how many portions

A

three

493
Q

What are the portions of the cerebral hemispheres

A

outer portion
inner portion
ventricles

494
Q

What is the outer portion of the cerebral hemispheres called

A

gray matter

495
Q

What does the gray matter contain

A

cell bodies

496
Q

What is the inner portion of the cerebral hemispheres called

A

white matter

497
Q

What is the white matter composed of

A

axons forming tracts or pathways

498
Q

What are the ventricles of the cerebral hemispheres

A

spaces filled with cerebrospinal fluid

499
Q

There cerebellum is composed of what parts

A

2 lateral lobes

midline portion

500
Q

What are the components of the brainstem classified as

A

diencephalon,
midbrain
pons
medulla

501
Q

In common usage the brainstem includes

A

pons
midbrain
medulla

502
Q

What shape is the spinal cord

A

cylindrical

503
Q

What are meninges

A

three connective tissue coverings

504
Q

What is the function of meninges

A

surround, protect, and suspend the brain and spinal cord within the cranial cavity and vertebral canal

505
Q

What are the three meninges called

A

dura mater
arachnoid mater
pia mater

506
Q

The dura mater is where

A

the most external of the meninges

507
Q

The arachnoid mater is where

A

agains the internal surface of the dura mater

508
Q

The pia mater is where

A

adherent to the brain and spinal cord

509
Q

Which of the meninges is the thickest

A

dura mater

510
Q

What is between the arachnoid and pia mater

A

the subarachnoid space

511
Q

What does the subarachnoid space contain

A

CSF

512
Q

What are the functional subdivisions of the nervous system called

A

somatic part

visceral part

513
Q

What is the somatic part of the CNS

A

Innervates structures derived from somites in the embryo

514
Q

What structures typically does the somatic part of the CNS innervate

A

skin and most skeletal muscle

515
Q

What is the function of the somatic part of the CNS

A

receiving and responding to information from the external environment

516
Q

What is the visceral part of the CNS

A

innervates organ systems in the body and other visceral elements in peripheral regions of the body

517
Q

What structures typically does the visceral part of the CNS innervate

A

smooth muscle and glands

518
Q

What is the function of the visceral part of the CNS

A

detecting and responding to information from the internal environment

519
Q

What does the somatic part of the nervous system consist of

A

nerves that carry conscious sensations from peripheral regions back to the CNS
AND
nerves that innervate voluntary muscle

520
Q

Somatic nerves arise along the developing CNS in association with what from the embryo

A

somites

521
Q

Where are somites in the embryo

A

arranged segmentally along each side of the neural tube

522
Q

What is the dermatomyotome

A

part of the somite that gives rise to skeletal muscle and the dermis of the skin

523
Q

As cells of the dermatomyotome differentiate, what occurs

A

they migrate into posterior and anterior areas of the developing body

524
Q

What occurs to cells that migrate anteriorly from the dermatomyotome

A

give rise to muscles of the limbs and trunks and to the associated dermis

525
Q

What is another name for the muscles of the limbs and trunks

A

hypaxial muscles

526
Q

What occurs to cells that migrate posterioly from the dermatomyotome

A

give rise to the intrinsic muscle of the back and associated dermis

527
Q

What is another name for the muscles of the back

A

epaxial muscles

528
Q

As the neural tube develops, what occurs in respect to the dermatomyotome

A

nerve cells within the anterior region of the neural tube extend processes peripherally into posterior and anterior regions of the dermatomyotomes of each somite

529
Q

As the neural tube develops and nerve cells extend processes peripherally into posterior and anterior regions, what also occurs

A

neural crest cells differentiate into neurons on each side of the neural tube and extend processes both medially and laterally

530
Q

What are neural crest cells

A

cells derived from neural folds during formation of the neural tube

531
Q

Medial processes from the neural crest cells pass where

A

into the posterior aspect of the neural tube

532
Q

Lateral processes from the neural crest cells pass where

A

into the differentiating regions of the adjacent dermatomyotome

533
Q

Neurons that develop from neurons within the spinal cord are called what type of neurons

A

motor neurons

534
Q

Neurons that develop from neural crest cells are what type of neurons

A

sensory neurons

535
Q

Spinal nerves and some cranial nerves are what

A

somatic sensory and somatic motor fibers that are organized segmentally along the neural tube

536
Q

Clusters of sensory nerve cells bodies located outside the CNS form what

A

sensory ganglia

537
Q

Generally, all sensory information passes into the spinal cord where

A

posterior aspect

538
Q

Generally, all motor fibers leave the spinal cord where

A

anterior aspect

539
Q

Somatic sensory neurons carry information directionally how

A

from periphery to the CNS

540
Q

What are other names for somatic sensory neurons

A

somatic sensory afferents

general somatic afferents (GSAs)

541
Q

What modalities are carried by somatic sensory neurons

A

temperature
pain
touch
proprioception

542
Q

What is proprioception

A

sense of determining the position and movement of the musculoskeletal system detected by special receptors in muscles and tendons

543
Q

Somatic motor neurons carry information directionally how

A

away from the CNS to skeletal muscles

544
Q

What are other names for somatic motor neurons

A

somatic motor efferents

general somatic efferents (GSEs)

545
Q

Because cells from a specific somite develop into the dermis of the skin in a precise location, what results with the somatic sensory fibers

A

enter the posterior region of the spinal cord at a specific level and become part of one specific spinal nerve

546
Q

Each spinal nerve carries information relating to what

A

specific area of skin on the surface of the body

547
Q

What is a dermatome

A

area of skin supplied by a single spinal cord level or on one side, by a single spinal nerve

548
Q

Do dermatomes overlap

A

yes slightly

549
Q

What forms one spinal nerve

A

somatic motor nerves from one anterior region of the spinal cord with the same level of sensory nerves

550
Q

What is a myotome

A

portion of a skeletal muscle innervated by a single spinal cord level, or one one side, by a single spinal nerve

551
Q

Spinal nerves carry motor fibers to what types of what muscle

A

muscles that originally developed from the related somite

552
Q

Are dermatomes or myotomes more easy to test

A

dermatomes

553
Q

Why are myotomes harder to test

A

skeletal muscle in the body is usually innervated by nerves derived from more than one spinal cord level

554
Q

testing movements at successive joints can help in what

A

localizing lesions to specific nerves or to a specific spinal cord level

555
Q

Where do muscles that move the shoulder innervate

A

at levels C5 and C6

556
Q

Where do muscles that move the elbow innervate

A

levels C6 and C7

557
Q

Where do muscles in the hand innervate

A

C8 and T1

558
Q

The visceral part of the nervous system consists of what components

A

motor and sensory components

559
Q

What is the function of sensory component in visceral part of nervous system

A

monitor changes in the viscera

560
Q

Where do motor component of the visceral part of the nervous system innervate

A

smooth muscle, cardiac muscle, and glands

561
Q

The visceral motor component is commonly referred to as what

A

autonomic division of the PNS

562
Q

What can the autonomic division of the PNS be subdivided into

A

sympathetic and parasympathetic parts

563
Q

Like the somatic portion, how is the visceral portion formed and arranged

A

segmentally arranged and develops in parallel fashion

564
Q

Visceral sensory neurons arise from what

A

neural crest cells

565
Q

Where do visceral sensory neurons send their processes medially

A

into the adjacent neural tube

566
Q

Where do visceral sensory neurons send their processes laterally

A

into regions associated with the developing body

567
Q

Visceral sensory neurons and their processes are called what

A

general visceral afferent fibers

568
Q

What is abbreviation for general visceral affernet fibers

A

GVAs

569
Q

What are general visceral afferent fibers associated with

A

chemoreceoption
mechanoreception
stretchreception

570
Q

Visceral motor neurons that arise from cells in lateral regions of the neural tube send their processes where

A

out of the anterior aspect of the tube

571
Q

Unlike the somatic part, the processes of the visceral motor neurons are different how

A

the processes synapse with other cells

572
Q

What is another name for the visceral motor neurons

A

general visceral efferent fibers

573
Q

What is the abbreviation for general visceral efferent fibers

A

GVEs

574
Q

What other cells do visceral motor neurons usually synapse with

A

other visceral motor neurons that develop outside the CNS from neural crest cells

575
Q

Visceral motor neurons located in the spinal cord are called what

A

preganglionic motor neurons

576
Q

What are the axons of preganglionic motor neurons called

A

preganglionic fibers

577
Q

Visceral motor neurons located outside the CNS are referred to as what

A

postganglionic motor neurons

578
Q

What are the axons of postganglionic motor neurons called

A

postganglionic fibers

579
Q

Cell bodies of the visceral motor neurons outside the CNS often do what

A

associate with each other in a discrete mass

580
Q

What is the name for the discrete mass formed from cell bodies

A

ganglion

581
Q

Visceral sensory and motor fibers enter and leave the CNS with what

A

their somatic equivalents

582
Q

With what do the visceral sensory fibers enter the CNS

A

somatic sensory fibers

583
Q

Where do the visceral sensory fibers enter the CNS

A

through posterior roots of the spinal nerves

584
Q

Where do preganglionic fibers of visceral motor neurons exit the spinal cord

A

anterior roots of spinal nerves

585
Q

What do preganglionic fibers of visceral motor neurons exit the spinal cord with

A

somatic motor nerves

586
Q

Where are postganglionic fibers traveling to visceral elements in the periphery found

A

in the posterior and anterior rami (branches) of spinal nerves

587
Q

Visceral motor and sensory fibers travel where

A

to and from viscera form named visceral branches

588
Q

are visceral and somatic branches the same thing

A

no

589
Q

What do the nerves form before branches arise to the viscera

A

plexuses

590
Q

What arises from the plexuses

A

branches to the viscera

591
Q

Do visceral motor and sensory fibers enter and leave the CNS at all levels

A

no

592
Q

In the cranial region, how many nerves are associated with visceral components

A

4

593
Q

How many nerves in the cranial region

A

12

594
Q

What cranial region nerves are visceral components associated with

A

CN III, VII, IX, X

595
Q

in the spinal cord what spinal cord levels are associated with visceral components

A

T1-L2

S2-S4

596
Q

Visceral components associated with T1-L2 are termed what

A

sympathetic

597
Q

visceral components in cranial and sacral regions are termed what

A

parasympathetic

598
Q

What does the sympathetic system innervate

A

structures in peripheral regions of the body and viscera

599
Q

The parasympathetic system innervates what

A

viscera only

600
Q

The sympathetic part of the autonomic division of the PNS leaves thoracolumbar regions of the spinal cord with what

A

somatic components of spinal nerves T1-L2

601
Q

On each side of the sympathetic part of the autonomic division of the PNS leaving the spinal cord is what

A

a paravertebral sympathetic trunks that extends

602
Q

Where does the paravertebral sympathetic trunk extend

A

base of the skull to the inferior end of the vertebral column

603
Q

At the ingerior end of the vertebral column, what occurs to the paravertebral sympathetic trunk

A

the two trunks converge antiorly

604
Q

What do the two trunks converge to

A

the coccyx at the ganglion impar

605
Q

What is each trunk attached to

A

anterior rami of spinal nerves

606
Q

What does the each trunk function as

A

route by which sympathetics are distributed to the periphery and all viscera

607
Q

Describe the path of visceral motor preganglionic fibers as they leave the spinal cord

A
  1. leave the T1-L2 part of spinal cord in anterior roots
  2. enter the spinal nerves
  3. pass through the anterior rami and into sympathetic trunks
608
Q

Where are the trunks located

A

one trunk is located on each side of the vertebral column and anterior to the anterior rami

609
Q

What is along the trunk

A

ganglia segmentally arranged

610
Q

What are the ganglia formed from

A

collections of postganglionic neuronal cell bodies where the preganglionic neurons synapse with postganglionic neurons

611
Q

What are anterior rami of T1-L2 connected to

A

sympathetic trunk or to a ganglion

612
Q

What connects anterior rami to the sympathetic trunk of to a ganglion

A

white ramus communicans

613
Q

What does white ramus communicans contain

A

preganglionic sympathetic fibers

614
Q

Why does the white ramus communicans appear white

A

the fibers are myelinated

615
Q

Preganglionic sympathetic fibers that enter through a white ramus communicans may provide what

A
  1. peripheral sympathetic innervation at the level of origin of the preganglionic fiber
  2. peripheral sympathetic innervation above or below the level of origin of the preganglionic fiber
  3. Sympathetic innervation of thoracic and cervical viscera
  4. Sympathetic innervation of the abdomen and pelvic regions and the adrenals
616
Q

Where do postganglion fibers enter after preganglionic sympathetic fibers synapse with postganglionic motor neurons in ganglia associated with the sympathetic trunk

A

enter the same anterior ramus and distributes with peripheral branches of the posterior and anterior rami of that spinal nerve

617
Q

What structures do the fibers that enter the anterior ramus and distribute with peripherla branches of the posterior and anterior rami of the spinal nerve innervate

A

structures at the periphery of the body in regions supplied by the spinal nerve

618
Q

What connects the sympathetic trunk or ganglion to the anterior ramus

A

gray ramus communicans

619
Q

What does the gray ramus communicans contain

A

postganglionic sympathetic fibers

620
Q

Why does the gray ramus communicans appear gray

A

postganglionic fibers are nonmyelinated

621
Q

Where is the gray ramus communicans positions in relation to the white ramus communicans

A

medial

622
Q

Preganglionic sympathetic fibers may ascend or descend to what

A

other vertebral levels

623
Q

When the ascend of descend to other vertebral levels, what may preganglionic sympathetic fibers synapse with

A

in ganglia associated with spinal nerves

624
Q

These spinal nerves that preganglionic sympatheticc fibers synapse with may or may not have what

A

visceral motor input directly from the spinal cord

625
Q

How do postganglionic fibers leave the distant ganglia

A

via gray rami communicantes

626
Q

Where are posganglion fibers that leave the distant ganglia distributes

A

along the posterior and anterior rami of the spinal nerves

627
Q

The ascending and descending fibers with all the ganglia form what

A

the paravertebral sympathetic trunk

628
Q

Where does the paravertebral sympathetic trunk extend

A

the entire lenght of the vertebral column

629
Q

The formation of this trunk enables what

A

visceral motor fibers of the sympathetic part of the autonomic division of the PNS to be distributed to peripheral regions innervated by all spinal nerves

630
Q

Where do visceral motor fibers of the sympathetic part of the autonomic division of the PNS emerge

A

T1-L2

631
Q

White rami communicantes only occur in association with what

A

spinal nerves T1-L2

632
Q

Gray rami communicates are associated with what

A

all spinal nerves

633
Q

Fibers from spinal cord levels T1-T5 pass predominantly where

A

superiorly

634
Q

Fibers from spinal cord levels T5-L2 pass predominantly where

A

inferiorly

635
Q

All sympathetics passing into the head have preganglionic fibers that emerge from the spinal cord level where

A

T1

636
Q

where do preganglionic fibers that pass into the head ascend to

A

the highest ganglion in the neck

637
Q

What is the highest ganglion in the neck called

A

superior cervical ganglion

638
Q

To target tissues in the head, postganglionic fibers travel along what

A

blood vessels

639
Q

What tissues do postganglionic fibers target in the head

A

blood vessels, sweat glands, small smooth muscles associates with upper eyelides, dilator of the pupil

640
Q

How do preganglionic sympathetic fibers innervate thoracic or cervical viscera

A

preganglionic sympathetic fibers synapse with postganglionic motor neurons in ganglia and then leave ganglia medially to innervate

641
Q

Before synapsing, what may preganglion sympatehtic fibers do

A

ascend

642
Q

After synapsing, what may postganglionic fibers do when innervationg thoracic and cervical viscera

A

combine with those from other levels

643
Q

What do postganglionic fibers that combine with other levels form

A

named visceral nerves

644
Q

Named nerves often join what

A

branches from the parasympathetic system

645
Q

What do named nerves and branches from the parasympathetic system for

A

plexuses on or near the surface of the target organ

646
Q

Branches of the plexuses will then do what

A

innervate the organ

647
Q

Spinal cord levels T1-T5 innervate what viscera

A

cranial, cervical, and thoracic

648
Q

Preganglionic sympathetic fibers that pass through the sympathetic trunk and paravertebral ganglia without synapsing doo with

A

form splanchnic nerves

649
Q

What do preganglionic sympathetic fibers form splanchnic nerves with

A

similar fibers from other levels

650
Q

What are splanchnic nerves

A

greater, lesser, least, lumbar, and sacral

651
Q

Where do splanchnic nerves pass

A

into the abdomen and pelvic regions

652
Q

The preganglionic sympathetic fibers that form splanchnic nerves are derived from what spinal cord levels

A

T5-L2

653
Q

What do splanchnic nerves generally connect with

A

sympathetic ganglia around the roots of major arteries that branch from abdominal aorta

654
Q

The ganglia that splanchnic nerves connect with are part of what

A

a large prevertebral plexus

655
Q

What does the large prevertebral plexus have input from

A

the parasympathetic part of the autonomic division of the PNS

656
Q

Post ganglionic sympathetic fibers are disctributes how

A

in extentions of the plexus along arteries, to viscera in the abdomen and pelvis

657
Q

Some of the preganglionic fibers in the prevertebral plexus do not synapse in the sympathetic ganglia of the plexus but pass through the system to what

A

adrenal gland

658
Q

At the adrenal galnd, where do preganglionic fibers synapse

A

directly with cells of the adrenal medulla

659
Q

Cells of the adrenal medulla are what

A

homologues of sympathetic postganglionic neurons

660
Q

What do the cells of the adrenal medulla secrete

A

adrenaline and noradrenaline into the vascular system

661
Q

The parasympathetic part of the autonomic division of the PNS leaves what regions of the CNS

A

cranial and sacral regions

662
Q

What parts of the cranial regions does the parasympathetic part of the autonomic division of the PNS leave

A

cranial nerves III, VII, IX, and X

663
Q

What parts of the cranial regions does the parasympathetic part of the autonomic division of the PNS leave

A

S2 to S4

664
Q

Where do parasympathetic fibers that leave cranial nerves III, VII, and IX go

A

to structures within the head and neck only

665
Q

Where do parasympathetic fibers that leave cranial nerve X go

A

head, neck, and innervates thoracic and most abdominal viscera

666
Q

What is another name for cranial nerve X

A

vagus nerve

667
Q

Where do the parasympathetic fibers of S2-S4 innervate

A

inferior abdominal viscera, pelvic viscera, and the arteries associated with erectile tissues of perineum

668
Q

What are the two neurons in visceral motor nerves of the parasympathetic system

A

preganglionic neurons and fibers

669
Q

In the sacral region, the preganglionic parasympathetic fibers form what

A

special visceral nerves

670
Q

What are the special visceral nerves formed y the preganglionic parasympathetic fibers called

A

pelvic splanchnic nerves

671
Q

Where do the pelvic splanchnic nerves originate

A

anterior rami of S2-S4

672
Q

Where to pelvic splanchnic nerves enter

A

pelvic extensions of the large prevertebral plexus formed around the abdominal aorta

673
Q

The fibers from the pelvic splanchnic nerves are then distrubuted to what

A

pelvic and abdomnal viscera mainly along blood vessels

674
Q

Where are the postganglionic motor neurons

A

in the walls of the viscera

675
Q

In the gastrointestinal system, do preganglionic fibers have postganaglionic fibers

A

no

676
Q

Where do preganglionic fibers synapse in the GI system

A

directly on neurons in the ganglia of the enteric system

677
Q

Preganglionic parasympathetic motor fibers in CN III, VII, and IX do what

A

separate from the nerves and connect with one of four distinct ganglia

678
Q

What do the ganglia house that preganglionic parasympathetic motor fibers in CN III, VII, and IX conect with

A

postganglionic motor neurons

679
Q

Where are the four distinct ganglia located near

A

branches of CN V

680
Q

Postganglionic fibers leave the distinct ganglia and go where

A

join the branches of CN V and are carried to target tissues

681
Q

What are the target tissues of CN V

A

salivary, mucous, lacrimal glands, constrictor muscle of the pupil, cilliary muscle in theeye

682
Q

The vagus nerve (X) gives rise to what

A

visceral branches along its course

683
Q

What do the branches of the vagus nerve contribute to

A

plexuses associated with thoracic viscera or to the large prevertebral plexus in the abdomen and pelvis

684
Q

When present, where are postganglionic parasympathetic neurons

A

in the walls of the target viscera

685
Q

What generally accompanies visceral motor fibers

A

visceral sensory fibers

686
Q

Visceral sensory fibers follow the course of what

A

sympathetic fibers entering the spinal cord at similar spinal cord levels

687
Q

Visceral sensory fibers may also do what

A

enter at levels other than those associated with motor output

688
Q

Visceral sensory fibers that accompany sympathetic fibers main function is

A

detecting pain

689
Q

Visceral sensory fibers accompanying parasympathetic fibers are carried mainly in…

A

IX and X

and in spinal nerves S2-S4

690
Q

What information do visceral sensory fibers in IX carry

A

chemoreceptors and baroreceptors associated with the walls of major arteries in the neck and from receptors in pharynx

691
Q

Visceral sensory fibers in X include what

A

those from cervical viscera and major vessels and viscera in the thorax and abdomen

692
Q

Visceral sensory fibers from pelvic viscera and the distal parts of the colon are carried where

A

S2-S4

693
Q

Visceral sensory fibers associated with parasympathetic fibers relay information to the CNS about what

A

status of normal physiological processes and reflex activities

694
Q

The enteric nervous system consists of what

A

motor and sensory neurons and their supportcells that form two plexus

695
Q

What plexus are the enteric nervous system composed of

A

myenteric and submucous nerve plexuses

696
Q

Where is the enteric nervous system located

A

walls of the gastrointestinal tract

697
Q

What composes theese plexuses of the enteric system

A

ganglia and bundles of nerve fibers

698
Q

What do the ganglia of the enteric system house

A

the nerve cell bodies and associated cells

699
Q

Where do the bundles of nerve fibers of the enteric system pass

A

between ganglia and from ganglia into surrounding tissues

700
Q

Where are neurons of the enteric system derived from

A

neural crest cells originally associated with occipitovervical and sacral regions

701
Q

Which has more neurons, the spinal cord or enteric system

A

enteric system

702
Q

Sensory and motor neurons within the enteric system control what

A

reflex activity within and between parts of the gastrointestinal system

703
Q

What do the reflexes controlled by the enteric system compose

A

regulate peristalsis, secretomotor activity, and vascular tone

704
Q

Sensory information from the enteric system is carried back to the CNS by what

A

visceral sensory fibers

705
Q

Nerve plexus are either what

A

somatic or visceral

706
Q

Nerve plexus combine what

A

fibers from different levels or sources to form new nerves with specific targets or destinations

707
Q

most somatic plexus formed from what

A

the anterior rami of spinal nerves

708
Q

The somatic plexuses are

A

cervical, brachial, lumbar, sacral, and coccygeal

709
Q

What levels are the cervical somatic plexuses

A

C1-C4

710
Q

What levels are the brachial somatic plexus

A

C5-T1

711
Q

What levels are the lumbar somatic plexus

A

L1-L4

712
Q

What levels are the sacral somatic plexus

A

L4-S4

713
Q

What levels are the coccygeal somatic plexus

A

S5-to Co

714
Q

Visceral nerve plexus contain what components

A

efferent and afferent components

715
Q

What composes the efferent component of the visceral nerve plexus

A

sympathetic and parasympathetic

716
Q

The visceral plexuses are

A

cardiac and pulmonary in the throax, large prevertebral plexus in the abdomen anterior to the aorta

lecom ms1 gross anatomy (12 decks)

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