LECOM MS1 Gross Anatomy--Initial Quiz Flashcards
What types of structures does technically anatomy include
macroscopic and microscopic
When used by itself, anatomy typically refers to which structures
macroscopic
Microscopic anatomy is also called what
histology
The term anatomy is derived from the Greek word “temnein” which means
to cut
What two approaches can anatomy be studied
regional approach
systemic approach
What is the regional approach to studying anatomy
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)
What is the systemic approach to studying anatomy
Each system of the body is studied and followed throughout the entire body
What is the anatomical position
the standard reference position of the body used to describe the location of structures
Describe the positions of the hands, feet, body, face, mouth, facial expression in the anatomical position
- 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
In the anatomical position, the bone under the eye aligns with what
the opening of the ear
How many major groups of planes pass through he body in the anatomical position
3
What are the 3 major groups of planes in the anatomical position
Coronal
Sagittal
Transverse
What orientation is the coronal plane
Oriented vertically
What does the coronal plane divide the body into
posterior and anterior parts
What orientation is the sagittal plane
Orientated vertically, but at 90 degree angles to the coronal plane
What does the sagittal plane divide the body into
left and right parts
What is the plane that passes through the center of the body dividing the body into equal left and right parts called
median sagittal plane
What is the orientation of the transverse plane
Horizontal
What are two other names for the transverse plane
Horizontal plane or axial plane
What does the transverse plane divide the body into
superior and inferior parts
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
anterior (ventral) vs. posterior (dorsal)
superior vs. inferior
Medial vs. lateral
What does the terms anterior and posterior mean
anterior: towards the front
posterior: towards the back
What do the terms medial and lateral mean
Medial: more towards the median sagittal plane
Lateral: more towards the sides of the body
What do the terms superior vs inferior mean
describe structures in reference to the vertical axis of the body
Superior: higher
Inferior: lower
What do the terms proximal and distal mean
Used with reference to being closer (proximal) or farther (distal) from a structure’s origin
What do the terms caudal and cranial mean
Cranial: towards the head
Caudal: toward the tail
Occasionally used in place of superior and inferior
When is the term rostral used
particularly in the head
What does the term rostral mean
to describe the position of a structure in reference to the nose
What do the terms superficial and deep mean
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
What is another name for plain radiography
Xray
What are xrays
photons
What are photons
a type of electromagnetic radiation
What are xrays generated from
complex x-ray tube (type of cathode ray tube)
After xrays are generate from a cathode ray tube, what happens
x-rays are collimated (directed through lead-lined shutters to stop them from fanning out) to the appropriate areas
What happens to xrays as they pass through the body
They are attenuated (reduced in energy)
What causes xrays to attenuate
as they pass through the tissues
After passing through the tissues, what occurs to the xrays
they interact with the xray film to form an image
How much does air attenuate xrays
very little (film is exposed to most amount of xrays)
How much does fat attenuate xrays
more than air but less than water
How much does bone attenuate xrays
the most (film is exposed to the least amount of xrays)
Differneces in attenuation result in what
differences in levels of exposure of the film
On xray, how does bone appear
white
On xray, how does air appear
dark
What is barium sulfate (structure)
nontoxic, an insoluble salt, relatively high density
What is used to demonstrate the bowel lumen in xray
barium sulfate suspension
What is also common with using a contrast agent in xrays
adding air to the suspension
How is air added to a contrast agent suspension
“fizzing” granules or directly instilling air into the body
What is a double contrast study
air and barium contrast
What contrast agent is used for injections
Iodine
Why is iodine good structurally
high atomic mass
Why is iodine good from a patient stand point
it is naturally excreted by the urinary system
Why are intravenous contrast agents good
help visualize arteries and veins and also the urinary system
What is the urinary system xray with contrast called
Intravenous urography
What makes angiography difficult
difficult to appreciate the contrast agent in the vessels through the overlying bony structures
What technique is used to circumvent the difficulty in an angiography
subtraction angiography
How is subtraction angiography performed
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.
What is ultrasound
series of high frequency sound wave
What produces the very high frequency sound waves for an US
piezoelectric materials
What can the piezoelectric material also do after producing the sound waves
receive these sound waves back
Traditionally, US is used for what
assessing the abdomen and the fetus in pregnant women
US can also be used to asses what
eyes, neck, soft tissues, and peripheral musculoskeletal system, stomach, esophagus, duodenum, transvaginal, transrectal
Doppler US enables determination of what
its direction, flow, and velocity within a vessel
How do US tell direction
the degree of frequency shift determines whether the object is moving away from or toward the probe and its speed
What does CT stand for
computed tomography
Simply describe what a CT scan does
obtain images of the body in slices in the axial plane
How are CT scans obtained
patient lies on a bed and an X-ray tube passes around the body. Computer transforms the images
What does MRI stand for
magnetic resonance imaging
What is the process of MRI dependent upon
free protons in the hydrogen nuclei in molecules of water
Why is the hydrogen proton ideal for MRI
water is found in almost all biological tissues
Protons within a patient’s hydrogen nuclei should be regarded as what
small bar magnets randomly orientated in space
During an MRI, the patient is placed in what
a strong magnetic field
During an MRI, placing the patient in a strong magnetic field does what
align the small bar magnets
What is passed through the patient during an MRI
pulse of radiowaves
As radiowaves are passed through a patient during an MRI, what happens
the small bar magnets are deflected
What occurs after the small bar magnets are deflected
they return to their aligned position and emit small radio pulses
How is a signal produced in an MRI
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
Signals from protons during an MRI then do what
are analyzed by a computer
How can different properties of protons be assessed during an MRI
by changing the sequence of pulses to which the protons are subjected
What are the different properties of protons called in an MRI
the “weighting” of the scan
What are the two weightings of an MRI
T1-weighted images
T2- weighted images
From the clinical point of view, what do T1 images show
dark fluid and bright fat (ex: cerebrospinal fluid is dark)
From the clinical point of view, what do T2 images show
bright signal from fluid and an intermediated signal from fat (ex cerebrospinal fluid is white)
What does Nuclear medicine imaging involves
gamma rays
What are gamma rays
a type of electromagnetic radiation
What is the important difference between gamma rays and x-rays
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
For an area to visualized with nuclear medicine imaging, what must the patient have
a gamma ray emitter
What are properties of a gamma ray emitter
a reasonable half life
an easily measurable gamma ray
energy deposition is as low a dose as possible in the patients tissues
What is the time length for a reasonable half life
6-24 hours
What is the most commonly used radionuclide (radioisotope)
technitium-99m
What is technitium-99m usually injected as
technitium salt or combined with other complex molecules
What is technitium-99m bound to to allow assessment of the skeleton
methylene diphosphonate (MDP)
What does MDP and technitium-99m together form and do
radiopharmaceutical that specifically binds to the bone
How are images obtained in nuclear medicine imaging
via a gamma camera
What causes the imaging in nuclear medicine imaging
the level on how the radiopharmaceutical is absorbed, distributed, metabolized, and excreted by the body after injection
What does PET stand for
positron emission tomography
What does PET detect
positron emitting radionuclides
What is a positron
anti-electron
What is an anti-electron
positively charged particle of antimatter
Where are positrons emitted from
the decay of proton rich radionuclides
Most of the radionuclides are made where
cyclotron
What is a characteristic of these radionuclides
they have extremely short half lives
What is the most commonly used PET radionuclide
Fluorode-oxyglucose (FDG) labeled with Fluorine-18
What is fluorine-18
positron emitter
What in the body takes up fluorode-oxyglucose with fluorine-18
any tissue that is taking up glucose
What does the tissue uptake of this radionuclide on a PET mean
any resulting localized high concentration of this molecule compared to the background emission is a “hot spot”
What are PETs commonly used for from a clinical aspect
detection of cancer and the assessment of its treatment and recurrence
What is the most commonly obtained form of imaging
plain radiography (x-rays)
How far away is the xray tube from the film at standard (excluding chest radiographs)
1 meter
In plain radiography, where is the patient’s body area of question placed
on the xray film
When describing subject placement for radiography, the part closest to the xray tube is referred to as
anterior
When describing subject placement for radiography, the part closest to the xray film is referred to as
posterior
When viewing an xray, the right side of the patient is seen where
on the left (vice versa)
The observer views the patient in an xray image as looking at what
the patient in the anatomical position
What is one of the most commonly requested plain radiographs
chest xray
How is the patient situated during a chest xray
patient is erect and placed posterioanteriorly (occasionally obtained anterioposterior position when patient too ill too stand)
A good quality chest xray will demonstrate what
lungs, cardiomediastinal contour, diaphragm, ribs, and peripheral soft tissues
How are plane abdominal xrays obtained (position of pt)
AP supine position
What is an exception to obtaining a plain abdominal xray in the AP supine position
Small Bowel obstruction suspected
When SBO is suspected, how is a plain abdominal xray obtained
erect position
CT images are viewed how
Obtained in axial plane and viewed from below looking upwards
What side of the patient is on the left side of the screen in a CT
the right
The uppermost border of the image in a CT is what
anterior
What is the great advantage of a CT scan
ability to extend and compress the gray scale to visualize the bones, soft tissues, and visceral organs
MRI contrast agents typically contain what
paramagnetic substances
What are typical MRI paramagnetic substances
gadolinium and manganese
What makes MRI and US ideal imaging studies
do not impart significant risk to the patient
What is the modality for imaging in assessing a fetus
US
What is the relationship between cost and imaging
the more complex, the more expensive
What is the order in least to greatest exposure dose of radiation for imaging methods
chest radiograph abdomen radiograph intravenous urography CT scan of head CT scan of abdomen and pelvis
What is the dose and duration of background exposure for chest radiograph
0.02 and 3 days
What is the dose and duration of background exposure for abdomen radiograph
1.0 and 6 months
What is the dose and duration of background exposure for intravenous urography
2.5 and 14 months
What is the dose and duration of background exposure for CT scan of head
2.3 and 1 year
What is the dose and duration of background exposure for CT of abdomen and pelvis
10.0 and 4.5 years
The skeleton can be divided into how many subgroups
two
What are the two subgroups of a skeleton
axial skeleton
appendicular skeleton
What does the axial skeleton consist of
bones of skull, vertebral columns, ribs and sternum
What does the appendicular skeleton consist of
bones of the upper and lower limbs
What is the skeletal system composed of
cartilage and bone
What is cartilage
avascular form of connective tissue
What is cartilage composed of
extracellular fibers embedded in a matrix that contains cells localized in small cavitites
Depending on the type of cartilage, how does the cartilage composition change
the amount and kind of extracellular fibers
In heavy weight bearing areas or areas prone to pulling forces, how is the cartilage composition different
more cartilage
Cartilage in heavy weight bearing areas is almost what..
inextensible
In areas that have less weight bearing demand and stress, how is the cartilage composition different
more elastic fibers, fewer collagen fibers
What are the 3 functions of cartilage
- support soft tissues
- provide a smooth, gliding surface for bone articulations at joints
- enable the development and growth of long bones
What are the 3 types of cartilage
- hyaline
- elastic
- fibrocartilage
What is hyaline cartilage composition
matrix contains a moderate amount of collagen fibers
What is elastic cartilage composition
matrix contains collagen fibers along with a large number of elastic fibers
What is fibrocartilage composition
matrix contains a limited number of cells and ground substance amidst a substantial amount of collagen fibers
What is an example of hyaline cartilage
articular surfaces of bones
What is an example of elastic cartilage
external ear
What is an example of fibrocartilage
intervertebral disks
Which of the 3 types of cartilage is most common
hyaline
Does cartilage have blood vessels
no
How is cartilage nourished
by diffusion
Does cartilage have lymphatics
no
Does cartilage have nerves
no
What is bone
calcified connective tissue
Is bone living or nonliving
living
What does bone consist of
intercellular calcified matrix, collagen fibers, and several types of cells within the matrix
What are the 5 functions of bone
- supportive structures for the body
- protectors of vital organs
- reservoirs of calcium and phosphorus
- levers on which muscles act to produce movement
- containers for blood-producing cells
What are the two types of bones
compact and spongy
What type of bone is compact bone
dense bone
What structures do compact bone form
outer shell of all bones (surrounds spongy bone)
What does spongy bone consist of
spicules of bone enclosing cavities containing blood-forming cells
What is another name for blood forming cells
marrow
How are bones classified
by shape
What are the 5 shapes of bones
long bones short bones flat bones irregular bones sesamoid bones
What shape do long bones have
tubular
What is an example of a long bone
humerus and femur
What shape do short bones have
cuboidal
What is an example of short bones
bones of wrist and ankle
What shape do flat bones have
two compact bone plates separated by spongy bone
What is an example of flat bones
skull
What is classified as an irregular bone
bones with various shapes
What are examples of irregular bones
bones of the face
What shape do sesamoid bones have
round or oval
What is an example of sesamoid bones
bones that develop in the tendons
Do bones have blood vessels
yes
Do bones have nerves
yes
Generally, how many nutrient arteries per bone
1
Where does the nutrient artery enter the bone
the internal cavity of the bone
What areas does the nutrient artery supply
the marrow, spongy bone, and inner layers of compact bone
All bones are covered externally by what
a fibrous connective tissue membrane
What is the name of the fibrous connective tissue membrane called that covers bones
periosteum
What areas does periosteum not cover bones
area of a joint where articular cartilage is present
What is the unique function of periosteum
forming new bone
What supplies the periosteum with nutrients
blood vessels
Will a bone stripped of its periosteum survive
no
The branches of the blood vessels that supply the periosteum also supply what
extend to the outer surface of the compact bone
Most of the nerves that pass into the internal cavity are what type of fibers
vasomotor fibers
What do the vasomotor fibers do
regulate blood flow
Does bone have sensory nerve fibers
yes
How many sensory nerve fibers do bone have
very few
Does periosteum have sensory nerve fibers
yes
How many sensory nerve fibers does the periosteum have
a lot
Because the periosteum has a lot of sensory nerve fibers results in what
very sensitive to any type of injury
Where do all bones come from in development
mesenchyme
What are the two ways bones develop from the mesenchyme
intramembranous ossification
endochondral ossification
What is intramembranous ossification
mesenchymal models of bones undergo ossification
What is endochondral ossification
cartilaginous models of bones form from mesenchyme and undergo ossification
In western countries, when does skeletal maturity occur
between ages of 20 and 25
Skeletal maturity is impacted by what factors
genetic factors and disease states
How can bone age be determined
image the nondominant hand (typically left) and compare to series of standard radiographs
In disease states of malnutrition and hypothyroidism, what occurs
bone maturity may be slow
In a healthy individual, the bone age accurately represents what
the true age of the patient
How many types of bone marrow are there
2
What are the two types of bone marrow
red and yellow
What is another name for red bone marrow
myeloid tissue
What arises from the red bone marrow
red blood cells, platelets, most white blood cells
What arises from the yellow bone marrow
a few white blood cells
What also composes the yellow bone marrow
large fat globules
From birth, most of the marrow is what kind
red
As a person ages, what occurs to the marrow
red is converted to yellow
Where is yellow bone marrow formed typically
in the medulla of the lone and flat bones
How many types of stem cells compose bone marrow
2
What are the two types of stem cells in bone marrow
hemopoietic
mesenchymal
What do hemopoietic stem cells give rise to
WBC, RBC, and platelets
What do mesenchymal stem cells give rise to
differentiate into structures that form bone, cartilage, and muscle
What causes fractures in bones
abnormal load or stress, diseases that lead to poor quality bone
In growing children, where can fractures occur
across the growth plate or across the shaft
Shaft fractures in growing children result in what
partial cortical disruption
What is the term for shaft fractures in growing children
greenstick fractures
After a fracture has occurred, what happens next
the healing process
What is the first step in the healing process for a bone fracture
clot forms between fracture margins into which new vessels can grow
After a clot forms between the fracture, what is the next step in the healing process for a bone fracture
a jelly-like matrix is formed and further migration of collagen producing cells occurs
What occurs on the soft collagen framework after it is formed
osteoblasts produce calcium hydroxyapatite and forms insoluble crystals
After insoluble crystals are formed by osteoblasts, what occurs
bone matrix is laid down
As more bone is produced, what can be visualized after a fracture
a callus across the fracture site
Treatment of fractures require what
reduction in fracture line
What can reduce the fracture line
cast (plaster of paris)
internal or external fixation with screws and rods
What is avascular necrosis
cellular death of bone resulting from a temporary or permanent loss of blood supply to that bone
When can avascular necrosis occur
variety of medical conditions
What is a typical site for avascular necrosis
fracture across the femoral neck in an elderly patient
What is the treatment for avascular necrosis in the femoral head
replace the femoral head with a prosthesis
What is osteoporosis
a disease where the bone mineral density is significantly reduced
What does osteoporosis cause the bone to be more prone to
fractures
Where do osteoporitic fractures typically occur
femoral necks, the vertebra, and wrists
Osteoporosis typically occurs more likely in what patients
postmenopausal women
What four factors predispose bones to osteoporosis
poor diet
steroid usage
smoking
premature ovarian failure
What is treatment for osteoporosis
remove underlying factors
prevent further bone loss with drug treatment
When are the two stages of intense bone growth
between 7-10 years
puberty
What are intense bone growth stages associated with
increased cellular activity around the growth plate and the metaphyseal region
As a result of increased cellular activity in bone growth, what renders the metaphyseal region and growth plate more vulnerable to
injuries
What is a joint
a site where two skeletal elements come together
How many categories of joints are there
2
What are the 2 categories of joints
synovial and solid joints
What are synovial joints
skeletal elements are separated by a cavity
What are solid joints
no cavity and the component are held together by connective tissue
How are joints supplied with blood vessels and nerves
branches from blood vessels and nerves that innervated muscles
What are the characteristic features of synovial joints
- 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
What type of cartilage usually covers the articulating surfaces in joints
hyaline cartilage
What does a joint capsule in synovial joints consist of
an inner synovial membrane and an outer fibrous membrane
The synovial membrane of the joint capsule attaches to what
margins of the joint surfaces at the interface between the cartilage and bone
What does the synovial membrane of the joint capsule encolse
articular cavity
Does the synovial membrane have blood vessels
yes, it is highly vascular
What does the synovial membrane produce
synovial fluid
What is the function of synovial fluid
it perculates into the articular cavity and lubricates the articulating surfaces
What structure of the synovial membrane forms outside of joints
closed sacs of synovial membrane
What are these closed sacs of synovial membrane called
synovial bursae or tendon sheaths
Where do synovial bursae occur typically
between structures such as tendons and bone, tendons and joints, or skin and bone
What is the function of synovial bursae
reduce the friction of one structure moving over the other
Where do tendon sheaths form
surround tendons
What is the function of tendon sheaths
reduce friction
What composes the fibrous membrane
dense connective tissue
Where does the fibrous membrane form
surround the joint
What is the function of the fibrous membrane in a synovial joint
stabilize the joint
What may occur to parts of the fibrous membrane in a synovial joint
it may thicken
Thickened fibrous membrane in a synovial joint forms what
ligaments
What are types of additional features that may be within the area enclosed by the capsule or synovial membrane
articular discs, fat pads, and tendons
What is the function of articular discs
absorb compression forces, adjust to changes in the contours of joint surfaces, increase the range of movements
Where do fat pads typically occur
between the synovial membrane and the capsule
What is the function of the fat pad
move into and out of region as joint contours change during movement
How are synovial joints described
based on shape and movement
Based on shapes, how can synovial joints be described
plane (flat) hinge pivot bicondylar (two sets of contact points) condylar (ellipsoid) saddle ball and socket
Based on movement, how can synovial joints be described
uniaxial
biaxial
multi axial
What are uniaxial joints
movement in one plane
What are biaxial joints
movement in two planes
What are multi axial joints
movement in three planes
Hinge joints are typically what type of joint movement wise
uniaxial
Ball and socket joints are typically what type of joint movement wise
multi axial
What function do plane joints allow
sliding or gliding movement when one bone moves across the surface of another
What is an example of a plane joint
acromioclavicular joint
What function do hinge joints allow
permit flexion and extension
What is an example of a hinge joint
elbow