Lecture Final New Material Flashcards
Identify the 3 planes of anatomy
- Transverse Plane
- Sagittal Plane
- Coronal Plane
What does the Coronal Plane Seperate?
Anterior and Posterior
What does the sagittal plane seperate?
Right and Left
What does the transverse plane seperate?
Superior and Inferior halves
Describe the orientation of the spinalis muscle
Next to the spine
What muscle group does spinalis, ilicostalis and longissimus belong to?
Erector Spinae Muscles
Describe the orientation of the longissimus
Most lateral
List the spinal meninges .
Dura Mater
Arachnoid Mater
Pia Mater
Describe the location of the Liver
Most of the liver resides in upper right quandrant, and just inferior to diaphram
What are the four Lobes of the Liver?
right,
left,
caudate (inferior and posterior)-inbeteen land and right and next to vena cava)
quadrate(next to gall bladder and inferior vena cava)
Where is the caudate lobe of the liver?
Surrounded by the inferior vena cava and leigamentum venosum on the right and left
Inferior-Quadrate
Right-Right Lobe
Left-Left Lobe
Where is the Quadrate Lobe of the liver?
Next to gall bladder in the middle
List some functions of the liver discussed in class.
Metabolize carbohydrates, fats and protein Produce bile Excretion Glycogen storage Detoxification Regulate blood clotting Over 500 functions have been identified
Where is the Quadrate Lobe of the liver?
Next to gall bladder in the middle
superior to it is the portal triad
List some functions of the liver discussed in class.
Metabolize carbohydrates, fats and protein Produce bile Excretion Glycogen storage Detoxification (anesthesia) Regulate blood clotting(clotting factor) Over 500 functions have been identified
Can the liver regenerate?
Yes
Good for transplants
Explain the pathways for blood to leave the liver.
There are two ways the blood can go to the liver:
1) r. and l. hepatic arteries (high in oxygen)
Common hepatic to proper hepatic to r and left hepatic)
2) hepatic portal vein
(supplies workload)
Blood leaves the liver via the ________________________.
Inferior Vena Cava
What faces posteriorly on the liver?
Veins
Portal Triad
Where is the portal triad located in the liver?
Hepatic portal vein is more anterior and have hepatic arterial supply next to it along with the
List the veins that join the hepatic portal vein and explain where they originated.
1) r. and l. gastro-omental veins-Stomach
2) splenic vein-Spleen
3) inferior mesenteric vein-Smalland large intestine
4) superior mesenteric vein-small and large intestine
5) pancreaticoduodenal vein-Pancreas and duadenum
6) r. and l. gastric veins-stomach
Explain the processes of a liver becoming cirrhotic.
Caused by chronic inflammation…process? Common sources of inflammation include ethanol, non-alcoholic fatty liver disease and viral infections (chronic hepatitis C infection). Permanently damages the liver. Connective tissue decreases -Enlargement of liver or fibrosis Cirrosis leads to liver cancer
Describe two pathways for bile release into the duodenum.
cystic artery
Describe two pathways for bile release into the duodenum.
Starting at the Gall Bladder:
-Cystic Duct to Common Bile Duct to duadenum
Staring at the Liver:
-Bile duct will come up and split into the hepatic duct and Cystic Duct.
-Hepatic Duct Comes up and splits into the R and L hepatic Ducts
Explain how the pancreas and gall bladder drain and how these two pathways are related.
Pancreatic duct delivers digestive enzymes and bicarbonate into the duodenum.
Pancreatic duct splits into the main and accessory pancreatic ducts (note location).
Minor and major duodenal papillae
Explain how the pancreas and gall bladder drain and how these two pathways are related.
Pancreatic duct delivers digestive enzymes and bicarbonate into the duodenum.
Pancreatic duct splits into the main and accessory pancreatic ducts (note location).
-Minor and major duodenal papillae
-Not all of digestive enzymes are made in pancreas but some are made in small intestine
Describe the location and function of the spleen
”Lymph node” of the blood.
- Can also store platelets
- More important when you are younger. (weaker immune system)
Explain the problems associated with spleen being a capsulated organ
Capsulated organ
Prone to mechanical damage and when it is swollen. (Mononeucleosis)
-Splenic Artery is large so you can bleed out
What blood does the superior mesentaaric artery receive?
All of small intestine, transverse and ascending colon
What veins dump into the inferior vena cava in the liver?
1) r. hepatic vein
2) middle hepatic vein
3) l. hepatic vein
When you look down from superiorly you usually see the openings
How is the hepatic portal system affected by a cirrotic liver?
Impairs circulation and difficult getting blood into liver. Build up of blood in venous supply.
How is the hepatic portal system affected by a cirrotic liver?
Impairs circulation and difficult getting blood into liver. Build up of blood in venous supply. Bad varicose veins around umbilics or hemhorroids
what happens if gall bladder is removed?
The common hepatic duct will swell over time working like a mini gall bladder
Describe the pathway from gall bladder of spleen
- Gallbladder
- Cystic Duct branches into
- Common hepatic duct and Common Bile Duct
- From Common Bile duct to Main pancreatic duct
- Major duodenal papilla
- To the left is the spleen
Where is the spleen located
Lateral and Posterior to Stomach
List the three parts of the small intestine
- Duodenum
- Jejunum
- Ileum
What do you see if you reflect the greater omentum superiorly?
The small intestine
What keeps the small intestine organized?
The dorsal mesentary
Where is the duodenum located?
coming right off the stomach and is the first part of the small intestine
1 ft long
-site of the c curvature
Where is the jejunum located?
The middle portion
Superior part of small intestine
Where is the ileum located?
inferior portion of the small intestine
What is the function of the small intestine?
1
What are the Tenia Coli of the colon?
They are three ribbons of smooth muscle that form the haustra from longitudal contractions
What does the ileocecal valve seperate?
The cecum from the ileum
What is the origin of the superior mesenteric artery?
Abdoominal Aorta
Name the three branches of the superior mesenteric artery
- Right Colic
- Middle Colic
- Ileocolic
What are the major branches that come off the inferior mesenteric artery?
Left Colic Artery
Sigmoid Arteries
What does the right Colic Artery Feed?
Ascending Colon
What Does the Middle Colic Artery Feed?
Transverse Coloon
What does the ileocolic artery feed?
Cecum, 1st part of colon on right
What is the orgin of the inferior mesentaric artery?
Abdominal Aorta
Where are the kidneys located in the abdominal cavity?
upper quadrants of adominal cavity
Posterior ribs provide some posterior protection to kidneys
What is the origin of the renal arteries?
They come directly off the abdominal aorta and goes to respective kidneys
Why is the left kidney more superior than the right anatomically?
liver is on the right and takes up alot of room
Why is the left kidney more prone to hypertention?
- Happens when renal arteries are disease free
- The superior mesenteric artery is anterior to the left renal vein so
- Abdominal aorta is deep to the left renal vein
- Left renal vein is sanwiched in between
- If the superior mesenteric artery becomes diseases it could create pressure on the left renal vein.
- Blood can’t leave kidney very well and kidney can shrink
- chronic hypertension can do the same thing
What is the origin of the ureters?
Renal Pelvis-Hilum of kidney
What is the function of the ureter?
Smooth muscle causes peristaltic movements to propel urine. This allows urine to get down to the bladder when you are lying down
Where does the ureter travel?
- Begins at the renal pelvis and comes out the hilum on the medial side of the kidney
- Travels superficial to iliac vessels (common iliac arteries and veins)
- runs to urinary bladder
Where is the renal cortex located?
Outer part
“rind of the kidney”
What is the function of the renal cortex?
Filtering-Location of glomeruli
What is the function of the renal pyramids?
-Adjusting concentration oof the urine
Where are the renal pyramids located?
In the medulla of the kidney
Fan shaped pieces
They have papillay Ducts
Where are the renal columns located?
In between renal pyramids
What is the function of the renal columns
Part of filteration in the cortex
What is the function of the Calcyces of the kidney?
Short tube that collects urine from the papilla of the pyramid and beings it to the major calcyc
What is the function of the major calyces of the kidney?
bring urine from minor calyce to renal pelvis
Where is the renal pelvis of the kidney?
Connects to ureter
What is the function of the renal pelvis of the kidney?
Brings urine from major calcye to ureter
Where is the renal pelvis of the kidney?
1
What are renal Calculi?
Kidney Stones which are stones oof concentrated urine with high levels of calcium
How do renal calculi form?
Many causes
-Low water intake (too much soda)
-Hyperparathyroidism-can increase blood calcium levels because parathyroid hormone removes calcium from bone
Crystals form from calcium salt buidup which promotes more crystal formation
What are some symptoms of renal calculi?
- Common-Blood in the urine-(smooth muscle of renal system squeezes down and cause trauma to tissue
- Severe back or flank pain (area of lower back in between ribs and hips)
Extremly painful to pass
What is the treatment for renal calculi?
Increase fluid intake (Less invasive procedure first)
Pain meds (Morphine)
Alpha Blockers
Ultrasound
Surgery-Last resort because scar tissue can form
The urinary bladder is a _______organ
retroperitoneal
What is the detrusor muscle made of?
Smooth muscle
Where is the urinary bladder?
Anterior to the rectum and inferior to the abdominal viscera (very Deep)
Where is the detrusor muscle?
Smooth Muscle that composes that bladder wall
-Feeling need to pee (contraction of detrusor)
What is the trigone of bladder?
Three holes in the inferior portion of the urinary bladder:
1. To urethra
2 and 3 each ureter
The ureters do not dump urine into top of bladder but in the inferior portion
What is micturition?
Urination
Describe the process of urination
- The urinary bladder stretches until it reflexivvely contracts (contrict) trying to void urine
- There are two sphinctors that keep the urine from leaving (interal at the base which is volutary and externa that is voluntary and made of skeltal muscle)
- If you don’t go then the muscle stops contracting but you lose the need to go but the bladder then continues to fill and once you have to go then you have to go really bad
What are the internal hip flexors?
Psoa Minor
Psoas minor
illacus
What is the function of the testes
Spermatogenesis and
Testosterone Production
Where is the tunica albuginea located?
On the outside of the testes
-White fibrous capsule
Where are the Lobules of the Testes located?
Contains Tightly packed dense coils called semineferous tubules where sperm is made
Where is the Rete Testis Located?
Where all lobules connect
Medial part of testes
Where is the epididymis located?
Comes off the rete testes
What and Where is the Ductus Deferens ?
- Comes off the epididymis
- Carries the sperm from epididymis to urethra
Pathway of Sperm form seminiferous tubules to spongy urethra.
- Semiiniferous tubules
- Rete Testes
- Epididymis
- Ductus Deferens
- ejaculatory duct
- Prostic Urethra
- Membranous urethra
- Spongy urethra
What are omental appendages?
Bags of fat coming off colon
What is the first branch off the abdominal aorta?
The Celiac Trunk
What feeds the small intestine?
Intestinal Arteries
what is the function of the ureter?
Bring urine to bladder from kidney
What structures are retroperintoneal?
Kidney
Ureter
Urinary Bladder
Where are the adrenal glands?
Superior Medial aspect of kidneys (look like fat)
Where is the hilum oof the kidney?
Medial aspect
Where does the right renal run?
Deep to inferior vena cava
Where does the left renal artery run?
Directly To the left side
Where does right renal vein run?
With Right Renal artery but stops at inferior vena cava
Where does the left renal vein run?
dives deep to superior mesenteric artery befor joing inferior vena cava
What is the problem with the kidney being a capsulated organ?
The kidney cannot swell due to the capsulation and can become painful
How much cardiac output goes to the kidneys?
About 20% and kidneys are only 2% of body weight
Because of this they have a high oxygen demand
What happens in the kidney when you excercise?
- Blood goes from kidneys to skeletal muscle to power it.
1. Afferent and Efferent Arterioles Constrict to maintain Gomerular filteration pressure to keep kidney functioning
What comes out of the hilum oof the kidney?
Renal Artery
Renal vein
ureter
What are the points of the renal pyramids called?
Papilla
Where do the papillary ducts drain?
Into the points of the papilla
Flow of Urine in the Kidney
- Papillary Ducts of pyramids
- Papilla
- Minor Calyce
- Major calcye
- Renal Pelvis
- Ureter
- Urinary Bladder
- Urethra
Where can kidney stones get stuck?
- Minor or Major Calcye
2. Ureter
Why is morphine a problem when trying to get out kidney stones?
- It slows peristalis in muscle
Why is the ureter located at the bottom of the bladder?
As urinary bladder starts to stretch we don’t want to overfill the bladder cause rupture is dangerous
Where is the psoas major muscle?
Biggest one
Where is the psoas minor muscle?
Mostly tendon, just superficial to psoas major
Thin strip
Where is the Iliacus Muscle?
Sitting in the iliac fossa
What is the group called of the 3 internal hip flexors?
iliosoas muscle group
Lateral side of ilium, Dive beloow
If you want to work your abdominal muscles what should you avoid?
Using your internal hip flexors
What are the ileosoas muscles important for and what happens if they get weak?
Keeping your pelvis aligned.
Weakness can cause anterior tilt which can cause canned femoral acetabulum impingement. Anterior also strtches internal flexors causing hip pain. You can prevent it by stretching hip flexors
What part of the nervous system are spinal nerves?
peripheral nervous system
What type of nerves are spinal nerves?
Mixed (it is the fusion of the ventral and dorsal root)
Where do you find the sensory portion of the spinal nerve?
In the Dorsal Root
Where do you find motor portion of the spinal nerve?
Ventral Root
In the dorsal root, there is a dorsal root ganglion, what do you find there?
The cell bodies of afferent (sensory) neurons
Spinalis
Bilateral muscle on each side of the spine
Most medial of the erector spinae group
Orientation of the Longissimus
Longest of the 3 erector spinae, in the middle
-Runs all the way up the thorax
orientation of iliocostalis
-Most lateral
Starts at the ileum and runs all the way up to ribs.
What branch of the spinal nerve is the posterior root?
Dorsal Root
What branch of the spinal nerve is the anterior root?
Ventral Root
What differentiates the dorsal root from the ventral root?
Dorsal root ganglion
What are longer sensory or motor nerves?
Sensory (cell bodies halfway)
What would happen if someone clipped a ventral root of a spinal nerve?
Lose motor function but still can feel
What is the difference between a sulcus and a fissure?
Fissure is larger
Where is the anterior median fissure?
on the bottom and bigger
Grey Matter
no myelin (Processing)
White Matter
Myelinated CNS neurons (sending and receiving)
Where are the anterior grey horns?
The same side as the anterior median fissure.
Contains somatic motor nucleui
Where are the posterior grey horns?
On the side of the posterior median sulcus and contain somatic and visceral sensory nucleui
What connects the left and right sides of grey matter?
Grey Commissure
Where is the cervical region of the spinal cord?
Around C8
Where is the Conus Medullaris of the Spinal Cord?
In the lumbar section
Spinal nerves follow the vertebrae excect that ______
There is one pair of extra nerves in the neck region (7 vertebrae but 8 pairs of spinal nerves)
The first pair of spinal nerves comes out ______ to the 1st neck vertebrae but end ______of C_
Superiorly, at the bottom of C7. the rest come off the bottom
What is the function of the Dura Mater?
Toughest outer layer made of collagen
What is the function of the arachnoid mater?
Spider web like appearance
Where is the pia mater?
Directly on the surface of the spinal cord with vasculature (sheen)
where is the ventral ramus?
Where the spinal nerve goes toward the front
What does the doral ramus innervate?
Erector spinae muscles
What do the lateral horns of the spinal cord contain?
Visceral motor neurons (sympathetic )
What part of the spinal cord comtain lateral gray horns?
Thoracic
What are interneurons?
processing neurons
spinal reflexes
What matter follows somatotrophy?
White matter
How is the white matter organized?
- 6 columns
- ascending(info from spinal cord to brain-sensory)) and descending tracts(brain to spinal cord-motor))
What is somatotrophy?
Body regions that corrospond to specific white mater tracts.
-The closer you are to the edge of the spinal cord the more it corresponds to the more distal region
Where is a typical lumbar puncture done?
Usually between L3-4 and L4-L5
Why is a lumbar puncture done in those regions?
the spinal cord ends on average around L1 so you can avoid skewering the spinal cord by inserting here yet still get csf.
What and Where is the cauda equina?
Means Horse tail
-It is a collection of nerve roots
What is the conus medularis and where is it?
Tapered lower end of the spinal cord. Occurs near L1 and sometime L2
What is the filum terminale?
Delicate strand of fibrous tissue that proceeds down from the apex of the conus medullaris.
-Provides longitudal support to the spinal Cord
Where is the Glenohumeral Joint
Between the scapula and humerus.
What is the glenohemeral joint?
- Shoulder joint-Ball and socket joint
- Connects the upper limb to the trunk
Describe the Glenohumeral joint
-Lots of movement but at a cost of joint stability
Articulation of genohumeral joint
The head of the humerus articulates with the glenoid cavity of the scapula.
- articulating surfaces are lined with hyaline cartilage
- inner lining of capsule is a synovial membrane that produces synovial fluid to reduce friction
- Bursa are present as well.
- allows circumduction
What are the muscles of the rotator cuff?
Suprapinitus
Infraspintus
Teres minor
Subscapularis (Only anterior muscle)-most often gets injured
What is the purpose of the rotator cuff?
Keep the humerus attached to the scapula
What is a shoulder impingment injury?
When the subacromial space becomes compressed and rubs against or impinges on the tendon and the bursa causing pain.
-Seen in active or older adults
What are the common causes of shoulder impingement?
when rotator cuff swells:
1. Pressure within the tendon increases and results in compression and reduced blood flow in the capillaries.When blood flow is reduced, the tendon can start too fray and pain occurs. It can even be as serious as a tear in the tendon and move as far down as the tear of biceps muscle tendon. The pain is made worse by reaching. Bursitis is closely related to Rotator Cuff impingement which is swelling of the fluid filled sac called the bura. Tendonitis is also
What is the subacromial space in the shoulder?
It is the space between the acromin and rotator cuff
Why is the shoulder sucestible to injury?
Unlike other joints the muscle and tendons of the shoulder are surrounded by bone. rather than musclee
Underneath the bone lies the rotator cuff. The rotator cuff is sandwiched inbetween the humerus and acromion. Injury causes it to sewell but because it is surrounded by bone a number of events can occur.
What is the rotator cuff?
A group of muscles and tendons we use to lift the arm overhead
Basilic vein
- Primary SUPERFICIAL vein that drains the upper limb
Why are the testes external?
Spermatogenesis needs to take place at a lower than normal body temp.
What happens in the epididymis?
Sperm mature and flagella become more active.
It is a tightly coiled tube.
Storage of sperm
what happens to extra sperm?
They will break down and immune system eats them
Testicular Artery Origin
Abdominal Aorta
Testicular Artery Destination
Spermatic Cord
Why is the testicular artery convoluted?
- Testes need to descend so extra slack is needed
2. More time for blood to cool before it gets to testes
Origin of the pampiniform plexus
Testes?
Destination of the pampiniform plexus
- Left testiclar vein to left renal vein
- Right Testicular Vein to inferior vena cava
Why is the pampiniform plexus close to the testicular artery?
Reclaims heat from testicular artery
What is the pampiniform plexus?
A countercurrent heat exchanger in the testes
What is the job of the scrotum?
To regulate the temp. of the testes
- lower = cooler
- males that sit have a lower sperm count
What are the cremaster and dartos muscles?
Thin layers of smooth muscle deep in the scrotum
Cremaster is the biggest player
What is the ideal scrotal temperature?
89 degrees F
What are the accessory glands of the male reproductive system?
- Seminal Vesicles
- Prostrate
- Bulbourethral Glands
Where are the seminal vesicles located?
(Two of these) Posteriorly to the urinary bladder where the ureter joins them
Where is the prostrate located?
Immediately inferior to urinary bladder and goes all the way around urethra
-immediately anterior to rectum
Where are the bulbourethral glands located?
(2) on each side in the urogenital diaphram (layer of muscle)
What do the walls of the seminal vesicles have?
smooth muscle
What is the seminal vesicle fluid made up of?
Coagulants (protect sperm when they enter acidic environment of vagina) and fructose (
What is the seminal vesicle fluid made up of?
Coagulants (protect sperm when they enter acidic environment of vagina) and fructose (carbohydrate monomer-Food for sperm)
What is the seminal vesicle fluid made up of?
Coagulants (protect sperm when they enter acidic environment of vagina) and fructose (carbohydrate monomer-Food for sperm)
What does the prostrate produce?
A milky white, alkaline fluid that contains prostrate specific antigen, to breakdown coagulants so sperm can swim once pH is neutral
What do the bulbourethral glands secrete?
Watery mucous sectretion that lubricates the urethra (high pH) so semen can slide through and also neutralize urine
What is benign prostatic hyperplasia?
-A conditon common with aging where the prostrategets enlarged and presses down on the urethra making it difficult to urinate (reduce stream)
How is benign prostatic hyperplasia treated?
Medication such as alpha blocker
-Smooth muscle relaxers
Prostrate Removal (Davinchi robut)
Why is it dangerous to remove prostrate?
You could damge the pudendal nerve and
impotence can occur
What is prostrate cancer?
-Cancer that is more serious in middle aged men or younger men
-Can mimic prostratic hyperplasia
-Often goes untreated
in older men
How do you diagnose an enlarged prostrate?
Prostrate exam-rectal exam-Insert finger and press anteriorly to rectum to feel prostrate
How can prostrate cancer be diagnosed?
Elevated PSA(prostrate specific antigen)
How is prostrate cancer treated?
Prostrate removal
Radiation (Rods inserted into prostrate)
Chemotherapy
What is the function of the penis?
Organ of copulation
What is the prepace?
Layer of skin that covers distal portion of penis.
What is cut off in circumcision?
prepace (pull forward and clipped)
What is the glans penis?
Distal enlargement of the corpus spongiosum
What is contained in the penile shaft?
Erectile tissue chambers (3 chambers) and respective vasculature
What are the chambers of the penile shaft?
2 dorsal chambers-Corpus cavernosum
1 ventral chamber- corpus spongiosum
What is the function of the corpus spongiosum?
- Forms the glans penis
- Ventral chamber of tissue that encircles the urethra
What is the function of the corpus spongiosum?
- Forms the glans penis
- Ventral chamber of tissue that encircles the urethra
- Penile artery in each
What is the Corpora Cavernosa?
Paired Dorsal Chambers, each chamber has its own penile artery
What causes an erection?
A parasympathetic release of nitrous oxide (relaxation response)
from pudendal nerve
-Arterial blood goes in but it cannot leave because veins become compressed
-Stress can make it hard to get an erection
What happens if an erection does not go away?
-Penis can become ischemic (when men self medicated)
-Pudendal nerve died
-
What are ED drugs?
Promoters of Nitrous Oxide
What are the different sections of the urethra?
Prostatic-in the prostrate gland
- Membranous-within the urogenital diaphram (bulbourethral glands)
- Spongy Urethra (surrounded by corpus spongiosum)
Where is bulbospongiosus muscle?
Wraps around base of penis
Where is the ishiocavernosus muscle?
shaft
What is the function bulbospongiosus muscle?
Ejaculation of semen out of penis
What is the function of the ischiocavernosus muscle?
Tenses during erection to stabilize penis larerally (billteral)
Where is the female reproduction system?
It sits very low in the abdominal pelvic cavity. Below ilium
-Lower than the first bifurcation off the internal iliac arteries
What is the labia majora?
Outermost fold of skin
Where does the musculocutaneous nerve run in the antecubital region?
Between the Biceps Brachaii and Brachial Muscles
What does the brachial artery split into in the antecubital region of the arm?
Radial and Ulnar Arteries
Where does the median nerve run in the antecubital region oof the arm?
Deep to the pronator teres muscle
Where does the radial nerve run in the arm?
Deep to the brachioradialis muscle
What borders the carpal tunnel?
Borders – flexor retinaculum anterior, proximal row of carpals
What are the borders of the ulnar tunnel?
Palmer Carpal ligament and pisiform bone
What runs through the carpal tunnel?
- Median Nerve
- Flexor Digitorum Superficialis tendons
- Flexor Digitorum Profundus Tendons
what runs through the ulnar tunnel?
Palmer ligament
Ulnar nerve and artery
Where does the ulnar nerve and artery go into the ulnar tunnel?
Distal to palmer ligament
What is the labia minora?
- Lacks keratinized stratified squamous epithelium
- Water can pass through
- Can dry out
What is the function of the labia majora?
To protect opening of vagina and labia minora so it doesn’t dry out
Where is the labia minora?
Medial and deep to the labia minora
What is the Clitorus made of?
Corpora cavernosa erectile tissue
What is the vestibule of the vagina?
Recess formed deep to the folds of labia minora
What do the vestibular glands secrete?
Watery Mucus (Homologous to bulbourethral glands) Contract during arousal
Why is the vagina acidic?
To protect it from bacteria
Function of the vagina
- Organ of copulation
- Birth Canal
- Provides exit for degenerated endomeitrium during menses
What is the purpose of vaginal rugae?
Rugae allows for expansion
What are the Carpometacarpal joints?
Base of the thumb where it meets the hand.
- allows thumb to move freely in many directions
- Strength to the hand for grasping and gripping
- cartilage lines it
What are the metacarpophalangeal joints?
Connect metacarpus (palm of hand to digits
(5)
-Can flex, extend, abduct, adduct, circumduct and limited rotation
-Provide stability and flexability
What are the proximal and distal interphlangeal joints?
-hinge Joints
2-5
Thumb is called interphalangeal joint of the thumb
-Fine motor movement (flex and extend)
Origin of Long thoracic Nerve, Medial pectoral nerve, lateral pectoral nerve.
Brachial Plexis
What does the Thoraco-acromial artery and thoracodorsal artery come off of?
Axilary Artery
what are the four branches of the Thoraco-Acromial Artery?
Acromial
Clavicular
Deltoid
Pectoral
Where is the clitrous?
Anterior (dorsal) to the urethra
What is anterior to the clitorus
Prepuce
What does engorgement of blood vessels in clitorus do?
Increase sensitivity
What is the order of vaginal openings?
Urethra, vagina
Where are the vestibular glands?
lateral posterior to vaginal opening
Where is the urinary bladder?
Posterioor to pubic symphysis
What way does the uterus tilt?
Forward (anterior)
What is the function of the vagina?
- organ of copulation
- Birth canal
- provides exit for degenerated endomeitrium during menses
What are the rugae in the vagina for?
- allows expansion for birth
What is the opening to the uterus called?
Cervix
Why is the vagina acidic?
Bacteria do not like acid but fungi grow
How does the vagina become acidic?
- commensal relationship with anaerobes that eat glycogen secreted by epithelium.
- The byproduct oof the breakdown of glycogen ends up being pyruvate.
- Pyruvate is then converted into lactic acid
What are the names for fallopian tubes?
Oviduct, fallopian tube, uterual tube
Where is the ovarian ligament?
Body of uterus to ovary
Function of suspensory ligament
Connect ovary to abdominal wall
What runs with suspensory ligament
ovarian artery and vein
Broad Ligament
Wide, Attaches body oof uterus to ovary and fallopian tube
Where do the ureters come in through
Broad ligament
What do the fimbre do?
Corraling the oocyte
Tunica albigunea
Outside the ovary capsule
Describe the arterial pathway for blood flow in the hand.
- Brachial
- ulnar artery=pinky side
- radial A. = thumb side-travels dorsally and joins the ulnar artery at the deep palmer arch.
- Deep palmer arch to palmer digital branches
How does the blood travel to the heart from from the hand?
Deoxygenated blood from Dorsal venous network of dorsal hand to basilic or cephalic vein of arm to axillary vein and then to heart.
What does the ulnar nerve run in the hand?
medial side of hand to medial side of 4th digit
What runs the lateral half of the 4th finger in the hand?
Median Nerve
intrinsic muscles of digits 2 and 3
Most of the thumb except the lateral portion
What runs the lateral portion of the thumb?
Radial Nerve (Anatomical snuff box)
Explain why the recurrent median nerve is susceptible to injury and how you would know it was injured.
It is superficial so if they get a cut through the hand they may lose thumb function. It is also another nerve point
List the major structures located within the axilla.
Brachial plexus, axillary artery and vein
Vessels: subclavian, axillary and brachial arteries (all the same tube but switches name based on location).
List the 5 brachial plexus nerves
Median Ulnar Radial Axillary Musculocutaneous
Describe a nerve compression injury.
Nerve compression syndrome occurs when a nerve is squeezed or compacted. It typically occurs at a single location. Nerves in the torso, limbs, and extremities may be affected. Common symptoms include pain, numbness, and muscle weakness at the site of the nerve.
Repetitive injuries, accidents, and medical conditions may lead to:
reduced blood flow to the nerve
swelling in the nerve and surrounding structures
damage to the nerve’s insulation (the myelin sheath)
structural changes in the nerve
All of these changes have a negative impact on the nerve’s ability to send and receive messages. This can cause symptoms such as pain, numbness, and reduced function.
Where is theAxillary Artery?
deep and lateral to brachial a.
Where is the Radial artery at the brachial plexus?
posterior to brachial a.
Where is the ulnar artery at the brachial plexus?
Medial
Where is the musculocutaeous nerve at the brachial plexus?
lateral to brachial a.
Lateral Cord
Origin of the Bracial Plexus
C5-T1
Describe where the following arteries branch from the axillary artery: thoraco-acromial
Between lateral border of 1st rib and medial border of p. minor
Describe where the following arteries branch from the axillary artery: anterior and posterior circumflex,
Lateral border of p minor to inf border of teres major
Describe where the following arteries branch from the axillary artery: subscapular and the profunda brachii.
Last part of axillary
Where does the axillary artery become the brachial artery?
Inferior border of teres major
Know the names and numbers for all 12 cranial nerves.
I Olfactory II optic III oculomotor IV Trochlear V Trigeminal VI Abducens VII Facial VIII Vestibulocochlear IX Glossopharengeal X Vagus XII Hypoglossal XI Accessoory
Olfactory Nerve
Primary function: special sensory (smell)
Optic Nerve
Primary function: special sensory (vision)
Oculomotor Nerve (N III)
Primary function: motor, eye movements
Intrinsic eye muscles
The Trochlear Nerve (N IV)
Primary function: motor, eye movements
Trigeminal V
Primary function: Mixed (sensory and motor)
3 Branches: mandibular, maxillary and opthalamic
Sensory to anterior face
Controls chewing muscles (masseter, pterygoids)
The Abducens Nerve (N VI)
Primary function: motor, eye movements
Facial Nerve (VII)
Primary function: mixed (sensory and motor)
Sensory from taste receptors on anterior two thirds of tongue
Motor – tear ducts, two pairs of salivary glands (submandibular and sublingual) and facial muscles. Think wet face!
Vestibulocochlear Nerve (N VIII)
Primary function: special sensory: balance and equilibrium (vestibular branch) and hearing (cochlear branch)
Origin: receptors of the inner ear (vestibule and cochlea)
Primary function: mixed (sensory and motor)
Destination:
Tongue…taste!
Somatic motor: pharyngeal muscles involved in swallowing
Visceral motor: parotid salivary gland
Glossopharyngeal Nerve (N IX)
Vagus (X)
Primary function: mixed (sensory and motor)
Destination:
Sensory fibers to sensory nuclei and autonomic centers of medulla oblongata
Somatic motor to muscles of the palate and pharynx
Visceral motor to respiratory, cardiovascular, and digestive organs in the thoracic and abdominal cavities.
Accessory Nerve (XI)
Primary function: motor
Destination:
External branch controls sternocleidomastoid and trapezius muscles
The Hypoglossal Nerve (XII)
Primary function: motor, tongue movements
Destination: muscles of the tongue
Describe the origin and pathway of the vertebral arteries.
- Vertebral
- Posterior Inferior Cerebellar
- Anterior Inferior Cerebeller
- Basillar
- Pontine Branches
- Superior Cerebellar
- Posterior Cerebrals
- Posterior Communicating
- Internal Carotids
- Middle Cerebrals
- Anterior Communicating
Anterior Triangle of the neck
Borders are formed by the sternohyoid, mandible and sternocleidomastoid muscle
Posterior triangle (occipital triangle)
Borders are formed by the sternocleidomastoid muscle, trapezius and clavicle
Explain the clinical relevance of the cricothyroid ligament.
This ligament is cut during emergency cricothyrotomy. This kind of surgical intervention is necessary if the airway is blocked above the level of vocal folds. This ligament’s main purpose is to keep the cricoid and thyroid from traveling too far.
Describe the arterial circulation through the neck using the R subclavian artery.
- Left Ventricle of the heart
- Ascending aorta
- Aortic arch
- Left Subclavian or Brachiocephalic trunk
- From brachicephalic trunk:
- Right subclavian
- Right vertebral through transverse foremen
- Basiliar Artery
- Posterior Communicating
- Circle of willis
Orientation of the internal jugular vein
The internal jugular vein (IJV) is a paired vessel found within the carotid sheath on either side of the neck. It extends from the base of the skull to the sternal end of the clavicle.
The internal jugular vein receives eight tributaries along its course. Its function is to drain the venous blood from the majority of the skull, brain, and superficial structures of the head and neck.
Describe the arterial circulation through the neck using: Left Subclavian Artery
- Left Ventricle
- Aortic Arch
- Left Subclavian
- Left vertebral
- Basilar Artery
- Posterior communicating Artery
- Circle of willis
Describe the arterial circulation through the neck using:Left common carotid artery to internal carotid
- Left Ventricle
- Ascending Aorta
- Aortic Arch
- Left common carotid
- Internal carotid
- Middle cerebral
- Anterior communicating branch
- Posterior communicating artery
- Opthalmic Artery
- To eye
Describe the arterial circulation through the neck using: Left Common Carotid Artery to external carotid
- Left Ventricle
- Ascending Aorta
- Aortic Arch
- Left Common Carotid
- External Carotid
- Superior Thyroid artery to join inferior thyroid artery
Describe the arterial circulation through the neck using: Left subclavian to Thryocervical Trunk
- Left Ventricle
- Aortic Arch
- Left Subclavian
- Left Thryocervical trunk
branches: - transverse cervical artery
2.Ascending cervical - suprascapular
- Inferior thyroid
Describe the orientation of the external intercostal muscles
- Most superficial
- occupy the 11 intercostal spaces
- found in the lower thoracic levels blend with the external abdominal oblique muscles
- fibers are oriented obliquely, downward, and forward, from the rib above to the rib below.
Describe the orientation of the internal intercostal muscles.
run obliquely, upward, and forward from the superior border of the rib below to the floor of the subcostal groove of the rib and the edge of the costal cartilage above, ending at the sternocostal junctions.
What are the hiding the intercostal arteries?
Costal groove of the rib
Where do the intercostal arteries originate?
Thoracic aorta
Where do the intercostal arteries originate?
Thoracic aorta (for every rib there is a intercostal artery)
How many intercostal arteries are there?
Same number as ribs (12)
When do the intercostal arties become posterior intercostal arteries?
Right off the rib toward the back
where do the intercostal arteries run?
Come off rib and run to both anteriorly and posteriorly to be called the posterior intercostal arteries and the anterior intercostal arteries. When they move anteriorly they will connect (Anastomose)to the internal thoracic arteries at the sternum. (R and L). The internal thoracic artieries changes its name to the superior epigastric arteries once you pass the costal cartilage. The superioor epigastric arteries become the inferior epigastric arteries after passing the umbilicus. eventually the inferior epigatric arteries will join with the external iliac arteries.
Why do the internal intercostal arteries anastomose with the internal thoracic arteries?
As the internal thoracic artery runs down all the way to the false ribs
What veins anastemose with the internal thoracic vein?
The posterior intercostal and anterior intercostal veins (Anastemose at the sternum)
Describe the azygous system
- Azygous vein is a large vein on the right side where the right intercostal veins anastemose.
- On the left side the left intercostal veins ddrain into the hemiazygous vein
- The accessory hemiazygous vein gets blood from the first 3-4 intercostal ribs
- Hemiazygous Vein anastemoses with the azygous
- Azygous vein then runs superiorly and dumps into the posterior side of the inferior vena cava
Explain the function of the trachea
“Windpipe”
Bring air to lungs and break into primary bronchi
What is the function of the primary bronchi?
Brings air to their respective lung (R and L)
What is the function of the secondary bronchi
Take air to individual lobes of each lung (3 on rt.) (2 on left) (Can send air to another lobe if one is bad)
Discuss the differences between the right and left lungs and explain the rationale for those differences.
Right- 3 lobes
Left- 2 lobes
Describe the structure of the pleura.
- Double walled sac
- with a cavity filled with fluid
- Pareital( outside) and visceral (surface of lungs)
Why Does the lung want to collapse naturally?
- Job is to reduce friction.
- Lungs always want to collapse
- Fluid is made of water and water is polar covalent molecules. In a polar moleule there is an unequal sharing of electrons making one end more positive and one end moore negative. In water the oxygen end is more negative so it attracts the positive Hydrogens on other water molecules and hydrogen bonding occurs. The cohesion of the water molecules is pulling inwards trying to collapse the lung
How does the pleura maintain a negative pressure?
This negative pressure within the pleura is called intrathoracic pressure. This pressure is due to three main things.
1. Surface tension of the alveolar fluid causes the lung to pull inwards
2. The recolil of the elasticity of the lung also causes an inward pulling force. When the lung mooves away from the thoracic cavity, the cavity gets larger creating a negative pressure.
3. The elasticity of the thoracic wall.
• The elastic thoracic wall tends to pull away from the lung, further enlarging the pleural cavity and creating this
negative pressure. The surface tension of pleural fluid resists the actual separation of the lung and thoracic wall.
What is an open pneumothorax?
- unsealed opening in the chest
- very large opening, muscles cn be impaired
- air entering makes a sucking sound
- The air pressure is = to the atm pressure.
What is an tension pneumothorax?
- Tension pneumothorax is accumulation of air in the pleural space under pressure, compressing the lungs and decreasing venous return to the heart.
- Pleural cavity pressure >atm
- can cause shock
- very dangerous (better too have on right side)
- neck vein distension
- blunt chest trauma
What is an closed pneumothorax?
- When air gets in the pleural space without outside wound
- cystic fibrosis
- Pleural cavity pressure < the atmospheric pressure
Explain the orientation of the great vessels of the heart.
Great Vessels are the coming out the top.
Where is the great cardiac vein located and where does it run?
Origin: Begins in the apex of the heart and runs up the interventricular sulcus and to the posterior side of the heart, turning into the cornary sinus.
Location: anterior interventricular sulcus (runs with anterior interventricular artery)
Where do the anterior cardiac veins start and drain into?
Origin: More on the right margin
Drain into the small cardiac vein
Where do the coronary arteries start and run to?
Start off the ascending aorta and feed each side of the heart. The right cornary artery continues to the posterior side where it gives off the posterior interventricular artery.
What does the right marginal artery come off of?
The right coronary artery and runs aloong the border of the right side of the heart
What does the posterior interventricular artery come off of and where does it run?
It comes off the right coronary artery at the posterior interventricular sulcus and runs down the sulcus.
What vessel runs with the right marginal artery?
The small cardiac vein where it originates
What vessel runs with the right marginal artery?
The small cardiac vein where it originates, (drains into the coronary sinus)
What vessels drain into the coronary sinus?
Receives blood from the great, middle and small cardiac veins
What does the coronary sinus drain into?
Right atrium
Where does the middle cardiac vein start and where does it run?
It runs with the posterior interventricular artery in the posterior interventricular sulcus
What is the most anterior great vessel of the heart?
Pulmonary trunk
What great vessel is immediately posterior to the pulmonary trunk?
Ascending Aorta
What great vessel lies to the right oof the Ascending aorta?
Superior Vena Cava
Where do the pulmonary veins come in and connect?
Posterior to the heart but connect to the left side of the heart.
Where is the inferior vena cava?
it comes up inferiorly and drains into the right atrium posteriorly
Describe the pathway of blood through the heart including the pulmonary circulation.
- Superior Vena Cava, Inferior Vena Cava and Cornary Sinus take blood into the right atrium.
- Right AV Valve (Tricuspid)
- Right Ventricle
- Pulmonary Semilunar Valve
- Pulmonary Trunk
- Right and left pulmonary arteries (low oxygen)
- Lungs (Pick up Oxygen)
8.
Describe the pathway of blood through the heart including the pulmonary circulation.
- Superior Vena Cava, Inferior Vena Cava and Cornary Sinus take blood into the right atrium.
- Right AV Valve (Tricuspid)
- Right Ventricle
- Pulmonary Semilunar Valve
- Pulmonary Trunk
- Right and left pulmonary arteries (low oxygen)
- Lungs (Pick up Oxygen)
- Right and Left Pulmonary Veins bring oxygenated blood to left atrium.
- Left AV valve (Mitral or bicuspid)
- Left Ventricle
- Aortic Semilunar Valve
- Ascending Aorta
- Aortic Arch
- Target organs
What is the function of the chordae tendinae?
- Found in Tricuspid and Bicuspid Valves
- Strings of connective tissue that connect to papillary muscles in the AV valves
- During the contraction pressure pushes valves clossed. Pressure is much lower in the atria so the cusps want to evert that way. Chordinae Tendinae prevent prolapse by tensing,pulling on the flaps and holding them closed.
What is the function of the papillary muscle?
- Attach to chordae Tendinae
- pulls flaps shut on semilunar valves
- prevent leakage through (prolapse)the AV valves during contraction
What are the Three Fetal Vasculature Structures we talked about?
- Ductus Arteriosus
- Oval Foramen
- Umbilical Vein
What does the Ductus Arteriosus Become?
Ligamentum Arteriosum
What Does the Foramen Ovale become?
Fossa Ovale
What does the Umbilical Vein Become?
Round Ligament of the Liver (ligamentum teres)
Fetal Blood Flow Pathway
- Placenta (oxygenated blood)
- Umbilical Vein (Oxygenated Blood)
- Ductus Venosus
- Hepatic Portal vein to liver (process food)
- Inferior Vena Cava
- Right Atrium
- Foramen Ovale (bypass lungs)
- Left Atrium
- Left Ventricle
- Aortic Semilunar Valve
- Ascending Aorta
- Circulation
Meanwhile: Superior Vena Cava is also bringing blood into right atrium - Right ventricle
- Pulmonary Semilunar Valve
4.Pulmonary trunk - Ductus Arteriorsum to mix with blood coming from aorta too bypass lungs
List the 4 problems and their effects with a fetus suffering from the tetralogy of Fallot.
Main issue is that blood leaving aorta is not fully oxygenated. 1. Right ventricular hypertrophy (enlarged ventricle)
- ventricular Septal Defect (Hole)
- Pulmonary Valve Stenosis
- Narrowed pulmonary trunk
What is the problem associated with ventricular hypertrophy?
The wall of the ventricle enlarges and there is a decreased volume of blood in one side.
Hoow dooes a ventricle become enlarged or hypertrophied?
Partially by pulmonary valve stenosis where the vessal wall is partially obstructed and blood cannot not get out so the ventricle is workking on overdrive to get blood out and it eventually hypertrophies. Also can be caused by a narrowed pulmonary trunk.
What is the associated problem with a ventricular septal defect?
There is a large hole in the septum and some of the blood from each ventricle mixes when it shouldn’t
What structures merge to form the right lymphatic duct?
The right jugular trunk and right subclavian trunk merge aloong with the right bronchomediastinal trunk before draining into the right subclavian vein
What does the Left Thoracic collect lymph from?
Left Jugular Trunk
Left Subclavian Trunk
Left Bronchomediastinal trunk and drains into the left subclavian vein
What areas are drained by the Right lymphatic Duct?
The right side from the waist up including the upper arm
What areas are drained by the thoracic duct?
The entire lower body and left side from the waist up
What is heart hypertrophy?
the enlargement of the heart from the increase in size of its cells.
What is Concentric Heart Hypertrophy?
- Maladaptive-more harm than help
- Addition of sarcomeres that results in a thicker ventricular wall
- Maladaptive because there is an increase in tissue without an corresponding increase in vasculature to supply the myocardium
- increase in sarcomeres in parallel
What causes concentric heart hypertrophy?
Hypertension, congenital heart defects, stenosis, etc.
What does concentric heart hypertrophy lead to?
- ischemia in areas of the heart
- ineffective pumping of the blood
- dialated ventricle
- heart failure
- can be reversed called reverse remodeling
What is eccentric heart hypertrophy?
“Athlete’s heart”
- normal response to excercise or pregnancy.
- Increase in hearts mass and pumping ability
- ihearts response toincreased blood volume
- increase in # of sarcomere’s in seris so heart can contract with greater force
- can have risk for conduction abnormalities oor left ventricular dialation (peripartum cardiomyopathy)
What is Cardiac Fibrosis?
- excess depositon of the extracellular matrix in cardiac muscle or abnormal thickening of heart valves due to inappropriate proliferation of cardiac fibroblasts
- Causes muscle to be stiffer and less compliant
- slows muscle relaxation and recoil
Where does heart fibrosis usually occur?
Tricuspid valve where you may hear a murmur
-stiffer flaps
What causes fibrosis of the heart?
- Aging
- Sedentary lifestyle (more free radicals)
- excersize reduces free radicals
Explain how a fibrous myocardium effects heart function.
- cannot relax as fast so the heart doesn’t fill all the way resulting in less blood leaving the heart (stroke volume decreases) so now heart has to contract with more force to try to maintain the same level of cardiac output
- heart is working harder at rest which can lead to heart failure
What are some possible treatments for heart fibrosis?
- Some evidence in animal models(mice) and some in humans suggests that if you excercise you can reverse some of the fibrosis and improve function of the heart
- Histology oof mice hearts
- Humans imaging
- noot a complete reversal
Define a heart attack
- A myocardial Infarcation
- heart cells die and since they do not undergo mitosis(amitotic), they cannot be replaced
- broad range of severity (mild to massive)
- implication is that if you survive you will have a weaker heart
- Treatment is that yoou strengthen the remaining poortion of the heart
- multiple heart attacks = higher risk for death
Explain why the inner layer of the myocardium is the most affected area.
Everytime your heart contracts blood flow to the heart tissue stops momentarily and when you relax blood vessels open back up. These cells also get the least amount of oxygen compared with the outer layer due to the temporary stop of blood flow during contraction so these cells will die first.
When dooes the superior epigastric artery bcome the inferior epigastric artery?
Once it passes the umbilicus
What do the epigastric arteries run through?
Rectus Abdominus
Describe the pathway of the inferior epigastric artery
Inferior epigastric serpentines through the rectus abdominus and then coomes down to connect with the external iliac artery where it comes out deep to the inguinal ligament to become the femoral artery
At what point do inter thoracic arteries become superior epigastric arteries?
After leaving the sternum
Explain how blood cell would travel from the subclavian artery to the femoral artery
- Subclavian Artery
- Passes costal cartilages and becomes internal thoracic arteries
- Leaves sternum to become superior epigastrics
- Passes umbilicus too become inferior epigastrics
- Serpentines throough rectus abdominas and then joins the external iliac artery.
- Runs deep to iniguinal ligament and comes out to become the femoral artery
Explain how blood cell would travel from the subclavian artery to Explain the differences between male and female pelvises.the femoral artery
- Subclavian Artery
- Passes costal cartilages and becomes internal thoracic arteries
- Leaves sternum to become superior epigastrics
- Passes umbilicus too become inferior epigastrics
- Serpentines throough rectus abdominas and then joins the external iliac artery.
- Runs deep to iniguinal ligament and comes out to become the femoral artery
Explain the differences between male and female pelvises.
- Female
- wider and
shallower - Pubic Arch
(distance
between
ischium bones)
wide for
childbirth
- wider and
- Male-
-taller top to
bottom
-Rougher bone
features
Explain Q angle
AKA Quadriceps angle
It is the angle formed between the quadriceps muscles and patella tendon.
Explain Q angle
AKA Quadriceps angle
It is the angle of the femur as it is coming through to the knee.
How does Q angle differ between sexes?
Females have a greater Q angle at 16 degrees vs. a male Q angle at 12 degrees
. this is because the female has a wider pelvis, pushing the femur out more laterally. This angle will effect gait slightly because the hip has to rotate and adjust orientation to keep the center of gravity on the shaft of the femur. It is possible that woman may be at a higher risk for ACL injury.
How does Q angle differ between sexes?
Females have a greater Q angle at 16 degrees vs. a male Q angle at 12 degrees
. this is because the female has a wider pelvis, pushing the femur out more laterally. This angle will effect gait slightly because the hip has to rotate and adjust orientation to keep the center of gravity on the shaft of the femur. It is possible that woman may be at a higher risk for ACL injury.
Q angle increase only ooccurs after puberty
Describe the origin and pathway of the femoral artery.
- Abdominal Aorta (Major Split by ilieum)
- R and L Common Iliac (splits into internal iliac and external iliac)
- Take R and L External Iliac (passes inguinal ligament)
- R and L Femoral
Where does the deep femoral artery arise?
It is the first medial branch off the femoral artery (Feeds the deep muscles)
What is the orgin and destination of the medial circumflex artery?
It comes off the deep femoral artery and goes deep and comes oout the back side (Very similar to circumflex in shoulder) Then it anastemoses with lateral circumflex
What is the orgin and destination of the lateral circumflex artery?
It comes off the deep femoral artery and goes around to the front
Describe the skeletal articulations of the knee.
Femur and Tibia Bones
- Tibial Condyles will articulate with femoral condyles superiorly
- The Patella (kneecap) articulates with the anterior surface of the femur
- Fibula does not articulate with the femur (only with the tibia)
Explain the movement of the knee during flexion and extension and the “screw home” movement of the knee.
When moving from extension to flexion to extension again there is some external rotation of the tibia at the end of extension(last 30 degrees) and then internal rotation during flexion.
External rotation tightens both collateral ligaments to stabilize knee joint when standing (improves stability) and rotates medially during flexing to stabilize.
-On knee extension the condyles of the femur also slide rather than rotating to dissicipate force on a bigger surface area
List the 4 ligaments of the knee and the functions of each
- Anterior Cruciate
- Posterior Cruciate
- Fibular collateral ligament ((lateral)
- Tibial Collateral Ligament (medial)
- Patellar Ligament
Explain how to test for ACL injuries.
Drawer test
- Person lays supine(on their back) and flexes knees 90 degrees
- You stabilize the foot and reach posteriorly behind tibia and pull anteriorly to see how much tibia will slide anteriorly (1 cm past is normal)
What is the function of the poosterior cruciate ligament?
Prevents posterior movement of the tibia (thicker than ACL) so stronger
less common than ACL
What is the function of the posterior cruciate ligament?
Prevents posterior movement of the tibia (thicker than ACL) so stronger
less common than ACL
List the 3 injuries that occur during an unhappy triad and how this occurs.
Sharp blow to the lateral side of the knee (football and soccer)
1. Blow (snap in half) Medial (tibial) collateral ligament
2. Medial meniscus (has a lateral attachment so it pulls apart)
3.Rupture Anterior cruciate ligament
Surgery is needed (9 months healing time)
List the muscles that insert into quadriceps tendon.
- Vastus Medias
- Vastus Intermedias
- Vastus lateralis
- Rectus femorus
Tendon has lots of force and runs
Explain how to test for PCL injuries.
posterior drawer test- You push posteriorly to see if there is give
What is the function of the fibular or lateral collateral ligament?
prevents lateral movement of knee
What is the postive Trendelenburg test?
The trendelenburg test, tests If there is Damage to the superior gluteal nerve.
A tilted pelvis to the side of the lifted leg = +. This happens when the gluteus medius
and minimus muscles cannot contract when the contralateral leg is lifted to maintain a level pelvis (hip addiuction)
-Right superior gluteal nerveinjured if (hip drops on left side)
Origin of the superior and inferior gluteal arteries?
internal iliac arteries
inferior gluteal artery comes out
How do the attachments for the gluteus maximus relate to the movement created by the muscle?
- If you shorten the fasicles of the muscle it would pull on the IT band and give you lateral rotation of the hip (Spinning femur)
- Gluteual Tuberosity is the inferior attachment which extends the hip
What does the superior gluteal artery provide blood to?
Gluteus Maximus
Identify the 3 compartments of the leg, general muscle actions for each and their respective arterial and nerve supplies.
Anterior Compartment:
Action: dorsiflexion and inversion
Innervation: Deep Fibular Nerve
Arterial Supply: anterior tibial artery
Lateral Compartment:
Action: eversion of foot and plantar flexion,
Innervation: superficial fibular nerve,
Arterial Supply: fibular artery
Posterior Compartment
Action: plantar flexion,
Innervation: tibial nerve,
Arterial Supply: posterior tibial artery
Identify origin and pathways for the following arteries: Medial superior genicular artery, Lateral superior genicular artery, Medial inferior genicular artery, Lateral inferior genicular artery, Anterior tibial artery
- Left Ventricle
- Ascending Aorta
- Aortic Arch
- Thoracic Aorta
- Abdominal Aorta
- R or L common iliac artery
- R or Left external iliac artery
- Turns into femoral artery
- Enters adductor hiatus and becomes the popliteal artery (this runs on the posterior side of the leg)
- To get to the anterior side it gives off the medial and lateral superior genicular arteries that run superior to the femoral condyles and the medial and lateral inferior genicular arteries inferior too the condyles (you can sometimes see these in the popliteal fossa)
- The poplital continues down the leg and splits into the anterior and posterior tibial arteries.
- The anterior tibial artery goes throough the interosseus membrane inbetween the tibia and fibia to supplythe front of the leg.
List and describe the orientation of the 3 hamstring muscles.
- Biceps Femoris-Most Lateral (2 heads)
- Semimembranosus (Most medial-M &M)
- Semitendinosus-Middle (longest Tendon)
Describe the orientation of the gastrocnemius, soleus and plantaris muscles.
-Gastrocnemius
-Crosses 2 joints (attaches to
- Most Superficial Muscle
-2 heads
Soleus-
-Deep to Gastrocnemius
-Wide
-Fuses with Gastronemius at calcaneal tendon
Plantaris Muscle
- turns to tendon quickly
- tendon inbetween the gatronemius and sooleus
-small and superior
Define the popliteal fossa and list the structures you would find in this area.
- a shallow depression located at the back of the knee joint (pit of the knee)
- Contains:
- Tibial nerve
- common fibular nerve
- Plantaris
- popliteal artery and vein
- genicular arteries
Identify the 4 quadrants of the abdomen and list the major organs found in each.
Right Upper Quadrant ( Left upper quadrant (Some of the liver, Spleen, Most of the stomach, Most of the pancreas) Right Lower Quandrant Left Lower quadrant
Labia Majora
outer most fold of skin
-
Labia Minora
Labia minora lacks keratinized stratified squamous epitheliu
Clitorus
composed of corpora cavernosa erectile tissue
Vestibule
Vestibule is a recess formed deep to folds of labia minora.
Vestibular Glands
Vestibular glands secrete a watery mucous.
Define an ecoptic pregnancy and describe 8 different forms of the pathology. Also, discuss treatments and symptoms of this condition.
Embryo imbeds in location other than endometrium of the uterus.
Symptoms varying depending on location but may include: vaginal bleeding, sharp abdominal pain, vomiting, pain on one side, fainting.
Usually requires surgery to remove imbedded embryo and stop internal bleeding.
- Interstitial
- Tubal (isthmus)
- Tubal (ampullar)
- Infundibular (ostial)
- Ovarian
- Peritoneal
- Cervical
- Abdominal
List the anatomical changes that occur during pregnancy and the reason for each change.
- Breasts enlarge and areola darken.
- Pelvic girdle widens.
- Increased vascularization of the vulva can give a purple hue (Chadwick’s sign).
- Compression of bladder, stomach and intestines.
- Varicose veins in lower extremities and hemorrhoids from compressed iliac veins.
Clitorus
- composed of corpora cavernosa erectile tissue
- sensory organ
- more anterior
- larger than it appears
Vestibular Glands
Vestibular glands secrete a watery mucous.
-lateral and posterior to urogenital opening
Vaginal Orifice
posterior to urethral opening
Urethral Orifice
Anterior to vagina
Explain why the urinary bladder is compressed late in pregnancy.
The uterus tilts anteriorly oover the urinary bladder compressing it
Discuss the location and function of the following: anterior and posterior vaginal fornix and the cervix.
Cervix-opening to uterus
Discuss the location and function of the following: anterior and posterior vaginal fornix and the cervix.
Cervix-opening to uterus
Recessed areas are fornixes
-Inspired diaphram design
Explain how the vagina has a low pH and its benefit to a woman’s health.
It keeps bacteria out and kills bacteria,
Fungus can grow-prone too yeast infections
-Low pH comes from a commensal relatioship from anaerobic bacteria that digest glycogen too produce pyruvate.
The pyruvate is converted to lactic acid
Broad Ligament
-wide
body of uterus to ovary to oviduct
-uterers come through this
Ovarian Ligament
Body of uterus to ovary
Suspensory Ligament
Connect ovary to abdominal wall
- Ovarian artery and vein run with it
- attachs to abdominal wall
Ovarian Artery
Runs with suspensory
Fimbre
Finger like projections
- corraling the oocyte and drawing it into the oviduct, ovary
- overlying the ovaries
Fimbre
Finger like projections
- corraling the oocyte and drawing it into the oviduct, ovary
- overlying the ovaries
- engorged with blood during ovulation to create a current to draw the oocyte in
- oocyte takes 3-5 days(slow time increases the time so sperm can locate the oocyte and fertilization can take place)
Describe the location of the uterus as well as locations and functions of the endometrium and myometrium.
Myometrium- Thick usually except in older people
- Strong
- endomeitrium is vascularized so fetus can eat it.
Define an ecoptic pregnancy and describe 8 different forms of the pathology. Also, discuss treatments and symptoms of this condition.
Def: Embryo imbeds in location other than endometrium of the uterus.
-Symptoms varying depending on location but may include:
vaginal bleeding, sharp abdominal pain, vomiting, pain on one side, fainting.
-Usually requires surgery to remove imbedded embryo and stop internal bleeding.
1. Interstitial
2. Tubal (isthmus)
3. Tubal (ampullar)
4. Infundibular (ostial)
5. Ovarian
6. Peritoneal
7. Cervical
8. Abdominal
