Living anatomy and dissection Flashcards
1
Q
Up until which vertebral level are nerves above the vertebrae?
A
C1-C7. At C8, nerves are below vertebrae.
2
Q
What is the pattern of primary/secondary curvatures as you move along the spine?
A
CTLS: 2121
3
Q
What is kyphosis?
A
‘hunchback’ Excessive thoracic curvature of spine
4
Q
What is lordosis?
A
Excessive lumbar curvature of spine
5
Q
What are the erector spinae muscles?
A
Iliocostalis
Longissimus
Spinalis
= group of muscles which help in movement of vertebral column.
6
Q
What is the name of the ligament which lines the anterior and posterior portions of the vertebral column?
A
The longitudinal ligaments
7
Q
What is the name of the ligament which connects the spinous processes?
A
Supraspinous ligaments
8
Q
What are the ligaments in between adjacent spinous procceses?
A
Interspinous ligaments
9
Q
Which ligament is most likely to be damaged in whiplash?
A
Anterior longitudinal ligament
10
Q
What head movements occur at atlanto-occipital and atlanto-axial joints?
A
Atlanto-occipital = flexion and extension Atlanto-axial = rotation
11
Q
What head movements occur at atlanto-occipital and atlanto-axial joints?
A
Atlanto-occipital = flexion and extension Atlanto-axial = rotation
12
Q
How many spinal arteries are there?
A
x1 anterior and x2 posterior
13
Q
Which is the only cervical vertebrae with a prominent spinous process?
A
C7
14
Q
How would you test for a vertebral compression fracture.
A
Find spinous process and tap. Patient will feel pain if fractured.
15
Q
Name x3 complications of central line insertion
A
Pneumothorax, nerve injury, artery puncture, arrhrythmias.
16
Q
What are the components of the carotid sheath?
A
Vagus nerve, internal jugular vein, common carotid artery.
17
Q
What is the difference between a vein and an artery?
A
Vein = Collapsible Artery = Pulsatile
18
Q
What does the suffix -spondy mean?
A
Vertebrae
19
Q
At which level does the spinal cord end?
A
L2
20
Q
What is the cauda equina?
A
A bundle of nerves where a lumbar puncture is taken.
21
Q
What is in the dorsal root ganglion?
A
Contains cell bodies of sensory neurons
22
Q
Name two differences between the anterior and posterior ramus?
A
The anterior ramus is larger than the posterior ramus.
The anterior ramus innervates limbs and arms whereas posterior ramus innervates only the back of the spine.
23
Q
What is the difference between a spinal and epidural anaesthetic?
A
Spinal anaesthetic: taken from inside the subarachnoid space.
Epidural anaesthetic: Taken from the epidural space.
24
Q
Which anaesthetic is easier to perform?
A
The epidural anaesthetic; more convenient for a larger volume of fluid.
25
What does more weight on the lower spine mean?
More chance of prolapsed disc.
26
What are the borders of the anterior triangle of the neck?
Inferior border of the mandible, midline of the neck, anterior part of sternocleidomastoid.
27
Which nerve innervates the sternocleidomastoid muscle?
The accessory nerve.
28
What are the infrahyoid muscles?
Omohyoid, sternothyroid, sternohyoid and thyrohyoid muscles.
29
Which cranial nerve number is the hypoglossal nerve?
12
30
What are the borders of the posterior triangle of the neck?
Anterior part of trapezius, posterior part of sternocleidomastoid, superior part of clavicle.
31
What are the two branches of the carotid arteries and what do they supply?
The internal carotid artery supplies the brain
| The external carotid artery supplies the face and neck
32
Which muscle does the parotid gland innervate?
The buccinator muscle. This muscle pushes food to the middle of the mouth.
33
The buccinator muscle gets its innervation from where?
The facial nerve
34
All muscles of mastication (apart from buccinator) receive innervation from which facial nerve?
The trigeminal nerve. The buccinator muscle receives innervation from the facial nerve.
35
Name two superficial muscles of mastication
Masseter and Temporalis
36
Name two deeper muscles of mastication
Pterygoid muscles
- Lateral pterygoid depresses mandible to open mouth
- Medial pterygoid elevates mandible for chewing
37
Which is the carotid artery with numerous branches - internal or external?
The external carotid artery: SALFOPMS
38
The mandibular nerve is a division of which cranial nerve?
The trigeminal nerve - CX 5.
39
Is the trigeminal nerve sensory or motor?
Sensory
40
How many divisions of the trigeminal nerve are there?
3 - Opthalmic, maxillary, mandibular. (V1, V2, V3).
41
Through which structure does the facial nerve enter the skull?
The stylomastoid foramen.
42
Through which structure does the facial nerve exit the skull?
The internal acoustic meatus.
43
What are the branches of the facial nerve?
Mandibular, buccal, cervical, zygomatic and temporal.
44
Which nerve innervates the posterior portion of the tongue?
Sensation and taste comes from the glossopharyngeal.
| Motor function comes from the hypoglossal nerve.
45
From which branch does the middle meningeal artery arise?
The maxillary artery.
46
How does the middle meningeal artery enter the skull?
Through the foramen spinosum.
47
Which nerve supples the parotid gland?
Glossopharyngeal nerve
48
Which nerve supplies the submandibular and sublingual glands?
Facial nerve
49
Which are the four muscles of mastication?
Masseter, temporalis, lateral pterygoid, medial pterygoid.
50
What is the role of the lateral pterygoid muscle?
Depresses mandible to open mouth
51
What is the role of the medial pterygoid muscle?
Elevates mandible for chewing
52
What is the chorda tympani?
A branch of the lingual nerve which is a branch of the mandibular nerve which is a divison of the facial nerve.
53
What is the chorda tympani?
A branch of the lingual nerve which is a branch of the mandibular nerve which is a division of the facial nerve. It facilitates taste for anterior portion of tongue.
54
What is the nerve innervation to the larynx?
The superior laryngeal nerve - branching into the internal and external nerves
The recurrent (inferior) laryngeal nerve - branching into the left and right nerves
55
What will a lesion on the vagus nerve cause for the larynx?
Complete paralysis
56
What will a lesion on the internal branch of the superior laryngeal nerve cause?
Loss of sensation above the vocal cords
57
What will a lesion on the external branch of the superior laryngeal nerve cause?
Paralysis of the cricothyroid muscle.
58
What will a lesion on the recurrent laryngeal nerve cause?
Paralysis of all other larynx muscles (except cricothyroid and vocal cord sensation).
59
What is the laryngeal prominence?
The adam's apple/ thyroid cartilage.
60
Which parts of the ear are most superficially viewed by an otoscope?
The auricle, external auditory meatus leading to the tympanic membrane.
61
Which structure is most seen most superficially by an otoscope?
The external auditory meatus
62
The eardrum refers specifically to which part of the ear?
The tympanic membrane
63
Which parts of the ear are most superficially viewed by an otoscope?
External auditory meatus leading to the tympanic membrane.
64
What is the eustachian tube?
From the nasopharynx to the cavity of the middle ear
65
What are 'deciduous' teeth?
Teeth including milk teeth.
66
Give x3 indications for a central venous line
Nutritional support
Pacing wire
Drug infusions
67
Give x3 contraindications for a central venous line
Trauma
Infection
Haemorrhage
68
Which is the only motor nerve of the tongue?
The hypoglossal nerve
69
Give x3 complications for a central venous line
```
Trachea damage
Artery puncture
Pneumothorax
Arrhythmias
Nerve injury
```
70
What are the contents of the carotid sheath?
Internal jugular vein, common carotid artery, vagus nerve.
71
Instead of a head tilt in those with spinal injury, what do we do?
A jaw thrust.
72
What level is the sternal angle?
T4
73
Where does the internal jugular vein drain into?
The brachiocephalic vein
74
Where does the accessory nerve exit the skull?
The Jugular Foramen
75
Which muscle does the Trochlear nerve control?
The Superior Oblique muscle
76
Which muscle does the Abducens nerve control?
The Lateral rectus muscle
77
Which bone borders the lacrimal bone on a diagram?
Ethmoid bone
78
What is the name of the posterior suture of the brain?
Lambdoid suture
79
Name the three branches of the trigeminal nerve
V1 - Opthalmic
V2 - Maxillary
V3 - Mandibular
80
How many cranial nerves enter the middle cranial fossa?
4; 2 enter anterior, 4 enter medial and 6 enter posterior cranial fossa.
81
Which cranial nerve pass through the supraorbital fissure?
oculomotor, trochlear, v1 of trigeminal - opthalmic and abducens
82
Which two cranial nerves pass through the internal acoustic meatus?
facial and vestibulococchlear nerve
83
What is the name of the bone which has a greater and lesser wing?
Sphenoid bone
84
What is the name of the pathology where sympathetic stimulation to the face is lost resulting in lack of sweating?
Horner's syndrome
85
Which are the two elbow flexors? (do the movement if stuck)
Biceps and brachialis
86
Which nerve is damaged in Carpel tunnel syndrome?
The median nerve
87
Is Carpel tunnel syndrome irreversible?
No; often recovery is good with surgical release of trapped nerve.
88
Which two muscles does the axillary nerve supply?
The teres minor and deltoid muscle
89
Which main nerves supply only the forearm but not the arm?
The ulnar nerve and median nerve (but they still run down the whole arm)
90
The ulnar nerve supplies which two muscles in the forearm?
The Flexor Carpi Ulnaris and Flexor Digitorum Profundus (FDP)
91
Does the radial nerve run anterior or posteriorly?
Posterior (triceps)
92
Does the musculocutaneous nerve run anterior or posteriorly?
Anteriorly (biceps)
93
Which muscle does the thoracodorsal nerve supply?
The Latissimus Dorsi
94
Which muscle does the Long thoracic muscle supply?
Serratus anterior
95
Which artery supplies most of the arm and what does it derive from?
The axillary artery which derives from the subclavian artery
96
Where does the axillary artery become the brachial artery?
At the inferior border of the teres major muscle.
97
Where does the brachial artery bifurcate to become the ulnar and radial arteries?
The cubital fossa.
98
The ulnar artery becomes which structure in the wrist?
The superficial palmar artery
99
The radial artery becomes which structure in the wrist?
The deep palmar artery
100
Describe the venous system of the limbs
Superficial and deep veins.
Superficial = cephalic and basilic veins.
Cephalic passes through deltoid and pectoralis major to pierce axillary vein
Basilic runs with the brachial artery and joints with its venae comitantes to form axillary vein.
Deep veins = venae comitantes
101
Which is lateral and which is medial between the cephalic and basilic veins?
```
Cephalic = lateral
Basilic = medial
```
102
Where does the subclavian artery become the axillary artery?
At the border of the first rib
103
How is the axillary vein formed?
The cephalic and superficial veins form the axillary vein.
104
Which muscles are affected in Erb's palsy?
Nerves C5 and C6 = muscles: Biceps, brachialis, deltoid, serratus anterior
105
What is damage to nerves C8 and T1 called as a lesion?
Klumpke's lesion
106
What is the difference between a claw like hand a true claw?
Claw hand = ulnar nerve injury
| Hand of benediction = median nerve injury
107
What happens in the 'Claw-like hand'?
Ulnar nerve injury = hyperextension at MCPs and flexion at IPs.
108
Describe the ulnar paradox
Injury more distal = more severe claw hand.
109
Which is the first long bone to ossify and through which process?
The clavicle; through intramembranous ossification; long bone.
110
On which bone are the capitulum and trochlea found and in what position relative to one another?
```
Capitulum = lateral
Trochlea = medial
```
111
What does the humeral head articulate with?
The Glenoid cavity
112
What does the humeral head articulate with?
The Glenoid cavity of the scapula.
113
The humerus is in contact with which nerves?
Axillary nerve; winds around surgical neck of humerus
Radial nerve - runs in radial groove of humerus
Ulnar nerve runs posterior to medial epicondyle
Median nerve (supracondylar fractures).
114
What are the superior, medial and inferior angles of the scapula levels?
T2, T3 and T7.
115
What is adduction?
Moving towards the midline of the body
116
What is rotation?
Moving around the longitudinal axis.
117
What is opposition?
Moving the pad of the thumb towards the pad of another digit.
118
Winging of the scapula can be caused by what?
Damage to long thoracic nerve - innervating serratus anterior.
119
Which are the carpal bones?
Triquetrum, scaphoid and lacunate
120
Where does the median nerve supply most muscles?
The forearm
121
Which muscles does the radial nerve supply?
Those of the forearm and arm.
122
What is the FCU and which nerve supplies it?
The Flexor Carpi Ulnaris - supplied by the ulnar nerve.
123
Which is more medial - the brachialis or the biceps brachii?
Brachialis
124
Name the boundaries of the cubital fossa
Pronator teres
Brachioradialis
Line between epicondyles
125
What are the contents of the snuffbox?
The radial artery and the scaphoid bone.
126
Which two muscles does the ulnar supply?
FCU (Flexor Carpi Ulnaris) and ulnar half of FDP.
127
Which structure forms the roof of the carpal tunnel?
The Flexor retinaculum
128
Which is the prominent artery of the hand?
The radial artery
129
How is each spinal nerve formed?
Between an anterior and dorsal root
130
How many spinal nerves are there? Describe their distribution.
31; 8, 12, 5, 5, 1
131
Which plexi supply the neck?
C1-C4
132
Which plexi supply the lower limbs?
L2-S2
133
Which plexi supply the upper limbs?
C5-T1 (The brachial plexus!)
134
What are the two ways in which innervation of the lower limb can be assessed?
1. Segmentally
| 2. Peripherally.
135
Which are the 5 ways to assess nerve function?
Motor, sensory, reflex, autonomic and trophic.
136
In the upper limb, do the anterior or posterior divisions supply the extensor muscles?
The posterior divisions
137
In the lower limb, which muscles are anterior?
The extensors (opposite to upper limb)
138
Caudal refers to which direction
Tail - more inferior
139
What is the name for where dermatomes are not linked to the spinal level?
Axial lines
140
Which are the dermatomes which supply the perineum and perianal region?
S2-S4.
141
Which dermatome(s) supplies the front of the thigh?
L3; L3 to the knee
142
Which dermatome(s) supplies the front of the whole leg?
L4; L4 to the floor
143
Which are the two jerks of the lower limb?
Knee; L3
| Ankle; S1
144
What does the sciatic nerve branch into?
The common peroneal nerve and the tibial nerve.
145
The sciatic nerve derives from which spinal roots?
L4,L5,S1, S2,S3
146
What does the sural nerve branch off of?
The common peroneal nerve
147
Which nerves supply the anterior, medial and posterior compartments of the thigh respectively?
```
Anterior = Femoral
Medial = Obturator
Posterior = Sciatic
```
148
Despite being superficial, which nerve is commonly injured by doctors (iatrogenic injuries) during procedures?
The femoral nerve
149
Which is the most common reason for injury to the superior gluteal/ sciatic nerve?
Hip replacement
150
The aorta first splits to form which arteries?
The iliac arteries
151
From the femoral artery forming the popliteal artery, what does the popliteal artery branch into?
The anterior and posterior tibial arteries.
152
Where is the Dorsalis pedis artery palpable?
Between the first and second metatarsal
153
What is the difference in location of the short and long saphenous vein drainage?
Long saphenous vein drains the medial part of the dorsal foot.
Short saphenous vein drains the lateral part of the dorsal foot.
154
How is the popliteal vein formed?
Venae comintantes of the anterior and posterior tibial arteries and the popliteal artery.
