MJM Anatomy Flashcards
What is a Colle’s Fracture?
Complete transverse fracture of the distal 2cm of the radius.
Distal fracture displaced dorsally.
The result of forced extension of the hand usually the result of a fall onto an outstretched hand.
Referred to as a dinner fork deformity.
What are the boders of the Axilla?
Medially: Serratus anterior and thoracic cage
Laterally: Intertubercular sulcus of the humerus
Anteriorly: Pectoralis major, Pectoralis minor and subclavius
Posteriorly: Subscapularis, Lattissimus Dorsi, teres major
Apex: Posterior border of clavicle, Superior border of scapula and lateral border of 1st rib
What structures pass through the axilla? Potential pathologies found here?
Axillary artery (aneurysm may compress brachial plexus)
Axillary vein (often involved in axillary wound, can cause air emboli)
Brachial plexus (upper, erbs palsy, lower klumpes palsy)
Biceps Brachii
Corocobrachialis
Axillary Lymph nodes (swell with breast cancer metastices)
What are the boundaries of the cubital fossa?
Medially: Pronator teres
Laterally: Brachioradialis
Superiorly: Imaginary line between Humeral Epicondyles
Floor: Brachialis and supinator
Roof: Skin, Fascia and Median Cubital Vein
What are the contents of the cubital fossa? What pathologies may arise here?
Median nerve (Thenar atrophy) Brachial artery Biceps tendon Radial nerve (wrist drop from falling on flexed elbow causing supraepicondylar fractures)
What are the borders of the carpal tunnel?
Medially: Hook of hamate and pisiform
Laterally: Tubercules of trapezium and schaphoid
Flexor retinaculum forms tunnel
What are the contents of the carpal tunnel?
Flexor pollicis longus
Flexor digitorum superficialis x4
Flexor digitorum produndus x4
Median nerve
What happens due to carpal tunnel syndrome?
Compression of the medial nerve
Causes thenar atophy
Numbness and tingling in lateral three and a half digits
Can be tested by reverse prayer position (Phalen’s sign test)
What is the test for Median nerve damage?
Loss of sensation digits 1-3
Thenar wasting
Thumb abduction reduced
Cant oppose thumb and fingers
What is the test for Radial nerve damage?
Wrist drop, test wrist and forearm extensors (triceps and wrist extensors)
How do you test for the ulnar nerve?
Weakness in finger abduction (hand on flat surface)
Test adduction with card between fingers
Sensory loss on ulnar side
How do you test for the Common peroneal nerve?
Causes foot drop so test dorsiflexion and eversion o’f the foot
Also sensory loss over the dorsum of the foot
What are the borders of the anatomical snuffox? and contents?
Medially: Extensor pollicis longus
Laterally: Abductor pollicis longus and extensor pollicis brevis
Proximally: Styloid process of the radius
Radial nerve, radial artery and cephalic vein
What possible pathologies occur in the anatomical snuffbox?
If FOOSH can get scaphoid fracture
Often not seen on initial radiographs so diagnosed as severe sprain
Radiographs 2 weeks later reveal fracture as bone resorption has occured
Blood supply is distal to proximal so fracture can cause avascular necrosis of proximal part
this leads to degenerative joint disease later in life
What are the borders of the femoral triangle?
Lateral border: Sartorius Medial border: Adductor longus Superior border: Inguinal ligament Roof: fascia lata Floor:Iliopsoas
What are possible pathologies found in the femoral triangle?
Femoral hernia through the femoral canal
femoral pulse found here
Access to the femoral artery for many image guided surgeries
What are the suprahyoid muscles and what are their innervations?
Mylohyoid- Trigeminal- mandibular branch
Gleniohyoid- C1 roots that run with hypoglossal
Digastric - anterior belly trigeminal, posterior belly facial
Stylohyoid - mandibular branch of facial nerve
What are the infrahyoid muscles and their innervations?
Sternohyoid- C1-C3, carried by a branch of the ansa cervicalis
Thyrohyoid-C1 which runs with Hypoglossal nerve
Omohyoid- C1-C3, carried by a branch of the ansa cervicalis
Sternothyroid- C1-C3, carried by a branch of the ansa cervicalis
What are the borders of the anterior neck triangle and what are the smaller triangles within this?
Superior- mandible Medial- imaginary sagital line Lateral- SCM medial border Roof- Subcutaneous tissue and Platysma Floor- Pharynx, larynx and thyroid gland carotid, muscular, submental, submandibular
What are the smaller triangles that make up the anterior neck triangle and any pathologies that are found here?
Carotid- inbetween omohyoid inferiorly and the digastric superiorly then the SCM anteriorly: Common carotid artery, IJV, CN X and XII Muscular- bordered superiorly by hyoid: Submandibular- digastric anteriorly: Facial artery and vein Submental- digastric anteriorly lymph
What are the borders of the posterior neck triangle and the smaller triangles?
Anteriorly-SCM
Posteriorly-Trapezius
Inferior-Middle third of the scapula
Omohyoid divides the triangle into subclavian and occipital triangles
What structures pass through the posterior neck triangle?
External jugular vein
Subclavian arterys and veins
CN XI
Suprascapular artery
What are the borders of the inguinal ligament and where are the rings located?
Roof- transversalis fascia, internal oblique, transversus abdominus
Posterior- transversalis fascia
Anterior- aponeurosis of external oblique
Floor- inguinal ligament
Deep ring- midpoint of inguinal ligament, invagination of transversalis fascia
Superficial ring- above pubic tubercle, invagination of external oblique
What are the borders of the popliteal fossa? what passes through it?
Superolateral- biceps femoris
Superomedial- semimembranosus
Posteriomedial- medial head of gastrocnemius
Posteriolateral- lateral head of gastrocnemius
Floor- knee joint capsule and femur
Roof- popliteal fascia
Contains:
Deep popliteal artery, popliteal vein, tibial nerve, common fibular nerve
What is a potential source of new muscle cells?
Satellite cells
rebuilds in a disorganised fashion
What is arteriosclerosis?
Build up of fat (mainly cholesterol) in the arterial walls
Calcium deposits form a hardened plaque
Can form a thrombus which leads to ischemia
What are vasicose veins?
dilation of veins due to loss of elasticity of the walls
Pressure of supporting column above weakens them
Valves do not touch so non functional
Where are ribs most likely to fracture?
Just anterior to their angle
Can puncture chest organs or diaphragm causing a diaphragmatic hernia
What is a flail chest?
Multiple rib fractures that allow a sizeable fraction of the rib cage to move in paradoxical motion
what is a median sternotomy?
To gain access to the chest cavity for procedures the sternum is divided medially and the flexibility of the ribs allow the chest to be opened
What is thoracic outlet syndrome?
structures emerging from the thorax are obstructed, usually obstructed in the lower neck
What does damage to the phrenic nerve result in and how is this detected?
Results in paralysis to the half of the diagram that that phrenic nerve supplies
Can be detected radiographically due to it paradoxial motion
What can a wound to the base of the neck result in?
A pneumathorax because the apex of the lung projects through the thoraxic outlet into the base of the neck
What is pleuritis?
Inflammation of the pleura that causes pleural rub
What is a pulmonary embolism and what is a cause of this?
An embolus for example a blood clot moves through the right lung into the pulmonary capillaries and causes a blockage.
A cause of this is an air embolus travelling from the leg from a compound fracture
This results in a V/Q mismatch
What kind of pain is pleural pain?
Visceral pleura has no innervation so no pain
Parietal pleura produces sharp stabbing pain that my be localised or reffered to dermatomes of that spinal nerve root
How does an aortic aneurysm present?
Chest pain that radiates to the back
May exert pressure on the trachea and oesophagus causing difficulty breathing and swallowing
Evident on plain film radiograph or Magnetic resonance (MR) angiogram
What does stenosis mean?
The abnormal narrowing of a body passage
What does the recurrent laryngeal nerve supply and how can it be damaged?
All of the intrinsic muscles of the larynx except one
This can be damaged by any investigative procedures
Can also be damaged by foreign bodies in the piriform recess
Only the left laryngeal nerve is recurrent as it passes under the aorta
When obstruction of the IVC occurs what are the alternative routes of return for the thoracic, abdominal and back regions?
Azygous, Hemi-azygous and occasionally the accessory hemi-azygous
How is aortic angiogram done?
Catheter inserted through the femoral artery or brachial artery
radiopaque contrast medium is injected into the arch
How may the inferior thoracic spinal nerves be injured and what is the result of this?
May be cut during surgical incisions
This results in weakening of the muscles of the abdominal wall due to multiple nerve innervation so there is not complete paralysis
This may predispose the individual to inguinal hernias
What is mcburney’s point and what is an incision made here for?
Two thirds of the way between the umbilicus and the ASIS
Common location of caecum of appendix so used to remove appendix
What can obstruction of the IVC result in?
Thoraco-epigastric veins provide collateral pathways to bypass the blockage
Causes dilated veins to be visible on the abdominal wall (caput medusae)
What are the two main types of hiatal hernia?
Para-oesophageal hernia- cardia remains in normal position but a pouch of peritoneum containing part of the fundus herniates
Usually no reflux as cardial orifice is in normal place
Sliding hernia- cardia and part of fundus slide through eosophageal hiatus into the thorax
Reflux may occur as diaphragm cannot play part in gastroesphageal sphincter
What can cause pancreatitis?
Blockage of the ampulla of Vater
This can cause bile to back up into the pancreas