Module 1: Trunk MSK Flashcards
1
Q
axial skeleton
A
bones of head, neck, trunk
2
Q
appendicular skeleton
A
bones of limbs, pectoral and pelvic girdles
3
Q
cartilage
A
resilient, semirigid, avascular connective tissue
4
Q
articular cartilage
A
covers articulating surfaces of bones
5
Q
what are the two types of bone tissue?
A
- compact (trabecular) bone
2. spongy (cancellous) bone
6
Q
sesamoid bones
A
(e.g. patella) develop in certain tendons, protect tendons from excessive wear
7
Q
condyle
A
rounded articular area of bone
8
Q
crest
A
ridge of bone (e.g. iliac crest)
9
Q
facet
A
smooth, flat area, usually covered w/ cartilage, where ab one articulates w/ another bone
10
Q
foramen
A
passage through a bone
11
Q
line (linea)
A
linear elevation (e/g/ soleal line of the tibia)
12
Q
malleolus
A
rounded prominance
13
Q
notch
A
indentation at the edge of a bone
14
Q
process
A
projecting spine-like process (e.g. spine of the scapula)
15
Q
trochanter
A
large, blunt elevation
16
Q
tubercule
A
small, raised eminence (e/g/ greater tubercle of humerus)
17
Q
tuberosity
A
rounded elevation (e.g. ischial tuberosity)
18
Q
mesenchyme
A
embryonic connective tissue
19
Q
diaphysis
A
shaft of a long bone
20
Q
epiphyses
A
end of long bone
21
Q
number of vertebrae by region
A
33
cervical: 7
thoracic: 12
lumbar: 5
sacral: 5
coccygeal: 4
22
Q
lumbosacral angle
A
located at the junction of the lumbar region of the vertebral column and sacrum
23
Q
intervertebral (IV) discs
A
joints that connect presaracal vertebral column, provides felxible portion of spine
24
Q
how many curvatures are there in the vertebral column?
A
4 all together 2 primary (thoracic and sacral) 2 secondary (cervical and lumbar)
25
insertion of the descending part of the trapezius
clavicle (lateral one third)
26
origin of the descending part of the trapezius
occipital bone: spinous process of C1-C7
27
innervation of the trapezius
accessory nerve; cervical plexus
28
action of the descending part of the trapezius
draws scapula obliquely upward; rotates glenoid cavity superiorly; tilts head to same side and rotates it to opposite
29
action of the transverse part of the trapezius
draws scapula medially
30
action of the ascending part of the trapezius
draws scapula medially downward
31
list the three types of joints
1. synovial
2. cartilaginous
3. fibrous
32
list the three types of fibrous joints and their functions
1. syndesmosis: unites bones w/ sheet of fibrous tissue-ligament or fibrous membrane
2. gomphosis: peg-like fibrous process stabilizing a tooth
3. suture: holds bones tightly in place, does not allow movement
33
list the two types of cartilaginous joints
1. primary cartilaginous joint (synchondroses): united by hyaline cartilage, permit growth of bone and allow slight bending during development
2. secondary cartilaginous joints (symphysis): strong, slightly mobile joints, united by fibrocartilage
34
what type of cartilage is found in syncondroses?
hyaline cartilage
35
what type of cartilage is found in symphyses?
fibrous cartilage
36
list the 6 types of synovial joints
1. hinge (elbow joint)
2. ball and socket (hip joint)
3. plane (acromioscavicular joint)
4. pivot (atlanto-axial joint)
5. condyloid (metacarpalphalangeal joit)
6. saddle (carpometacarpal joint)
37
list the common bony structures of all vertebrae
```
body
vertebral foramen
vertebral arch
1 spinous process
2 transverse processes
4 articular processes (2 inferior, 2 superior)
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38
discuss the features that distinguish thoracic vertebrae
GIRAFFE
body: heart shaped
transverse process: long and strong, gets smaller as you go down the thoracic vertebrae, T1-T10 have transverse costal facets for articulation w/ tubercle of rib.
vertebral foramen: circular, small, 1 or 2 bilateral costal facets that articulate with the head of the rib.
spinous process: long, slopes posterior/inferior, overlaps w/ adjacent vertebral body
articulating facets: superior points lateral/posterior, inferior points medial anterior
39
discuss the features that distinguish lumbar vertebrae
MOOSE
body: massive, kidney-shaped
transverse process: long/slender
vertebral foramen: triangular
spinous process: short and sturdy, hatchet shaped
articulating facets: superior points posterior/medial, inferior points anterior/lateral
40
interspinous ligaments
weak, almost membranous ligament that connect adjacent spinous processes
41
supraspinous ligaments
strong fibrous ligaments that that connect adjacent spinous processes, it goes up to C7, then merges w/ the nuchal ligament
42
nuchal ligament
strong, medial ligament of neck, composed of thickened fibroelastic tissue, extends from the external occipital protuberance to the supraspinous ligament inferiorly
43
anterior longitudinal ligament
strong, broad fibrous band, covers and connects anterolateral aspects of the vertebral bodies and IV discs. extends from pelvic surface of the sacrum to anterior tubercle of C1 (atlas) and the occipital bone anterior to the foramen magnum.
44
posterior longitudinal ligament
narrower, somewhat weaker than anterior longitudinal ligament, runs w/i the vertebral canal along posterior aspect of the vertebral bodies. extends from sacrum to C2 (axis).
45
ligamenta flava
yellow elastic fibrous tissue that connects laminae of adjacent vertebral arches, resist abrupt flexion of vertebral column, assist w/ straightening vertebral column after flexion
46
function of extrinsic back muscles
superficial back muscles, connect upper limbs to trunk, receive nerve supply for anterior rami of cervical nerves, act on upper limbs
47
trapezius
1. extrinsic back muscle
2.
3. cranial nerve XI- spinal accessory nerve
48
function of intermediate extrinsic back muscles
thin muscles, commonly designated superficial respiratory muscles, more likely proprioceptive rather than motor though
49
function of intrinsic back muscles
deep back muscles, act to maintain posture, control movements of vertebral column, innervated by posterior rami of spinal nerves
50
thoracocolumbar fascia
thoracic and lumbar parts of deep fascia that hold intrinsic back muscles in place. made up of anterior layer, middle layer, and posterior layer.
51
how are intrinsic muscles grouped?
superficial, intermediate, deep
52
splenius cercivis
superficial intrinsic back muscle, thick, flat, lie on lateral and posterior aspects of neck covering vertical muscles (somewhat like a bandage)
1. origin: arises from nuchal ligament and spinous process of T3-T6
2. insertion: tubercles of transverse process of C1-C3 or C4
3. innervation: posterior rami of spinal nerves
4. action: alone- laterally flex neck and rotate head; together w/ splenius captius- extend head
53
splenius capitis
superficial intrinsic back muscle, thick, flat, lie on lateral and posterior aspects of neck covering vertical muscles (somewhat like a bandage)
1. origin: arises from nuchal ligament and spinous process of C7-T4
2. insertion: fibers run superolaterally to mastoid process of temporal bone and lateral third of superior nuchal line of occipital bone
3. innervation: posterior rami of spinal nerves
4. action: alone- laterally flex neck and rotate head; together w/ splenius cervicis- extend head
54
name the muscles that make up the superficial layer of the intrinsic back muscles
1. splenius capitus
| 2. spleius cervicis
55
name the muscle columns that make up the erector spinae
1. iliocastalis: lateral column
2. longissimus: intermediate column
3. spinalis: medial column
56
iliocostalis
lateral column of erector spinae, intermediate intrinsic back muscle, runs vertically.
1. origin: broad ligament that attaches to post. part of iliac crest, post. surface of sacrum, sacroiliac ligaments, sacral and inferior lumbar spinous processes and supraspinous ligament
2. insertion: fibers run superiorly to ribs and transverse process of C4
3. innervation: posterior rami of spinal nerves
4. action: bilaterally- extend spine and head, control movement during flexion of spine; unilaterally- laterally flex vertebral column
57
longissimus
medial column of erector spinae, intermediate intrinsic back muscle, runs vertically. LONGEST of erector spinae
1. origin: broad ligament that attaches to post. part of iliac crest, post. surface of sacrum, sacroiliac ligaments, sacral and inferior lumbar spinous processes and supraspinous ligament
2. insertion: mastoid process of temporal bone, transverse processes in thoracic and cervical regions
3. innervation: posterior rami of spinal nerves
4. action: bilaterally- extend spine and head, control movement during flexion of spine; unilaterally- laterally flex vertebral column
58
spinalis thoracic
medial column of erector spinae, intermediate intrinsic back muscle, runs vertically. LONGEST of erector spinae
1. origin: L2
2. insertion: T1
3. innervation: posterior rami of spinal nerves
4. action: bilaterally- extend spine and head, control movement during flexion of spine; unilaterally- laterally flex vertebral column
59
muscles included transversospinales muscle group
this group is the deep layer of intrinsic back muscles
1. semispinalis
2. multifidus
2. rotatores
60
name the muscles that compose the deep layer of intrinsic back muscles
transversospinales muscle group:
1. semispinalis (superficial)
2. multifidus (deep)
3. rotatores (deepest)
61
semispinalis
most superficial of the deep intrinsic back muscles
1. origin: transverse process of C4-T10
2. insertion: run superomedially to occipital bone and spinous processes in upper THORACIC and CERVICAL regions
3. innervation: posterior rami of the spinal nerves
4. action: extends head and thoracic and cervical regions of vertebral column, rotates them contralaterally
62
multifidus
intermidate layer of the deep intrinsic back muscles
1. origin: posterior sacrum, posteriosuperior iliacspine of ilum, aponeurosis of erector spinal, sacro-iliac ligaments, mammillary process of lumbar vertebrae, transverse processes of THORACIC vertebrae and articular processes of C4-C7
2. insertion: thickest in lumbar region, attach to spinous processes of vertebrae 1-2 segements superior or origin
3. innervation: posterior rami of spinal nerves
4. action: unilateral- rotates to contralateral side; stabilizes vertebrae during
63
rotatores
deepest layer of the deep intrinsic back muscles
1. origin: transverse process of vertebrae, best developed in thoracic region
2. insertion: junction of laminae and spinous process of vertebrae immediate (brevis) or two segments (longus) superior to vertebrae of origin
3. innervation: posterior rami of spinal nerves
4. action: may be for proprioception, possibly stabilize vertebrae
64
name the intrinsic back muscles
superficial: spinalis capitis, spinalis cervicis
intermediate: iliocostalis, longissimus, spinalis
deep: semispinalis, multifidus, rotatores
65
name common structures seen on a typical rib (ribs 3-9)
heady, neck, tubercle, body (costal groove- protects intercostal nerve and vessels)
66
sternal angle
superior edge of sternum that articulates w/ the manubrium
67
jugular notch
superior angle of the manubrium
68
clavicular notch
notches on each side of the manubrium that articulate w/ the first rib on either side.
69
what rib articulates with the xiphisternal joint?
7th rib
70
the head of the rib articulates w/ T6, what does the tubercle from the same rib articulate with?
T7
71
intervertebral joint type
symphysis
72
costovertebral joints of the head of the ribs are what kind of joint?
synovial plane joint
73
costotransverse joint type (tubercle of rib articulating w/ vertebra)
synovial plane joint
74
sternocostal joint types
1st rib: primary cartilaginous joint (synchondrosis)
| 2nd-7th ribs: synovial plane joints
75
sternoclavicular joint type
synovial saddle joint
76
costochondral joint type
primary cartilaginous joint (synchondroses)
77
what is the difference between the sternocostal joints and the costochondral joints?
sternocostal joints are medial (costal cartilage articulating w/ sternum)
costochondral joints are lateral (costals articulating w/ costal cartilage)
78
interchondral joint
articulation of costal cartilages of ribs 6-9
79
interchondral joint type
synovial plane joint
80
manubriosternal joint type
secondary cartilaginous joint (symphysis)
81
xiphisternal joint type
primary cartilaginous (synchondrosis)
82
list the fascia and structures of the anterior abdominal wall from superficial to deep (12 layers)
1. skin
2. Camper fascia (superficial fatty layer of subcutaneous tissue)
3. Scarpa fascia (deep membranous layer of subcutenous tissue)
4. superficial investing fascia
5. external oblique
6. intermediate investing fascia
7. internal oblique
8. deep investing fascia
9. transverse abdominis
10. transversalis fascia
11. extraperitoneal fat
12. parietal peritoneum
83
list the three flat muscles of the anterolateral abdomen from superficial to deep
1. external oblique
2. internal oblique
3. transverse abdominis
84
the aponeurosis of which muscle forms the inguinal ligament?
external oblique
85
rectus sheath
tough sheet of aponeurosis from midclavicular to midline that encloses the rectus abdominis
86
lineal alba
intersection of the aponeuroses of the internal and external oblique and transverse abdomini. surface anatomy that runs down midline.
87
external oblique
1. origin: external surfaces of the 5th-12th ribs
2. insertion: linea alba, pubic tubercle, anterior half of iliac crest
3. innervation: thoraco-abdominal nerves (anterior rami of T7-T11) and subcostal nerve
4. action: compress and support trunk; flex and rotate trunk
88
internal oblique
1. origin: thoracolumbar fascia, anterior 2/3 of iliac crest, and connective tissue deep to inguinal ligament
2. insertion: inferior borders of 10th-12th ribs, linea alba, pubis vs. conjoint tendon
3. innervation: thoraco-abdominal nerves (T7-T11), subcostal and first lumbar nerve
4. action: compress and support trunk; flex and rotate trunk
89
transversus abdominis
1. origin: internal surfaces of the 7th-12th costal cartilages, thoracolumbar fascia, iliac crest, connective tissue deep to inguinal ligament
2. insertion: linea alba w/ aponeurosis of internal oblique, pubic crest, and pubis via conjoint tendon
3. innervation: thoraco-abdominal nerves (T7-T11), subcostal and first lumbar nerve
4. action: compress and support abdominal viscera
90
rectus abdominis
1. origin: pubic symphysis and pubic crest
2. insertion: xiphoid proccess and 5th-7th costal cartilages
3. innervation: thoraco-abdominal and subcostcal nerves (anterior rami of T7-T12 nerves)
4. action: flexes trunk; compresses abdominal viscera; stabilizes and controls tilt of pelvis
91
name of L1 nerve
ilio-inguinal
92
inguinal ligament
most inferior part of the external oblique aponeurosis
93
inguinal canal
where the spermatic cord passes through from the abdominal cavity to the testes
94
deep (internal) inguinal ring
evagination of the transversalis fascia, superior to the middle of the inguinal ligament, lateral to the inferior epigastric vessels
95
superficial (external) inguinal ring
exit from the inguinal canal, slit-like opening in the aponeurosis of the external oblique, superolateral to the pubic tubercle
96
pectineal line (of Cooper)
portion of the inguinal ligament that runs along the pectin pubis.
97
thoraco-abdominal nerve
distal abdominal parts of lower 5 intercostal nerves T9-T11: innervate muscles of anterolateral abdominal wall and overlying skin (T7-T9: superior to umbilicus; T10: around umbilicus; T11: immediately below umbilicus)
98
subcostal nerve
anterior ramus of T12: innervate muscles of anterolateral abdominal wall and overlying skin midway between levels of umbilicus and iliac crest; inguinal ligament and pubic crest inferiorly
99
iliohypogastric nerve
superior branch of L1: innervates skin overlying iliac crest, upper inguinal and hypogastric regions; internal oblique and transfers abdominis
100
ilio-inguinal nerve
inferior branch of L1: innervates skin of scrotum of labium magus, mons pubis, and adjacent medial aspect of thigh; most inferior internal oblique and transverses abdominis
101
direct inguinal hernia
exit from anterior abdominal wall via superficial ring, lateral to cord; rarely enters scrotum
102
indirect inguinal hernia
exit from anterior abdominal wall via superficial ring inside cord, commonly passing into scrotum/labium magus.
103
what two ligaments form the foundation of the inguinal canal?
1. inguinal ligament (made of external oblique aponeurosis-more superficial)
2. iliopublic tract (made up of transversalis fascia-deeper)
104
what two bony landmarks are the attachment points of the ligaments that form the inguinal canal?
hip bone- anterior superior iliac spine and the public tubercle
105
what 5 ligaments make up the inguinal canal?
1. inguinal ligament (of Poupart)
2. iliopubic tract
3. Lacunar ligament (of Gimbernaut)
4. pectineal ligament (of Cooper)
5. conjoined tendon
106
hip bone- pectineal line
line that runs posterior-lateral from the hip bone-pubic tubercle
107
pectineal ligament (of Cooper)
helps make up the inguinal canal, attaches along the pecineal line of the hip bone
108
which two ligaments form the floor of the inguinal canal?
inguinal ligament and lacunar ligament
109
lacunar ligament (of Gimbernaut)
attaches between the pectineal line and the inguinal ligament, helps form the floor of the inguinal canal
110
conjoined tendon
makes up posterior wall of the inguinal canal, attaches along the pectineal line, arises from the merging of internal and external oblique aponeuroses
111
round ligament of the uterus
structure in females that extends from internal (deep) inguinal ring to the external (superficial inguinal ring), derived from gubernaculum during development.
112
where does the internal inguinal ring lie in relation to the inferior epigastric vessels?
lateral
113
what layer of anterior abdominal wall layer is NOT present in the scrotum?
Camper's fascia
114
what is Scarpa's fascia called in the scrotum?
Dartos' fascia
115
what is the transversalis fascia layer called in the scrotum?
internal spermatic fascia
116
what is the parietal peritoneum layer called in the scrotum?
tunica vaginalis
117
what nerve controls the cremasteric reflex?
L1-ilioinguinal nerve
118
inferior epigastric vein and artery
lie inferiorly to ductus deferens in males, connect to the external iliac artery and vein
119
superficial epigastric artery
lies superficial to inguinal ligament, comes off of external iliac arery
120
musculophrenic artery
follows costal angle inferiorly, comes off of internal thoracic artery
121
superior epigastric artery
medial branch of internal thoracic artery
122
name the major vessels off the aorta in the abdomen from superior to inferior.
1. celiac artery
2. superior mesenteric artery
3. R and L renal arteries
4. L and R gonadal arteries
5. inferior mesenteric
6. L and R common iliac
123
discuss the arterial supply of the breast
subclavian branches into axillary then lateral thoracic artery branches off to supply lateral breast. medially, subclavian branches into internal thoracic artery to supply medial breast.
124
discuss the venous drainage of the breast
lateral thoracic vein merges w/ axillary vein which then turns into subclavian vein. Internal thoracic vein trains directly into superior vena cava.
125
discuss the lymphatic drainage of the breast
from areola to subareolar lymphatic plexus, most lymph drains to axillary lymph nodes. Can also drain to infra, the supra clavicular nodes. Perasternal lymph nodes help drain medial portion of breast.
