Most Important, Stuff I Don't Know Flashcards
Cervical zygopophyseal joint orientation and movements?
Thoracic zygopophyseal joint orientation and movements?
T12-L1 zygopophyseal joint orientation and movements?
Inferior lumbar zygopophyseal joint orientation and movements?
- Horizontal (Transverse)- allows for flex/ext, ab/adduction, rotation
- Coronal- allows for ab/adduction and rotation but limits flex/extension
- Saggital- allows for flex/ext but limits ab/adduction and blocks rotation
- Coronal- allows ab/adduction and rotation but limits flex/ext
Ribs - have 3 articulatons with the vertebrae while ribs ,-_ have only 2 articulations with the vertebrae.
Where are these articulations?
What do these articulations limit?
- 2-9
- 1,10-12
- Ribs 2-9 have articulations with the vertebrae above and below at the costovertebral joints while ribs 1,10,11, and 12 only join with a single vertebrae.
- All ribs articulate with the transverse process of the vertebrae.
-The articulations limit both flexion/extension and abduction/adduction.
Where is the anterior longitudinal ligament and what does it do?
Where is the posterior longitudinal ligament and what does it do?
Anterior:
- Runs from C1 and occipital bone to pelvic surface of sacrum, interconnecting the anterior/lateral surfaces of vertebrae
- Limits extension of vertebral column
Posterior:
- Runs from C2 to sacrum through the vertebral canal interconnection posterior bodies and IV disks
- Limits hyperflexion
Zygapophyseal joints are classified as what?
What ligaments stabilize the zygopophyseal joint and where are they located?
-planar type synovial (weak capsule)
Ligaments:
- Ligament flava- connects lamina
- Interspinous ligaments- connects spinous precesses
- Supraspinous ligaments- on top of spinous processes
- Nuchal ligaments- connects cervical spinous processeses to occipital
- Intertransverse ligaments- connect transverse processes
What are the ligaments of the atlanto-axial joint?
What is their main function?
Ligaments:
- transverse ligament of atlas- holds dens to anterior arch of C1
- longitudinal bands- connects transverse ligament to occipital bone and body of C2
- alar ligaments- connect dens to lateral foramen magnum
- tectoral membrane- continuation of posterior longitudinal ligament
-All act to hold dens in place
What are the ligaments of the sacroiliac joint?
Ligaments:
- Anterior SI ligament- capsule thickening
- Posterior SI ligament- limits depression of sacrum, elevation of ilium. Strong shock absorber
- Interosseous SI ligament- limits all movement, transfers weight from vertebral column to hip
- Sacrotuberous and Sacrospinous ligaments- limit posterior tilt of sacrum/coccyx
Cervical curve?
Thoracic curve?
Lumbar curve?
Sacral curve?
L
K
L
K
L=lordosis K=kyphosis
What are the main arteries of the cervical vertebrae?
What are the main arteries of the thoracic vertebrae?
What are the main arteries of the lumbar vertebrae?
What are the main arteries of the sacral vertebrae?
C= vertebral and ascending cervical (thyrocervical branch) T= posterior intercostal L= subcostal and lumbar S= iliolumbar and lateral/medial sacral
What are the veins?
- Anterior and posterior external vertebral plexus
- Anterior and posterior internal vertebral plexus
- Basivertebral vein
What are the nerves associated with the vertebral column?
- Recurrent meningeal n.- supplies dura mater, periosteum, ligaments, disks, and blood vessels of vertebrae
- articular branches from medial branches from posterior rami- supply zygopophyseal joints
What are the 8 bones of the cranial cavity?
- Frontal
- Ethmoid
- Sphenoid
- Occipital
- (2) Temporal
- (2) Parietal
What is the viscerocranium and what are the bones?
Viscerocranium= facial bones
(15) Bones
- Mandible
- Ethmoid
- Vomer
- (2) Maxilla
- (2) Inferior nasal conchae
- (2) Zygomatic
- (2) Palatine
- (2) Nasal
- (2) Lacrimal
What are the 7 bones that make up the eye socket?
- Frontal bone
- Zygomatic bone
- Maxillary bone
- Sphenoid bone
- Ethmoid bone
- Palatine bone
- Lacrimal bone
What goes through the foramen magnum?
- Spinal Cord
- Brain stem
- Vertebral Arteries
- CN11 (Accessory) (IN)
What goes through the jugular foramen?
- Internal Jugular Vein
- CN9 (glossopharyngeal), CN10 (Vagus), CN11 (Accessory)
What goes through the carotid canal?
- Internal Carotid artery
- Sympathetic plexus
What forms the piriform aperture?
- Nasal
- Maxilla
What makes up the nasal cavity walls?
Roof
-Ethmoid
Lateral Wall
- Ethmoid Superior and Middle Nasal Conchae
- Palatine perpendicular plate
- Inferior nasal conchae
- Maxilla
Floor
- Maxilla palatine process
- Palatine bones
Medial Wall = Nasal Septum
- Vomer
- Ethmoid perpendicular plate
- Septal cartilage
Bones of the anterior cranial fossa?
Bones of the middle cranial fossa?
Bones of the posterior cranial fossa?
Anterior:
- Frontal
- Ethmoid
- Sphenoid
Middle:
- Sphenoid
- Temporal
Posterior:
- Occipital
- Sphenoid
- Temporal
What bones have sinuses?
- Frontal sinus
- Ethmoidal air cells
- Maxillary sinus
- Sphenoid sinus
FEMS
sinuses for sound resonation
Coronal
-seperates ________ and _______
Sagittal
-seperates right and left __________
Lambdoid
-seperates _______ from _______
Occipitomastoid
-seperates ________ from ________
Squamos
-seperates ________ from _________
Lambda
-intersection of ________ and ________ sutures
Bregma
-intersection of ________ and _______ sutures
Pterion
-“H” shaped intersection of _______, _______, and _______ bone
Vertex
-most superior point of calvaria on ________ suture
Asterion
-junction of _______, __________, and _______
Coronal
-seperates frontal and parietal
Sagittal
-seperates right and left parietal
Lambdoid
-seperates occipital from parietal
Occipitomastoid
-seperates occipital from temporal
Squamos
-seperates temporal from parietal
Lambda
-intersection of lambdoid and sagittal sutures
Bregma
-intersection of sagittal and coronal sutures
Pterion
-“H” shaped intersection of coronal, squamos, and sphenoid bone
Vertex
-most superior point of calvaria on sagittal suture
Asterion
-junction of lambdoid, occipitomastoid, and squamos
What are the ligaments of the TMJ?
Lateral ligament of the TMJ
-prevents posterior dislocation
Stylomandibular ligament
-prevents downward dislocation
Sphenomandibular ligament
-prevents downward dislocation
What are the muscles of mastication?
Which is the only one that depresses to open the mouth?
- Masseter
- Medial pterygoid
- Lateral Pterygoid
- Temporalis
-Lateral pterygoid
What are the three layers of the deep cervical fascia?
Superficial, Middle, Deep
Investing Layer, Pretracheal Layer, Prevertebral Layer
What is the superior attachment of the investing layer?
What is the inferior attachment of the investing layer?
What are the walls of the investing layer?
- Superior- Skull, hyoid
- Inferior- pectoral girdle, rib cage
- Walls- deep fascia of traps, SCM, nuchal ligaments
What does the pretracheal layer enclose?
- Trachea
- Esophagus
- Thyroid Glands
- Infrahyoid Muscles
What does prevertebral layer include?
-forms a CT tube around cervical vertebrae column and muscles attached to cervical vertebral column:
- longus colli
- longus capitis
- scalenes
- posterior deep cervical muscles
- also has sympathetic chain ganglia
What is inside the carotid sheath?
Carotid arteries, jugular veins, vagus nerves, and lymphatics
Cranial Nerves and their functions?
1.) Spinal accessory (CN11)- to trapezius and SCM
2.) Hypoglossal nerve (CN12)- goes to tongue, runs with cervical plexus (ansa cervicalis)
3.)Glossopharyngeal (CN9)- to tongue and pharynx
4.)Vagus nerve (CN10)- to tongue, pharynx, thorax, and abdomen
-right recurrent laryngeal- loops around right
subclavian artery to trachea, esophagus, and muscles of larynx
-left recurrent laryngeal- loops around aortic arch to trachea, esophagus, and muscles of larynx
-cardiac branches- to cardiac plexus of heart
-pharyngeal branches- pharynx
Parts of the cervical plexus?
- Ansa cervicalis (C1-C3)- goes to omohyoid, sternothyroid, and sternohyoid
- Phrenic nerves (C3-C5)- 3,4,5 keep the diaphragm alive
- Sensory nerves
- lesser occipital n. (C2)- cutaneous to posterolateral scalp
- great auricular n.(C2,3)- cutaneous to lateral scalp (ear) and superior neck
- transverse cervical n. (C2,3)- cutaneous to anterolateral jaw and neck
- supraclavicular n. (C3,4)- cutaneous to base of neck and shoulder
How many ganglia is the sympathetic trunk composed of?
Go in depth on all
3 ganglia
- )Superior ganglion
- superior cervical cardiac n. to cardiac plexus
- arterial branches
- internal carotid (symp) plexus- symp innervation to brain - )Middle ganglion
- middle cervical cardiac n. to cardiac plexus - )Inferior ganglion
- inferior cervical cardiac n. to cardiac plexus
Arteries of the larynx?
Veins?
- superior branches from the external carotid a.
- inferior branches from the subclavian a.
-veins travel with and are names for artery
What are the subdivisions of the pharynx?
Nasopharynx- from nasal cavity to soft palate
Oropharynx- from soft palate to base of tongue
Laryngeopharynx- from superior epiglottis to esophagus
What are the muscles of the pharynx called?
What is their action?
What is their innervation?
- ) external circular layer
- superior, middle, and inferior pharyngeal constrictors
- Action- constrict/squeeze walls of pharynx
- Innervation- CN10 - ) internal longitudinal layer
- patatopharyngeus- Go from palate to pharynx
- Innervation- CN10
- Action- elevate/shorten/widen pharynx
- salpingopharyngeus
- eustachian tube to pharynx
- Innervation- CN10
- Action- elevate/shorten/widen pharynx
- stylopharyngeus
- styloid process to pharynx
- Innervation-CN9 (glossopharyngeal)
TRIANGLES OF THE NECK
TRIANGLES OF THE NECK
The neck is divided into a ________ and _______ triangle.
Posterior and Anterior
What are the boundaries of the posterior triangle?
- Anterior= SCM
- Posterior= Trapezius
- Inferior= Clavicle
What are the contents of the posterior triangle?
Arteries?
Veins?
Nerves?
Arteries
- suprascapular artery in base
- subclavien artery in base of triangle
Veins
- external jugular vein
- subclavian vein
- brachiocephalic vein
Nerves
- CN11
- cutaneous nerves of cervical plexus
- greater auricular n.
- lesser occipital n.
- transverse cervical n.
- supraclavicular n.
- brachial plexus at base
What are the borders of the anterior triangle?
- anterior= median line of neck
- posterior= SCM
- superior= mandible
What are the subtriangles of the anterior triangle?
- Submental
- Submandibular
- Carotid
- Muscular
What are the boundaries of the submental triangle?
- inferior= body of hyoid
- right lateral= right anterior belly of digastric
- left lateral= left anterior belly of digastric
What are the contents of the submental triangle?
-lymphnodes and small veins
What are the boundaries of the submandibular triangle?
- superior= inferior border of mandible
- anterior= anterior belly digastric
- posterior= posterior belly digastric
What are the contents of the submandibular triangle?
- submandibular salivary glands
- CN12 (out of hypoglossal foramen), CN5 (trigeminal)
- branches of external carotid to face
- facial a. and v.
- submental a.
What are the boundaries of the carotid triangle?
- superior= posterior belly digastric
- inferior medial= superior belly omohyoid
- inferior lateral= SCM
What are the contents of the carotid triangle?
- area to palpate pulse in common carotid artery
- thyroid
- blood vessels:
- common carotid branching into int and ext
- carotid body
- branches of external carotid= ascending pharyngeal a., occipital a., facial a., superior thyroid a.
- internal jugular v. and branches
- nerves:
- CN11 (accessory)
- CN12 (hypoglossal)
- ansa cervicalis (C1,2,3)
- CN10 (vagus) with superior laryngeal branch
- sympathetic plexus
What are the borders of the muscular triangle?
- medial= medial plane neck
- superior lateral= superior belly omohyoid
- inferior lateral= SCM
What are the contents of the muscular triangle?
- thyroid gland
- parathyroid glands
- larynx and trachea
- veins
- anterior jugular
- communicating vein
- nerve
- recurrent laryngeal
What are the ligaments of the head of the ribs?
- Intra-articular ligaments- from crest of head to intervertebral disc (limits rotation)
- Radiate ligament- anterior capsule thickening
What is the joint type of the costotransverse joint?
- Planar
a. )ribs 1-6 slightly convex (rib) with slightly concave (transverse process)- this allows rotation= pump handle
b. )ribs 7-10 are flat planar - allow gliding=bucket handle
- this allows rotation= pump handle
What are the ligaments of the costotransverse joints?
Lateral costotransverse ligament:
- goes from vert. transverse process to adjacent rib
- prevents lateral seperation
Superior costotransverse ligament:
- goes from vert. transverse process to rib below
- prevents inferior seperation
What ligament is known as the bone fuzz?
Radiate costosternal ligament
Nerves involved with the muscles of the thoracic cavity.
a. ) ventral rami T1-11 = intercostal nerves = sup and inf collateral branches = lateral and anterior cutaneous
b. ) ventral rami T12 = subcostal nerve
c. ) dermatomes = peripheral nerve sensory area correlate with spinal cord level
d. ) T1 superior collateral contributes to brachial plexus
e. ) sympathetic chain ganglia
- connected to the ventral rami by rami communicantes
- located on either side of vertebral bodies forming thoracic vertebral column
Blood and lymph vessels of the thoracic wall?
a. ) anterior and anterior/lateral wall: right and left subclavian arteries → internal thoracic artery → anterior intercostal arteries (ant and lat intercostal spaces of ribs 1-10)
b. ) posterior and posterior/lateral wall: descending thoracic aorta → paired posterior intercostal arteries (post and post/lat intercostal spaces of ribs 4-11)
c. ) veins follow arteries and are named for the arteries they follow
- anterior intercostal veins → internal thoracic veins→ brachiocephalic veins
- posterior intercostal veins → hemi/azygous system → SVC
d. ) lymph vessels
- lymph flow
- right lymphatic duct- drains right side of head, arms, and thorax
- thoracic duct- drains left side of head, arms and thorax. Also drains entire abdomen, pelvis, legs
What are the contents of the intercostal space?
Muscles: -external intercostals -internal intercostals -innermost intercostals -subcostals (cross 2 intervertebral spaces) Blood Vessels: -intercostal artery -intercostal vein Nerves: -intercostal nerves / ventral rami (mixed motor/sensory)
Arranged superior to inferior:
Vein→Artery→Nerve
The right coronary artery runs in what and branches to what?
Runs in the AV sulcus
Branches into:
- SA node
- Base of heart- right and left ventricles to the apex via right marginal
- Posterior R and L ventricles and IVC via posterior interventricular
The left coronary artery runs in what and branches to what?
Runs in the AV sulcus
Branches into:
- SA Node (40%)
- Anterior R and L ventricles and IVS (interventricular septum) via anterior interventricular artery
- Posterior surface- left atria and ventricle via circumflex artery
- Left Border- left ventricle via marginal artery
- Posterior R and L ventricles and IVC (30%) via posterior interventricular artery
Coronary innervation includes?
Intrinsic pathway: -SA node (pacemaker)→internodal fibers→AV node→AV bundle of His→bundle branches→Purkinje fibers Sympathetic: -Sympathetic trunk=cervical (superior,middle,inferior) and superior thoracic trunk ganglia Parasympathetic: -Vagus nerves Cardiac plexus: -both sympathetic and parasympathetic
General lung locations
- Apex- extend through thoracic inlet into base of neck
- Base- rests on diaphragm
- 3 surfaces (costal, diaphragmatic, mediastinal)
Hilum:
- pulmonary a.- deox blood
- pulmonary v.- ox blood
- bronchial a.- ox blood
- bronchial v.- deox blood
- primary bronchus
- lymphatics
- nerves
- pulmonary ligament- fold of visceral and parietal pleura connecting lung to mediastinum
The conduction portion of the ariway consists of what?
- Oral and nasal cavities
- Pharynx
- Larynx
- Trachea
- Primary (main) bronchi → whole lung
- Secondary bronchi (lobar) → lobes
- Tertiary bronchi (segmental) → segments (10 per lung)
- Bronchioles- more smooth muscle than cartilage for dilation/constriction
- Terminal bronchioles- more smooth muscle than cartilage for dilation/constriction
The Bronchioles and terminal bronchioles function?
regulation of airflow
The respiratory portion consists of what?
- Respiratory bronchioles → lubules
- Alveolar duct
- Alveolar sac
- Alveoli
What are the quadrants and what are in each quadrant?
RUQ: -Liver, gallbladder RLQ: -Appendix, cecum LUQ: -Stomach, spleen LLQ: -Sigmoid Colon
What muscles pass through the diaphragm?
- paired psoas major under medial arcuate ligaments
- paired quadrates lumborum under lateral arcuate ligaments (rib to hip)
Blood and Lymph vessels passing through the diaphragm
Descending aorta: -via aortic hiatus formed by left and right crus Inferior vena cava: -via caval opening in central tendon Superior epigastric a. and v. : -via sternocostal triangle Azygous and hemiazygous veins: -via aortic hiatus Thoracic duct: (junction between L jugular and subclavian)
Vasculature of the diaphragm
- ) Superior surface
- thoracic aorta→ superior phrenic a.’s
- internal thoracic→ musculophrenic and pericardiophrenic a.’s
- veins named for arteries drain into IVC and internal thoracic - )Inferior surface
- abdominal aorta→ inferior phrenic a.’s
- veins named for arteries drain into IVC
Anteriolateral muscular wall layers
superficial to deep
- skin
- subcutaneous layer= hypodermis: fat layer held together by CT fibers
- camper fascia- superficial layer of CT below naval
- scarpa fascia- deep layer of CT below naval - muscles and aponeurosis
- deep fascia of transverse abdominis
- extraperitoneal fat
- parietal peritoneum
The rectus sheath is divided into what components?
Superior Sheath components:
- anterior formed from external oblique and anterior internal oblique aponeurosis
- posterior formed from posterior internal oblique and transverse abdominis aponeurosis
Inferior Sheath components:
- anterior formed from external oblique, internal oblique, and transverses aponeurosis
- posterior- no aponeurosis
Sensory innervation (nerves) of the anteriolateral abdominal wall
- ) thoracoabdominal m.’s
- ) lateral cutaneous branches of intercostals n.’s
- ) Subcostal n.
- ) Iliohypogastric n.
- )Ilioinguinal n.
Blood vessels of the anteriolateral wall
- ) internal thoracic arteries
- musculophrenic→ anterolateral diaphragm and abdominal wall near diaphragm
- superior epigastric→ anterior abdominal wall - ) descending abdominal aorta
- lower intercostals a.’s→ lateral superior abdominal wall
- subcostal a - ) external iliac a.’s
- inferior epigastric→ anterior inferoir abdominal wall
- deep circumflex→ inguinal region - ) femoral a.’s
- superior circumflex→ inguinal region
- superficial epigastric
Inguinal canal crosses:
- peritoneum
- retroinguinal space of Bogros
- transversalis fascia forms covering of the canal contents
- transversus abdominal muscle
- internal oblique
- external oblique
What are the suboccipital muscles and their attachments?
Rectus capitis posterior major:
-Attachment- C2 spinous p.→ occipital bone/lateral nuchal line
Rectus capitis posterior minor:
-Attachment- C1 posterior tubercle→ occipital bone/ medial nuchal line
Obliquus capitis inferior:
-Attachment- C2 spinous process→ C1 transverse process
Obliquus capitis superior:
-Attachment- C1 transverse process→ occipital bone/ lateral nuchal line
What muscles make up the suboccipital triangle?
- Rectus Capitis posterior major (superior/medial)
- Obliquus capitis inferior (inferolateral)
- Obliquus capitis superior (superolateral)
What are the contents of the suboccipital triangle?
Vertebral artery/vein and suboccipital nerve
What are the main arteries supplying the cord?
a. )vertebral, subclavian arteries- supply the cervical spinal cord
b. ) intercostals arteries- supply thoracic spinal cord
c. ) lumbar arteries- supply lumbar spinal cord
d. ) lateral sacral arteries- supply the sacral spinal cord
What runs through the greater sciatic foramen?
- Sciatic nerve
- Superior gluteal n.a.v.
- Inferior gluteal n.a.v.
- Piriformis muscle (takes up most space)
Pubic symphysis: Articulation? Joint Type? Ligaments? Movements?
- Articulation- between pubic bones of right and left hip
- Joint Type- cartilaginous disk= symphysis
- Ligaments-
a. ) superior pubic ligament
b. ) inferior pubic ligament- forms apex of pubic arch - Movements- syn- or amphiarthrosis
What is the floor of the pelvic diaphragm composed of?
- Coccygeus muscle
- Levator Ani (3 muscles)
- Urogenital hiatus
- Structures passing through
What are the muscles of expiration?
-Resipratory Diaphragm
-Internal Intercostal
-Innermost Intercostal
Subcostal
-Rectus Abdominis
-External Oblique
-Internal Oblique
-Transverse Abdominis
-Quadratus Lumborum
What are the muscles of inspiration?
- Diaphragm
- Scalenes
- Levator costarum
- External Intercostal
