questions Flashcards
what is pronation?
palm down
what is supination?
palm up
what is circumduction?
rotating distal aspect (arm) while the proximal end (attached to the joint) is fixed
what digit does the median plane of the foot travel through?
2
what are the 5 bone classifications?
long, short, flat, irregular, and sesamoid
describe function of long bones
provide strength, structure, and mobility
describe function of short bones
provide support and stability
describe describe function of flat bones
provide protection and allow for muscle attachment
describe function of irregular bones
they serve different functions
describe function of sesamoid bones
protects tendons from wear and tear
what are the types of surfaces that form joints?
head, facet, condyle
what are the types of depressions and openings?
foramen, groove, fissure, notch, fossa, meatus, sinus
what is the importance of the von Hochstetter triangle? where is it?
it is safe for injections due to no nerves being present underneath. it is located under the hip on the surface
where is “new” (more) bone generated?
at the epiphyseal plate
what is the out layer of bones?
periosteum
what is the relationship between osteocyte and osteoblast?
some osteoblast will differentiate into osteocyte
what allows for communication between osteocytes?
canaliculi which branches off the cell body
what do bone cells start off as?
osteoprogenitor cells
what are the bone types?
corticol (COMPACT) and trabecular (SPONGY)
describe corticol bone
“compact” - exterior of bone covered in periosteum
describe trabecular bone
“spongy” - interior of bone, sometimes replaced by medullary cavity
what maintains the bone?
osteoblasts and osteoclasts! osteoblasts create bone while osteoclasts degrades it
what causes osteoporosis?
degradation of too much bone due to osteoclasts. the bone is now very fragile
what is a haversian canal?
blood vessel surrounded by a ring of osteoblasts
what supplies an osteon?
by 1 haversian canal
what are the types of fractures?
comminuted, compression, epiphyseal, depressed, spiral, green stick
describe a comminuted fracture. who does it generally occur in?
3 or more bone fragments. generally occurs in those with brittle bones so basically aged people
describe compression fracture . who/where is it more common in?
crushed bone. common in porous bones subjected to extreme trauma
describe epiphyseal fracture. who/where common?
epiphysis separates from diaphysis along epiphyseal plate. generally occurs in preadolescence
describe a depressed fracture. who/where is it common?
broken bone portion pressed inwards. common skull fracture
describe a spinal fracture. common in?
ragged break due to excessive twisting forces. common sports fracture or in toddlers
describe a green stick fracture. common in?
incomplete break: one side broken and one side bent. common in children
what is the difference between a simple fracture and a compound fracture?
simple only injures the bone while compound pierces the skin
what does aging result in (regarding bones)?
loss of bone mass due to demineralization - decrease in calcium. increased brittleness due to decrease in protein synthesis - decease in collagen
what strengthens bones?
strain. eg gravity
name the neurocranium bones of the skull
sphenoid, frontal, parietal, occipital, temporal
name the viscerocranium bones of the skull
ethmoid, inferior nasal concha, lacrimal, zygomatic, vomer, mandible, maxilla, nasal, palatine
what can the sphenoid bone be divided into?
the lesser wing (on top) and the greater wing (on bottom)
what are sutures?
fibrous immovable joints in the skill between the neurocranium bone
what are fontanelles?
allows the cranium to be flexible. they solidify into sutures with age
how many vertebrae in the spine in total?
24
list the subgroups of the vertebrae and how many in each
cervical has 7. thoracic has 12. lumbar has 5
describe scoliosis
medial and lateral deviation of the spine
describe kyphosis
curvature out, in thoracic region of spine
describe lordosis
curvature in, in lumbar region of spine
where do the spinal cord and spinal nerves exit?
intervertebral foramen formed from adjacent vertebra
what is another name for C1? what is special about it?
ATLAS. it has no body or spine
what is another name for C2? what is special about it?
AXIS. it has dens which forms a joint with C1 allowing for rotation of the head
what is special about a typical cervical vertebrae?
it has bifid spinous process which is two extended projections. it also has transverse foramen which allows the vertebral artery and vein through
what is the circle of willis?
provides blood flow between anterior and posterior circulations of the brain
what can happen when the vertebra articulates during cervical adjustment?
leads to the impingement of artery or dislodging of thrombous (blood clot) . results in stroke
what is special about thoracic spine?
has costal facets which articulate with the rib
what is special about lumbar spine?
squat thick bodies
how many vertebrae in the coccyx?
3-5
where do spinal nerves emerge from?
posterior/anterior sacral foramina
how many vertebrae in sacrum?
5
what are the types of longitudinal ligaments?
anterior, posterior, supraspinous, interspinous, ligamentum
describe anterior ligament
in front of vertebral body. broad fibrous
describe posterior ligament
behind vertebral body. narrow fibrous. within the vertebral canal
where is supraspinous ligament?
on top of spinous process. technically posterior to it
where is interspinous ligament?
between spinous proceeses.
describe the atlanto-occipital joints (type? where? purpose?)
synovial joints between superior articular facets of atlas and occipital condyles of the skull. allows for nodding (flexion/extension)
describe the atlanto-axial joints (includes? purpose?)
consists of 2 lateral and 1 medial (between atlas and axis) joint. allows head to pivot
describe zygapophyseal (facet) joints (type? where? purpose? innervated by?)
plane, synovial joints between the articulate process of vertebrae. helps stabilize column. innervated by dorsal rami
describe intervertebral joints (type? where?)
fibrocartilaginous joints between vertebral bodies/intervertebral discs. but not between C1&C2.
what is responsible for shock absorption in the spine?
intervertebral disc
describe structure of intervertebral disc
outer part composed of annulus fibrosis which a thick fibrous ring. inner part composed of nucleus pulposus - a gelatinous center
what is disc herniation?
when fragment of the disc nucleus leaks out annulus and impinges on the spinal cord/nerve
describe costovertebral/ costotransverse joints (where?)
between vertebra and ribs at the transverse process and costal tubercle respectively
describe the thoracic cage (where? what?)
composed of 12 ribs which are attached to costal cartilage which attaches to the sternum (only for 1-7). ribs are connected to the thoracic vertebrae (T1-T12)
what are true ribs? how many?
true ribs connect to sternum. the top 7 are true ribs
what are false ribs? how many?
attached to cartilage. ribs 8-10 so 3
what are floating ribs? how many?
no articulation. ribs 11-12 so 2
what are the classifications of joints?
fibrous, cartilaginous, and synovial
describe fibrous joints
bones connected by fibrous tissue, limiting the movement which depends on the length of fibers
what type of joint is a suture?
fibrous
describe cartilaginous joints. give examples of each type
bones connected by hyaline or fibrocartilage. primary cartilaginous joints are joined by hyaline and are in early life bone development at epiphyseal plates. secondary cartilaginous joints and joined by fibrocartilage and are strong, slightly movable joints. they are found between vertebrae
describe synovial joints
articular surfaces covered in hyaline and cartilage. there is free movement between bones. the joint capsule lined by synovial membrane contains synovial fluid for lubrication. it is reinforced by ligaments and other things such as discs and menisci.
name the different types of synovial joints
saddle, ball and socket, hinge, condyloid, plane, & pivot
what must be sacrificed for stability in a joint?
range of motion
what 5 structures are synovial joints composed of?
bones, ligaments/capsule, tendons/muscle, intra-articular structures (menisci, discs, labrum, etc), and bursae
what is the treatment for joint injuries?
PRICE. protection, rest, ice, compression, elevation
what are some intra-articular structures that contribute to joint function?
extracapsular ligaments which reinforce joint capsule. intracapsular ligaments within a joint to provide stability. articular disc to absorb shock and distribute weight. labrum found in ball and socket joints to deepen socket and improve contact
what is bursitis? describe it
a synovial joint injury, it is a chronic inflammation of a bursa which are fluids filled sacs meant to reduce friction between moving parts
what is the most stable type of joint?
fibrous joints
which type of joint does not have cartilage?
fibrous
what are the 3 types of cartilage?
hyaline, elastic cartilage, fibrocartilage.
what is the weakest type of cartilage?
hyaline but is still well suited to bear weight and transfer load
what is the strongest type of cartilage?
fibrocartilage
describe hyaline
a metabolically active tissue that has no blood supply/lymph channels/neurological supply.
what is the composition of hyaline cartilage?
cells take up less than 10%. rest is the extracellular matrix which is made up of interstitial fluid (water, lipids, electrolytes), collagen, and proteoglycans
how is nutrient exchange accomplished in hyaline cartilage?
synovial fluid exchanges via cartilage loading
name and describe the types of cartilage injury
osteoarthritis is when joint cartilage is gradually lost, it happens on one side. rheumatoid arthritis is inflammation of joint linings and cartilage, it occurs on both sides and joint becomes immovable
what are the types of muscle?
skeletal, cardiac, smooth
where is smooth muscle found?
blood vessels, skin, viscera (intestines, etc)
which muscle types are voluntary? which are involuntary?
skeletal muscle is voluntary while cardiac and smooth are involuntary
which of the muscle types is multi-nucleated?
skeletal
what are the properties of muscle tissue?
electrical excitability, contractility, elasticity, extensibility
put muscle terms in order from smallest to biggest
thick&thin filaments, sarcomeres, myofibrils, fascicle, muscle
what is a fascicle?
bundle of myofibres
what is a myofibre?
muscle cell, repeating units of sacromere
what protein molecule is in thick filaments?
myosin
what protein molecule is in thin filaments?
tropomyosin, troponin, actin
how are muscles attached to the bone?
with tendons
muscles cant ____. they can only ______.
cant push. they can pull
how do signals travel from the brain to a muscle?
thru 2 neurons that synapse at the spinal cord
what is one motor unit?
motor neuron and all the fibers it innervates
describe the sliding filament theory
interaction between myosin and actin leads to muscle contraction. when myosin attaches to actin’s binding site forming a crossbridge, myosin undergoes a change in shape and its head swings producing a power stoker which slides actin pass the myosin
what are the 5 states of the sliding filament theory?
bound, power stroke, rigor, relaxed, binding. it repeats
what allows myosin to bind to actin?
the conversion of ATP to ADP
what role does calcium play in muscle contraction?
it binds to the troponin complex and causes the tropomyosin to roll away allowing contraction to occur
describe the calcium flow when a muscle cell is depolarized
calcium flows out. down the gradient
as one ages, what is muscle mass replaced with?
fibrous connective tissue and adipose
name and describe the types of cells in the nervous system
neurons which provide sensory info and transmit motor info to the body. and neuroglia which support and insulate and nourish neurons
what are the types of neurons?
multipolar motor and pseudounipolar sensory
what are some examples of neuroglia and where are they found?
in the CNS is oligodendroglia and in the PNS is schwann cells
where do neurons connect?
axon terminal sends info to dendrites which collect info. neurons synapse between here
how are oligodendrocytes and schwann cells different?
oligodendrocytes myelinate sections of several axons and are in the CNS. schwann calls myelinate one section of an axon and are in the PNS
what is the resting membrane potential?
-80mV. it is the difference between the outside (positive) and inside (negative)
what ions are outside a cell? inside?
outside is sodium and chlorine. inside is potassium
what causes signal propagation?
progressive depolarization of the cell
what causes an action potential?
resting membrane potential is -80mV. Na rushes in thru voltage gated channels causing depolarization 40mV (cell becomes more positive). K flows out of cell causing repolarization (back to negative inside). Na/K pump restores the balance of ions
what does the velocity of conduction in a neuron depend on?
myelination and the diameter of fiber (larger is faster)
how are signals transmitted from one neuron to another?
through the release of neurotransmitters in a synaptic cleft
describe the process of a neuronal synapse after a signal has been sent down the axon
impulse arrives at the end bulb. the calcium voltage gated channels open allowing the calcium to flow into the cell causing neurotransmitters to be releases. the neurotransmitters cross the synaptic cleft to bind to receptors on the postsynaptic membrane. sodium voltage gated channels open allowing sodium to enter the cell, depolarizing the post synaptic cell. a nerve impulse is initiated.
what is the difference between white and gray matter?
gray matter consists of nerve cell bodies while white matter includes axons with glial sheath. in the CNS, gray matter is the cortex and nucleus while white matter are the pathways. in the PNS, gray matter is ganglion while white matter is the nerve
what divides the hemispheres?
longitudinal fissure
how do the two hemispheres communicate?
through the corpus callosum, which is a white fiber tract (bundle of axons)
define a fissure
deep groove on the brain
define a sulcus
shallow groove on the brain
define a gyrus
ridge on the brain
what is the frontal lobe responsible for?
coordination of voluntary motor activity. behaviour and emotional control. personality. problem solving.
damage to WHAT leads to difficulty in producing language?
frontal lobe - broca’s area
damage to WHAT leads to difficulty in understanding speech?
parietal lobe - wernicke’s area
what is the parietal lobe responsible for?
integrates sensory info. processes touch, pain, proprioception
what is the temporal lobe responsible for?
auditory info processing. processes languages. processes smell
what is the occipital lobe responsible for?
receives and processes visual info
what does the diencephalon consist of?
thalamus, hypothalamus, and pituitary gland
what does the thalamus do?
relate center for sensory info. checks the info before sent to rest of brain
what does the hypothalamus do?
maintains homeostasis
what does the pituitary gland do?
secretes hormones
what do pons do?
transmits sensory info to brain from periphery
what does the cerebellum do?
coordination of voluntary movement with use proprioception. monitors and makes adjustment to correct motor plan. controls balance and equilibrium.
why is white matter white?
myelin on the axons
describe where cerebrospinal fluid goes through
produced in the lateral ventricles. goes to interventricular foramen. then third ventricle. then cerebral aqueduct. then fourth ventricle. then central canal
what are the types of meninges?
dura mater, arachnoid mater, pia mater
describe dura mater
a thick outer layer
describe arachnoid mater
white and wispy. in between dura mater and pia mater
describe pia mater
thin interior later that goes into the sulci
what do meninges do?
provide a supportive framework for vasculature. protect CNS from mechanical damage - similar to CSF
describe epidural space
arterial blood supply between dura mater and the skull
describe subdural space
venous blood supply between dura mater and arachnoid mater
describe subarachnoid space
CSF is here. it is between arachnoid mater and pia mater
list in order from outermost, the meninges and blood supply
skull, epidural space, dura mater, subdural space, arachnoid mater, subarachnoid space, pia mater
what makes up dura mater?
periosteal/endosteal and meningeal layers
what and where is extracerebral hemorrhages?
occurs between the skull and brain when blood makes contact with cells after intracranial pressure
where are meninges?
on the brain and spinal cord
where would you insert the needle to access the spinal cord? why here?
lumbar. into the subarachnoid space to collect cerebrospinal fluid. insert here because spinal nerves are floating so they can dodge the needle
why are two areas of the spinal cord enlarged? where are these enlargements?
for limb innervation. a cervical enlargement including the cervical plexus and brachial plexus. a lumbar enlargement including a lumbar plexus and a sacral plexus. the ones more so responsible for limb innervation are the brachial plexus and sacral plexus.
at which vertebra does the spinal cord end? what is the remaining structure of nerves called?
L1/L2 - conus medullaris. the remaining structure of nerves is called cauda equina
what are the roots of the brachial plexus
C5 - T1
describe the difference between dorsal and ventral horn
sensory info goes thru the dorsal (posterior) horn and motor info goes thru the ventral (anterior) horn
describe the pathway of sensory info
thru any rami. then the nerve. then the dorsal root. then the dorsal horn
describe the pathway of motor info
from ventral horn. ventral root. then spinal nerve. then any rami
what forms the peripheral nerves?
anterior rami from C5-T8
from largest to smallest, name the parts of the brachial plexus
RTDCB. roots trunks divisions cords branches.
what are the trunks of the brachial plexus
upper, middle, lower
what are the divisions of the brachial plexus
anterior and posterior
what are the cords of the brachial plexus (how are they named)
lateral, medial, posterior. named for their position around the axillary artery
what are the branches/peripheral nerves of the brachial plexus
axillary, radial, musculocutaneous, median, ulnar
how many cervical nervers are there?
C1 - C8. but for vertebrae its up to C7
which of the branches are extensors? where are they?
axillary and radial. to the back
which of the branches are flexors? where are they?
ulnar, median, musculocutaneous. to the front
what muscles does the axillary innervate?
deltoid and teres minor up in the shoulder
what innervates the triceps brachii?
radial nerve
what muscles does the musculocutaneous innervate?
bicep brachii, brachialis, and coracobrabrachialis
what does the stretching of root C5/C6 lead to?
musculocutaneous and axillary nerve impairment
what does the stretching of root C8/T1 lead to?
poor ulnar nerve function. loss of sensation to medial and distal hand
between flexors and extensors, what type of muscle is in the front for the arm?
flexors are anterior. extensors are posterior
what innervates the posterior/extensors in the arm compartment?
radial nerves
what innervates the anterior/flexors compartment in the arm?
musculocutaneous for the arm. median and ulnar for forearm
between flexors and extensors, what type of muscle is in the front for the leg?
extensors in the front (anterior). flexors in the back (posterior)
what is compartment syndrome?
the fibrous sheaths surrounding the compartment do not stretch causing pressure to build up if damage and swelling occur
what could be done to release pressure in a muscle compartment?
fasciotomy, a surgery
list the arterial supply of the upper limb. from the shoulder to the hand
brachiocephalic trunk. subclavian artery. axillary. splits into radial and ulnar. palmer arches. radial leads to deep palmer arch and ulnar leads to superficial palmer arch
what is anastomosis? give an example of where this occurs
when there’s two blood supply in an area. for example, the hand and the venous supply of the upper limb
where does shoulder separation occur?
at the acromioclavicular and sternoclavicular joints
what type of joint is acromioclavicular?
synovial - plane
what type of joint is glenohumeral?
synovial - ball and socket
where does labrum exists? what does it do?
in ball and socket joints. it deepens the socket for better contact and is a thick fibrocartilage layer
where does shoulder dislocation occur? what nerves could it impair?
only in the glenohumeral joint. impairs axillary and musculocutaneous nerves
describe scapulohumeral rhythm
arm abduction movement which requires two joints working together. glenohumeral on its own can move 30 degrees. but after that it will require the help of scapulathoracic. for every 2 degrees of GH, ST will move 1 degree
describe the axilla
a fat filled space in the armpit which provides passageway for blood vessels and nerves. it contains axillary lymph nodes
what is saturday night palsy
radial nerve compression leading to wrist drop and sensory loss on posterior arm
what are the types of muscles acting on the shoulder?
superficial layer (extrinsic back), deep layer (rotator cuff), pectoral, brachium
name the extrinsic back muscles
trapezius, latissimus dorsi, rhomboids, teres major
name the rotator cuff muscles
supraspinatus, infraspinatus, teres minor, subscapularis
name the pectoral muscles
serratus anterior, pectoralis major, pectoralis minor
name the brachium muscles
deltoid, long head of bicep, long head of tricep
using the “some love try positions that they cannot handle” name the carpal bones
scaphoid, lunate, triquetrum, pisiform, trapezium, trapezoid, capitate, hamate
what muscle are responsible for thumb movement? what are they innervated by?
thenar (median and ulnar)
what muscle are responsible for pinky movement? what are they innervated by?
hypothenar (ulnar)
what muscle allows fingers to move to the midline? innervated by?
this is called adduction and it is due to the 3 palmer interossei. innervated by the ulnar
what muscle allows fingers to move away from the midline? innervated by?
this is called abduction and is due to the 4 dorsal interossei. innervated by ulnar
what do lumbricals do? innervated by?
flex metacarpophalangeal joints but extend interphalangeal joints. innervated by median and ulnar which each do 2/4
name the digitorum muscles
extensor indicis, extensor digiti minimi, extensor digitorum, flexor digitorum superficialis, flexor digitorum profundus
name the carpi muscles
extensor carpi radialis, extensor carpi ulnaris, flexor carpi radialis, flexor carpi ulnaris, (flexor) palmaris longus
name the joints of the hand
carpal metacarpal (CMC), metacarpal phalangeal (MCP), proximal interphalangeal (PIP), distal interphalangeal (DIP)
what is carpal tunnel syndrome?
caused by compression of median nerve due to swelling. causes thenar muscle to weaken and skin paraesthesia
what is the condyloid joint? responsible for?
wrist joint responsible for flexion, extension, abduction, and adduction of wrist
name the joints of the wrist and what they are responsible for
radiocarpal (condyloid) and distal radioulnar (pronation/supination)
which nerves go through the cubital fossa
median and radial
where does elbow dislocation occur at?
cubital joint
describe the cubital joint
made up of the humeroradial joint and the humeroulnar joint. its at the elbow. and performs flexion/extension
describe the proximal radioulnar joint
at the elbow and performs supination and pronation
what muscle performs arm extension? innervated by?
long head innervated by radial
what performs forearm extension? innervated by?
triceps innervated by radial
what performs arm supination ? innervated by?
biceps innervated by musculocutaneous
what performs shoulder flexion? innervated by?
coracobrabrachialis innervated by musculocutaneous
what performs elbow flexion? innervated by?
brachialis innervated by musculocutaneous and radial
what type of movement does the ulna and radius assist with?
pronation and supination
what type of movement do the tarsal bones assist with?
inversion and eversion
describe flexion for arms and legs
for arms its forward and for legs its back
describe extension for arms and legs
for arms it back and for legs its forward
what are the nerves of the lumbosacral plexus
femoral, obturator, sciatic (tibial & fibular)
describe the path of the femoral nerve
L2-L4 to extensors of the knee
describe the path of the obturator nerve
L2-L4 to adductors of the hip
describe the path of the sciatic nerve
L4-S3 and then splits into the tibial and fibular nerve
describe the path of the tibial nerve
L4-S3 to flexors of the knee, plantar flexors and intrinsic flexors of foot
describe the path of the fibular nerve
L4-S2 to dorsiflexors, extensors and evertors of foot
what artery supplies the lateral aspect of the shank
fibular artery
what artery supplies the bottom of the foot
medial plantar artery
what are the two routes of venous supply - what are they for
deep veins to return blood during exercise and superficial for at rest
how is blood returned during exercise?
muscle contractions squeeze deep veins. valves force blood return to heart
describe the fascia lata
encloses thigh muscles, and thickened at the iliotibial tract. (a bit above the knee on a diagram)
describe the deep fascia of the shank
“crural fascia”. divides shank into 3 compartments: anterior, posterior, lateral. (a bit below the knee on a diagram)
what makes up the os coxae?
ilium, ischium, pubis
what fuses at the acetabulum?
the bones of the os coxae (ilium, ischium, pubis)
name the ligaments of the pelvis and what they connect/hold
sacrospinous (sacrum to ischial spine), sacrotuberous (sacrum to ischial tuberosity), sacroiliac (holds the sacroiliac joint), greater sciatic foramen, and lesser sciatic foramen
name the joints of the pelvis
sacroiliac, hip, pubis
describe the sacroiliac joint
a bilateral, SYNOVIAL joint. quite IMMOBILE due to the strong ligaments on the anterior and posterior aspects
describe the pubic symphysis joint
between the left and right pubic rami. a CARTILAGINOUS joint. hyaline cartilage at the ends attached to the bones and in between is a fibrocartilage disc. it is quite IMMOBILE
what is an open book fracture?
separation of pubic symphysis due to child birth or traumatic injury. can lead to infection or hemorrhage
what are the ligaments the help support the hip joint?
iliofemoral, pubofemoral, ischiofemoral (each os foxae bone attached to femoral)
what is the purpose of bursae?
to help cushion ligaments and skin. they crossover bone
differentiate between hip fracture and dislocation
hip fracture is more common in older people. it is due to the pull of iliopsoas on the greater trochanter resulting in external rotation. hip dislocation is due to posterior dislocation which causes traction of the adductor group and results in internal rotation
what is the iliopsoas
muscle which separates ilium from hip joint capsule and reduces friction. it is composed of iliacus and psoas. innervated by the femoral nerve, it causes hip flexion
describe foot drop
due to a hip dislocation. symptoms include inability to dorsiflex and reduced eversion. the foot hangs and plantar is flexed
where does the head of the femur get its blood supply from?
foveal artery (from obturator) and lateral circumflex femoral artery (from femoral artery)
what does a fracture in the femoral neck result in?
avascular necrosis (death of bone tissue)
what are the types of muscles acting on the hip?
gluteals, iliopsoas, deep rotators and thigh muscles which include (hip adductors, flexors, hamstrings)
which compartments are on the anterior aspect of the glutes?
iliopsoas and hip adductors. a bit of the gluteals on the front but most of it is on the posterior aspect. deep rotators are in the middle
what muscle does the inferior gluteal nerve innervate? what is its purpose?
gluteus maximus which is responsible for hip extension and lateral rotation
what muscle does the superior gluteal nerve innervate? what is its purpose?
gluteus medius/minimus which is responsible for hip abduction and medial rotation. tensor fascia latae which is responsible for tense fascia latae
what innervates the deep rotators of the hip?
piriformis, obturator internus, and quadratus femoris are innervated by their respective nerves. obturator nerve innervates everything else
what are the functions of the deep rotators?
lateral rotation of hips, hip abduction, and hip adduction (due to obturator externus)
how would you identify the sciatic nerve
thick nerve below the piriformis. splits into tibial and fibular nerve
what does the sciatic nerve innervate?
hamstrings
which nerves go thru the greater sciatic foramen?
inferior gluteal, superior gluteal, and sciatic
which nerves go thru the lesser sciatic foramen?
pudendal
movement of the lower limb originates at the _____?
hip
what is the anterior compartment of the thigh innervated by?
the extensors are innervated by the femoral nerve
what is the medial compartment of thigh innervated by?
the adductors are innervated by the obturator nerve
what is the posterior compartment of the thigh innervated by?
the flexors are innervated by the sciatic nerve more specifically tibial
what muscles make up the anterior compartment of the thigh?
sartorius, rectus femoris, quadricep femoris (vastus… etc)
what innervates the adductor magnus? where is the adductor magnus?
half by the obturator nerve and other half by tibial nerve. adductor magnus is in the medial compartment
what is pes anserine?
3 muscles: sartorius, gracilis, and semitendinosis which originate from the different bones of the os coxae
what are the boarders of the femoral triangle?
sartorius, inguinal ligament, adductor longus
describe the purpose of the adductor hiatus and subsartorial canal
provides passage for femoral vessels from anterior thigh to popliteal fossa
what does the tibia do?
bear weight
what does the fibula do?
rotational stability! it had not contact with the femur
what separate joints makes up the knee joint?
femorotibial and patellofemoral. they share a joint capsule
describe the functions of the knee
transition zone: connects thigh to shank. standing and locomotion: stability and mobility
what contributes to joint stability/mobility?
shape and arrangement of articulating surfaces, ligaments crossing the joint, and tone of surrounding muscles (aging, injury, etc)
what does a small area of contact mean?
high force of transmission
describe menisci
fibrocartilage shock absorbers that deepen and stabilize articulating surfaces. it protects underlying hyaline cartilage and bones
between which collateral ligament and meniscus is there space between?
the lateral collateral ligament and lateral meniscus
what do collateral ligaments do?
provide mediolateral stabilization
describe cruciate ligaments
crossed on tibial attachment (between condyles)
what does the anterior cruciate ligament do?
if foot planted: prevent femur moving posterior on tibia. if foot free: prevent tibia from moving anterior under femur. both are same movement but with different bones in different direction
what does posterior cruciate ligaments do?
if foot planted: prevent femur from moving anterior on tibia. if foot free: prevent tibia moving posterior under femur
what is an unhappy triad?
tearing of the collateral ligaments and medial meniscus
describe the location of the cruciate ligaments in relation to joints
the anterior and posterior cruciate ligament are inside the knee joint capsule but are extra-synovial (outside synovial membrane)
what “unlocks” the knee from its standing position?
popliteus
from where to where does the popliteus attach to? what is it innervated by?
lateral femoral condyle to posterior tibia. it is innervated by the tibial nerve
what type of bone is the patella?
sesamoid. it is fact the largest sesamoid bone with a tendon
what causes patellar dislocation? what resists it?
due to pull of vastus lateralis. resisted by vastus medialis and lateral femoral condyle
name the knee bursa and what they do
subpatellar (protects patella from femur), prepatellar (protects skin from knee), and superficial/deep infrapatellar (cushion patellar ligaments)
what joint in the knee is responsible for rotational stability?
superior/proximal tibiofibular joint
what are the boarders of the popliteal fossa
semimembranosus, biceps femoris, gastrocnemii (medial and lateral are on the bottom)
what are the contents of the popliteal fossa?
popliteal artery and vein, sciatic nerve
where is popliteal fossa?
back of the knee
what is the anterior compartment of the shank responsible for? what is it innervated by?
ankle dorsiflexion. it is innervated by deep peroneal (fibular) nerve
what are the muscles of the shank’s anterior compartment
tibialis, extensor digitorum longus, extensor hallucis longus
what is the purpose of a retinaculum?
to pin down tendons
what is the lateral compartment of the shank responsible for? what is it innervated by?
ankle eversion. innervated by superficial fibular nerve
what are the muscles of the shank’s lateral compartment
fibularis longus and fibular brevis
from where to where does the fibularis longus go from
from head of fibula to base of the 5th metatarsal
what does the fibular nerve split into? what compartment of the shank do they correspond with?
superficial branch (lateral) and deep branch (anterior)
what is the superficial posterior compartment of the shank responsible for? what is it innervated by?
responsible for plantar flexion, knee flexion, and unlocking knee. it is innervated by the tibial nerve
what is the deep posterior compartment of the shank responsible for? what is it innervated by?
responsible for plantar flexion, inversion, and digit flexion. innervated by tibial nerve
name the muscles of the anterior compartment of the shank
tibialis anterior, extensor digitorum longus, extensor hallucis longus
name the muscles of the lateral compartment of the shank
peroneus (fibularis) longus, peroneus (fibularis) brevis
name the muscles of the deep posterior compartment of the shank
tibialis posterior, flexor digitorum longus, flexor hallucis longis
name the muscles of the superficial posterior compartment of the shank
gastrocs, soleus, plantaris, popliteus
what is a continuation of the adductor hiatus?
popliteal fossa
what is important for articulation at the ankle?
ankle mortise
where is the talocrural joint?
near the ankle mortise, kind of overlaps with it
where is the distal tibiofibular joint?
between the tibia and fibula, it is near the ankle
where is the subtalar joint?
beneath the talus
what type of joint is the distal tibiofibular joint?
syndesmosis. fibrous joint
what holds the distal tibiofibular joint in place?
anterior and posterior tibiofibular ligaments
what is a high ankle sprain? when is there pain why? what causes the high ankle sprain?
tearing of anterior/posterior ligament of the distal tibiofibular joint. pain upon dorsiflexion due to talus spreading ankle mortise. caused by lateral rotation of the foot
what is the purpose of the crural joint?
permits dorsi- and plantar flexion
what ligaments help maintain the crural joint structure?
posterior talofibular, anterior talofibular, calcaneofibular, calcaneonavicular, deltoid
describe an ankle inversion sprain
leads to separation of the crural joint. caused by damage to ligaments
what does the subtalar joint allow for?
it allows for inversion and eversion
what are the 2 compartments of the subtalar joint? what separates these compartments?
at the anterior is the talocalcanealnavicular complex and on the posterior is the talocalcaneal joint. it is separated by the interosseous talocalcaneal ligament
what are the ligaments the hold the subtalar joint in place?
cervical (anterior talocalcaneal), lateral talocalcaneal, medial talocalcaneal, interosseous talocalcaneal
between the tibialis posterior and anterior which one is a flexor? extensor?
tibialis posterior is an extensor. tibialis anterior is a flexor
are the fibularis muscles in the foot extensor? flexor? both?
they are flexors
describe an avulsion on the base of the 5th. causes? symptoms?
caused by when peroneus/fibularis brevis resists movement and pulls the base of the 5th metatarsal bone off. causes pain on lateral aspect and swelling
what does the ventral portion of the spinal cord not innervate?
zygapophyseal joints and muscles of the deep back
describe the size of the posterior (dorsal) ramus and anterior (ventral) ramus?
ventral is much larger as it innervates much more and carries more info
what are the types of deep back muscles?
deep and superficial
what are the superficial deep back muscles?
erector spinae which includes iliocostalis, longissimus, and spinalis. and then the splenius cervicis and splenius capitus
what are the deep deep back muscles?
the transverso spinal group which includes semispinalis, rotatores, and multifidus
what innervates the deep back muscles?
posterior rami of the spinal nerve
what makes up the erector spinous group?
iliocostalis, longissimus, spinalis
what is the purpose of the erector spinous group?
to extend vertebral column and head. laterally flex column
what does the splenius cervicis do?
laterally flexes neck
what does the splenius capitis do?
rotate and extend head
what does the semispinalis capitis of the transverso spinalis group?
head and neck extension
what makes up the transverso spinalis group?
semispinalis captis, multifidus, rotatores
what does the multifidus of the transverso spinalis group?
vertebral extension and stabilization
what does the rotatores of the transverso spinalis group?
vertebral extension and stabilization and rotation
what forms the intervertebral foramen?
superior and inferior notches of the adjacent vertebra
what is the anterior rami referred to as in the thorax? why?
intercostal nerve. bc there is no plexus there
describe the pathway of the intercostal nerves
runs from posterior to anterior alongside the intercostal artery and vein (inferior to rib). vein is directly under rib, followed by artery, and then nerve (VAN)
what type of intercostal muscles are there?
external, internal, and innermost
describe the external intercostal muscles
elevates rubs (inspiration). runs superolateral to inferomedial. like hands in pocket
describe the internal and innermost intercostal muscles
depresses ribs (forced expiration like during a workout). runs superomedial to inferolateral. like hands grabbing collarbone
what does the central tendon of a diaphragm allow for?
contractions to lower the dome, increasing thoracic cavity volume while decreasing abdominal cavity volume
what are the 3 openings in the diaphragm? what are the openings innervated by?
caval opening (T8), esophageal hiatus (T10), aortic hiatus (T12) CEA
what innervates the diaphragm?
phrenic nerve
name the abdominal muscles superficial to deep. and describe their “paths”.
external oblique (“hands in pocket”). internal oblique (hands grabbing collar). rectus abdominus (up and down). transversus abdominus (left to right). EIRT
which abdominal muscle is responsible for compression of the abdomen?
all 4: external oblique, internal oblique, rectus abdominus, tranversus abdominus
which abdominal muscle is responsible for flexing vertebral column?
external, internal, rectus
which abdominal muscle is responsible for rotation of vertebral column and lateral bending?
external and internal oblique
what ligament runs from hip to pubic symphysis
inguinal ligament
what is diastasis recti? when is it common?
separation of fascia at linea alba. common during/following pregnancy
what increases volume when breathing?
inspiration with the use of the diaphragm and external intercostals
what is muscle function dependent on?
angle of insertion and joints crossed
what do arteries do?
carry blood away from heart
what do veins do?
carry blood to heart
describe the pressure and walls in arteries and veins
arteries has thick wall to deal with HIGH pressure. veins have thin walls to deal with LOW pressure
where does diffusion happen in the cardiovascular system?
capillaries
what are arterioles?
small arteries that regulate blood flow into the capillary network. they can redirect blood flow thru vasoconstriction and vasodilation
what are venules?
drain capillary blood but the smaller ones are also a site for diffusion. they can hold lots of blood
what is a venous sinus? where are they?
drains venous blood back to heart or other veins. exists in the brain or heart
what is an anastomoses?
union of 2 or more arterial branches supplying the same area. collateral blood supply for important areas such as the circle of willis in the brain
describe the blood flow from the heart
heart, arteries, arterioles, capillaries, venules, veins/sinus, back to heart
what is varicose veins? caused by what?
occurs when valves promote unidirectional flow back to the heart. caused by retrograde flow from valves not being able to close properly
describe the deep palmar arch
an anastomosis in the hand. radial artery to ulnar artery RU
describe the superficial palmar arch
an anastomosis in the hand. ulnar artery to radial artery. UR
where does blood supply to the right upper limb begin? for the left? why is it different?
right: brachiocephalic trunk. left: subclavian artery. different due to 3 vessels coming out of the arch of aorta
which type of vein delivers blood at rest? during exercise?
superficial vein returns blood during rest. and deep returns during exercise
how do deep veins return blood to the heart?
thru muscle contractions which squeeze the deep veins. valves force blood return to the heart stopping retrogade flow
what are the thoracic cavities?
superior mediastinum, middle mediastinum, anterior mediastinum, posterior mediastinum, left and right pleural cavities (6 IN TOTAL)
what does the superior mediastinum contain?
superior vena cava, brachiocephalic veins, arch of aorta, trachea, esophagus
what does the middle mediastinum contain?
heart, pericardium (covers the heart), great vessel roots (superior vena cava, ascending aorta, pulmonary trunk)
what does the posterior mediastinum contain?
descending thoracic aorta, esophagus, vagus nerve, sympathetic trunk
what does the anterior mediastinum contain?
connective tissue, thymus gland (goes away after puberty)
what do the pleural cavities contain?
lungs, pleura, hilum
where is the hilum? whats in it?
it is the connection between the lungs and heart. it contains pulmonary arteries, veins, and bronchi
describe the thickness walls of the heart and why they are like that
right walls are thin because they only pump blood to lungs. left walls are much thicker because they pump blood further with more pressure
which is more superior? atriums or ventricles?
atriums on top.
what are the types of circulation?
pulmonary (lungs), systemic (body), coronary (itself).
what part of the heart receives deoxygenated blood from the body?
right atrium
what part of the heart receives oxygenated blood from the lungs?
left atrium
what part of the heart pumps blood to rest of body?
LEFT ventricle
what part of the heart collects blood to transfer to the lung?
RIGHT ventricle
what is an interventricular sulcus?
pocket of fat on the heart’s outer layer containing arteries, vessels, and nervers
how does blood enter the heart from the body? (thru what?) what side are these parts on?
superior vena cava, inferior vena cava, and cardiac sinus. all are on the right side (right atrium)
what does blood go thru to lungs?
pulmonary trunk and arteries
how does blood enter the heart from the lungs? (thru what?) what side are these parts on?
pulmonary veins. they are on the left side (left atrium)
how does blood leave the heart to the body? (what does it go thru)
aortic arch
what muscle is important for contraction in the atria?
pectinate
what muscle is important for contraction in the ventricle?
trabeculae carnae
what valve is between the right atrium and ventricle?
tricuspid
what valve is between the left atrium and ventricle?
mitral
what are the semilunar valves?
aortic and pulmonary
what are the atrioventricular valves?
tricuspid and bicuspid/mitral
what contains oxygenated blood?
veins and the left side of the heart
what contains deoxygenated blood?
arteries and the right side of the heart
what is heart failure?
when heart muscle doesnt pump as well as it should causing a decrease in oxygen/nutrient delivery. the left side is usually impaired, with time the right side will be impaired as well
what is the pericardium?
3 layered sac (fibrous, parietal, visceral) in which the heart resides
what veins are in the coronary sinus?
great cardiac, left posterior ventricular, left marginal, middle cardiac, small cardiac, anterior cardiac
where does the coronary sinus drain into?
right atrium along with the anterior cardiac vein
what is a heart attack?
disruption to coronary blood flow. caused by atherosclerosis which is a narrowing of lumen due to plaque deposits on the vessel wall. NOT THE SAME AS CARDIAC ARREST
what is angina?
temporary disruption in coronary blood flow
describe cardiac muscles
striated, involuntary muscle found within the heart. contains same contractile filament as skeletal muscle
what are the types of cardiomyocytes?
pacemaker and non-pacemaker cells
describe pacemaker cells
cardiomyocytes which spontaneously contract (depolarize).
where are pacemaker cells found?
found in the SA node, AV node, bundle of His, purkinje fibers
describe non pacemaker cells
cardiomyocytes that from most of the heart. basic contractile myocytes. depolarization caused by adjacent cells depolarizing
what is a syncytium?
network of cardiomyocytes connected by intercalated discs
what allows the atria to contract before ventricular contraction?
the heart having separate syncytium: ventricular syncytium and atrial syncytium
differentiate between neuronal and cardiomyocyte’s depolarization
neuronal is much faster at 1ms while cardiomyocytes are 200-400ms (pacemakers being much slower)
what causes depolarization in myocytes?
sodium and calcium
describe the refractory period
when cell cant be re-excited. limits firing rate
what is the SA node? where?
“pacemaker”. origin of cardiac impulses. it is above the right atrium
where is the rate of depolarization the greatest in the cardiovascular system?
SA node
what is the AV node? where is it?
electrically connects atria and ventricles with the bundle of His. below the right atrium
what slows the SA node signal?
AV node
how does the electrocardiogram (ECG) work?
electrodes pick up electrical impulses when cardiomyocytes depolarize/repolarize
what is a P wave?
atrial depolarization
what is QRS wave?
ventricular depolarization
what is T wave?
ventricular repolarization
what is the order in a ECG recording? (the letter waves)
P QRS T
when is atrial depolarization?
in QRS wave but it has a weak signal. before the ventricular contraction
list in order when the valves open and close
mitral valve closes, aortic valve opens, aortic valve closes, mitral valve opens
what causes the heart sounds?
first sound (S1): mitral valve closing. second sound (S2): aortic valve closing
list in order, the steps of the cardiac cycle
- atrial systole. 2. isovolumetric contraction. 3. rapid ejection. 4. reduced ejection. 5. isovolumetric relaxation. 6. rapid filling. 7. reduced filling.
what happens in atrial systole?
atria contracts. ventricles in diastole. blood pushed into ventricles. QRS complex starts at end
what are the two phases of the cardiac cycle?
systole: ventricular contraction. diastole: ventricular relaxation
what happens in isovolumetric contraction?
atria relaxes. ventricles contract (systole). no blood ejected. QRS complex starts
what happens in rapid ejection?
aortic and pulmonary valves open. blood rushes into aorta and pulmonary trunk. ventricle contracts, increasing pressure
what happens in reduced ejection?
pressure decrease in aorta. pressure in atria rises as it slowly fills up with blood. T wave starts (ventricular repolarization)
what happens in isovolumetric relaxation?
semilunar valve (aortic) closes. ventricle enters diastole. av valves closed so volume in ventricle doesnt change
what happens in rapid filling?
pressure in atria exceeds ventricle’s. av valve opens. blood moves into ventricle from atria
what happens in reduced filling?
blood flows into heart from vena cava and pulmonary arteries. av valve open. p-wave starts, triggering atrial contraction
what are the functional divisions of the respiratory system?
conducting and respiratory
what does the conducting division of the respiratory system contain?
nasal cavities to terminal bronchioles
what does the respiratory division of the respiratory system contain?
respiratory bronchioles to alveoli
what does the upper division of the respiratory system contain?
nose and pharynx
what does the lower division of the respiratory system contain?
larynx, trachea, bronchioles, alveoli
what are the structural divisions of the respiratory system?
upper and lower
what are the parts of the pharynx?
naso, oro, laryngo
where is the cribriform plate?
at the top of the nasal cavity. it is part of the skull
what are the mucous linings on the nasal cavity?
olfactory (on the cribriform plate) and respiratory
what connects the nasal cavity to the larynx?
pharynx
describe the 3 sections of the pharynx (what goes thru it)
nasophraynx (air only). oropharynx (air and food). laryngopharynx (divides air and food)
what are the functions of the larynx?
prevents food from entering trachea. permits air. produces vocals
what are the 9 cartilages of the larynx?
thyroid, cricoid, epiglottis, arytenoid, cuneiform, corniculate
which of the 9 cartilages of the larynx are in pairs?
arytenoid, cuneiform, corniculate
where is the vestibular fold?
above vocal folds
where does the trachea divide into primary bronchi?
carina
differentiate between left and right primary bronchi. sizes and amount of lobes
left is longer and more wider. right is shorter but goes vertical. left has 2 lobes and right has 3
list the path of the respiratory zone
tertiary bronchiole, respiratory bronchiole, alveolar duct, alveoli
what are the two types of alveoli cells. differentiate between them
type 1 pneumocytes are long and flat. make up walls of alveoli and interface with pulmonary cavities. type 2 pneumocytes are cuboidal. they secrete surfactant to reduce surface tension. allows alveoli to remain popped open
what are the surfaces of the lung?
costal surface, diaphragmatic surface, mediastinal surface (aka hilum)
how many fissures does the right lung have? name them
2 (for 3 lobes): oblique and horizontal
how many fissures does the left lung have? name them
1 (for 2 lobes): oblique
which lung has a lingula?
left
describe the pulmonary ligament
double layer of pleura from visceral to parietal
what is the outer layer of the pleural cavity? inner layer?
outer layer: parietal. inner layer: visceral
what is the relationship between alveolar pressure and atmospheric pressure?
alveolar pressure = atmospheric pressure
when the thoracic cage expands…? (pressure)
parietal pleura expands too, decreasing intrapleural pressure. lung expands decreasing alveolar pressure
what is pneumothorax?
when air exists in the thorax (it shouldnt be there!). caused by a puncture to pleural membrane
what to note about the pressure and resistance of bronchial (systemic) circulation?
high pressure and high resistance
what to note about the pressure and resistance of pulmonary circulation in the lungs?
low pressure and low resistance
whats the goal of bronchial (systemic) circulation?
perfuse lung tissue
what are the 3 zones in order oxygen must pass thru?
alveoli, fused basement membrane, pulmonary capillary
what are the 3 zones in order carbon dioxide must pass thru?
pulmonary capillary, fused basement membrane, alveoli
what is ventilation?
air in alveoli
what is perfusion?
blood flow thru capillaries
what is gas exchange dependent on?
V/Q: alveolar ventilation/cardiac output (perfusion)
what is shunt?
perfusion but no ventilation
what is dead space?
ventilation but no perfusion
what is pulmonary edema?
leads to shunt. swelling and leaking of pulmonary capillaries caused fluid to accumulate and increases pressure in interstitium
