regional gross anatomy 2 Flashcards
1
Q
how many vertebrae are in the cervical region?
A
7
2
Q
how many vertebrae are in the thoracic region?
A
12
3
Q
how many vertebrae are in the lumbar region?
A
5
4
Q
how many vertebrae are in the sacral region?
A
5 fused vertebrae that form the sacrum
5
Q
how many vertebrae are in the coccygeal region?
A
3-5 fused vertebrae that form the coccyx
6
Q
what is a primary curvature of the spine?
A
a curvature the same as seen in development
kyphotic curvature
7
Q
what is a secondary curvature?
A
develops after birth as the foetus extends from the flexed foetal position
lordotic curvature
8
Q
what are the 4 principal curvatures of the spine?
A
cervical lordosis
thoracic kyphosis
lumbar lordosis
sacral kyphosis
9
Q
what are lateral curvatures of the spine called?
A
scoliosis
10
Q
what is a postural curvature of the spine?
A
disappears when posture is corrected e.g. sitting over a desk
11
Q
what is a pathological curvature of the spine?
A
never resolves
12
Q
how is the vertebral arch connected to the body of the vertebra?
A
by the pedicle on either side
13
Q
what do the 2 pedicles form?
A
the laminae
14
Q
what is the spinous process composed of?
A
the laminae uniting in the midline
15
Q
where is the spinal cord found and how is this space formed?
A
found in the vertebral foramen
vertebral foramen formed by the space between the body of the vertebra and the vertebral arch
16
Q
what makes C1 / atlas atypical?
A
no body or spinous processes
17
Q
what makes C2 / axis atypical?
A
dens / odontoid process that projects up from the body
18
Q
what is the unique feature of the spinous process in the cervical vertebrae?
A
it is bifid so as it reaches the distal end it splits in 2
19
Q
what is the unique feature of the thoracic vertebrae?
A
there are costal facets for the articulations w/ the ribs
20
Q
what is the shape of the body of the lumbar vertebrae?
A
massive kidney shaped body
21
Q
what is the unique feature of the transverse processes of the lumbar vertebrae?
A
there are accessory processes on the transverse processes
22
Q
what type of joints are found between vertebral bodies?
A
secondary cartilaginous
23
Q
what type of joints are found between articular processes?
A
synovial plane joints
24
Q
what type of joints are found between articular processes?
A
synovial plane joints
25
what are the joints between articular processes called?
zygapophyseal joints
26
what are the 2 distinct components of the IV disc?
annulus fibrosis around the margin
nucleus pulposus in the middle
27
what is the function of the nucleus pulpous?
allows the IV disc to change shape and accommodate movements of the vertebral column
28
what are the superficial muscles of the back?
trapezius
latissimus dorsi
rhomboid major
rhomboid minor
levator scapulae
29
where does trapezius attach?
nuchal ligament
spinous processes from C7-T12
30
what is the function of trapezius?
acts to rotate the scapula
31
what innervates trapezius?
spinal accessory nerve (CN11)
32
where does latissimus dorsi attach?
to the spinous processes of T7-T12
33
what innervates latissimus dorsi?
thoracodorsal nerve (C6-C8) - from brachial plexus
34
where does rhomboid major lie in relation to rhomboid minor?
inferior to rhomboid minor
35
where does rhomboid major attach?
spinous processes of T2-T5
36
what innervates rhomboid major and minor?
dorsal scapular nerve (C4,5)
37
what is the function of both rhomboid muscles?
both act to retract the scapula (pull it closer to the midline)
38
where does rhomboid minor attach?
nuchal ligament and spinous processes of C7-T1
39
where does levator scapulae attach?
to the posterior tubercles of transverse processes of C1-C4
40
what is the function of levator scapulae?
raise the scapula
41
what innervates levator scapulae?
cervical spinal nerves C3,4 and dorsal scapular nerve C4,5
42
what are the intermediate extrinsic muscles?
serratus posterior superior
serratus posterior inferior
43
where does serrates posterior superior attach?
to the nuchal ligament and spinous processes of C7-T3
44
where does serrates posterior inferior attach?
to the spinal processes of T11-L2
45
what is serratus posterior superior innervated by?
intercostal nerves 2-5
46
what is the function of serratus posterior superior?
assist in raising the upper ribs
47
what is the function of serratus posterior inferior?
assist in lowering the lower ribs
48
what is the innervation of serratus posterior inferior?
anterior rami of T9-T12
49
what are the intrinsic muscles of the back?
the deep back muscles (muscles of the back proper)
50
what is the function of the intrinsic muscles of the back?
to maintain posture and control the movement of the vertebral column
51
how are the intrinsic muscles of the back divided?
superficial layer
intermediate layer
deep layer
52
what is the superficial layer of the intrinsic muscles of the back?
only found in the cervical region
contains splenius muscles
53
what is the intermediate layer of the intrinsic muscles of the back?
run the entire length of the back
erector spinae group
54
what is the deep layer of the intrinsic muscles of the back?
many small muscles
55
what are the 2 splenius muscles?
splenius captius and splenius cervicus
56
where do the splenius muscles attach?
along the nuchal ligament and to the spinous processes of C7-T3/4
57
where do splenius captius fibres attach?
to the mastoid process and to the lateral 1/3rd of the superior nuchal line of the skull
58
where do splenius crevicis fibres attach?
transverse processes of C1-C3/4
59
what are the 3 muscles that make up the erector spinae group / intermediate muscles intrinsic muscles of the back?
iliocostalis
longissimus
spinalis
60
what are the 3 parts that iliocostalis is broken down into?
lumborum
thoracis
cervicus
61
what are the 3 parts that longissimus is broken down into?
thoracis
cervicus
capitis
62
what are the 3 parts that spinalis is broken down into?
thoracis
cervicus
capitis
63
what are the muscles of the deep intrinsic muscles of the back?
semispinalis
multifidus
rotatores
levato costarum
interspinale
intertransversearii
64
what are the 3 parts that semispinalis is broken into?
thoracis
cervicus
capitis
65
what is the function of levator costarum?
assists in raising the ribs
66
where are intertransversarii muscles found?
in between transverse processes
67
what are the intrinsic muscles of the back covered by?
thoracolumbar fascia
68
what are the 2 ligaments of the vertebral arch?
anterior longitudinal ligament
posterior longitudinal ligament
69
where does the anterior longitudinal ligament run from / to?
from the base of the skull down to the sacrum
70
what is the function of the anterior longitudinal ligament?
limit extension of the vertebral column
71
where does the posterior longitudinal ligament run from / to?
from C2 to the sacrum
72
what is the main function of the posterior longitudinal ligament?
to prevent posterior herniation of the IV disc into the vertebral canal?
73
where does the ligamentum flavum run?
connecting laminae of adjacent vertebrae
74
what are the 3 functions of ligamentum flavum?
help maintain the curvatures of the spine
reinforce the wall of the vertebral canal posteriorly
limit flexion
75
what do interspinous ligaments connect?
adjacent spinous processes
76
what is the supraspinous ligament continuous with superiorly?
the nuchal ligament
77
what is the function of the supraspinous ligament?
helps limit flexion of the vertebral column
78
what do inter transverse ligaments connect?
adjacent transverse processes
78
what is the nuchal ligament?
a broad ligament important in the site of muscle attachment and also limits flexion
79
explain the course of the spinal cord?
begins at the foramen magnum and ends at L1/2
79
what is the medullary cone?
the narrowing of the spinal cord as it reaches its caudal end
80
what are the 2 enlargements of the spinal cord?
cervical enlargement - C4-T1
lumbosacral enlargement - L1-S3
81
nerves asssoc w/ what area of body leave the spinal cord at the cervical enlargement?
nerves assoc w/ the upper limb
82
nerves assoc w/ what area of the body leave the spinal cord at the lumbosacral enlargement?
nerves assoc w/ the lower limb
83
how are cervical spinal nerves named and what is the exception to this rule?
named based on the vertebrae below
except C8 - there is no C8 vertebrae and so spinal nerve C8 emerges below C7
84
below C8 how are the spinal nerves named?
of the vertebra of the same number
85
what is the caudal equina?
a collection of spinal nerves that run below the end of the spinal cord
86
what is the filum terminale?
the remnant of the caudal part of the spinal cord composed of coverings of the cord (esp Pia mater)
87
what are the 2 spinal meninges?
dura mater
arachnoid mater
pia mater
88
what is the dural root sheath?
the dural covering of the initial part of the spinal nerves
89
what are the features of dura mater?
tough outer protective covering
90
how is the dura mater attached to the coccyx?
via the hilum terminale
91
where is the epidural space between?
the bone of the vertebrae and the dura mater
92
what is the epidural space filled w/?
epidural fat
93
what are the features of the arachnoid mater?
delicate membrane lining the dura
lies directly on the dura
94
what is the subarachnoid space?
the space between the arachnoid mater and the pia mater
95
what is found in the subarachnoid space?
CSF
96
what is the lumbar cistern?
enlargement of the subarachnoid space around the conus medullaris at L2-S2
97
what are arachnoid trabeculae?
extension of the arachnoid mater that connect the arachnoid mater to the deep pia mater
98
what is the pia mater?
a thin layer closely assoc w/ the spinal cord
99
what are the denticulate ligaments?
extensions that form on the lateral sides of the pia mater
100
what are the 3 vessels that provide arterial supply to the spinal cord?
1 anterior spinal artery
2 posterior spinal arteries
101
what are the smaller arteries that supply the nerve roots called?
radicular arteries
102
describe the venous drainage of the spinal cord
3 anterior spinal veins
3 posterior spinal veins
103
what are the smaller veins that drain the nerve roots called?
radicular veins
104
where is the vertebral venous plexus found?
in the epidural space
105
what are the bones of the pectoral girdle and glenohumeral joint?
scapula
clavicle
humerus
106
what are the features of the shoulder joint?
high range of mobility
low stability
107
where do all rotator uff muscles except subscapularis insert?
into the greater tubercle
108
where does subscapularis insert?
into the lesser tubercle
109
what creates the bicipital groove?
the tendon of the long head of biceps brachii
110
where does the clavicle pass between?
the sternum and the scapula
111
what type of joint is the glemohumeral joint?
a synovial ball and socket joint
112
blood supply to the glenohumeral joint is from where?
subclavian artery
113
where does the subclavian artery become the axillary artery?
as it emerges from beneath the clavicle and passes over the surface of the first rib
114
which 2 things pass through the quadrangular space?
axillary nerve
posterior circumflex humeral artery
115
which 2 things pass through the triangular space?
radial nerve
profunda brachii artery (aka deep brachial artery)
116
in relation to the glenohumeral joint, what are the 2 functions of pectorals major?
flexion of the arm
adduction of the arm
117
what is the innervation of pectoralis major?
median pectoral nerve (C8-T1)
lateral pectoral nerve (C5-7)
118
in relation to the glenohumeral joint, what are the 2 functions of pectoralis minor?
pull scapula forwards
stabilise the shoulder in movement of the upper limb
119
what is the innervation of pectoralis minor?
median pectoral nerve (C8-T1)
120
what is the function of serratus anterior?
protraction of the scapula (move the scapula away from the midline)
121
what is the innervation of serratus anterior?
long thoracic nerve (C5,6,7)
122
what are the 3 functions of trapezius?
elevate the scapula
depress the scapula
retract the scapula
123
what is the motor innervation of trapezius?
spinal accessory nerve (CN11)
124
what is the innervation of latissimus dorsi?
thoracodorsal nerve (C6-8)
125
what are the 2 functions of levator scapulae?
raise the scapula
lateral flexion of the neck
126
what is the innervation of levator scapulae?
dorsal scapular nerve (C3,4,5)
127
explain abduction of the arm
the first 10 degrees are carried out by supraspinatus (one of the rotator cuff muscles)
the remaining 110 degrees is carried out by the deltoid muscle (mainly the middle fibres)
128
what is the common insertion point of the deltoid?
the deltoid tuberosity of the humerus (all the deltoid fibres come together here)
129
what is the function of the deltoid fibres that attach at the clavicle?
flex the arm
130
what is the function of the deltoid fibres that attach at the spine of the scapula?
extend the arm
131
what innervates the deltoid muscle?
the axilllary nerve (C5,6)
132
where is the cephalic vein found?
in a small groove that sits between the deltoid muscle and the pectoralis major muscle (deltopectoral groove)
133
is teres major part of the rotator cuff?
no
134
where in relation to teres minor does teres major attach on the scapula?
inferior to teres minor
135
what is the function of teres major?
draw the arm closer to the body
136
what is the innervation of teres major?
subscapular branch of posterior cord of brachial plexus (C5,6)
137
where does subclavicus lie?
between the undersurface of the clavicle and the first rib
138
what is the innervation of subclavicus?
nerve to subclavicus (C5,6)
139
what is the main function of the rotator cuff?
prevent dislocation of the humeral head from the glenoid fossa
140
where is the most common shoulder dislocation and why?
anterior inferior
because the rotator cuff covers the joint capsule except at the most inferior aspect where a small gap remains and so the most common dislocation is through this gap
141
what is the only rotator cuff muscle that lies on the anterior surface of the scapula?
subscapularis
all other rotator cuff muscles lie on the posterior surface
142
what is the only rotator cuff muscle that attaches to the lesser tubercle of the humerus?
subscapularis
all other rotator cuff muscles attach to the greater tubercle
143
what is the function of subscapularis?
medially rotate the arm
144
what innervates supraspinatus and infraspinatus?
supraclavicular nerve (C5,6)
145
where does supraspinatus sit?
in the supraspinous fossa of the scapula
146
where does infraspinatus sit?
in the infraspinous fossa of the scapula
147
what innervates teres minor?
axillary nerve (C5,6)
148
which muscle is enclosed in the clavipectoral fascia?
pectorlais minor
149
where does the clavipectoral fascia run from / to?
runs from the clavicle to blend w/ the fascia in the floor of the axilla
150
which 3 structures pierce the clavipectoral fascia?
cephalic vein - as it enters the axilla to join the axillary vein
thoracoacromial artery - as it leaves the axilla to supply the body wall
lateral pectoral nerve - as it leaves the axilla to supply pectoralis minor w/ motor innervation
151
when does the axillary vein become the axillary vein?
when it crosses the inferior margin of teres major
152
when does the subclavian artery become the axillary artery?
when it crosses the lateral border of the first rib
153
when does the axillary artery become the brachial artery?
as it passes over the inferior border of teres major
154
how many branches of the first part of the axillary artery are there and what are they?
1 - superior thoracic artery
155
how many branches of the second part of the axillary artery are there and what are they?
2 - thoracoacromial artery and lateral thoracic artery
156
how many branches of the third part of the axillary artery are there and what are they?
3 - sub scapular artery, anterior circumflex humeral artery and posterior humeral artery
157
what are the 5 groups of axillary lymph nodes?
humeral
pectoral
subscapular
central apical
158
where does the brachial plexus lie?
in the axilla
159
where do the fibres of the brachial plexus originate from?
C5-T1 nerve roots
160
what are the nerve roots of the superior trunk of the brachial plexus?
C5 and C6
161
what is the nerve root for the middle trunk pf the brachial plexus?
C7
162
what are the nerve roots of the inferior trunk of the brachial plexus?
C8 and T1
163
do the middle and inferior trunks of the brachial plexus give rise to nerves
no
164
C5 root of the brachial plexus along with C3 and C4 give rise to what nerve?
the phrenic nerve
165
what component of the thoracodorsal nerve originates from the brachial plexus?
C5
166
which nerve is derived directly from C5-7 of the brachial plexus?
the long thoracic nerve
167
name 3 terminal branches of the anterior division of the brachial plexus?
musculocutaneous, median and ulnar nerve
168
name 1 terminal branch of the posterior division of the brachial plexus?
the radial nerve
169
the lateral cord of the brachial plexus contains fibres from which nerve roots?
C5-7
170
the lateral cord of the brachial plexus is derived from which trunks?
superior and middle trunks
171
the posterior cord of the brachial plexus contains fibres from which nerve roots?
C5-T1
172
the posterior cord of the brachial plexus is derived from where?
the posterior divisions from all trunks
173
the medial cord of the brachial plexus contains fibres from which nerve roots?
C8-T1
174
the medial cord of the brachial plexus is a continuation of which trunk?
the inferior trunk
175
what is the branch of the lateral cord?
the lateral pectoral nerve
176
explain the course of the lateral cord of the brachial plexus
it gives off the lateral pectoral nerve before continuing onto become the musculocutaneous nerve and then gives its contribution to the median nerve
177
explain the course of the posterior cord of the brachial plexus
it forms the subscapualr nerve and the thoracodorsal nerve before forming its terminal branches of the axillary nerve and the radial nerve
178
explain the course of the medial cord of the brachial plexus
it gives off the medial pectoral nerve and 2 cutaneous nerves to the arm before forming the ulnar nerve and giving its contribution to the median nerve
179
the median nerve is formed from which 2 cords?
the medial cord and the lateral cord
180
what compartment of the arm and forearm is the extensor compartment?
the posterior compartment
181
what compartment of the arm and forearm is the flexor compartment?
the anterior compartment
182
what is the innervation of the anterior compartment of the forearm?
musculocutaneous nerve (C5-7)
183
what are the 3 muscles of the anterior compartment of the forearm?
biceps brachii
coracobrachialis
brachialis
184
where does the short head of biceps brachii originate from?
coracoid process of the scapula
185
where does the long head of biceps brachii originate from?
supraglenoid fossa of the scapula
186
where does the tendon of biceos brachii insert?
onto the radial tuberosity
187
what are the 2 functions of biceps brachii?
supination of the forearm - it is the most powerful supinator of the forearm
flexion of the elbow
188
what is the innervation of biceps brachii?
the musculocutaneous nerve
189
where does coracobrachialis originate from?
the coracoid process of the scapula
190
which 2 things origionate from the coracoid process of the scapula?
the short head of biceps brachii
coracobrachialis
191
where does coracobrachialis insert?
into the medial aspect of the shaft of the humerus
192
what is the innervation of corachobrachialis?
the musculocutaneous nerve
193
what are the 2 functions of corachobrachialis?
flexion of the arm
adduction of the arm
194
where does brachialis originate from?
the humerus
195
where does brachialis insert?
onto the ulnar tuberosity
196
what is the main function of brachialis?
flexion of the elbow - it is the workhorse in flexion of the elbow
197
explain the innervation of brachialis
mainly innervated by musculocuatneous nerve but a small component innervated by the radial nerve
198
what muscle fills the extensor compartment of the arm?
triceps brachii
199
what are the 3 heads of triceps brachii?
long head
lateral head
medial head
200
where doe the long head of triceps brachii origionate?
from the infraglenoid tubercle of the scapula
201
where do the lateral and medial heads of triceps brachii origionate?
the humerus
202
where do all 3 heads of triceps brachii insert?
into olecranon process of the ulna via a common tendon
203
what is the innervation of triceps brachii?
radial nerve
204
what is the function of triceps brachii?
extension of the elbow joint
205
what are the 3 anastomaosis between the radial and ulnar arteries?
deep carpal arch
deep palmar arch
superficial palmar
206
where is the common flexor origin?
medial epicondyle of the humerus
207
where is the common extensor origin?
lateral epidoncdule of the humerus
208
what articulations form the elbow joint?
the rounded capitulum of the humerus and the head of the radius with the trochlea of the humerus and ulna
209
the posterior surface of the humerus provides attachment for which 2 muscles?
triceps brachia and anconaeus
210
what is the cubital fossa?
a depression on the anterior surface of the elbow joint
211
what forms the floor of the cubital fossa?
brachialis
212
what forms the lateral boundary of the cubital fossa?
brachioradialis
213
what forms the medial boundary of the cubital fossa?
pronator teres
214
at the cubital fossa there is communication between which 2 veins?
cephalic and basilic
215
what is the median cubital vein?
the connecting vein between the cephalic and basilic vein at the cubital fossa
216
what are the 3 structures found in the cubital fossa?
median vein
bifurcation of the brachial artery into radial and ulnar arteries
tendon of triceps
217
explain the relationship between the radial nerve and the cubital fossa
the radial nerve is not in the cubtual fossa but near the lateral boundary as it lies beneath brachioradialis
218
what type of joint is the elbow joint?
a synovial hinge joint
219
what are the 3 bones present at the elbow joint?
humerus
radius
ulna
220
which 2 movements are possible at the elbow joint?
flexion and extension
221
where in relation to the elbow joint does the ulnar nerve pass to reach the anterior compartment of the forearm?
ulnar nerve passes to the medial side of the elbow joint
222
where in relation to the elbow joint does the radial nerve pass to reach the posterior compartment of the forearm?
radial nerve passes to the lateral side of the elbow joint
223
which ligaments prevent abduction and adduction of the elbow joint?
medial and lateral collateral ligaments
224
what are the 2 bones of the forearm?
radius and ulna
225
what is the function of the anterior compartment of the forearm?
flexion
226
what nerve supplies (nearly) all muscles in the anterior compartment?
the median nerve
227
which 2 muscles of the anterior compartment of the forearm are not supplied by the medial nerve and what nerve are these supplied by?
flexor capi ulnaris
medial side of flexor digitorm profundus
supplied by the ulnar nerve
228
which muscle of the anterior compartment of the forearm is not present in everyone?
palmaris longus
229
where does palmaris longus originate from?
the medial epicondyle of the humerus (common flexor origin)
230
what is the function of palmaris longus?
tightens the palmar aponeurosis
231
where is the insertion point of palmaris longus?
the palmar aponeurosis
232
what is the function of pronator teres?
pronation of the forearm
233
where do the 2 heads of pronator teres originate from?
one from the humerus and one from the ulna
234
where does pronator teres insert?
lateral surface of the radius
235
what is the innervation of pronator teres?
median nerve
236
what is the function of flexor carpi ulnaris and flexor carpi radialis?
flexion of the wrist
237
what is the innervation of flexor carpi ulnaris?
ulnar nerve
238
what is the innervation of flexor carpi radialis?
median nerve
239
what is the function of flexor digitorum superficialis?
flexor the MCP and PIP joints
240
what innervates flexor digitorum superficiais?
median nerve
241
what is the function of flexor digitorum profundus?
flexion of all of the joint in the fingers:
- MCP
- DIP
- PIP
242
where does flexor digitorum originate from?
the ulna and interosseous membrane
243
explain the innervation of flexor digitorum profundus?
medial side is innervated by the ulnar nerve and these are the tendons that go to the ring and little finger
lateral side is innervated by the median nerve and these are the tendons that go to the index and middle finger
244
what is the function of flexor pollicus longus?
flexor of the thumb
245
what is the innervation of flexor polices longus?
anterior interosseous branch of the median nerve
246
where does pronator quadratus lie?
deep in the anterior forearm close to the wrist
247
what is the function of pronator quadratus?
pronate the forearm
248
what is the innervation of pronator quadratus?
anterior interosseous branch of median nerve
249
what are the 5 structures that pass through the carpal tunnel?
tendons of flexor digitorum suprficialis
tendons of flexor digitorum profunuds
tendon of flexor pollicis longus
tendon of flexor carpi ulnaris
median nerve
