session 3: neck/abdo/face/back Flashcards
1
Q
how many vertebrae are there in total?
A
24
2
Q
how many cervical vertebra are there?
A
7
3
Q
how many thoracic vertebra are there?
A
12
4
Q
how many lumbar vertebra are there?
A
5
5
Q
how many vertebra does the sacrum consist of?
A
5, fused
6
Q
how many vertebra does the coccyx consist of?
A
3/4 small segments, fused
7
Q
what does C1 articulate with?
A
skull and C2
8
Q
what do the thoracic vertebra articulate with?
A
ribs
9
Q
what does the sacrum articulate with to form?
A
hip bones
pelvis
10
Q
in which direction does the spine curve?
A
lower cervical forward
throacic back
lumbar forward
sacrum sharply backward
11
Q
what does the neural arch of the vertebra enclose?
A
the spinal cord
12
Q
what forms the vertebral canal and what is it for?
A
series of vertebral foramen
spinal cord
13
Q
where do the spinal nerves emerge from the vertebrae?
A
intervertebral foramen
14
Q
what are the projections from the neural arch/
A
spinous in midline
transverse processes either side
15
Q
how many articular processes are there from the neural arch and what is their role?
A
4, 2 above and 2 below. interlock with adjacent vertebrae forming a synovial joint
16
Q
what are the features of the cervical vertebrae/
A
small body upper and lower surface of the body is saddle curved large triangular vertebral foramen neural arch mainly laminae short pedicles spinous process short and double point
17
Q
which way do the articular facets face in the cervical vertebra?
A
upper: up and inward
lower: down and forward
18
Q
what is the C1 vertebra called?
A
atlas
19
Q
give some features of the atlas.
A
no vertebral body or spinous process
lateral masses connected by anterior and posterior arch
20
Q
what is the C2 vertebra called?
A
axis
21
Q
give some features of the axis.
A
dens=odontoid process=extends superiorly from anterior portion
22
Q
where are the antlanto-axial joints?
A
medial: anterior arch C1 and dens of axis
2 lateral: inferior articular facets atlas and superior articular facets axis
23
Q
which cervical vertebra is most prominent?
A
C7-long spinous process with a single point
24
Q
which vertebrae are the most mobile and why?
A
cervical
curved bodies and shallow articular processes
25
what movements occur in the cervical vertebra/
flexion, extension, lateral flexion, rotation (mainly between atlas and axis)
26
give some features of the thoracic vertebra.
body gets bigger as go down
transverse processes point sideways
spinous processes point down
articular processes almost verticle
27
where do thoracic vertebra articulate with ribs?
end of transverse process and where pedicle meets body
28
what movements occur in the thoracic vertebra.
little movement due to ribs and spinous processes overlap
| forward flexion, lateral flexion, rotation
29
give some features of the lumbar vertebra.
big body
small transverse processes,
spinous processes pount backwards
upper articular processes face inwards, lower outwards
30
what movements occur in the lumbaar vertebrae?
almost no rotation
| flexion, extension, lateral flexion
31
where is the sacral promontory?
most anterior point
32
what emerges through the pelvic sacral foramina?
anterior rami S1-4
33
where to the posterior rami emerge in the sacrum?
dorsal sacral foramina
34
where does the vertebral canal end
sacral hiatus (upside down V)
35
describe the composition of the intervertebral discs.
concentric rings
anulous fibrosis: tough fibrocartilage on outside
nucleus pulposus: soft centre
36
where are the interspinous ligaments?
lower edge of one spinous process to the upper edge of the next down
37
where are the supraspinous ligaments?
merge with interspinous, runs whole length vertebral column
38
where is the ligamentum flavum and its function?
on front of laminae, moves from one laminae to the next, thich and fibro elastic tissue
limit rotation
39
where are the anterior longitudinal ligaments and their function?
covers side and front of vertebral bodies, runs whole length of column, attached to upper and lower edges of each body. thick
limit extension
40
where are the posterior longitudinal ligaments and their function/
along back of vertebral bodies, widen over each disc
| slightly limit flexion
41
where are the posterior intervertebral joints and their function?
between articular processes, surrounded by capsular ligament. prevent vertebra sliping forward
42
what are the deep paravertebral muscles?
short and long rotators
| multifidus
43
what are the superficial paravertebral muscles?
lower=erector spinae (spinalis, longissimus thoracis, iliocostalis)
upper=splenius, longissimus, semispinalis
44
where do the short and long rotators attach?
short: base of spinous process to vertebra above
long: same but to next vertebra above
45
where is the origin and insertions of multifidus?
each segment arised from a transverse process
inserts on spinous proces 2-4 vertebra above
whole length of spine
46
where do the erector spinae originate and insert?
origin: lumbar vertebra, sacrum, iliac crest, thoracolumbar fascia
separate out
spinalis: inserts spinous processes thoracic vertebra
longissimus thoracis: inserts lower 9 ribs
iliocostalis lumborum: inserts lower 6 ribs
47
what are the functions of the erector spinae muscles?
keep body upright, lateral flexion
48
what is the dural sac?
sleeve of dura around spinal cord
open at top and passes through foramen magnum and continuous with dura of brain
closed at S2
49
where is the subarachnoid space?
between pia and arachnoid, filled with fluid
50
where is the epidural space?
between dura and wall of vertebral canal
| filled with fat, connective tissue and blood vessels
51
where does the spinal cord end?
L1
52
how is the spinal cord attached to the dura?
denticulate ligaments (triangular)
53
where do the spinal nerves arise from/
dorsal filaments that unit to form dorsal sensory roots
54
what do the ventral filaments form?
ventral motor root
55
in which direction do the nerve roots run?
cervical region: down and oblique
thoracic: more oblique
lubar and sacral: form cauda equina (run vertical)
56
which primary ramus is larger-anterior or posterior?
ant
57
which are the largest anterior rami?
C5-T1 (brachial plexus)
| L1-S3 (lumbar and sacral plexus)
58
how are the nerves numbered?
in cervical region the nerve takes number from vertebra below
from T1 down the nerve takes number from vertebrae above
C8 has no corresponding vertebra
59
what are the parts of the sternum and which allow movement?
manumbrium, body, xiphoid process
| some movement between manubrium and body (sternal angle)
60
which costal cartilage does the manumbrium articulate with?
1st
61
which costal cartilage does the sternal angle articulate with?
2nd
62
which costal cartilages form the costal arch/
7th-10th
63
how many pairs of ribs are there?
12
64
what type of joint iare the costovertebral?
synovial
65
which are the strongest ligaments at the costo vertebral joints?
radiate, superior costotransverse
66
which rib is the broadest?
1st
67
what is the dome of the pleura level with?
1st rib, although rises when pressure is raised
68
what are the 2 layers of pleura and where are they continuous?
parietal pleura: lines pleural csvity
visceral pleura: covers lung
hilum of lung
69
what is the diaphragm?
thin continuous sheet of muscle
70
where does the diaphragm originate and insert?
inside lower thoracic aperture
| sternum, costal arch, 12th rib
71
where does the oesophagus pass through the diaphragm>
oesophageal hiatus
72
where does the IVC pass through the diaphragm>
vena caval opening
73
where does the descending aorta pass through the diaphragm?
aortic opening
74
what are the muscles of inspiration?
external intercostals, scalene
75
what is the origin and insertion of the external intercostals?
inferior border rib above
superior border rib below
fibres run forward from up to below
76
what is the action o the external intercostals?
pull ribs up and forward
77
what is the action of the scalene muscles?
raise 1st, 2nd ribs and manubrium in deep inspiration
78
where does the anterior scalene originate and insert?
anterior tubercle transverse process C3 to 6
| first rib
79
where does the middle scalene originate and insert?
posterior tubercle transverse process C2-7
| 1st rib
80
where does the posterior scalene originate and insert?
posterior tubercle C6-7
| 2nd rib
81
what are the muscles of expiration>
internal intercostals, abdominal wall muscles
82
where are the internal intercostals and which direction do their fibres run?
beneath external, angle of ribs to intercostal spaces in front
fibres run forward from below upward
83
what is the action of the internal intercostals?
move anterior chest wall down and back
84
what are the parts of the thoracic aorta?
ascending, arch, descending
85
what is the first branch of the aorta?
coronary arteries
86
what are the branches of the aortic arch/
braciocephalic trunk: R subclavian and R common carotid
L common carotid
L subclavian
87
where does the internal thoracic artery run?
branch of subclavian, runs down anf forward over dome of pleura and behind 1st costal cartilage
88
where do the posterior intercostal arteries branch from
descending aorta
89
describe the path of the azygous vein.
begins below diaphragm, takes blood from lateral and posterior chest, joins SVC
90
what does the phrenic nerve supply?
motor and sensory to diaphragm
91
what is the sympathetic supply for the abdo?
splanchnic nerves
92
which nerve to the recurrent laryngeal nerves come from?
vagus
93
where does the sympathetic trunk run?
alongside vertebral column, from T1 to sacurm
94
what are rami communicantes?
connections between sympathetic trunk and anterior rami of spinal nerves
95
where are the intercostal nerves from and what do they supply/
direct continuation of anterior rami of thoracic spinal nerves
motor innervation to intercostals and sensation to chest wall
96
what is the pecten?
sharp upper border of superior ramus ofpubis
97
what is the inguinal ligament?
strong tendinous band of tissue from ASIS to pubic tubercle
| lowest part of external oblique aponeurosis
98
what encloses the erector spinae muscles?
thoracolumbar fascia-arises from spinous processes on back and transverse on front
99
where does quadratus lumborum originate and insert?
posterior iliac crest
| 12th ribs and transverse processes L1-4
100
what are the actions of quadratus lumborum?
assists in lateral flexion of the lumbar spine
101
where is psoas major in relation to quadratus lumborum?
medial
102
what fibres form the iliopsoas?
medial fibres iliacus and lateral fibres psoas majjor
103
what civers the iliopsoas muscle?
iliopsoas fascia, and peritoneum
104
where does the rectus abdominus originate and insert?
5th-7th costal cartilages, xiphoid process
| pubic crest and symphysis
105
what is the rectus abdominus divided by?
3/4 tendinous intersections
106
what are the actions of rectus abdominus
flexion of lumbar spine (acts in opposition to erector spinae muscles)
static effect: keep lumbar spine straight
107
what is the rectus abdominus enclosed by?
aponeurosis: anterior and posterior rectus sheath. anterior is attached to tendinous intersections
2 layers join at the linea alba
108
where doesthe linea alba run?
xiphoid process to pubis
109
what are the layers of the flat muscles of the abdomen?
innermost=transversus abdominus
internal oblique
external oblique
110
where does the transversus abdominus originate and insert?
internal surgace 6th-12th rub, thoracolumbar fascia, inner aspect iliac crest, iliopsoas fascia, lateral inguinal ligament
transversus aponeurosis, fuses with that of interbal oblique
111
which direction do the fibres of transversus abdominus run?
transverse
| lower run obliquely down
112
where does the internal oblique originate and insert?
thoracolumbar fascia, iliac crest, iliopsoas fascia, lateral inguinal ligament
fans out
highest fibres: lowest 3 ribs
othes: internal oblique aponeurosis
113
which direction do the fibres of internal oblique run?
highest fibres run upwards, midle transverse, lowest down
114
what is the arcuate line/
below is there the aponeuorsis is only infront of rectus abdominus
115
where does the external oblique originate and insert?
external surface 6th-12th ribs (zig zags with serratus anterior)
posterior part=01th-12th ribs: anterior iliac crest, remains fleshy
anterior=6th-9th: lower 3 ribs and external oblique aponeurosis
116
what are the actions of the flat abdominal muscles?
increase pressure in abdo cavity pushing diaphragm upwards
| when contract individually produce lateral flexion and rotation
117
what lines the abdominal cavity?
parietal peroneum
| iliopsoas fascia/transversalis fascia
118
what is the inguinal canal for/
spermatic cord (male), round ligament (female)
119
what is the lacunar ligament?
triangle coming from inguinal ligament, inserts on pecten
120
what is the conjoint tendon?
tendinous fibres of transersus and internal oblique
121
where does the inguinal canal begin?
deep inguinal ring-arch beneath lower border transversus abdominus
122
where is the superficial inguinal ring?
opening in external oblique aponeurosis
123
at what level does the descending aorta become the abdominal aorta/
T12
124
what and where is the aortic bifurcation?
abdo aorta divides to R and L common iliac
| L4
125
at what level does the celiac trunk arise?
T12
126
what are the branches of the celiac trunk and what do they supply/
common hepatic, L gastric, splenic
| live, stomach, duodenum, pancreas, spleen
127
where does the superior mesenteric arise and what does it supply?
L1
| Li and SI
128
where does the inferior mesenteric artery arise and what does it supply/
L3
| distal LI
129
where doe the R and L renal arteries arise and what do they supply?
below superior mesenteric
| kidneys
130
where does the ovarian/testicular artery arise/
L2
131
how many lumbar arterues are there, where do they arise and what d they supply/
4 pairs
back of aorta
back, spine, abdo wall
132
where does the common iliac artery divide?
pelvic brim
133
what branches does the external iliac give off before the inguinal ligament?
deep circumflex laterally, inferior epigastric medially
134
what are the veins of the abdominal region/
common iliac
renal join IVC at L2
portal vein->liver->hepatic veins->IVC
135
what are the blood vessels of the anterior abdo wall.
```
superior epigastric (continuation external thoracic)
inferior epigastric (from external iliac0
anastomose i rectus abdominus
```
136
what is the nerve supply of the lower anterior and lateral abdominal wall?
continuation of intercostal nerves from T7 down
137
what supplies the posterior abdominal wall
lumbar plexus (T12-L5)
138
what are the autonomic nerves of the abdominal region/
vagus, sympathetic trunk, aortic plexus
139
what gives sympathetic sensation to the abdominal viscera?
aortic plexus
140
what does the vagus supply in the abdo region?
parasympathetic to stomach, LI, SI, plus more
141
what bones make up the cranium?
occipital, parietal, temporal , sphenois, frontal
142
what is it called where the fusions of the bones in the cranium are?
sutures
143
where does the spinal cord leave the head?
foramen magnum
144
what are the muscles of mastication/
temporalis, masseter
145
what is the origin and insertion of temporalis?
temporal fossa and fascia
coronoid process of mandible
runs under zygomatic arch
146
what is the origin and insertion of masseter muscle?
zygomatic arch
angle and ramus of mandible
on side of jaw
147
where does the sternocleidomastoid originate and insert?
superior portion of manubrium, medial side of clavicle
| mastoid process and lateral superiod nuchal line
148
what are the actions of sternocleidomastoid/
neck flexion and rotation
149
where is the temporal mandibular joint?
anterior to external ear, inline with C2
150
how can you test te muscles of mastication?
clench teeth
151
where is the external occipital protuberance?
at back of skull
152
where is the mastoid process prominent?
behind ears-posterior to earlobe
153
what attaches at the mastoid process/
sternpcleidomastoid, splenius capitis, longissimus capitis
154
where can you palpate C1?
move down from occipital prominence into a dip
155
where are the facets relative to the processes in the cervical spine?
1.5-2cm lateral
156
how do you palpaye the cervical spine?
start at C7 and work up-to differentiate C6 and 7 extend the neck, C6 will disappear and C7 will remain
start at C2 (below occipital protuberance)
157
how can you palpate the thoracic spine?
spine of scapula in line with T3
T7/8 in line with inferior aspect scapular
T1-4 at sam elevel of transverse processes which are 2 finger widths latera, T5-6 processes are slightly superior
158
how can you palpate the lumbar spine?
iliac crests at L4, transverse processes 2 finger widths latersl
159
where can the tip of the coccyx be palpated?
upper part of natal cleft
160
how can sternocleidomastoid be palpated?
lying prone, rotate and lift head
161
how can the intercostals be palpted?
slow deep breath, feel ribs separate
| cant differentiate interncal and external
162
how can you assess external oblique?
side crunch-shoulder to opposite hip, external obliques working on the side that goes up (same side as elbow using)
163
how can you assess the internal obliques?
side crunch-shoulder to opposite hip. internal obliques on side lower down (side of hip)
164
how can rectus abdominus be palpated?
flex abdomen
| landmarks: edge of ribs, xiphoid prcess, pubic crest
165
how can quadratus lumborum be palpated?
prone on table
bony landmarks: 12th rib, posterior iliac crest, transverse processes lmbar vertebrae
palpate while lifting hip towards shoulder-hip hitch
repeat on side
166
where can you palpate the first rib/
fins C7, move lteral to bony prominence=posterior portion
| anterior portion: sternocleidomastoid, follow down to bony prominence
167
how can erector spinae be palpated
lying on fron tand raise feet, can see muscls contract to stabilise pelvis=lower fibres
for upper fibres arch back
bony landmarks: spinous processes thoracic and lumbar vertebra
168
what muscles make up the spinotransversales?
splenius capitis, splenius cervicis
169
what are the actions of spinotransversales?
rotate the head, extend head and neck
170
where does splenius capitis originate and insert?
lower ligamentum nuchae, spinous processes C7-T3/4
| mastoid process and occipital bone
171
where does splenius cervicis originate and insert?
spinous processes T3-6
| transverse processes C1-3/4
172
which are the 3 main muscles making up transversospinalis/
semispinalis, multifidus, rotatores
173
which muscles make up the posterior abdominal wall/
iliacus, psoas major, psoas minor, quadratus lumborum, diaphragm
174
what are the vertebral ligaments present throughout the vertebral column?
anterior longitudinal, posterior longitudinal,, ligamentum flavum, interspinous, supraspinous, intertransverse
175
which ligaments are unique to the cervical vertebrae?
nuchal ligament (continuation of supraspinous), transverse ligament of atlas (between lateral masses)
176
what ligaments are unique to the thoracic spine/
radiate ligament of head of rib, costotransverse, lateral costotransverse, superior costotransverse
177
where is the radiate ligament of heead of rib?
rib to bodies of 2 vertebra and disc
178
where is the costotransverse ligament?
neck of rib to transverse process
179
where is the lateral costotransverse ligament?
transverse process to tubercle of rib
180
where is the superior costotransverse ligament?
neck ot rib to transverse process of superior vertebra
181
what are the ligaments unique to the lumbar spine?
iliolumbar: transverse process L5 to ilia of pelvis
182
what are the names for the different curves of the spine?
c-shaped curves of the neck (cervical spine) and lower back (lumbar spine) are called lordosis.
The reverse c-shaped curve of the chest (thoracic spine) is called kyphosis
183
how can the scalene muscles be palpated?
come backwards off sternocleidomastoid, scalenes in the posterior triangle
