Spinal Anatomy Flashcards
Sinuvertebral N. is a rich nerve supply that comes from the:
Medial branch of the Dorsal (posterior) primary division of the spinal nerve
Sinuvertebral Nerve is a branch from:
N. of VonLuschka –> Recurrent Meningeal N.
Flexion & Extension pivots around the _____ axis.
Coronal Axis
Left & Right Rotation pivots around the _____ axis.
Longitudinal axis
Left & Right Lateral Flexion pivots around the _____ axis.
Saggital axis
Overall Greatest amount of ROM in Spine takes place @
C4-C6
Greatest amount of flexion & extension of a face joint takes place @:
C5-C6
Greatest amount of overall ROM in Lumbar spine takes place @
L4-L5
Greatest amount of Flexion & Extension in Lumbar spine is @
L5-S1
Trapezius muscle is innervated by the:
Accessory Nerve (CN XI) & Ansa Cervicalis (C1-C3)
1st SP & most prominent spinous below the EOP
C2 spinous
Hyoid Bone is located at _____ level upright & _____ level lying down.
C-4 upright
C-3 lying down
Cricoid Cartilage is located at level _____
C6
Suprasternal notch (jugular notch) is located at:
T2
Sternal Angle (Angle of Louis) is located at:
T4-T5
Spine of the Scapula is located at what level upright & lying down:
T4 upright
T3 lying down
Inferior border of the scapula is located at what level upright & lying down?
Upright : T9
Lying down : T6
Xiphoid Process located at what level
T10
Umbilicus is located at what level
L3
Area of Aortic Pressure Point
Level of disc space L3-L4
Crest of the ilium is located at what level upright & lying down?
Upright: L5
Lying down: L4
Common fx of tip of the SP of C7
Clay Shoveler’s
Most common areas of Thoracic Compression Fx:
Body of T11-T12
Most common area of Lumbar Compression Fx:
Body of T12/L1
Most common area for Sacral Fx:
Horizontal fx at the 3rd or 4th sacral tubercle
Cervical Lateral Bending: VB moves to the _____ side & the SP moves to the _____ side.
VB = same side SP = opposite side
Lumbar Lateral Bending: VB moves to the _____ side & SP moves to the _____ side.
VB = opposite SP = same
Fertilization of the female egg by the male sperm takes place in the:
Distal 1/3 of the Fallopian Tubes
After fertilization, how long does it take the single egg to travel down the Fallopian tube to the uterus?
1 week (7-8 days)
What layer gives rise to all neurons & supporting cells?
Ectoderm
What layer forms the neural plate?
Ectoderm
Notochord induces the ectoderm to form the:
Nucleus pulposus of IVD
What forms the neural groove which houses the Spinal cord & brain vesicles?
Neural Plate
Neural Plate develops into:
- Macroglial Cells
- Oligodendrocytes
- Astrocytes
- Neurons CNS
- Ependymal cells
- Retinal cells
Glands, buccal cavity, esophagus, stomach, pharyngeal pouches & pharynx
Foregut
Duodenum, jejunum, appendix, part of transverse colon
Midgut
Part of transverse, descending & sigmoid colon, rectum & upper anal canal
Hindgut
Urinary bladder, vagina, urethra, prostate & urethral glands
Allantois
Somite cells form the _______ which form the Vertebral column
Sclerotome
Dermatomes of Cspine (C2-C7)
C2 - Scalp C3 - Nape of Neck C4 - Trap C5 - Deltoid C6 - Lat Elbow + thumb & index C7 - Middle Finger
Dermatomes of Tspine (T1, T2, T4, T7, T10)
T1 - Medial Elbow T2 - Axillary T4 - Nipples T7 - Xyphoid T10 - Umbilicus
Dermatomes for Lspine (L1 - L5)
L1 - Sup Ant Thigh (inguinal ligament) L2 - Mid Thigh L3 - Medial Knee L4 - Medial Lower Leg / Calf L5 - Top/Dorsum Foot & Lat Leg (1st-4th toe)
Dermatomes for Sspine:
S1 - Baby toe, plantar foot, posterior calf (lat outside)
S2 - Post Thigh
S3 - Anus (around it)
S4 - Anus
Foramen Ovale b/t interatrial septum becomes:
Fossa Ovalis
Ductus Arteriosus bypasses lung pulmonary trunk to arch of aorta and becomes…
Ligamentum Arteriosum
Ductus Venosus bypasses sinusoids of fetal liver & becomes…
Ligamentum Venosum
Umbilical Vein becomes…
Ligamentum Teres (round ligament)
Umbilical Arteries become…
Medial Umbilical Ligaments
Urachus is a remnant of the …
Duct of Allantois
“Glue”, gives rise to astrocytes & oligodendrocytes
Glioblast
Most numerous cell of CNS ***
Acts like connective tissue
Part of blood brain barrier
Forms “scar-like” tissue in injury
Astrocyte
Quite numerous (less than astrocyte) *** Forms MYELIN around CNS
Oligodendrocytes
Lines CNS, ciliated, makes “leaky” barrier b/t CSF & CNS
Ependymal
Phagocyte (macrophage)
Not many
Microglia aka Gitterzellen
What makes neurons
Neuroblast
Neurons within CNS, connects b/t two hemispheres
Commissural fibers
Neurons within CNS, connects different parts of same hemisphere
Association fibers
Neurons within CNS, connects lower centers to cerebral cortex
Projection
Most common type of neurons in CNS
Multipolar
Cell bodies & dendrites are part of the _____ matter
Gray matter
Myelinated axons are part of the _____ matter
White matter
Ventricles:
Proencephalon develops into the…
Telencephalon
Diencephalon
Mesencephalon develops into the…
Mesencephalon —> Midbrain
Rhombencephalon develops into…
Metencephalon
Myelencephalon
What structures & cranial nerves develop from these Secondary Structures:
- Telencephalon
- Diencephalon
- Mesencephalon
- Metencephalon
- Myelencephalon
Tel = Forebrain (I) Die = Thal, Hypothal, Pineal, Retina, Mam. Body, Post. Pit (II) Mes = Midbrain (III, IV) Met = Pons, Cerebellum (V, VI, VII, VIII) Mye = Medulla Oblongata (IX, X, XI, XII)
Name the Neural Canal Regions:
Pro – Tel – Forebrain (I) =
Pro – Die – Thalamus (II) =
Mes – Mes – Midbrain (III, IV) =
Rho – Met – Pons, Cerebellum (V-VIII) =
Rho – Mye – Medulla Oblongata (IX-XII) =
- Lateral Ventricles separated by Septum Pellucidum
- Foramen of Monroe (interventric foramen)
- Cerebral Aqueduct of Sylvius
- 4th Ventricle
- 4th Ventricle
Arterial anastomosis:
- Blood supply communication b/t forebrain & hindbrain
- Anatomically around the pituitary gland & optic chiasm
Circle of Willis
What arteries supply the Circle of Willis
Internal Carotid & Vertebral arteries
What arteries form the circle of the Circle of Willis?
Ant & Post Cerebral Arteries
Ant & Post Communicating Arteries
What artery carries more blood than other arteries (approx. 800ml/min)
Middle Cerebral Artery
Most common location of “cerebral vascular accident” (CVA)
Middle Cerebral Artery
aka Pallium - developed from neural plate
Cerebral Cortex
90% of the cortex is:
Neocortex
10% of the cortex is:
Allocortex
Relay for cortex that processes sensory info, sleep, consciousness; motor relay (mostly forms thalamus)
Diencephalon (thalamus)
Responsible for postural adjustments, steadying voluntary movements, enkephalins
Basal Ganglia
Basal Ganglia - Striatal lesions cause…
Tremors – Parkinson’s, Huntington’s Chorea, Ballism
Basal Ganglia includes…
Corpus Striatum
Amygdaloid
Claustrum
Telencephalon nuclei include…
Caudate
Putamen
Globus Pallidus
Basal Ganglia
Mesencephalon nuclei include…
Substantia nigra
Subthalamic
Head of the caudate + putamen = ?
Corpus Striatum
Globus pallidus (medial) & Putamen (lateral)
Lentiform Nucleus
Brainstem is made up of the ….
It’s a conduit for the …
It contains the reflex centers associated with …
It contains important nuclei of …
Medulla, Pons & Midbrain
Ascending & Descending Tracts
Respiration, CV & consciousness
CN III-XII
CSF in an adult
140-270ml
What are the layers of Meninges from inside to outside
Pia, Arachnoid, Dura
Between arachnoid & pia (lumbar puncture or spinal tap)
Subarachnoid Space
Innermost layer of neural tube
Lines CNS, ciliated, makes “leaky” barrier b/t CSF & CNS
Ependymal Cells
Produces CSF***
Choroid Plexus
Resorbs CSF ***
Arachnoid Granulations
How much CSF is in the ventricles?
Approximately 25ml
Atrophy or damage of the basal ganglia can produce…
Chorea (quick movements)
Parkinsonism is due to neuronal degeneration of the…
Substantia Nigra (Lewy Bodies)
Spinal Cord:
- How many pairs of spinal nerves?
- Bell-Magendi Law?
- Terminates?
- End is called?
- Roots for Lumbar, Sacral, Coccygeal are thru & called?
31 pairs of Spinal Nerves
Dorsal roots, Sensory, Afferent fibers & Ventral, Motor, Efferent
Terminates @ L1/L2
End is called Conus Medullaris
Roots thru Lumbar Cistern forming Cauda Equina “horse’s tail”
Part of brain associated with vision, hearing, motor control, sleep/wake, arousal (alertness) & temp regulation
Midbrain
CSF exchange between 3rd & 4th ventricles
Cerebral aqueduct of Sylvius (Midbrain)
Cerebral peduncles (midbrain) contain…
Tegmentum
Substantia Nigra
Crus Cerebri
CN III, IV
Substantia Nigra is _____ in color;
Dopamine from _____;
_____ is a by product (causes dark color)
Black color
Dopamine from Tyrosine
Melanin is by-product
Part of Cerebral Peduncle - Corticospinal, Corticopontine, Corticobulbar, Corticomesencephalic fibers (eye mvmts)
Crus Cerebri
Function: integration of “momentary” static muscle contraction, joint tension, visual & auditory input regarding equilibrium.
Cerebellum
Medial Cerebellum
Vermis
Anterior Cerebellum - general muscle tone
Paleocerebellum
Posterior Cerebellum - coordination of skilled movements
Neocerebellum
Part of cerebellum that controls equilibrium (Flocculonodular)
Archicerebellar
Corpus Medullare (aka) (afferent, efferent, commissural & association fibers)
White Matter
Gray matter neuron cell types?
Purkinje Golgi II Stellate Basket Granular
MC type of cell in Cerebellum
Purkinje
Cerebellar Nuclei (from medial to lateral, small to large)
Fastigial
Globus
Emboliform
Dentate
Neural Crest develops into:
DRG & spinal nerves
Vertebra develop from:
Sclerotome (union of 2 different somites)
What forms the lining of the digestive tube & its associated structures?
Endoderm epithelium
Nuclei in basal forebrain that is rich in ACH
Meynert’s
Lateral Vestibular Nuclei
Deiter’s
Nuclei found in Medulla (brain stem) that releases Serotonin
Raphe
Nuclei that is part of corpus striatum & comprises putamen & globus pallidus
Lenticular Nuclei
Part of brain that is responsible for crude sensation & integrations; “Relay Center”
Thalamus
Part of brain responsible for conscious interpretation & movement
Cortex
Main pathway between thalamus & cortex is through the…
Internal Capsule & Corona Radiata
Postcentral Gyrus is the Primary _____ Cortex
Sensory
Precentral Gyrus is the primary _____ cortex
Motor
What lesion would cause: Increased DTR & muscle tone (+) Pathological Reflexes (Babinski) Spasticity Hypertrophy Clonus Decreased Superficial Reflexes (bilateral)
UMNL
What lesion would cause: Decreased DTR & muscle tone No pathological reflexes Flaccidity Atrophy Fasciculations Decreased superficial reflexes (Unilateral)
LMNL
Name the 5 Descending Tracts
motor, efferent, ventral, basal plates
Corticospinal Reticulospinal Tectospinal Rubrospinal Vestibulospinal
What tract is associated with precise & skilled voluntary movement (motor)
- Post limb of int capsule to 80% Lat & 20% Ang
Corticospinal
What tract is associated with inhibiting or facilitating voluntary movement
Reticulospinal
What tract is associated with Reflex postural movement to visual stimuli
Tectospinal
What tract facilitates flexors & inhibites extensors
Rubrospinal
Name the Tract & Pathway:
- Function: Pain & Temp
- Tract of Lissauer
- NT: Substance P
Lateral Spinothalamic
FNE - DRG - SC - AWC - Thal (VPL) (ILN) - PLIC
Fluid-filled cyst that leads to cape-like (bilateral) loss of pain & temperature
Syringomyelia
Lat Spinothalamic
Name the Tract & Pathway:
- Fxn: “protopathic” - pain, temp, crude light touch
- Tract of Lissauer
- Clinical Pearls: “tactile sensation”
Anterior Spinothalamic
FNE - DRG - SC- AWC - Thal (VPL) (ILN) - PLIC
Name the Tract & Pathway:
- Discrimitive touch (2point), Vibration & Conscious Proprioception
Dorsal Columns
Pacinion Corpuscle - DRG - F.Cuneatus (above T6) / F.Gracilis (below T6) - Cuneate or Gracilis Nucleus - cross in Internal Arcuate Fibers (2nd order neurons) - Med Lemniscus - Thalamus - PLIC
Name the Tract:
- Unconscious proprioception
Path: DRG –> Nucleus Dorsalis –> Peduncle –> Cerebellum
“Clark’s column” from C8-L4
Clinical Pearl: “PI” - posterior inferior peduncle
Posterior Spinocerebellar
Name the Tract:
- Unconscious Proprioception
Path: DRG –> Nucleus Dorsalis –> Peduncle –> Cerebellum
“Clark’s column” fibers that cross, cross back to ipsi side
Clinical: “AS” - anterior superior peduncle
Anterior Spinocerebellar
Name the Tract & Pathway:
- pain modulation; visual reflexes; controls mvmt of eyes & head toward stimulus
aka Spino-quadrigeminal system of Mott
Spinotectal
FNE - DRG - SC- AWC - Midbrain periaquaductal grey - N.Raphe
Name the Tract & Pathway:
- ANS reflex pain response & Levels of consciousness
Clinical Pearl: COMA
Spinoreticular
FNE - DRG - SC - AWC - Reticular formation in Pons & Medulla
PNS has what type of cells?
Schwann cells
PNS: groups of neuron cell bodies
Ganglia
PNS peripheral nerves are mostly _____ axons.
Myelinated
PNS: cells found in retina & sensory ganglia of cochlear & vestibular nerves
Bipolar cells
PNS Myelin sheath gaps are called:
Nodes of Ranvier
4 Cutaneous Sensory branches of the Cervical Plexus (superficial)
Lesser Occipital
Greater Auricular
Transverse Cervical
Supraclavicular
List the following spinal roots & structures served:
- Lesser Occipital
- Greater Auricular
- Transverse Cervical
- Supraclavicular
C2-C3 : sensory to Posterolateral neck
C2-C3 : sensory to Ear & Parotid Gland
C2-C3 : sensory to Anterior & Lateral neck
C3-C4 : sensory to Shoulder & Anterior Chest
Motor Branches of Cervical Plexus (deep)
Ansa Cervicalis
Segmental branches
Phrenic Nerve ***
List the following spinal roots & structures served:
- Ansa Cervicalis
- Segmental Branches
- Phrenic Nerve
C1-C4 : motor to Geniohyoid & Infrahyoid muscles of neck
C1-C5 : motor to Neck & Scalenes, Levator, Trapezius, SCM
C3-C5 : “keep the DIAPHRAGM alive”
Sensory nerve of the lumbar plexus to the thigh, leg, foot, hip & knee joints
Femoral Nerve (L2-L4)
Motor nerve of the lumbar plexus to the anterior thigh, psoas, pectineus & iliacus
Femoral Nerve (L2-L4)
Sensory nerve of lumbar plexus to the medial thigh & hip joint
Obturator nerve (L2-L4)
Motor nerve of the lumbar plexus to the adductors, gracilis & obturator externus
Obturator nerve (L2-L4)
Sensory nerve of lumbar plexus to the lateral thigh & branches to peritoneum (“Meralgia Parasthetica”)
Lateral Femoral Cutaneous (L2-L3)
Sensory nerve of lumbar plexus to the lower abdomen, lower back & hip, anterolateral abdominal wall & pubic region
Iliohypogastric (L1)
Sensory nerve of the lumbar plexus to external genitalia, thigh & abdominals
Ilioinguinal (L1)
Sensory nerve of the lumbar plexus to the scrotum, labia, thigh & cremasterics
Genitofemoral (L1-L2)
Motor nerve of Sacral Plexus to the Tibial & Common Peroneal
Sciatic Nerve (L4-S3)
Sensory nerve of the Sacral Plexus to the posterior leg & foot
Tibial nerve (L4-S3)
Motor nerve of the Sacral Plexus to all muscles of posterior leg & foot
Tibial Nerve (L4-S3)
Sensory nerve of the Sacral Plexus to the Anterior Leg & Dorsum Foot
Common Peroneal nerve (aka Fibular) L4-S2
Motor nerve of Sacral Plexus to lateral component of leg
Superficial Peroneal aka Fibular (L4-S2)
Motor nerve of sacral plexus to Anterior compartment of leg
Deep Peroneal (L4-S2)
Motor nerve of sacral plexus to Gluteus Medius, Minimus & TFL
Superior Gluteal Nerve (L4-S1)
Motor nerve of sacral plexus to Gluteus Maximus
Inferior Gluteal Nerve (L5-S2)
Sensory nerve of sacral plexus to muscles of perineum
&
Motor nerve of sacral plexus to External Anal Sphincter
(Cauda Equina Syndrome)
Pudendal nerve (S2-S4)
Brachial Plexus: C5 & C6 roots:
What cords are involved?
What branches are involved?
Lateral cords
Musculocutaneous & Median branches
Brachial Plexus - C7 nerve root:
What cords are involved?
What branches are involved?
Posterior cords
Axillary & Radial branches
Brachial Plexus - C8 & T1 nerve root:
What cords are involved?
What branches are involved?
Medial cord
Median & Ulnar branch
CN 1 - Olfactory
Foramen of exit or path?
Function?
Nuclei & Ganglion?
Cribiform Plate
Sensory - smell
Does not synapse - Thalamus
CN II - Optic
Foramen of Exit?
Function?
Optic Canal
Sensory - Vision
CN III - Oculomotor
Foramen of Exit?
Function?
Nuclei & Ganglion?
SOF
Motor - eye muscles except Lat Rectus & Sup Oblique (SO4LR6R3)
Edinger Westphal nucleus
CN IV - Trochlear
Foramen of Exit?
Function?
Important fact?
SOF
Motor to Superior Oblique
Smallest CN ***
CN V - Trigeminal Foramen? Function? Nuclei & Ganglion? Clincial?
V1 - Opthalmic = SOF
V2 - Maxillary = Foramen Rotundum
V3 - Mandibular = Foramen Ovale
Fxn: Sensory to face & tongue / Motor for Mastication
Gasserian Semilunar or Trigeminal Ganglion
(Largest CN)
Trigeminal Neuralgia “Tie douloureux”
CN VI - Abducens
Foramen?
Fxn?
SOF
Motor to Lateral Rectus
CN VII - Facial Foramen? Fxn? Nuclei? Clinical?
Internal Auditory Meatus exits thru Styloid Mastoid
Sensory - Ant 2/3 tongue
Motor - facial expression
Superior Salvatory (branch of Chorda Tympani)
“Bells Palsy” (eyes stuck open
CN VIII - Vestibulocochlear
Foramen?
Fxn?
Nuclei?
Internal Auditory Meatus
Sensory - Balance & Hearing
Vestibular Ganglion (of SCARPA)
CN IX - Glossopharyngeal
Foramen?
Fxn?
Nuclei?
Jugular Foramen (temporal + occipital)
Sensory - Post 1/3 tongue
Motor - secretion of parotid
Nucleus Ambiguous (inf salvatory)
CN X - Vagus
Foramen?
Fxn?
Nuclei?
Jugular Foramen
Sensory - bitter taste, epiglottis, external auditory meatus
Motor - pharynx & larynx
Parasympathetic Dorsal Motor Nucleus
CN XI - Accessory
Foramen?
Fxn
Nuclei?
Jugular Foramen
Motor - SCM & Trapezius
Nucleus Ambiguous
CN XII - Hypoglossal
Foramen?
Fxn?
Nuclei?
Hypoglossal canal
Motor - tongue
Hypoglossal nuclei
What cranial nerves are mixed nerves?
What cranial nerves are Parasympathetic to 90% of the body?
Mixed: V, VII, IX, X
PS: III, VII, IX, X
Middle Meningeal Artery exits the…
Foramen Spinosum
“spine is in the middle”
Internal Carotid Artery (temporal & sphenoid) exits the…
Foramen Lacerum
“If you lacerate the ICA, you’ll die!”
Injury to the PTERION (junction of sphenoid, temporal, frontal & parietal bones) “hockey puck” causes damage to…
Middle Meningeal Artery
possible death
ANS Sympathetic nervous systems
- Axons?
- Fibers/NT?
Axons: T1-L1/L2 (basically whole Tsp)
Short Preganglionic NT = ACH
Long Postganglionic NT = Epi/Norepi
ANS Parasympathetic nervous system
- Axons
- Fibers/NT
Axons: CNS III, IV, IX, X & Sacral S2-S4
Long Preganglionic NT = ACH
Short Postganglionic NT = ACH
Enteric Division (ENS) controls the GI Tract. What are the 2 types of neurons & what do they do?
(1) Myenteric (Auerbach’s) - motor innervation to both layers of tunica muscularis (PS & Symp input)
(2) Submucosal (Meissner’s) - secretomotor to lumen (PS ONLY!)
Enteric Nervous System has over 30 NT’s. What is found in the bowels?
95% of serotonin & 50% dopamine
Ossification of the Skull & Vertebral Column?
Both begin 7-8 weeks (embryo)
Describe the sutures on the skull
- b/t frontal & parietal
- b/t 2 parietals
- b/t parietal & occipital
- b/t temporal & parietal
Coronal
Sagittal
Lambdoidal
Squamous
What bone is formed by the Cribiform Plate (inferiorly) & Crista Galli (superiorly)
Ethmoid
The Maxillary is formed by the….
Hard palate
Palatine
Orbital processes
Sphenoid contains what structures?
Sella Turcica F. Ovale (V3 mandibular exits) F. Rotundum (V2 maxillary exits) F. Lacerum (ICA exits) F. Spinosum (Mid.Men.A. exits)
The sphenoid, frontal, zygomatic, palatine, ethmoid, lacrimal & maxillary are all part of the Orbit. Which bone isn’t?
Nasal bone
Mastoid is found on the…
Temporal bone
How many ossification centers in the vertebral column & what are they?
Three
1 - Body (centrum)
1 - Each Vertebral Arch (b/c lamina & pedicles)
How many secondary ossification centers in the vertebral column & what are they?
Five
1 - Tip of SP
2 - TVP’s
2 - Annular ring epiphyses (sup & inf aspect of body)
What is different about the ossification centers in the lumbar?
They have 2 additional ossification centers for Mamillary processes
Teeth @ 3 years old v. Teeth @ adult
20 teeth (3yo) 32 teeth (adult)
Describe teeth from top to bottom
Enamel Dentin Pulp (nerves & vessels) Cementum Root
Bones that have no direct sternal attachment, but attach by costal cartilages?
Flat Bones
How many pairs of Ribs? Which ones are “typical”? Which ones are “atypical”?
12 pairs of Ribs
Typical = 3-9
Atypical = 1, 2, 11, 12
Shortest costochondral joint that articulates with manubrium
- Scalene tubercle location
- Supports subclavian vessels
1st Rib
Thinner & 2x length of Rib 1
- Serratus Anterior tuberosity
2nd Rib
Short, no neck or tubercle, “floaters” (do not articulate w/sternum)
Only articulates w/ VB, single facet on head, end capped cartilage
11 & 12 ribs
Where manubrium & sternum meet (2nd rib attaches)
Angle of Louis
Sternum aka _____ is located at …
Gladiolus
T5-T9 (costal notches from lateral border)
Landmark: diaphragm, diaphragmatic surface of liver & inferior border of heart
Xiphoid process (T10)
Sacrum = 5 fused vertebra (by age 25)
- Sacral promontory?
- Lateral sides aka wings?
- Branches of sacral spinal nerves pass thru ___ ?
- Articulates with coccyx?
Sacral Base
Sacral Ala
Sacral Foramina
Sacral Apex
Cervical Landmarks: posterior arch connects lateral masses of atlas:
- Hyoid Bone
- Cornu of Thyroid
- Body of Thyroid
- Cricoid Cartilage
- Carotid Tubercle
Hyoid - C3/C4 Cornu of Thyroid - C4 Body of Thyroid - C5 Cricoid Cartilage - C6 Carotid Tubercle - C6
What are the motor unit boundaries of the IVF?
Pedicles, Body, Disc, Facets
What are the atypical vertebra in adults & what are they called?
C2-C6
Joints of Luska
Lowest level of vertebral artery?
C6
What is the shape of the body of cervical vertebra?
Circular
Shape of Thoracic vertebra body?
Heart shaped
Shape of lumbar vertebra body?
Kidney-shaped
N: CN VII Facial Nerve
A: Eyelid Sphincter
O: Frontal & Maxilla
IN: Eyelid
Obicularis oculi
N: CN VII Facial
A: Mouth angle back & up (laughing)
O: Zygomatic
IN: Mouth corner
Zygomaticus (major)
N: CN VII Facial
A: Raises lower lip (doubt/disdain)
O: Mandible
IN: Chin
Mentalis
N: CN VII Facial
A: Contracts/protrudes lips
O: Maxilla & Mandible
IN: Mouth
Orbicularis oris
N: CN VII Facial
A: Compresses cheeks / expels air / aids in mastication
O: Maxilla & Mandible
IN: Obicularis oris
Buccinator
N: CN XII Hypoglossal
A: Protrudes tongue
O: Mandible
IN: Hyoid & tongue
Genioglossus
Innervation: CN XII Hypoglossal
Action: Depresses tongue
Origin: Hyoid
Insertion: Tongue
Hyoglossus
Innervation: CN XII Hypoglossal
Action: Retracts & elevates tongue
Origin: Temporal
Insertion: Tongue
Styloglossus
Muscles of Mastication
Temporalis
Masseter
Medial (internal) Pterygoid
Lateral (external) Pterygoid
N: CN V Trigeminal
A: Elevate & Retract jaw
O: Temporal
IN: Coronoid of Mandible
Temporalis
N: CN V Trigeminal
A: Elevate Jaw / prime mover of jaw closure
O: Zygomatic arch
IN: Mandible
Masseter
Elevate & protract jaw (close)
Medial (internal) Pteygoid
Protrudes jaw & depresses (open)
Lateral (external) Pterygoid
Superficial muscle of neck:
N: CN VII Facial
A: Depresses lower lip & jaw
Platysma
Superficial Muscle of the Neck: N: CN XI Accessory A: (1) Ipsilateral flexion, contralateral rotation (2) Flexion O: Manubrium & Clavical IN: Mastoid
SCM
What are the 4 Suprahyoid muscles?
Digastric
Stylohyoid
Mylohyoid
Geniohyoid
N: CN V Trigeminal & VII Facial
A: Elevates hyoid, depresses jaw
O: Mandible & Mastoid
IN: Hyoid
Digastric
N: CN VII Facial
A: Elevates & retracts hyoid
Stylohyoid
N: CN V Trigeminal
A: Elevates hyoid
Mylohyoid
N: CN XII Hypoglossal
A: Pulls hyoid anterior & up
Geniohyoid
4 Infrahyoid muscles
Sternohyoid
Sternothyroid
Omohyoid
Thyrohyoid
N: C1-C3
A: Depresses hyoid
O: Manubrium
IN: Hyoid
Sternohyoid
N: C1-C3
A: Pulls thyroid cartilage down
O: Manubrium
IN: Thyroid
Sternothyroid
N: C1-C3
A: Depresses & retracts hyoid
O: Scapula
IN: Hyoid
Omohyoid
N: CN 1 via CN XII
A: Depresses hyoid & Elevates thyroid cartilage
O: Thyroid
IN: Hyoid
Thyrohyoid
Name the 4 Vertebral muscles
Longus coli
Scalenus anterior
Scalenus medius
Scalenus posterior
N: Primary Rami C2-C8 **
A: (1) lat flex (2) flexes & rotates vertebrae
Attaches to anterior tubercle of atlas **
Longus coli
N: Primary rami C5-C8
A: Elevates 1st rib, flexes & rotates vertebra
O: TVP of Csp
IN: First 2 ribs
Scalenus anterior
N: Primary rami C3-C4***
A: Elevates 1st rib, flexes & rotates vertebra
O: TVP of Csp
IN: first 2 ribs
Scalenus medius
N: Primary rami C5-C8
A: Elevates 2nd rib***, flexes & rotates vertebra
O: TVP of Csp
IN: first 2 ribs
Scalenus posterior
Suboccipital Triangle:
- Roof?
- Floor?
Roof = Semispinalis capitis muscle Floor = Posterior atlanto-occipital membrane
What artery transverses thru the suboccipital triangle?
Vertebral artery
Which nerve transverses thru the suboccipital triangle?
Suboccipital nerve
Name the superior, lateral border of the suboccipital triangle
Superior Oblique
Name the medial border of the suboccipital triangle
Rectus Capitus Posticus Major
Name the inferior, lateral border of the suboccipital triangle
Inferior Oblique
Erector spinal muscle groups
Iliocostalis — Ilium/Ribs
Longissimus — TP/Ribs
Spinalis — SP/SP
Actions for all: Extend & Ipsi Flex
Innervation for all: Spinal n. Dorsal
Muscles of the thorax
External Intercostals
Internal Intercostals
Transverse Thoracic
Subcostalis
O: Lower border of rib
IN: Upper border of rib below
A: Elevates ribs ***
N: Intercostal nerve
External intercostals
both have E in them
O: Lower border of rib
IN: Upper border of ribs below
A: Depress ribs, interchondral part elevates ribs
N: Intercostal nerves
Internal Intercostals
O: Posterior sternum & xiphoid
IN: Costal cartilages 2-6
A: Depresses ribs
N: Intercostal n.
Transverse thoracic
O: Inner, lower ribs near angles
IN: Upper borders of ribs 2 or below
A: Elevates ribs
N: Intercostal
Subcostalis
Muscles of the anterior abdominal wall
External Oblique
Internal Oblique
Transverse Rectus Abdominus
Cremaster
Muscles of the posterior abdominal wall
Quadratus lumborum
Psoas Major
Psoas Minor
What nerve pierces the Psoas Major?
Femoral Nerve
Muscles of the lateral pelvic wall
Piriformis
Obturator internus
O: Anterior Sacrum & Sacrotuberous ligament
IN: Greater trochanter
A: External hip rotation, Abduction of thigh
N: S1-S2
Piriformis
O: Inner obturator membrane
IN: Greater trochanter
A: External rotation thigh
N: Nerve to obturator internus
Obturator internus
What are the Levator Ani muscles?
Pubococcygeus
Puborectalis
Iliococcygeus
O: Pubis
IN: Coccyx
A: Supports pelvic viscera***
N: S3-S4 & Pudendal
Pubococcygeus
O: Pubis
IN: “U” shaped rectal sling
A: Completes pelvic floor
N: S3-S4 & pudendal
Puborectalis
O: Pelvic fascia tendinous arch & ischial spine
IN: Coccyx & anococcygeal ligament
A: Completes pelvic floor
N: S3-S4 & Pudendal
Iliococcygeus
O: Ischial spine & Sacrospinous ligament
IN: Lower sacrum & coccyx
A: Supports & pulls coccyx anteriorly
N: S4-S5
Coccygeus
Muscles of Urogenital diaphragm (deep perineum)
Sphincter urethrae
Deep transverse perinei
O: Medial inferior pubic ramus
IN: Median raphe & central perineal tendon
A: Constricts urethra & blends w/vaginal wall
N: Pudendal N
Sphincter urethrae
Pudendal nerve pass thru the greater & lesser _____ foramen
Sciatic
O: Medial ischial ramus
IN: Central perineal tendon
A: Supportive role
N: Pudendal N
Deep transversus perinei
What are the superficial perineum muscles?
Ischiocavernosus
Bulbospongiosus
Superficial Transversus Perinei
O: Ischial Tuberosity & ramus
IN: Crus (penis/clitoris)
A: Aids in erection; Constricts vaginal orifice
N: Perineal
Ischiocavernosus
O: Central Perineal tendon
IN: Corpus Spongiosum
A: Aids in erection
N: Perineal
Bulbospongiosus
O: Ischial tuberosity
IN: Central perineal tendon
A: Support
N: Perineal
Superficial transversus perinei
What CN goes with the following Brachial (pharyngeal) Arches:
- Arch: I
- Skeletal Structures: Malleus (Meckel’s cartilage) & Incus (Quadrate cartilage)
- Muscles: Muscles of mastication & jaw-closing muscles
V3 Mandibular branch of CNV Trigeminal
What CN goes with the following Brachial (pharyngeal) Arch:
- Arch: 2
- Skeletal Structures: Stapes, Styloid
- Muscles: Muscles of facial expression & jaw opening muscles; Stylohyoid, Stapedius
Facial (CN VII)
What CN?
- Branchial Arch: 3
- Skeletal Structures: Cornu, Hyoid
- Muscles: Stylopharyngeus
Glossopharyngeal (IX)
What CN?
- Branchial Arch: 4
- Skeletal Structures: Thyroid cartilage, Cricoid cartilage
- Muscles: Pharyngeal, Cricothyroid, Levator palatine
Superior laryngeal of Vagus (X)
What CN:
- Branchial Arch: 6
- Skeletal Structures: Arytenoid, Corniculate cartilage, Cuneiform cartilage
- Muscles: Laryngeal
Inferior Laryngeal of Vagus (X)
Front of the VB’s from Atlas to Occiput
ALL (anterior longitudinal ligament)
aka Anterior Atlanto-Occipital
Back of the VB’s from Axis to Occiput
PLL (posterior longitudinal ligament)
aka Membrane Tectoria
Lamina to Lamina - (yellow ligament)
Ligamentum Flava
Ligament b/t Spinous processes
thickest in lumbars
Interspinous ligament
Ligament from SP to SP from C7-Occiput
Supraspinous Ligament
aka Ligamentum Nuchae
Holds the dens in fovea dentes of atlas (across posterior dens)
Transverse ligament
Ligament from body of C2 to occiput
Cruciform ligament
Ligament from the sides of the dens to occiput - Limits rotation
Alar ligament
aka Check Ligament
Ligament from tip of the dens to the rim of the occiput
Apical dental
“Toothed” ligament, anchors the spinal cord to the bony vertebral canal
Denticulate ligament
Where is the ALL located?
Front of VB’s from Atlas to Occiput
Where is PLL (Membrane Tectoria) located?
Back of VB’s from Axis to Occiput
Where is the Ligamentum Nuche located?
SP-SP from C7 to Occiput
Which ligaments can affect the IVF?
Flava, PLL
Projections from the tongue where taste buds are embedded
Papillae
both start with P
Cylindrical, largest, least in number, bitter taste receptor, 8-12 “V” shaped form anterior to the sulcus terminalis
Circum “Vallate” papillae
V-shape = Vallate
Mushroom-shaped, most numberous taste receptors, tip tongue
Fungiform
Mushrooms = Fungi
Posterior roof/mouth lateral margins
Foliate
Thread-like, sensitive to touch (no taste)
Filiform
Anterior 2/3 of the tongue is innervated by CN _____
Describe the pathway
CN VII (Facial) - sweet, sour, salty
Taste Buds – Solitary Tract (VII, IX, X) – Solitary Nucleus – Central Tegmental Tract – VPM Thalamus – PLIC – Gustatory Cortex
Posterior 1/3 of the tongue is innervated by CN ______
CN IX Glossopharyngeal (bitter)
Epiglottis & larynx are innervated by CN _____
CN X Vagus (bitter)
Embryonic thyroid diverticulum (dorsal depression of tongue)
Foramen Caecum
Aqueous humor is _____ while Vitreous humor is _____
Anterior / Posterior
IVD remnant from ____
Nucleus Pulposus
Cones are for _____
color
Structures that contain endolymph:
Scala media
Saccule
Utricle
Semicircular ducts
Confluence of sinuses
EOP, IOP
Limbic area that contains Granular cells (interneurons), Mitral cells & Tufted cells & a Glomerulus
Olfactory Bulb
What is the nerve supply for Olfaction & describe the pathway
CN I - Olfactory Nerve
Receptors – CN I – Cribiform Plate (Ethmoid) – Olfactory Bulb – Olfactory Tract (mitral & tufted cells) – Olfactory Cortex (Lat Olf Gyrus, UNCUS or Med Olf Gyrus & Periamygdaloid) – Hypothalamus – Neocortex
What kind of cells does the Upper surface of the superior concha - main chemoreceptor?
Pseudostratified columnar epithelium
Retina develops from _____
Sclera develops from _____
Ectoderm
Dura
Retinal cells include:
Amacrine Bipolar Ganglion Horizontal Pigments Rods & Cones (rhodopsin)
Semicircular Canals control…
Angular acceleration & deceleration of sound
Utricle & Saccule control …
Linear Acceleration
Structure from Middle Ear to Nasopharygeal area?
Auditory Tube (Eustachian Tube)
Base Tympanic Membrane is _____ pitch
High
Pathway for Parasympathetic Nerves (III, VII, IX, X):
Hair cell – Vestibular Ganglion – Superior Vestibular Nucleus – MLF ***
Pathway for CN V Trigeminal:
Trigeminal Ganglion – Pars Interpolaris – Thalamus – PLIC
Pathway for CN VII Facial:
Geniculate Ganglion – Pars Caudalis – Thalamus – PLIC
Pathway for CN IX Glossopharyngeal & CN X Vagus:
Superior Ganglion – Pars Caudalis – Thalamus – PLIC
Where is the Transverse Ligament located?
Holds Dens in fovea dentes of Atlas (across posterior dens)
Where is the Cruciform Ligament?
C2 Body to Occiput
Where is the Alar (Check) Ligament?
Sides of Dens to Occiput (limit rotation)
Where is Apical Dental ligament?
Tip of Dens to Rim of Occiput
Where is Denticulate ligament?
Anchors spinal cord to bony vertebral canal
Nerve supply pathway for Vision:
Retina – Optic N – Optic Chiasm – Optic Tract (connects superior colliculus) – LATERAL geniculate nucleus (synapse) – down the optic radiations – calcarine fissure of the occipital lobe
Center of the Macula Lutea of Retina that provides greatest acuity (only cones)
Fovea Centralis
“Blind Spot” where optic nerve & vessels attach to the eye
Optic Disc
What muscle controls the lens shape?
Ciliary Muscle
Nerve supply Auditory pathway
Hair Cell (Organ of Corti) – Spiral Ganglion – CN VIII – Ant & Post Cochlear Nucleus – Lateral Lemniscus – Inferior Colliculus – MEDIAL geniculate nucleus – Internal Capsule – Temporal lobe
Describe the pathway of sound travel
External auditory meatus - tympanic membrane (ear drum) - Handle of Malleus - Head of Malleus - Incus - Stapes - Oval Window - Cochlea (perilymph) - Round Window
Intraoccular pressure causes ____ b/c blockage of Canal of Schlemm
Glaucoma
