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FRCA Anatomy > Surface Anatomy > Flashcards

Surface Anatomy Flashcards

1
Q

Boundaries of the ACF

A

Base - line joining medial and lateral epicondyles of humerus
Lateral - medial border of brachioradialis
Medial - lateral border of pronator teres
Apex - meeting of l and m borders

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2
Q

Roof and floor of the acf

What lies in the roof plane

A

Roof - bicepital aponeurosis, deep fascia and skin
Floor - brachialis and supinator muscles
In the roof plane is the medial cubital vein. Medially and laterally are the medial and lateral cutaneous nerves of the forearm, basalic vein and cephalic vein

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3
Q

Contents of the ACF from lateral to medial and pneumonic

A

Radial nerve, biceps tendon, brachial artery, median nerve (really need booze to be at my nicest)

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4
Q

Relationships of the median nerve in the acf

A

Superficial - bicepital aponeurosis and median cubital vein
Deep - brachialis
Medial - pronator teres and medial cutaneous nerve of forearm
Lateral - brachial artery

Leaves ACF between heads of pronator teres

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5
Q

Path of cephalic vein up the arm

A 
Lateral end of dorsal venous arch 
Ascends lateral forearm and arm. 
Enters deltopectoral groove 
Pierces clavipectoral fascia 
Drains into axillary vein
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6
Q

Common site of picc lines sticking in cephalic vein

A

Where it turns sharply to pierce claviopectoral fascia

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7
Q

Route of basilic vein in arm

A

Medically on Dorsum of hand
ascends medial forearm
Pierces deep fascia medial to biceps brachii
Combines with brachial vein at lower border of teres major forming axillary vein

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8
Q

Route of median cubital vein

A

Originate in cephalic vein

Ascends medially in acf superficial to bicepital aponeurosis joining basilic vein

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9
Q

Route of brachial artery

A

Originates from axillary artery
Lies medially but then moves laterally
Lies beneath bicepital aponeurosis in acf
Terminates in ACF dividing into radial and ulnar arteries

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10
Q

What is the bicepital aponeurosis

A

Starts from medial lower border of biceps
Moves medially and inferiorly blending with deep fascia of forearm
Forms a strong fibrous band

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11
Q

Where is the anterior triangle of the neck

A

Meet in the midline
Superiorly the body of the mandible
Apicies at suprasternal notch
Posterior limit anterior border of SCM

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12
Q

What is contained in the anterior triangle of the neck

A

Carotid and jugular vessels
Glossopharyngeal, vagus, accessory and hypoglossal nerve
Salivary glands
Larynx, pharynx, trachea, thyroid

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13
Q

Where is the posterior triangle of the neck

A

Anterior edge is posterior border of SCM
Posterior edge is anterior border of trapezius
Apex is cephalad where the muscles converge
Base is formed by mid third of clavicle

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14
Q

What is contained in the posterior triangle of the neck

A

Subclavian artery
External jugular vein
Brachial and cervical plexus
Accessory nerve

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15
Q

What are the attachments of SCM

A

Sternum and medial third of clavicle (2 heads) into mastoid of skull

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16
Q

What is contained in the carotid sheath

What is its course?

A

Carotid arteries
IJV
Vagus nerve
Deep cervical lymph nodes

Runs in anterior triangle from line between sternoclavicular joint to a point midway between tip of mastoid process and angle of mandible

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17
Q

Where in surface anatomy does the carotid artery bifurcate

Clinical significance

A

On the line of the carotid sheath (SC joint to midway between mastoid and angle of jaw) at the level of the thyroid cartilage.
Strongest arterial pulse ration at this level

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18
Q

What is the orientation of the carotid artery with respect to other components within the carotid sheath.

A

Artery is medial to the vein and anterior to the vagus nerve

19
Q

What is the path of the subclavian artery in relation to the posterior triangle of the neck

A

The third part of the subclavian artery (lateral to scalenus anterior) runs through the anterior inferior apex of the posterior triangle, arching convexly upwards between the sternoclavicular joint and the midpoint of the clavicle over the first rib

20
Q

What is the relationship between the subclavian vein and artery?

A

The vein sits anterior and superficial to the artery rarely rising above the clavicle

21
Q

What is the course of the EJV

Why can’t it be used for a central line

A

Runs from angle of jaw diagonally down towards middle of clavicle through posterior triangle. about 2cm above clavicle drops through deep fascia and then under clavicle joins the subclavian vein. A valve at the junction prevents central cannulation.

22
Q

Where does the brachial plexus emerge in the posterior triangle

A

Between scalenus anterior and medius in the interscalene groove.
This itself is found behind posterior edge of SCM anterior to the EJV.

23
Q

What is the surface anatomy that indicates the cephalad limit of the brachial plexus

A

A line from the cricoid cartilage to the clavicle mid point

24
Q

What is the relationship between the brachial plexus trunks and the subclavian artery

A

Run through the inferior medial corner of the posterior triangle with it. Upper and middle trunks lie above the artery, lower trunk behind it.
They end in divisions just laterally as they continue behind the clavicle.

25
Q

Where does the cervical plexus emerge and travel in the neck?

A

Emerges at midpoint of posterior border of SCM
Lesser occipital nerve follows posterior border of the SCM up
Greater auricular nerve runs over SCM towards ear
Transverse cervical nerves pass forward over SCM to anterior neck
Supraclavicular nerves descend towards the clavicle

26
Q

Vertebral level of the cricoid cartilage

A

C6

27
Q

What is the advantage to a tracheostomy at the level of the second or third tracheal ring over a cricothyrotomy? How is the ideal site located

A

Less risk of tracheal stenosis

Half way between cricoid cartilage and sternal notch

28
Q

What is a big risk of bleeding in tracheostomy insertion

How can it be identified to some extent

A

Blood vessels, particularly the anterior jugular vein crossing the anterior of the trachea

If pt is conscious ask them to perform a vasalva, or perform an USS

29
Q

Length of adult male/female spine

A

71/61 cm

30
Q

What are the vertebral landmarks?

A

C2 - palpable
C7 - large spinous process easily palpable
T3 - level of medial root of spine of scapula
T7 - level of inferior angle of scapula with arms at side
T12 - trace back lower ribs to attachment
L4 - tuffners line between highest points of both iliac crests (can also be L4/5 space)
S2 - between the posterior superior iliac spines (skin dimples)

31
Q

Where does the spinal cord end in an adult
In a child?

Where does the dural sac end in an adult

A

L1
L3
S2

32
Q

Can you palpate C1

A

No, no spinous process

33
Q

What is the midline point of the occipital protuberance called

A

Inion

34
Q

What vertebral level is the cricoid cartilage

A

C5

35
Q

What vertebral level is apex of lung

A

C7

36
Q

What vertebral level is carina

A

T3

37
Q

What vertebral level is upper border of heart

A

T4

38
Q

What vertebral level is lower border of heart

A

T8

39
Q

Lower border of lung

Cardia of stomach

A

T10

40
Q

What vertebral level is lowest level of pleura

A

T12

41
Q

What vertebral level is hilum of kidney

A

L1

42
Q

What vertebral level is lower border of kidney

A

L3

43
Q

What vertebral level is bifurcation of aorta

A

L4

44
Q

What vertebral level is formation of IVC

A

L5

FRCA Anatomy (3 decks)

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