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Regional Anatomy > The Concept of Junctional Anatomy > Flashcards

The Concept of Junctional Anatomy Flashcards

1
Q

What is junctional anatomy

A
  • The study of anatomy where any distinct regions of the body meet
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2
Q

Give 4 examples of junction in the body

A
  • Where the head meets the neck
  • Where the neck emerges from the thorax
  • Where the upper limbs take root in the thorax
  • Where the lower limbs take root from the pelvic girdle
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3
Q

What are the major junctional areas of the body

A
  • Atlanto-occipital joint
  • Root of the neck
  • The axilla and the shoulder joint
  • The hip joint
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4
Q

Give an alternative definition for junctional anatomy (joining and converging) and give some examples of when this would apply

A
  • The study of the body’s anatomy where a minimum of two anatomical entities come together or diverge from each other.
  • Web spaces of the hand, anatomical areas where bones change their morphology, splitting of blood vessels.
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5
Q

Give another alternative definition of junctional anatomy (changes in layout) and give some examples of when this would apply

A
  • The study of the body’s anatomy where the anatomical layout of tissues changes with the desired functions of that part of the body.
  • The ankle joint
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6
Q

Slide 12

A

Slide 14

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7
Q

What are Langer’s line and what causes the pattern they form

A
  • Linear clefts in the skin
  • Pattern is caused by underlying collagen fibres
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8
Q

What is the controversy around Langer’s lines

A
  • Surgical incision have been recommended along or parallel to Langer’s lines to avoid permanent scarring. However they do not correspond to the best surgical orientation for incisions.
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9
Q

What are striae distensae

A
  • Stretchmarks
  • Occur from tissue under the skin tearing from overstretching or rapid growth
  • Rum perpendicular to tension lines of the skin
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10
Q

Why do plastic surgeons consider
Striae distensae a better guide to skin
incisions than Langer’s Lines

A
  • Striae distensae lines can be used to determine the direction skin tension lines. Aligning surgical incisions here results in minimal tension across the closure of the incision, optimal scar formation and minimal wound contraction.
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11
Q

Slide 18

A

Slide 22

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12
Q

What is the significance of a junction in trauma medicine

A
  • You cannot apply a tourniquet
  • Blood vessels transverse these areas
  • Profound bleeding is a major risk
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13
Q

What is a Type 1 junctional trauma

A
  • Wound enters the junctional zone however surgical control can be gained without entering an adjacent body cavity.
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14
Q

What is a type 2 junctional trauma

A

-Wound enters a junctional zone which requires surgical access to enter a body cavity to gain control of the haemorrhage.

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15
Q

What are some causes of junctional trauma causes and give examples of them

A
  • Penetration (knife, bullet, shrapnel)
  • Blunt (fall, tackle, car accident)
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16
Q

What is the relationship between the energy of the object causing the trauma and the damage it will cause in the junctional zone

A
  • The higher the energy of the object, the more damage caused.
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17
Q

What are the 2 injuries a bullet can cause to the body

A
  • Injury due to the path of the bullet
  • Injury due to energy wave released by the buller
18
Q

What are the key anatomical points to remember when trauma is in the shoulder joint/axilla (blood vessels)

A
  • Sides of the body and aortic arch.
  • Origin of axillary artery
  • Location of axillary artery
  • Zones of axillary artery
  • Branches of axillary artery
19
Q

What is the difference between the right side of the aortic arch and the left side of it

A
  • Right side gives rise to brachiocephalic (which then gives rise to right subclavian and right common carotid)
  • Left side of the aortic arch gives raise to left subclavian and left common carotid directly
20
Q

Where does the axillary artery originate and what is its location

A
  • Subclavian artery
  • Starts at 1st rib and ends inferior to the border of the teres major muscle
21
Q

How many ‘zones’ does the axillary artery have and what are their positions

A
  • 3 zones
  • Zone 1 (above pec minor, gives off 1 branch)
  • Zone 2 (behind pec minor, gives off 2 branches)
  • Zone 3 (distal to pec minor muscle, gives off 3 branches)
22
Q

What is the mnemonic used to remember the branches of the axillary artery in each zone

A
  • Stay (Superior thoracic)
  • Till (thoracoacromial trunk)
  • Late (Lateral thoracic)
  • S (subscapular)
  • P (Posterior circumflex)
  • A (Anterior circumflex)
23
Q

What are the key anatomical points to remember when trauma is in the shoulder joint/axilla (brachial plexus)

A
  • Brachial plexus is found on top of the third zone of the axillary artery.
  • Can be identified by the M shape of the plexus
24
Q

What are the key anatomical points to remember when trauma is in the shoulder joint/axilla (Common Carotid Artery)

A
  • Main blood supply to the brain
  • Wrapped in carotid sheath (fascia for protection)
  • One carotid may be compromised as long as other is fully functioning
25
Q

What are the structures wrapped in the carotid sheath (proximal to distal)

A
  • Carotid artery
  • Vagus nerve
  • Internal jugular vein
26
Q

Why is a catastrophic haemorrhage managed before an airway blockage in an emergency

A
  • Profuse bleeding is likely to kill patient before they die from a lack of oxygen
27
Q

What is the immediate management for a patient who is bleeding profusely

A
  • Hold finger or hand to the bleeding sight and apply pressure, if this is not possible use small and tightly packed dressing
28
Q

Give 3 examples of haemostatic agents

A
  • Factor concentrators
  • Mucoadhesive dressing
  • Procoagulant
29
Q

How do factor concentrators work to stop profuse bleeding

A
  • Work through fast absorption of the water content of blood, causing the rest of it to clot
30
Q

How does mucoadhesive dressing work to stop profuse bleeding

A
  • Use strong adherence to the tissue to physically stop bleeding from wounds
31
Q

How does procoagulant work to stop profuse bleeding

A
  • Deliver procoagulant factors to the haemorrhagic wound to help with the forming of clots
32
Q

After immediate responses to catastrophic bleeding what steps should be taken next

A
  • Patient still requires surgery
  • Patient needs to be kept warm (platelets work best when warm)
  • Proximal and distal control of artery needs to be gain to clamp and repair
  • If proximal control cannot be gained you may need to open up the chest (body cavity)
33
Q

What are the 2 types of brachial plexus injuries

A
  • Upper root injuries - Injury to C5,C6
  • Lower root injuries - Injury to C8, T1
  • INJURY TO C7 CAN BE EITHER
34
Q

What causes an upper brachial plexus injury and what does this cause

A
  • Lateral flexion of the neck
  • Causes Erb Duchene Paralysis (Waiter’s tip deformity)
35
Q

What causes a lower brachial plexus injury and what does this cause

A
  • Forced extreme abduction
  • Klumpke Paralysis
36
Q

What is the effect of an injury to the radial nerve

A
  • Wrist drop
37
Q

What is the effect of an injury to the ulnar nerve

A
  • Ulnar nerve palsy
38
Q

What is the effect of an injury to the median nerve

A
  • Median nerve palsy
39
Q

What is the effect of an injury to the long thoracic nerve

A
  • Winging of the left scapula
40
Q

Why should a person’s broken bone be restored as soon as possible following junctional trauma

A
  • Restoring normal position of bone will help with haemostasis and reduce bleeding.
41
Q

What are the 2 ways that bone can be restored

A
  • Closed reduction - pulling a bone out and back into the correct position.
  • Open reduction - doing surgery to cut down to bone and restore it
42
Q

What steps should you take when repairing tissue following junctional trauma

A
  • Ensure wound is clean
  • Remove necrosed tissue
  • Negative pressure dressing - vacuum
  • Prevent compartment syndrome.

Regional Anatomy (13 decks)

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