Trunk Flashcards

1
Q

Attachment of Iliocostalis lumborum

A

Angle of the rib

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2
Q

Cost-vertebral joint

A

TWo facets on head of rib –> vertebral body above and below

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3
Q

Costo-transverse joint

A

Tubercle of rib –> transverse process of corrosponding vertebrae

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4
Q

Ligaments supporting the rib

A

Radiate ligaments around cost-vertebral joint

Superior costo-transervse ligament around costo-tranverse joint

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5
Q

Muscles of inspiration

A

Diapgragm

External intercostals

Scalene muscles

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6
Q

Muscles of expiration

A

Internal intercostals

Rectus abdominis

Transversus abdominis
Internal oblique
External oblique

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7
Q

Passages through the diaphragm

A

T8: IVC

T10: Oesophagus

T12: Descending Aorta

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8
Q

Origins of median arcuate ligamaent

A

Left crus arises L2

Right crus arises L3

For median arcuate ligament over aorta

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9
Q

Origins and Insertions of the Scalene Muscles

A

Anterior Scalene

  • Anterior tubercles of the transverse processes C3-C6
  • Inserts 1sr rib

Middle Scalene

  • Posterior tubercles of the transverse process of C2-C6
  • Inserts 1st rib

Posterior Scalene

  • Posterior tubercles of the transverse process of C4-C6
  • Inserts 2nd rib
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10
Q

Branches of the aorta in the Thorax

A

Ascending Aorta
-Coronary arteries immediately

Arch of the Aorta

1st. Brachiocephalic trunk (right)
2nd: Left common carotid artery
3rd: Left subclavian artery (–> internal thoracic artery)

Descending Aorta
-Posterior intercostal arteries

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11
Q

Veins of thr Thorax

A

Subclavian vein and internal jugular vein join behind medial clavicle

Form the brachiocephalic vein

2 x Brachiocephalic veins join to make SVC

SVC joined by azygous vein posteriorly as it branches over right main bronchus

SVC joins RA

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12
Q

Azygous vein

A

Ascends right side of vertebral column

Right sided intercostal veins drain directly into azygous

Left sided posterior intercostal veins drain into hemizygous prior to this joining with azygous

Arches over right main bronchus to joing SVC just priot to RA

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13
Q

Phrenic Nerves in Thorax

A

C3 C4 C5
Motor and sensory supply to the diapragm

Runs down front of anteror scalene muscle

Passes in front of subclavian artery and behind subclavian vein

Right side: runs in front of root of right lung and close to SVC / RA

Left side: Passes arch of arota, left vetricle

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14
Q

Vagus Nerves in Thorax

A

Parasympathic supply to thorax and abdomen

Runs down between internal jugular vein and common carotid

Passes in front of subclavian artery
Left side: recurrent laryngeal nerve divides off and runs around subclavian artery to larynx

Right side: passes in front of aorta, recurrent laryngeal nerve passes back around ligamentum arteriosum

Both had posteriorly to oesophagus

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15
Q

Origins of Thoraco-Lumbar Fascia

A

O: posterior layer from spinous process of thoracic vertebrae
anterior layer from transverse process of thoracic vertebrae

Forms single band which is the fascia

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16
Q

Origins, Insertion and Function of Quadratus Lumborum

A

O: 12th rib and transverse process of L1 - L3

I: Medial iliac crest and transverse process of L5

F: Lateral flexion of the lumbar spine

17
Q

Origins, Insertion and Function of Psoas Major

A

Lies medially to the quadratus lumborum
O: transverse process, vertebral bodies, and intervertebral discs of T12 - L5

Becomes continuous with iliacus to form iliopsoas

I: Lesser trochanter of the femur

F: Hip flexion

18
Q

Origins, Insertion and Function of Iliacus

A

O: Ilaic fossa

Becomes continuous with psoas to form iliopsoas

I: Lesser trochanter of the femur

F: Hip flexion

19
Q

Origins, Insertion and Function of Rectus Abdominis

A

O: 5th, 6th and 7th costal cartilages

I: Pubic crest

Separates into sections by the tendinous intersections

F: Flexion of lumbar spine

20
Q

Origins, Insertion and Function of Transversus Abdominis

A

O: Board origin

  • Costal margins 6th - 12th ribs
  • Edge of thoraco-lumbar fascia
  • Iliac crest
  • Thickening of iliopsoas fascia

I: Transversus aponeurosis which becomes continuous with intenral onblique aponeurosis

Fibres run mostly horizontal

21
Q

Origins, Insertion and Function of Internal Oblique

A

O:

  • Edge of thoraco-lumbar fascia
  • Iliac crest
  • Thickening of iliopsoas fascia

I: Ribs 9-12
Internal oblique aponeurosis

Fibres span in fan, change according to position

22
Q

Origins, Insertion and Function of External Oblique

A

O:
Borad area fro, 12th - 5th ribs

I:
Anterior (9th - 6th ribs) –> External oblique aponeurosis
Posterior (12th-10th ribs) –> Outer edge of iliac crest

Fibres run downwards and forwards, oblique

F: Lateral flexion of lumbar
Rotation of thoracic

23
Q

Branches of Abdominal Aorta

A

T12: immediately below diaphragm
–> Coeliac trunk (hepatic, splenic, and left gastric)

Superior mesenteric artery
L1

Renal Arteries just below SMA

Ovarian / Testicular arteries L2

Inferior mesentaric artery L3

Medial sacral artery
L4, just prior to bifurcation

Lumbar arteries, 4 pairs

24
Q

Branches of Common Iliac Artery

A

Divides into extenral and internal iliac arteries

Extrenal iliac artery passes down, gives off deep cicumflex iliac artery on the lateral side

Gives of inferior epigastric artery medial side

Passes under inguinal ligament and becomes femoral artery

25
Ligaments of the sacrum
Anterior sacroiliac ligament Posterior sacroiliac ligament Sacro-tuberous ligament (inserts ischial tuberosity) Sacrospinous ligament (inserts ischial spine)
26
Muscles of the pelvic diaphragm
Coccyegus -Runs from ischial spine to edge of lower sacrum + coccyx Levator Ani - Complex line of origin: bone-tendon-bone - Arises body of pubis --> Tendinous arch --> Ischial spine - Fibres downwards, backwards and medial
27
Origins, Insertion and Function of Piriformis
O: Anterior sacrum --> passes through greater sciatic foramen and passes laterally I: Greater trochanter of the femur F: Rotation of the hip
28
Origins, Insertion and Function of Obturator internus
O: Obturator membrane (covering obturator foramen) --> passes through greater sciatic foramen and passes laterally I: Greater trochanter of the femur F: Rotation of the hip
29
Tendinous Arch
Obturator Internus is covered by fascia that has a thickening = tendinous arch Runs from body of the pubis to the ischial spine Forms part of the origin for levator ani muscle
30
Parts of Levator Ani Muscle
Superior part: Ilio-coccygeal (thin) Inferior part: Pubo-coccygeus (thick)
31
Ano-coccogyeal ligament
Forms at the posterior communication of the two levator ani muscles Extends to the external anal sphincter
32
Branches of International Iliac Artery
Internal iliac artery Vesicular --> Superior gluteal --> Inferior gluteal -->Internal pudendal artery -->Middle rectal -->Obturator artery
33
Path of Internal Pudendal Artery
Branches from internal iliac Leaves through greater sciatic Forman Crosses Sacrospinous ligament Passes back in through lesser sciatic foramen Ends up below pelvic diaphragm
34
Sacral Plexus
S1 - S4 anterior rami L4-L5 contributions from the limbo-sacral trunk Lies over piriformis Leaves through greater sciatic foramen
35
Pudendal Nerve
Follows course of pudendal artery --> out of greater sciatic foramen and back through lesser sciatic foramen S2-S4 Supplies: Anal sphincter External genitalia Urogenital diaphragm