Week 1 Anatomy

Question 1

what are the only intrinsic muscles of the back?

Answer 1

iliocostalis, longissimus, spinalis

Question 2

what are the superficial muscles of the back?

Answer 2

1. trapezius 2. latissimus dorsi 3. levator scapulae 4. rhomboid major and rhomboid minor

Question 3

what structure is shown/highlighted?

Answer 3

suboccipital triangle

*does NOT include the rectus capitus posterior minor, which sits right next to it.

Question 4

What structure is usually injured in a rotator cuff injury

Answer 4

The supraspinatus muscle is the most frequently injured component of the rotator cuff muscles, and tears are the most common pathological finding.

The rotator cuff consists of tendons from 4 muscles: subscapularis, supraspinatus, infraspinatus, and teres minor. They are fused with the capsule of the glenohumeral joint and play a major role in stabilizing the joint by holding the head of the humerus in the glenoid cavity during the movements of the scapula at the shoulder joint.

Question 5

What spinal nerve travels between C7 and T1? What about C5 and 6?

Answer 5

C8 spinal nerve, which travels between C7 and T1. This is because there are only 7 cervical vertebrae.
Clinical Correlate: A herniated disc/herniated nucleus pulposus (HNP) or an osteophyte between C5 and C6 compresses C6 spinal nerve.

Question 6

Answer 6

Question 7

knee radio

Answer 7

Question 8

Answer 8

*recall that the short head of the TRICEPS runs along the humerus, but the long head of the BICEPS runs along the humerus and into the joint

Question 9

what structure is shown

Answer 9

plantar aponeurosis

another view shown attached

Question 10

what structure is the red arrow pointing to

Answer 10

flexor retinaculum

Question 11

State each thing being pointed to

Answer 11

Question 12

what/where is the pars interarticularis

Answer 12

Question 13

what pathology is shown

Answer 13

scotty dog fracture ie spondylosis

*the collar of the dog is the fractured pars interarticularis

Question 14

what structures are being pointed to

Answer 14

*recall that the C1 “spinous process” is called the posterior tubercle… It’s technically a “rudimentary spinous process”

Question 15

name each thing

Answer 15

Question 16

what pathology is shown

Answer 16

atlanto-axial instability secondary to loss of transverse ligament of the atlas.

High yield because of intubation procedures in downs syndrome and Rheumatoid arthritis

Question 17

what pathology is shown

Answer 17

hangman’s fracture: bilateral fracture of the pars interarticularis of C2

Hangman’s fractures result from a hyperextension-compression injury typically occurring in an unrestrained occupant in a motor vehicle accident who strikes his forehead on the windshield.

Question 18

what pathology is shown

Answer 18

Jefferson’s Fracture

▪A Jefferson’s fracture is a fracture of C1 usually involving both the anterior and posterior arches. In its classical presentation, there are bilateral fractures of both the anterior and posterior arches of C1 producing four fractures in all.

▪It is caused by an axial loading injury (such as diving into a swimming pool and hitting one’s head on the bottom).

. On conventional radiographs, the hallmark of a Jefferson fracture is bilateral, lateral offset of the lateral masses of C1 relative to C2 as seen on the open-mouth view (atlantoaxial view) of the cervical spine. The fracture is confirmed utilizing CT

Question 19

what pathology is shown

Answer 19

burst fracture

(*don’t confuse with compression fracture, which is a height decrease but no retropulsion of bone)

Question 20

Identify the hidden structures (ignore others)

Answer 20

median sacral crest

posterior sacral foramen

sacral hiatus

posterior sacral facets

Question 21

the sacrum is ____ fused vertebra (#)

Answer 21

5

Question 22

the coccyx is ___ fused vertebrae (#)

Answer 22

4

Question 23

what is an annulus fibrosis

Answer 23

Question 24

Identify the hidden structures

Answer 24

Question 25

1. full name of muscle 2. superficial, intermediate, or deep? 3. what is its action

Answer 25

1. serratus posterior inferior 2. intermediate 3. depresses ribs in forced expiration \*Notice on the same picture you can see the serratus posterior superior - function is elevation of ribs during forced inspiration

Question 26

what are the covered structures

Answer 26

For the **erect**orspinae muscles, from lateral to medial: 1. iliocostalis 2. longissimus 3. spinalis the mnemonic is: **I** **L**ove **S**pine (lateral to medial) (you know this mnemonic, you just have to remember which group it belongs to --\> remember that when you're in love your dick is **erect**

Question 27

what muscle group and depth are these muscles 1. iliocostalis 2. longissimus 3. spinalis

Answer 27

erector spinae group of the deep muscles of the back (listed in order of lateral to medial)

Question 28

name the hidden structures, their function, and relative depth

Answer 28

Of the spinotransversales group. splenius capitis (top) and splenius cervicis (bottom) **function**: Together—draw head backward, extending neck; individually—ipsilateral rotation of the head MN: "Fiona, lemme 'splain you something - you need to sit up straight" (these are the muscles that are weak for me when I'm hunching)

Question 29

Name the hidden structures and what do they innervate and/or supply

Answer 29

from top to bottom 1. levator scapulae muscle 2. dorsal scapular nerve --\> innervates levator scapulae, rhomboid major and rhomboid minor (motor) 3. superficial branch of transverse cervical artery --\> supplies the trapezius

Question 30

blood supply to levator scapulae, rhomboid minor and rhomboid major

Answer 30

they all use the dorsal scapular artery for blood supply (which in turn, originates from the subclavian artery)

Question 31

For the latissimus dorsi: 1. blood supply 2. Innervation 3. Insertion 4. function

Answer 31

latissimus dorsi is latin for the "most extra" ... so this bitch gets arrested three **(thraco-**) dorky (-**dorsal)** officers and handcuffed. she's sulking (sulcus) in between (inter-) the two (-tubercular) back seats of the car. 1. blood supply - thoracodorsal artery (which originates from subscapular artery 2. Innervation - thoracodorsal nerve (which originates from the posterior cord of the brachial plexus) 3. Insertion - intertubercular sulcus of the humerus 4. function -all the handcuffing motions (medial rotation, adduction, extension) ^mnemonic to remember this is the handcuff muscle

Question 32

from top to bottom, what are the hidden structures

Answer 32

Question 33

motor versus sensory innervation of the trapezius

Answer 33

motor: spinal accessory nerve (CN 11) sensory: C3-4 \*clinical application: if the patient can't push against something with trapezius muscle, you need to assess brainstem because CN 11 is affected

Question 34

what nerve is going through the triangular interval wjat artery is going through the trangular interval?

Answer 34

1. radial nerve 2. brachial artery

Question 35

origin of the trapezius

Answer 35

mn: it's trap-EASY... it follows the same path as the spinal cord (C1 -T12) \*except in the cervical spine it's technically attaching to the superior nuchal line

Question 36

what path would a needle follow during a lumbar puncture

Question 37

trapezius insertion

Answer 37

clavicle (lateral 2/3) and scapula (along the spine of the scapula) clinical application: the patient with a clavicle fracture will only elevate part of the clavicle because the muscle only inserts onto part of it

Question 38

blood supply of trapezius

Answer 38

subclavian artery --\> thyrocervical trunk --\> **superior branch of transverse cervical artery**

Question 39

what structure is outlined in blue

Answer 39

thoracolumbar fascia (connected to latissimus dorsi)

Question 40

what is the exact name of the structure with a pin in it

Answer 40

floor of the intertubercular sulcus (insertion point for latissimus dorsi)

Question 41

state the pathway of blood flow from the sublavian artery to exiting out the triangular space

Answer 41

subclavian--\> axillary (3rd segment)--\> subscapular--\> circumflex scapular artery

Question 42

trace the pathway of blood supply from the subclavian artery to supplying the latissimus dorsi

Answer 42

subclavian --\> axillary (to 3rd segment) --\> subscapular --\> thoracodorsal (

Question 43

the subscapular artery branches off of the ______________ and branches into the \_\_\_\_\_\_\_\_\_\_\_\_and the \_\_\_\_\_\_\_\_\_\_

Answer 43

off of _axillary_ artery (3rd segment) into the _circumflex scapular_ artery and the _thoracodorsal_

Question 44

the thoracodorsal nerve branches off of the ____________ of the brachial plexus

Answer 44

posterior cord mn: it goes to the back (latissimus dorsi) hence "posterior"

Question 45

thoracodorsal nerve is aka/synonymous with \_\_\_\_\_\_\_\_\_\_

Answer 45

middle subscapular nerve

Question 46

name the hidden structures of this AP XR of the shoulder

Answer 46

Question 47

what is the origin and insertion of the levator scapulae

Answer 47

Origin: TRANSVERSE process of C1-6 on either side Insertion: medial superior angle of the scapula mn: S for Six (C6 vertebra) and Scapula

Question 48

what artery pierces through the brachial plexus

Answer 48

dorsal scapular artery (pierces between the superior and median trunks of brachial plexus)

Question 49

what structure is shown and what are the origin and insertion points. is it part of an anatomical triangle?

Answer 49

1. rectus capitus posterior minor 2. origin: posterior arch of C1; insertion: inferior nuchal line 3. NO - although it is directly adjacent to the suboccipital triangle

Question 50

name the muscles that make the borders of the suboccipital triangle

Answer 50

Question 51

name the structures that make up the floor, roof, and contents of the suboccipital triangle

Answer 51

floor: posterior arch of C1 roof: semispinalis capitus muscle contents: dorsal ramus of C1 nerve (aka supoccipital) and vertebral artery (same as blood supply and innervation)

Question 52

what are the borders of the triangle of auscultation

Answer 52

superior: scapula (medial border) lateral: trapezius (inferior order of) inferior: latissimus dorsi (superior border of)