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1 Regional anatomy Flashcards

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1
Q

What is the difference between the three types of cartilage?

A

Hyaline cartilage: blue/white translucent. (costal, nasal, epiphyseal growth plates)
Fibrocartilage: white fibrous tissue with islands of cartilage and ground substance between collagen bundles (knees, hips, mandible, clavicle)
Elastic: yellow (ear, eustachian tube and epiglottis)

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2
Q

How does the cellular structure vary between muscle types?

A

Smooth muscle: single nucleus
Cardiac muscle: single or double nucleus
Skeletal: multiple nuclei

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3
Q

Describe smooth muscle cells

A

Spindle-shaped cells

Parallel

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4
Q

Describe cardiac muscle cells

A

Thick broad short cells that branch

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5
Q

Describe skeletal muscle cells

A

Long cylindrical, cells surrounded by endomysium

Either parallel or oblique

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6
Q

Three patterns of oblique pattern of skeletal muscle fibres

A

Unipennate muscles: all slope to one side of a tendon (FPL)
Bipennate: slope to two sides of a tendon (rectus femoris)
Multipennate: multiple bipennate side by side (subscapularis) or cylindrical (tibialis anterior)

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7
Q

What are muscle spindles?

A

Intrafusal

Sensory receptor

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8
Q

What are the two key types of bone?

A

Compact: Surface cortex, mineralised collagen embedded with osteocytes
Cancellous: Spongework of trabeculae

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9
Q

What are the two processes by which bones form?

A

Intramembranous ossification: osteoblasts lay down bone on fibrous tissues (skull, face, clavicle)
Endochondral ossification: pre-existing hyaline cartilage model is gradually destroyed and replaced by bone

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10
Q

What are the three types of joint?

A

Fibrous
Cartilaginous (primary or secondary)
Synovial

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11
Q

What is a fibrous joint?

A

Two bones separated by only connective tissue (sutures of the skull)

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12
Q

What is a cartilaginous joint?

A

Primary: bone and hyaline cartilage meet (epiphyses and ribs)
Secondary: union between bones covered by hyaline cartilage

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13
Q

What are the six features of synovial joints?

A
  1. Bones covered in hyaline cartilage
  2. Surrounded by capsule
  3. Enclosing a joint cavity
  4. Enforced by ligaments
  5. Internally lined by a synovial membrane
  6. Capable of movement
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14
Q

Definition of mucus membrane

A

Lining of internal body surface with communicates with the exterior

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15
Q

Definition of serous membrane

A

Lining of closed body cavity

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16
Q

Wall of capillaries

A

Flattened endothelial cells

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17
Q

Wall of arteries

A

Tunica intima
Tunica media-elastic
Tunica adventitia

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18
Q

Wall of veins

A

Tunica intima- valves
Tunica media
Tunica adventitia

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19
Q

Where is myelin formed?

A

CNS: Oligodendrocytes
PNS: Schwann cells

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20
Q

How does the size of peripheral nerve fibres relate to their function?

A

Widest tend to conduct fastest
Largest: motor or proprioceptive
Smallest: autonomic or sensory

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21
Q

How many spinal nerves are there?

A

31

8 cervical
12 thoracic
8 Lumbar
5 sacral
1 coccygeal
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22
Q

Describe the formation of a spinal nerve

A

Formed by anterior and posterior root
Happens in the intervertebral foramen
Anterior (motor and autonomic fibres plus pain)
Posterior (sensory-no synapses)
Then splits into anterior and posterior ramus
Anterior forms plexuses
Posterior ramus NEVER SUPPLIES SKIN OR MUSCLE

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23
Q

Which is the only spinal nerve with no cutaneous branch?

A

C1

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24
Q

Where is the neurovascular plane of the thoracic wall?

A

The layer between inner layer (subcostals, innermost intercostals and transversus thoracis) and internal intercostals.
Nerves lie below arteries except the nerves cross arteries alongside vertebral column and ventral midline
At these points the nerves are close to the skin

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25
Describe the skin supply of the cervical nerves
C1-nil C2- Occiput, posterior neck and skin over parotid C3- Neck C4- Infraclavicular region, shoulder and above scapula spine C5- Lateral arm C6- Lateral forearm and thumb C7- Middle finger C8- Little finger and distal medial forearm
26
Describe the skin supply of the thoracic nerves
``` T1- medial arm above and below elbow T2- axilla and thorax T3- Thorax and occasionally axilla T4- nipple T7-subcostal angle T8- Rib margin T10- umbilicus T12- lower abdomen, upper buttock ```
27
Describe the skin supply of the lumbar spinal nerves
L1- Suprapubic and inguinal regions, penis and anterior scrotum L2- Anterior thigh, upper buttock L3- Anterior and medial thigh and knee L4- Medial leg, medial ankle and medial foot L5- Lateral leg, dorsum of foot, medial sole
28
Describe the skin supply of the sacral spinal nerves
S1- Lateral ankle, sole and lateral dorsum of foot S2- Posterior leg, thigh, buttock penis S3- Sitting area of buttock, posterior scrotum S4- Perianal S5 and coccygeal- Behind anus and over coccyx
29
What is a myotome?
Amount of muscle supplied by one segment of the spinal end
30
What are the four key facts about myotomes?
1. Most muscles are supplied equally by 2 adjacent segments 2. Muscles sharing a primary action on a joint are all supplied by the same segments 3. Their opponents share the same nerve segments 4. For distal joints the spinal centre lies lower in the cord. For each joint one segment more distal in the limb, the centre lies one segment lower in the cord
31
What are the main spinal segments controlling hip flexion and extension
Hip Flex L2,3 Extend L4,5
32
What are the main spinal segments controlling knee extension and flexion
Knee Flex L3,4 Extend L5,S1
33
What are the main spinal segments controlling ankle dorsi and plantar flexion
Ankle Dorsiflex: L4,5 Plantar: S1,2
34
What are the main spinal segments for foot inversion and eversion
Foot Invert: L4 Evert: L5, S1
35
What are the main spinal segments controlling elbow flexion and extension
Elbow Flex C5, 6 Extend: C7, C8
36
What are the spinal segments that control shoulder movement?
Abduct and laterally rotate: C5 | Abduct and medially rotate: C6, 7, 8
37
What are the spinal segments to pronate and supinate the forearm?
Pronate: C7,8 Supinate: C6
38
What are the main spinal segments controlling wrist flexion and extension
Wrist Flexion: C6,7 Extend: C6, 7
39
What are the main spinal segments controlling finger and thumb flexion and extension
Flex C7, 8 | Extend C7, 8
40
Which spinal segment controls the intrinsic muscles of the hand?
T1
41
What is the key anatomical difference between the somatic and autonomic nervous system?
Autonomic is interrupted by synapses in a ganglion (preganglionic and postganglionic)
42
What are the four parasympathetic ganglia of the head and neck?
Ciliary Pterygopalantine Submandibular Otic
43
Describe embryonic development from zygote to neural tube
Zygote Morula Blastocyst- splits into trophoblast and inner cell mass Trophoblast becomes placenta Inner cell mass becomes amnion and yolk sac Between amnion and yolk sac is embryonic plate Embryonic plate is split into 3, endoderm, mesoderm and ectoderm An axial rod of cells grows from endoderm to ectoderm, this is the notocord On ectodermal side of embryonic plate the neural groove develops which becomes neural tube
44
How does the eventual outcome of neural tube cells differ to those in the neural crest?
Neural tube=brain and spinal cord | Neural crest= posterior root ganglia, autonomic ganglia, CN ganglia and schwann cells
45
What does paraxial mesoderm form?
Mesodermal somites | Which produce sclerotome--(dura mater and vertebrae) and myotome-- (muscles of body wall)
46
What does the intermediate cell mass (of the mesoderm) form?
Lateral side= pronephros, mesonephros, metanephros (genital and urinary systems) Medial side= gonad and suprarenal gland
47
What is the splanchnopleure?
Inner layer of the embroyonic coelom/body cavity. Formed as the lateral plate curls around to enclose the yolk sack. Innervated by the autonomic nervous system
48
What is the somatopleure?
Outer layer of the lateral plate innervated by spinal nerves.
49
Where do limbs come from embryologically?
From lateral plate mesoderm and muscles develop in situ
50
What is the difference between branchial arches and branchial pouches?
Branchial arches: condensed mesoderm develop into the side wall of the pharynx by meeting in the middle Branchial pouches: internal grooves between the branchial arches
51
What does the first branchial arch form?
Mandibular and maxillary branches of trigeminal nerve Maxillary artery Meckel's cartilage which becomes incus and malleus and Sphenomandibular ligament Lingula Anterior 2/3 tongue mucus membrane Muscles of mastication Mylohyoid
52
What are the lateral derivatives of the first pharyngeal arch?
First pouch No dorsal/ventral diverticulum Auditory tube External acoustic meatus
53
What does the second pharyngeal arch form?
``` Facial nerve Stapedial artery and hyoid artery Stapes, styloid process, stylohyoid ligament, lesser horn and upper body of hyoid bone Smiling muscles (buccinators, platsyma Stapedius Stylohyoid Posterior belly of digastric ```
54
What are the lateral derivatives of the second pharyngeal arch?
Second pouch Dorsal diverticulum forms tympanic cavity Ventral diverticulum forms tonsillar crypts, supratonsillar fossa from endoderm. Lymph tissue of palatine tonsil Supplied by glossopharyngeal
55
What forms from the 3rd pharyngeal arch?
Glossopharyngeal nerve Common carotid artery and proximal internal carotid Greater horn of hyoid and caudal half of body of hyoid Stylopharyngeus
56
What are the lateral derivatives of the 3rd pharyngeal arch?
Dorsal diverticulum: inferior parathyroid gland | Ventral diverticulum: thymic rudiment -> join caudaly -> bilobed thymus
57
What forms from the 4th pharyngeal arch?
Superior laryngeal and pharyngeal branch of the vagus nerves Proximal right subclavian artery Arch of the aorta Thyroid cartilage, cricoid cartilage, artyneoid cartilage, epiglottic cartilage Intrinsic muscles of the larynx Muscles of pharnyx Levator palati
58
What are the lateral derivatives of the 4th pharyngeal arch?
Fourth pouch Dorsal diverticulum: superior parathyroid glabd Ventral: attached to thyroid, probably contributes to thymus
59
What does the 6th pharyngeal arch form?
Recurrent laryngeal and pharyngeal branch of the vagus nerve Ductus arteriosus and proximal pulmonary arteries Thyroid cartilage, cricoid cartilage, artyneoid cartilage, epiglottic cartilage Intrinsic muscles of the larynx Muscles of pharnyx Levator palati
60
What does the fifth pouch form?
Regresses | Forms utimobranchial body-> parafollicular C cells of the thyroid which produce calcitonin
61
What is the cervical sinus?
A pit formed as the arches grow together. The endoderm fuses over top and imprisons the ectoderm which disappears, if it does not a branchial cyst forms
62
Which arches form the tongue?
1,3 and 4
63
How is the thryroglossal duct form?
Endoderm of the pharynx at the foramen caecum. Travels down in front of hyoid bone Thyroid gland buds from distal end of the duct
64
What is the furcula?
A wishbone shaped ridge over the 4th and 6th pharyngeal arches As the edges of the ridge grow together, they convert the gutter into a tube, forming the larynx and trachea split from the esophagus The furcula persists at the aperture of the larynx
65
What do the 6 branchial arch arteries form?
1: maxillary artery 2. stapedial artery (does not persist after birth) 3: common carotid and internal carotid arteries 4: Right- right subclavian artery Left- aortic arch 5: disappears 6: Right- pulmonary artery Left- pulmonary artery and ductus arteriosus
66
What are the most common anomalies of the great vessels?
Patent ductus arteriosus Coarctation of the aorta (defect of tunica media) Abnormal origin of the right subclavian artery: comes from the arch of aorta and passes behind esophagus-> dysphagia Also causes right recurrent laryngeal nerve to be non recurrent
67
How does the heart develop embryologically?
Endocardial tubes Fuse into heart tube Heart tube (truncus arteriosus, bulbus cordis, primitive ventricle, primitive atrium, sinus venosus) Bulb twists to right and ventricle twists to the left at around 23 days Heart has 4 fully formed chamber by 8 weeks
68
What are the 3 sources of blood supply for the sinus venosus?
Placenta via umbilical veins Yolk sac via vitelline veins Embryo tissues via cardinal veins
69
Which 3 primitive veins disappear?
R umbilical L vitelline L cardinal
70
What does the R vitelline vein become?
Portal vein and upper end of IVC
71
What does the R anterior cardinal vein form?
R branchiocephalic vein and part of SVC
72
What does the common cardinal vein form?
SVC
73
What does the right posterior cardinal vein form?
Azygous and hemiazygous veins
74
Which vessels combine to make up the cardinal veins?
IJV + subclavian -> anterior cardinal EIV + IIV -> posterior cardinal ACV + PCV -> common cardinal
75
What forms the ligamentum teres and ligamentum venosum (round ligament)?
In the fetus, o2 rich blood from the placenta passes into the L umbilical vein and bypasses the liver via ductus venosus straight into the IVC. After birth, the umbilical vein and ductus venosus form the round ligament (which is continuous with the falciform ligament and connects left branch of portal vein to IVC)
76
What is the function of the foramen ovale?
RA to LA to bypass lungs
77
What is the function of the ductus arteriosus?
Deoxygenated blood from SVC through pulmonary trunk to aorta to bypass lungs to get to placenta
78
What happens to the ductus arteriosus at birth?
Closes due to contraction of muscular walls | Persists as ligamentum arteriosum
79
When do the fontanelles close?
Anterior: 18 months Posterior: 3 months Frontal bone fuses by 8 years but metopic suture persists in 8% of people
80
How to the skull ossify?
Base of the skull ossifies in acrtilage | Vault and face ossify in membrane
81
Why is the facial nerve vulnerable in children?
Absent mastoid process
82
How does the inner ear differ between a child and adult?
Tympanic membrane is more downwards and less lateral than adults
83
Describe the mandible of a newborn
2 halves Mental foramen at lower border (rises with age) Mental neurovascular bundle emerges forwards (instead of backwards in adults) Coronoid process above condyle
84
How do the facial proportions of a newborn differ to an adult?
Vertical height of mandible+maxilla =height of orbit | 3:1 in an adult
85
What is a key consequence of the short neck of the newborn?
L brachiocephalic vein sits above the jugular notch Vocal cords 5mm Enlarge from 8mm to 16mm in a year of puberty (in males)
86
Why do small children have pot bellies?
Large liver (2x as big relatively) and less content in pelvic cavity, urinary bladder is above pubic syphysis Appendix is at the apex of the conical caecum Adrenals are nearly same size as kidneys at birth
87
How does the upper limb grow?
Growth occurs more at the shoulder and wrist
88
How does the lower limb grow?
Growth occurs more at the knee
89
How is the spinal cord differ in a newborn?
It ends at L3 | Rises to L1/L2 junction
90
What is the only area of the abdomen to have valves in veins?
Testicles

Anatomy (6 decks)

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