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MRCS Part B - Paul Edit > Anatomy 1 > Flashcards

Anatomy 1 Flashcards

(85 cards)

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1
Q

What is the normal neck-shaft angle of the femur? Neck anteversion?

A

130 degrees

10 neck anteversion

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2
Q

Vascular supply to hip joint?

A

Medial and lateral femoral circumflex - branches of profunda femoris. Anastomose and pierce joint capsule at base of neck mostly posteriorly Small contribution from artery of ligamentum teres

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3
Q

Why is leg deformed in fracture neck of femur?

A

Shortened, abducted and externally rotated with inability to SLR

due to unopposed pull of muscles on lesser trochanter (iliopsoas sartorius etc causes shortening, gluteus maximus obturators and piriformis ie short muscles of gluteal region cause rotation)

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4
Q

What is the definition of a subtrochanteric neck of femur fracture?

A

Below but within 5cm of lesser trochanter

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5
Q

Label these?

A

1 - tibial nerve

2 - common peroneal nerve

3 - sural nerve

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6
Q

Label these parts of popliteal fossa?

A

1 - semitendinosus

2 - semimembranosus

3 - gracilis

4 - gastrocnemius

5 - biceps femoris

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7
Q

What is the deepest structure in the popliteal fossa? What is next most superficial?

A

Polpiteal artery

Popliteal vein just superficial

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8
Q

What are the boundaries of the popliteal fossa?

A

Lateral - biceps femoris above, lateral head of gastrocnemius and plantaris below

Medial - semitendinosus and semimembranosus above, medial head gastrocnemius below

Floor - popliteal surface of femur, popliteus and posterior ligament of knee joint

Roof - superficial and deep fascia

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9
Q

What are the contents of the popliteal fossa?

A

Popliteal artery and vein

Small saphenous vein

Common peroneal nerve

Tibial nerve

Posterior cutaneous nerve of thigh

Genicular branch of obturator nerve

Lymph nodes

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10
Q

Lable this femur bony landmarks?

A
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11
Q

What are the major muscle attachments?

A
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12
Q

What is this and what is its functional purpose?

A

Patella - sesamoid bone contained within tendon of quadriceps that reduces work required to extend the knee joint

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13
Q

Label these?

A

A - vastus medialis

B - Sartorius

C - gracilis

D - gastrocnemius

E - semitendinosus

F - semimembranosus

G - rectus femoris

H - adductor magnus tendon

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14
Q

What is this, where is it and what attaches here?

A

Adductor tubercle on medial condyle of femur

Tendon of adductor magnus inserts here

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15
Q

Label these?

A

A - tibialis anterior

B - peroneus longus

C - long head biceps femoris

D - iliotibial band

E - vastus lateralis

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16
Q

What attaches to 1? Where does it go from and 2? What does it do?

A

ACL

From anterior tibia to lateral intercondylar notch of femur

Prevents tibia sliding anteriorly

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17
Q

What attaches to 2? Where does it go from and to? What is its role?

A

PCL

From posterior tibia to medial intercondylar notch of femur

Prevents tibia sliding posteriorly

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18
Q

What demarcates the femoral neck from the body and what does this continue as?

A

Intertrochanteric crest which continue inferomedially as a spiral line running below lesser trochanter

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19
Q

What does the intertrochanteric line attach to medially?

A

Inferior end of iliofemoral ligament

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20
Q

Where does the synovial membrane of the hip joint stop inferiorly?

A

Intertrochanteric ilne

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21
Q

What muscles attach to greater trochanter of femur?

A

Gluteal muscles

Vastus lateralis more distally

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22
Q

What line runs posteriorly down body of femur? What is its relevance?

A

Linea aspera

Upper-middle linea aspera forms part of origin of attachments of thigh adductors, then spreads out inferiorly to form bony floor of popliteal fossa

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23
Q

Where do vastus intermedius and medialis originate from with respect to each other on femur?

A

Intermedius anterosuperior

Medialis more medial

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24
Q

Besides the circumflex arteries, what else contributes arterial supply to femoral head?

A

Branches from inferior gluteal

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25
What is this? What are its key features?
C1 atlas vertebra Ring with anterior and posterior arches, with lateral bony masses Transverse processes containing foramen transversarium which transmits the vertebral artery
26
What structure attaches to X? What is its role?
Transverse ligament - holds dens in place
27
What forms the anterior arch and lateral masses of C1 embryologically?
Ossification of vertebral arch
28
Label this? Where does 1 split into its 2 branches?
1 = brachiocephalic trunk - splits into RSCA and RCCA at level of right sternoclavicular joint 2 - left common carotid 3 - left subclavian artery
29
Which branch of the aortic arch do the phrenic and vagus nerves related closely to? Where do they run?
Left subclavian - phrenic continue across anterior surface of pericardium, vagus branches around inferor aspect of aorta and gives off left recurrent laryngeal nerve
30
Where in the mediastinum is the aortic arch? What level does it become descending aorta?
Superior mediastinum Becomes descending at level of T4
31
3 things anterior to aortic arch?
Thymic remnants Lungs Pleura
32
Label these?
1 - right brachiocephalic vein 2 - left brachiocephalic vein 3 - SVC
33
What feature of the brachiocephalic veins makes it easy to appreciate JVP?
Don't have valves
34
Where are the brachiocephalic veins in relation to the aortic arch?
Anterior
35
What are the tributaries of the left brachiocephalic vein?
Subclavian vein Internal jugular vein Thoracic duct Vertebral vein Internal thoracic vein Inferior thyroid vein Superior intercostal vein
36
Where does the thoracic duct join the venous system?
Left brachiocephalic vein at junction of internal jugular and subclavian veins
37
Label this? Which side is it?
Left lung 1 - lower left pulmonary vein 2 - oblique fissure 3 - groove for left subclavian artery 4 - left pulmonary artery 5 - upper left pulmonary vein
38
Label the structures in each of these notches?
1 - descending aorta 2 - heart 3 - arch of aorta
39
40
What structures pass through the superior orbital fissure? 4 nerves 2 vessels
CN3 (superior division) CN4 CN6 Lacrimal nerve Recurrent meningeal/anastomotic branch of MMA Superior ophthalmic vein
41
Which structures pass through the optic canal?
CN2 Ophthalmic artery
42
What 3 structures pass through the inferior orbital fissure?
Maxillary nerve V2 Inferior ophthalmic vein Zygomatic nerve
43
What is the first branch of the ICA post-cavernous sinus? What are its 6 orbital branches?
Ophthalmic artery - lacrimal artery, supraorbital artery, posterior/anterior ethmoidal arteries, medial palpebral artery, frontal artery and dorsal nasal artery
44
What is the first ocular branch of the ophthalmic artery?
Central retinal artery
45
What are the 6 ocular branches of the ophthalmic artery?
Long and short posterior ciliary arteries Anterior ciliary artery Central retinal artery Superior and inferior muscular arteries
46
Label the carpal bones?
1 - scaphoid 2 - trapezium 3 - trapezoid 4 - capitate 5 - hamate 6 - pisiform 7 - triquetrum 8 - lunate
47
What is the significance of the scaphoid blood supply?
May be from nutrient foramina in distal segment from carpal vessels in palmar arch, so fractures may compromise blood supply to proximal aspect resulting in AVN
48
Is the hook of hamate palmar or dorsal and what attaches to it?
Palmar - flexor retinaculum
49
What type of bone is the pisiform and where is it located?
Sesamoid bone situated within tendon of flexor carpi ulnaris
50
What 3 bones of the carpus are stabilised by ligaments only and don't have tendons attaching to them?
First 3 - Scaphoid Lunate Triquetrum
51
Label these?
1 - peroneus brevis tendon 2 - peroneus tertius muscle 3 - extensor digitorum longus tendon 4 - extensor hallucis longus tendon 5 - extensor hallucis brevis tendon
52
Label these parts of the medial malleolus?
1 - flexor retinaculum 2 - tibialis posterior tendon 3 - flexor digitorum longus tendon 4 - flexor hallucis longus tendon also posterior tibial artery and tibial nerve
53
Label these foot bones?
1 - Medial cuneiform 2 - navicular 3 - talus 4 - calcaneum
54
What is this and what does it do? What is its innervation?
Tibialis anterior - innervated by deep peroneal nerve L4/5, dorsiflexes ankle and inverts foot
55
What are the 2 arches of the foot?
Longitudinal Transverse
56
Which intertarsal joint is the highest point in the lateral part of the longitudinal arch of the foot?
Calcaneocuboid
57
What ankle ligaments do you know?
These
58
6 major intrinsic muscles of the foot?
Abductor hallucis Abductor digiti minimi Adductor hallucis Flexor digitorum brevis Flexor hallucis brevis Extensor digitorum brevis
59
What are the 2 main intrinsic nerves of the foot?
Medial and lateral plantar nerves
60
What does the lateral plantar nerve do?
Splits to superficial and deep branches to innervate abductor digiti minimi and adductor hallucis
61
What does the medial plantar nerve do?
Innervates abductor hallucis, flexor digitorum brevis and flexor hallucis brevis
62
What artery in the foot is a continuation of the anterior tibial artery and what does it do?
Dorsalis pedis - gives off arcuate artery then continues as first dorsal metatarsal artery
63
What are the main intrisic arteries of the foot?
Medial and lateral plantar arteries
64
Label this? Which kidney is it?
Left kidney 1 - gonadal vein 2 - gonadal artery 3 - left renal vein 4 - left renal artery 5 - left ureter
65
What muscle is related posteriorly to the kidneys?
Psoas major
66
Roughly between which upper rib and lower vertebral bodies do the kidneys sit? Where are the hila?
11th rib L3 Hilum at L1 (left) and L1/2 (right)
67
What fascia encloses the kidneys and suprarenal gland? What is this derived from?
Gerotas fascia Derived from transversalis fascia
68
What is posterior-anterior in the renal hilum?
Ureter posterior Artery middle Vein anterior
69
What is the renal papilla?
Innermost apex of the renal pyramids
70
What do the renal sinuses contain?
Branches of renal artery Tributaries of renal vein Major/minor calyces Fat
71
Label these structures of the anterior neck?
A - facial artery B - EJV C - IJV
72
What are the 2 major tributaries of the EJV and where does it begin?
Posterior division of retromandibular veins Posterior auricular veins Begins either within parotid or near angle of mandible
73
What is the main inflow into the IJV?
Sigmoid sinus
74
What surface marking would you use to gain access to the IJV for a central line? Where are you aiming? What are the advantages/disadvantages of this approach?
Line from ear lobe to medial end of clavicle Aim needle between sternal and clavicular heads of SCM into the lesser clavicular fossa Greater risk of pneumothorax but avoids valves lying superior to the bulb of IJV so easier to get guidewires through
75
What structures are superficial to the EJV?
Skin Superficial fascia Platysma
76
Label these?
A - superior thyroid artery B - vagus nerve C - inferior thyroid artery
77
Where does the superior thyroid artery come from?
External carotid - first part
78
What 4 nuclei give branches to the vagus nerve? Where are they?
Dorsal nucles of vagus Nucleus ambiguus Solitary nucleus Spinal trigeminal nucleus All in medulla
79
Where does the inferior thyroid artery come from?
Thyrocervical trunk
80
What are the boundaries of the anterior triangle of the neck?
Anterior border of SCM Lower border of mandible Anterior midline
81
What are the 3 subtriangles within the anterior triangle of neck? What are they divided by?
Muscular triangle Carotid triangle Digastric / submandibular triangle Divided up by digastric and omohyoid
82
What are the contents of the muscular triangle of the neck?
Strap muscles EJV
83
What are the contents of the carotid triangle of the neck?
Carotid sheath containig CCA, vagus nerve and IJV Ansa cervicalis
84
What 4 things are in the submandibular/digastric triangle of the neck?
Submandibular gland Submandibular nodes Facial vessels Hypoglossal nerve
85

MRCS Part B - Paul Edit (29 decks)

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