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MRCS part B- JMB > Anatomy > Flashcards

Anatomy Flashcards

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1
Q

Name parts of cervical, thoracic and lumbar vertebrae

A

https://www.getbodysmart.com/skeletal-system-quizzes/cervical-vertebrae-quiz

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2
Q

Divisions of subclavian artery

A

Vertebral
Internal thoracic
Thoraco dorsal

Cervical
Dorsal scapular

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3
Q

What is the path of the vertebral artery?

A 
1st part of subclavian
Posterior to ant scalene
To c6 transverse process for amen
Up to c2
At c1 horizontal extradural part in occipital triangle
Enters spinal canal
Joins basilar artery
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4
Q

Most common c spine fracture?

Types and management?

A

Odontoid peg
Type 1 tip of peg- Miami j
Type 2 waist of peg- high risk of non union- watershed blood supply from vertebral artery
Type 3 extension into c2 body- Miami j

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5
Q

What is the origin of the mental nerve?

A

V3 and inf alveolar nerve

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6
Q

Muscles of mastication?

A

Temporalis
Masseter
Lateral- opens jaw
Medial pterygoid- closed jaw

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7
Q

Muscles of the tongue?

A 
Intrinsic- longitudinal, transverse, vertical
Extrinsic- genioglossus- cn xii
Myoglossus cnxii
Hyoglossus cn xii
Palatoglossus- cn x
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8
Q

Tongue sensation?

A

Anterior 2/3
Somatic sensation- lingual of v3
Taste- chords tympani

Post 1/3
Glossopharyngeal

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9
Q

Structures that run through parotid gland?

A

Cnvii
External carotid a
Retromandibular vein
Lymph nodes

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10
Q

Course of facial nerve?

A 
Pontine medullary junction
Through internal auditory meatus
To geniculate ganglion
Gives off staepedius, greater pertrosal, chorda tympani
Stylomastoid foramen
To parotid gland
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11
Q

Blood supply of thyroid gland?

A

Superior thyroid a
Inf thyroid a
Thyroid ima

Sup and middle thyroid being drain to ijv
Inferior thyroid being drains to brachiocephalic vein

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12
Q

Nerve supply of laryngeal muscles?

A

Recurrently laryngeal to all bar…
Cricothroid muscle- external laryngeal

Sensation above vocal cords is internal laryngeal n
Below is recurrent laryngeal

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13
Q

Recurrent laryngeal nerve palsy symptoms?

External laryngeal?

A

Hoarseness

High pitched voice

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14
Q

Facial compartments of the neck?

A

Investing
Pretracheal
Prevertebral
Carotid sheath

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15
Q

Name parts of the rib

A 
Head- 2 articular facets
Neck
Shaft
Tubercle
Costal groove
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16
Q

Structures around scalene anterior?

A

Anterior- subclavian vein and phrenic nerve

Post- subclavian a and brachial plexsus

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17
Q

Thoracic outlet syndrome definition and aetiology and test

A

Compression of NV bundle going from neck to arm

Anatomical- cervical rib, fibromuscular bands
Traumatic- axillary vein thrombosis, repetitive movements- squash
Costoclavicular space entrapment

Roo’s test- arm. Abducted, ext rotation and flex. Hand flexion. Symptoms recreated

Adsons

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18
Q

Superior mediastinum contents?

A 
Thymus
Trachea
Thoracic duct
Phrenic and vagus nerves
Symph chain
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19
Q

Inferior mediastinum contents?

A

Ant- thymus
Middle- phrenic, pericardium
Post- vagus, thoracic duct, azygous, symph trunk (DATES)

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20
Q

What blood vessel supplies the san and avn?
And what veins drain them?
And what is heart dominance

A

San- rca/LCX
Avn- RCA/LCX

Veins
Great cardiac- drains lad
Middle cardiac drains pda

Heart dominance- which artery the PDA comes off

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21
Q

What are the impression in the lung hilum?

A

Right- svc superior
Azygous vein inferior

Left- aortic arch
Heart

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22
Q

Diaphragmatic openings?

A

Caval- ivc and right phrenic
Oesophageal- oesophageal, vagus nerves, left gastric vessels
Aortic- aorta, thoracic duct, azygous, hemiazygous

Left phrenic pierced diaphragm
Sup epigastric vessels
Symph trunk

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23
Q

Adrenal bloody supply

A

Superior from inf phrenic
Middle from aorta
Inferior from renal a

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24
Q

Retroperitoneal structures?

A 
Ivc
Supra renal glands
Aorta and ivc
Duodenum- all bar first 2cm
Pancreas- all bar tail
Ureters
Colon ascending and descending
Kidneys
Esophageus
Rectum (upper 2/3)
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25
Layers of scrotum?
``` Skin Dartos External Cremasteric Internal Tunica vaginalis Tunica albuginea Testes ```
26
Lymphatic drainage of scrotum and testis?
Scrotal skin to inguinal | Testis to para aortic
27
Spermatic cord contents?
Artery to vas Cremasteric artery Testicular a Pampiniform plexuss Lymphatics Vas deferens Genital branch of genitofemoral n Ilioinguinal n- runs outside canal Symphathetics
28
Axillary a divisions
Save the lawyer, screw a patient ``` Superior thoracic Thoracoacromial Lateral thoracic Subscapular Anterior humeral circumflex Post humeral circumflex ```
29
Rotator cuff muscles?
Suprascapular- abduction- greater trochanter Infrascapular- external rotation gt Subscaparis- internal rotation- lt Teres minor adduction + external rotation- gt
30
Boarders and contents of antecubital fossa?
Lateral epi to medial epi Brachioradialis Pronator teres ``` Contents Median nerve Brachial a Biceps tendon Radial nerve- between brachialis and brachioradialis ```
31
Contents of carpal tunnel?
Fpl Fdp Median nerve Fpl Fcr runs outside
32
Extensor compartments of the wrist?
``` Lateral to medial 1-epb and apl 2- ecrl and ecrb 3- epl 4- extensor in incidis + post interosseous n + extensor digitorum 5- edm 6-ecu ```
33
Short rotators of the hip?
Piriformis Gemelli Obturator Quadratus femoris
34
Blood supply of the femoral head?
Retinacular vessels from circumflex femoral a Interosseous Ligamentum teres artery
35
Paths of great and short saphenous veins?
``` Great drains medial dorsal arch Ant to medial malleolus Posteromedial to patella Through saphenous tunnel? Piercers tensor fascia Lata Joins at saphenofemoral junction- below and lateral to pubic tubercle ``` Short Lay margin of dorsal arch Post to lateral malleolus Joins popliteal vein
36
Femoral triangle content boarders floor
Navy + lymphatics Sartorial inguinal ligament adductor longus Iliopsoas, pectineus, adductor longus
37
Femoral canal boarders and content?
Inguinal lig, femoral vein, lacunae ligament medially, pubic rami/pectineus Empty space- allows for expansion of femoral vein Cloquet’s lymph node
38
Boarders of inguinal canal and locations of ring?
Ant- eo Sup- arching fibres of io and ta Post- tf Inferior- inguinal ligament Deep ring- superior to mid inguinal point Superficial- above pubic tubercle
39
Contents of adductor canal?
``` Sfa Descending genicular arteries Femoral vein Long saphenous n N to Vastus medialis ```
40
Popliteal fossa boundaries
Semimembranosus/semitendinosus Biceps femoris Gastrocnemius Contents- deep to superficial Popliteal a Popliteal vein Tibial nerve
41
Lower limb compartments and nerve and blood supply?
Anterior- tibia ant, ehl, extensor digitorum, peroneus tertius Deep peroneal and ant tibia artery Lateral peroneal longus and brevis Superficial peroneal and peroneal artery Posterior deep- fdl, fhl, tibialis post, popliteus Superficial- gastrocnemius, soleus, plantaris Tibia nerve, post tibial a
42
Structures posterior to medial malleolus
Tom dick and very nervous Harry Ant to post ``` Tibialis post Flexor digitorum Post tibial a Post Tibial vein Tibial nerve Fhl ```
43
Ankle ligaments?
Tibular and fibula ant and post Laterally- talofibular ant and post Calcaneofibular and bifurcate Medially deltoid ligament Superficial tibionavicular and tibicalcaneal log Deep tibiotalar ant and post Arches Long and short plantar reinforce lateral arch Spring ligament- reinforces medial arch
44
Cranial fossa and structures passing through + cranial fossa boundaries
Ant fossa- frontal, ethmoidal and sphenoid bones Frontal bone + lesser wings/limbus of sphenoid bone Middle fossa- sphenoid and temporal bones Lesser wings/limbus of sphenoid bone anterior to petrous temporal and dorsum sella posteriorly Post fossa- occipital, temporal bones Ant- dorsum sella/clivus and petrous temporal bones to squamous occipital bone
45
Contents of superior orbital fissure? | Inferior orbital?
``` Cn 3 Cn 4 Cn 6 Cn v1- ophthalmic Ophthalmic vein ``` Inferior ophthalmic vein Cnv2- zygomatic n Infraorbital artery and vein and nerve
46
Csf Volume Secreted by? Cycle
``` 150-200 mls circulating volume Secreted by choroid plexus Into lateral ventricles Foramen of Munro to 3rd ventricle Slyvius aqueduct to 4th ventricle Magedie and Lusaka to subarachnoid space ```
47
Cranial nerve origins ?
``` Olfactory epithelium cn 1 Retinal epithelium cn 2 Midbrain cn 3/4/5 Pons cn 6/7 Cerebellopontine angle cn 8 Medulla cn 9/10/11/12 ```
48
Types of spinal cord nerve pathways
Ascending Spinothalamic- pain and temp Dorsal columns- fine touch vibration and proprioception Spinocerebellar- unconscious propioception Decscending Corticospinal- skilled and discrete movements Extrapyramidal system- modulation and regulation of movement
49
Draw brachial plexus
50
Contents of carotid sheath | Where does carotid divide?
Cca, vagus, ivc And a cervicalis Cn 9.11,12 Splits at c4
51
Divisions of ica?
``` Opthalmic a Ant choroidal An cerebral Middle cerebral Post communicating ```
52
Describe the parasympathetic nervous system
3, 7,9,10 S2-4 3 to ciliary ganglion 7 to pterygopalatine and submandibular ganglion 9 to otic ganglion 10 to rest of body
53
location and contents of transpyloric plane?
L1- halfway between pubic symphysis and jugular notch Contains Pylorus, neck of pancreas, joining of SMV and splenic vein, SMA, Renal hilum, end of spinal cord, fundus of gallbladder, splenic hilla, cisterna chyli, colonic/hepatic flexure
54
Surface anatomy of the liver?
5th IC to 10th IC in midclavicular line then to 5th IC | Runs along nipple line
55
Splenic surface anatomy?
Overlied by ribs 9-11 posteriorly
56
Aorta paired and unpaired branches?
``` Paired- phrenic arteries T12 Renal As L1/2 Testicular As L2 Iliac As L4 Lumbar As L1-4 Middle suprarenal As L1 ``` ``` Unpaired Coelia SMA IMA Middle sacral ```
57
Surface anatomy of the kidneys?
Right is 12 th rib Left is 11/12th rib
58
Function of the spleen?
``` FISH Filtration of encapsulated organisms (n.menigitidis, s.pneumonia, pneumococcus)/WBC/RBCs/Platelets Immunological (lymphocyte production) Storage of platelets Haemtopoesis in fetus ```
59
Portosystemic anastomosis areas?
``` Bare area of liver Periumbilical area Upper rectum Oesophageal Retroperitoneum ```
60
Areas where fluid/pus collects in abdomen?
``` R and left paracolic gutters R subhepatic space Pelvis Inbetween bowel loops R and left subphrenic spaces ```
61
Stomach and pancreas parts?
Stomach- antrum, fundus, pylorus, cardia, body Pancreas- head, ucinate process, neck, body, tail
62
Difference between jejunum and ileum
Jejunum more proximal Bigger and thicker Longer vasa recta, fewer arcade Jejunum has thinner mesentry and more arcades More vascular?
63
Describe the endocrine and exocrine function of the pancreas?
Exocrine function- acinic cells, produce digestive enzymes Endocrine- alpha cells- glucagon Beta cells- insulin Delta cells- somatostatin (inhibitory hormone of the others)
64
What is a Meckel's diverticulum and what is its hernia?
Failure of the obliteration of the Vitelointestinal duct Littre's hernia Rule of 2s, 2% population, 2:1 male to femal, 2 feet from ileocaecal junction, 2 inches in length
65
What is produced in the adrenals?
Adrenal cortex- GFR ACE Zona glomerulosa- Aldosterone Zona fasculata- Cortisol (gluccocorticoids) Zona reticularis- Androgens Adrenal medulla- epi/norepi
66
Order of vessels at renal hila?
Ant to post Vein Artery Ureter (runs posteriorly over psoas major and iliacus
67
What is the ureter crossed by?
Gonadal vessels Left side is crossed by left colic A Right by ileocolic and right colic As
68
What is the blood supply to the ureter?
Segmental Superior- Renal Middle- gonadal and common iliac Inferior- internal iliac- uterine and superior vesicular
69
Different positions of the appendix?
``` Retrocaecal Subcaecal Pelvic Preileal Post ileal ```
70
Blood supply and nerve supply of rectum?
Sup rectal A- from IMA Middle Rectal A from internal iliac Inferior rectal A from Internal pudendal Symph from sup hypogastric plexus and lumbar splanchnics Parasymph from S2,3,4
71
How many valves are there in the ureter?
Just one- false valve Detrusor muscle forms muscular sphincter When contraction of detrusor muscle in closes ureter and prevents back flow
72
Nerve supply to bladder?
Hypogastric plexus- symph | S2-4 gives parasymph
73
What makes up the conjoint tendon and lacunar ligament of the inguinal canal?
Conjoint tendon- medial posterior injuinal canal stabiliser- TA and IO Lacunar lig- medial floor inguinal canal stabliser
74
What is the nerve supply to EO?
Intercostal N (lower 6) and subcostal N
75
Why do you get abdominal pain with testicular torsion?
T10 nerve supply- radiation to umbilicus
76
Nerves at risk in hernia repair?
Ilioinguinal- runs outside of cord but in canal Sensation loss to anterior scrotum, base of penis and groin Iliohypogastric- pierces EO medially, sensation to base of pubis Genital branch of genfem- Loss of cremaster muscle, sensation scrotum
77
Oesophageal arterial and lymphatic supply?
Segmental!!! Superior- inferior thyroid artery => deep cervical LNs Middle- aortic branches=> mediastinal LNs Inferior- oesophageal branches of left gastric and inf phrenic => left gastric and coeliac nodes
78
Types of oesophageal hernias?
Congenital- Morganis, Bouchdalek's Acquired- sliding (90%) and rolling Fixed by oesophageal fundoplication
79
What is Barrett's oeosphageus?
Chronic GORD leads to metaplasia of the lower oesophageus and rolling up the Sq cells to replace columnar cells Premalignany SqCC of oesophageus
80
Constriction points of the oesophageus?
Arch of aorta Bronchus- left Cricoid cartillage Diaphram
81
What is the surface A of the GB The contents of calot's triangle And what stiumlates the contraction of the gallbladder?
9th costal margin to lateral edge of the rectus muscle Tranpyloric plane Cystic A and Nodes of Lund CCK- cholecystokinin
82
Surface A of breast?
2nd to 6th costal cartilage, sternum to mid axillary line
83
Deep muscle relations of the breasts?
Serratus Ant Pec major and mine Rectus Latissiumus dorsi
84
Structure of the breast
15-20 lobule per breast, each drain to a lactiferous duct and sinus and join via the nipple
85
What are Cooper's ligament?
Suspensory ligaments that extend from the subcutaneous fat to the deep fascia Malignany infiltration leads to puckering and retraction of the skin
86
What is the lymphatic drainage of the breast?
75% via axillary LN Parasternal and post intercostal LNs Supraclavicular LNs ContraL breast
87
What is the nerve and blood supply of the breast?
N- intercostal Nerves 4-6 Blood Internal thoracic A Lat thoracic/thoraco acromial branch Intercostal As
88
Location of DP and PT?
DP lateral to EHL- between 1 and 2 metatarsal PT 2-3 cm behind medial malleolus
89
Where do the peroneal muscles insert?
Peroneus longus-head of fibula to medial cuneiform and 1st metatarsal base Brevis- onto 5th metatarsal Tertius- onto 5th metatarsal
90
Which muscles invert and evert the foot?
Inversion- tib ant and post and EHL Eversio- peroneal muscles
91
What attaches to the linea aspera in the thigh?
Lateral ridge- Gleuteal tuberosity- gleuteus maximus/ vastus lateralis Intermediate ridge- pectineal line- pectineus Medial ridge- vastus medialis Adductor magnus Short head of biceps femoris
92
Describe the fasciotomy incision for the lower leg?
4 compartment fasciotomy 2 incisions Anterior and lateral compartments- 2cm ant to fibula from tibial tuberosity to sup to ankle Post compartments- posteromedial to tibial, tuberisty to 5cm above medial malleolus
93
Where does popliteal A divide and where does tibioperoneal A divide?
Popliteal A divides at soleus arch in fossa into anterior tibial A and tibioperoneal trunk TP trunk divides 2-5cm below this into post tibial and peroneal A
94
How to tell ACL and PCL apart?
ACL is hands in front pockets- post to ant Lateral post intercondylar notch on femur to medial ant tibial spine PCL is hands in back pockets reveres of above
95
What NVI to be aware of in anteromedial approach to the knee?
Geniculate As Long saphenous Saphenous N
96
What makes up the blood supply to the knee?
An anastomotic mesh of femoral, popliteal and cural As Sup and inf geniculate As Middle geniculate- supplies ACL and PCL
97
What is contained in popliteal fossa?
``` Superfiscial to deep N- common peroneal and tibial V- popliteal vein A- popliteal A LNs ``` Floor is knee joint, femur and popliteus
98
What are the divisions of the axillary A?
1st- Sup thoracic 2nd- Thoracoacromial and Lat thoracic 3rd- Subscapular, ant and post circumflex humeral Split by pec minor
99
What is the glenoid labrum?
Fibrocartillage collar of glenoid fossa
100
What cause shoulder impingement syndrome?
Painful arc from 60-120 Coracoacromial lig- compression of suprascapular lig Subacromial bursitis
101
What are the boarders of the quadrangular space and what does it contain?
Humerus, teres minor and major and latissimus dorsi Contains- post circumflex humeral a, axillary N
102
Where is the triangular space and its contents?
Teres minor and major and long head of triceps Cicrumflex scapular A
103
Where is the triangular interval and its contents?
Triceps long head, teres major and triceps lateral head/humerus Radial N and profuna brachii artery
104
What supplies the rhomboids?
Dorsal scapular Nerve- C5
105
What are the 3 arches of the foot?
Transverse- metatarsal heads, peroneus longus and interossei ligs Medial- spring lig and tarsal bones and interosseous ligs Lalteral- long and short plantar ligs and bones
106
What are the joints of the elbow?
HUmero ulna- trochlea and olecranon Humero radial- capitelum and radial head Ulnaradial- radial head and radial notch
107
What are the flexors of the elbow?
Brachialis, biceps and brachioradialis
108
What is the contents and boarders of antecubital fossa?
Floor- supinator and brachialis Roof- bicipital apoN Lateral- brachioradialis Medial- pronator teres Contents Medial to lateral Median nerve, brachial a, bicipital tendon, radial nerve
109
What are the compartments of the forearm?
Volar and dorsal Volar- superfiscial- FDS, FCR, FCU, PT and PL (from medial epicondyle) Deep- from forearm- FPL, FDP, PQ Mobile wad- Brachioradialis and ECRL/B Dorsal- Superfiscial- ECU and aconeus Intermediate- EDC and EDM Deep- APL, EPB, ECU, EPL, EI, supinator
110
What are the incisions for a forearm fasciotomy?
Volar- along ulna boarder- FCU to medial epi (avoid ulna nerve)- extend to carpal tunnel Dorsal- lat epicondyle to dorsal mid line
111
Hand fasciotomy incisions?
10 compartments (7 interossei, hypothenar, thenar and adductor pollicis) Volar- hypothenar and thenar Dorsal over 2 and 4th metacarpals +- carpal tunnel
112
What is the contents of the carpal tunnel?
FDS, FDP and FPL | Median nerve- medial cuntaneous n of hand has branched off prior
113
What is the gardners classification of NOF?
1- incomplete NOF 2- complete undisplaced 3- complete, partially displaced 4- fully displaced, complete
114
What are the ligaments surrounding the hip?
Iliofemoral- strongest- prevents hyperextension of hip joint | Pubofemoral and ischiofemoral
115
What is the origin and insertion of iliopsoas?
T12-L4 | Lesser trochanter
116
What is the surface A of the sciatic N?
Runs through the greater sciatic notch generally under piriformis Trace line curved line between 2 points 1/2 way between Ischial tuberosity and PSIS 1/2 way between Ischial tubersoity and >trochanter
117
What runs through the greater and lesser sciatic notch?
Greater Suprapiriform- super gleuteal Artery and N and vein Infrapiriform- sciatic N, inferior glutean VAN, pudendal N, N to piriformis Lesser Obturator internus Pudendal N Internal pudendal V and A
118
What muscles attach to the anterior proximal humerus?
Lady between two majors MEdial to lateral Teres Major Lat Dorsi Pec Major
119
What muscles insert onto the coracoid?
Pec minor Coracobrachilais Short head of biceps
120
Where to perform LP?
L4/5 | Between Iliac crests
121
What are the spinal columns?
Spinothalamic- pain and temp- decussate at spinal level Corticospinal- movement and fine control- decussate at in hindbrain Dorsal columns- sensation and proprioception- high up decussation
122
Blood supply of spinal column?
Anterior spinal A- from vertebral As and segmentally from aorta, artery of adamzweich Post spinal A- post inf cerebellar As
123
What is central cord syndrome?
Hyper extension injuries in elderly Upper limbs affected more than lower limbs Good prognosis
124
Draw Brachial plexus
https://www.physio-pedia.com/index.php?title=Brachial_plexus_injury&veaction=edit§ion=42
125
What is the origin of lat dorsi?
T7 to L5 spinous process | Adducts, internal rotates and extends arm
126
Where does the spinal cord terminate?
L1/2 in adults L3 in kids Cauda equina carries on to S2 where the dural sac ends
127
What type of joints are the intervertebral joints?
Type 2 cartillagenous | Like pubic symphsis
128
Where are most disc prolapses?
L4/5, L5/S1- 95%
129
What is anterior spinal cord syndrome?
Anterior spinal artery normally affected Lower limbs worse than upper Dorsal columns are spared
130
What structures are at risk during a subclavian line insertion?
Thoracic duct on left Subclavian a and lung Phrenic nerves (go over anteriro scalenes)
131
What is the role of thymus
PLays role from fetus to puberty and then regresseses Recognises self t cells and eliminates them
132
What are the atypical ribs?
1,2 | 10, 11, 12
133
What is the contents of the inguinal canal?
Spermatic cord /round ligament Spermatic cord- 3s 3As- cremasteric, testicular, vas 3Ns- symphatetics, ilioinguinal- runs outside of cord, genital branch 3 others- pampiniform plexus, lymphatics, vas deferens
134
What is at the mid inguinal point and the mid point of the inguinal canal?
Mid point of the inguinal ligament= deep ring | Mid inguinal point is femoral A
135
What is the medial aspect of the femoral canal | And what does it contain?
Lacunar lig LN of cloquet + sapce
136
Where is the adductor hiatus and what are its boarders?
``` 2/3 of way from ASIS to adductor tubercle Sartorius is roof Adductor magnus is floor Vastus medialis is lateral Magnus/longus is medial ```
137
Difference between CN 3 palsy and horner's?
Key difference is CN3 is parasymph and Horner's symph interupriton CN3- eye is down and out, enlarged pupil Horner's- miosis, anhidrosis, ptosis and enopthalmos
138
What enters through the foramen magnum?
``` Medulla oblongata ANt and post spinal As, vertebral A 3 dural layers Apical dens ligament Tentorium CNXI spinal root ```
139
Jugular foramen contents?
Jugular vein | CN9,10,11 (accessory)
140
ICA branches?
MCA, ACA, posterior communicating, anterior choroidal, opthalmic A
141
Tongue muscle nerve supply?
All CN12 bar palatoglossus which in CN10
142
What is the course of the facial nerve?
From pontine medulla junction To facial canal via internal auditory meatus Gives off greater petrosal, chorda tympani and n to staepedius Exits through stylomastoid foramen Curves to parotid
143
What exits through superior orbital foramen?
Nerves- CN3,4,6 and V1 (lacrimal and frontal, nasocillary) V- superior opthalmic vein A- branches of lacrimal and middle meningeal
144
What are the layers of the peridcardium?
Fibrous | Serous- parietal and visceral
145
Which parts of the aortic valve supply the right and left coronary arteries?
Anterior supplies RCA | Left post supplies LCA
146
What is the venous drainage of the heart?
Coronary sinus reasonable for 2/3 of drainage, enters posterior part of RA Drains, great, middle, small, oblique and post cardiac veins 1/3 drain directly in to right atrium /other chambers Cardiac veins/venae cordis (thesbian veins)
147
Where is the sinoatrial node and what supplies it?
In the right atria christa terminalis Supplied by RCA in 60% of people and LCA in 40%
148
What is the course of the phrenic nerves?
C3,4,5 Anterior to scalene anterio, post to subclavain veins Right runs with IVC Left runs with aortic arch, crosses anterior over the pericardium
149
What is the course of the vagus nerves?
RIght post to oesophageuas and run with ICA | Left anterior to oesophageus, runs with ICA
150
Where does the trachea begin?
C6
151
What is a bronchopulmonary segment?
Functionally independent bit of lung Separated by connective tissue Receives its own AVB 10 in each lung
152
What is the blood supply to the lung?
Pulmonary As | Bronchial As
153
What are the branches of the Exeternal carotid A
``` SLFOPSM superior thyroid artery ascending pharyngeal artery lingual artery facial artery occipital artery posterior auricular artery superficial temporal maxillary ```
154
What muscles make up the prevertebral muscles?
Scalens, levator scapulae | splenius capitus
155
What nerve is at risk in the middle of the post triangle of the neck?
Spinal accessory nerve | Runes from 1/3 down SCM to 2/3 down Trapezius
156
What bones make up the orbit?
Frontal, maxillary, zygomatic Lacrimal and ethmoidal Sphenoid and palatine
157
What goes through the infra orbial fissure?
CNV2- infraorbital and zygomatic Inferior opthalmic vein Pterygopalatine ganglion
158
What are the clinical signs of an orbital blow out fracture?
Traumatic deformity of floor/medial wall Enopthalmos Diplopida Infraorbital numbness Orbital emphysema
159
Location of the parotid gland surface A?
Anterior to tragus to posterior boarder of masseter | to angle of mandible to mastoid process
160
What runs throug parotid?
Facial N Retromandibular Vein ECA- gives off superficial temporal and maxillary
161
What is Frey's syndrome?
Iatrogenic damage to auriculotemporal n (provides symph to parotid) unopposed parasymph => gustatory sweating- excessive
162
What may damage to the zygomatic nerve cause?
CNV2- numbness of zygoma Paralysis of obicularis oris Only muscle that can open eye Dry eye
163
When do cranial sutures close | Name of condition with fused sutures at birth?
18-24 months Craniosynothsis
164
What runs in the foramen lacerum?
ICA | Greater and lesser petrosal nerve- run near by through hiatuses
165
What is the cavernous sinus and what does it contain?
Drains the opthalmic veins, superfiscial cerebral vein and sphenopalatine sinus as well as danger area of the face Contains OTOM and CA CN3 CN4 CN V1 and V2 Carotid artery Abducens nerve
166
What does the posterior mediastinum contain and its boundaries?
Ant- pericardium to T5-T12 posteriorly T4 superiorily to diaphram ``` Contains DATES Descending aorta Azygous vein Thoracic duct Symphathetics Eosphageus ```
167
What is the azygous vein?
Formed by right lumbar and right subcostal veins Joined by hemiazygous at T8 (left lumbar and left subcostal veins) And by accessory hemiazygous at T7 (4-8 intercostals) Drains posterior thorax, trunk and mediastinal viscera
168
What is the right lymphatic duct?
Drains right head, neck, arm and breast | Thoracic duct does rest
169
What is the supply of the diagastric muscle? And other suprahyoid muscles?
Ant- CNV3 Post- CNVII Stylohyoid (CNVII) Geniohyoid (C1 via hypoglossal n) Myohyoid (CNV3)
170
What are the strap muscles?
Omohyoid, sternothryroid, sternohyoid and thyrohyoid All bar thyrohyoid (C1) are supplied by cerva ancalis (in wall of carotid sheath)
171
What nerves are risked damage when operating on submandibular gland?t
Marginal mandibular nerve Lingual Nerve Hyoglossus Nerve The duct runs with hyoglossus
172
What are the surface landmarks of the lung fissures?
Oblique bilaterally run from 4th thoracic spinous process to 6 costochondral cartillage Horizontal on right runs from 4th constochnodral cartillage to mid axillarly line of the oblique fissure
173
What is the sensation supply to the larynx?
Superior to vocal cords- internal laryngeal | Inferior is RLN
174
Draw the vertebral arteries and branches
https://thoracickey.com/carotid-and-vertebral-artery-intervention/
175
Where is the most likely place for a circle of willis aneurysm?
ANterior cerebral circulation
176
What symptoms does a basilar lip Aneurysm cause?
SAH acutely | Bitemporal hemianopia- sits on optic chiasm
177
What are the divisions of the internal iliac artery?
Anterior trunk- obturator, umbilical (sup vesical), inf vesical, Women- uterine and vaginal, Middle rectal, internal pudendal (inf rectal), lateral sacral, sup gleuteal Post- Iliolumbar, lateral sacrals, inferior gleuteal
178
What are the divisions of the lumbar plexus?
I I Get Leftovers On Fridays ``` Iliohypogastric Ilioinguinal Genitofemoral Lateral cutaneous nerve of the thigh Obturator Femoral ```
179
Sacral plexus?
Some Irish Sailor Pesters Polly ``` Sup Gleuteal Inf Gleuteal Sciatic Post Femoral Cutaneous Pudendal ``` N to piriformis/obtuartors
180
What muscles make up the pelvic floor?
Levator ani (pubococcygeus, iliococcygeus, puborectalis) + coccygeus
181
What supplies IO and TA?
Iliohypogastric and ilioinguinal
182
What are the boarders of the perineum?
PS to coccyx Ischial tuberosities Iscial and pubic rami Roof is the pelvic floor
183
What structures are contained in the anal triangle of the perineum?
Pudendal NAV Anal aperture Ischioanal fossae
184
What structures are contained in the urogenital triangle?
Deep perineal pouch- urethra, deep fascia, perineal membrane, vagina Superfiscial perineal pouch- ischiocavernosa, bulbospongiosa, superfiscial transverse perineal muscle, Bartholin's gland
185
What is the perineal body
Sits between anal and urogenital triangle Where muscles attach ``` Levator ani Bulbospongiosa Ischiocavernosa Perineal muscles Ext anal sphincter ```
186
What are the layers of the scalp?
``` SCALP Skin Connective tissue deep Epicranial Aponeurosis Loose areolar connective tissue (containing the emissary veins) Perisoteum ```
187
Venous drainage of the brain?
Superior and straight (inferior sagittal and great cardiac vein) sinuses drain into the confluence of sinuses Transverese comes off confluence and anastaomses with superior petrosal sinus to form sigmoid sinus Greater and less petrosl sinus drain cavernous sinus Lesser petrosal and sigmoid sinus form IJV
188
Types of joints and examples?
Fibrous- sutures (skull), gomphoses (teeth), syndesmoses (radio-ulna/tibiafibula) Immovable Cartillagenous- 1o- Hyaline cartillage- at diaphases 2o- fibroelastic cartillage- PS and intervertebral joints ``` Synovial joints- fluid filled joint cavity with fibrous cavity, freely moveable Hinge- elbow Saddle- CMCJ Plane- Subtalar Pivot- C1/C2 Condyloid- Wrist Ball and socket- hip/shoulder ```
189
Types of cartillage?
``` Hyaline- weakest, precursor to bone, contains type 2 collagen Found in growth plates Articular cartillage (subset of hyaline) found in synovial joints ``` Elastic cartillage- resislient and flexible Ear, epiglottis and larynx Fibro-cartillage- strongest, alternating layers of hyaline matrix and dense collagen Joint capsules, tendon insertions, intervertebral discs
190
Types of collagen?
Type 1- strongest- majority of body Type 2- spongy/shock absorbing- hyaline cartillage Type 3- strong but no tensile, found in granulation tissue- early wound bed collagen Type 4- Solidifies cellular structures- basement membrane Kidneys/eyes/ears/skin
191
What is the blood supply of the diaphram?
Costal portion by subcostal artery and lower 5 intercostal arteries Inferior phrenic- off abdominal aorta T12 Superior phrenic- off thoracic aorta T11
192
What are the facial nerve branches after the stylomastoid foramen but before it enters the parotid?
Posterior auricular N to stylohyoid N to posterior digastric
193
What is the clivus?
bone posterior to sella turcica
194
What makes up the cervical plexus? Where do they emerge?
C1-4 Sensory- all enter the skin at Erb's point, middle of posterior boarder of SCM Greater auricular (runs over SCM, parallel to Accessory nerve) Lesser occipital Transverse cervical Supraclavicular Motor Phrenic nerve N to geniohyoid N to thyrohyoid Ansa cervicalis- rest of infrahyoid muscles
195
What runs anterior to anterior scalene?
A- carotid/transverse cervical/suprascapular aa V- IJV/subclavia N- vagus/phrenic LNs
196
What is the arterial supply to the brain?
ACA/MCA/PCA Post inf cerebellar a Ant inf cerebellar Sup cerebellar a
197
Where are the motor and somatosensory cortexs found in the brain?
Pre central gyrus- motor | Post central gyrus- sensation
198
What passes through the foramen lacerum?
ICA and greater/lesser petrosal nerves
199
What happens at the level C6?
Pharynx to oesophageus Larynx to trachea Cricoid cartillage
200
What are contained in the anterior triangles of the neck?
Sub mental- LNs Submandibular- gland, LN, facial a, ligual N, hypoglossal N Carotid triangle- carotid sheath Muscular- strap muscles, thyroid, trachea, oesophageus
201
What is contained in the posterior triangle?
``` LNs External jugular vein, transverse cervical, suprascapular Superfiscial cervical a, suprascapular a Cervical plexus + CNXI Omohyoid ```
202
What is the surface anatomy of the CNXI?
Sup 1/3 of scm middle 1/3 of post triangle inf 1/3 of trapezius
203
What is the venous drainage of the danger area of the face?
Deep facial veins to pterygoid plexus to cavernous sinus
204
What is the intracranial course of CNVI?
Longest intracranial course Pons to cavernous sinus to SOF to LR
205
What is a d-dimer test measuring?
The breakdown of fibrin
206
What are the signs of hypovolaemic shock?
``` Sinus Tachy Hypotension Oliguria Cold Klammy peripheries Slow cap refi Dry mucous membranes and low JVP ```
207
Describe the SA of the lung fissures?
Oblique fissures go from T2/3 to 6th rib mid clavicular | Right horizontal goes travels along 4th rib to mid axillarly line meeting oblique fissure
208
Differences between lung hila?
Both lungs- Pulmonary veins straddle bronchus- infront and below In right lung- artery is anterior to bronchus In left lung artery is superior to bronchus

MRCS part B- JMB (10 decks)

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