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Block 2 > Anatomy > Flashcards

Anatomy Flashcards

1
Q

What do bones attach to?

A

Other bones (direct, indirect via tendon, fascia, ligament, cartilage), organs (eyes), mucous membranes (tongue), skin (fascia)

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2
Q

Major blood supply to UE vs LE

A

Subclavian arteries vs external iliac arteries

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3
Q

How are muscles divided in the limbs?

A

Compartmentalized by deep fascia; arteries w/in compartments give blood supply to nearby muscle

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4
Q

Anastomoses

A

Connections b/w vessels that provide collateral circ; more in veins and lymphatics, less in arteries (it’ll inc d/t demand or dz)

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5
Q

purposes of skeleton

A

support, protection, movement, storage, blood cell formation

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6
Q

muscle shapes: flat vs pennate vs fusiform vs convergent vs quadrate vs circular/sphincteral vs multiheaded/bellied

A

parallel fibers w/ aponeurosis vs featherlike, uni/multi vs spindle shaped w/ tapered ends vs from broad area and converge to single tendon vs 4 sides b/w attachments vs surrounds body opening, constricts when contracted vs >1 attachment or contractile belly

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7
Q

vein comitantes/accompanying veins

A

when veins surround artery –> artery pulsates –> surrounding veins do too –> improve blood/nutrient flow. veins nmlly don’t pulsate

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8
Q

varicose veins

A

veins lose elasticity –> weaken and dilate –> valves become incompetent –> incompetent fascia –> can’t ctx muscles

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9
Q

can blood flow reverse? hat happens if no anastomoses?

A

yes thru anastomoses. ischemia

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10
Q

3 fxns of lymphatics

A

immune, cardiovasc (bring fluid to heart), digestive

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11
Q

spinal nerves vs cranial nerves

A

31 pairs, exit spinal cord thru intervertebral foramina vs 12 pairs, exit CNS thru openings of cranium

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12
Q

plexus

A

where fibers from several spinal levels join and form branching network

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13
Q

radioopaque vs radiolucent

A

more dense structures –> bright vs less dense structures –> dark

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14
Q

angiography vs barium study

A

shows distribution of arteries vs ingest barium contrast to study GI tract

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15
Q

CT. advantages vs disadvantages?

A

compilations of spiral XR that make cross-sectional views of body; includes iodine contrast to identify vasc structures (don’t use iodine for bad kidney fxn). quicker, cheaper, more readily available –> best for trauma case vs can’t distinguish soft tissue like MRI, metal can interfere, less sensitive for brain imging

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16
Q

MRI. advantages vs disadvantages?

A

uses strong magnetic field and pulses body w/ radiowaves –> diff tissue produce diff signals produced by free H (water imging). no radiation, high res –> distinguish soft tissues, imgs can be reconstructed in any plane regardless of pt position vs strong magnetic field interferes w/ pacemakers, cochlear implants, surgical clips; don’t do if pt = claustrophobic

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17
Q

US. advantages vs disadvantages?

A

more common in ER for MSK dx and procedures; high freq waves reflect off diff structures. quick and safest vs not good for structures filled w/ gas, high res only for tissue close to skin, bone and dense structures cause shadowing

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18
Q

nuclear imging and examples

A

find trace amounts of radioactive substances in body. ex: PET scan finds gamma rays from ca cells; bone scan finds radiolabeled markers taken up by bone; SPECT imging uses single p+ emission + CT for better res

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19
Q

paraxial vs intermediate vs lateral mesoderm

A

become somite vs become urinary and reproductive system vs parietal/somatic –> muscles of body wall, bones of limbs OR visceral/splanchnic –> muscles of gut/GI tract

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20
Q

somites can become: sclerotome vs myotome vs dermatome

A

become vertebrae vs muscles of body wall/trunk, limbs, back; each myotome = innervated by one spinal nerve vs become dermis of body wall, back; represents area of skin innervated by one spinal nerve

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21
Q

neural crest vs neurons

A

differentiates into nerve cells innervating dermatome vs from neural tube innervating myotome

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22
Q

why and how does sclerotome split?

A

to allow passage of spinal nerves. caudal part of one sclerotome fuses w/ cranial part of next sclerotome

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23
Q

describe muscle formation

A

mesoderm and neural crest –> mesenchyme –> myoblasts –> mature muscle cells –> inc # of myofilaments for muscle growth (muscle cells don’t divide even tho they have SOME muscle stem cells)

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24
Q

skel vs cardiac vs smooth muscle

A

striated, voluntary; from myotomes in head and trunk, and from parietal lateral mesoderm vs unstriated, involuntary, visceral; from visceral lateral mesoderm surrounding heart tube –> heart vs unstriated, involuntary, visceral; from parietal lateral mesoderm –> sm muscle in blood vessel wall, from visceral lateral mesoderm surrounding gut tube –> sm muscle in gut, from ectoderm –> sm muscle in sweat and mammary glands

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25
Q

2 clusters of myotome: dorsomedial vs ventrolateral to dermatome

A

both contiguous but remain distinct. becomes epimere; epimere = innervated by dorsal ramus vs hypomere –> mixes w/ muscle fibers of parietal lateral mesoderm –> muscles of anterior body wall; hypomere = innervated by ventral ramus

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26
Q

epimere vs hypomere

A

from dorsomedial myotome cluster; innervated by dorsal ramus; become epaxial muscles (above transverse process –> TRUNK); form extensors of head, neck, back => erector spinae group vs from ventrolateral myotome cluster; innervated by ventral ramus; become hypaxial muscles (below transverse process –> LIMBS); form flexors of erector spinae group + intercostal, abd, serratus, quadratus, pelvic floor, limbs

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27
Q

Prune Belly Syndrome

A

from absent or poorly formed abd wall muscles –> fluid accumulate in abd –> distended abd –> wrinkly appearance –> urinary and reproductive malformations

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28
Q

describe eye muscle formation

A

not from somites; from preotic myotome in cranial paraxial mesoderm

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29
Q

describe face muscle formation

A

from cranial mesoderm derived mesenchyme (facial muscles) and neural crest derived mesenchyme (tendons and fascia of facial muscles) in pharyngeal arches; each arch has associated cranial nerve innervating the muscle from that arch

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30
Q

describe limb bud formation

A

appear on sides of embryo in cervical and sacral regions in 4/5th wk –> 1) myotome & dermatome mesenchyme migrate to limb buds –> myotome makes ant/post condensation –> muscles of limb; 2) parietal lateral mesoderm migrate to limb buds –> central core –> skel and vasc components of limbs

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31
Q

apical ectodermal ridge

A

leading edge of limb bud forming a ridge of epithelium (ectoderm); secretes growth factors –> development and differentiation of limb

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32
Q

describe upper limb formation

A

formed by day 26-27. lateral mesoderm migrate to limb bud in 4th wk and paraxial mesoderm/myotome migrate to limb bud in 5th wk –> ant condensation –> flexor and pronator muscles; post condensation –> extensor and supinator muscles; ventral rami of spinal nerves C5-T1 combine then divide to ant division –> innervate ant condensation; post division –> innervate post condensation. dermatome also migrates an creates segmented pattern on skin

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33
Q

describe lower limb formation

A

formed by day 30-31. lateral mesoderm and paraxial mesoderm/myotome migrate to limb bud –> ant condensation –> flexor and adductor muscles; post condensation –> extensor and abductor muscles; ventral rami of spinal nerves L2-S3 divide into ant division –> innervate ant condensation; post division –> innervate post condensation; dermatome also migrates and creates segmented pattern on skin

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34
Q

Describe hand and feet formation

A

Hand plates develop in upper limb buds in wk6, foot plates develop in lower limb buds in wk 7; digits rays form in hand/foot plates in wk 6/7 respectively

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35
Q

Describe nail formation

A

Nail beds form wk 11, nails form wk 12; nail growth = consistent —> can determine degree of prematurity

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36
Q

Describe epidermal friction ridge formation (fingerprints/footprints)

A

Form at jxn of epi/dermis in wk 11 —> ridges = pronounced in wk 16 —> “fingerprints”

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37
Q

Describe bone limb formation

A

Mesenchyme/central core —> primordial bones —> chondrification centers form in primordial bones in wk 6 —> IZ mesenchyme form b/w cartilage models —> ossification centers form in cartilage models in wk 7

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38
Q

What do HOX genes vs Tbox genes vs BMP do w/ limbs?

A

Create somite identity, limb differentiation along its length vs differentially expressed in UE & LE (determines location) vs for chondrification and ossification

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39
Q

Zone of polarizing activity (ZPA)

A

Secretes sonic hedgehog and retinoic acid —> differentiate limbs like radius/ulna, tibia/fibula, thumb (low conc)/pinky (high conc)

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40
Q

What’s the most critical period for limb development?

A

24-36d post fertilization

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41
Q

bone and muscle malformation: amelia vs meromelia vs talipes/club foot

A

Absence of limb; caused by genetic and environ factors (best known thalidomide) vs absence of part of limb, presence of limb stump; caused by genetic and environ factors (best known thalidomide) vs actually a deformation; foot fixed at abnml position, can occur independently or w/ syndrome

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42
Q

Muscle malformation: arthrogryposis

A

Absence of muscle, muscle hypoplasia —> stiffness and ctx across joints

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43
Q

Digit malformations: syndactyly vs cleft hand/foot vs polydactyly

A

Reduction in digits d/t incomplete separation of digits; can be cutaneous (incomplete for apop in webbing) or osseous (fusion of digital bones) vs variation of syndactyly where 5 digits rays don’t form nmlly vs supernumerary digits d/t extra digit rays

44
Q

Amniotic band syndrome

A

Bands of amniotic membrane can detach and be free in amniotic cavity —> wrap around digits —> cut off circ —> abnml growth of digits or limbs

45
Q

What’s the critical period of MSK development?

A

4-7wks
Early wk 4: somites form
Late wk4: upper limb buds form
Wk5: lower limb buds form
Wk6: hand plates and digit rays form for UE
Wk7: foot plates and digit rays form for LE

46
Q

cerebral palsy

A

from developmental brain dmg during gestation or in first 5 yrs after birth; assoc w/ intraut infxns, epilepsy, postnatal head trauma/shaken baby syndrome; dx by XR/CT/MRI and EEG

47
Q

extrinsic vs intrinsic back muscles ctrl (by layers):

A

superficial: limb movement, intermediate: resp movement vs deep: vertebrae movement and posture

48
Q

ex of superficial extrinsic/posterior axioappendicular muscles vs intermediate extrinsic back muscles

A

trap, lat dorsi, lev scapulae, rhomboids vs serratus posteriors

49
Q

trap vs lat dorsi vs lev scapulae vs rhomboids vs serratus posterior actions

A

upper elevates scap, middle retracts scap, lower depresses scap vs extends, internal rotates, adducts humerus; works w/ pec major to abduct humerus vs elevate scap w/ low trap vs retract and rotate scap; works w/ serratus anterior to fix scap to thoracic wall vs proprioception

50
Q

triangle of auscultation

A

gap in musculature; b/w lat dorsi, scapula, trap; good place to put stethoscope

51
Q

intrinsic shoulder muscles: scapulohumeral muscles and fxn

A

RC muscles, teres major, deltoid. act on GH joint

52
Q

deltoid vs teres major vs supraspinatus vs infraspinatus vs teres minor vs subscapularis

A

fl/ex, in/external rotation, abduction of arm vs adducts and medially rotates arm, stabilizes humeral head vs initiates first 15degrees of abduction and helps deltoid w/ abduct vs external rotation vs works w/ infra for laterally rotation and adduct vs medial rotation and adduct, stabilizes shoulder joint during movement

53
Q

quadrangular space

A

in b/w teres minor/major, triceps long head, humeral surgical neck; axillary n. and posterior circumflex humeral a. in space

54
Q

triangular space

A

in b/w teres minor/major, triceps long head; circumflex scapular artery in space

55
Q

axillary nerve injury

A

loss of lateral proximal arm sensation (over deltoid), deltoid and teres minor atrophy, FLAT SHOULDER

56
Q

anterior axioappendicular muscles: pec minor vs pec major vs subclavius vs serratus anterior actions

A

stabilize scap vs medially rotates and adducts humerus vs anchors and depress clavicle vs protracts and rotates scap

57
Q

boundaries of axilla: apex vs base vs anterior wall vs posterior wall vs medial wall vs lateral wall

A

cervico-axillary canal vs skin, subq and axillary deep fascia; makes axillary fossa/armpit vs anterior axillary fold made of pecs and clavicopectoral fascia vs posterior axillary fold made of teres major, lat dorsi, scap, subscapularis vs thoracic all an serratus anterior vs intertubercular sulcus of humerus

58
Q

contents of axilla

A

brachial plexus, axillary a/v., lymphatic vessels and nodes

59
Q

axillary artery: 1 branch vs 2 branches vs 3 branches

A

superor thoracic a. vs thoracoacromial, lateral thoracic a. vs subscapular, anterior/posterior circumflex humeral a.

60
Q

you can dissect axillary nodes but which 2 nerves are at risk? what other phenomenon can happen?

A

long thoracic n and thoracodorsal n –> infxn. lymph drainage impeded –> lymphedema

61
Q

axillary vein = large and exposed –> complications…?

A

risk of profuse bleeding and air emboli

62
Q

afferent vs efferent vs mixed neurons

A

sensory, dorsal rootlets, cutaneous nerves vs motor, ventral rootlets vs both sensory and motor, spinal nerves, dorslal/ventral rami

63
Q

Spinal cord characteristics

A

in vertebral canal; divided into segments, each segment = connected to PNS via spinal nerves that innervate limbs

64
Q

where do spinal nerves travel thru?

A

intervertebral foramina

65
Q

how many spinal nerves by region?

A

8 cervical, 12 thoracic, 5 lumbar, 5 sacral, 1 coccygeal

66
Q

anatomy of spinal cord segment

A

dorsal/ventral rootlets –> dorsal/ventral roots –> dorsal/ventral roots converge to form spinal nerve –> spinal nerve divides into dorsal and ventral rami

67
Q

dermatome vs myotome

A

area of skin innervated by sensory fibers from single spinal nerve vs muscle mass innervated by motor fibers from single spinal nerve

68
Q

cervical vs brachial vs lumbar vs sacral plexus

A

C1-C5; supplies cutaneous and motor fibers to neck, head, thorax vs C5-T1; supplies cutaneous and motor fibers to UE vs L1-L4; supplies cutaneous and motor fibers to lower trunk and LE vs same as lumbar

69
Q

cervical n. vs accessory n. vs lower subscapular n. vs intercostal n. vs long thoracic n. vs medial pectoral n. innervate?

A

lev scapulae vs trap vs teres major, subscapularis vs serratus posterior superior/inferior vs serratus anterior vs pec minor and major

70
Q

when to use axillary view and scapular Y vs external rotation view vs internal rotation view on XR?

A

Dislocation vs eval greater tuberosity vs calcific tendonitis, Hill Sachs lesion

71
Q

T1W vs T2W

A

MRI where fat = bright, water = dark vs MRI where water = bright, fat = dark

72
Q

rugby injury characteristics

A

bulge below clavicle, dec ROM, axillary nerve numbness

73
Q

5 basic densities of XR (inc attenuation)

A

• Gas/air –> fat –> water (organs, muscle, blood) –> bone –> metal

74
Q

synovial osteochondromatosis

A

benign rare metaplasia of synovial membrane; monoarticular joint pain, crepitus, stiffness –> tx by loose body removal and/or synovial resection

75
Q

scapula fx = assoc w/?

A

head trauma, pneumothorax, rib fx, lung contusion, brachial plexus tear

76
Q

6 oss centers of elbow. and know when they fuse?

A

CRMTOL. 1357911y

77
Q

little league elbow

A

medial epicondyle apophysitis; overuse injury; XR: nml or widen apophysis

78
Q

common extensor tendon injury sx, dx, tx

A

epicondylitis: lat > med; chronic overuse w/ supination/pronation –> tennis elbow; dx w/ US/MRI; tx w/ NSAIDs, steroids, brace, tenotomy, surgery

79
Q

who’s usually more at risk for hook of hamate fx?

A

swingers: racquet, bat, club

80
Q

manage vs complications of Colle’s fx

A

nondisplaced and min angulation? –> sugar-tong splint; displaced? –> reduction vs median nerve injury, compartment syndrome, vasc compromise

81
Q

osteoclastoma (brown tumors)

A

w/ primary or secondary hyperparathyroid and metastataic calcinosis

82
Q

what does Paget’s look like under CT?

A

cotton wool appearance

83
Q

MR is good for what problem?

A

neuro prob

84
Q

limitations of cervical spine radiographs?

A

pt motion, pt short neck, first set of films done by portable XR machines, hard to see subtle fx

85
Q

Jefferson fx

A

C1 fx from severe axial loading

86
Q

percutaneous thoracic vertebroplasty vs kyphoplasty

A

use img guidance to inject cement into fxed bone vs insert balloon into fxed bone to create space for injecting cement

87
Q

spondylosis vs spondylolysis vs spondylolisthesis

A

osteophyte formation in vertebral bodies –> disc space narrowing –> lumbar OA vs defect of pars interarticularis, check Scottie dog, congenital or acquired (children/adolescents, hyperextension injuries) vs slippage of lumbar vertebral body, congenital or acquired (spondylolysis); grades 1-5

88
Q

4 regions of neck

A

anterior cervical region (ant triangle), SCM, lateral cervical region (post triangle), posterior cervical region

89
Q

brachial plexus = formed by union of _____ of C5-T1

A

anterior rami

90
Q

roots, trunks, divisions = ____clavicular while cords are ____ and branches = ____clavicular

A

supra, at level of clavicle, infra

91
Q

brachial plexus injuries: upper lesion vs lower lession

A

d/t excess angle b/w head and shoulder –> affect deltoid, biceps, brachialis –> sensory changes below elbow (Erb-Duchenne Palsy) vs d/t excess angle b/w trunk and upper limb –> C8-T1 nerve injury/median and ulnar supplied muscles –> hand weakness and sensory changes on palmar hand and ulnar dorsal hand (Klumpke paralysis)

92
Q

motions of interphalangeal joints

A

PIP/DIP; only fl/ex

93
Q

is palmaris brevis a hypothenar muscle?

A

nope, it’s a small thin muscle in hypothenar superficial fascia but not in hypothenar compartment –> covers and protects ulnar a./n.

94
Q

dorsal vs palmar interossei fxn

A

DAB vs PAD

95
Q

handlebar neuropathy vs dupuytren contracture of plamar faascia

A

compresses ulnar nerve –> lose sensation of medial hand vs fibrous degen of palmar aponeurosis on medial hand –> pulls partial flexion at MCP/PIP –> tx w/ excision of fibrosis

96
Q

3 main transitions of upper limb

A

axilla, cubital fossa (median n. and brachial a.), carpal tunnel (median n.)

97
Q

anterior vs posterior compartment fascia of upper limb

A

flex GH and elbow, supinate radioulnar joint; musculocut n, brachial a/v vs extend GH and elbow; radial n, deep brachial a/v

98
Q

brachial a. branches

A

profunda brachii, sup/inf ulnar collateral a., radial/ulnar a

99
Q

where are superficial vs deep lymphatic vessels?

A

palmar/dorsal of hand, fingers vs w/ deep veins terminating in humeral axillary LN

100
Q

injury to musculocut vs radial n vs ulnar n/cubital tunnel syndrome

A

weak shoulder flexion vs wrist drop b/c no extension vs claw hand b/c ulnar digits extended at MCP and flexed at remaining joints

101
Q

spina bifida occulta vs cystica

A

neural arches of L5 and/or S1 fail to fuse posterior to vertebral canal vs 1+ vertebral arch fail to fuse completely –> herniation of meninges (meningocele) and/or spinal cord (meningomyelocele)

102
Q

how and what happens if you have injury to long thoracic nerve?

A

knife fight b/c limb = elevated, bullets to thorax, mastectomy. serratus anterior = paralyzed –> can’t rotate scap as much, scap winging

103
Q

how and what happens if you have injury to accessory nerve?

A

whiplash, cervical LN bx, surgery at posterior triangle/lateral cervical region. dropped shoulder and ipsilateral weakness when elevated

104
Q

how and what happens if you have injury to thoracodorsal nerve?

A

surgery at scap LN or inferior axilla, mastectomy. lat dorsi = paralyzed –> can’t raise trunk w/ upper limbs –> can’t climb

105
Q

what happens if you have injury to dorsal scapular nerve?

A

rhomboid = paralyzed –> scapula = farther from midline

106
Q

shrug sign

A

supraspinatus torn –> need to shrug to get trap initiate 15 degrees abduction before deltoid does the rest

107
Q

components of carpal tunnel

A

median n., flexor digitorum superficialis/profundus, flexor pollicis longus

Block 2 (16 decks)

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