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Anatomy Flashcards

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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
2 clusters of myotome: dorsomedial vs ventrolateral to dermatome
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
26
epimere vs hypomere
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
27
Prune Belly Syndrome
from absent or poorly formed abd wall muscles --> fluid accumulate in abd --> distended abd --> wrinkly appearance --> urinary and reproductive malformations
28
describe eye muscle formation
not from somites; from preotic myotome in cranial paraxial mesoderm
29
describe face muscle formation
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
30
describe limb bud formation
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
31
apical ectodermal ridge
leading edge of limb bud forming a ridge of epithelium (ectoderm); secretes growth factors --> development and differentiation of limb
32
describe upper limb formation
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
33
describe lower limb formation
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
34
Describe hand and feet formation
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
35
Describe nail formation
Nail beds form wk 11, nails form wk 12; nail growth = consistent —> can determine degree of prematurity
36
Describe epidermal friction ridge formation (fingerprints/footprints)
Form at jxn of epi/dermis in wk 11 —> ridges = pronounced in wk 16 —> “fingerprints”
37
Describe bone limb formation
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
38
What do HOX genes vs Tbox genes vs BMP do w/ limbs?
Create somite identity, limb differentiation along its length vs differentially expressed in UE & LE (determines location) vs for chondrification and ossification
39
Zone of polarizing activity (ZPA)
Secretes sonic hedgehog and retinoic acid —> differentiate limbs like radius/ulna, tibia/fibula, thumb (low conc)/pinky (high conc)
40
What’s the most critical period for limb development?
24-36d post fertilization
41
bone and muscle malformation: amelia vs meromelia vs talipes/club foot
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
42
Muscle malformation: arthrogryposis
Absence of muscle, muscle hypoplasia —> stiffness and ctx across joints
43
Digit malformations: syndactyly vs cleft hand/foot vs polydactyly
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
Amniotic band syndrome
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
What’s the critical period of MSK development?
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
cerebral palsy
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
extrinsic vs intrinsic back muscles ctrl (by layers):
superficial: limb movement, intermediate: resp movement vs deep: vertebrae movement and posture
48
ex of superficial extrinsic/posterior axioappendicular muscles vs intermediate extrinsic back muscles
trap, lat dorsi, lev scapulae, rhomboids vs serratus posteriors
49
trap vs lat dorsi vs lev scapulae vs rhomboids vs serratus posterior actions
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
triangle of auscultation
gap in musculature; b/w lat dorsi, scapula, trap; good place to put stethoscope
51
intrinsic shoulder muscles: scapulohumeral muscles and fxn
RC muscles, teres major, deltoid. act on GH joint
52
deltoid vs teres major vs supraspinatus vs infraspinatus vs teres minor vs subscapularis
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
quadrangular space
in b/w teres minor/major, triceps long head, humeral surgical neck; axillary n. and posterior circumflex humeral a. in space
54
triangular space
in b/w teres minor/major, triceps long head; circumflex scapular artery in space
55
axillary nerve injury
loss of lateral proximal arm sensation (over deltoid), deltoid and teres minor atrophy, FLAT SHOULDER
56
anterior axioappendicular muscles: pec minor vs pec major vs subclavius vs serratus anterior actions
stabilize scap vs medially rotates and adducts humerus vs anchors and depress clavicle vs protracts and rotates scap
57
boundaries of axilla: apex vs base vs anterior wall vs posterior wall vs medial wall vs lateral wall
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
contents of axilla
brachial plexus, axillary a/v., lymphatic vessels and nodes
59
axillary artery: 1 branch vs 2 branches vs 3 branches
superor thoracic a. vs thoracoacromial, lateral thoracic a. vs subscapular, anterior/posterior circumflex humeral a.
60
you can dissect axillary nodes but which 2 nerves are at risk? what other phenomenon can happen?
long thoracic n and thoracodorsal n --> infxn. lymph drainage impeded --> lymphedema
61
axillary vein = large and exposed --> complications...?
risk of profuse bleeding and air emboli
62
afferent vs efferent vs mixed neurons
sensory, dorsal rootlets, cutaneous nerves vs motor, ventral rootlets vs both sensory and motor, spinal nerves, dorslal/ventral rami
63
Spinal cord characteristics
in vertebral canal; divided into segments, each segment = connected to PNS via spinal nerves that innervate limbs
64
where do spinal nerves travel thru?
intervertebral foramina
65
how many spinal nerves by region?
8 cervical, 12 thoracic, 5 lumbar, 5 sacral, 1 coccygeal
66
anatomy of spinal cord segment
dorsal/ventral rootlets --> dorsal/ventral roots --> dorsal/ventral roots converge to form spinal nerve --> spinal nerve divides into dorsal and ventral rami
67
dermatome vs myotome
area of skin innervated by sensory fibers from single spinal nerve vs muscle mass innervated by motor fibers from single spinal nerve
68
cervical vs brachial vs lumbar vs sacral plexus
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
cervical n. vs accessory n. vs lower subscapular n. vs intercostal n. vs long thoracic n. vs medial pectoral n. innervate?
lev scapulae vs trap vs teres major, subscapularis vs serratus posterior superior/inferior vs serratus anterior vs pec minor and major
70
when to use axillary view and scapular Y vs external rotation view vs internal rotation view on XR?
Dislocation vs eval greater tuberosity vs calcific tendonitis, Hill Sachs lesion
71
T1W vs T2W
MRI where fat = bright, water = dark vs MRI where water = bright, fat = dark
72
rugby injury characteristics
bulge below clavicle, dec ROM, axillary nerve numbness
73
5 basic densities of XR (inc attenuation)
• Gas/air --> fat --> water (organs, muscle, blood) --> bone --> metal
74
synovial osteochondromatosis
benign rare metaplasia of synovial membrane; monoarticular joint pain, crepitus, stiffness --> tx by loose body removal and/or synovial resection
75
scapula fx = assoc w/?
head trauma, pneumothorax, rib fx, lung contusion, brachial plexus tear
76
6 oss centers of elbow. and know when they fuse?
CRMTOL. 1357911y
77
little league elbow
medial epicondyle apophysitis; overuse injury; XR: nml or widen apophysis
78
common extensor tendon injury sx, dx, tx
epicondylitis: lat > med; chronic overuse w/ supination/pronation --> tennis elbow; dx w/ US/MRI; tx w/ NSAIDs, steroids, brace, tenotomy, surgery
79
who's usually more at risk for hook of hamate fx?
swingers: racquet, bat, club
80
manage vs complications of Colle's fx
nondisplaced and min angulation? --> sugar-tong splint; displaced? --> reduction vs median nerve injury, compartment syndrome, vasc compromise
81
osteoclastoma (brown tumors)
w/ primary or secondary hyperparathyroid and metastataic calcinosis
82
what does Paget's look like under CT?
cotton wool appearance
83
MR is good for what problem?
neuro prob
84
limitations of cervical spine radiographs?
pt motion, pt short neck, first set of films done by portable XR machines, hard to see subtle fx
85
Jefferson fx
C1 fx from severe axial loading
86
percutaneous thoracic vertebroplasty vs kyphoplasty
use img guidance to inject cement into fxed bone vs insert balloon into fxed bone to create space for injecting cement
87
spondylosis vs spondylolysis vs spondylolisthesis
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
4 regions of neck
anterior cervical region (ant triangle), SCM, lateral cervical region (post triangle), posterior cervical region
89
brachial plexus = formed by union of _____ of C5-T1
anterior rami
90
roots, trunks, divisions = ____clavicular while cords are ____ and branches = ____clavicular
supra, at level of clavicle, infra
91
brachial plexus injuries: upper lesion vs lower lession
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
motions of interphalangeal joints
PIP/DIP; only fl/ex
93
is palmaris brevis a hypothenar muscle?
nope, it's a small thin muscle in hypothenar superficial fascia but not in hypothenar compartment --> covers and protects ulnar a./n.
94
dorsal vs palmar interossei fxn
DAB vs PAD
95
handlebar neuropathy vs dupuytren contracture of plamar faascia
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
3 main transitions of upper limb
axilla, cubital fossa (median n. and brachial a.), carpal tunnel (median n.)
97
anterior vs posterior compartment fascia of upper limb
flex GH and elbow, supinate radioulnar joint; musculocut n, brachial a/v vs extend GH and elbow; radial n, deep brachial a/v
98
brachial a. branches
profunda brachii, sup/inf ulnar collateral a., radial/ulnar a
99
where are superficial vs deep lymphatic vessels?
palmar/dorsal of hand, fingers vs w/ deep veins terminating in humeral axillary LN
100
injury to musculocut vs radial n vs ulnar n/cubital tunnel syndrome
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
spina bifida occulta vs cystica
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
how and what happens if you have injury to long thoracic nerve?
knife fight b/c limb = elevated, bullets to thorax, mastectomy. serratus anterior = paralyzed --> can't rotate scap as much, scap winging
103
how and what happens if you have injury to accessory nerve?
whiplash, cervical LN bx, surgery at posterior triangle/lateral cervical region. dropped shoulder and ipsilateral weakness when elevated
104
how and what happens if you have injury to thoracodorsal nerve?
surgery at scap LN or inferior axilla, mastectomy. lat dorsi = paralyzed --> can't raise trunk w/ upper limbs --> can't climb
105
what happens if you have injury to dorsal scapular nerve?
rhomboid = paralyzed --> scapula = farther from midline
106
shrug sign
supraspinatus torn --> need to shrug to get trap initiate 15 degrees abduction before deltoid does the rest
107
components of carpal tunnel
median n., flexor digitorum superficialis/profundus, flexor pollicis longus

Block 2 (16 decks)

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