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Primary Vivas > Anatomy > Flashcards

Anatomy Flashcards

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0
Q

Medial longitudinal arch of the foot

A

Bones: calcaneus, talus, navicular, 3 cuneiforms, 3 medial metatarsals

Pillars: posterior - tuberosity of calcaneus, anterior - heads of 3 metatarsals

Keystone: talar head

Strength: tibialis anterior (1MT + med cuneiform), fibularis longus tendon

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1
Q

Layers of the sole

A
  1. Flexor digitorum brevis, abductor hallucis, abductor digiti minimi
  2. Tendon of flexor hallucis longus, tendon of flexor digitorum longus, quatratus plantae, lumbricals
  3. Flexor hallucis brevis, adductor hallucis, flexor digiti minimi brevis
  4. Interosseous mm (dorsal + plantar 3h), tendon of fibulae is longus, tendon of tibialis posterior
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2
Q

What veins join the great saphenous vein in the region of the saphenous opening?

A
  1. Superficial circumflex iliac vein
  2. Superficial epigastric vein
  3. Superficial external pudendal vein
  4. Deep external pudendal vein
    +/- deep vein piercing fascia lata over adductus longus
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3
Q

Name the branches of the femoral artery.

A
  1. Superficial epigastric artery
  2. Superficial circumflex iliac artery (and sometimes the deep)
  3. Superficial external pudendal artery
  4. Deep external pudendal artery
  5. Profunda femoris
  6. Superior genicular artery
  7. Muscular arteries
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4
Q

What passes through the lesser sciatic foramen?

A
  1. Tendon of obturator internus
  2. Nerve to obturator internus
  3. Internal pudendal artery
  4. Internal pudendal vein
  5. Pudendal nerve
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5
Q

Describe the femoral triangle.

A

Boundaries: superior - inguinal lig, medial - lat border of adductor longus, lateral - med border of sartorius, floor - iliopsoas, pectineus, adductor longus, roof - fascia lata
Skin: genitofemoral nerve
Contents (lat-med): femoral n, femoral sheath, femoral a, femoral v, femoral canal (deep inguinal LNs + lymph vessels)

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6
Q

What ligaments make up the lateral ligament of the ankle?

A

Anterior talofibular ligament
Posterior talofibular ligament
Calcaneofibular ligament

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7
Q

Lateral longitudinal arch

A

Bones: calcaneus, cuboid, lateral 2 metatarsals

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8
Q

Plantar aponeurosis

A
  • dense collagen fibres, forms central compartment of the sole
  • arises medial process of calcaneus, divides near heads of MT bones into 5 processes
  • inferior to heads of MTs reinforced by supf transverse MT lig
  • midfoot: vertical intermuscular septum extend from margins of PA to 1/5 MT (forming med/cent/lat compartments of foot)
  • abductors of big/little toe not covered by PA
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9
Q

Ligaments of the knee

A
  1. Patella lig: inf border of patella to tib tuberosity, cont of quad tendon
  2. MCL: med epicondyle of femur (below add tubercle) down/forward to med condyle of tib, attaches to meniscus, crossed by tendons of sartorius/gracilis/semitendinosus
  3. LCL: lat epicondyle of femur (above groove of popliteus) down/back to head of fib, covered by tendon of biceps femoris
  4. Oblique popliteal lig: extension of semimembranosus, at to lat condyle of femur, forms floor of pop fossa
  5. Arch ate popliteal lig: Y shaped, post inter condylar area of tib + lat epicondyle of femur to just below head of fib
  6. Transverse lig: intracapsular, joins ant edges of menisci
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10
Q

Branches of common peroneal nerve.

A
  • sural communicating nerve
  • lat cutaneous nerve of the calf
  • superior and inferior genicular nerves
  • recurrent genicular nerve
  • divides into deep and superficial peroneal nerves
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11
Q

What is deep and superficial to the superior extensor retinaculum?

A

Deep (med-lat): tibialis anterior, extensor hallucis longus, tibial artery, deep peroneal nerve, extensor digitorum longus, peroneus tertius

Superficial: superficial peroneal nerve

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12
Q

Popliteus

A

Origin: lat surface of the lat condyle of femur and lat meniscus
Insertion: post surface of tibia, superior to soleal line
Nerve: tibial nerve (L4/L5/S1)
Action: unlocks knee by med rotating the femur 5 degrees on flexed tib, weak flexor

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13
Q

Name the CSF cisterns and the important structures that run through them.

A
  1. Cisterna magna (cerebromedullary) - vertebral arteries, PICA, glossopharyngeal n (CN 9), vagus n (CN 10), accessory n (CN 11)
  2. Pontine (pontocerebellar) cistern - basilar artery, CN 5-12
  3. Suprasellar (Chiasmatic) cistern - optic chiasma, infundibular stalk, Circle of Willis
  4. Interpeduncular cistern - oculomotor n (CN 3), basilar artery
  5. Quadrigeminal cistern - PCAs, post choroidal aa, sup cerebellar aa, trochlear nerve (CN 4), venous confluence great cerebral vein (v of Galen, inf sag sinus, straight sinus).
  6. Ambient cistern - PCAs, sup cerebellar aa, basal vv of Rosenthal, trochlear n (CN 4)
  7. Cerebellopontine cistern
  8. Premedullary cistern
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14
Q

Relations of CSF cisterns.

A

Cerebellomedullary cistern - between cerebellum & medulla
Pontocerebellar cistern - interpeduncular fossa
Chiasmatic cistern - inf & ant to optic chiasm (point of crossing of optic nerves)
Quadrigeminal cistern - between colliculi, corpus callosum, & sup surface of cerellum. Extends from 3rd ventricle to great cerebral v.
Ambient cistern - lateral aspect of the midbrain, cont post with quadrigeminal cistern

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15
Q

Hyaline cartilage.

A
  • no blood vessels or nerves, nutrition from fibrous perichondrium
  • ossifies with age
    Examples
  • costal, nasal, tracheobronchial, some laryngeal
  • articulate cartilage of typical synovial jts
  • epiphyseal growth plates of bones
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16
Q

Examples of fibrocartilage

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A
  • knee menisci
  • intervertebral discs
  • glenoid labrum
  • articulate surfaces of the clavicle
17
Q

Secondary cartilaginous joints.

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A
  • Opposed surfaces covered in hyaline cart, connected by fibrocartilage
  • Small amount of movement
  • Intervertebral discs
  • Sternomanubrial joint
  • Pubic symphysis
18
Q

Talk about deep fascia.

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A
  • very sensitive, nerve supply is that of overlying skin
  • always anchored to periosteum when passes over bone
  • not found in the face/ischioanal fossa
  • devoid of fat
  • limits outward expansion of the bellies of contracting skeletal mm
19
Q

Functions of bone.

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A
  1. Haematopoeisis
  2. Lipid and mineral storage
  3. Support
  4. Protection
20
Q

What are the 3 types of cells in bone, and their functions?

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A

Osteoblasts - Synthesised uncalcified/unmineralised ECM (osteoid) -> later become calcified/mineralised to become bone.
Osteocytes - As osteoid mineralises, osteoblasts become entombed btw lamellae in lacunae & mature into osteocytes. They then monitor the minerals/proteins to regulate bone mass.
Osteoclasts - Derived from monocytes, resorb bone by releasing H+ ions & lysosomal enzymes. Large & multinucleated cells.

21
Q

Describe compact bone.

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A
  • Lamellar bone
  • Forms outer shell, organised in concentric circles around vertical Haversian canal (nv bundle) -> total structure called osteon
  • Haversian canals connected by horizontal Volkmann’s canals (vasc)
  • Osteocytes located between lamellae with lacunae (sm cavities)
  • Lacunae connected by interconnecting tunnels called canaliculi
22
Q

Describe spongy bone.

Study These Flashcards
A
  • Lamellar bone
  • Located deep to compact bone, honeycomb appearance, light
  • Network of fine columns called trabeculae, strong against multidirectional lines of force
  • Trabeculae filled with bone marrow (yellow - adipocytes, red - haematopoietic stem cells)
23
Q

What are the 2 types of ossification?

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A

Endochondral - Hyaline cartilage is replaced by osteoblasts secreting osteoid.
Intramembranous - Mesenchymal (embryonic) tissue is condensed into bone. Forms in flat bone (eg temporal bone/scapula).

24
What are the 2 types of bone?
Woven - primary bone - embryonic development and fracture repair, laid down rapidly, osteoid & collagen arranged randomly. Temporary. Lamellar - secondary bone - bone of the adult skeleton, highly organised sheets of mineralised osteoid. Much stronger.
25
Describe upper limb myotomes.
Shoulder - Flexion/Abduction/Lat Rot C5 axillary, Extension/Adduction/Med Rot C6/C7/C8 Elbow - Flexion C5/C6 biceps, Extension C6/C7 triceps Wrist - Flexion & Extension C6/C7 radial, Sup C6, Pron C7/C8 Fingers - Flexion C7/C8 median, Extension C7/C8 radial(post interosseous), Abduction/Adduction T1 ulnar
26
Describe myotomes of lower limb.
Hip - Flexion L2/L3 (femoral, iliopsoas), Extension L4/L5 (inf gluteal, glut max), Adduction L1/L2/L3/L4 (adductors), Abduction L5/S1 (glut med/min), Int Rot L1/L2/L3, Ext Rot L5/S1 Knee - Extension L3/L4 (femoral), Flexion L5/S1 (sciatic) Ankle - Dorsiflexion L4/L5 (deep peroneal), Plantarflexion S1/S2 (tibial), Inversion L4/L5, Eversion L5/S1. Toes - Dorsiflexion L5/S1, Plantarflexion S1/S2 (except great toe - Flexion L5 (deep peroneal))
27
Primary cartilaginous joints.
- Usually a temporary form of joint - No movement - Between epiphyses/diaphyses of long bones - Between occipital and sphenoid bones - Between petrous parts of temporal bones and jugular processes of occipital bone
28
Describe the foramens that the cranial nerves exit through.
1. Olfactory - cribriform plate 2. Optic - optic canal 3. Oculomotor - superior orbital fissure 4. Trochlear - superior orbital fissure 5. Trigeminal - V1 - superior orbital fissure - V2 - foramen rotundum - V3 - foramen ovale 6. Abducens - superior orbital fissure 7. Facial - internal acoustic meatus 8. Vestibulocochlear - internal acoustic meatus 9. Glossopharyngeal - jugular foramen 10. Vagus - jugular foramen 11. Accessory - jugular foramen 12. Hypoglossal - hypoglossal
29
Where are the sensory and motor nuclei of trigeminal nerve found?
Motor - upper pons | Sensory - trigeminal ganglion at apex of petrous temporal bone
30
Dermatomes of lower limb.
L3 - anterior & medial thigh and knee L4 - medial leg, medial ankle, and side of foot L5 - lateral leg, dorsum of foot, medial sole, 1-3 toes S1 - lateral ankle, lateral side of dorsum & sole of foot, 4-5 toes S2 - posterior leg, posterior thigh, buttocks, penis
31
Describe Horner's Syndrome.
- Lesion of the sympathetic trunk, lesion is on ipsilateral side. - Miosis (constricted pupil), ptosis, apparent anhidrosis (dec sweating) +/- enophthalmus (inset eyeball), +/- facial flushing (ipsi) - First-order neuron disorder: central lesions that involve the hypothalamospinal tract (eg transaction of cervical spinal cord) - Second-order neuron disorder: Preganglionic lesions (eg compression of symp chain by lung tumour) that releases Ach - Third-order neuron disorder: Postganglionic lesions at the level of the int carotid a (eg tumour in cavernous sinus or carotid a dissection) that release noradrenaline
32
Describe the sympathetic path to the pupil.
From cells in hypothalamus, fibres run down through the brain stem and spinal cord to the lateral horn cells in the T1 segment of the cord. Preganglionic fibres enter the sympathetic truck via the white rami communicantes of the T1 nerve and pass up to the superior cervical ganglion. From there the postganglionic fibres accompany the internal carotid a in to the skull and cavernous sinus, leaving the artery to join the ophthalmic nerve and become distributed to the eye by the nasociliary and the long ciliary branches. Damage to the above fibres can interrupt this pathway. Thus vascular lesions of the cortex or brainstem and damage to the sympathetic trunk by a cervical rib, lung/thyroid/oesophageal ca may give rise to Horner's syndrome.
33
Position of brachial plexus.
Trunks (upper, middle, & lower) are formed by the joining of the rami, located in the post triangle of the neck. Ant & post divisions are formed behind the clavicle and named according to their r/ship to the axillary artery. Divisions form lat, med, & post cords before entering the axilla. Cords enter the axilla above the 1st part of the axillary a and then embrace the 2nd part. Branches of the cords surround the 3rd part of the axillary a.
34
What passes through the clavipectoral fascia (or costacoracoid membrane)?
Inwards: lymphatics (infraclav to apical nodes), cephalic vein Outwards: thoracoacromial artery (or branches - pectoral, acromial, deltoid, clavicular) and lateral pectoral nerve
35
Discuss the radial nerve.
Radial nerve is the LARGEST branch of the brachial plexus. Continuation of POSTERIOR CORD (C5/6/7/8/T1). Crosses lower border of the POST AXILLARY WALL lying on the tendon of LAT DORSI. It passes out of sight through the TRIANGULAR SPACE below the lower border of this tendon as it lies in front of TERES MAJ, between the long head of triceps and the humerus. Radial nerve gives of POST INTEROSSEOUS N in between brachialis and brachioradialis. It has a POST CUT BRANCH. It only occupies the lower part of the RADIAL GROOVE.
36
What passes through the quadrangular space?
Axillary nerve and post circumflex humeral artery.
37
1. Which muscles directly attach the pectoral girdle to the thorax? 2. Which muscles provide indirect attachment?
1. Provided by muscles that insert into the clavicle or scapula from the axial skeleton. Pectoralis minor, subclavius, trapezius, the rhomboids, levator scapula, serratus anterior. 2. Pectoralis major, lat dorsi
38
What bones does the scaphoid articulate with?
Medially - lunate Distomedially - capitate Distal convex surface - trapezium and trapezoid
39
Branches of the axillary artery.
Screw The Lawyer, Save A Patient 1st part of axillary a - superior thoracic artery 2nd part of axillary a - thoraco-acromial trunk, lat thoracic artery 3rd part of axillary a - sub-scapular artery, anterior humeral circumflex artery, posterior humeral circumflex artery.
40
Radial nerve in the forearm.
- Branches in the distal arm to become deep and supf branches - Deep branch enters the forearm where it remains the deep branch until it emerges on the lower border of supinator, here it becomes the post interosseous n. - It gives off branches to ext carpi ulnaris, ext digitorum, ext digiti minimi, abd pol longus, ext pol longus & brevis, ext indicis. - Superficial branch runs under brachioradialis with radial artery before traversing post to provide cutaneous innervation in the hand.
41
Describe the anatomical snuffbox.
``` Bony points (prox-dist): radial styloid, scaphoid, trapezium, base of 1st MC. Borders: radial side - abd pol longus & ext pol brevis, ulnar side - ext pol longus. Contains: radial artery, cephalic vein (begins in the roof), cutaneous branches of radial n (can be rolled on tendon of EPL). ```

Primary Vivas (4 decks)

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