Anatomy Flashcards

1
Q

The upper limb is divided into which regions?

A
  • axilla
  • arm or brachium
  • elbow / cubital fossa
  • forearm
  • wrist
  • hand
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2
Q

The lower limb is divided into which regions?

A
  • inguinal region / groin
  • thigh
  • knee / popliteal fossa
  • leg
  • ankle
  • foot
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3
Q

What are the two types of fascia?

A

Superficial and deep

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4
Q

Describe the superficial fascia

A
  • subcutaneous tissue
  • varies in depth
  • loose connective tissue and fat
  • includes superficial blood vessels, cutaneous nerves, lymphatics and sweat glands
  • there can be variation between people and between different areas of the body eg. gluteal region and the hand region
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5
Q

Describe the deep fascia

A
  • covers most of the body deep to the skin and superficial fascia
  • relatively tough and sheet like
  • dense connective tissue
  • usually white, sometimes glistening appearance
  • named according to the location it is found in
  • divides limbs into compartments
  • present throughout most of the body but not all
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6
Q

Name an example where deep fascia is absent /hard to find or see

A

In the face

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7
Q

Name the sections of deep fascia in the upper limbs

A
  • pectoral fascia
  • deltoid fascia
  • brachial fascia
  • antebrachial fascia
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8
Q

Name the sections of deep fascia in the lower limbs

A
  • fascia lata (thigh)
  • iliotibial tract
  • crural fascia (leg)
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9
Q

Describe the features of the iliotibial tract (or iliotibial band)

A
  • lateral area of the thigh
  • thickened band of fascia lata
  • joins to the tibia inferiorly and the ilium superiorly
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10
Q

Describe the roles of deep fascia

A
  • invests muscles
  • forms intermuscular septa
  • forms compartments
  • aids in venous return
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11
Q

What is investing?

A

When the deep fascia not only covers the outer aspect of the limb but extends internally to cover deep structures

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12
Q

Describe investing in the lower limb

A

Deep fascia invests the muscles not only individually but also by way of a thickened sheet known as intramuscular septa. This forms a fascial compartment - muscle in the compartment have similar actions and the same neural supply

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13
Q

What are the benefits of compartments within the fascia?

A
  • can help with the spread of infection or tumours
  • can help to prevent overstretching
  • forms part of the muscular skeletal pump
  • occurs in both the lower and upper limbs
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14
Q

Describe the route of the arterial supply of the upper limbs starting with the subclavian artery

A
  • subclavian artery passes under the clavicle
  • then becomes the axillary artery
  • then the brachial artery
  • then the deep brachial artery
  • within the cubital fossa the brachial artery then bifurcates to give two branches; the radial artery and the ulnar artery
  • these then branch into deep and superficial palmar arches
  • then the metacarpal and digital arteries
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15
Q

How many digital arteries are there per digit?

A

4

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16
Q

Describe the route of arterial supply of the lower limb starting with the external iliac artery

A
  • external iliac artery
  • then deep femoral artery
  • then femoral artery
  • then popliteal artery
  • within the popliteal fossa the popliteal artery bifurcates to give two branches; anterior tibial artery and the posterior tibial artery
  • then dorsalis pedis artery
  • medial and lateral plantar arteries
  • arcuate artery and deep plantar arch
  • metatarsal and digital arteries
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17
Q

What is the chief arterial supply to the lower limb?

A

Femoral artery

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18
Q

What is the arterial supply of the thigh?

A
  • deep femoral artery by way of perforator branches (usually 3 or 4)
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19
Q

Which artery essentially supplies the dorsal arch?

A

Arcuate artery

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20
Q

Digital arteries are what type of artery?

A

End arteries

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21
Q

How would you limit blood loss from an artery?

A

By applying pressure proximal to the site of injury

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22
Q

Where is the carotid artery found?

A

At the level of the upper border of the thyroid cartilage, posterior to the sternocleidomastoid muscle

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23
Q

Where is the femoral artery found?

A

Inferior the the inguinal ligament

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24
Q

Where is the dorsalis pedis artery found?

A

Medial to the tendon of the extensor hallicus longus muscle

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25
Q

Describe superficial veins

A
  • run in superficial fascia
  • smaller, thinner
  • highly variable; vein pattern analysis can be used for identification
  • drain into deep veins
26
Q

Describe deep veins

A
  • run deep to the deep fascia
  • larger, thicker
  • more predictable
  • often occur in neurovascular bundles
  • pierce the deep fascia
27
Q

Describe the cephalic vein

A
  • arises from dorsal venous network
  • travels the lateral aspect of the limb
  • travels through the deltopectoral groove
  • pierces deep fascia to drain into the axillary vein
28
Q

Describe the basilic vein

A
  • arises from the dorsal venous network
  • travels the medial aspect of the limb
  • drains into the brachial vein
29
Q

What are the three most common variants of superficial veins in the cubital fossa?

A
  • median cephalic vein
  • median vein of the forearm (20%)
  • median basilic vein
30
Q

What percentage of people will have no connecting veins in the cubital fossa?

A

80%

31
Q

Describe the great saphenous vein

A
  • arises from the dorsal venous arch
  • travels the medial aspect of the limb
  • drains into femoral vein; femoral triangle
32
Q

Where is the great saphenous vein found?

A
  • immediately anterior to medial arelous

- 4 fingers width from the medial aspect of the platella

33
Q

The great saphenous vein travels with what?

A

The saphenous nerve (somatic sensory nerve)

34
Q

Describe the small saphenous vein

A
  • arises from dorsal venous arch, the lateral aspect
  • travels the posterior midline of the leg
  • drains into popliteal vein, posterior to the knee
35
Q

Describe the drainage of veins of the lower limbs starting with the planter arch

A
  • planter arch
  • drains to posterior and anterior tibial vein
  • drains into fibular vein
  • drains into popliteal vein
  • drains into femoral vein
  • drains into external iliac vein
  • drains into common iliac vein
  • finally drains into the IVC
36
Q

Describe the drainage of the upper limbs starting with the superficial and deep palmer venous arches

A
  • superficial and deep palmer venous arches
  • drains to radial and ulnar vein
  • drains to brachial vein
  • drains to axillary vein
  • drains to subclavian vein
  • drains axillary vein
  • drains to subclavian vein (internal jugular also drains to subclavian vein)
  • drains to brachiocephalic vein
  • finally, drains to SVC
37
Q

Are deep veins usually bilateral or unilateral?

A

Bilateral or more. Except from IVC and SVC

38
Q

How does venous blood normally flow from superficial into deep veins?

A

Through perforating veins.

Enter at an oblique angle

39
Q

Describe the features of venous valves

A
  • ensure unidirectional blood flow against gravity
  • incompetent valves result in reverse flow into superficial veins
  • become weak and dilated - varicose veins
40
Q

Describe the action of the musculovenous pump

A
  • as the muscle contracts, deep fascia helps to increase the pressure in the compartment so perforating veins compressed preventing backflow
  • pushes blood back towards the heart
41
Q

Describe the action of the arterial venous pump

A
  • accompanying veins (vena comitantes) surrounded with artery in vascular sheath, veins are flattened so helps blood to flow back to the heart
42
Q

The lymphatics of the upper limb generally follow what?

A

The veins

43
Q

Describe superficial lymphatics of the upper limb

A
  • arise from plexuses in fingers and hand

- follow cephalic and basilic veins

44
Q

Describe deep lymphatics of the upper limb

A
  • follow deep veins of upper limbs

- drain into lateral axillary axillary nodes

45
Q

Where does axillary nodes drain?

A

Generally drain into the subclavian lymphatics

46
Q

Which lymph nodes will the cephalic vein mainly drain into?

A

Mainly pass into apical axillary lymph nodes

47
Q

Which lymph nodes will the basilic veins drain into?

A

They drain into the cubital nodes and then into lateral axillary lymph nodes

48
Q

The lymphatics of the lower limb generally follow what?

A

The veins

49
Q

The superficial lymphatics of the lower limbs follow which veins?

A

The saphenous veins - great and small

50
Q

The deep lymphatics of the lower limbs follow which veins?

A

The deep veins of the lower limbs

51
Q

Describe the lymphatics of the great saphenous vein

A
  • tend to pass to superficial inguinal lymph nodes

- then to iliac or deep inguinal nodes

52
Q

Describe the lymphatics of the small saphenous vein

A
  • pass to the popliteal fossa nodes first
  • then to deep inguinal nodes
  • then to external iliac nodes
53
Q

Where do the external iliac lymph nodes drain to?

A

The common iliac nodes and enter the lumbar lymphatics

54
Q

Where do the deep lymphatics of the lower limb drain to?

A
  • usually first towards popliteal lymph nodes
  • then deep inguinal nodes
  • then external iliac nodes
55
Q

Define ischaemia

A

Inadequate oxygenation of cells / tissues / organs due to an interruption to blood supply (arterial or venous)

56
Q

Name reasons for reduced arterial perfusion pressure

A
  • left ventricular failure
  • arterial bleed (injury)
  • arterial rupture (aneurysm)
  • occlusion of lumen (atherosclerosis, PVD)
  • arterial spasm
  • external compression of arterial supply (tumour, compartment syndrome, inflammation)
57
Q

What is the most common site of venous ulceration?

A

Gator area

58
Q

Describe venous ulceration

A
  • venous pressure increases
  • damages blood vessels in the skin
  • skin becomes inflamed, dry and itchy
  • cannot heal well due to poor blood supply
  • begins to break down
59
Q

The gator area is the territory of which veins?

A

The small and great saphenous veins

60
Q

If a thrombus breaks away to the lungs, depending on the diameter is can occlude what?

A
  • segmental artery
  • lobar artery
  • pulmonary artery
  • pulmonary trunk
61
Q

What type of embolus can arrests the circulation of the lungs?

A

Saddle embolus - pulmonary trunk