block I Flashcards
1
Q
Define anatomy and gross anatomy
A
a field in the biological sciences concerned with the identification and description of the body structures of living things.
– Gross anatomy involves the study of major body structures by dissection and observation and in its narrowest sense is concerned only with the human body
2
Q
How is the anatomical position?
A
The anatomical position refers to a person standing erect, with their:
– Head, eyes (gaze), and toes directed anteriorly (forward)
– “Arms” at the sides with the palms facing anteriorly (forward)
– “Legs” close together with the feet parallel and the toes directed anteriorly (forward)
3
Q
Que es de cúbito?
A
acostado de lado forma horizontal
4
Q
Define supine and prone
A
Supine:
– when body is lying on its “back side”, facing
“upwards” (“face up”)
- Prone:
– when body is lying on its “front side”, facing
“downwards” (“face down”)
5
Q
Mention the anatomical planes
A
-sagittal (midsagittal or parasagittal) - divides de body into right and left halves
-Coronal (frontal)- divides into anterior and posterios portions
-Transvere (horizontal, axial, transaxial)- divides the body into superior and inferior parts
6
Q
Mention the anatomical sections (3)
A
Longitudinal Sections:
– Run the length of the body vertically (head-to-foot)
– In the median, sagittal, or coronal planes, or in any vertical plane angled between 0 degrees and 180 degrees to these vertical planes
* Transverse (Cross) Sections:
– Sections in the horizontal plane.
– Perpendicular to the long axis of the body and to longitudinal sections.
– Exception: Transverse section of the foot is in the coronal plane because the long axis of the foot is horizontal (heal-to-toe)
* Oblique Sections:
– Sections that are not entirely in the median, sagittal, coronal or horizontal planes.
– In practice, a common type of imaging (radiology) section, owing to difficulties in accuracy and precision in staying entirely within the above planes
7
Q
What is superior, inferior, anterior, and rostral?
A
Superior:
– Towards (closer to) the head or vertex (top of head).
* Inferior:
– Towards (closer to) the feet.
* Anterior:
– Towards (closer to) the front side of the body.
– Comparable to the common terms “forward” and “in front”.
– AKA Ventral, commonly used in embryology.
* Rostral:
– At the head end or closer to the nose and mouth.
– Alternative word to anterior or superior, depending upon the context.
– Used when referring to structures of the central nervous system (CNS).
8
Q
Explain posterior, cranial, caudal and dorsal
A
Posterior:
– Towards (closer to) the back side of the body
– Comparable to the common term “behind”
* Cranial:
– Towards (closer to) the head
– Most commonly used in embryology
* Caudal:
– Towards (closer to) the tail or hind parts
– Most commonly used in embryology
* Dorsal (Dorsum):
– Towards (closer to) the back side of the body
– Most commonly used in embryology
9
Q
Explain in plane terms
A
10
Q
Explain palmer (palm), plantar (sole), medial, lateral
A
Palmer (Palm)
– Term used specifically for the hand
– Comparable to anterior
* Plantar (Sole)
– Term used specifically for the foot
– Comparable to inferior
* Medial
– Towards (closer to) the midline or median plane of the body
* Lateral
– Farther from the midline or median plane of the body
11
Q
Explain in plane terms
A
12
Q
Explain proximal, distal, superficial, deep, intermediate, external and internal
A
- Proximal
– Closer to the attachment or origin of a limb, body segment, or structure - Distal
– Farther (more distant) from the attachment or origin of a limb, body segment, or structure - Superficial
– Closer to the external surface of the body - Deep
– Closer to the innermost structures of the body. - Intermediate
– In between more superficial structures and deeper structures - External:
– Outside or farther from the center of an organ or cavity
– Similar to superficial, but not related to a particular direction - Internal:
– Inside or closer to the center of a structure, organ, or cavity
– Similar to deep, but not related to a particular direction
13
Q
In terms of laterality, what is bilateral and provide an example?
A
– Body segments, organs, or structures in the body that are paired (one on the left and one on the right)
-Lungs, kidneys
14
Q
In terms of laterality, what is unilateral and provide an example?
A
-Organs or structures in the body that are not paired (only one) and occur on one side of the body
-right or left side; pancreas, liver
15
Q
In terms of laterality, what is ipsilateral and provide an example?
A
-Body segments, organs, or structures that are on the same side of the body
-left arm, left leg
16
Q
In terms of laterality, what is contralateral and provide an example?
A
-Body segments, organs, or structures that are on opposite sides of the body
-left arm, right leg
17
Q
Identify all the laterality terms
A
18
Q
Which organs can not be classified by the laterality terms due to their position?
A
heart, aorta, esófago, nariz
19
Q
Demonstrate flexion and extension of upper limb at shoulder and lower limb at hip joint
A
20
Q
Demonstrate flexion and extension of forearm at elbow joint and of leg at knee joint
A
21
Q
Demonstrate flexion and extension of vertebral column at intervertebral joints
A
22
Q
Demonstrate flexion and extension of hand at wrist joint
A
23
Q
Demonstrate opposition and reposition of thumb and little finger at carpometacarpal
A
24
Q
Demonstrate pronation and supination of forearm at radio-ulnar
A
25
Demonstrate ABDuction and ADDuction of 2nd, 4th and 5th digits at metacarpophalangeal joints
26
Demonstrate ABDuction of 3rd digits at metacarpophalangeal joints
27
Demonstrate ABDuction and ADDuction of thumb at metacarpophalangeal joint occuring in sagittal plane rotated at 90 degrees
28
Demonstrate extension and flexion at metacarpophalangeal and interphalangeal joints that occurs in frontal planes, opposite to the movements at all other joints.
29
Demonstrate ABDuction and ADDuction of right limbs and rotation of left limbs at glenohumeral and hip joints
30
Demonstrate circumduction of lower limb at hip joint
31
Demonstrate dorsiflexion and plantarflexion of foot at ankle joint
32
Demonstrate inversion and eversion of foot at subtalar and transverse tarsal joints
33
Demonstrate lateral bending (lateral flexion) of trunk and rotation of upper trunk, neck and head
34
Demonstrate elevation and depression of shoulders
35
Demonstrate portrusion and retrusion of jaw at temporomandibular joints
36
Demonstrate protraction and retraction of scapula on thoracic wall
37
What are anatomical variations?, do they have effects? how are they discovered?
– Structural change from the classical description.
– Usually has no effect on effect normal function of the anatomical structure.
– Often discovered during imaging or surgical procedures, or in cadaver dissection.
38
What is a congenital anomaly or birth defect and provide example?
-Variation often evident at birth or soon to o aberrant form or function
-spina bifida
39
What are the classifications of joints?
-Synovial joints
-Fibrous joints
Cartilaginous joints
40
What are synovial joints? examples
-These joints has a joint capsule line by a serous synovial membrane enclosing the articular cavity that contains synovial fluid
-Bones that unite inside a fibrous capsule with fluid
-Needs to have hyaline cartilage
ex: knee joint
41
What are fibrous joints? examples
-These joints are united by fibrous tissue and membranes or ligaments
ex: suture in skull and dentro-alveolar syndesmosis (gomphosis)
42
What are cartilaginous joints? examples
-These joints are united by hyaline cartilage or fibrocartilage
-Can also be synovial
ex: Femur (primary) and intervertebral disc (secondary).
43
What is the function of synovial fluid?
Serves as lubricant like WD-40
44
Mention the types of synovial joints
-Pivot
-Ball and socket
-Plane
-Hinge
-Saddle
-Condyloid
45
Mention the plane of movement of Pivot joint and an example
-uniaxial (a rounded process of bone fits into a body ligamentous socket, permitting rotation
-Dents, Atlas C1 and Axis C2 (movimiento de decir que "no" con la cabeza)
46
Mention the plane of movement of Ball and Socket joint and an example
-multiaxial (A rounded head fits into a concavity, permitting movement on several axes)
-Hip joint and shoulder joint
47
Mention the plane of movement of Plane joint and an example
-Usually uniaxial (Permit gliding or sliding movements; not much range of movement)
-Acromioclavicular joint
48
Mention the plane of movement of Hinge joint and an example
-Uniaxial (Permit flexiona nd extension only)
-Elbow joint
49
Mention the plane of movement of Saddle joint and an example
-Biaxial (Saddle-shaped heads permit movement in two different planes)
-Carpometacarpal joint
50
Mention the plane of movement of Condyloid joint and an example
-Biaxial (Permit flexion and extension, ABDuction and ADDuction, and circumduction.
-Metacarpophalangeal joint
51
Mention the components of body walls
Thoracic wall
Abdominal Wall
Deep muscles of the back
52
Mention the surface anatomy of anterior thoracic wall in a man's body
53
Mention the surface anatomy of anterior thoracic wall in a woman's body
54
Mention the surface anatomy of the anterior
55
Mention the vertical lines of the lateral
56
Mention the posterior vertical lines of the posterior
57
What does the thoracic wall consists of?
Skin, fascia, nerves, vessels, muscles, cartilages, and bones.
58
What are the functions of the components of the thoracic wall?
-Resist the negative internal pressures generated by the elastic recoil of the lungs and inspiratory movements.
-Provides attachment for and supporting the weight of the upper limbs
-Provides attachment for many of the muscles of the upper limbs, neck, abdomen, and back and the muscles of respiration.
59
Mention the types of ribs
-True
-False
-Free
60
What are the bony structures of the thoracic cage?
-12 pairs of ribs
-Costal cartilage
-Sternum
-12 Thoracic vertebrae and intervertebral discs
-Apertures
61
What are the parts of the sternum?
-Manubrium
-Body
-Xiphoid process
62
Which are the apertures of the thoracic wall?
-Superior thoracic aperture (thoracic inlet)
-Inferior thoracic aperture (thoracic outlet)
63
Identify structures
64
How many true, false and free ribs are there present and how are they connected?
7 (true) [cartilage connects directly with sternum]
3 (false) [Their cartilage is attached to the cartilage of rib #7]
2 (free) [Dont have cartilage but provide form to the abdominal cavity]
65
What does the costal cartilage attach?
Attaches ribs to the sternum
66
Identify the structures of thoracic wall and vertebral level
67
Draw and identify the structures of a typical rib
3rd to 10th rib
68
Draw and identify the structures of an atypical rib; which are the atypical ribs?
1st, 2nd, 11th, and 12th
69
Identify the structures of the posterior joints of thoracic wall
70
Describe inspiration
Increase the intrathoracic diameters and volume of the thorax
71
Describe passive expriation
* The diaphragm, intercostal muscles, and other muscles relax
* Decreasing intrathoracic volume and increasing intrathoracic pressure, expelling air from the lungs through the same passages
72
With what structure does the superior articular facet of a typical rib articulates?
With the head of the vertebrae
73
With what structure does the tubercule of a typical rib articulates?
With transverse process
74
What is instrinsic?
Works where it is located
75
What is extrincsic?
Works outside of where it is located
76
Which muscles are used for respiration?
Pectoralis Major
Pectoralis minor
Inferior part of the serratus anterior
77
Mention the functions of the pectoralis major
Movement of shoulder joints; flexion, adduction and medial rotation of the humerus
78
Mention the functions of the pectoralis minor
Depresses the point of the shoulder
79
Mention the functions of the inferior part of the serratus anterior
Pulls the scapula forward around the thorax
80
Identify the muscles
81
Identify muscles
82
Identify muscles
83
Identify the structure
Axillary process or tail of Spence
84
Where are the mammary glands located?
In the subcutaneous tissue overlying the pectoralis major and minor muscles
85
What is the cutaneous innervation of the nipple?
T4
86
Where does the bed of the breast extend from? identify
Extends from the 2nd rib above to the 6th or 7th rib below and may extend along the inferolateral edge of the pectoralis major toward the axillary fossa (armpit), forming an axillary process
87
Identify structures
88
Mention the functions of the suspensory ligaments of cooper
firmly attached the mammary glands to the dermis of the overlying skin
89
Mention the function of the lactiferous ducts
Give rise to buds that develop into 15– 20 lobules of the mammary gland
90
Mention the function of the lactiferous sinus
Each lactiferous duct has a dilated portion deep to the areola, the lactiferous sinus, in which a small droplet of milk accumulates or remains in the nursing mother
91
Identify arteries and explain how they irrigate the breast.
The blood passes through subclavian artery which converts into the axillary artery. Then, the bood passes through axillary artery which divides into the brachial artery and the lateral thoracic artery which gives rise to the lateral mammary branches to irrigate the lateral portion of the breast. On the medial portion of the breast or bed of the breast blood flows from the subclavian artery into the internal thoracic and its perforating branches and then the medial mammary branches.
92
Identify veins and explain how they drain the breast.
The blood drains through the lateral mammary veins into the lateral thoracic vein. then from the lateral thoracic vein, drains to the axillary vein and then into the subclavian vein. From the medial side, the medial mammary vein and the perforating branches of the internal thoracic vein, drain into the internal thoracic vein, then draining up and connecting with the subclavian and the jugular vein.
93
Why is the lymphatic drainage of the breast important?
Because of its role in the metastasis (spread) of cancer cells.
94
Mention some of the axillary lymph nodes
pectoral, humeral, subscapular, central, and apical groups
95
Where des lymph drain?
Most lymph (75%), especially from the lateral quadrants of the breasts, drains to the axillary lymph nodes
96
Identify the lymph nodes and explain how they drain
On the lateral side of the breast,the subscapular posterior lymph nodes, along with the humeral (lateral) lymph node, drain into the pectoral (anterior) lymph node, and then into the central lymph node. The lymphatic drainage continues woth the central lymph node and then into the apical lymph nodes. After, the drainage continues with the infraclavicular lymph nodes and then the subclavicular lymph nodes then into the deep cervical lymph nodes. On th emedial side, the subareolar lymphatic plexus drains into the parasternal lymph nodes, then the drainage continues into the bronchomediastinal lymphatic trunk. It drains in the duct and then into the subclavian vein.
97
Which lymph nodes are the red flag for breast cancer and lung cancer?
Deep cervical lymph nodes
98
What are adenocarcinomas and where does it arise?
(glandular cancer) arising from the epithelial cells of the lactiferous ducts in the mammary gland lobules.
99
How does breast cancer spread?
Breast cancer typically spreads from the breast by means of lymphatic vessels (lymphogenic metastasis), which carry cancer cells from the breast to the lymph nodes, chiefly those in the axilla
100
What are the breast cancer superficial signs
101
What organs are in the right upper quadrant of the abdomen?
102
What organs are in the right lower quadrant of the abdomen?
103
What organs are in the left upper quadrant of the abdomen?
104
What organs are in the left lower quadrant of the abdomen?
105
What does the anterolateral abdominal wall consists of?
* Skin
* Subcutaneous tissue (superficial fascia)
-Campers Fascia
-Scarpa Fascia
* Muscles and their aponeuroses
* Deep fascia
-Investing Fascia
* Extraperitoneal fat
* Parietal peritoneum
106
Identify the structures
107
Which are the flat muscles of the of the anterolateral wall?
External oblique
Internal Oblique
Transversus abdominis
108
Which are the vertical muscles of the anterolateral wall?
Rectus abdominis
Pyramidalis
109
Identify the anterolateral abdominal muscles
110
What is the rectus sheath and what is it made of?
Formed by the interlaced aponeuroses
of the flat abdominal muscles, and its basically a coat of aponeuroses that cover the muscles of anterior abdominal wall
111
What is the rectus sheath's content?
* Rectus abdominis and pyramidalis muscles
* The anastomosing superior and inferior epigastric arteries and veins
* Lymphatic vessels
* Thoraco-abdominal and subcostal nerves
112
Draw the rectus sheath and identify components
113
What'a the difference between fascia and aponeurosis?
Fascia is more thin and it's for dividing, and aponeurosis is more thick and it's for support
114
How is the rectus sheath superior to the arcuate line?
Enveloped by the anterior layer of the rectus sheath
115
How is the rectus sheath inferior to the arcuate line?
The aponeuroses of all three muscles, external and internal oblique and
transversus abdominis, pass anterior to the rectus abdominis to form the
anterior rectus sheath, leaving only the transversalis fascia to cover the
rectus abdominis posteriorly
116
Which arteries travel along the rectus sheath?
inferior and superior epigastric artery
117
Which arteries irrigate the abdominal wall?
Superior epigastric
-Branch of internal thoracic artery
Inferior epigastric
-Branch of external iliac artery
118
Identify
119
Where does the muscolophrenic artery go to?
To the diaphragm
120
What does the superior epigastric artery irrigate?
Supplies the rectus abdominis in the superior posterior part
121
What does the subcostal artery irrigate?
posterior intercostals and external oblique, internal oblique, transversus abdominis
122
The inferior epigastric artery comes from?
Comes from the external iliac artery.
123
Identify
124
What is the inguinal region?
-Extends between the anterior superior iliac spine and the pubic tubercle
-It is a region where structures exit and enter the abdominal cavity and is,
therefore, clinically important because these are potential sites of herniation
125
What are the boundaries of the inguinal canal?
Anterior wall:
-Formed by external oblique aponeurosis
Posterior wall:
-Formed by transversalis fascia
-Reinforced by the internal oblique and transversus abdominis aponeuroses into a common tendon—the inguinal falx (conjoint tendon)
126
Which are the main structures in the inguinal canal?
male:
* Spermatic cord conveying the ductus deferens in males and
* Ilio-inguinal nerve
female:
* Round ligament of the uterus in females
* Ilio-inguinal nerve
127
What are the two openings of the inguinal canal?
Deep inguinal ring:
-The internal entrance to the inguinal canal, is an evagination of the transversalis fascia
Superficial inguinal ring:
-The exit from the inguinal canal, is a slit-like opening in the aponeurosis of the external oblique
128
Draw the inguinal canal and identify structures
129
Draw the inguinal canal for male
130
Draw the inguinal canal for female
131
Que hace el ligamento redondo y donde se degrada?
Mantiene el utero en su posición y se degrada en la labia majora
132
What is an inguinal hernia?
Protrusion of parietal peritoneum and viscera, such as the small intestine, through a normal or abnormal opening from the abdominal cavity.
133
What are the types of hernias and where are they found?
Direct Inguinal hernia [acquired by too much force]
-Usually found medial to the inferior epigastric arteries
-Pasan medial a las epigastricas y pueden llegar hasta la labia majora
-MENOS DIRECTA EN MUJERES
Indirect inguinal hernia [congenital]
-Usually found lateral to the inferior epigastric arteries
-pasan lateral a las epigastric
-can also occur in women
134
Which organ can be affected by hernias and how?
Since the intestine passes through the canal it can get pinched and necrotize
135
Mention the muscles of the posterior abdominal wall
-Psoas major
-Quadratus lumburom
-Iliacus
136
What is the function of the Psoas major and the innervartion?
* Acting inferiorly with iliacus flexes thigh. [most strong flexor]
* Acting superiorly, flexes vertebral column laterally to balance the trunk
* when sitting, acts inferiorly with iliacus to flex the trunk.
-insertion point is in the femur
* Innervated by L2- L4
-starts in T12-L1 and ends by L3/L4
137
Identify the muscles
138
What is the function of the Quadratus lumborum and the innervartion?
-Fixes or depresses the 12th rib during respiration.
-only muscles that is not from the back and it is associated tot he abdominal wall
-Laterally flexes vertebral column
-Innervated by anterior rami T12, L1-L4
-originate in the ribs and works til the iliac crest
139
What is the function of the iliacus and the innervartion?
(lateral side of the inferior part of the psoas major)
-Flexes thigh and stabilizes hip joint (works with psoas muscle)
-Innervated by (L2-L4) femoral nerve
140
How many vertebrae do we have?
Total of 33 vertebrae:
* Cervical (7)
* Thoracic (12)
* Lumbar (5)
* Sacral (5)
* Coccygeal (4)
141
Which vertebrae do not fuse?
S5 and Co, women move this in the process of child birth
142
What are are the primary curvatures?
* Develop during the fetal period
* Caused by vertebral shape
-thoracic
-sacral
143
What are are the secondary curvatures?
* Develop after birth
* caused by changes in intervertebral discs; vital for upright position and bipedal locomotion
- cervical [develop when babies start to lift their heads when they're facing down]
-lumbar [develops when baby starts to crawl and starts standing up]
144
What are are the adult curvatures?
* Cervical lordosis
* Thoracic kyphosis
* Lumbar lordosis
* Sacrococcygeal kyphosis
145
Identify the curvatures
146
Mention some functions of the vertebral column
* Protect the spinal cord and the spinal nerves
* Support weight
* Provide a rigid and flexible axis for the body
* Vital for posture and locomotion
* Provides for the a pivot head
147
What are the parts of a typical vertebrae structure?
Vertebral body
Pedicles
Lamina
Vertebral arch
Transverse vertebral process
Spinous process
Articular process
148
Identify the structures of the vertebrae and their functions
149
Identify structures
150
What are the pedicles?
* Connects the lamina to the vertebral body to form the vertebral arch
151
What is the lamina?
Provides roof for the spinal canal and protects the back of the spinal cord
152
What is the vertebral arch?
* Includes a pair of pedicles and a pair of laminae
* Supports 2 transverse processes, 1 spinous process and 4 articular processes
153
What is the transverse vertebral process?
Site of attachment for muscles and ligaments of the spine; point of articulation of the ribs in thoracic spine
154
What is the spinous process?
Bony projection of the back of the vertebra that enables muscle and ligament attachment to the spine
155
What is the articular process?
Serve the purpose of fitting with an adjacent vertebra through the articular facet
156
What is characteristic of cervical vertebrae?
Ucinate process
157
What is the foramina trasnversarii?
Allow the vertebral artery to pass from the thoracic inlet to the hea
158
Which cervical vertebrae are short and bifid?
C3-C6
159
Mention characteristics of Atlas (C1)
* Lack of vertebral body and spinous process
* Composed of 2 arches
-Anterior arch
-Posterior arche
* Transvers process:
-Arise from the lateral lateral masses
160
Mention characteristics of Axis (C2)
* Presence of Dens (odontoid process) [held by transverse ligament]
-enables movements in transverse plane-say NO
* Superior articular facets
-Allow the rotation of the atlas
161
Identify
162
Identify
163
Mention characteristics of thoracic vertebrae
* Body:
-Heart shape
-2 or 4 costal facets for articulation with the heads of the ribs
* Vertebral foramen:
-Circular and smaller than the foramens in cervical and lumbar vertebrae
* Transverse process:
-Long and strong
* Articular process:
-Superior and inferior facets to articulate between vertebrae
-Superior and inferior costal facets
* Spinous process:
-Pointed, long and slope posteriorly
-Tip extend to the level of the vertebral body below
164
Identify
Thoracic
165
Identify
166
Mention characteristics of lumbar vertebrae
* Body:
-Kidney shape
* Vertebral foramen:
-Triangular and larger than the foramens in thoracic vertebrae and smaller than in cervical vertebrae
* Transverse process:
-Short and slender
* Articular process:
-Superior and inferior facets to articulate between vertebrae
-Mammillary process or bodies??
*Spinous process:
-Short and sturdy, thick broad and hatched shaped (flat)
167
Identify
Lumbar
168
Identify
169
Mention the characteristics of the sacrum
* Five fused sacral vertebrae
* Sacral canal:
-Continuation of the vertebral canal
-Contains the cauda equina(bundle of spinal nerves root inferior to L1)
* Sacral foramina:
-Allows the exit of the posterior an anterior rami of the spinal nerves
* Sacral promontory
* Median sacral crest
170
Mention the characteristics of the coccyx
* Usually formed by the fusion of the 4 rudimentary coccygeal vertebrae
* Co1- often fuses with the sacrum
171
Identify
Sacral and coccygeal
172
identify
Sacral and coccygeal
173
What dies the intervertebral disc consists of?
-The disc accounts 20%-25% of the height of the vertebral column
* Consists of:
* Anulus fibrosus:
-Outer fibrous part, composed of concentric lamellae of fibrocartilage
* Nucleus pulposus:
-Core of the IV disc; gelatinous central mass
-Pulpy nuclei are about 88% water
-Their semifluid nature is responsible for much of the flexibility and resilience of the IV disc and of the vertebral column as a whole.
174
Identify
Intervertebral disc
175
Identify
176
How many cervical spinal nerves are there?
8
177
Where does spinal nerves exit the cervical spine and where is it located?
through the intervertebral foramen; right above their corresponding
vertebral body level.
178
Which are the most common disc hernias?
lateral
179
What is the anterior longitudinal ligament and its function?
-A strong, broad fibrous band that covers and connects the anterolateral aspects of the vertebral bodies and IV discs
-Prevents hyperextension of the vertebral column, maintaining stability of the joints between the vertebral bodies.
-Only ligament that limits extension; all other IV ligaments limit forms of flexion.
180
What is the posterior longitudinal ligament and its function?
-Narrower and weaker ligament
-Runs within the vertebral canal along the posterior aspect of the vertebral bodies
* *This ligament weakly resists hyperflexion of the vertebral column and helps prevent or redirect posterior herniation of the nucleus pulposus.
181
Identify
182
Mention the ligaments of the vertebral column
Anterior longitudinal ligament
Posterior longitudinal ligament
Ligamentum flava
Interspinous ligaments
Supraspinous ligaments
183
Mention the function of the ligamentum flava
Bind the lamina of the adjoining vertebrae together
184
Mention the function of the interspinous ligaments
Connect adjoining spinous processes, attaching from the root to the apex of each process
185
Mention the function of the supraspinous ligaments
Connects the tips of the spinous processes from C7 to the sacrum and merge superiorly with the nuchal ligament at the back of the neck
186
Identify
187
Identify
188
Identify muscles and nerves
189
What is the innervation of the Trapezius and its action?
-Innervation:
-Accessory nerve (CN XI)
* Action:
-Descending (superior) fibers elevate the scapula (e.g., when squaring the shoulders).
-Middle fibers retract the scapula (i.e., pull it posteriorly).
-Ascending (inferior) fibers depress the scapula and lower the shoulder.
190
What is the innervation of the Latissimus dorsi and its action?
Action:
-acts directly on the glenohumeral joint and indirectly on the pectoral girdle
Innervation:
-Thoracodorsal nerve
191
Which are the superficial muscles of the back?
Trapezius
Latissimus dorsi
Levator scapulae
Rhomboids
192
What is the innervation of the Levator scapulae and its action?
* Action: Elevates the scapula
* Innervation: Dorsal scapular nerve
193
What is the innervation of the Rhomboids and its action?
* Action: Retracts the scapula
* Innervation: Dorsal scapular nerve
194
What are the intermediate extrinsic muscles of the back
* More likely proprioceptive rather than motor in function muscles
* Designated as superficial respiratory muscles
Serratus posterior superior
Serratus posterior inferior
195
What is the innervation of the Serratus posterior superior and its action?
* Lies deep to the rhomboid muscles [inspiration]
* Innervated: 2nd -5th intercostals
* Action: Proprioception of the elevation of the ribs
196
What is the innervation of the Serratus posterior inferior and its action?
* Lies deep to the latissimus dorsi muscle [expiracion]
* Innervated: anterior rami T9-T12 thoracic spinal nerves
* Action: Proprioception of the depression of the ribs
197
Identify
198
What are the intrinsic muscles of the back (superficial, intermediate and deep layer)?
Superficial layer:
-Splenius capitis & Splenius cervicis
Intermediate layer:
-Erector spinae:
*Iliocostalis
*Longissimus
*Spinalis
Deep layer:
-Transversospinalis muscle group
*Seminspinalis
*Multifidus
*Rotatores
199
What are the intrinsic muscles of the back (Minor deep layer spare in the thoracic region)?
Interspinales
Intertransversaruu
Levatores costarum
200
What is the function of the splenius capitis & splenius cervicis?
Laterally flexes the neck and rotates the head to the side of the active muscle
201
Identify
202
What is the function of the erector spinae and its innervation?
Innervated:
-Posterior rami of the spinal nerves
Action:
* Unilaterally - flex laterally the vertebral column
* Bilaterally - extend the vertebral column and head
* When the back is flexed , control movement via eccentric contraction
203
Identify
204
Identify
205
Identify
206
What is the function of the semispinalis, multifidus and rotatores; and its innervation?
Semispinalis:
* Action: extends the head and the thoracic & cervical vertebral regions
Multifidus:
* Stabilized the vertebra under local movement of vertebral column
Rotatores:
* Stabilized vertebrae and assist with local extension and rotatory movements of the vertebral column
* All are innervated by the posterior rami of the spinal nerves
207
Identify
208
Identify
209
What is the function of the interspinales and its innervation?
* Aid in extension and rotation of vertebrae
* Innervated: Post. rami of spinal nerve
210
What is the function of the Intertransversarii and its innervation?
* Aid in lateral flexion of vertebral column acting bilaterally
* Innervated: Post. and ant. rami of spinal nerve
211
What is the function of the Levatores costarum and its innervation?
* Elevates the ribs assisting respiration
* Innervated: Post. rami of C8-T1 spinal nerves
212
Identify
213
Draw the upper view of the muscles of the back
214
What muscles are used when doing flexion of the trunk, starting from extended position?
Rectus abdominis and Psoas Major
215
What muscles are used when doing extension of the trunk, starting from flexed position?
Erector spinae, multifidus, seminspinalis thoracis, gluteus maximus
216
What muscles are used when doing lateral flexion of the trunk, to the right
217
What muscles are used when doing lateral flexion of the trunk, to the left
218
What is a laminectomy and why they perform it?
Surgical excision of one or more spinous processes and the adjacent supporting vertebral laminae in a particular region of the vertebral column
* Often performed to relieve pressure on the spinal cord or nerve roots caused by a tumor, herniated IV disc, or bony hypertrophy
219
How is the fracture and dislocation of the Atlas called? How dies it happen?
Jefferson or burst fracture.
-Striking the bottom of a pool in a diving accident
-Compression to the lateral masses by the occipital condyles drive them apart, fracturing one or both of the anterior or posterior arches
-Itself does not necessarily result in spinal cord injury, because the dimensions of the bony ring actually increase.
-Spinal cord injury is more likely to happen if the transverse ligament has also been ruptured
220
Identify
Jefferson or burst fracture
221
What is the herniation of nucleus pulposus?
(Herniation of IV Disc)
* Protrusion of the gelatinous nucleus pulposus into or through the anulus fibrosus
* Herniations of the nucleus pulposus usually extend posterolaterally
* Can be damaged by violent rotation
222
identify
herniation of nucleus pulposus
223
Identify the abnormal curvatures of the vertebral column
224
What is Excessive thoracic kyphosis?
(humpback or hunchback)
* Characterized by an abnormal increase in the thoracic curvature; the vertebral column curves posteriorly
* Can result from osteoporosis in older women
225
What is Excessive lumbar lordosis?
(clinically shortened to lordosis)
* Characterized by an anterior tilting of the pelvis with increased extension of the lumbar vertebrae
* Associated with weakened trunk musculature, especially the anterolateral abdominal muscles
* Obesity in both sexes can also cause
226
Identify
Lateral view of excessive kyphosis
227
Identify
Scoliosis
228
What is Scoliosis?
Characterized by an abnormal lateral curvature that is accompanied by rotation of the vertebrae
* The spinous processes turn toward the cavity of the abnormal curvature, and when the individual bends over, the ribs rotate posteriorly (protrude) on the side of the increased convexity.
229
The father of anatomy and one of the first very few people to dissect a human body.
Herophilus
230
The most prominent anatomist of this period was?
Galen he dissected pigs and monkeys.
231
Da vinci
In the late 15th century, Leonardo Da Vinci secretely made use of human cadavers for his anatomical drawings, detailing the human skeletal, muscular and vascular systems as never before.
232
In 16th century published his anatomical treatise De Humani Corporis Fabrica , a series of detailed plates of drawings of dissected corpses. The
Andreas Vesalius
233
"Founder of modern anatomy"
Andreas Vesalius
234
Also in the 16th century, ________________ published the first
anatomical atlas written in spanish, Historia de la Composición del Cuerpo
Humano
Juan Valverde de Amusco
235
endorsed a policy to donate the bodies of executed criminals to medical schools, a policy also followed in other countries. Although this helped
England´ s Henry VIII
236
ran a boardinghouse in which they murdered the tenants
and delivered the bodies to anatomy schools for
very high amounts of money. They were caught
William Hare and William Burke
237
Anatomy Act
1830
238
Ley de Donaciones Anatómicas de Puerto Rico Ley Núm. 296 del 25 de diciembre de 2002
In Puerto Rico
239
How is the nervous system structurally divided?
CNS: brain, spinal cord
PNS: cranial nerves, spinal nerves, autonomic nerves, ganglia
240
What are ganglia?
Conglomerates of cells
241
How is the nervous system FUNCTIONALLY sub-classified?
Somatic and Autonomic
The autonomic is sub-divided into:
-Sympathetic & parasympathetic
242
Describe the somatic system
Sensory (afferent) and motor (efferent) innervation of all body, except smooth muscle, glands and viscera in the body cavities
243
Describe the autonomic system
Visceral motor system and associated sensory fibers innervating smooth muscle, glands and viscera in the body cavities.
244
What are the cellular components?
-Neurons
-dendrites
-body
-axon
-terminals
-synapses
-Glia
white matter-axons, processes or fibers, covered with myelin
gray matter-collections of neuronal cell bodies:
-ganglia (PNS)
-nuclei, cortex, horns (CNS)
245
What is a neuron?
Specialized cells into transmitting a signal/message
246
What are Glia?
Glial cells that provide structural support to neurons and membrane coverage
247
How are axons in the white matter?
High number of myelinated axons
248
Identify
249
Identify the type of neuron
bipolar
250
Identify the type of neuron
multipolar
251
Identify the type of neuron
pseudounipolar
252
Identify
Protoplasmic astrocyte; fibrous astrocyte
253
Identify type of cell
Schwann cell
254
Oligodendrocyte
255
Which receives information?
afferent or sensory modality
256
Which sends or responds?
efferent or motor action
257
Identify
6 : forebrain/cerebral hemisphere
5: Diencephalon - Thalamus, hypothalamus, epithalamus
4: Midbrain
3: metencephalon - pons, cerebellum
2: medula
1: spinal cord
258
What deos the brain stem consists of?
Midbrain
Pons
Cerebellum
Medulla
259
What does the gray matter and white matter consists in the brain and identify the structures in the picture; respectively.
GM: Nuclei and cortex; most external part of brain or superficial
WM: Tracts, commissures [cuerpo calloso] (deepest pasrt or interior part of the brain)
260
What occupies the ventricles?
filled with cerebrospinal fluid (CSF), which is an exudate of blood with other components added from the neural tissue of the brain and spinal cord
261
How is the cerebrospinal fluid produced?
The bulk of this fluid is produced by a structure found within each ventricle, the choroid plexus
262
Identify the ventricles
263
Identify the ventricles
264
Identify the ventricles
265
The 4th ventricle communicates with?
The central canal
266
Identify level of spinal cord
Cervical
267
Identify level of spinal cord
Thoracic
268
Identify level of spinal cord
Lumbar
269
Identify level of spinal cord
Sacral
270
Ventral is what type of action?
Motor
271
Dorsal is what type of action?
Sensorial
272
Which parts of the spinal cord have enlargements?
Cervical and lumbar
273
Identify structures
Denticulate ligament, rootlets, dura mater, arachnoid
274
Where does the conus medullaris end in adults?
Between L1 and L2
275
Identify structures
Cauda equina, conus medullaris, filum terminale
276
What are the meninges of the spinal cord?
Dura mater, arachnoid mater, pia mater and denticulate ligaments
277
Which are the spaces of the spinal cord?
Epidural, subdural (potential space) and subarachnoid pscae
278
Where is the subarachnoid space located?
Between the pia mater and the arachnoid
279
Where is the epidural space located?
Outside the dura mater; between the vertebral canal and the dura mater
280
Where is the subdural space located?
Between the dura mater and the arachnoid
281
Where deos the CSF pass through?
The subarachnoid space
282
Identify
283
Identify
284
Where does the anterior spinal artery originate from?
From the vertebral arteries
285
Where does the posterior spinal artery originate from?
From the vertebral arteries
286
Identify
287
Identify blood drainage and its surrounding spaces/structures
additional: epidural space, dura mater, arachnoid, subarachnoid space
288
Identify
289
Identify the vascularization of meninges
290
identify the horns
dorsal horn, lateral horn and ventral horn
291
What is the function of the dorsal, lateral and ventral horn; respectively?
Dorsal: sensorial
Lateral: autonomic motoneurons
Ventral: somatic motoneurons
292
Where do spinal tracts pass through?
White matter
293
Where does laminae pass through?
Gray matter
294
Identify
add: dorsal, ventral, dorsal root ganglion, dorsal ramus
295
How are neurons that enter the dorsal root ganglion and where do they synapse?
sensorial, Pseudiunipolars; gray matter
296
What is proximal and distal to the ganglion
Proximal: axon
Distal: dentrite
297
Mention the spinal nerves of the body wall -segmental nerves
Intercostal nerve, ventral ramus of thoracic nerve, anterior subcutaneous branch of intercostal nerve (only sensorial), lateral cutaneous branch of intercostal nerve, posterior cutaneous.
298
What are dermatomes?
The region of skin innervated by each segmental nerve
299
Which dermatomes extend to the hand?
C5, C6, C7, C8 and T1
300
What are the spinal nerves of the extremities? draw
Brachial plexus:
-musculocutaneous nerve
-axillary nerve
-radial nerve
-ulnar nerve
-median nerve
Lumbar plexus:
-Lateral femoral cutaneous nerve
-Femoral nerve
-Obturator nerve
301
How many cranial nerves are there?
12;
I olfactory
II Optic
III Oculomotor
IV Trochlear
V Trigeminal
VI Abducens
VII Facial
VIII Vestibulocochlear
IX Glossopharyngeal
X Vagus
XI Accessory
XII Hypoglossal
302
How many ganglias are there?
Somatic system
1. Dorsal Root Ganglia
Autonomic system
2. Sympathetic Chain Ganglia (Paravertebral)
3. Sympathetic Prevertebral Ganglia
4. Parasympathetic Ganglia
303
from who the CNS receive information and how?
1. External world:
a. via special senses (olfaction, sight, hearing, taste, balance)
b. via interactions with the body or “soma” (touch, temperature, pressure, pain, proprioception, muscle and tendon tension
2. the internal (visceral) world:
a. via interactions with the internal organs (heart, lungs, digestive tract, glands, blood vessels, etc.)
All this information is received through various modalities of the afferent (sensory) system, carried via peripheral nerves towards the CNS
304
How does teh CNS respond to the information it receives?
1. The somatic efferent (motor) system, via spinal and cranial nerves
2. The autonomic nervous system
305
To what structure does afferent info go to?
Almost all to the thalamus
306
Explain this pathway
In the somatic sensory afferent system there are at least 3 neurons and the first neuron is pseudounipolar. 1st neuron gathers the info from the PNS, passes through the soma in the dorsal root ganglion and then it synapses in the dorsal horn of the spinal cord. Now the 2nd neuron which synapsed in the dorsal horn, is part of the CNS and travels the electrical impulse to the brain and synapses in the thalamus; then a 3rd neuron travels the info to the last stop, they cortex and it synapses.
307
The somatic motor efferent pathway starts in the CNS in the cortex where a motor neuron activates in the brain stem or motor cortex and travels the information to the spinal cord entering the ventral horn and making synapse here. Then the secondary neuron travels the info through a branch of the spinal nerve into the myofibrils of the muscle.
308
Draw the somatic: sensory afferent and motor efferent pathways
309
What does the Autonomic nervous system, innervate?
involuntarymuscle(smooth and modified cardiac) and glands; its actions are multiple, widespread and relatively slow.
310
What is the sympathetic?
produces the so-called “fight or flight” response (catabolic effects: increasing heart rate and blood pressure, decreasing digestive functions, mobilizing glucose reserves. Consumes energy. Heart, brain and musculo skeletal system. Blood vessels contract
311
What is the sympathetic?
produce responses associated with maintaining homeostasis (anabolic effects [conservation of energy] decreasing heart rate and blood pressure, increasing digestive functions) [internal organs functions]
312
Explain the autonomic pathway
In the CNS, a multipolar neuron, does synapse in the hypothalamus in the brain, then travels the electrical impulse through the spinal cord synapsing in the lateral horn. Exists the lateral horn and enters the ventral root where it synapses again in the autonomic ganglion and from there the impulse travels to the skin & viscera of smooth muscle/blood vessels or gland
313
What neurotransmissor does the somatic motor neuron use?
ACh
314
Does the sympathetic motor neuron use ACh as neurotransmitter throughout whole impulse?
No; pre-synaptic uses ACh and post synaptic uses NE
315
Which are the exceptions of the NE neurotransmitter
except for sweat glands, where the transmitter is primarily ACh, acting through muscarinic receptors
316
Does the parasympathetic motor neuron use ACh as neurotransmitter throughout whole impulse?
Yes, both the pre-synaptic and post-synaptic
317
Where does ACh attaches in the sympathetic?
pre-synaptic, Nicotinic receptors
318
What does the somatic innervates?
Skeletal muscle
319
What does the Autonomic (para and symp) innervate?
Smooth muscles, cardiac muscle, gland cells
320
Where does the NE attaches in the sympathetic pathway?
post synaptic, attaches to adrenergic receptors
321
Where does the ACh post-synaptic attaches in the parasympathetic pathway?
Muscarinic receptors
322
Where can we find the pre-synaptic soma of the sympathetic system?
in the spinal cord from T1-L2/3. thoracolumbar
323
Where can we find the pre-synaptic soma of the parasympathetic system?
brain stem and in S2,S3,S4. craniosacral
324
Que son los conectivos interganglionicos?
Conectan los ganglios en cada nivel
325
Where can we find sympathetic ganglions?
In all vertebral levels (sympathetic chain)
326
Where can we find white rami communicans?
are found only at the levels at which presynaptic neurons leave the spinal cord (T1-L2,3).
327
Where can we find gray rami communicans?
are found at all levels of the chain of ganglia
328
Where can we find other sympathetic ganglia
prevertebral or paraaortic, found adjacent to the main branches of the abdominal aorta.
329
Mention the ganglia of the sympathetic system
celiac
superior mesenteric
aorticorenal
inferior mesenteric
330
Explain the pathway of the sympathetic
Somas in of the pre-synaptic neurons are located in the lateral horn; the axon of the neuron exist through the ventral root it incorporates in the spinal nerve, travels and exits the spinal nerve to enter the chain of the sympathetic ganglion. From there it can synapse with the post synaptic neuron there and that axon from that post synptic neuron, enters the spinal nerve though gray communicans rami. The it distributes through the ventral and dorsal spinal nerve rami.
331
Explain the pathway of the somatic
Soma travels and distributes through the spinal nerve rami instead of doing synapse in the ganglion
332
Explain this pathway
Somas of the pre-synaptic neurons located in the lateral horn, axons there exit through the ventral root they integrated to the spinal nerve and exit the spinal nerve through the white rami communicans. Enter the ganglion of the level they are located and they synapse with the neurons in the ganglion, and the axon of that post-synaptic neuron re-integrates to the spinal nerve through the gray rami communicans. Once in the spinal nerve, it distributes through the ventral and dorsal ramus. some of the pre-synaptic neruons here, do not synapse in the ganglion, instead they travel through the interganglionic connectors to synapse in the cervical ganglion or go down into the ganglions in the lumbar region or sacral or coccyx. Some of these neurons are not gonna synapse in the sympathetic chain, they are in the look of other ganglions that surround the aorta; those fibers that remain without synapse in the ganglion form nerves called splachnic nerve, which is a nerve that will direct to the visceral parts, an autonomic nerve that will go to the thoracic cavity, abdominal cavity or pelvic cavity in order to find they post synaptic neuron for synapse and innervate the corresponding organ.
333
Explain
Sympathetic pre-synaptic neuron with soma in the lateral horn exits through the ventral root and enters the spinal nerve, arriving in the sympathetic chain (ganglion) through the white ramus communicans. It can synapse there and the post-synaptic axon unites to the spinal nerve through the gray ramus communicans and distributes to the spinal nerves either through the ventral or dorsal ramus. Those exons supply the body wall and can supply blood vessels or sweat glands and arrector pili muscle. [emergency situations: palido, pelos parados, sudar frio; sangre la necesita el corazon, regulacion de temperatura y contrae musculo].
if the axon does not synapse in the sympathetic chain, goes out through splachnic nerve, til it finds the post-synaptic soma of the ganglions around the paraortic region.
Only case where a pre-synaptic neuron of sympathetic goes directly into the organ (adrenal medulla of the kidney). this is because the cells produce adrenaline wich is similar to NE as neurotrasmitter,
334
What are Cardiopulmonary Splanchnics?
formed by postsynaptic fibers
* Cardiac splanchnic nerves (cervical levels and T1-T2)
*Pulmonary splanchnic nerves (T3-T5)
335
Abdominopelvic Splanchnic
formed by presynaptic fibers
* Thoracic splanchnic nerves
* Lumbar splanchnic nerves
* Sacral splanchnic nerves
336
Explain
Axon pre sinaptico sale por el ventral root, llega a la cadena de ganglios simpaticos por el ramo comunicante blanco y hacen sinapsis en su propio nivel o en niverl cervical o nivel lumbar. Salen de la cadena por el ramo comunicante gris para integrarse al nervio espinal en su nivel. estas van a musculos pilo erecti, galandulas sudoriparas y vasos sanguineos.
Por el otro lado son nervios suplen organos en sus cavidades. neuronas que salen por el ramo comunicante blanco , entran en la cadena de los ganglios las d enivel superior toracico, desde T5 hacia arriba y los cervicales, la neurona post sinaptica de estos ganglios va a salir atraves del nervio splachnic (nervio q va del autonomico al organo directo) estan formados en su mayoria por axones post sinapticos y suplen en cavidad toraxica, pulmones, corazon y cabeza (glandulas salivaares y estructuras de los ojos). En los niveles toraxicos inferiores y lumbares es donde la neurona pre-sinaptica el axon no hace sinapsis en la cadena, continua en splachnic nerves con axones pre-sinapticos y hacen sinapsis en ganglios q rodean la aorta y la neurona post sinaptica va a los organos en cavidad abdominal y pelvica.
337
A blocker of norepinephrine (NE) receptors would
affect the function of synapses between:
A. Neurons within the parasympathetic ganglia of the head
B. Neurons within the ganglia of the sympathetic chain
C. Neurons within the sympathetic para aortic ganglia
D. Somatic motor neurons and skeletal muscles in the lower limb
E. Sympathetic neurons and smooth muscle in the walls of arteries
E. Sympathetic neurons and smooth muscle in the walls of arteries
338
Explain
For thoracic, abdominal and pelvic cavities, the pre-synaptic axon exits and finds they post-synapic neuron in a plexus or in the walls of an organ. Only post synaptoc axons and ganglions present are in the cranial region (nerves). Neurons in the brain stem, travel through cranial nerves, the neurons in the spinal cord in S2, S3, S4 the nerve where they exit is the pelvic splachnic nerve.
339
Explain
Parasympathetic division
Axon exits the intermediate region (not really lateral horn) through the ventral root and enters in the spinal nerve and immediately exits, there are not ramus communicans so it goes directly as the pelvic spalchnic nerve.
340
Where do we find somas on the parasympathetic divison?
Head
Enteric nervous system:
-Myenteric (auerbach's) plexus
-submucosal (Meissner's) plexus
341
Where is parasympathetic innervation absent?
THE BODY WALL OR EXTREMITIES
342
Where is the parasympathetic fibers absent?
In the ventral or dorsal rami of spinal nerves
343
In the body wall, activation of sympathetic POSTSYNAPTIC neurons may result in:
A. Contraction of skeletal muscles in the lower limb
B. Dilation of blood vessels in the skin
C. Increased redness of the skin of the upper limb
D. Reduced heart rate
E. Sweating at the axilla
E. Sweating at the axilla
344
Explain afferents
Although the ANS is considered a motor or efferent system, afferent fibers from the viscera travel along with these efferent fibers in the same nerve trunks or fibers.
345
Where can we find the cell bodies (soma) of these afferent neurons
The cell bodies of these afferents are also found in the dorsal root ganglion, as are the afferents associated with body wall and limb structures.
346
Where can afferent neurons enter after passing the spalchnic nerve?
Only through the white communicans ramus to re-integrate to the spinal nerve. for the sympathic nerves This is possible only through T1-L2/L3 since those are the only places that have white communicans ramus. and the axon finally enters through the dorsal horn.
for parasympathetic afferent fibers use pelvic splechnic nerves to re-enter and only can enter through S2, S3, S4 and the cell bodies are in the dorsal root ganglions
347
What is referred pain? explain the pathway
pain fibers from the viscera are generally carried through nerve fibers of the sympathetic division (with some exceptions).
In the somatic (from skin etc), when the afferent neurons enter the spinal nerves, when ir arrives to the dorsal horn it synapses with ONE neuron, maintaining the 1:1 communication as it arrives to the cortex so information doesnt get lost or spreaded.
On the other hand in the afferent info that comes from the visceras, it contacts/synapses with more than one neuron, that is why the pain might be spreaded or not specifically in one play
The pain usually radiates to the part of the body that is supplied by somatic sensory fibers associated with the same segment of the spinal cord that receives the visceral sensory fibers. For instance, if information came from T10, pain will localize within the area in contrast as to when you get pinched with a needle on a finger that the pain is more localized
348
Mention the referred pain dermatomes
Heart: T1-T5
Stomach: T6-8
Liver & gallbladder: T7-T9, C3-5
Appendix: T10
Kidneys: T10-T11
