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Flashcards in clinical anatomy And Physiology Deck (31)
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1
Q

what and Where is the patella? What holds it in place?

A
  • Sesamoid bone that sits at the patellofemoral groove
  • held in place by quadricep tendon on top & patellar tendon on the bottom (attached to tibia at tibial tuberosity)
2
Q

How is the femur held to the tibia and fibula? What are their functions

A
  • Center: anterior and posterior cruciate ligament in the center and
  • Around: meniscus (cartilage acting as shock absorber)
  • inner lateral of knee: medial collateral ligament holding femur and tibia
  • Outer lateral of knee: lateral collateral ligament holding femur and fibula
3
Q

Describe the structure of thyroid gland? What anatomical location & compartment is it in?

A
  • 2 lobes connected by isthmus at C5-T1
  • cricoid of larynx and superior ring of trachea
  • visceral compartment of the pretracheal fascia
4
Q

What does pretracheal layer of the neck consist of?

A
  • Visceral: Thyroid gland, esophagus, trachea
  • Muscle: infrahyoid muscles: sternothyroid, omohyoid, sternohyoid
  • Recurrent laryngeal (branch of vagus nerve) runs through pretracheal layer to innervate the larynx
5
Q

What is the pathway of recurrent laryngeal nerves? What is the clinical relevance in terms of thyroid surgery?

A
  • Travels down with vagus nerve then loop around right subclavian artery and aortic arch then travel inside pretracheal layer (between trachea and esophagus in the tracheoesophageal groove) to supply larynx
  • Runs close in proximity of thyroid gland (beneath-> behind), damage of this nerve could cause hoarse voice
6
Q

What are the anatomical relations closest to furthest of the thyroid gland? (anteriorly, laterally, medially)

A
  • Anteriorly: infrahyoid muscles (sternothyroid-> sternohyoid in middle & omohyoid on side)
  • posterolaterally: carotid sheath (common carotid artery, internal jugular vein, vagus nerve, deep cervical lymph nodes)
  • Medially: trachea, larynx, esophagus, recurrent laryngeal nerve
7
Q

What is the arterial supply to the thyroid gland?

A
  • Superior thyroid artery (first branch of external carotid artery)
  • Inferior thyroid artery (branch of thyrocervical trunk from subclavian artery)
  • Thyroid ima artery (10% of people, from brachiocephalic trunk)
  • reminder: aorta-> (brachiocephalic -> right common carotid & right subclavian), left common carotid, left subclavian
8
Q

What is the venous supply of the thyroid gland?

A
  • Superior, middle thyroid veins (branched from internal jugular vein)
  • Inferior thyroid vein (brachiocephalic)
  • reminder: Superior vena cava-> brachiocephalic vein-> internal jugular vein, subclavian vein
9
Q

What are the carpal bones? Name them from radial (thumb) to ulnar (pink) side

A
  • Proximal row: scaphoid, lunate, triquetrum, pisiforms
  • Distal row: Trapezium, trapezoid, capitate, hamate
10
Q

what are the features if lunate, scaphoid bone

A

lunate: crescent bone w/ concave surface
scaphoid: if fractured cause pain in anatomical snuffbox

11
Q

How is the carpal tunnel formed? What is inside the carpal tunnel?

A
  • Arch made by the carpal bones + flexor retinaculum
  • Median nerve, flexor pollicis longus,
  • 4x flexor digitorum producus, 4x flexor digitorum superficialis
12
Q

What muscles are in the thenar eminence of the hand? Which nerve supplies it? What is the clinical relevance?

A
  • Opponens pollicis, abductor pollicis brevis, flexor pollicis brevis
  • Median nerve: wasting of these muscles in carpal tunnel syndrome
13
Q

What muscles are in the hypothenar eminence of the hand? Which nerve supplies it? What is the clinical relevance?

A
  • Opponens digiti minimi (deep), abductor digiti minimi, flexor digiti minimi brevis
  • Ulnar nerve: wasting of these muscles in cubital tunnel syndrome
14
Q

What is the function of lumbricals? What are they attached to? What is the nerve supply?

A
  • 4 muscles in the palmar aspect of hand in charge of MCP flexion & interphalangeal extension
  • Attached to the 4 flexor digitorum profundus tendons (muscle attached to ulna) on the radial side (side close to thumb)
  • median nerve supplies index & middle, ulnar nerve supplies ring & pinky
15
Q

What is the kiesselbach plexus? What arteries does this area contain?

A
  • Region of nasal septum where blood vessel come together, damage leads to epistaxis
  • Anterior and posterior ethmoidal artery
  • Septal branch of superior labial artery
  • Sphenopalatine artery and greater palatine artery
16
Q

Where do the anterior and posterior ethmoid artery of the kiesselbach plexus come and enter from?

A
  • Both from ophthalmic artery of internal carotid
  • enter to the nasal septum via anterior and posterior ethmoid foramen
17
Q

Where do the sphenopalatine and greater palatine artery of the kiesselbach plexus come and enter from?

A
  • Both from maxillary artery of external carotid.
  • Sphenopalatine artery enter from sphenopalatine foramen
  • Greater palatine artery enters through greater palatine foramen then incisive canal
18
Q

what type of connective tissue and gland does the external ear have? what is the external ear canal surrounded by

A
  • Have elastic cartilage in lateral ⅓
  • Surrounded by external acoustic meatus of temperal bone
  • Contain ceruminous glands that produce ear wax
19
Q

What is the tympanic membrane? Describe the components of it

A
  • Separates external and middle ear
  • Contain pars tensa (thick/ dense irregular connective tissue) and pars flaccida (thin loose connective tissue, easy to injure)
  • Attached to malleus and tensor tympani (can be seen otoscopy)
20
Q

What is the nerve supply for tympanic membranes?

A

internal: glossopharyngeal nerve
External wall: mandibular V3 and vagus

21
Q

What are the components of the middle ear/ tympanic cavity?

A
  • Bones: malleus, incus, stapes connected by synovial joints
  • window: oval (enclosed by stapes), round (entrance to cochlea, covered by membrane)
  • Muscles: Tensor tympani, stapedius
  • nerves: tympanic nerve, stapedius nerve
22
Q

What are the nerves supplying the middle ear/ tympanic cavity?

A
  1. Glossopharyngeal (CN IX): tympanic branch forming tympanic plexus (supply middle ear, internal surface of tympanic membrane, eustachian tube)
  2. Facial (CN V): stapedius nerve
    (tympanic chorade only pass through)
23
Q

Where and what is the eustachian tube? What are the different portions of this tube?

A

connection between tympanic cavity and nasopharynx to equalize air pressure
Osseous portion-> cartilaginous portion-> pharyngeal opening

24
Q

What are the components of the bony labyrinth in the inner ear? Can you describe them

A
  1. Cochlear: shell shaped spiral encircling modiolus (bony core), round window
  2. Vestibule: oval window that communicates /w stapes, contain 2 organs (utricle and saccule)
  3. Semilunar canals: superior, lateral, posterior semilunar duct (right angles to each other)
25
Q

What is the general pathway and branches of glossopharyngeal nerve

A
  1. From Oblongata medulla goes out at jugular foramen
  2. Tympanic branch-> tympanic plexus-> lesser petrosal nerve
  3. Stylopharyngeus branch (somatic motor, muscle)
  4. carotid sinus nerve (runs w. Carotid, sensory for bp & O2)
  5. pharyngeal branch-> lingual branch-> tonsillar branch
26
Q

What does tympanic branch of glossopharyngeal nerve innervate

A
  • Tympanic plexus (motor): middle ear, internal tympanic membrane, eustachian tube
  • Lesser Petrosal (parasympathetic/ secretomotor), Goes through otic ganglion, innervate Parotid gland
27
Q

What does the pharyngeal, lingual, tonsillar branch of glossopharyngeal nerve innervate?

A
  • Pharyngeal: mucosa of oropharynx- stimulates gag reflex (absent if damaged)
  • Lingual: posterior ⅓ of tongue (taste)
  • tonsillar : palatine tonsils
28
Q

Where is the aqueous humor produced?

A

Energy dependent process in the epithelial layer of the ciliary body (posterior chamber of the eye)

29
Q

What is the pathway for aqueous humor drainage?

A
  • Epithelial process of ciliary body in posterior chamber
  • Pass through trabecular meshwork in the iridocorneal angle
  • drain to scleral venous sinus
30
Q

What is the function and content of aqueous humor for the eyes?

A
  • Specialized fluid that nourishes lens and cornea
  • Provide oxygen and metabolites and contains bicarbonate
  • High ascorbate, powerful antioxidant
31
Q

What is the function of bicarbonate in aqueous humor?

A

anaerobic glycolysis: Buffers the H+ produced by the cornea and lens