Exam 1- Back Flashcards Preview

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Flashcards in Exam 1- Back Deck (89):
1

Peau D'Orange

Orange like skin- Dimpling of skin of breat due to cutaneous lymphatic edema. From lymphatic tissue blockage from a cancerous tumor.

2

Retracted nipple

From a cancerous mass causing a retraction of the milk ducts.

3

Dimpling of Skin

From a cancerous mass on a suspensory ligament causing a pull of one part of the skin in the breast.

4

Extrinsic Back Muscles

Consist of the Superficial and Intermediate layers of back muscles.

5

Triangle of Ausculatation

Listening section of the back bordered by the vertebral border of the scapula, superior border of the latissimus dorsi, and the lateral border of the trapezius.

6

Lordosis

Cervical and Lumbar regions- inward curvature of the spine (spine towards stomach)
80% are ideopathic and the remaining are neuromuscular in origin.
Associated with weak trunk muscles, pregnancy, or beer belly

7

Kyphosis

Thoracic and Sacral regions- outward curvature of the spine, causing hunching of the back (spine away from stomach)
Common cause in from wedge fracture result of osteoporosis
Results from erosion of anterior part of vertebrae and cause an overall loss of height

8

Scoliosis

Abnormal lateral curvature accompanied by rotation of vertebrae.
Asymmetric intrinsic back muscle weakness, difference in length of lower limbs, developmental defect in vertebrae.
Altered center of gravity, reduced lung function, can lead to equilibrium problems

9

Cervical Vertebrae Movements

Protraction (sticking chin out) cause extension of atlas and axis and flexion of C3-C7
Retraction (pulling chin in) cause flexion of atlas and axis and extension of C3-C7
Lateral Flexion naturally causes the head to turn and look down and in the direction of the tilt. The atlas and axis naturally have rotation that keeps the face looking forward.

10

Spinal Regions with Most Ruptures

Cervical (most movement is here) and Lumbar (most weight stress in here,
T12 is the most fractured vertebra

11

Superficial Landmarks of the back

Roof of the spine of the scapula- T3
Inferior Angle of the Scapula- T7
Iliac Crest- L4-L5
External Occipital Protuberance (bump on head)
Spinous Processes (Visible parts of the vertebrae)
Iliac Crest- Hip Bones

12

Importance of Surface Anatomy

Helps determine locations of organs and other parts of the body that are deep to the skin.

13

Purpose of Curvature of the Spine

The curvature of the spine is there to protect against damages from shock and therefore prevents lectute

14

Spinous Process and Transcerse Process

Mostly serve as connections for the ligaments and muscles

15

Vertebral Artery

Passes through the Transverse Foramen

16

Dens or Odontoid Process

(Teeth... Dontoid) The bone of the axis that sticks up through the atlas.
If the Atlas shifts too much on the Axis, it could sever the spinal cord.

17

Atlanto-Axial Joint

The transverse ligaments limit rotational events by essentials oally hugging the Odontoid Process
The atlanto-occipital, concave convex, part of the atlas permit movement to be able to say yes.
Atlanto-Axial Joint rocks back and forth
Axio-Occipital Joint is the rotation of the head as when indicating "no"

18

Thoracic Vertebrae

Looks kind of like a giraffe (to be able to distinguish it)

19

T12

Looks kind of like a moose
Lumbar vertebrae don't permit rotation. Therefore this vertebrae experiences the most stress since it's the transition between the rotation of the thoracic and the lack thereof in the lumbar.
Most fractured vertebrae

20

L5

Occasionally fuses into Sacrum making 1 more sacrum and 1 fewer Lumbar

21

Intervertebral Discs (IV Discs)

A lot like jelly donuts.
Nucleus Pulposus (jelly) and Anulus Fibrosus (dough) make up the IV discs.
Can grow a half inch over night since they are compressed during the day.

22

Herniated Disc

The Nucleus Pulposus (jelly) squirts out of the Anulus Fibrosus (dough) and causes nerve pain by pressing against parts of the nerves.
Herniation of the nucleus pulposus of an IV disc usually occurs posterolaterally.

23

IV Disc most prone to rupture

Lumbo-Sacral Joint- Between L5 and S1
Drastic change from lordotic to kyphotic curve
More lordosis in the lumbar can increase the likelihood of a rupture (pregnancy, beer belly, or obesity)

24

Spinal Fractures

Stress fracture of the Pars Interarticularis is the most common type of fracture resulting in back pain in adolescents
The Lamina is the weakest part of the vertebrae
Spondylolysis is a common break and spondylolythesis is where there is a break with a shift (most common in young girls who are doing gymnastics)

25

Scottie Dog

This is Spondylolysis- a defect through the pars interarticularis (a narrow strip of bone located between the lamina and inferior articular process below, and the pedicle and superior articular process above)
It is most common at the L5 vertebral segment
If Scottie has a collar, then there is a fracture.

26

Lactiferous Ducts

Openings are in the nipples
Generally 15-20
The ducts that provided milk for the child

27

Lactiferous Sinus

The collection of milk that squirts out to encourage the child to continue drinking.

28

Mammary

The lymph nodes around the nipple and areola are collected and sampled by the body

29

Suspensory Ligaments

Greatly contribute the the "perkiness"/"nonsagginess" of the breast.

30

Lymphatic Drainage

Drain into the following groups of lymph nodes
Axillary (5 subgroups) (75%) drainage
Parasternal (Along Internal Thoracic Vein) (20%)
Supraclavicular
Posterior Intercostal
Lymph Nodes are arranged along all of the arteries and veins

31

Difference between Cyst and Carcinoma

Cysts are well defined smooth opacity
Carcinomas are irregular density, distortion of breast tissue, calcification

32

Supernumery Nipples

Nipples somewhere else on the milk line
Polythelia (nipples over breast), Athelia (no nipple over breast), Polymastia (accessory breast along milk ridge), Amastia (no breast development), and Amazia (no nipple or breast development)

33

T4 and T10

Nipple and Belly button lines of innervations

34

Serratus Anterior Nerve

This nerve is exposed as it runs across the surface of the muscle.
This is the "wing" muscle next to the ribs

35

Proximal, Distal

Proximal=Origin
Distal=Insertion

36

Intercostal Muscles

There are three layers of intercostal muscles:
External Intercostal Muscles start back two thirds of the way around to the front with a small downward angle
Internal Intercostal Muscles start front and run two thirds of the way around to the back.
Innermost Intercostal Muscle essentially just sills the space in between

VAN- In order Superior to Inferior- Vein, Artery, Nerve

37

Axilla

Functionally it's a large quadrangular space

38

Clavipectoral Fascia

Thick bilateral connective tissue structure deep to the pectoralis major muscle. Extends superiorly from the clavicle, medially from the costochondral joints, and superolaterally from the coracoid process.
Converges with the axilla where it acts as a protective structure over the neurovascular structure of the axilla.
Fascia can pinch nerves and cause problems.
Parts of the fascia include the costocoracoid ligament, costocoracoid membrane, and suspensory ligament of the fascia

39

Axillary Sheath

Enclosed in it are the brachial plexus and veins and arteries.

40

Axillary Artery*************

Divided into three parts:
1-from sternum to medial side of pec minor- has just one vessel, Superior Thoracic Artery
2-the part just below pec minor- two vessels, Thoracoacromial Artery (4 branches: pectoral, deltoid, clavicular, and acromial) and Lateral Thoracic Artery (the most variation and supplies serratus anterior)
3-part of the lateral side of the pec minor- three vessels, Subscapular Artery, Anterior Circumflex Humeral Artery (Corocobrachialis and Biceps), and Posterior Circumflex Humeral Artery (Deltoid, Teres Major/Minor, Long Head of Triceps)

41

Axilla Nerves, Arteries, and Veins

Between people, Nerves are the most varied, veins are the least varied, and arteries are somewhere in between.

42

Anterior Rami

They basically contribute to all of the muscles that are not postural

43

Brachial Plexus Order

Randy Travis Drinks Cold Beer
Roots, Trunk, Divisions, Cords, Branches
Comes from C5, C6, C7, C8, T1

The Cords are the first section that we are able to see.
5 Roots, 3 Trunks, 6 Divisions, 3 Cords, 5 Branches

Formed by the anterior rami of C5-T1.
Which then unite to form 3 trunks: Superior (C5, C6), Middle (C7) , and Inferior (C8, T1).
Each trunk divides into a posterior and anterior, making up 6 divisions as it passes through the cervico-axillary canal (posterior to the clavicle)- Anterior division supplies flexors and posterior provides extensors
The division of the trunks for 3 cords: Lateral cord (anterior divisions of superior/middle), Medial cord (anterior division of the inferior trunk continues), and the Posterior cord (all of the posterior divisions)- Their names indicate where they are compared to the axillary artery.

44

Myotomes

The sets of muscles innervated by a given nerve
One of the most frequently injured nerves of the brachial plexus is the long thoracic

45

Fascia

Fascia is a continuous unit. This means that things that are distal in t he fascia can affect things that are proximal.

The thickness is greatest over the flexor and extensor retinacula

Three Components (Functions) of Fascia: Invests all of the muscles and prevents over expansion, Serves as an anchor, and Divides the limbs into functional compartments.

46

Dorsal Scapular Nerve

Innervates Rhomboid Major, Rhomboid Minor, and Levator Scapula

47

Erector Spinae Group

Iliocostalis, Longissimus, Spinalis

48

Naming of Spinal Nerves

C1-C7 Nerves- The vertebrae it lies superiorly to
C8- Inferior to C7
T1 and Down- The vertebrae it lies inferiorly to.

Associated Vertebrae

49

Pacemaker Placement

Retromammary Space- Between breast and Pectoralis Major

50

Vertebrae Prominens

C7

51

"Winged" Scapula

Damage to the long thoracic nerve of the shoulder. If the long thoracic nerve is damaged or bruised it can cause paralysis of the serratus anterior muscle and winging of the scapula

Serratus Anterior muscle is the muscle used for boxing

52

Supraspinatus

Initiates abduction for the first 15 degrees

53

Quadrangular Space

Inside is the Axillary Nerve and the Posterior Humeral Circumflex Artery
Bordered by the inferior border of teres minor muscle (superior), superior border of teres major muscle (inferior), long head of triceps brachii muscle (medial), and surgical neck of the humerus (lateral)

54

Pathway of the Arteries

Subclavian Artery ---->
Axillary Artery ---->
Brachial Artery ---->
Radial Artery + Ulnar Artery.

55

Pathway of the Veins (technically reverse)

Subclavian Vein ---->
Axillary Vein ----> Cephalic Vein AND
Brachial Vein + Basilic Vein

56

Spinal Accessory Nerve

Innervates the Trapezius
When damage, loses muscular sensation and causes drooping, but does not cause a loss of sensation

57

Dermatome

The lateral wall of each somite in a vertebrate embryo, giving rise to the connective tissue of the skin
An area of the skin supplied by nerves from a single spinal root

Specific

58

Cutaneous Field

Cutaneous innervations refer to areas innervated by specific peripheral nerves (e.g. the lateral femoral cutaneous nerve), which can contain fibers from multiple spinal nerve roots. This happens because of how the spinal nerves form plexuses (brachial, lumbar, sacral), which in turn form terminal nerves

General

59

Number of Spinal Nerves

Baskin Robbins
31: C1-C8, T1-T12, L1-L5, S1-S5, Coccygeal 1.

60

Breast

Generally run from T2-T6
Nipple, Areola, Lactiferus Sinus, Lactiferus Ducts, Gland Lobules, Suspensory Ligaments, Retromammary Space

61

Abduction of the Upper Limb

First 15 degrees is Supraspinatus
After that, it's mostly the Deltoid that deals with Abduction.

62

Deltoid Muscle

Origin: Spine of scapula, Acromion of the scapula, and the lateral one-third of the clavicle.
Insertion: Deltoid tuberosity of the humerus.
Action: Abducts the humerus
Nerve: Axillary Nerve (out of quadrangular space)
Blood Supply: Posterior circumflex artery (out of quadrangular space)

63

Teres Minor

Origin: Lateral border of the scapula.
Insertion: Inferior facet of the greater tubercle of the humerus.
Action: Laterally rotates the humerus
Blood Supply: Subscapular and circumflex scapular arteries
Nerve: Axillary Nerve

64

Teres Major

Origin: Inferior angle of the scapula
Insertion: Medial lip of the intertubercular sulcus of the humerus
Action: Adducts and medially rotates the humerus
Blood Supply: Subscapular and circumflex scapular arteries
Nerve: Lower subscapular nerve (C6 and C7) (C6, C7)

65

Supraspinatus

Origin: Supraspinous fossa of scapula
Insertion: Superior aspect of greater tubercle of humerus
Action: Initiates Abduction
Blood Supply: Suprascapular Artery
Nerve: Suprascapular Nerve (C5)

66

Infraspinatus

Origin: Infraspinous fossa of the scapula
Insertion: Middle facet of greater tubercle of the humerus
Action: Laterally rotates the arm at the shoulder (glenohumeral) joint
Blood Supply: Suprascapular and circumflex scapular arteries
Nerve: Suprascapular Nerve (C5)

67

Lateral Cord of Brachial Plexus

Lies immediately lateral to the Axillary Artery

68

Subscapularis

Origin: Subscapular fossa
Insertion: Lesser tubercle of humerus
Action: Medially rotates the arm at the shoulder (glenohumeral) joint
Blood Supply: Subscapular artery
Nerve: Upper subscapular nerve, lower subscapular nerve (C5, C6)

69

Humerus Fracture

Most fractures occur at the Surgical neck of the Humerus

70

Sternoclavicular Joint

It has an articular disk
It allows anterior-posterior movement of the clavicle
It allows some rotation of the clavicle
It allows elevation and depression of the clavicle
Injuries to this area (including dislocation) are relatively uncommon

71

Axillary Lymph Nodes for Breast Cancer

Organized into three levels by their relative location to the pectoralis minor.

72

Synovial Joints

Gliding- sliding/twisting
Pivot- rotation around central axis
Hinge- flexion/extension
Saddle- back and forth, side to side
Condyloid- variety of movements, no rotation
Ball and Socket- all planes of rotation

73

Pars Interarticularis

Pars for short, is the part of vertebra located between the inferior and superior articular processes of the facet joint

74

Cruciform Ligament

Strengthens the atlantoaxial joint

75

Superior Articular Processes

Limits undo movements

76

Cervical Enlargement
Lumbar Enlargement

C3-T2
L1-S3

77

Spinal Cord Length

In the embryo, spinal cord completely occupies vertebral column and nerves exit transversely.
As the body grows, nerves begin running longitudinally before exiting in order to exit in the same location.
Growth results in the formation of the cauda equina from the conus medullaris

78

Splanchnic Nerve

Paired visceral nerves (innervation of the internal organs), carrying fibers of the autonomic nervous system (visceral efferent fibers) as well as sensory fibers from the organs (visceral afferent fibers)

79

Sympathetic Nerves

Go to literally every part of the body.

80

Meninges

Dura, Arachnoid, and Pia Mater together form this.

81

Nervous System

Autonomic Nervous System divides into the sympathetic nervous system (thoracolumbar division) and parasympathetic nervous system (craniosacral division)
The autonomic nervous system functions to regulate the body's unconscious actions

82

Sympathetic Nervous System

Fight or flight
Preganglionic neurons in lateral gray horns of spinal segments T1-L2 send preganglionic fibers to ganglia near spinal cord which release ACh, stimulating ganglionic neurons. This sends postganglionic fibers to target organs and release NE at neuroeffector junctions causing a "fight or flight response"

83

Parasympathetic Nervous System

Rest and Repose
Preganglionic neurons in brain stem and lateral portions of gray horns of S2-S4 send preganglionic fibers to ganglia in target organs which release ACh, stimulating ganglionic neurons. This sends postganglionic fibers to target organs which release ACh at neuroeffector junctions causing and "Rest and Repose" response

84

Visceral Sensory System

Central Nervous System (brain and spinal cord) leads to the Peripheral Nervous System
PNS (Cranial and Spinal Nerves) leads to a motor divison and a sensory Divison
-Sensory (afferent) divides into Somatic Sensory (normal external sensory and then Hearing, Equilibrium, Vision, and Smell) and Visceral Sensory (normal internal sensory and then Taste)
-Motor (efferent) divides into Somatic Motor (motor innervation of all skeletal muscles) and Visceral Motor (motor innervation of smooth muscle, cardiac muscle, and glands

Visceral Motor divides into the parasympathetic division and sympathetic division

Somatic Neurons are for voluntary movement

85

Roots of Brachial Plexus

Two Terminal Nerves are formed here
Long Thoracic and Dorsal Scapular.

86

Trunks of Brachial Plexus

Two Terminal Nerves are formed here
Suprascapular and Nerve to Subclavius

87

Divisions of Brachial Plexus

Zero Terminal Nerves are formed here

88

Cords of Brachial Plexus

Seven Terminal Nerves are formed here
Lateral Pectoral, Upper Subscapular, Middle Subscapular (Thoracodorsal), Lower Subscapular, Medial Pectoral, Medial Cutaneous of Arm, and Medial Cutaneous of Forearm

89

Branches of Brachial Plexus

Zero Terminal Nerves are formed here