LECOM MS1 Gross Anatomy--Initial Quiz Flashcards
1
Q
What types of structures does technically anatomy include
A
macroscopic and microscopic
2
Q
When used by itself, anatomy typically refers to which structures
A
macroscopic
3
Q
Microscopic anatomy is also called what
A
histology
4
Q
The term anatomy is derived from the Greek word “temnein” which means
A
to cut
5
Q
What two approaches can anatomy be studied
A
regional approach
systemic approach
6
Q
What is the regional approach to studying anatomy
A
Each region of the body is studied separately and all aspects of that region are studied at the same time (example all structures of thorax studied at same time)
7
Q
What is the systemic approach to studying anatomy
A
Each system of the body is studied and followed throughout the entire body
8
Q
What is the anatomical position
A
the standard reference position of the body used to describe the location of structures
9
Q
Describe the positions of the hands, feet, body, face, mouth, facial expression in the anatomical position
A
- Person is standing upright with feet together, toes point forward
- Hands are by the side with palms forward with the fingers straight and together. Thumb pad turned 90 degrees to pads of fingers
- Face looking forward, mouth closed
- Neutral facial expression, eyes open and focused on something in the distance
10
Q
In the anatomical position, the bone under the eye aligns with what
A
the opening of the ear
11
Q
How many major groups of planes pass through he body in the anatomical position
A
3
12
Q
What are the 3 major groups of planes in the anatomical position
A
Coronal
Sagittal
Transverse
13
Q
What orientation is the coronal plane
A
Oriented vertically
14
Q
What does the coronal plane divide the body into
A
posterior and anterior parts
15
Q
What orientation is the sagittal plane
A
Orientated vertically, but at 90 degree angles to the coronal plane
16
Q
What does the sagittal plane divide the body into
A
left and right parts
17
Q
What is the plane that passes through the center of the body dividing the body into equal left and right parts called
A
median sagittal plane
18
Q
What is the orientation of the transverse plane
A
Horizontal
19
Q
What are two other names for the transverse plane
A
Horizontal plane or axial plane
20
Q
What does the transverse plane divide the body into
A
superior and inferior parts
21
Q
What are the three major pairs of terms used to describe the location of structures relative to other structures or the body as a whole
A
anterior (ventral) vs. posterior (dorsal)
superior vs. inferior
Medial vs. lateral
22
Q
What does the terms anterior and posterior mean
A
anterior: towards the front
posterior: towards the back
23
Q
What do the terms medial and lateral mean
A
Medial: more towards the median sagittal plane
Lateral: more towards the sides of the body
24
Q
What do the terms superior vs inferior mean
A
describe structures in reference to the vertical axis of the body
Superior: higher
Inferior: lower
25
What do the terms proximal and distal mean
Used with reference to being closer (proximal) or farther (distal) from a structure's origin
26
What do the terms caudal and cranial mean
Cranial: towards the head
Caudal: toward the tail
Occasionally used in place of superior and inferior
27
When is the term rostral used
particularly in the head
28
What does the term rostral mean
to describe the position of a structure in reference to the nose
29
What do the terms superficial and deep mean
Superficial: closer to skin
Deep: farther from skin
Used to describe the relative position of two structures with respect to the surface of the body
30
What is another name for plain radiography
Xray
31
What are xrays
photons
32
What are photons
a type of electromagnetic radiation
33
What are xrays generated from
complex x-ray tube (type of cathode ray tube)
34
After xrays are generate from a cathode ray tube, what happens
x-rays are collimated (directed through lead-lined shutters to stop them from fanning out) to the appropriate areas
35
What happens to xrays as they pass through the body
They are attenuated (reduced in energy)
36
What causes xrays to attenuate
as they pass through the tissues
37
After passing through the tissues, what occurs to the xrays
they interact with the xray film to form an image
38
How much does air attenuate xrays
very little (film is exposed to most amount of xrays)
39
How much does fat attenuate xrays
more than air but less than water
40
How much does bone attenuate xrays
the most (film is exposed to the least amount of xrays)
41
Differneces in attenuation result in what
differences in levels of exposure of the film
42
On xray, how does bone appear
white
43
On xray, how does air appear
dark
44
What is barium sulfate (structure)
nontoxic, an insoluble salt, relatively high density
45
What is used to demonstrate the bowel lumen in xray
barium sulfate suspension
46
What is also common with using a contrast agent in xrays
adding air to the suspension
47
How is air added to a contrast agent suspension
"fizzing" granules or directly instilling air into the body
48
What is a double contrast study
air and barium contrast
49
What contrast agent is used for injections
Iodine
50
Why is iodine good structurally
high atomic mass
51
Why is iodine good from a patient stand point
it is naturally excreted by the urinary system
52
Why are intravenous contrast agents good
help visualize arteries and veins and also the urinary system
53
What is the urinary system xray with contrast called
Intravenous urography
54
What makes angiography difficult
difficult to appreciate the contrast agent in the vessels through the overlying bony structures
55
What technique is used to circumvent the difficulty in an angiography
subtraction angiography
56
How is subtraction angiography performed
1 or 2 images are obtained before the injection of contrast media. Images are inverted to create a "negative image". Images obtained after injection of the contrast media. The negative image is added to the positive post contrast image to create a solitary image of contrast only. (bones and soft tissues were subtracted.
57
What is ultrasound
series of high frequency sound wave
58
What produces the very high frequency sound waves for an US
piezoelectric materials
59
What can the piezoelectric material also do after producing the sound waves
receive these sound waves back
60
Traditionally, US is used for what
assessing the abdomen and the fetus in pregnant women
61
US can also be used to asses what
eyes, neck, soft tissues, and peripheral musculoskeletal system, stomach, esophagus, duodenum, transvaginal, transrectal
62
Doppler US enables determination of what
its direction, flow, and velocity within a vessel
63
How do US tell direction
the degree of frequency shift determines whether the object is moving away from or toward the probe and its speed
64
What does CT stand for
computed tomography
65
Simply describe what a CT scan does
obtain images of the body in slices in the axial plane
66
How are CT scans obtained
patient lies on a bed and an X-ray tube passes around the body. Computer transforms the images
67
What does MRI stand for
magnetic resonance imaging
68
What is the process of MRI dependent upon
free protons in the hydrogen nuclei in molecules of water
69
Why is the hydrogen proton ideal for MRI
water is found in almost all biological tissues
70
Protons within a patient's hydrogen nuclei should be regarded as what
small bar magnets randomly orientated in space
71
During an MRI, the patient is placed in what
a strong magnetic field
72
During an MRI, placing the patient in a strong magnetic field does what
align the small bar magnets
73
What is passed through the patient during an MRI
pulse of radiowaves
74
As radiowaves are passed through a patient during an MRI, what happens
the small bar magnets are deflected
75
What occurs after the small bar magnets are deflected
they return to their aligned position and emit small radio pulses
76
How is a signal produced in an MRI
the frequency and strength of the emitted pulses and the time it takes for the protons to return to their pre-excited state results in a signal
77
Signals from protons during an MRI then do what
are analyzed by a computer
78
How can different properties of protons be assessed during an MRI
by changing the sequence of pulses to which the protons are subjected
79
What are the different properties of protons called in an MRI
the "weighting" of the scan
80
What are the two weightings of an MRI
T1-weighted images
| T2- weighted images
81
From the clinical point of view, what do T1 images show
dark fluid and bright fat (ex: cerebrospinal fluid is dark)
82
From the clinical point of view, what do T2 images show
bright signal from fluid and an intermediated signal from fat (ex cerebrospinal fluid is white)
83
What does Nuclear medicine imaging involves
gamma rays
84
What are gamma rays
a type of electromagnetic radiation
85
What is the important difference between gamma rays and x-rays
gamma rays are produced from within the nucleus of an atom when an unstable nucleus decays, whereas x-rays are produced by bombarding an atom with electrons
86
For an area to visualized with nuclear medicine imaging, what must the patient have
a gamma ray emitter
87
What are properties of a gamma ray emitter
a reasonable half life
an easily measurable gamma ray
energy deposition is as low a dose as possible in the patients tissues
88
What is the time length for a reasonable half life
6-24 hours
89
What is the most commonly used radionuclide (radioisotope)
technitium-99m
90
What is technitium-99m usually injected as
technitium salt or combined with other complex molecules
91
What is technitium-99m bound to to allow assessment of the skeleton
methylene diphosphonate (MDP)
92
What does MDP and technitium-99m together form and do
radiopharmaceutical that specifically binds to the bone
93
How are images obtained in nuclear medicine imaging
via a gamma camera
94
What causes the imaging in nuclear medicine imaging
the level on how the radiopharmaceutical is absorbed, distributed, metabolized, and excreted by the body after injection
95
What does PET stand for
positron emission tomography
96
What does PET detect
positron emitting radionuclides
97
What is a positron
anti-electron
98
What is an anti-electron
positively charged particle of antimatter
99
Where are positrons emitted from
the decay of proton rich radionuclides
100
Most of the radionuclides are made where
cyclotron
101
What is a characteristic of these radionuclides
they have extremely short half lives
102
What is the most commonly used PET radionuclide
Fluorode-oxyglucose (FDG) labeled with Fluorine-18
103
What is fluorine-18
positron emitter
104
What in the body takes up fluorode-oxyglucose with fluorine-18
any tissue that is taking up glucose
105
What does the tissue uptake of this radionuclide on a PET mean
any resulting localized high concentration of this molecule compared to the background emission is a "hot spot"
106
What are PETs commonly used for from a clinical aspect
detection of cancer and the assessment of its treatment and recurrence
107
What is the most commonly obtained form of imaging
plain radiography (x-rays)
108
How far away is the xray tube from the film at standard (excluding chest radiographs)
1 meter
109
In plain radiography, where is the patient's body area of question placed
on the xray film
110
When describing subject placement for radiography, the part closest to the xray tube is referred to as
anterior
111
When describing subject placement for radiography, the part closest to the xray film is referred to as
posterior
112
When viewing an xray, the right side of the patient is seen where
on the left (vice versa)
113
The observer views the patient in an xray image as looking at what
the patient in the anatomical position
114
What is one of the most commonly requested plain radiographs
chest xray
115
How is the patient situated during a chest xray
patient is erect and placed posterioanteriorly (occasionally obtained anterioposterior position when patient too ill too stand)
116
A good quality chest xray will demonstrate what
lungs, cardiomediastinal contour, diaphragm, ribs, and peripheral soft tissues
117
How are plane abdominal xrays obtained (position of pt)
AP supine position
118
What is an exception to obtaining a plain abdominal xray in the AP supine position
Small Bowel obstruction suspected
119
When SBO is suspected, how is a plain abdominal xray obtained
erect position
120
CT images are viewed how
Obtained in axial plane and viewed from below looking upwards
121
What side of the patient is on the left side of the screen in a CT
the right
122
The uppermost border of the image in a CT is what
anterior
123
What is the great advantage of a CT scan
ability to extend and compress the gray scale to visualize the bones, soft tissues, and visceral organs
124
MRI contrast agents typically contain what
paramagnetic substances
125
What are typical MRI paramagnetic substances
gadolinium and manganese
126
What makes MRI and US ideal imaging studies
do not impart significant risk to the patient
127
What is the modality for imaging in assessing a fetus
US
128
What is the relationship between cost and imaging
the more complex, the more expensive
129
What is the order in least to greatest exposure dose of radiation for imaging methods
```
chest radiograph
abdomen radiograph
intravenous urography
CT scan of head
CT scan of abdomen and pelvis
```
130
What is the dose and duration of background exposure for chest radiograph
0.02 and 3 days
131
What is the dose and duration of background exposure for abdomen radiograph
1.0 and 6 months
132
What is the dose and duration of background exposure for intravenous urography
2.5 and 14 months
133
What is the dose and duration of background exposure for CT scan of head
2.3 and 1 year
134
What is the dose and duration of background exposure for CT of abdomen and pelvis
10.0 and 4.5 years
135
The skeleton can be divided into how many subgroups
two
136
What are the two subgroups of a skeleton
axial skeleton
| appendicular skeleton
137
What does the axial skeleton consist of
bones of skull, vertebral columns, ribs and sternum
138
What does the appendicular skeleton consist of
bones of the upper and lower limbs
139
What is the skeletal system composed of
cartilage and bone
140
What is cartilage
avascular form of connective tissue
141
What is cartilage composed of
extracellular fibers embedded in a matrix that contains cells localized in small cavitites
142
Depending on the type of cartilage, how does the cartilage composition change
the amount and kind of extracellular fibers
143
In heavy weight bearing areas or areas prone to pulling forces, how is the cartilage composition different
more cartilage
144
Cartilage in heavy weight bearing areas is almost what..
inextensible
145
In areas that have less weight bearing demand and stress, how is the cartilage composition different
more elastic fibers, fewer collagen fibers
146
What are the 3 functions of cartilage
- support soft tissues
- provide a smooth, gliding surface for bone articulations at joints
- enable the development and growth of long bones
147
What are the 3 types of cartilage
- hyaline
- elastic
- fibrocartilage
148
What is hyaline cartilage composition
matrix contains a moderate amount of collagen fibers
149
What is elastic cartilage composition
matrix contains collagen fibers along with a large number of elastic fibers
150
What is fibrocartilage composition
matrix contains a limited number of cells and ground substance amidst a substantial amount of collagen fibers
151
What is an example of hyaline cartilage
articular surfaces of bones
152
What is an example of elastic cartilage
external ear
153
What is an example of fibrocartilage
intervertebral disks
154
Which of the 3 types of cartilage is most common
hyaline
155
Does cartilage have blood vessels
no
156
How is cartilage nourished
by diffusion
157
Does cartilage have lymphatics
no
158
Does cartilage have nerves
no
159
What is bone
calcified connective tissue
160
Is bone living or nonliving
living
161
What does bone consist of
intercellular calcified matrix, collagen fibers, and several types of cells within the matrix
162
What are the 5 functions of bone
1. supportive structures for the body
2. protectors of vital organs
3. reservoirs of calcium and phosphorus
4. levers on which muscles act to produce movement
5. containers for blood-producing cells
163
What are the two types of bones
compact and spongy
164
What type of bone is compact bone
dense bone
165
What structures do compact bone form
outer shell of all bones (surrounds spongy bone)
166
What does spongy bone consist of
spicules of bone enclosing cavities containing blood-forming cells
167
What is another name for blood forming cells
marrow
168
How are bones classified
by shape
169
What are the 5 shapes of bones
```
long bones
short bones
flat bones
irregular bones
sesamoid bones
```
170
What shape do long bones have
tubular
171
What is an example of a long bone
humerus and femur
172
What shape do short bones have
cuboidal
173
What is an example of short bones
bones of wrist and ankle
174
What shape do flat bones have
two compact bone plates separated by spongy bone
175
What is an example of flat bones
skull
176
What is classified as an irregular bone
bones with various shapes
177
What are examples of irregular bones
bones of the face
178
What shape do sesamoid bones have
round or oval
179
What is an example of sesamoid bones
bones that develop in the tendons
180
Do bones have blood vessels
yes
181
Do bones have nerves
yes
182
Generally, how many nutrient arteries per bone
1
183
Where does the nutrient artery enter the bone
the internal cavity of the bone
184
What areas does the nutrient artery supply
the marrow, spongy bone, and inner layers of compact bone
185
All bones are covered externally by what
a fibrous connective tissue membrane
186
What is the name of the fibrous connective tissue membrane called that covers bones
periosteum
187
What areas does periosteum not cover bones
area of a joint where articular cartilage is present
188
What is the unique function of periosteum
forming new bone
189
What supplies the periosteum with nutrients
blood vessels
190
Will a bone stripped of its periosteum survive
no
191
The branches of the blood vessels that supply the periosteum also supply what
extend to the outer surface of the compact bone
192
Most of the nerves that pass into the internal cavity are what type of fibers
vasomotor fibers
193
What do the vasomotor fibers do
regulate blood flow
194
Does bone have sensory nerve fibers
yes
195
How many sensory nerve fibers do bone have
very few
196
Does periosteum have sensory nerve fibers
yes
197
How many sensory nerve fibers does the periosteum have
a lot
198
Because the periosteum has a lot of sensory nerve fibers results in what
very sensitive to any type of injury
199
Where do all bones come from in development
mesenchyme
200
What are the two ways bones develop from the mesenchyme
intramembranous ossification
| endochondral ossification
201
What is intramembranous ossification
mesenchymal models of bones undergo ossification
202
What is endochondral ossification
cartilaginous models of bones form from mesenchyme and undergo ossification
203
In western countries, when does skeletal maturity occur
between ages of 20 and 25
204
Skeletal maturity is impacted by what factors
genetic factors and disease states
205
How can bone age be determined
image the nondominant hand (typically left) and compare to series of standard radiographs
206
In disease states of malnutrition and hypothyroidism, what occurs
bone maturity may be slow
207
In a healthy individual, the bone age accurately represents what
the true age of the patient
208
How many types of bone marrow are there
2
209
What are the two types of bone marrow
red and yellow
210
What is another name for red bone marrow
myeloid tissue
211
What arises from the red bone marrow
red blood cells, platelets, most white blood cells
212
What arises from the yellow bone marrow
a few white blood cells
213
What also composes the yellow bone marrow
large fat globules
214
From birth, most of the marrow is what kind
red
215
As a person ages, what occurs to the marrow
red is converted to yellow
216
Where is yellow bone marrow formed typically
in the medulla of the lone and flat bones
217
How many types of stem cells compose bone marrow
2
218
What are the two types of stem cells in bone marrow
hemopoietic
| mesenchymal
219
What do hemopoietic stem cells give rise to
WBC, RBC, and platelets
220
What do mesenchymal stem cells give rise to
differentiate into structures that form bone, cartilage, and muscle
221
What causes fractures in bones
abnormal load or stress, diseases that lead to poor quality bone
222
In growing children, where can fractures occur
across the growth plate or across the shaft
223
Shaft fractures in growing children result in what
partial cortical disruption
224
What is the term for shaft fractures in growing children
greenstick fractures
225
After a fracture has occurred, what happens next
the healing process
226
What is the first step in the healing process for a bone fracture
clot forms between fracture margins into which new vessels can grow
227
After a clot forms between the fracture, what is the next step in the healing process for a bone fracture
a jelly-like matrix is formed and further migration of collagen producing cells occurs
228
What occurs on the soft collagen framework after it is formed
osteoblasts produce calcium hydroxyapatite and forms insoluble crystals
229
After insoluble crystals are formed by osteoblasts, what occurs
bone matrix is laid down
230
As more bone is produced, what can be visualized after a fracture
a callus across the fracture site
231
Treatment of fractures require what
reduction in fracture line
232
What can reduce the fracture line
cast (plaster of paris)
| internal or external fixation with screws and rods
233
What is avascular necrosis
cellular death of bone resulting from a temporary or permanent loss of blood supply to that bone
234
When can avascular necrosis occur
variety of medical conditions
235
What is a typical site for avascular necrosis
fracture across the femoral neck in an elderly patient
236
What is the treatment for avascular necrosis in the femoral head
replace the femoral head with a prosthesis
237
What is osteoporosis
a disease where the bone mineral density is significantly reduced
238
What does osteoporosis cause the bone to be more prone to
fractures
239
Where do osteoporitic fractures typically occur
femoral necks, the vertebra, and wrists
240
Osteoporosis typically occurs more likely in what patients
postmenopausal women
241
What four factors predispose bones to osteoporosis
poor diet
steroid usage
smoking
premature ovarian failure
242
What is treatment for osteoporosis
remove underlying factors
| prevent further bone loss with drug treatment
243
When are the two stages of intense bone growth
between 7-10 years
| puberty
244
What are intense bone growth stages associated with
increased cellular activity around the growth plate and the metaphyseal region
245
As a result of increased cellular activity in bone growth, what renders the metaphyseal region and growth plate more vulnerable to
injuries
246
What is a joint
a site where two skeletal elements come together
247
How many categories of joints are there
2
248
What are the 2 categories of joints
synovial and solid joints
249
What are synovial joints
skeletal elements are separated by a cavity
250
What are solid joints
no cavity and the component are held together by connective tissue
251
How are joints supplied with blood vessels and nerves
branches from blood vessels and nerves that innervated muscles
252
What are the characteristic features of synovial joints
- a layer of cartilage covers the articulating surfaces
- presence of a joint capsule
- presence of additional structures within the area enclosed by the joint capsule
253
What type of cartilage usually covers the articulating surfaces in joints
hyaline cartilage
254
What does a joint capsule in synovial joints consist of
an inner synovial membrane and an outer fibrous membrane
255
The synovial membrane of the joint capsule attaches to what
margins of the joint surfaces at the interface between the cartilage and bone
256
What does the synovial membrane of the joint capsule encolse
articular cavity
257
Does the synovial membrane have blood vessels
yes, it is highly vascular
258
What does the synovial membrane produce
synovial fluid
259
What is the function of synovial fluid
it perculates into the articular cavity and lubricates the articulating surfaces
260
What structure of the synovial membrane forms outside of joints
closed sacs of synovial membrane
261
What are these closed sacs of synovial membrane called
synovial bursae or tendon sheaths
262
Where do synovial bursae occur typically
between structures such as tendons and bone, tendons and joints, or skin and bone
263
What is the function of synovial bursae
reduce the friction of one structure moving over the other
264
Where do tendon sheaths form
surround tendons
265
What is the function of tendon sheaths
reduce friction
266
What composes the fibrous membrane
dense connective tissue
267
Where does the fibrous membrane form
surround the joint
268
What is the function of the fibrous membrane in a synovial joint
stabilize the joint
269
What may occur to parts of the fibrous membrane in a synovial joint
it may thicken
270
Thickened fibrous membrane in a synovial joint forms what
ligaments
271
What are types of additional features that may be within the area enclosed by the capsule or synovial membrane
articular discs, fat pads, and tendons
272
What is the function of articular discs
absorb compression forces, adjust to changes in the contours of joint surfaces, increase the range of movements
273
Where do fat pads typically occur
between the synovial membrane and the capsule
274
What is the function of the fat pad
move into and out of region as joint contours change during movement
275
How are synovial joints described
based on shape and movement
276
Based on shapes, how can synovial joints be described
```
plane (flat)
hinge
pivot
bicondylar (two sets of contact points)
condylar (ellipsoid)
saddle
ball and socket
```
277
Based on movement, how can synovial joints be described
uniaxial
biaxial
multi axial
278
What are uniaxial joints
movement in one plane
279
What are biaxial joints
movement in two planes
280
What are multi axial joints
movement in three planes
281
Hinge joints are typically what type of joint movement wise
uniaxial
282
Ball and socket joints are typically what type of joint movement wise
multi axial
283
What function do plane joints allow
sliding or gliding movement when one bone moves across the surface of another
284
What is an example of a plane joint
acromioclavicular joint
285
What function do hinge joints allow
permit flexion and extension
286
What is an example of a hinge joint
elbow
287
How many axis do plane joints use
1
288
What function do pivot joints permit
rotation
289
Pivot joints allow movement around how many axis
1
290
This one axis in a pivot joint allow movement how
longitudinally along the shaft of the bone
291
What is an example of a pivot joint
atlanto-axial joint
292
How many axis do bicondylar joints allow movement around
2 (limited in the second direction)
293
What is an example of a bicondylar joint
knee
294
How are bicondylar joints formed
two convex condyles that articulate with concave or flat surfaces
295
Condylar joints allow movement around how many axis
2
296
What type of axis are condylar joints
two axes that are at right angles to each other
297
What function do condylar joints allow
flexion, extenstion, abduction, adduction, and circumduction
298
What is an example of condylar joint
wrist joint
299
How many axes for saddle joints
2 axis
300
What type of axes are saddle joints able to move
two axes that are at right angles to each other
301
What gives saddle joints their shape
the articular surfaces are saddle shaped
302
What do saddle joints permit
flexion, extension, abduction, adduction, and circumduction
303
What is an example of a saddle shaped joint
carpometacarpal joint of the thumb
304
How many axes do ball and socket joints allow movement
multiple
305
What do ball and socket joints permit
flexion, extension, abduction, adduction, circumduction, and rotation
306
What is an example of ball and socket joints
hip joint
307
What are solid joints are connections between skeletal elements where adjacent surfaces are linked together by what
fibrous connective tissue or cartilage
308
What type of cartilage usually would link solid joints
fibrocartilage
309
How is the movement in solid joints different than in synovial joints
more restricted
310
What are the 3 types of fibrous joints
sutures, gomphoses and syndesmoses
311
Where do sutures occur
only in the skull
312
What are suture joints
adjacent bones are linked by a thin layer of connective tissue
313
What is the name of the connective tissue that links at suture joints
sutural ligament
314
Where do gomphoses occur
only between the teeth and adjacent bones
315
What are gomphoses
joint, where short collagen tissue fibers in the periodontal ligament run between the root of the tooth and the bony socket
316
What are syndesmoses
joints in which two adjacent bones are linked by a ligament
317
What are the two different types of solid joints
fibrous joints and cartilaginous joints
318
What are the two types cartilaginous joints
synchondroses and symphyses
319
Where do synchondroses occur
two ossification centers in a developing bone remain separated by a layer of cartilage
320
What do synchondroses allow for
bone growth
321
What eventually occurs to synchondroses
eventually become completely ossified
322
Where do symphyses occur
most occur in the midline, where two separate bones are interconnected by cartilage
323
What are two examples of symphyses
```
pubic symphysis (between the two pelvic bones)
intervertebral discs between adjacent vertebrae
```
324
What are two other names for degenerative joint disease
osteoarthritis or osteoarthrosis
325
What is osteoarthritis related to
aging
326
What is typically seen structurally in osteoarthritis
decrease in water and proteoglycan content within the cartilage
327
What occurs to the cartilage in osteoarthritis
cartilage becomes more fragile and more susceptible to mechanical disruption
328
As the cartilage wears, what occurs to the bones
becomes fissured and thickens
synovial fluid may be forced into cracks and form cysts
reactive juxta articular bony nodules are formed
329
What is another name for juxta-articular bony nodules
osteophytes
330
How many PCP visits does osteoarthritis account for in US
one quarter of PCP visits
331
What is the etiology of osteoarthritis
unclear, but can occur secondary to other joint diseases and infection
332
What are treatments for osteoarthritis
weight reduction, proper exercise, anti-inflammatory drugs, joint replacement
333
What is arthroscopy
the technique of visualizing the inside of a joint using a small telescope placed in a tiny incision in the skin
334
Where is arthroscopy most often performed on the body
knee, shoulder, ankle, hip joints, elbow, wrist
335
What are three advantages of arthroscopy
performed through small incisions
patients recover quicker
only requires a light or regional anesthetic
336
What is the largest organ of the body
skin
337
What two things does the skin consist of
epidermis and dermis
338
What is the epidermis/ composition
the outer cellular layer of stratified squamous epithelium
339
Does the epidermis have blood vesels
no its avascular
340
How thick is the epidermis
varies in thickness
341
What is the dermis/ compostion
dense bed of connective tissue
342
Does the dermis have blood vessels
yes
343
What are the functions of the skin (3 things)
mechanical and permeability barrier
sensory and thermoregulatory organ
initiate immune responses
344
What is fascia
connective tissue containing varying amounts of fat
345
What are functions of fascia
separate, support, and interconnect organs and structures
enable movement of one structure relative to another
allow the transit of vessels and nerves from one area to another
346
What are the two general categories of fascia
superficial and deep
347
What is another name for superficial fascia
subcutaneous
348
Where does superficial fascia lie
just deep to the dermis and is attached to the dermis of the skin
349
What is the composition of the superficial fascia
loose connective tissue containing a large amount of fat
350
What is the thickness of the superficial fascia
varies
351
What two ways does the superficial fascia vary
between people and between areas of the body
352
What does the superficial fascia allow for
movement of the skin over deeper areas of the body
353
What does the superficial fascia acts as
conduit for vessels and nerves coursing to and from the skin
354
What does the superficial fascia serve as
an energy (fat) reservoir
355
What does deep fascia consist of
dense, organized connective tissue
356
Where is deep fascia located
outer layer attached to deep surface of superficial fascia
357
What does deep fascia form
thin fibrous covering over most of the deeper region of the body
358
What do inward extensions of the deep fascia form
intermuscular septa
359
What do the intermuscular septa of the deep fascia do
compartmentalize groups of muscles with similar functions and innervations
360
The deep fascia has other extensions (other than intermuscular septa) that do what
surround individual muscles and groups of vessels and nerves
361
What do these other extensions form
an investing fascia
362
What is it called when deep fascia forms around some joints and thickens
retinacula
363
What do fascial retinacula do
hold tendons in place and prevent them from bowing during movements at the joints
364
Where else is deep fascia found other than joints and below subcutaneous fascia
lining the abdominal cavity
365
What is another name for the fascia lining the abdominal cavity
parietal peritoneum
366
what is the name of the fascia that covers the deep surface of the muscles of the abdominal wall
transversalis fascia
367
What is the layer of fascia called that separated the membrane lining the abdominal cavity from the fascia covering the deep surface of the muscles of the abdominal wall
extraperitoneal fascia
368
What is a similar layer of fascia to the extraperitoneal fascia in the thorax termed
endothoracic fascia
369
What is fascia
thin band of tissue that surrounds muscles, bones, organs, nerves, and blood vessels
370
Do fascias have blood vessels
yes
371
Clinically how are fascias important
often limit the spread of infection and malignant disease
372
What are the three types of muscle in the body
skeletal, smooth, cardiac
373
How is muscle characterized
controlled voluntarily or involuntarily
striated or smooth
associated with body wall or with organs and blood vessels
374
What is a term to describe location near body wall
somatic
375
What is a term to describe location near organs and blood vessels
visceral
376
What muscle forms the majority of muscle tissue in the body
skeletal
377
What is the structure of muscle tissue
parallel bundles of long, multinucleated fibers with transverse stripes
378
What is the function of muscle tissue
powerful contractions to move bones and other structures
provides support
gives form to the body
379
What type of nerves innervate muscle tissue
somatic and branchial motor nerves
380
How are individual skeletal muscles named by
shape, attachments, function, position, fiber orientation
381
Where is cardiac muscle found
only in walls of the heart and in some large vessels close to where they join the heart
382
What is the structure of cardiac muscle
branching network of individual cells linked electrically and mechanically to work as a unit
383
Is cardiac muscle striated
yes
384
In comparison to skeletal muscle, compare cardiac muscles contractions
less powerful
385
What type of nerves innervate cardiac muscle
visceral motor nerves
386
Does smooth muscles have striations
no
387
What is the structure of smooth muscle
elongated or spindle shaped fibers
388
What type of contractions do smooth muscle produce
slow and sustained contractions
389
Where is smooth muscle found
walls of blood vessels, hair follicles in skin, eyeball, wall of various structures of GI, respiratory, GU, and urogenital systems
390
What type of nerves innervate smooth muscle
visceral motor nerves
391
What is muscle paralysis
inability to move a specific muscle or muscle group
392
What may cause muscle paralysis
abnormalities in the brain, spinal cord, and nerves supplying the muscles, drugs that affect neurotransmitters, stroke, trauma, poliomyelitis, iatrogenic factors
393
What will muscle paralysis produce in the long run
secondary muscle wasting and overall atrophy of the region
394
What are two effects of using anesthesia in relationship to muscle paralysis
enter the region of the body with agonistic and antagonistic patient muscle response
prevents the patient from breathing
395
What is muscle atrophy
wasting disorder of the muscle
396
what can cause muscle atrophy
nerve damage and disuse
397
What are muscle strains related to
sudden exertion and muscle disruption
398
How do muscle injuries and strains tend to occur
in specific muscle groups
399
What does the cardiovascular system consist of
the heart and the blood vessels
400
What is the function of the heart
pump blood throughout the body
401
What is the function of the blood vessels
closed network of tubes that transport the blood
402
How many types of blood vessels are there
3
403
What are the three types of blood vessels
arteries
veins
capillaries
404
What are arteries
vessels that transport blood away from the heart
405
What are veins
vessels that transport blood towards the heart
406
What are capillaries
vessels that connect the arteries and veins and are where oxygen, nutrients, and wastes are exchanged in the tissues
407
Which of the three blood vessels is the smallest
capillaries
408
Walls of blood vessels consist of how many layers (tunics)
3
409
What are the three layers of blood vessels
tunica externa
tunica media
tunica intima
410
What is another name for the tunica externa
adventitia
411
What is the tunica externa
outer connective tissue layer
412
What is the tunica media
middle smooth muscle layer
413
Other than smooth muscle, what else may the tunica media contain
elastic fibers in medium and large arteries
414
What is the tunica intima
inner endothelial lining of the blood vessels
415
Arteries can be divided into how many subclasses
3
416
How are arteries divided into the 3 subclasses
according to the variable amounts of smooth muscle and elastic fibers contributing to the thickness of the tunica media,
overall size of vessel,
and function of vessel
417
What do large elastic arteries contain structurally
substantial amounts of elastic fibers in the tunica media
418
What do large elastic arteries allow for
a constant flow of blood during diastole
419
What do the increased elastic fibers in large elastic arteries allow for
expansion and recoil during the normal cardiac cycle
420
What are examples of large elastic arteries
aorta, brachiocephalic trunk, left common carotid, left subclavian artery, pulmonary trunk
421
What is the structure of medium muscular arteries
tunica media contains mostly smooth muscle fibers
422
What is allowed for due to the structure of medium muscular arteries
vessels regulate their diameter and control the flow of blood to different parts of the body
423
What are examples of medium muscular arteries
most of the named arteries (femoral, axillary, radial)
424
What is the function of small arteries and arterioles
control the filling of the capillaries and contribute directly to the arterial pressure in the vascular system
425
How many classes are veins divided into
3
426
What are the 3 classes of veins
large veins
small and medium veins
venules
427
What are the 3 classes of arteries
large elastic
medium muscular
small arteries and arterioles
428
What is the structure of large veins
contain some smooth muscle in the tunica media, but thickest layer is the tunica externa
429
What are examples of large veins
superior vena cava, inferior vena cava, portal vein
430
What is the structure of small and medium veins
contain small amounts of smooth muscle and the thickest layer is the tunica externa
431
What are examples of small and medium veins
superficial veins in the upper and lower limbs and deeper veins of the leg and forearm
432
What are the smallest veins
venules
433
What is the function of venules
drain the capillaries
434
Structurally, how are veins different from arteries
the walls of veins are thin
luminal diameters of veins are large
often are multiple veins closely associated with arteries in peripheral regions
valves are often present in veins
435
What wall of the veins is specifically different
tunica media
436
Where are valves in veins typically present
in veins inferior to the level of the heart
437
What are valves in veins
paired cusps that facilitate blood flow toward the heart
438
What is atherosclerosis affect
the arteries
439
What is atheroscleriss
chronic inflammatory reaction in the walls of the arteries with deposition of cholesterol and fatty proteins
440
What can result because of the chronic inflammatory reaction and fatty deposits in atherosclerosis
secondary calcification, reduction in the diameter of the vessels, impeded distal flow
441
What is the importance of atherosclerosis and its effects depends upon what
which vessel it is occuring in
442
What are varicose veins
tortuous dilated veins
443
where do varicose veins typically occur
in the legs
444
What causes varicose veins to form
valves in veins become damaged allowing blood to pass in opposite direction resulting in increased volume and pressure, thus dilation and tortuosity of the superficial veins
445
What do lymphatic vessels collect
fluid lost from vascular capillary beds during nutrient exchange processes
446
What do lymphatic vessels do with the fluid they collect
deliver it back to the venous side of the vascular system
447
What is also included in the interstitial fluid that drains into the lymphatic capillaries
pathogens, cells of the lymphocytic system, cell products (like hormones) and cell debris
448
In the small intestin, certain fats absorbed are processed into what by the intestinal epithelium
chylomicrons
449
What are chylomicros
protein coated lipid droplets
450
Chylomicrons go where
drain into the lymphatic capillaries in small intestine
451
What are the lymphatic capillaries in the small intestine knows as
lacteals
452
The lymphatic system function related to the gut is what
major route of transport for fat absorbed by the gut
453
What color is the fluid of the lymphatic system is typically what
clear
454
What is the name of the fluid of the lymphatic system
lymph
455
The color of the fluid from small intestine is what color
opaque and milky
456
Why is the fluid color milky from the small intestine
due to chylomicrons
457
What is the name of the fluid from the small intestine called
chyle
458
Where are there not lymphatic vessels
brain
bone marrow
avascular tissues (epithelia and cartilage)
459
Movement of lymph through vessels is generated how
mainly by indirect action of adjacent structures (contraction of skeletal muscles and pulses in arteris)
460
How is unidirectional flow maintained in lymphatic vessels
valves
461
What are lymph nodes
small encapsulated structures that interrupt the course of lymphatic cessels
462
What is the size of lymph nodes
0.1-2.5 cm long
463
What do lymph nodes contain
elements of the body's defence system
| like macrophages and lymphocyte clusters
464
What is the function of lymph nodes
elaborate filters that trap and phagocytose particulate matter in the lymph that perculates through them
defect and defend against foreign antigens that were also carried by lymph
465
Where do cells that metastasize from primary tumors typically grow secondarily
lymph nodes
466
What characteristics occur to a lymph node that has cancer
enlarge or undergo certain physical changes (become "hard" or "tender"
467
What three areas are high risk sites for the entry of foreign pathogens
digestive system, body's surface, respirtory system
468
What is located at these high risk sites for foreign pathogen entry
clusters and increased abundance of lymph nodes
469
Where are lymph nodes abundant and accessible to palpation
axilla, groin, femoral region, and neck
470
Deep sites of more abundant lymph nodes are where
trachea, bronchi, aorta and its branches in the abdomen
471
Are deep sites of lymph nodes palpable
no
472
All lymphatic vessels coalesce to form what
larger trunks or ducts
473
What do larger trunks or ducts of lymphatic vessels do
drain into the venous system at sites in the neck
474
Where in the neck do larger trunks or ducts of lymphatic vessels drain
internal jugular veins join the subclavian veins to form teh brachiocephalic veins
475
Lymph that drains into the right side of the neck comes from what areas of the body
right side of head and neck
right upper limb
right side of thorax
right side of upper and more superficial region of the abdominal wall
476
Lymph that drains into veins on the left side of the neck come from what areas of the body
All other regions of the body not mentioned for draining into the right side of the neck
477
What structure do lymph nodes have
internal honeycomb of reticular connective tissue
478
What is the internal honeycomb of reticular connective tissue of lymph nodes filled with
lymphocytes
479
What is the function of lymphocytes within lymph nodes
act on bacteria, viruses, other bodily cells to destroy them
480
When a lymph node is "active" in fighting off something, what occurs
rapid cell turnover and production of local inflammatory mediators
481
As a result of increased cell turnover and production of local inflammatory mediators, what occurs to the lymph node
enlarges and becomes tender
482
In systemic illnesses, what may occur to lymph nodes
diffusely enlarged or local groups enlarge
483
What are two ways to separate the nervous system
structure and function
484
Structurally, how can the nervous system be divided
central nervous system and peripheral nervous system
485
Functionally, the nervous system can be divided into what
somatic and visceral parts
486
What is the CNS composed of
brain and spinal cord
487
Where do the brain and spinal cord develop from
the neural tube in the embryo
488
What is the PNS composed of
all nervous structures outside the CNS that connect the CNS to the body
489
Where do elements of the PNS develop from
neural crest cells and as outgrowths of the CNS
490
PNS consists of what
spinal and cranial nerves
visceral nerves and plexuses
enteric system
491
What are the parts of the brain divided into
cerebral hemispheres
the cerebellum
the brainstem
492
The cerebral hemispheres consist of how many portions
three
493
What are the portions of the cerebral hemispheres
outer portion
inner portion
ventricles
494
What is the outer portion of the cerebral hemispheres called
gray matter
495
What does the gray matter contain
cell bodies
496
What is the inner portion of the cerebral hemispheres called
white matter
497
What is the white matter composed of
axons forming tracts or pathways
498
What are the ventricles of the cerebral hemispheres
spaces filled with cerebrospinal fluid
499
There cerebellum is composed of what parts
2 lateral lobes
| midline portion
500
What are the components of the brainstem classified as
diencephalon,
midbrain
pons
medulla
501
In common usage the brainstem includes
pons
midbrain
medulla
502
What shape is the spinal cord
cylindrical
503
What are meninges
three connective tissue coverings
504
What is the function of meninges
surround, protect, and suspend the brain and spinal cord within the cranial cavity and vertebral canal
505
What are the three meninges called
dura mater
arachnoid mater
pia mater
506
The dura mater is where
the most external of the meninges
507
The arachnoid mater is where
agains the internal surface of the dura mater
508
The pia mater is where
adherent to the brain and spinal cord
509
Which of the meninges is the thickest
dura mater
510
What is between the arachnoid and pia mater
the subarachnoid space
511
What does the subarachnoid space contain
CSF
512
What are the functional subdivisions of the nervous system called
somatic part
| visceral part
513
What is the somatic part of the CNS
Innervates structures derived from somites in the embryo
514
What structures typically does the somatic part of the CNS innervate
skin and most skeletal muscle
515
What is the function of the somatic part of the CNS
receiving and responding to information from the external environment
516
What is the visceral part of the CNS
innervates organ systems in the body and other visceral elements in peripheral regions of the body
517
What structures typically does the visceral part of the CNS innervate
smooth muscle and glands
518
What is the function of the visceral part of the CNS
detecting and responding to information from the internal environment
519
What does the somatic part of the nervous system consist of
nerves that carry conscious sensations from peripheral regions back to the CNS
AND
nerves that innervate voluntary muscle
520
Somatic nerves arise along the developing CNS in association with what from the embryo
somites
521
Where are somites in the embryo
arranged segmentally along each side of the neural tube
522
What is the dermatomyotome
part of the somite that gives rise to skeletal muscle and the dermis of the skin
523
As cells of the dermatomyotome differentiate, what occurs
they migrate into posterior and anterior areas of the developing body
524
What occurs to cells that migrate anteriorly from the dermatomyotome
give rise to muscles of the limbs and trunks and to the associated dermis
525
What is another name for the muscles of the limbs and trunks
hypaxial muscles
526
What occurs to cells that migrate posterioly from the dermatomyotome
give rise to the intrinsic muscle of the back and associated dermis
527
What is another name for the muscles of the back
epaxial muscles
528
As the neural tube develops, what occurs in respect to the dermatomyotome
nerve cells within the anterior region of the neural tube extend processes peripherally into posterior and anterior regions of the dermatomyotomes of each somite
529
As the neural tube develops and nerve cells extend processes peripherally into posterior and anterior regions, what also occurs
neural crest cells differentiate into neurons on each side of the neural tube and extend processes both medially and laterally
530
What are neural crest cells
cells derived from neural folds during formation of the neural tube
531
Medial processes from the neural crest cells pass where
into the posterior aspect of the neural tube
532
Lateral processes from the neural crest cells pass where
into the differentiating regions of the adjacent dermatomyotome
533
Neurons that develop from neurons within the spinal cord are called what type of neurons
motor neurons
534
Neurons that develop from neural crest cells are what type of neurons
sensory neurons
535
Spinal nerves and some cranial nerves are what
somatic sensory and somatic motor fibers that are organized segmentally along the neural tube
536
Clusters of sensory nerve cells bodies located outside the CNS form what
sensory ganglia
537
Generally, all sensory information passes into the spinal cord where
posterior aspect
538
Generally, all motor fibers leave the spinal cord where
anterior aspect
539
Somatic sensory neurons carry information directionally how
from periphery to the CNS
540
What are other names for somatic sensory neurons
somatic sensory afferents
| general somatic afferents (GSAs)
541
What modalities are carried by somatic sensory neurons
temperature
pain
touch
proprioception
542
What is proprioception
sense of determining the position and movement of the musculoskeletal system detected by special receptors in muscles and tendons
543
Somatic motor neurons carry information directionally how
away from the CNS to skeletal muscles
544
What are other names for somatic motor neurons
somatic motor efferents
| general somatic efferents (GSEs)
545
Because cells from a specific somite develop into the dermis of the skin in a precise location, what results with the somatic sensory fibers
enter the posterior region of the spinal cord at a specific level and become part of one specific spinal nerve
546
Each spinal nerve carries information relating to what
specific area of skin on the surface of the body
547
What is a dermatome
area of skin supplied by a single spinal cord level or on one side, by a single spinal nerve
548
Do dermatomes overlap
yes slightly
549
What forms one spinal nerve
somatic motor nerves from one anterior region of the spinal cord with the same level of sensory nerves
550
What is a myotome
portion of a skeletal muscle innervated by a single spinal cord level, or one one side, by a single spinal nerve
551
Spinal nerves carry motor fibers to what types of what muscle
muscles that originally developed from the related somite
552
Are dermatomes or myotomes more easy to test
dermatomes
553
Why are myotomes harder to test
skeletal muscle in the body is usually innervated by nerves derived from more than one spinal cord level
554
testing movements at successive joints can help in what
localizing lesions to specific nerves or to a specific spinal cord level
555
Where do muscles that move the shoulder innervate
at levels C5 and C6
556
Where do muscles that move the elbow innervate
levels C6 and C7
557
Where do muscles in the hand innervate
C8 and T1
558
The visceral part of the nervous system consists of what components
motor and sensory components
559
What is the function of sensory component in visceral part of nervous system
monitor changes in the viscera
560
Where do motor component of the visceral part of the nervous system innervate
smooth muscle, cardiac muscle, and glands
561
The visceral motor component is commonly referred to as what
autonomic division of the PNS
562
What can the autonomic division of the PNS be subdivided into
sympathetic and parasympathetic parts
563
Like the somatic portion, how is the visceral portion formed and arranged
segmentally arranged and develops in parallel fashion
564
Visceral sensory neurons arise from what
neural crest cells
565
Where do visceral sensory neurons send their processes medially
into the adjacent neural tube
566
Where do visceral sensory neurons send their processes laterally
into regions associated with the developing body
567
Visceral sensory neurons and their processes are called what
general visceral afferent fibers
568
What is abbreviation for general visceral affernet fibers
GVAs
569
What are general visceral afferent fibers associated with
chemoreceoption
mechanoreception
stretchreception
570
Visceral motor neurons that arise from cells in lateral regions of the neural tube send their processes where
out of the anterior aspect of the tube
571
Unlike the somatic part, the processes of the visceral motor neurons are different how
the processes synapse with other cells
572
What is another name for the visceral motor neurons
general visceral efferent fibers
573
What is the abbreviation for general visceral efferent fibers
GVEs
574
What other cells do visceral motor neurons usually synapse with
other visceral motor neurons that develop outside the CNS from neural crest cells
575
Visceral motor neurons located in the spinal cord are called what
preganglionic motor neurons
576
What are the axons of preganglionic motor neurons called
preganglionic fibers
577
Visceral motor neurons located outside the CNS are referred to as what
postganglionic motor neurons
578
What are the axons of postganglionic motor neurons called
postganglionic fibers
579
Cell bodies of the visceral motor neurons outside the CNS often do what
associate with each other in a discrete mass
580
What is the name for the discrete mass formed from cell bodies
ganglion
581
Visceral sensory and motor fibers enter and leave the CNS with what
their somatic equivalents
582
With what do the visceral sensory fibers enter the CNS
somatic sensory fibers
583
Where do the visceral sensory fibers enter the CNS
through posterior roots of the spinal nerves
584
Where do preganglionic fibers of visceral motor neurons exit the spinal cord
anterior roots of spinal nerves
585
What do preganglionic fibers of visceral motor neurons exit the spinal cord with
somatic motor nerves
586
Where are postganglionic fibers traveling to visceral elements in the periphery found
in the posterior and anterior rami (branches) of spinal nerves
587
Visceral motor and sensory fibers travel where
to and from viscera form named visceral branches
588
are visceral and somatic branches the same thing
no
589
What do the nerves form before branches arise to the viscera
plexuses
590
What arises from the plexuses
branches to the viscera
591
Do visceral motor and sensory fibers enter and leave the CNS at all levels
no
592
In the cranial region, how many nerves are associated with visceral components
4
593
How many nerves in the cranial region
12
594
What cranial region nerves are visceral components associated with
CN III, VII, IX, X
595
in the spinal cord what spinal cord levels are associated with visceral components
T1-L2
| S2-S4
596
Visceral components associated with T1-L2 are termed what
sympathetic
597
visceral components in cranial and sacral regions are termed what
parasympathetic
598
What does the sympathetic system innervate
structures in peripheral regions of the body and viscera
599
The parasympathetic system innervates what
viscera only
600
The sympathetic part of the autonomic division of the PNS leaves thoracolumbar regions of the spinal cord with what
somatic components of spinal nerves T1-L2
601
On each side of the sympathetic part of the autonomic division of the PNS leaving the spinal cord is what
a paravertebral sympathetic trunks that extends
602
Where does the paravertebral sympathetic trunk extend
base of the skull to the inferior end of the vertebral column
603
At the ingerior end of the vertebral column, what occurs to the paravertebral sympathetic trunk
the two trunks converge antiorly
604
What do the two trunks converge to
the coccyx at the ganglion impar
605
What is each trunk attached to
anterior rami of spinal nerves
606
What does the each trunk function as
route by which sympathetics are distributed to the periphery and all viscera
607
Describe the path of visceral motor preganglionic fibers as they leave the spinal cord
1. leave the T1-L2 part of spinal cord in anterior roots
2. enter the spinal nerves
3. pass through the anterior rami and into sympathetic trunks
608
Where are the trunks located
one trunk is located on each side of the vertebral column and anterior to the anterior rami
609
What is along the trunk
ganglia segmentally arranged
610
What are the ganglia formed from
collections of postganglionic neuronal cell bodies where the preganglionic neurons synapse with postganglionic neurons
611
What are anterior rami of T1-L2 connected to
sympathetic trunk or to a ganglion
612
What connects anterior rami to the sympathetic trunk of to a ganglion
white ramus communicans
613
What does white ramus communicans contain
preganglionic sympathetic fibers
614
Why does the white ramus communicans appear white
the fibers are myelinated
615
Preganglionic sympathetic fibers that enter through a white ramus communicans may provide what
1. peripheral sympathetic innervation at the level of origin of the preganglionic fiber
2. peripheral sympathetic innervation above or below the level of origin of the preganglionic fiber
3. Sympathetic innervation of thoracic and cervical viscera
4. Sympathetic innervation of the abdomen and pelvic regions and the adrenals
616
Where do postganglion fibers enter after preganglionic sympathetic fibers synapse with postganglionic motor neurons in ganglia associated with the sympathetic trunk
enter the same anterior ramus and distributes with peripheral branches of the posterior and anterior rami of that spinal nerve
617
What structures do the fibers that enter the anterior ramus and distribute with peripherla branches of the posterior and anterior rami of the spinal nerve innervate
structures at the periphery of the body in regions supplied by the spinal nerve
618
What connects the sympathetic trunk or ganglion to the anterior ramus
gray ramus communicans
619
What does the gray ramus communicans contain
postganglionic sympathetic fibers
620
Why does the gray ramus communicans appear gray
postganglionic fibers are nonmyelinated
621
Where is the gray ramus communicans positions in relation to the white ramus communicans
medial
622
Preganglionic sympathetic fibers may ascend or descend to what
other vertebral levels
623
When the ascend of descend to other vertebral levels, what may preganglionic sympathetic fibers synapse with
in ganglia associated with spinal nerves
624
These spinal nerves that preganglionic sympatheticc fibers synapse with may or may not have what
visceral motor input directly from the spinal cord
625
How do postganglionic fibers leave the distant ganglia
via gray rami communicantes
626
Where are posganglion fibers that leave the distant ganglia distributes
along the posterior and anterior rami of the spinal nerves
627
The ascending and descending fibers with all the ganglia form what
the paravertebral sympathetic trunk
628
Where does the paravertebral sympathetic trunk extend
the entire lenght of the vertebral column
629
The formation of this trunk enables what
visceral motor fibers of the sympathetic part of the autonomic division of the PNS to be distributed to peripheral regions innervated by all spinal nerves
630
Where do visceral motor fibers of the sympathetic part of the autonomic division of the PNS emerge
T1-L2
631
White rami communicantes only occur in association with what
spinal nerves T1-L2
632
Gray rami communicates are associated with what
all spinal nerves
633
Fibers from spinal cord levels T1-T5 pass predominantly where
superiorly
634
Fibers from spinal cord levels T5-L2 pass predominantly where
inferiorly
635
All sympathetics passing into the head have preganglionic fibers that emerge from the spinal cord level where
T1
636
where do preganglionic fibers that pass into the head ascend to
the highest ganglion in the neck
637
What is the highest ganglion in the neck called
superior cervical ganglion
638
To target tissues in the head, postganglionic fibers travel along what
blood vessels
639
What tissues do postganglionic fibers target in the head
blood vessels, sweat glands, small smooth muscles associates with upper eyelides, dilator of the pupil
640
How do preganglionic sympathetic fibers innervate thoracic or cervical viscera
preganglionic sympathetic fibers synapse with postganglionic motor neurons in ganglia and then leave ganglia medially to innervate
641
Before synapsing, what may preganglion sympatehtic fibers do
ascend
642
After synapsing, what may postganglionic fibers do when innervationg thoracic and cervical viscera
combine with those from other levels
643
What do postganglionic fibers that combine with other levels form
named visceral nerves
644
Named nerves often join what
branches from the parasympathetic system
645
What do named nerves and branches from the parasympathetic system for
plexuses on or near the surface of the target organ
646
Branches of the plexuses will then do what
innervate the organ
647
Spinal cord levels T1-T5 innervate what viscera
cranial, cervical, and thoracic
648
Preganglionic sympathetic fibers that pass through the sympathetic trunk and paravertebral ganglia without synapsing doo with
form splanchnic nerves
649
What do preganglionic sympathetic fibers form splanchnic nerves with
similar fibers from other levels
650
What are splanchnic nerves
greater, lesser, least, lumbar, and sacral
651
Where do splanchnic nerves pass
into the abdomen and pelvic regions
652
The preganglionic sympathetic fibers that form splanchnic nerves are derived from what spinal cord levels
T5-L2
653
What do splanchnic nerves generally connect with
sympathetic ganglia around the roots of major arteries that branch from abdominal aorta
654
The ganglia that splanchnic nerves connect with are part of what
a large prevertebral plexus
655
What does the large prevertebral plexus have input from
the parasympathetic part of the autonomic division of the PNS
656
Post ganglionic sympathetic fibers are disctributes how
in extentions of the plexus along arteries, to viscera in the abdomen and pelvis
657
Some of the preganglionic fibers in the prevertebral plexus do not synapse in the sympathetic ganglia of the plexus but pass through the system to what
adrenal gland
658
At the adrenal galnd, where do preganglionic fibers synapse
directly with cells of the adrenal medulla
659
Cells of the adrenal medulla are what
homologues of sympathetic postganglionic neurons
660
What do the cells of the adrenal medulla secrete
adrenaline and noradrenaline into the vascular system
661
The parasympathetic part of the autonomic division of the PNS leaves what regions of the CNS
cranial and sacral regions
662
What parts of the cranial regions does the parasympathetic part of the autonomic division of the PNS leave
cranial nerves III, VII, IX, and X
663
What parts of the cranial regions does the parasympathetic part of the autonomic division of the PNS leave
S2 to S4
664
Where do parasympathetic fibers that leave cranial nerves III, VII, and IX go
to structures within the head and neck only
665
Where do parasympathetic fibers that leave cranial nerve X go
head, neck, and innervates thoracic and most abdominal viscera
666
What is another name for cranial nerve X
vagus nerve
667
Where do the parasympathetic fibers of S2-S4 innervate
inferior abdominal viscera, pelvic viscera, and the arteries associated with erectile tissues of perineum
668
What are the two neurons in visceral motor nerves of the parasympathetic system
preganglionic neurons and fibers
669
In the sacral region, the preganglionic parasympathetic fibers form what
special visceral nerves
670
What are the special visceral nerves formed y the preganglionic parasympathetic fibers called
pelvic splanchnic nerves
671
Where do the pelvic splanchnic nerves originate
anterior rami of S2-S4
672
Where to pelvic splanchnic nerves enter
pelvic extensions of the large prevertebral plexus formed around the abdominal aorta
673
The fibers from the pelvic splanchnic nerves are then distrubuted to what
pelvic and abdomnal viscera mainly along blood vessels
674
Where are the postganglionic motor neurons
in the walls of the viscera
675
In the gastrointestinal system, do preganglionic fibers have postganaglionic fibers
no
676
Where do preganglionic fibers synapse in the GI system
directly on neurons in the ganglia of the enteric system
677
Preganglionic parasympathetic motor fibers in CN III, VII, and IX do what
separate from the nerves and connect with one of four distinct ganglia
678
What do the ganglia house that preganglionic parasympathetic motor fibers in CN III, VII, and IX conect with
postganglionic motor neurons
679
Where are the four distinct ganglia located near
branches of CN V
680
Postganglionic fibers leave the distinct ganglia and go where
join the branches of CN V and are carried to target tissues
681
What are the target tissues of CN V
salivary, mucous, lacrimal glands, constrictor muscle of the pupil, cilliary muscle in theeye
682
The vagus nerve (X) gives rise to what
visceral branches along its course
683
What do the branches of the vagus nerve contribute to
plexuses associated with thoracic viscera or to the large prevertebral plexus in the abdomen and pelvis
684
When present, where are postganglionic parasympathetic neurons
in the walls of the target viscera
685
What generally accompanies visceral motor fibers
visceral sensory fibers
686
Visceral sensory fibers follow the course of what
sympathetic fibers entering the spinal cord at similar spinal cord levels
687
Visceral sensory fibers may also do what
enter at levels other than those associated with motor output
688
Visceral sensory fibers that accompany sympathetic fibers main function is
detecting pain
689
Visceral sensory fibers accompanying parasympathetic fibers are carried mainly in...
IX and X
| and in spinal nerves S2-S4
690
What information do visceral sensory fibers in IX carry
chemoreceptors and baroreceptors associated with the walls of major arteries in the neck and from receptors in pharynx
691
Visceral sensory fibers in X include what
those from cervical viscera and major vessels and viscera in the thorax and abdomen
692
Visceral sensory fibers from pelvic viscera and the distal parts of the colon are carried where
S2-S4
693
Visceral sensory fibers associated with parasympathetic fibers relay information to the CNS about what
status of normal physiological processes and reflex activities
694
The enteric nervous system consists of what
motor and sensory neurons and their supportcells that form two plexus
695
What plexus are the enteric nervous system composed of
myenteric and submucous nerve plexuses
696
Where is the enteric nervous system located
walls of the gastrointestinal tract
697
What composes theese plexuses of the enteric system
ganglia and bundles of nerve fibers
698
What do the ganglia of the enteric system house
the nerve cell bodies and associated cells
699
Where do the bundles of nerve fibers of the enteric system pass
between ganglia and from ganglia into surrounding tissues
700
Where are neurons of the enteric system derived from
neural crest cells originally associated with occipitovervical and sacral regions
701
Which has more neurons, the spinal cord or enteric system
enteric system
702
Sensory and motor neurons within the enteric system control what
reflex activity within and between parts of the gastrointestinal system
703
What do the reflexes controlled by the enteric system compose
regulate peristalsis, secretomotor activity, and vascular tone
704
Sensory information from the enteric system is carried back to the CNS by what
visceral sensory fibers
705
Nerve plexus are either what
somatic or visceral
706
Nerve plexus combine what
fibers from different levels or sources to form new nerves with specific targets or destinations
707
most somatic plexus formed from what
the anterior rami of spinal nerves
708
The somatic plexuses are
cervical, brachial, lumbar, sacral, and coccygeal
709
What levels are the cervical somatic plexuses
C1-C4
710
What levels are the brachial somatic plexus
C5-T1
711
What levels are the lumbar somatic plexus
L1-L4
712
What levels are the sacral somatic plexus
L4-S4
713
What levels are the coccygeal somatic plexus
S5-to Co
714
Visceral nerve plexus contain what components
efferent and afferent components
715
What composes the efferent component of the visceral nerve plexus
sympathetic and parasympathetic
716
The visceral plexuses are
cardiac and pulmonary in the throax, large prevertebral plexus in the abdomen anterior to the aorta
