Spinal Anatomy Flashcards
(301 cards)
1
Q
Mesoderm Subgroups (4)
A
Paraxial (somatic and splanchnic)
Intermediate
Head
Lateral Plate
2
Q
Endoderm derivatives
A
Organs, gut, respiratory tract
“tubular structures”
3
Q
Mesoderm: Paraxial
(two parts…)
A
Somatic:
musculoskeletal- muscles, ligaments, tendons…
Splanchnic
smooth muscle of organs
4
Q
Mesoderm: Intermediate
A
Urogenital system and kidneys
5
Q
Mesoderm: Head
A
skull muscles, dentine of teeth
6
Q
Mesoderm: Lateral Plate
A
Adrenal cortex, connective tissue, cardiovascular and lymph
7
Q
Ectoderm Subgroups
A
“Ectoderm: nerves and skin”
Surface ectoderm
Neuroectoderm (2)
8
Q
Ectoderm: Surface Ectoderm
A
Epidermis, anterior pituitary, lens of eye, skin, enamel, hair, nails
9
Q
Ectoderm: Neuroectoderm
(Subgroups and derivatives)
A
Neural Tube
posterior pituitary, retina of eye, CNS, oligodendrocyte
CNS: brain and sc
- *Neural Crest**
- *Outside CNS:** sympathetic chain gangion, DRG, ANS, PNS, Schwann cells, Parafollicular cells of thyroid, adrenal medulla
10
Q
Neuroectoderm:
Embryological order
A
notochord
↓
neural plate
↓
neural groove
↓
neural tube
↓
neural crest cell
11
Q
CNS Pathologies derived from neural tube defects:
Spina Bifida Occulta
A
lamina failed to fuse
tuft of hair growth = “fawn’s beard”
Caused by folic acid deficiency
(“Folic acid” / “Vit B9” / “methylfolate” / “tetrahydrofolate”)
12
Q
CNS Pathologies derived from neural tube defects:
Spina Bifida Vera / “Spina Bifida Manifesta”
Meningocele, myelocele, meningiomyelocele…
A
Meningocele: meninges protrude
Myelocele: sc protrudes because of underdeveloped meninges
Meningiomyelocele: sc and meninges protruding
13
Q
CNS Pathologies derived from neural tube:
Arnold Chiari Syndrome
(two types)
A
Type I:
cerebellar peduncles come below foramen magnum
Type II:
Type I + meningiomyelocele
14
Q
CNS Pathologies derived from neural tube:
Cleft Palate
A
failure of maxillary and palatine bones to fuse
neural tube defect, B9 deficiency
15
Q
(Embryological stages of development)
Mesodermal Development
A
Sclerotome = membranous vertebral column
Myotome = muscle
- Somatic: skeletal muscle
- Splanchnic: “visceral” smooth muscle
- Epimere: dorsal, posterior mm, extensors
- Hypomere: ventral, anterior mm, flexors
Dermatome = nerves
16
Q
(Embryological stages of development)
Ossification
A
intramembranous/intramedullary ossification
- mesenchymal tissue → bone
- clavicle / parietal bone*
*or any skull bone, all are partially intramembranous
Enchondral ossification = preformed in cartilage
- ossification for all other bones (98%)
17
Q
Dorsal Primary Rami
A
to back mm
18
Q
Ventral Primary Rami
A
to front mms
Exception: any back mm that is innervated by a nerve coming off brachial plexus is primary..
rhomboids → dorsal scapular n
latissimus dorsi → thoracodorsal n
19
Q
(GI Embryology)
Mouth
Foregut
Midgut
Hindgut
A
Mouth: stomodeum
Foregut: back of throat to first 1/3 duodenum
Midgut: last <span>2</span>/3 duodenum to first <span>2</span>/3 transverse colon
Hindgut: last <span>1</span>/3 transverse colon to anus
20
Q
The Gubernaculum
A
Males
becomes scrotal ligament aka “gubenacular testes”
Females
suspensory ligament of ovary, ovarian lig, and round lig.
21
Q
Primary and Secondary Vesicles
A
“Tell Di Mes Met Mye”
Prosencephalon
- Telencephalon
- Diencephalon
Mesencephalon
- Mesencephalon
Rhombencephalon
- Metencephalon
- Myelencephalon
22
Q
Telencephalon
A
Derived from Prosencephalon
Cortices, basal ganglion, cingular gyrus
CN I (Olfactory n)
Lateral Ventricle
23
Q
Diencephalon
A
Derived from Prosencephalon
thalamus (hypo-, epi-, sub-)
*epithalamus = pineal gland
CN II (Optic n)
3rd ventricle
24
Q
Mesencephalon
A
remains mesencephalon
midbrain
CN III (oculomotor) CN IV (trochlear) *\*only CN off posterior portion of brainstem, and contralateral*
Aqueduct of Sylvius AKA Cerebral Aqueduct
25
Metencephalon
From Rhombencephalon
Pons and cerebellum
CNs 5-8
(V: trigeminal, VI: abducens, VII: facial, VIII: vestibulocochlear)
roof of 4th ventricle
26
Myelencephalon
From Rhombencephalon
medulla oblongata
CNs 9-12
(IX: glossopharyngeal, X: vagus, XI: accessory, XII: hypoglossal)
floor of 4th ventricle
*\*fold of tissue at floor of 4th vent: "obex"
just below 4th ventricle: cisterna magna/"cerebellomedullary cisterm"*
27
(Neurology)
Dendrites vs Axons
Dendrites: impulse towards cell body
Axon: impulse away from body
*\*impulse originates at axon hillock*
28
Overview
receptor (dendrite) → peripheral nerve → spinal cord → brainstem → cerebellum
(or) ↓
thalamus → parietal lobe → Wernicke's area (POT) → limbic system → motor response
*\*Only senseation that bypasses thalamus is smell. Cerebellum receives information after impulses pass thru brainstem and also from cortex*
29
(Action Potential)
Resting Membrane Potential
muscle vs neuron
_Resting Membrane Potential:_ (-) inside, (+) outside
*large molecules create (-) inside, sodium creates (+) outside*
**Muscle = (-85-90mv)**
**Neuron = (-65-70mv)**
30
(Action Potential)
Receptors
Allow Na+ leak into cell, twoards depolarization of nerve for AP
Depolarization = Na+ rushing in
31
Dorsal Column Receptors
Pacinian
insignificant vibration
A-beta fibers
32
Dorsal Column Receptors
Ruffini
joint position sense
A-beta fibers
33
Dorsal Column Receptors
Meissner's/Merkel's
accurate touch
A-Beta fibers
34
Spinothalamic Tracts
Free Naked endings
pain, temperature, crude touch
unmyelinated C fibers
35
AP Threshold
controlled by
Ca++
36
Subnormal Period
"Hyperpolarized"
"relative refractory period"
more negative, harder to fire
37
Na/K Pump
kicks in after subnormal/hyperpolarized period
helps reach equilibrium/resting
**pumps 3 Na+ OUT
2 K+ IN**
38
Medulla and Pons
Respiratory and cardiac center
autonomics
CN 5-12
39
Midbrain
reflexes to light and sound
proximal flexor relay
CN 3&4
40
Thalamus
relay station
sensory fibers
Pulvinar region = integration of sensory information
41
VPM of Thalamus
sensory from face
42
VPL of Thalamus
sensory from arms and legs
43
Lateral geniculate of Thalamus
sensory from eyes
44
Medial Geniculate of Thalamus
sensory from ears
45
Cerebrum
Intellect and association
46
Parietal Lobe
localization
"somesthetic cortex"
Post-central gyrus
Brodman 1,2,3
problem solving
47
Occipital Lobe
Vision
Brodman's 17
48
Superior Temporal Lobe
Hearing
49
Inferior Temporal Lobe
Long term memory
(hippocampal cells)
damage to hippocampus = anterograde amnesia
smell
(parahippocampal cells)
Uncal area
"Uncus is the skunkest"
50
Wernicke's Area
**junction of P/O/T lobes**
sensory matching, **interpretation**
*(does this make sense? if not, fire sympathetics)*
**Destroyed by B1/Thiamine**
*d/t alcoholism = Wernicke Korsakoff Syndrome
d/t diet = Beri Beri*
**sensory** **aphasia**: can't understand language
**word blindness in angular gyrus**
51
Frontal Lobe
**Voluntary Motor**
**precentral gyrus**
brodman 4, 4s, 6
**corticospinal tracts**
corticobulbar/pyramidal tracts = personality
**motor aphasia** = broca's speech, left inferior frontal lobe
**blood supply from middle cerebral artery**
52
Limbic System
associated w amygdala
## Footnote
*pleasure or pain?
do I need to remember this?*
53
Basal Ganglia
inhibits thalamus
Disfunction: trivial information elicits motor response
= Parkinson's
| (stops motor response)
54
Basal Ganglia
Caudate Nucleus
secretes GABA
defective caudate
= Huntington's Chorea
55
Basal Ganglia
Striatum
putamen + caudate
separated by internal capsule
56
Basal Ganglia
Lentiform Nucleus
globus pallidus + putamen
57
Hypothalamus
hunger
thirst
temperature regulation
sex
rage
fear
58
Cerebellum
balance
equilibrium
involuntary coordination
unconscious proprioception
59
Blood-Brain Barrier
astrocytes + tight capillary beds
stores glucose/glycogen
60
Microglia
macrophages
61
Ependymal Cells
line ventricles, produce CSF
CSF made in choroid plexus in lateral ventricles
resorbed in arachnoid granulations of superior sagittal sinus
62
Oligodendrocytes
myelin in CNS
demyelination = MS
derived from neural tube because within CNS
63
Schwann Cells
myelinate PNS
demyelinization = post-infectious polyradiculopathy
"Guillan-Barre"
ascending paralysis, post vaccine, post infection
64
Meissner's & Auerbach's Plexuses
allows peristalsis
from neural crest cells
absense = no peristalsis
**congenital megacolon/Hirschprung's Disease**
65
Renshaw Cells
inhibit alpha motor neuron
(-) feedback
66
Alpha waves
quiet, meditative
disappear in sleep
67
Beta waves
intense mental activity
REM sleep
68
Delta waves
deep sleep or coma
**ARAS = Ascending REticular Activating System
= wakes up the cortex**
*flying delta puts you to sleep/coma*
69
Theta waves
normal in children, abnormal in adults
2nd/3rd stage of sleep, non-REM
70
Association fibers of cerebrum
connect same hemisphere
from frontal to temporal, etc.
71
Commissural fibers of cerebrum
connect L to R
corpus callosum
72
Projection fibers of cerebrum
connect up and down both directions
brainstem/sc
**pass through internal capsule**
73
Central chemoreceptors
found in **brainstem** (medullary neurons)
most sensitive to HIGH CO2
dilate cerebral blood vessels
74
Peripheral chemoreceptors
found in **carotid and aortic bodies**
most sensitive to LOW OXYGEN
dilate cerebral blood vessels
75
Vertebral arteries enter spine at
C6 transverse foramen
feed into Circle of Willis
enter skull at foramen magnum
76
PICA
**Posterior Inferior Cerebellar Artery**
off Vertebral Arteries
Damage to PICA = **Wallenberg Syndrome**
ipsilateral loss of pain and temperature to face
contralateral loss of pain and temperature to body
77
Anterior Spinal Artery
from both vertebral arteries
blood to anterior 2/3 of spinal cord
78
Posterior Spinal Arteries
off radicular arteries
blood to posterior 1/3 of spinal cord
79
Carotids
**Right Carotid** off R brachiocephalic
**Left Carotid** off Aorta
both bifurcate at C3/4 into
**Internal** **Carotid** and **External** **Carotid**
manterior and middle cerebral aa // maxillary to middle meningeal a
80
Straight Sinus
Great Cerebral Vein of Galen drains into Straight Sinus
"Great is Straight"
Straight Sinus found in tentorium cerebelli
81
Superior Sagittal Sinus
Superior Cerebral Vein drains into Superior Sagittal Sinus
"Superior is Superior"
Superior Sagittal Sinus found in falx cerebri
contains arachnoid granulations for resorbing CSF
82
Falx Cerebri attachments
Anterior attachment: crista galli of ethmoid
Posterior attachment: tentorium cerebelli
83
Confluence of Sinuses
torculus herophilus
on inner portion of occipital bone
84
Damage to sinuses
subdural hematoma
85
Emissary veins
drain scalp into superior sagittal sinus
86
Damage to middle meningeal a
epidural hemorrhage
epidural hematoma
87
Damage to venous system
subdural hemorrage
7-14 days to show
slow bleed
88
Beri aneurysm
| (Circle of Willis)
subarachnoid hemorrhage
worst headache of life
full intensity, immediately
89
Flocculonodular lobe of cerebellum
midline
**balance** of spine
90
Cerebellar Nuclei
Fastigial
spine
91
Cerebellar Nuclei
Globus
proximal joints
**g**lenohumeral
92
Cerebellar Nuclei
Emboliform
middle joints
**e**lbow
globus + emboliform = interpose nuclei
93
Cerebellar Nuclei
Dentate
**d**istal joints
**d**igits
motor output
94
Interpose Nuclei
globus + emboliform
95
MSC
type 1a fibers
stretch
96
GTO
type 1b fibers
tension
97
Tectum of Midbrain
superior and inferior colliculi
* *superior** = light
* *inferior** = sound
reflex to light and sound = **tectospinal** **tract**
**Corpora quadrigemina = the 4 colliculi**
98
Tegmentum of Midbrain
CN 3 and 4\*
CN4 comes off **posterior** portion
center of mesencephalon
99
Cerebral peduncles
"Basis Pedunculi"
contains corticospinal tracts
red nucleus = origin of rubrospinal tract
substantia nigra = dopamine for thalamus
Parkinsons if damaged
100
**CN I: Olfactory**
Origin
Foramina/bone
Action
frontal lobe
cribiform plate of ethmoid
smell
101
**CN II: Optic**
Origin
Foramina/bone
Action
thalamus
optic foramen of sphenoid
S: vision
R: afferent pupillary light reflex
102
**CN III: Oculomotor**
Origin
Foramina/bone
Action
midbrain
superior orbital fissure of sphenoid
M: "All else 3" (SO4, LR6, all else 3)
R: pupillary constriction
P: efferent pupillary light reflex
103
**CN IV: Trochlear**
Origin
Foramen/bone
Action
midbrain
superior orbital fissure/sphenoid
M: superior oblique
104
**CN V1: Opthalmic/Trigeminal**
Origin
Foramen/bone
Action
pons
superior orbital fissure of sphenoid
S: corner of canthus to bald spot
R: afferent corneal, afferent oculocardiac
"Oval Man, Rotate Max, Spin the Middle"
105
CN V2: Maxillary
pons
foramen rotundum of sphenoid
S:corner of canthus to corner of mouth
"Oval Man, Rotate Max, Spin the Middle"
106
CN V3: Mandibular/Trigeminal
pons
foramen ovale of sphenoid
S: corner of mouth to chin, general sensation to tongue
M: mm of mastication and tensor tympani
R: jaw jerk (afferrent and efferent)
107
CN VI: Abducens
pons
superior orbital fissure of sphenoid
M: lateral rectus
108
CN VII: Facial
pons
internal auditory meatus to stylomastoid foramen
of temporal bone
**pierces parotid**
S: "chordae tympani" from middle ear to anterior 2/3 of tongue for taste
M: facial mm and stapedius
R: efferent corneal
P: lacrimation, salivation
109
CN VIII: Vestibulocochlear
pons
internal auditory meatus, temporal bone
S: Balance (vestibulo)
Hearing (cochlear)
110
CN IX: Glossopharyngeal
medulla
jugular foramen, temporal/occipital
S: posterior 1/3 tongue - taste. middle ear
M: stylopharyngeus
R: carotid afferent, gag afferent
P: salivation (parotid glands)
111
CN X: Vagus
medulla
jugular foramen, temporal/occipital
S: tympanic membrane
M: palate, pharynx, larynx
R:carotid, gag, and oculocardiac efferent
P: palate to 1st 2/3 transverse colon
112
CN XII: Spinal Accessory
medulla
jugular foramen, temporal/occipital
M: SCM (w/CN2,3) - cont'l rotation, ipsi'l lat. flexion
traps (w/CN3,4) - forms slope of neck
O: acromion + clavicle I= sup nuchal line
113
CN XII: Hypoglossal
medulla
hypoglossal foramen, occiput
M: intrinsic mm of tongue
114
Temporalis
O: Temporal fossa
I: coronoid of mandible
closes jaw
115
Masseter
O: Zygomatic
I: external angle of jaw
closes jaw
116
Internal/medial pterygoid
O: medial pterygoid process
I: internal angle of jaw
closes jaw
117
External/lateral pterygoid
O: lateral pterygoid process
I: disc of TMJ and condyle of mandible
opens/depresses jaw
protrudes jaw
118
119
Greatest input into parasympathetics
nucleus solitarius (CN 7,9,10) for taste
120
Fovea centralis
most acute vision
has cones: bright light and colors
121
Rods
periphery
dim light, night vision
glaucoma affects rods first
122
Optic nerve decussates at
optic chiasm
nasal tracts also decussate at optic chiasm
carry temporal fields of vision
damage: bitemporal hemianopia
123
Upper Motor Neuron lesion
no inhibition
clonus because constant firing
spasticity because increased firing
= increased muscle tone
hyperreflexia from tight mm spindle
124
Lower Motor Neuron lesion
fasciculations = muscle dying, spontaneously firing
hypotonia: lose 1b and 1a afferents for tone
hyporeflexia: decrease tone on spindles
125
True Ribs
Ribs 1-7
126
False Ribs
ribs 8-10
127
Floating ribs
Ribs 11-12
128
Direction of articular facets
Cervical = AIL
Thoracic = AIM
Lumbar = AIL
129
Anterior boundary of IVF
disc, body, rib head
cervicals include uncinates
thoracics include rib heads
130
Posterior boundary of IVF
articular facets = articular pillars
Z joints
131
Superior/Inferior boundaries of IVF
pedicle or 'vertebral notch'
132
Landmarks
Hyoid bone
C3
133
Landmarks
Carotid artery bifurcation
C3, C4
134
Landmarks
Carotid tubercle
C6 transverse process
135
Landmarks
Episternal Notch
T2
136
Landmarks
Dermatome of Xyphoid process
T7
| (vertebral level T10)
137
Landmarks
Dermatome of umbilicus
T10
| (vertebral level L3)
138
Landmarks
Transpyloric Line
L1
139
Landmarks
Transtubercular Line
L5
140
2 neck mm with cranial nerve and cervical innervation
Trapezius = CN XI, cervical 3,4
SCM = CN XI, cervical 2,3
141
Muscles that elevate first four ribs during inspiration
Serratus Posterior Superior
Innervation T1-T4 thoracic/costal nn
142
Muscles that depress last four ribs during exhalation
Serratus Posterior Inferior
innervation T9-T12 thoracic/costal nn
143
Anterior scalene
inserts on scalene tubercle of first rib
located between subclavian vein and subclavian artery
144
Digastric
anterior belly: CN5
posterior belly: CN7
derived from 1st, 2nd branchial arches
form two sides of submandibular triangle
145
Galea aponeurotica
forehead fascia
146
Levator palpebrae superioris
oculomotor III
147
Levator scapulae
transverse processes of C1-C4
148
Longus capitis
flex the head and neck
149
Longus Colli
anterior tubercles and anterior surfaces of bodies of C1-T3
deep neck flexor
150
masseter
powerful m of mastication
151
mentalis
skin of the chin
152
middle scalene
upper surface of first rib
153
orbicularis oculi
closes the eyelids
CN VII facial
154
orbicularis oris
purses the lips
kissing muscle
155
palatoglossus
vagus nerve X
156
palatopharyngeus
vagus nerve x
157
posterior scalene
lateral surface of second rib
longest of scalene muscles
158
risorius
active in expressions of mirth
159
sphincter pupillae
constricts the pupil
parasympathetic fibers of oculomotor CN III
160
splenius
splenius means bandage
named for broad, flat shape
161
stapedius
derivative of second pharyngeal arch
starts second bracheal arch
**first muscle fired in a sprinter**
162
styloglossus
retracts and elevates tongue
hypoglossal nerve XII
extrinsic muscle of the tongue
163
tensor veli palatini
opens auditory tube
164
L5 Vertebra
wedge-shaped
large anteriorly, small posteriorly
fused to sacrum = sacralization
if L6 = lumbarization
**smallest spinous of all lumbars**
165
Typical ribs
Ribs 3-9
166
Atypical ribs and vertebrae
ribs 1 and 2
thoracics 10, 11, and 12
**R1**: short and flat
**R2**: surface for posterior scalene/serratus ant.
**T10**: full facet and superior demifacet
**T11,T12 body**: single full facet, floating ribs
167
Branchial Arches
1st: "Mandibular"
CN V
Trochlear
Mandible, malleus, incus
all mm of mastication
tensor tympani
tensor veli palatini
**anterior belly of digastric**
*"from jaw to stapes"*
general sensation to anterior 2/3 of tongue
168
Branchial Arches
2nd: "Hyoid"
stapes, styloid process, cornu of hyoid
CN VII Facial
mm of facial expression
stylohyoid
stapedius
**posterior belly of digastric**
taste anterior 2/3 of tongue
169
Branchial Arches
3rd: "Thymus"
CN IX
body of hyoid
greater cornu
stylopharyngeus
thymus gland
taste and general sensation to posterior 1/3 of tongue
170
Branchial Arches
4th-6th: "Thyroid and Cricoid"
CN X, Vagus
laryngeal cartilage
cricothyroid
levator veli palatine
mm of larynx
*recurrent laryngeal nerve, part of "5th" arch*
171
Ectoderm
nn and skin
172
Folic Acid
B9
Methylfolate
Tetrahydrofolate
deficiency: neural tube defects, spina bifida occulta
"Hypovitaminosis B"
cleft palate
173
Spina Bifida Vera ("true")
Spina Bifida Manifesta
meningocele, meningomyelocele, myelocele
174
175
Nucleus Pulposis collagen
type II
176
Annulus fibrosis collagen
Type I
177
what organ is found in foregut and midgut
duodenum
178
what organ is found in midgut and hindgut
transverse colon
179
DRG cell type
unipolar
180
Striking golgi tendon
stretch muscle spindles
myototic reflex = monosynaptic
181
Medial branch of dorsal primary rami
facet joint innervation
T1-T7 skin on back
182
Lateral branch of dorsal primary rami
innervation to T8-glutes
183
Back mm with nerve supply from brachial plexus
ventral primary ramus
## Footnote
**rhomboids: dorsal scapular n**
**latissimus dorsi: thoracodorsal n**
184
Voluntary motor tracts
lateral corticospinal
reticulospinal
rubrospinal
185
UMN
runs from cerebral cortex down to anterior horn, does not include alpha motor neuron (AKA"ventral/ant horn cell")
186
LMN
anterior horn to muscle
187
Final common pathway
lower motor neuron
alpha motor neuron
188
Endplate potential
alpha motor neuron innervates muscle
189
Pineal gland on level with
3rd ventricle
190
CN4
only one off posterior portion of brainstem
and contralateral side
191
Obex
at floor of 4th ventricle
## Footnote
*just below 4th ventricle - cisterna magna
"cerebellomedullary cistern"*
192
Bellies of digastric
Anterior: V
Posterior: VII
193
stylopharyngeous
CN IX
derived from 3rd br. arch
194
Myesthenia Gravis
thymus
195
Free naked nerve endings
sensitive to chemical pain/ nociception, temperature
lateral spinothalamic
crude touch
ventral spinothalamic
196
A delta fibers
extreme pain
fast pain
pressure pain
197
Unmyelinated C fibers
chemical pain
slow pain
198
Depolarization
ascending limb of spike potential
drive to Na+ equilibrium point
199
Repolarization
descending limb of spike potential
drive to K+ equilibrium point
200
Na+ movement
in direction of concentration gradient
in direction of electrochemical gradient
201
K+ movement
in direction of concentration gradient
**against** electrochemical gradient
202
Divergence
when one cell fires onto many
203
Convergence
when many cells fire onto one
"spatial summation"
204
Temporal summation
one or more cells fire **over time**
205
Inhibitory Post-Synaptic Potential
chloride ion
206
Cardioinhibitory Center
vagus → heart
slows down heart
207
Cardioacceleratory center
sympathetics → heart
increase HR
208
Reflexes to light
superior colliculi
209
Reflexes to sound
inferior colliculi
210
Corpra quadrigemini
2 superior + 2 inferior colliculi
tectum of midbrain
Cspine (tectospinal tract)
turns head in response to light or sound
CN 3 or 4
211
Somesthetic Cortex
post-central gyrus
212
Calcarine fissure
Calcarine sulcus
vision
brodmans area 17
213
Corticospinal & corticobulbar tracts
"pyramidal tracts"
start at giant cells of Betz (pyramid shaped)
214
Any motor tract NOT
Corticospinal or corticobulbar
extrapyramidal tracts
215
Broca's blood supply
middle cerebral artery
## Footnote
*mc for stroke*
216
Most common tumor of ventricles
ependymoma
217
MS
distal mm weakness
S.I.N.
* *S**lowed speech
* *I**ntention tremor
* *N**ystagmus
218
Meissner's
mucosal
219
failure of neural crest to migrate
Hirschprung's Disease
congenital megacolon
220
Wallenberg Syndrome
damage to PICA
221
Basilar artery
begins at foramen magnum,
ends as posterior cerebral artery
222
Artery of Adam Kiewitcz
large radicular artery
supplies lumbar and sacral portions of spinal cord
223
Synarthrosis
Immovable
Fibrous
Synostosis = skull sutures
Gomphosis = teeth
224
Amphiarthrosis
Slightly movable
cartilagenous
**synchondrosis** = epiphyseal plates, *hyaline* *cartilage*
**symphysis** = IVD, pubic symph, *fibrocartilage*
**syndesmosis** = tib/fib, *interosseous membrane*
225
Diarthrosis
Freely Movable
Synovial
_Uniaxial_
* *hinge/ginglymus =** phalanges
* *pivot/trochoid** = rotatory, C1/C2
_Biaxial_
* *ovoid** = MCP, TMJ, knee (modified)
* *saddle/sellar =** sternoclavicular jts
_Triaxial_
* *gliding/planar** = facets, intercarpal/intertarsal
* *ball and socket =** shoulder, hip
*\*SI jts are atypical diarthrodial*
226
Schindylesis
perpendicular articulation of ethmoid and vomer
227
C3 C4 C5
keeps the human alive
phrenic → diaphragm
228
C5 C6 C7
long thoracic n → serratus anterior
"SA/LT"
damage = scapular winging
229
Femoral Nerve
off posterior divisions of L2 L3 L4
| (even though its in front)
230
Obturator Nerve
off anterior divisions of L2 L3 L4
231
Cords of brachial plexus
named for relationship to axillary artery
232
Brachial Plexus
Lateral Cord
musculocutaneous n → biceps, coracobrachialis, brachialis
233
Brachial Plexus
Medial Cord
ulnar nerve → all adductors
234
Brachial Plexus
Posterior Cord
axillary n → deltoid, teres minor
subscapularis → (lower) to t. major
radial n → all extensors of forearm, wrist, hand, supinator mm, branches to fingers (posterior interosseous nerve)
median → pronators, all flexors of wrist and hand
(branches to anterior interosseous)
235
Flexor digitorum profundus
dual innervation
*"dual innervation is profound"*
medial and ulnar nn
236
Axillary n
sensory
shoulder → elbow
237
musculocutaneous n
sensation
lateral elbow → wrist
"lateral antebrachiocutaneous"
238
Medial cord
medial senseation elbow → wrist
"medial antebrachialcutaneous"
239
Superficial branch of radial n
all posterior structures from shoulder down
240
fracture of surgical neck of humerus
axillary n damage
241
fracture to mid-shaft of humerus
radial nerve damage
242
Subclavian artery
to first rib
@ R1, becomes axillary artery
@ t major, becomes brachial artery
243
Lumbosacral Plexus
| (runs L4-S2/S3)
gluteal nerves
@L5-S1: superior gluteal → g med & min
@S1-S2: inferior gluteal → g max
244
Sciatic Nerve
comes out of back as common peroneal and tibial, down back of leg
245
tibial branch of sciatic
→ hamstrings
EXCEPT: short head of bic. femoris = common peroneal
con't back of leg to plantarflexors
gastroc, soleus, plantaris
ends in foot as medial and lateral plantar nerves
246
short head of biceps femoris
common peroneal
247
fracture at head or neck of fibula
damage to common peroneal
| (wraps around, splits into deep/superficial)
248
Deep peroneal nerve
anterior tibialis
peroneous tertious
= dorsiflexion
249
Superficial Peroneal
peroneous longus and brevis
= eversion
250
Sensory to posterior thigh
posterior femoral cutaneous
251
Sensory to lateral thigh
lateral femoral cutaneous n
L2/L3
damage = myralgia paresthetica
252
Sensory from anterior thigh
femoral
253
Sensory from medial thigh
obturator
254
Sensory from posterolateral leg
sural nerve from sciatic
255
sensory from anteromedial leg
saphenous from femoral
256
Sensory from webbing between toes
superficial peroneal
EXCEPT between 1st and 2nd
= deep peroneal
257
L5
flexes toes
258
S1
extends toes
259
Cervical enlargement
C5, C6
central canal expansion
*loss of sensation C5 C6 = syringomyelia*
260
Alpha Motor Neuron
controlled by cortex
extrafusal fibers
movement and strength
261
Gamma motor neuron
cerebellum (unconscious)
and vestibular nuclei
intrafusal = tone
262
Cortex
aware
263
cerebellum
unaware
264
Annulospiral/Flowerspray
primary: annulospiral
secondary: flowerspray
265
M**S**C
Muscle Spindle Cells
unconcsious
**s**tretch
1a fibers fired
**s**lightly faster
266
G**T**O
Golgi Tendon Organ
unconscious
**t**ension
1b fibers fired
267
MSC/GTO → posterior horn → cerebellum
spinocerebellar pathways
268
MSC/GTO → posterior horn → cerebellum
spinolivary tract → inferior olive of medulla → cerebellum
via climbing fibers
269
Climbing fibers
Mossy fibers
excitatory
270
Purkinje fibers
inhibitory
found in cerebellum
271
Fastigial nuclei
spine
272
any stimulus to cortex
→ to cerebellum
273
anything to cerebellum
→ to cortex
274
Tract of Lissauer
pain and nociception
275
Dorsal Nucleus of Clarke
cerebellum
| (C8-L2)
276
IML
Inter-medio-lateral
located in lateral horn from T1-L2
lamina 7
bar of H
primary neuron for sympathetics
("visceral efferents")
= motor to viscera
277
Red Nucleus
rubrospinal origin
278
Substantia Nigra
dopamine production
279
Adrenergic receptors
norepinephrine/epinephrine
280
sweat glands
Ach, muscarinic
(only in ANS)
for "sudomotor" activity
281
visceral efferents
myelinated when leaving lateral horn
282
Preganglionic Sympathetics
"white rami communicantes"
size B
most synapse at pre chain ganglion
283
Postganglionic Sympathetics
"gray rami communicantes"
C fibers
synapse at adrenal medulla
*Pheochromocytoma
284
All splanchnics
sympathetic
\*EXCEPT: S2-S4 pelvic splanchnic
= parasympathetics
pudendal nn
*keep urine off the floor, keeps mr. happy off the floor*
285
Greater splanchnic
T5-T9
286
Lesser splanchnic
T10-T11
287
Least splanchnic
T12
288
Inferior splanchnic
L1
289
Cervical Parasympathetics
CN 3,7,9,10
CN7 from second br. arch
290
Olfactory bulb of CN1
mitral cells
291
Exiting superior orbital fissure
CN 3,4,6,V1
292
Exit internal auditory meatus
CN 7 and 8
CN7 to stylomastoid foramen
to middle ear
"cauda tympani"
pierces parotid
taste sensation
\*acoustic neuroma
293
Child with middle ear infection most likely to lose
taste sensation
294
Child with mumps (parotitis) most likely to lose
taste sensation
295
Exiting jugular foramen
CN 9,10,11
296
Corneal reflex
CN5 sensory
CN7 motor
297
Parotid gland
produces only serous fluid, no mucous
Stenson's duct, opens opposite 2nd molar
298
SCM
CN11, spinal accessory
ipsilateral lateral flexor
contralateral rotator
torticollis = wry neck
299
pain and temperature from face
trigeminothalamic tract
VPM
(from body = VPL)
300
mm of mastication
"TIME"
Temporalis
Internal Pterygoid
Masseter
External Pterygoid
only mm of mastication that opens/depresses jaw
301
