Shared Flashcard Set

Details

Anatomy final
Anatomy - nervous system, back, upper limb
87
Anatomy
Graduate
12/12/2008

Additional Anatomy Flashcards

 


 

Cards

Term
Are cranial nerves a part of central nervous system?
Definition
No, they are a part of the PNS
Term
Define ganglion and nucleus
Definition

Ganglion - collection of cells outside of the CNS

 

Nucleus - collection of cells in the CNS

Term
Can CNS axons regenerate?
Definition

No

But they can in the PNS if cell bosy remains intact and myelinating Schwann cells remain active

Term
Where does spinal cord begin and end?
Definition

Begins at foramen magnum

Ends at vertebral L1-L2 level

Term
What enlargements/thickenings are found in the spinal cord?
Definition
Cervical (for upper limb) and lumbosacral (for lower limb)
Term

How many pairs of cranial nerves are there?

How about spinal nerves? 

Definition

12 pairs of  cranial nerves

31 pairs of spinal nerves (8C, 12T, 5L, 5S, 1CC)

Term
What is the end of the spinal cord known as?
Definition
Conus medullaris
Term
How do we name spinal nerves in the relation to the vertebra they are associated with?
Definition

C1 - between skull and atlas (above C1 vertebra)

C2-C7 - above the corresponding vertebrae

C8 - below C7 vertebra

all the others - below corresponding vertebrae

Term

What makes up a spinal nerve?

What does a spinal nerve split into?

Definition

Dorsal root (sensory) + ventral root (motor)

 

Spinal nerves are very short; after 1 cm they divide into dorsal primary ramus and ventral primary ramus (both of those are mixed nerves - motor and sensory)

Term
What innervates erector spinae muscles of the back?
Definition
Dorsal primary rami of spinal nerves
Term
Where can we find cell bodies of sensory neurons in spinal cord?
Definition
In dorsal root ganglia
Term
Where are the cell bodies of spinal motor neurons found?
Definition
In the ventral (anterior) horn of spinal cord
Term

Key dermatomes:

C6

C8

C5-T2

T4

T10

Definition

C6 - thumb

C8 - little finger

C5-T2 - upper limb

T4 - nipple

T10 - umbilicus

Term
At what spinal level does dura mater end?
Definition

S2 - ends as a blind sac

 

Dural filum terminale (a.k.a. coccygeal ligament) is attached to the coccyx

Term

Epidural space

Subdural space

Subarachnoid space

Definition

Epidural - between skull and dura

Subdural - potential space above arachnoid

Subarachnoid - between arachnoid and pia; filled with CSF

Term
At what spinal level does pia mater end?
Definition
L2; after that continues as pial filum terminale within coccygeal ligament
Term
Where would you do a lumbar puncture/spinal tap?
Definition

between L3 and L4 or between L4 and L5

 

Use highest points of iliac crests as a landmark to get into the subarachnoid space

Term

What spinal neurons does polio virus affect?

How about Herpes zoster?

How about herniated intervertebral disk - what does it compress?

Definition

Polio - ventral horn motor neurons

Herpes zoster - dorsal root ganglia

 

Herniated disk - nucleus pulposus compresses the spinal nerve (both sensory and motor)-generally one associated with lower vertebra(L4-L5 disk --> L5 nerve root)

Term

Kyphosis

Lordosis

Scoliosis

Definition

Kyphosis - posterior convex (thoracic)

Lordosis - lumbar (anterior curvature)

Scoliosis - lateral curvature

Term
Erector spinae muscles
Definition

Spinalis, longissimus, iliocostalis

Innervated by dorsal rami of spinal nerves

Laterally bend and extend the back

Term
Sympathetic nervous system
Definition

Preganglionic - in lateral horn in T1-L2; axons leave in ventral roots and enter T1-L2 spinal nerves; leave nerves in white rami communicans (myelinated) and enter sympathetic chain ganglia; synapse and re-enter spinal nerves as gray rami communicans. Some pass through ganglia without synapsing and leave ganglia as thoracic and lumbar splanchnic nerves on the way to abdominal and pelvic ganglia.

 

The ones from above and below T1 and L2 travel in sympathetic chain until they reach cervical, lower lumbar and sacral ganglia; no white rami at these levels.

Thus there are 14 white rami communicans and 31 gray rami communicans  

Term
Parasympathetic nervous system
Definition

Preganglionic neurons are in brain stem (CN 3,7,9,10) and in S2-S4 spinal segments (travel in spinal nerves S2-S4 nerves and branch off as pelvic splanchnic nerves)

 

Brainstem ganglia are - ciliary, pterygopalatine, submandibular and otic; there also are thoracic and abdominal ganglia (receive fibers from CN X) and pelvic ganglia (pelvic splanchnic nerves)

Term
Horner's syndrome
Definition

Ptosis, miosis (constricted pupil) and anhydrosis (lack of sweating in the face)

 

SNS issue - cervical sympathetic chain

Term

Are pectoral and pelvic girdles a part of axial skeleton?

Definition
No; they are a part of appendicular skeleton
Term
Condyle
Definition

A rounded part of a bone that forms part of a joint

(i.e. capitulum [radius] and trochlea [ulna] for the humerus)

Term
Epicondyle
Definition
A raised region near a condyle; typically where muscles that extend across the joint formed by a condyle attach
Term
Synovial joint
Definition

Surrounded by tough outer fibrous capsule and thin inner lining that keeps small amount of synovial fluid between the articulating surfaces

 

Includes ball and socket joint and hinge joint

Term
Anterior compartment of the arm
Definition

Muscles that flex shoulder and/or elbow

Innervated by musculocutaneous nerve

Term
Posterior compartment of the arm
Definition

Muscles extend shoulder and/or elbow

Innervated by radial nerve

Term
Biceps brachii
Definition

Primary flexor of the elbow

Supinates the forearm

Crosses 3 joints - elbow, glenohumeral, proximal radioulnar)

Innervated by musculocutaneous nerve

Long head originates from sup. glenoid fossa;

short head - from coracoid process of scapula

Both heads insert onto radial tuberosity 

 

Term

Dermatomes of the upper limb:

C6, C7, C8

Definition

C6 - lateral forearm and thumb

C7 - posterior forearm and middle finger

C8 - medial forearm and little finger

Term
What helps you raise your arm above the horizontal plane?
Definition
Lateral rotation of the scapula (for reference - inferior angle of the scapula moves laterally)
Term
Pectoralis major
Definition

O: medial clavicle, sternum, costal cartilages

I: humerus

Innervation - medial and lateral pectoral nerves

Action - aDDucts and medially rotates humerus

Term
Pectoralis minor
Definition

O: ribs 3-5

I: coracoid process of scapula

Innervation - medial pectoral nerve

Action - stabilize and medially rotate scapula, accessory muscle of respiration

Term
Serratus anterior
Definition

O: ribs 1-8

I: anterior surface of medial scapular border

Innervation - long thoracic nerve (runs superficial to the muscle)

Action - lateral rotation of scapula to permit abduction of scapula above the horizontal plane

 

Injury --> "winged scapula"

Term
Deltoid muscle
Definition

O: clavicle, acromion, scapular spine

I: deltoid tuberosity of humerus

Innervation - axillary nerve

Action - everything except ADDuction

Term
Name 4 rotator cuff muscles
Definition

SITS

 

Supraspinatus

Infraspinatus

Teres minor

Subscapularis

Term
Supraspinatus
Definition

O: supraspinous fossa of scapula

I: greater tubercle of humerus

Innervation - suprascapular nerve

Action - stabilizes joint; assists onset of aBduction

Term
Infraspinatus
Definition

O: infraspinous fossa of scapula

I: greater tubercle of humerus

Innervation - suprascapular nerve

Action - laterally rotate arm, stabilize joint

Term
Teres minor
Definition

O: lateral border of scapula

I: greater tubercle of humerus

Innervation - axillary nerve

Action - lateral rotation of arm, joint stabilization

Term
Subscapularis
Definition

O: subscapular fossa

I: lesser tubercle of humerus

Innervation - upper and lower subscapular nerves

Action - medially rotate humerus; joint stabilization

Term
What is the most common injury in the rotator cuff injury?
Definition
Supraspinatus tendon
Term
Teres major
Definition

O: inferior angle of scapula

I: shart of humerus

Inervation - lower subscapular nerve

Action - aDDucts and medially rotates arm

Term
Triangle of auscultation
Definition
Bordered by trapezius, latissimus dorsi and rhomboid (or medial border of scapula, whatever)
Term
What artery does thyrocervical trunk branch off?
Definition
Subscapular artery
Term
Name 3 parts of axillary artery and branches in each part
Definition

Screw the lawyers, save a patient

 

1 - superior thoracic artery

2 - thoracoacromial artery, lateral thoracic artery

3 - posterior and anterior humeral circumflex arteries, subscapular artery(this one later divides into thoracodorsal and circumflex scapular)

Term
What 5 parts is brachial plexus divided into?
Definition

Richard Tucker Drinks Cold Beer

 

R - rami (C6-T1)

T - trunks (upper [C5,C6], middle [C7], lower [C8,T1])

D - divisions (anterior and posterior)

C - cords (lateral, posterior, medial)

B - branches(axillary, radial, musculocutaneous, median, ulnar)

Term
Axillary nerve
Definition

C5 and C6

Travels through quadrangular space

Innervates deltoid and teres minor

Becomes superior lateral cutaneous nerve of the arm (supplies small patch of skin over the shoulder)

Term
Radial nerve
Definition

C5-C8

Wraps around the shaft of humerus (frequently injured here)

Sensation on skin over posterior arm, forearm,  dorsum of hand 

Innervates extensors of arm and forearm

Superficial branch suppiles dorsum of radial side if hand; until wrist travels deep to brachioradialis

Deep branch supplies extensor carpi radialis brevis and supinator Posterior interosseous nerve after comes out of the supinator

Injury results in wrist drop

Term
Musculocutaneous nerve
Definition

Mostly C5 and C6

Thravels through coracobrachialis muscle (can get compressed here)

Innervates anterior compartment of the arm

Continues as lateral cutaneous nerve of the forearm to the lateral forearm

Term
Median nerve
Definition

C6-T1

Innervates anterior compartment of the forearm and thenar compartment

(Rule of anterior compartment of the forearm - median nerve innervates muscles that flex the fingrs and pronate the forearm - exception is flexor carpi ulnaris)

Supplies most of the palm and index and middle fingers with sensation

Term
Ulnar nerve
Definition

C8 and T1

Innervates some forearm muscles

Primary nerve to small muscles of the hand

Supplies skin on the ulnar side of the hand, little finger and ulnar side of the ring finger with sensation

Passes posterior to middle epicondyle of humerus

Term
Long thoracic nerve
Definition

C5, C6, C7

Innervates serratus anterior

Runs superficial to the muscle - easily injured here

Term
Dorsal scapular nerve
Definition

Comes from ventral ramus of C5

Innervates rhomboids and levator scapulae

Term
Suprascapular nerve
Definition

From upper trunk (C6 and C7)

Innervates suprasinatus and infraspinatus

Term
Medial and lateral pectoral nerves
Definition

Medial - from medial cord; innervates pectoralis major and minor

 

Lateral - from lateral cord; innervates pectoralis major

Term
Upper subscapular nerve
Definition

From posterior cord

Innervates subscapularis

Term

Middle subscapular nerve

(a.k.a nerve to latisimus dorsi)

(a.k.a. thoracodorsal nerve)

Definition

From posterior cord

Innervates latissimus dorsi

Term
Lower subscapular nerve
Definition

From posterior cord

Innervates subscapularis and teres major

Term
Medial brachial and medial antebrachial cutaneous nerves
Definition

From medial cord

Supply skin on medial arm and forearm

Term
Coracobrachialis
Definition

O: coracoid process of scapula

I: shaft of humerus

Innervation - musculocutaneous nerve (C6)

Action - flexes and aDDucts arm

Term
Brachialis
Definition

O: shaft of humerus

I: ulna

Innervation - musculocutaneous nerve

Action - flexes forearm

Term
Triceps brachii
Definition

O: long head of scapula

I: olecranon

Innervation - radial nerve (esp. C7)

Action - extends forearm

 

Long head crosses glenohumeral joint

Term

Clinical correlate:

muscles of anterior compartment are innervated primarily by C6

Muscles of posterior compartment are innervated mainly by C7

 So C7 injury will affect primarily posterior compartment and anterior should be ok

Definition
Yeah.... it was just a clinical correlate, not a question. Sorry.
Term
The injury of which nerve results in "wrist drop"?
Definition

Radial nerve.

 Lose extensors and so wrist remians flexed

Term
Anterior compartment of the forearm - superficial layer
Definition

Flexor carpi radialis - median n. (flex, aBducts)

Palmaris longus - median n.

Flexor carpi radialis - ulnar n. (flex, aDDucts)

Pronator teres - median n. [C7] (also flexes forearm)

 

Term
Common flexor origin of forearm
Definition

Medial epicondyle

 

Injury results in "golfer's elbow"

Term
Anterior compartment of the forearm - intermediate layer
Definition

Flexor digitorum superficialis - median n.

Flexes MP and PIP joints

Term
Anterior compartment of the forearm - deep layer
Definition

 Flexor digitorum profundis - 1/2 median nerve, 1/2 ulnar nerve

Flexor pollicis longus - median n.

Pronator quadratus - median n.

Term
What is the exception to the rule "Median nerve innervates anterior compartment of the forearm"?
Definition
Ulnar nerve innervates one and a half muscles - flexor carpi ulnaris and 1/2 of flexor digitorum profundis
Term
Median nerve injury
Definition

Can get injured between 2 heads of pronator teres (pronator syndrome) or in carpal tunnel

Severely limited movement of thumb and wasting of thenar eminence

Loss of cutaneous sensation in hand and fingers - test tip of index finger

Lose fine motor control of index finger

Bishop's hand - if injury higher up

Term
Wrist bones
Definition

Some Lovers Try Positions That They Can't Handle (proximal to distal row, radial to ulnar)

Scaphoid

Lunate (can compress median nerve)

Triquetrum

Pisiform (sesamoid - in tendon of flexor carpi ulnaris)

 Trapezium ("base of thumb")

 Trapezoid

Capitate

Hamate (with hook)

Term
Carpal tunnel
Definition

Covered by flexor retinaculum

9 tendons and 1 nerve

[Flexor digitorum superficialis and profundus and flexor pollicis longus

Median nerve]

No major vessels pass through carpal tunnel

Term
Thenar compartment of the hand
Definition

Innervated by recurrent branch of median nerve (C8)

Abductor pollicis brevis

Flexor pollicis brevis

Opponens pollicis

Term
Hypothenar compartment of the hand
Definition

Deep branch of ulnar nerve (T1)

 

Abductor digiti minimi

Flexor digiti minimi

Opponens digiti minimi

Term
Central compartment of the hand
Definition

"Bye-bye muscles" - flex MP, extend IP

Lumbricals - from tendons of flexor digitorum profundus to extensor expansion; innervated by median nerve and deep branch of ulnar n.

Palmar interossei (PAD) - deep branch of ulnar nerve

Dorsal interossei (DAB) - deep branch of ulnar nerve

Test - by ability to adduct/abduct fingers (T1)

Adductor pollicis - deep branch of ulnar nerve

 

Term
Cutaneous innervation of the hand
Definition

Ulnar - tip of little finger

Median - tip of index finger

Radial (superficial branch) - skin on dorsal webbing of thumb

Term
Testing dermatomes of the hand
Definition

C6 - dorsum of thumb

C7 - tip of middle finger

C8 - tip of little finger

Term
Ulnar nerve injury
Definition

Injured at medial epicondyle or in canal of Guyon at the wrist

Impaired abduction/adduction of fingers

Uncoordinated fingers

Claw hand - 4th and 5th MPs hyperextended at rest

Paresthesia in ulnar palm and little finger - test little finger

Term
Superficial palmar arch
Definition
Ulnar artery + superficial branch of radial artery
Term
Deep palmar arch
Definition
Deep branch of ulnar artery + radial artery
Term
Posterior compartment of the arm - superficial layer
Definition

All innervated by radial nerve

Brachioradialis - C6; flexes forearm

 Extensor carpi radialis longus - C6 and C7

Extensor carpi radialis brevis

Extensor digitorum (mainly MP joints, weak IP)

Extensor digiti minimi

Extensor carpi ulnaris

All but ECRL and brachioradialis come from common extensor origin - lateral epicondyle

Term
Common extensor origin
Definition

Lateral epicondyle

Posterior forearm except for brachioradialis (which is a flexor, so no worries) and extensor carpi radialis longus

 

Injury = tennis elbow

Term
Posterior compartment of the forearm - deep layer
Definition

All innervated by radial nerve

 

Supinator

Extensor indicis

3 outcropper muscles - extensor pollicis longus and brevis and abductor pollicis longus

Term
Anatomical snuffbox
Definition

Between the tendons of the outcropper muscles - extensor pollicis longus and brevis and abductor pollicis longus

 

Indicates fractured scaphoid bone

Palpate pulse of the radial artery here

Term
Erb palsy
Definition

Trauma to upper trunk of brachial plexus - lose C5 and C6

Radial - lose C6 muscles - brachioradialis and ECRL

Lose most of musculocutaneous - flexors of arm

Lose lateral pectoral n., upper and lower subscapular n., suprascapular nerve

 Result - lose aBduction and lateral rotation; see upper limb aDducted and medially rotated, elbow extended and pronated at rest; flexed wrist - "head waiter's tip hand"

Term
Describe collateral circulation from subclavian to brachial artery (bypass axilary artery)
Definition
Subclavian -> thyrocervical trunk -> suprascapular -> circumflex scapular -> subscapular -> 3rd part of axillary artery -> brachial artery
Supporting users have an ad free experience!