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Anatomy questions
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103
Anatomy
6th Grade
03/16/2012

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Term
NERVE LESION:
surgical neck of humerus
Definition
Axillary
Term
NERVE LESION:
Dislocation of shoulder
Definition
Axillary
Term
problem of adduction from 10-90 degrees

(what other muscle is lost? what sensory loss?)
Definition
axillary nerve lesion

- Teres minor (lateral rotation is weakened)
- lateral side of upper arm
Term
NERVE LESION:
Removal of lymph nodes during mastectomy
Definition
Long thoracic

(may also be lesioned by a stab wound)
Term
NERVE LESION:
Humerus fracture @ midshaft
Definition
Radius
Term
NERVE LESION:
improper use of crutches
Definition
Radius
Term
loss in radial nerve injury?
motor & sensory
Definition
MOTOR:
- extensor compartments (triceps are usually weak, but still functional; forarm muscles are useless)
- supinator

SENSORY:
- posterior forearm
- lateral aspect of dorsum of hand
Term
NERVE LESION:
Supracondylar fracture of humerus
Definition
Median nerve
Term
Proximal median nerve lacerations Sx?
Definition
(i.e. in a suprcondylar fracture)
Motor:
- all forearm flexors except flexar carpi ulnaris & medial 1/2 flexor digitorum profundus (ulnar deviation on wrist flexion & no DIP flexion of digits 2&3)
- loss of pronation
- 1st & 2nd lumbricles
- thumb muscles except adductor (ulnar N)

Sensory:
- median nerve distribution of hand

Thenar muscle wasting --> ape hand
Term
Ape hand
Definition
Median nerve damage (proximal or distal)

(this means flattening of thenar eminence & inability to oppose)
Term
NERVE LESION:
Suicide attempt
Definition
Median nerve (slashing wrist)
Term
NERVE LESION:
carpal tunnel/lunate dislocation
Definition
median nerve
Term
distal median nerve lesion Sx?
Definition
Motor: only hand manifestations
- thenar muscles (abductor, opponens, flexor)

Sensory:
- median nerve distribution of hand
- nebulous wrist pain & decreased grip strength in carpal tunnel; loss of sensation in fingers, but not palm
Term
NERVE LESION:
Medial epicondyle of humerus
Definition
Proximal ulnar nerve
Term
NERVE LESION:
ulnar subluxation
Definition
proximal ulnar nerve
Term
Proximal ulnar nerve lesion effects
Definition
Motor:
- flexor carpi ulnaris & ulnar portion of FDP (radial deviation on wrist flexion & DIP flexion of last 2 fingers lost)
- 4th&5th lumbricles
- interosseus muscles (can't ab/adduct fingers)
- adductor pollicis
- all the little finger muscles (digiti minimi)

Sensory:
- ulnar distribution of hand


2 possible manifestations:
- Popes blessing: loss of lumbricles --> hyperextension of MP & flexion of PIP/DIP of 4th&5th digits
- Claw hand: paralysis of ulnar 1/2 of FDP --> clawing when making fist
Term
NERVE LESION:
Slashing of wrist, hook of hamate fracture
Definition
Distal ulnar nerve
Term
Distal ulnar nerve lesion
Definition
Motor:
- no forearm deficits
- lumbricles of 4th & 5th digit --> pope's blessing
- interosseus mucles --> can't ab/adduct fingers
- adductor pollicis
- digiti minimi muscles

Sensory:
- ulnar hand distribution
Term
NERVE LESION:
Violent stretch btw head & shoulder
Definition
upper trunk of brachial plexus (C5&6)

Erb's palsy --> arm medially rotated & pronated (waiter's tip)

(From paralysis of C5&C6 --> biceps (musculocutaneous) & subscapular muscle (lower&upper subscapular nerves in posterior cord, but they derive from C5& C6)
Term
NERVE LESION:
sudden pull upward of arm
Definition
Lower trunk of brachial plexus (C8 & T1)

Klumpke's palsy

Loss of function of hand and wrist (claw hand)
Term
What goes through flexor retinaculum?
Definition
FDS, FDP, Flexor pollicis longus, & median nerve
Term
Contents of cubital fossa
Definition
From lateral to medial:
-Radial nerve
- Biceps tendon
- Brachial artery
- Median nerve

- medial cubital vein is a superficial boundary

Boundaries of cubtial fossa:
Superior: medial/lateral epicondyle of humerus
Medial: pronator teres
Lateral: brachioradialis
Term
Colle's fracture
Definition
most common wrist fracture:
- Fracture of distal radius pulls it posterior & shortens it (dinner-fork deformity)
- often accompanied by fracture of styloid process of ulna
Term
avascular necrosis w/ this wrist fracture
Definition
scaphoid (distal-to-proximal blood flow)
Term
where can you palpate anterior tibial artery?
Definition
dorsalis pedis pulse (courses w/ deep peroneal nerve)
Term
Where can you palpate posterior tibial artery?
Definition
behind medial malleolus (courses w/ tibial nerve)

Posterior tibial also gives off peroneal artery, which passes behind lateral malleolus
Term
major blood supply to head & neck of femur
Definition
medial femoral circumflex artery
Term
NERVE LESIONS:
surgery above piriformis in greater sciatic foramen; polio
Definition
Superior gluteal (Trendelenburg's sign)
Term
Things you can get Trendelenburg's sign w/?
Definition
- superior gluteal nerve lesion (above piriformis in greater sciatic foramen)
- Gluteus medius/minimus paralysis
- Polio
- Congenital/acquired hip dislocations
- Femur fractures
- Coxa vara
Term
which hip falls if you have a lesion of the right superior glueteal nerve?
Definition
left hip (the right glut medius/maximus holds up the left hip)
Term
NERVE LESIONS:
inferior greater sciatic foramen (2)
Definition
sciatic nerve & inferior gluteal
Term
can't get out of chair, climb stairs, or jump

Will lean backwards before heal strike when walking
Definition
inferior gluteal nerve injury (glut max)
Term
can't adduct thigh & sensation is lost on medial aspect
Definition
obturator (rarely injured)

(courses in/around psoas --> follows internal iliac to obturator vessels --> exits through obturator foramen)
Term
NERVE LESIONS:
Trauma to femoral triangle
Definition
femoral nerve
Term
femoral nerve injury Sx?
Definition
Motor:
- Iliacus & sartorius --> weakened flexion of thigh
- quadriceps femors --> loss of leg extension

Sensory:
- anterior thigh
- medial leg & foot
Term
NERVE LESIONS:
Popliteal fossa trauma
Definition
Tibial nerve
Term
Tibial nerve paralysis Sx?
Definition
Motor:
- Gastroc, soleus, plantaris --> can't plantar flex foot
- can't flex toes (FDL & flexor ballucis longus)
- Tibialis posterior --> weakened inversion

Sensory:
- sole of foot
Term
NERVE LESIONS:
Calcaneovalgocavus (i.e. dorsiflexion & eversion of foot)
Definition
Tibial (popliteal fossa injury)
Term
NERVE LESIONS:
fracture of neck of fibula/blow to lateral leg
Definition
common fibular (peroneal) nerve
Term
NERVE LESIONS:
footdrop & inversion of foot --> high stepping gate
Definition
common fibular (peroneal)
Term
Common fibular (peroneal) nerve lesion
Definition
Motor:
- eversion lost (peroneus longus&brevis)
- foot drop (peroneus longus)
- loss of toe extention (extensor digitorum & ballucis longus)

Sensory:
- anterolateral leg
- Dorsum of foot (between 1st & 2nd phalanges is deep peroneal, everything else is superficial peroneal)
Term
Lower limb flexed at hip joint, adducted, medially rotated, & shorter than opposite limb
Definition
posterior dislocation of hip; sciatic nerve may be damaged
Term
where does the great saphenous join femoral vein?
Definition
femoral triangle
Term
where does the ACL attach?
Definition
anterior tibia, posterior femur (prevents anterior displacement
Term
Lateral blow to knee?
Definition
unhappy triad:
-MCL
-ACL
- medial meniscus or lateral meniscus, can't figure out who's right w/ this
Term
Pott's fracture
Definition
ankle forcibly everted --> medial ligament torn, which avulses medial malleolus --> ankle moves laterally --> fibula fractured
Term
what is anterior to medial maleolus of ankle?
Definition
- saphenous nerve (sensation of medial leg)
- great saphenous vein (drainage of medial leg & thigh)
Term
What is posterior to medial maleolus in order of most anterior to most posteior
Definition
- Tibialis anterior
- Flexor Digitorum longus
- tibial nerve & posterior tibial artery
- Flexor Hallucis longus
Term
Name branches of internal carotid
Definition
No branches in neck, 3 branches in cranium:
- Ophthalmic (goes through superior orbital fissure)
- Anterior cerebral
- Middle cerebral
Term
Name branches of external carotid (8, all in neck)
Definition
- superior thyroid
- Lingual
- Facial
- Ascending pharyngeal
- Occipital
- Posterior auricular
- Superficial temporal
- Maxillary (middle meningeal is a branch)
Term
what gives rise to the middle meningeal artery & what foramen does it come through?
Definition
External carotid --> maxillary artery --> middle meningeal

foramen spinosum --> epidural hematoma
Term
What provides most venous drainage of face?

How can this vein cause a meningitis?
Definition
facial vein (drains into internal jugular)

Facial vein collects blood from the cavernous sinus through the superior ophtalmic vein (danger zone of face)
Term
connects facial vein w/ cavernous sinus
Definition
superior ophthalmic vein
Term
Describe cervical triangles by answering these questions:

- What divides anterior/posterior triangles?
- What is the carotid triangle
- What is the occipital triangle
Definition
- Sternocleidomastoid
- Anterioinferior: anterior omohyoid ; Anterosuperior: posterior digastric ; Posterior: SCM
CT has (CA, Internal JV, CN X)*, ansa cervicalis, sympathetic trunk, CN XI, CN XII)

- Anterior: SCM; Inferior: posterior digastric; Posterior: trapezius
OT has:
Arteries: transverse cervical, suprascapular, subclavian, -external jugular vein

Nerves: Brachial plexus, phrenic, lesser occipital, greater auricular, transverse cervical, supraclavicular, XI
Term
knife wound to posterior triangle --> can't abduct arm past 90 degrees
Definition
CN XI --> Trapezius muscle paralyzation
Term
where is the brachia plexus (in terms of neck anatomy)
Definition
posterior triangle (occipital triangle) between anterior & medial scalenes
Term
how does the internal jugular/carotid/vagus neurovascular bundle run
Definition
medial to lateral: carotid, vagus, internal jugular
Term
only muscle that abducts vocal cords
Definition
cricoarytenoid
Term
only muscle not innervated by recurrent laryngeal
Definition
cricothyroid (external branch of superior laryngeal, from vagus)
Term
what does bilateral damage to recurrent laryngeal nerves cause?
Definition
dyspnea (b.c. vocal folds move down & close off air passage
Term
fracture of temporal/parietal bones
Definition
epidural hematoma
Term
Name 11 cranial foramen & the structures that pass through each.
Definition
1) Cribriform plate: CN 1
2) Optic canal: CN2, retinal artery
3) Superior orbital fissure: CN3,4,6,&V1; superior ophthalmic vessels
4) Foramen rotundum: V2
5) Foramen ovale: V3, lesser petrosal nerve
6) Foramen spinosum: middle meningeal
7) Foramen lacerum: internal carotid
8) Internal auditory meatus: VII & VIII
9) Jugular foramen: IX, X, XI, sigmoid sinus (fracture causes uvula paralysis & inability to shrug shoulders)
10) Hypoglossal canal: XII
11) Foramen Magnum: medulla, XI, Vertebral arteries

1 is in anterior fossa (ethmoid)
2-8 are in middle fossa (sphenoid)
9-11 are in posterior fossa (temporal & occipital)
Term
herniation w/ epidural hematoma?
Definition
uncal --> compress CNIII

(middle meningeal artery)
Term
headache --> blood seen on csf tap
Definition
subarachnoid hemorrhage (don't see blood in CSF for other brain hemorrhages)
Term
what ligament limits excess neck movement (shaking head no)
Definition
alar ligaments (atlantoaxial joint); left ligament limis turning head to right

(aside: nodding head yes is the atlanto-occipital joint)
Term
cruciform (transverse) ligament rupture
Definition
dens goes into brain --> quadriplegia or death
Term
whiplash stretches which tendon
Definition
anterior longitudinal
Term
breast lung & prostate cancer spread to brain via?
Definition
vertebral venus plexus (communicate w/ dural sinuses)
Term
H-shaped vertebra
Definition
sickle cell (central depressions in vertebral body from avascular necrosis due to sickling in vertebral arteries)
Term
A herniated disc will always impinge on which nerve route (e.g. herniation btw T4&T5)
Definition
the bottom one (e.g. T5)
Term
pedicles don't develop properly --> anterior vertebral displacement
Definition
Spondylolisthesis
Term
Fracture of lamina between articular processes --> vertebral body dislocation
Definition
Spondylolysis
Term
Ossification of annulus fibrosis (bamboo spine); inflammatory infiltrate; HLA-B27
Definition
Ankylosing Spondylitis
Term
Vertebral level of:
- Carotid bifurcation
- Thyroid cartilage
- Cricoid cartilage (& start of trachea/esophagus)
- Sternal notch
- Sternal angle/carina
- Hilum (covers 3)
- IVC hiatus
- Esophageal Hiatus
- Aortic Hiatus
- Kidneys
- Celiac
- SMA
- Renal arteries
- Gonadal arteries
- IMA/end of spinal cord/ umbilicus
- Iliac crest/aortic bifurcation
- end of dural sac
- end of sigmoid colon
Definition
- Carotid bifurcation: C4
- Thyroid cartilage: C5
- Cricoid cartilage (& start of trachea/esophagus): C6
- Sternal notch: T2
- Sternal angle/carina: T4
- Hilum (covers 3): T5-7
- IVC hiatus: T8
- Esophageal Hiatus: T10
- Aortic Hiatus: T12
- Kidneys: T12-L3 (12th rib is immediately deep to left kidney)
- Celiac: T12
- SMA: L1
- Renal arteries: L1
- Gonadal arteries/end of spinal cord: L2
- IMA/ umbilicus: L3
- Iliac crest/aortic bifurcation: L4
- end of dural sac: S2
- end of sigmoid colon: S3
Term
anterior spinal artery supplies how much spinal cord?
Definition
anterior 2/3s
Term
Important blood supply to lower part of spinal cord
Definition
great radicular artery of adamkiewicz

comes directly off aorta: can be damaged during repair of AAA --> person becomes paraplegic & has bladder/bowel incontinence
Term
name layers when doing epidural
Definition
skin
superficial fascia
supraspinous ligament
infraspinous ligament
ligamentum flavum
epidural space (has internal vertebral venous plexus)
dura mater
arachnoid
Term
Name dermatome for specific landmark:
- Clavicle:
- Thumb:
- Middle & index fingers:
- Ring & little fingers:
- Nipples:
- Umbilicus:
- Inguinal region:
- Anterior & medial surface of lower limb
- Big toe:
- Dorsum of foot:
- Lateral surface of foot & little toe:
- Perineum
Definition
- Clavicle: C5
- Thumb: C6
- Middle & index fingers: C7
- Ring & little fingers: C8
- Nipples: T4
- Umbilicus: T10
- Inguinal region: T12
- Anterior & medial surface of lower limb: L1-4
- Big toe: L4
- Dorsum of foot: L5 (Tibial nerve)
- Lateral surface of foot & little toe: S1
- Perineum: S2,3,4 (pudendal)
Term
Scottie dog appearance of lumbar vertebra, what is the:
- Eye:
- Head:
- Collar:
- Front leg:
- Back leg & Body:
Definition
- Eye: Pedicle
- Head: transverse process
- Collar: Pars intarticularis (thing fractured in spondylolysis)
- Front leg: inferior articular process
- Back leg/Body: spinous process & lamina
Term
where do you insert a subclavian venous catheter
Definition
midclavicular line, below the clavicle; must go through skin, superficial fascia, subclavius muscle, & clavipectoral fascia

(the anterior scalene & R subclavian artery are located posterior to the vein, improper insertion = hemothorax)
Term
the central tendon of the diaphragm lies directly posterior to...
Definition
the xyphoid-sternal notch
Term
person w/ bronchogenic carcinoma has a displaced carina
Definition
- mets to tracheobronchial lymph nodes
Term
single enlarged node at the head of the clavicle
Definition
Virchow's node: primary cancer of upper abdomen (usually gastric adenocarcinoma)
Term
pt px w/ right sided diaphragm paralysis, hoarseness, pain in shoulder & axilla, & horners on right side
Definition
tumor @ apex of lung
- phrenic nerve
- recurrent laryngeal nerve
- superior thoracic nerve
- sympathetic chain
Term
cancer of the scrotum mets ___
cancer of the testes mets ____
Definition
- superficial inguinal nodes
- deep lumbar nodes (para-aortic)
Term
Name layers of flank abdomen & the corresponding layers int he scrotal sac
Definition
- Skin --> skin
- Campers/scarpas fascia --> Colles/Dartos fascia
- External oblique --> External spermatic fascia
- Internal oblique --> Cremasteric muscle
- Transverse abdominus --> DOES NOT PASS THROUGH IC
- Transversalis fascia --> Internal spermatic fascia
- Parietal peritoneum --> Tunica vaginalis
Term
tumors of lower 1/3 of esophagus spread to which lymph nodes?
Definition
celiac (below diaphragm)
Term
3 sites of gallstone obstruction
Definition
- cystic duct: painful epigastric colic; possibility for cholecystitis
- common bild duct: obstructive jaundice possible
- ampulla: obstructive jaundice & pancreatitis possible
Term
long vasa recta & large plica circularis
Definition
jejunum

(ileum has short vasa recta & small plica)
Term
define false & true pelvis
Definition
true pelvis is below linea terminalis (pelvic inlet

false pelvis is between iliac crests & the pelvic inlet
Term
boarders of greater & lesser sciatic foramen
Definition
(PICTURE IS NECESSARY)
Greater:
superomedial: sacrum
Inferomedial: sacrotuberous&spinous ligaments
Lateral: greater sciatic notch
-----------------
Lesser:
superior: iscial spine/sacrospinous ligament
Lateral: lesser sciatic notch
Inferiomedial: sacrotuberous ligament

(pudendal nerve must pass around sacrospinous ligament in order to get to the perineum)
Term
name structures coming out:
- Greater Sciatic Foramen:
- Lesser Sciatic Foramen:
Definition
- Greater Sciatic Foramen: Piriformis, Sciatic N, Sup Gluteal N/A/V, Inf Gluteal N/A/V
(also: posterior femoral cutaneous N & nerve to quadratus femoris)

- Both: Internal pudendal V/A, Pudendal N, (also: nerve to obturator internis)

-Lesser: Pudendal V/A/N & N to obturator internis
Term
Ureter passes inferior to ___ in males/females
Definition
Males: ductus deference/testicular artery

Females: transverse cerivcal (i.e. cardinal) ligament housing uterine artery (from internal iliac)
Term
Median ligament
Medial ligaments
Lateral ligaments
Definition
- urachus (allantois)
- umbilical arteries
- inferior epigastric vessels
Term
Cancer of the rectum may met to the liver b.c. of the IMV, alternatively, direct spread in the following directions would cause what?:
- Posterior:
- Lateral:
- Anterior (for males & females):
Definition
- Posterior: sciatica
- Lateral: invade ureter
- Anterior males: prostate, seminal vesicle, bladder
- Anterior females: uterus/vagina
Term
finish the path: inferior rectal vein -->
Definition
inferior rectal vein --> internal pudendal vein --> internal iliac vein --> IVC
Term
prostate drains in which 2 places (explain location of mets)
Definition
1) internal iliac veins (mets to lung & heart)
2) Vetebral venous plexus (mets to vertebral column & brain)
Term
Corpus spongiosum or cavernosum transmit the urethra
Definition
spongiosum (cavernosum has 2 columns)
Term
which muscle provides protection of subclavian vessels when there is a fracture of the clavicle?
Definition
subclavius
Term
Pt px w/ spinal TB; months later, he has a red bulge on flank & groin. What happened?
Definition
psoas abscess: infection gets into psoas sheath and spreads (classically w/ TB)
Term
the sternoclavicular joint overlies the bifurcation of what artery?
Definition
braciocephalic vein into subclavian & internal jugular

disolocation of this joint could compress: trachea, carotids/jugular, subclavian A/V, brachiocephalic trucks
Term
Where is the most common location of a rib fracture?

Which intercostal nerve innervates rib 7?
Definition
- Just anterior to the angle

- The nerve that lies just inferior to that rib (i.e. give anesthetic in the 7th intercostal space, between 7th & 8th ribs)
Term
interosseous artery in the forarm ends where
Definition
proximal to the wrist (sort of like the profunda brachii in the arm)
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