ANAT Exam

Muscular strain

Tear in muscle collagen fibres. Can occur at muscle belly, musculotendinous junction or in tendon.

ureter

long muscular tube (~20cm) that carries urine from the kidney to the urinary bladder has 3 narrowing points: 1. At uteropelvic junction (immediately after renal pelvis) 2. Crossing pelvic brim (enters pelvis & passes pelvic brim) 3. Traversing bladder wall

psoas minor

long tendon (very variable, disappearing through evolution)

broad ligament

The ligament extending from the lateral margins of the uterus to the pelvic wall; keeps the uterus centrally placed and provides stability within the pelvic cavity.

planes of the abdomen

median plane (xiphoid process to pubis) transumbilical plane (above ASIS) give rise to upper/lower right/left quadrants

Corpus Callosum

Thick, unfolded band of white matter that connects left and right hemispheres of the cerebrum. Cut in severe cases of epilepsy.

Deep fascia

Thin, rough sheet made from collagen. - Strong and inelastic; not found in areas where expansion is required readily. - Functional divider of muscle tissue. - Fascial/Intermuscular septum: extension of dense connective tissue that divides muscles into compartments. - Retinaculum: thickening of deep fascia to hold tendons down as they cross over different structures.

Intervertebral Joint degradation

Thinning of intervertebral discs = bones rubbing up against each other = painful + limiting in movement* *N.B. Actually causes osteoblasts to grow more bone = osteophytes This may add to pain as osteophytes may encroach on structures of intervertebral foramen.

Thoracic Cavity

Thoracic cavity has 3 compartments: - Left pulmonary cavity (left lung) - Right pulmonary cavity (right lung) - Mediastinum = everything else that functionally separates left and right lung. Mostly occupied by heart, pericardium, great vessels, trachea, oesophagus, thymus, lymph nodes, vessels, bronchi

Sympathetic Outflow from CNS

Thoracolumbar outflow. - Pre-ganglionic c ell body is in lateral horn. - Axon leaves spinal cord through ventral roots & enters mixed spinal nerve (like somatic) - Reaches Sympathetic Chain of Ganglia via communicating ramus: Site of synapse with post-ganglionic neuron next to spinal cord. - Post-ganglionic neuron extends to organ of interest.

Upper limb artery

Though it is one artery, name changes depending on the region it passes through: - Subclavian artery - Axillary artery: well protected by pec major. - Brachial artery: under biceps, above brachialis (ventro-medial side of arm). Supplies blood to anterior compartment of arm - Ulnar & Radial artery: branch from brachial artery Anastomoses around elbow joint.

Anterior Leg muscles

Tibialis Anterior Anterior & Medial to tibial; primary action on ankle (dorsiflexion). Secondarily aids inversion Extensor Digitorum Longus (EDL) & Extensor Hallucis Longus (EHL) Muscles that extend down to digits or hallucis. Held down by extensor retinaculum. Act on ankle + digits/hallucis through dorsiflexion

Deep posterior leg muscles

Tibialis posterior Flexor Hallucis Longus Flexor Digitorum Longus The tendons of these 3 muscles extend down through tarsal tunnel, into the foot. - Plantarflex the ankle - FHL & FDL flex the toes

Shin splints

Tibials Anterior or EDL starts irritating periosteum of shin bone

Accessory structure of skin: Nail

Tightly packed, dead keratinised cells (like hair). Backing support for fingers. Lunule = half-moon, lighter crescent shape Free edge = "fingernail" Nail plate = hardened fingernail surface that extends into and below skin. Nail bed = sits below nail plate; composed of epidermis and subungual dermis = thick + highly vascularised + attaches to periosteum

Burns

Tissue damage that can result in catastrophic loss of body fluid: 1st degree = epidermis injured 2nd degree = epidermis and papillary dermis injured 3rd degree = epidermis and all of dermis is damaged. Often also extends into superficial & deep fascia.

Nasopharynx

Top region of pharynx. Consists of tonsillar tissue = pharyngeal tonsil. If swollen = closes nasal cavity = nasal voice. Pharyngotympanic/Auditory tube = Cartilaginous + muscular tube in lateral wall of nasopharynx communicates with middle ear; allows for equalisation of pressure b/w middle ear and atmosphere = same pressure across both sides of ear drum.

Medial

Towards the midline

Lateral

Towards the side (away from midline)

renal pelvis

most posterior structure of renal hilum that collects the urine and passes it to the ureter

Tracts vs. Nerves

Tracts = Bundles of white matter (axons) in the CNS that bridge two regions of grey matter. Nerves = Bundles of axons in the PNS

Intrinsic back muscles

True back muscles = origin + insertion are both on back: Erector Spinae & Transversospinalis - Lie below extrinsic back muscles. - Innervated by posterior rami (through multiple branches at each intervertebral level).

Tumour Angiogenesis

Tumour releases VEGF-A, causing nearby blood vessels to grow towards tumour = vascularised tumour = uncontrolled growth.

Neurovascular supply of blood vessels

Tunica media of blood vessels contains smooth muscle = able to vasoconstrict, affecting blood flow. This is regulated by vasomotor nerves = sympathetic nervous system

Carpal tunnel

Tunnel formed by flexor retinaculum & carpal bones: - 9 tendons run through carpal tunnel - PL (superficial) runs superior to tunnel - FCR goes through flexor retinaculum

Embryonic disk

Two layers of epiblast & hypoblast in inner cell mass that become the embryo

Nasal Cavity

Two nasal cavities, each containing lateral and medial wall. Highly vascular, mucous membrane lines both walls: - humidifies air to body temp to avoid spasms - traps foreign particles Vestibule = outer part of nasal cavity. Skin protects and hair traps foreign particles. No mucosa. Roof = nasal bones, ethmoid bone, sphenoid bone Lateral walls = maxillary & ethmoid sinuses Floor = Upper side of hard palate

Intercostal Arteries

Two types: - Posterior intercostal arteries: arise from aorta, run between internal and innermost intercostals - Anterior intercostals arise from internal thoracic arteries Posterior and Anterior branches anastomose laterally with each other. Each intercostal artery is accompanied by an intercostal vein (which also runs b/w internal and innermost intercostals)

Fascia

Type of connective tissue that wraps and insulates deep structures: superficial or deep. Fascial layers form boundaries between different muscles both functionally and in terms of deep/superficial.

Radius & ulna at elbow vs wrist

Ulna = larger at elbow (articulate), smaller at wrist (non-articulate) Radius = smaller at elbow (non-articulate), larger at wrist (articulate)

Ulnar Claw

Ulnar nerve can be injured at medial epicondyle or wrist (they are quite superficial at these points). Forms ulnar claw of 4th and 5th digit

Ulnar & Radial artery

Ulnar: - larger, branches early to supply both anterior and posterior compartments of forearm. - Branches at wrist to superficial and deep components. Radial: - smaller, lateral, less important (doesn't supply much blood) - Becomes superficial at wrist; branching into superficial and deep.

Thumb

Unique: - Carpo-metacarpal joint I is saddle. II-V are plane type joints Only 2 phalanges

Bone growth

Until 25 y/old: ccurs longitudinally and appositionally (diameter) After 25 y/old: Variance in apposition.

Intermediate Mesoderm forms

Urogenital system: kidneys + gonads

Pons Cranial Nerves

V) Trigeminal = innervates face dermatome VI) Abducens = eye movement VII) Facial = Face muscles; Parasympathetic VIII) Vestibulocochlear = hearing & balance

Sulcus terminalis

V-shaped groove pointing posteriorly that separates anterior and posterior tongue

Development of vascular & lymph system

Vascular system is mesodermally derived = only present in mesodermally derived structures (muscular/connective tissue, dermal skin)

Mucosa

Vascular, mucous membrane that lines lateral and medial wall of nasal cavity (vestibule not lined). Can be divided into 2 parts: Olfactory region = superior region lines top 1/3 of nasal cavity (smelling, sensory nerve terminals from 1st cranial nerve) Respiratory region = inferior 2/3 of nasal cavity; lined by vascular epithelium with hairlike processes (cilia) that move mucous from bottom of airways to outside nose. Continues all the way down to airways.

Nerves/Veins of bone

Veins accompany arteries and drain blood away from bone. Nerve supply is very rich in periosteum; sensitive. Nerves also accompany blood vessels, accessing periosteum through the same foramen.

Upper limb deep veins

Veins associated with arteries in venae comitantes: plamar arterial arches, radial/ulnar arteries, brachial artery etc.

Upper limb Superficial veins

Veins located in superficial fascia; location varies: - Dorsal arch on dorsal side of hand. Forms into 2 major veins: cephalic and basilic veins - Cephalic vein runs on top, all the way to heart. Basilic vein runs below, all the way to heart. Both veins delve deep at upper end of limb. - Medial cubital vein connects C and B veins at forearm.

Superior sagittal sinus

Venous sinus that sits in dura mater, above falx cerebri. Arachnoid villi poke into the sinus = site of CSF reabsorption.

Subphylum

Vertebrate - Backbone: spine - Skeleton - Spinal cord + Spinal nerves - 4 limbs with 5 digits = tetrapods

Moving thoracic cage

Vertical movement: Diaphragm contraction/relaxation affects vertical dimension Movement up and out: external intercostals contraction = increased volume - Upper ribs increase rib volume anterioposteriorly (from front to back) - Lower ribs increase rib volume laterally (from side to side)

Coracoclavicular ligaments

Very strong ligaments between coracoid process and clavicle: provide extrinsic ligament support for acromioclavicular joint.

Tunics

Vessel is first surrounded by endothelial cells, then 3 layers of tunics surround the lumen: Tunica intima = inner tunic = flattened epithelial cells, supported by connective tissue. Only tunic in capillaries. Tunica media = middle layer comprised of smooth muscle. Most variable. Tunica adventitia = outer layer

Small arteries & arterioles

Vessels that take blood into capillary beds. They have narrow lumina & thick smooth muscle walls (to control blood flow) Arterioles are unnamed as there are too many Low calibre

Hollow viscera

Viscera containing hollow tube, cylindrical wall and a lumen. Components: - Serosa = external layer (shiny) - Muscularis = muscular middle layer (smooth muscle) - Mucosa = internal layer that lines lumen: often has folds to increase SA

Unpaired viscera

Viscera develops in midline but migrate away (to different extents) Receive nerve supply from BOTH sides of spinal cord = brain can't tell which side hurts = referred pain in midline skin.

Paired viscera

Viscera which develop on each side of the body. Usually symmetrical. Nerve & blood supply runs on each side. Ejaculatory ducts, Kidneys, Ureters etc.

Solid viscera

Viscus without lumen (thought parts of hollow lumen may extend inside). Usually secretory glands. Structure: Serosa for protection and friction-reduction. Organised into subdivisions (eg. outer cortex and inner medulla for kidney) or lobes. Appearance: Some solid viscera have shapes/grooves from impressions of nearby structures.

Inferior and superior fold of vocal ligaments

Vocal ligaments are surrounded by 2 mucosa folds: Inferior fold = vocal fold = fold of mucosa over vocal ligament Superior fold = protects (false vocal ligament)

Left Ventricle

Wall: Thickest wall of all 4 chambers; has to pump blood too all of body. Internal surface covered by trabeculae carnae Mitral (bicuspid) valve: chordae tendinae attach to 2 papillary muscles

Right Atrium

Walls: Thin. Most of internal surface is smooth, except anterior wall = covered by musculi pectinati Function: Receives all venous blood from entire body. - SVC: drains above diaphragm (except heart) - IVC: drains below diaphragm - Coronary sinus: next to IVC, drains heart Tricuspid valve/AV valve Fossa Ovalis

Puborectalis

What component of the pelvic diaphragm forms the rectal sling (muscle of continence)? - puts kink into rectum - faecal continence also under controlled by external anal sphincter

Hydrocephalus

When CSF is not reabsorbed into superior sagittal sinus via arachnoid villi = increase in inter-cranial pressure. CSF must be drained manually.

Vertebral canal/vertebral foramen/spinal cord

Where spinal cords & cauda equina run. Surrounded by vertebral bodies, laminae, pedicles.

Radiocarpal joint

Wrist joint between radius & 2 key carpal bones: scaphoid and lunate. - Condylar synovial joint = biaxial movement - Ulnar is non-articular at wrist: intra-articular disc sits at end of ulna

levator ani muscle

muscle composing the pelvic floor; supports pelvic viscera. consists of: - Puborectalis - Pubococcygeus - Iliococcygeus Puborectalis & pubococcygeus often torn during child birth > urinary stress incontinence, prolapse of uterus & faecal incontinence may result

Metaphysis

Zone of active maturation from cartilage to bone. Between secondary ossification centre of epiphysis and diaphysis. Location of epiphyseal plate.

fallopian tubes

a pair of tubes with fingerlike projections which carry eggs from the ovaries to the uterus and which provides the place where fertilization occurs. consists of: - Infundibulum: structure located most distally to ovary & has funnel-shaped with frimbriae - Frimbriae: facillitates collection of oocytes into fallopian tube - Ampulla: Relatively large, labyrinthine lumen where fertilisation occurs - Isthmus: narrow portion that connects to the uterus

hypospadias

abnormal congenital opening of the male urethra on the undersurface of the penis

Superior

above

prostate

an exocrine gland surrounding the neck of the bladder in male mammals and releasing prostatic fluid - contributes 3-35% to ejaculate & assists in ejaculation by stopping semen from entering bladder whilst doing so contains 3 zones: 1. Peripheral - outer 70% (prostate cancer often occur in this zone) 2. Central - middle 20% 3. Transitional - centre 5-10%

lobes of the liver

anatomical: - left and right - separated by falciform ligament accessory: - caudate and quadrate (divisions of right lobe) - separated by sagittal fissures and transverse portal hepatis

vulva (pudendum)

area containing female external genitalia

renal hilum

area in the midportion of the kidney where the renal vessels and ureter enter and exit contains: - Renal vein - Renal artery - Renal pelvis

psoas major

arise form lumbar vertebrae pass inferiorly insert to lesser trochanter of femur enclosed in fasical envelope

accessory renal artery

arises from the aorta superior or inferior to the main renal artery. An accessory renal artery may cross anterior to the ureter and obstruct it causing hydronephrosis - provides additional blood supply to kidney & should be liberated after development

Pyramidalis muscles

attaches pubis to linea alba

Dorsal

back of body

renal artery

blood vessel that carries blood to the kidney - gives rise to 5 segmental arteries when it enters kidney to provide blood supply to each renal segment of the kidney to allow each segment to become surgically resectable

Renal vein

blood vessel that carries venous blood away from the kidney and toward the heart to drain in IVC - most anterior structure at renal hilum

gallstones

can occur in gallbladder, cystic/bile ducts or in liver

renal calculi (kidney stones)

concentration of mineral salts in renal pelvis or calyces Incidence is 1 in 1000 About 80% are calcium

peritoneum

continuous serous membrane (pariteal/visceral) peritoneal cavity: potential space between parietal and visceral containing serous fluid, reduces friction during movements abdominal viscera are either: Intraperitoneal (full coat of peritoneum, therefore have attaching mesentery and motility) Retroperitoneal (not a full coat, attached to posterior wall)

ischiocavernosus muscles

covers attached parts of corpora cavernosa & maintain erection of clitoris

perinephric fat

covers the surface of the kidney & extends into the hilum which has space for it (renal sinuses) - provides cushioning and insulation

Oral Cavity

"Mouth"", consisting of: Lips for speaking, grasping food, sucking liquid Roof is made of: - Hard palate: maxilla bone, palatine bone - Soft palate: muscles Uvula: end of soft palate dips down; visible Floor = Mylohyoid muscle bridges space within mandible

Larynx

"Voice box" at the top of airways. System of cartilages and vocal ligaments: - Epiglottis = flap of cartilage at back of tongue. When food comes over tongue, it is pushed down and laryngeal inlet is closed (to prevent choking) Protected anteriorly by laryngeal cartilages: - Thyroid Cartilage = Adam's apple - Cricoid cartilage = below thyroid cartilage. Articulates with arytenoid cartilage. ^These all sit above trachea Lower pharynx = lower respiratory tract

Extrinsic back muscles

(Posterior) axio-appendicular muscles: attach to upper limb and back. Not true back muscles as their primary action is on upper limb. - Innervation is mainly from brachial plexus. Except Trapezius. - Trapezius and Latissimus Dorsi attach to thoracolumbar fascia.

Development of Heart

- 2 Endocardial tubes form along midline where heart grows. - 2 Tubes fuse forming one tube with 2 inlets and 2 outlets. - Swelling and elongation (resulting in looping & knotting) - Septa form. End result: 4 chambers, 2 inlets, 2 outlets.

Fibrocartilage

- A mix of fibrous tissue and hyaline cartilage = Dense, irregular collagen fibres - Forms specialised joints (eg. intervertebral discs) without covering surfaces - Can withstand prolonged pressure

Common features in both lungs

- Apex projecting into cervical inlet - Base sitting on top of dome of diaphragm 3 surfaces: costal, mediastinal, diaphragmatic 3 borders: inferior, anterior, posterior - Fissures & lobes

Somite

- Blocks of tissue along both sides of embryo trunk, just under the head. - Produce muscle, bone, dermis. - Differentiate further*

Central Nervous System

- Brain + Spinal cord, enclosed in cranium and vertebral column. - Depends on PNS for input and output.

Lateral mesoderm forms

- Cardiovascular system Ventro-lateral body wall - Outer wall of gut - Bones of limbs

Notochord

- Cartilage-like, transient structure - Defines mid-line of embryo; induces formation of other structures. - Within mesoderm (from primitive streak/node) Formation: Cells migrate cranially through primitive streak into primitive node. Primitive streak regresses and notochord lengthens back caudally.

Cells in Hypoxia (low O2)

- Cells far away from blood vessels do not have O2. - Release VEGF-A growth factor - Nearby blood vessels can detect the VEGF-A gradient and grow towards area of hypoxia.

Surfaces of the lung

- Costal surface = lateral against ribs/intercostal space - Mediastinal surface = medial surface against mediastinum - Diaphragmatic surface = inferior surface against diaphragm

Vasculogenesis

- De novo formation of blood vessels in lateral mesoderm of yolk sac. Only early on in embryo. Quickly replaced by angiogenesis. 1) Endoderm signals to mesoderm 2) Mesodermal cells form clusters = Haemangioblasts 3) Cells in cluster differentiate: - Outer cells --> Angioblasts --> Endothelial cells (line vascular cells) - Inner cells --> Haematopoietic cells --> blood cells 4) Pericyte recruitment to stabilise vessels.

Dermis

- Deeper, thicker layer of skin. - Composed collagen (for support) and elastic fibres (for flexibility) - Composed of papillary layer and reticular layer - Rich supply of nerve fibres, blood vessels and lymphatic vessels = all mesodermal origin

Angiogenesis

- Development of blood vessels from pre-existing blood vessels. - Mechanism of Hypoxia. - Stabilised by pericytes

Medium veins

- Drain venous plexuses and accompany artery. - Contain valves, especially where blood flow opposes gravity (limbs)

Allantois

- Endodermal sac at caudal end of embryo. - Surrounded by blood vessels that later become umbilical arteries/veins; allows for gas exchange/excretion - Becomes urachus

Ectodermal derivatives

- Epidermis (melanocytes from neural crest + Langerhan cells from bone marrow) - Neurons: glial cells + ganglia (from neural crest) - Pigment: Melanocytes - Neural tube/plate, and thus CNS - Pharyngeal clefts

epithelial-mesenchymal transition

- Epithelial cells = polarised and form a close layer around tissues. - Mesenchymal cells = irregular shaped cells that are migratory. Can transition between the two (eg. at neural crest)

Wolffian/Mesonephric Duct

- First duct that forms from MET in the intermediate mesoderm. - Develops into male gonads (requires testosterone from testes). Without testosterone, wolffian duct disappears.

Elastic Cartilage

- Flexible cartilage; contains bundles of elastic fibres - Forms discrete structures of external ear, auditory tube, parts of larynx

Paraxial Mesoderm (general)

- Forms somites from Mesenchymal --> epithelial transition - Epithelial cells surround a group of mesenchymal cells, fusing caudally first, then cranially = somitogenesis - Occurs for successive somites.

Cerebrum

- Greater part of brain, consisting of left & right cerebral hemispheres. - Surrounded by cerebral cortex = outer layer of grey matter - Contains 4 lobes: frontal, parietal (middle), occipital (vision), temporal (hearing); divided by sulci

Borders of the lung

- Inferior border = bottom aspect: thin & sharp - Anterior border = against sternum: thin & smooth - Posterior border = against thoracic vertebra: thick and smooth

Myelin

- Insulating wrapping around some axons; increases conduction speed. - Non-continuous segments of myelin line the axon = nodes of Ranvier = propagates faster by jumping from node to node. - Formed by glial cells: oligodendrocytes for CNS & Schwann cells for PNS.

Typical pathway of left coronary artery

- Left CA arises from left side of aortic base - Runs anteriorly b/w left atrial appendage + pulmonary trunk Branches into: - Circumflex branch = runs to back of heart within AV groove = supplies LV, LA - Anterior Interventricular branch = runs in IV groove. At inferior border, continues posteriorly = supplies LV, RV Both branches meet + anastomose with right CA.

Lymphatics

- Like blood vessels, have 3 tunics (but walls are thinner). They tend to accompany veins. - Drainage is facilitated by smooth muscles (tunica media) = pulsatile contraction - Vessels become larger as they merge. Large lymphatics have valves; eventually entering lymphatic trunks

Intermediate Mesoderm (general)

- Mesenchymal --> epithelial cells form Wolffian/Mesonephric Duct - Tubules develop along Wolffian duct* - 2nd duct forms from invagination intraembryonic cavity = Mullerian Duct.

Septum Transversum

- Mesodermal structure that appears cranially during body folding. - It splits the intraembryonic cavity into abdominal and thoracic cavities. - Develops into part of diaphragm.

Hyaline Cartilage

- Most common cartilage - Covers articular surfaces = reduces friction - Model for early fetal skeleton: ossified into bone - Contains moderate amounts of collagen

Neurovascular supply of (skeletal) muscles

- One nerve, artery and one or more veins serve each muscle, via neurovascular hilum - Every skeletal muscle fibre is stimulated at a neuromuscular junction with alpha motor neuron. - Muscles have rich blood uspply as they are nutrient/energy-demanding and produce lots of waste.

Lower limbs (vs. Upper limbs)

- Pelvic girdle evolved for stability to transport weight vs. shoulder girdle = motility. 2 scapulae are unconnected vs. connected os coxae. - Overall, lower limb is more adapted for weight-bearing. - During development, lower limbs rotate internally (big toe is medial, flexor = posterior) vs. external rotation of upper limbs - Lower limbs are longer - Femurs angle inward - Non-opposable big toe (like thumb)

Cerebrospinal Fluid (CSF)

- Plasma-like fluid that negates effects of gravity on CNS; protective. - Contained within 3 layers of meninges; subarachnoid space - Produced in ventricles - Reabsorbed into superior sagittal sinus via arachnoid villi.

Primordial germ cells (PGC)

- Precursor cells of sperm and egg - Specified at caudal end of primitive streak (near allantois) by signalling of nearby cells. - This occurs early in development when there are 2 germ layers= need to have the potential to form all 3 germ layers. - Migrate to intermediate mesoderm (where gonads are)

Endodermal derivatives

- Primitive gut (inner layer) including all GIT organs + lungs + bladder - Pharynx - Allantois (becoming urachus) - Pharyngeal pouches

Contraction of right side of heart

- RA contraction: P(RA) > P(RV) = blood pushes open tricuspid valves (passively) - RA stops contracting: pressure gradient is gone = tricuspid valves close (passively) - RV contraction: P(RV) > P(pulmonary) = contraction towards tricuspid valve and RA. Papillary muscles + chordae tendinae go in the same direction, pushing tricuspid valve closed.

Typical Pathway of Right coronary artery

- Right CA arises on right side of aortic base. - Runs anteriorly b/w right atrial appendage and pulmonary trunk - Runs within anterior AV groove = coronary sulcus - At inferior border, CA continues within AV groove to posterior side. Gives off a posterior interventricular artery - Meets and anastomoses with branches of left CA

Mullerian Duct

- Second duct that forms from invagination of intraembryonic cavity. - Develops into female gonads. - Remains unless AMH (produced by testes)

Mesodermal derivatives

- Septum Transversum - Muscle of pharyngeal pouches Paraxial mesoderm: somites (dermis, myotomes, axial skeleton Intermediate mesoderm: Urogenital system Lateral mesoderm: bones of limbs, outer wall of gut, cardiovascular system, lymphatics,

Short bones

- Similar in width and length (cube shaped). - Offer stability and support with little movement. eg) carpal bones of wrist, sesamoid bones

Synovial Joint Accessory Structures: Fat Pads

- Space fillers that smooth movement between joints by spreading synovial fluid; like sponge - intracapsular (inside joint capsule) but extrasynovial (outside synovial cavity).

PGC migration

- Start near base of allantois (caudal end of PS). - Move through hindgut & dorsal mesentary. - Arrive at intermediate mesoderm = site of gonad development. Coalesce with somatic cells of gonads.

Glial cells

- Support neurons in the CNS and PNS. - Maintain local environment so that neurons/nerve fibres are healthy and work correctly. Aid nervous system development. - Overall, number of neurons and glial cells are the same, but variation occurs regionally.

Secondary Cortices

- Tells primary areas HOW to activate muscles/activates. - Sit beside respective primary cortex

Stabilising synovial joints

- The fit between bones - How strong/tight the joint capsule is - Add stabilising ligaments - Muscles that wrap around/over joints can stabilise the joint (eg. rotator cuff muscles)

Flat bones

- Thin, flattened and usually curved. - Protect vital organs, provide surface for muscle attachment eg) sternum

Methods of venous blood return

- Vascular venous pumps - Musculovenous pumps (contraction of skeletal muscle) - Thoracic venous pump N.B. Any compression of veins causes unidirectional flow back to heart (due to valves)

damage to the spleen

- situated behind ribs 9, 10, 11 on the left - laceration by sharp edges of ribs can easily tear capsule of spleen - rich blood supply causes profuse bleeding into peritoneal cavity

Function of vertebral column

- supporting axis for rest of body - movement - protection for nervous system

Types of joints

1 mobile joint: 1) Synovial joint Bones united by articular cavity. Most mobile. 2 solid joints (no cavity): 2) Fibrous joint Bones united by fibrous tissue. Solid, minimal movement depending on fibre length. 3 types. 3) Cartilaginous joint: Bones united by hyaline cartilage or fibrocartilage. Provide strength and shock absorption. 2 types

Axial skeleton

1 of 2 sections of the skeleton. Bones found along centre axis: head, neck, trunk

Appendicular Skeleton

1 of 2 sections of the skeleton: Bones of the limbs (including pectoral girdle + pelvic girdle)

Long bones

1 of 4 types of bones. Longer than they are wide. Bear a lot of weight. eg) Femur, Humerus

Basic principles of limb arteries

1) Arteries branch to supply different regions of the limb: skin, muscle, joints etc. 2) Arteries will branch to form anastomoses at joints

4 Properties of muscular tissue

1) Electrical excitability: muscles respond to neural stimuli and produce AP 2) Contractility: Muscles contract when stimulated. 3) Extensibility: muscles can stretch without damage 4) Elasticity: Muscles are able to return to original formation after contraction/extension

Factors influencing ROM

1) Fit of articulating bones: hinge joint vs. ball-and-socket 2) Strength/Tension of joint ligaments: different ligaments are taught in different joint positions. 3) Arrangement/Tension of muscles: whether a muscle is tense/loose will affect ROM 4) Body surface contact (eg. adipose tissue) affects ROM 5) Hormones (eg. Relaxin is produced near end of pregnancy to expand pelvis) 6) Disuse: less blood flow = reduced synovial fluid = reduced flexibility

Principles of arteries in limbs

1) For each limb, there is always a single stem artery 2) Arteries change name according to the region through which it travels: braciocephalic artery = subclavian artery = axiliary artery = brachial artery etc. 3) Main stem artery always travels on flexor aspect of the limb: posterior for knee, anterior for elbow 4) When artery crosses a hinge joint, the artery will anastomose to avoid compression. 5) Terminal branches are generated when the artery crosses the middle joint (elbow or knee)

Gastrulation

1) Forms primitive streak which defies major body axes 2) Forms all 3 germ layers 3) Gives rise to distinct tissues

4 Functions of Muscles

1) Movement: - Skeletal muscles = locomotion - Cardiac muscle = pump blood - Smooth muscle = propel substances like food/waste 2) Maintain posture/Body position 3) Stabilise joints (eg. rotator cuff) 4) Generate heat

Development of serous membrane

1) Organs first develop INSIDE body wall. 2) Cavity largens. Viscera moves into cavity, dragging membrane with it. 3) Viscera occupies most of space. Parietal layer lines body wall. Visceral layer lines viscera wall. Both layers are essentially the same. Stalk of double-layered membrane between viscera and body wall = mesentery or ligament

Journey of egg (fertilisation - 2nd week)

1) Ovulation of oocyte 2) Fertilisation: sperm + egg = zygote 3) Cleavage 4) Morula 5) Blastocyst: implants onto the uterine wall (5-10 days)

Tubules/Buds along Wolffian Duct

1) Pronephros = temporary, cranial 2) Mesonephros & mesonephric tubules function as embryonic kidney. Gonads form here. 3) Ureteric bud = bud at caudal end that communicates with surrounding M-cells to form definite kidney.

Function of integumentary system

1) Regulate body temp 2) Store blood 3) Protect from external environment 4) Excrete/absorb substances 5) Synthesise vitamin D 6) Detect cutaneous sensations

Conduction System of Heart

1) SA Node = Pacemaker cells in right atrium (near SVC) that initiate spontaneous electrical signal. 2) Atrial contraction as signal spreads across left/right atrium 3) AV node at right atrium. - Collects signal from SA node - Sends signal through AV bundle of His across right fibrous ring - Branches into right and left bundle (running along either side of IV septum)

Coronary Artery Pathologies

1) SA node and AV node are supplied from right coronary artery = pathology here can impede conduction system. 2) Anastomoses b/w left and right coronary arteries contain very small arterioles = functionally insufficient = cannot bypass sudden pathology. If pathology (i.e. plaque) occurs over a very long time, anastomosing arterioles can compensate by dilating = becoming functional end-arteries.

Principles of veins of the limbs

1) Superficial system of veins drains from skin and superficial fascia only. 2) Deep system of veins drains deeper structures (muscles) 3) Veins are paired (venae comitantes), especially distally. Single veins are proximal to accompany arteries. 4) There is a set of communicating veins that connect superficial and deep veins by penetrating through deep fascia.

Functions of skeletal system

1) Support: Structural framework/attachment points 2) Protection 3) Movement 4) Mineral Homeostasis: stores minerals which can be released into blood 5) Blood cell production within red bone marrow 6) Triglyceride storage in yellow bone marrow

Types of Cartilaginous joints

1) Synchondrosis = Primary cartilaginous joints Two ossifications centres of growing bone united by a plate of hyaline cartilage. Epiphyseal plate of growing bone. 2) Symphysis = Secondary cartilaginous joint Bone segments united by fibrocartilage. Pubic symphysis. ^Difference is in the connective cartilage

mesentery

double folded peritoneum - attaches intraperitoneal viscus to posterior abdominal wall

Variations in epidermal thickness

1.4-4mm across different regions of the body. - Variability in epidermal thickness; dermis is mainly the same - Thin skin = hairy = absent of stratum lucidum, other strata are thinner; on flexor surfaces - Thick skin = hairless = thicker stratum corneum from greater mechanical stress; on extensor surfaces

small intestine

duodenum jejunum ileum 2 complete muscle layers: longitudinal (superficial), circular (deep)

Braciocephalic trunk

1st branch of aortic arch. - Branches into right common carotid artery = supplies right head/right neck - Branches into right subclavian artery = supplies upper right limb

Gluteus medius & minimus

2 Gluteal Muscles: - Located more laterally - Attach to greater trochanter of femur Function: - Abduction/Adduction of hip - Promote stability (especially for gluteus minimus); - Maintain horizontal position of pelvis during locomotion

Simple joint

2 bones

Synovial Joint

2 bones separated by fluid filled cavity (synovial cavity). Many different types. Comprised of: 1) Articular Cartilage = hyaline covering articulating surfaces; minimal friction, shock absorption, survives prolonged pressure 2) Joint capsule: Inner synovial membrane & Outer fibrous membrane 3) Accessory structures*

Coronary arteries

2 coronary arteries arise at the base of the ascending aorta, - One on right, one on left; immediately superior to aortic valves - Supply the myocardium of the heart N.B. Most people have 2 coronary arteries. Distribution patterns are highly variable.

male erectile tissue

2 corpora cavernosa & 1 corpus spongiosum (expands distally to form glans penis) ischiocavernosus & bulbospongiosus muscles move blood into body of penis to constrict venous drainage

female erectile tissue

2 corpora cavernosa, 2 vestibular bulbs, glans clitoris

Knee Menisci/Discs

2 discs/menisci attach to ridge of tibia plateau at anterior horn + posterior horn. Semi-lunar & wedge-shaped: Lateral meniscus: smaller, rounder. Medial meniscus: larger, ovular. Function - Thicker in periphery than at horns = increased SA = increased congruence with condlyes - Provide cushion for femoral condyles = weight-absorption/prevents hyaline cartilage degradation - Spreads synovial fluid fluid around joint = lubrication Extension: larger condyle contact = more stable Flexion: smaller condyle SA = more mobile (less stable)

Pelvic Girdle

2 hip bones = os coxae that come together at midline. Strong "ring" of bone for weight transfer and protection/stability. Many ligaments. Features: Hip bone = os coxae Pelvis = os coxae + sacrum + coccyx Sacroiliac joint Pubic symphysis Female pelvic girdle is wider and shorter (for child birth) VS. Pectoral girdle, pelvic girdle is more rigid, less movement = more stability/less mobility

Tibiofibular joints

2 joints between tibia and fibula (like radius & ulna): Superior (proximal) - Plane joint = gliding motion - Ligamentous support Inferior (distal) - Fibrous joint = syndesmosis - Anterior + Posterior ligaments support - Extension of interosseus membrane provides extra support; prevents ankle dislocation

Skin

2 layers: Epidermis = outermost, thinner layer; not much functionality, some sweat pores; 5 layers. Dermis = thicker layer of dense connective tissue. Only dermis is vascularised; 2 layers. Hypodermis = layer of subcutaneous tissue deep to the skin

Muscles of Pelvic Girdle

2 or 3 Anterior pelvic muscles = Iliopsoas muscles Psoas major: attached to lumbar spine and femur's lesser trochanter Iliacus: broad attachment across ilium. Joins with psoas major to attach to lesser trochanter. Psoas minor ^These are all strong, powerful hip flexors Not really any axio-appendicular muscles; reflects different role = stability

Joint capsule*

2 parts: Inner synovial membrane:Highly vascular lining of internal surface except articular cartilage; produces synovial fluid = lubricant. Outer fibrous membrane that encloses synovial joint/cavity/membrane - Dense connective tissue (collagen) that joins with periosteum. - May be reinforced by ligaments or receive muscle attachments - Rich supply of nerve fibres for joint health, control and injury-prevention.

Demifacets of rib

2 small surfaces (one superior, one anterior) where the rib articulates with ventral body of thoracic vertebrae

Knee joint

2 synovial joints in 1 capsule: Patellofemoral joint Patella sits in asymmetrical ridge between two femoral condyles. Tibiofemoral joint - Hinge joint (permitting some rotation) = not "true" hinge joint. Formed by round femoral condyles and flat tibial plateau = incongruous = better ROM but less stable Supported by: - Intra-articular discs - Crucial ligaments - Collateral ligaments - Bursae - Patellar ligament

Lower limb venous system

2 venous systems occur here: in superficial fascia and deep fascia. - Some perforating veins connect deep and superficial veins - All veins have valves = important in perforating veins; if valves don't work, blood can flow in both directions = deep valves push blood into superficial veins = vessel swelling = varicose veins

Anterior axio-appendicular muscles

3 muscles sitting on anterior chest wall: attach to both axial and appendicular skeleton; act on upper limb: Pectoralis Major + Minor Serratus Anterior

Gallbladder and extrahepatic bile ducts

3 parts of gallbladder: neck, body, fundus - major duodenal papilla = tight anatomical sphincter (usually closed - after a fatty meal, hormones cause relaxation of sphincter, contraction of gallbladder pushes bile into duodenum

Meninges

3 protective layers of membrane that protect CNS: - dura mater: Thick, fibrous, tough, vascularised outer layer. - arachnoid mater: stringy membrane; subarachnoid space contains CSF - pia mater: innermost layer, very thin. All 3 layers encase the entire brain + spinal cord.

Muscle compartments of thigh

3-4 Muscle compartments in thigh. Anterior = quads; knee extensors; largest Posterior = hamstrings; hip extensors; knee flexors Medial = adductors (Lateral) = gluteal muscles; do not really extend into thigh.

Spinal cord

31 segments, grouped into levels based on bones: - Cervical (thick): arms, hands, fingers - Thoracic - Lumbar (thick): legs, feets - Sacral - (Coccygeal nerve) ^thickness changes depending on intricacy required by each section = more neurons

Bone composition

35% Organic Collagen = flexible connective tissue; allows for tension resistance 65% Inorganic Hydroxyapatites = Mineral salts (Calcium Phosphate, Calcium Carbonate); allows for compression resistance.

Quadricep muscles

4 large/powerful muscles in anterior thigh compartment: - Rectus femoris: attaches to ilium (pelvis) and quadriceps tendon - 3 Vastus muscles: vastus medialis, lateralis, intermedius These muscles facilitate knee extension. RF also aids in hip flexion.

Head structures

4 pharyngeal arches, formed from neural crest cells rather than mesoderm. Each pharyngeal arch gives rise to a different head structure.

Sacrum

5 fused vertebra; vertebra get smaller as you get closer to coccyx - 1st & 2nd sacral vertebra distributes weight to pelvis = these need to be bigger than the lower sacral vertebra - presence of foramens

Vertebral column overview

7 Cervical vertebra 12 Thoracic vertebra = where ribs articulate 5 Lumbar vertebra 5 Sacral vertebra; later in development, 5 sacral vertebra fuse to form one sacrum Coccyx = number of coccygeal vertebra varies (3-4); fused Residual tail Each region has distinct properties

Distal foot bones

7 tarsal bones (including talus + calcaneus), 5 metatarsal bones, phalanges - Joints are the same as hand: main joints = talocrural + subtalar - Talicis = big toe = unique (only 2 phalanges vs. 3 phalanges) - Arched foot

Carpal bones

8 wrist bones - Arranged into 2 rows of 4. Midcarpal joint between rows = adds to movement (flexion/extension) - Many intercarpal joints between bones. - Scaphoid and lunate articulate with radius - Bones are arched, not flat

Neural Plate

= Ectodermal cells above notochord = Intermediate stage between notochord and neural tube - Notochord cells signal neighbouring ectodermal cells to thicken & invaginate, eventually forming neural tube.

Ramus/Rami

A branch of mixed spinal nerve. Branching occurs almost immediately after sensory and motor neurons combine. 2 types of rami: - Anterior: innervates front of body - Posterior: innervates back of body

Neural crest

A group of ectodermal, epithelial cells at the end of the neural tube. They transform into mesenchymal cells that then migrate away, becoming various different tissues: -glial cells (nervous system) - ganglia (nervous system) - Melanocytes (pigment cells)

Epididymis

A long (~5m), coiled duct surrounded by smooth muscle cells, on the outside of the testis in which sperm mature & stored (7 days - 1 month)

vagina

A muscular, elastic passageway that connects the uterine cavity to the outside of the body Located between urethra anteriorly & rectum posteriorly

Morula (day 4)

A solid ball of cells that arises from cell divisions in zygote. Enters uterus.

kidney

A solid viscus that removes urea, excess water, and other waste products from the blood and passes them to the ureter has hilum that allow communication with vessels, nerves & duct systems - faces anteromedially to communicate with vessels Located @ level T12-L3 fixed against the posterior abdominal wall (retroperitoneal) - ≠ have a mesentery position allows surgeons to reach kidney laterally/posteriorly To reach the kidney: Renal fascia > Perinephric fat > Capsule of the kidney

Septomarginal trabecula (moderator band)

A special traneculae carnae that runs from interventricular septum to the base of anterior papillary muscle. Transmits the right bundle of the conducting system of the heart.

Primitive node

A swelling at cranial end of primitive streak - Fluid-filled (like lake) - Bottom of node contain cilia that rotate in same direction (causing fluid to flow from right to left) = differentiation

Uterus

A thick, hollow muscular organ in the pelvic cavity of the female, that facilitates the development of embryo & foetus. Blood supply from Uterine artery - Internal iliac artery Position can be described as: - Anterverted (AV): relative to vagina - Anteflexed AF): over bladder Consists of: - Fundus: part furthest away from opening in any hollow organ - Body: contain Endometrium (highly vascularised inner lining that supports pregnancy & is shed through mentrual cycle) & Myometrium (muscular part of uterus) - Cervix: supports uterus best & opens inferiorly to vagina

Nerve innervation of heart

ANS adjust heart rate + contractility of heart Comes through cardiac plexus containing both sympathetic & parasympathetic fibres

Diaphragm

Abdominal muscle: Circumferential origin: muscles arise peripherally from inferior border of thoracic cage = xiphoid process, costal cartilage, tips of ribs 11-12, T12 Insertion = central tendon Shape = left & right dome: - Right dome, slightly higher because liver sits below

Abnormal curvature of vertebral column

Abnormal lordosis = increased secondary curvature in lumbar region Kyphosis = increased primary, thoracic curvature (hunchback) Scoliosis = vertebral column deviates laterally.

Deep veins of lower limb

Accompany arteries venae comitantes. Also present through venous sinuses. Soleus has many deep venous sinuses which store blood during inactivity; venous return is aided by muscular venous pump

Calcaneal tendon

Achilles tendon formed by gastrocnemius tendon & soleus tendon (and plantaris tendon)

Medial Thigh Muscles

Adductors of femur into midline: - Common origin = pubic ramus - Line of muscles that come down posterior aspect of femur, attaching to linear aspira - One muscle has a hole = adductor hiatus = structures pass through

Tooth development and crowding

Adult teeth emerge at different ages. Generally, adult teeth emerge from front to back. Crowding occurs when 3rd molar (wisdom tooth) does not have enough space to grow through, because it emerges so late

Sensory receptors of skin

All contained within the dermal layer (both derived from mesoderm) Somatic sensation arises from stimulation of these receptors: tactile/touch, thermal, pain, proprioception

Upper limb fascia

All muscles + muscle groups are covered by fascia; limb muscles are organised into compartments by fascia: anterior/posterior muscles in same compartment do the same action: generally innervated/supplied by same nerve/artery - Anterior = flexor - Posterior = extensor

Collateral flow

Alternate routes for blood flow. Anastomoses result in collateral flow.

Vascular Venous pumps

An arrangement of veins near arteries: Arteries pulsate = compression onto neighbouring veins = pushing of blood (unidirectionally due to valves)

Intrinsic muscles of foot

Analogous to hand: - Group of muscles at base of hallucis - Group of muscles at base of little toe (digiti minimi) - Central group of muscles Muscles appear in deep and superficial layers. Different to hand: - Intrinsic muscles on dorsum of foot

Kingdom

Animalia - Independent movement - External energy source (heterotrophs) - Cells surrounded by cell membrane (vs. rigid cell wall)

Movements of foot

Ankle/Talocrural joint = hinge joint - Dorsiflexion (extension) - Plantarflexion (flexion) Subtalar joint = ball & socket joint - Foot inversion & eversion

Insular cortex

Another lobe = Layer of folded tissue underneath temporal lobe. Part of lymbic system

Ligaments of vertebral column

Anterior Longitudinal Ligament: runs down anterior side of ventral body Posterior Longitudinal Ligament: runs down posterior side of vertebral body Interspinous Ligament: Between spinous processes Supraspinous Ligament: runs over interspinous ligament Ligamenta flava: connects lamina of upper and lower ventral bodies; necessary for movement (highly elastic)

Biceps Brachii

Anterior arm muscle = flexor, 2 origins/heads: - short head attaches to scapula coracoid process - long head runs through bicipital groove (between greater and lesser tubercule), entering shoulder joint capsule, over humerus, finally attaching to top of glenoid fossa on scapula. This also helps shoulder stability. Other end attaches to radius

Brachialis

Anterior arm muscle; - Main flexor of elbow joint. - Attaches to ulna (flexor of elbow)

Pectoralis Minor

Anterior axio-appendicular muscle: - Deep to pec major - Serrated attachment to ribcage & scapula (coracoid process)

Serratus Anterior

Anterior axio-appendicular muscle: - Serrated muscle attachment to lateral ribs - Attachment to medial border of scapula - Keeps scapula firm against ribcage.

Pectoralis major

Anterior axio-appendicular muscle: - Attach on axial skeleton via sternum + clavicle - Attach on appendicular skeleton via head of humerus

Sternum

Anterior bone of thorax. Consists of: - Manubrium (top) - Body (majority) - Xiphoid process (pointing downwards)

Muscle compartments of the (lower) leg

Anterior compartment = dorsiflexors Posterior compartment = plantarflexors Lateral compartment = everters

Shoulder joint dislocation

Anterior dislocation more common than posterior dislocation. - Humerus drops inferiorly, like clavicle fracture.

Other muscles influencing respiration

Any muscle attached to thoracic cage can influence breathing. During quiet breathing, only external intercostals and diaphragm control breathing though.

CSF Reabsorption

Arachnoid villi are parts of arachnoid membrane that protrude into a blood vessel above falx cerebri = superior sagittal sinus. Here, CSF is reabsorbed into blood.

Foot arch

Arch in foot facilitated by: - Plantar aponeurosis on base of foot - Spring ligament at apex of foot arch; keeps head of talus up - Interosseus ligament between talus and calcaneus (gap in subtalar joint) = improves stability

Malleolar mortise

Arched socket formed by lateral malleolus (fibula), distal tibia and medial malleolus (tibia). Complements talus well.

Lung hilum

Area enclosed by pleural sleeve; where lung root runs. Contains: - Airway: on right lung, the airways is already forming into 2 lobar bronchi (most posterior in each hilum). - Pulmonary artery (most superior) + 2 pulmonary veins (most anteriorly/inferiorly), allows for extra space for expansion. - Bronchial vessels = bronchial arteries/veins = very small = take blood to and from lung tissues themselves - Bronchial nerves - Lymphatics

Dermatome

Area of skin which is neurally reported on by one spinal cord segment. - Nerve and (dermal) skin both come from mesoderm; thus they are organised in similar ways. - Dermatome boundaries are fuzzy, not sharp.

White matter funiculi

Arrangement of white matter in spinal cord, surrounding grey matter. Forms a column down spinal cord. - lateral - anterior - posterior

Grey Matter horns

Arrangements of grey matter in spinal cord: - dorsal horn: somatic/sensory, contains afferent neurons - ventral horn: motor, contains motor neuron cell bodies Each side of segment has a dorsal and ventral horn.

Large Elastic Arteries (conducting arteries)

Arteries closest to the heart = high pressure & velocity. Facilitated by many elastic layers = smoother blood flow High calibre

End arteries

Arteries that do not link with another artery = no anastomoses. They still branch into capillary beds. eg) Central artery of retina Anatomical end-artery: single artery which does not anastomose. Entire area of supply is compromised by occlusion. Functional end-artery: take part in limited anastomoses. Part of the area of supply will remain viable during sudden occlusion.

Types of blood vessel

Arteries: take blood away from heart at high pressure. Typically O2 rich, except pulmonary artery. Thick tunics, smaller lumen. 3 types Capillary bed: Where nutrient/gas exchange occurs. Only one tunic Veins: Take blood back to heart at low pressure; O2 poor, except pulmonary vein. Thin tunics, large lumen, valves.

Aorta

Artery arising from LV. Named regionally: Thoracic aorta - Ascending aorta = short upward region coming from LV - Aortic arch = At T4/5, aorta goes up/left then downwards - Descending (thoracic) aorta = left of midline, moves towards midline as it descends until T12, where it becomes Abdominal aorta = inferior to diaphragm, into the abdomen.

Lower limb dermatomes/myotomes

As lower limb buds out from lumbar and sacral nerves, skin is taken with it: - Striped dermatomal distribution in lower limb matches innervation of neurosomes

Musculovenous pump

As muscles contract, vein is constricted = unidrectional flow towards heart (due to valves)

Ulnar/Radial/Fibular in naming

Associated with ulna/radius/fibula

Bronchial Tree

At T4/5, trachea branches into 2 main bronchi: left & right = aerates each side of lung - right main bronchus = shorter/wider/more vertical than left bronchus = inhaled particle is more likely to end up on right side - left main bronchus = more horizontal/longer, passes under aortic arch. Each main bronchus gives rise to 2-3 lobar bronchi = aerates each lobe Each lobar bronchus gives rise to 2-3 segmental bronchi = aerates a bronchopulmonary segment of the lung Bronchial Tree = Main + Lobar + Segmental

Artium vs Ventricle

Atria are thin walled (receive blood) Ventricles are thick walled (pump blood)

Tricuspid Valve & Contraction

Atrioventricular valve between RA & RV. Atrial side is smooth, ventricular side has 3 cusps + chordae tendinae.

Sternoclavicular joint

Attaches sternum to clavicle in a saddle joint = biaxial movement (protraction/retraction & elevation/depression) - Strong & stable due to strong capsule + multiple other ligaments. - Costoclavicular ligament provides extrinsic ligament support - Intra-articular disc = increases complexity of movement

Lumbar Fascia

Attachment for extrinsic back muscles: trapezius & latissimus dorsi, but also for intrinsic back muscle erector spinae. Fascia is continuous with whole abdominal wall; can promote good lifting practice.

blood supply/drainage abdomen

BLOOD SUPPLY paired branches supply paired viscera and abdominal walls unpaired branches supply unpaired viscera VENOUS DRAINAGE paired viscera and abdominal walls directly drain into IVC unpaired viscera (except liver) drain into IVC via portal vein Portal vein- hepatic vein- IVC- right atrium

Posterior aspect of heart

Back of heart is mainly made of left chambers. Some right chamber presence. Majority of LV makes left border of heart. Posterior AV sulcus

Synovial Joint Accessory Structures: Bursae & Tendon sheaths

Bags of lubricant that reduce friction & absorb force Bursae = flattened fibrous sacs containing synovial fluid Tendon sheaths = stretched out sheath around tendons that allow movement over rough bones.

Subtalar joint

Ball & socket joint between talus and calcaneus: - Foot inversion (inwards) and foot eversion (eversion) - Joint is discontinuous = a gap in the middle allowing for ligament

Movements of hip joint

Ball and socket joint allowing 3 planes of movement: - Flexion/Extension - 2 types of Abduction/Adduction: (one normal + one hips swing) - Internal/External rotation

Posterior

Behind

Ventral

Belly-side

Inferior

Below

Flexion

Bending a joint; reducing angle

Surface anatomy of heart

Between each chamber is a sulcus/groove. Helps differentiate chambers. - Atrioventricular sulcus = b/w RA and RV: both anterior + posterior - Interventricular sulcus = b/w RV and LV: becomes posterior at inferior border

Ossification

Bone formation: All bones are derived from mesenchymal cells, via 2 pathways: Intramembranous ossification: Mesenchymal cells --> bone (directly) Endochondral ossification: Mesenchymal --> cartilage --> bone

Longitudinal Bone Growth

Bone grows longitudinally via epiphyseal plate 1) Growth of cartilage on epiphyseal side epiphyseal plate 2) Replacement of cartilage on diaphyseal side with bone via endochondral ossification. N.B. Thickness of epiphyseal plate remains constant

Bone remodelling & its factors

Bone is constantly undergoing remodelling: - spongy bone is replaced every 3-4 years - compact bone is replaced every 10 years Remodelling is influenced by: - Vitamins/Minerals: Calcium hardens bone, Vitamin D increases Ca absorption - Exercise: mechanical stress stimulate osteoblasts to lay down more tissue - Hormones: Sex hormones stimulate osteoblasts and slow bone resorption by osteoclasts. Over a lifetime, bone mass decreases especially in females due to menopause = less sex hormones.

Appositional bone growth

Bone width growth; after 25, this is the only growth that occurs: 1) New bone is deposited on outer surface by osteoblasts. 2) Old bone that lined the cavity is destroyed by osteoclasts; medullary cavity gets bigger and bigger

Ligaments

Bone-Bone fibrous connections, primarily made of collagen: -Intrinsic: ligament that thickens joint capsule -Extrinsic: ligament that is separate from capsule (either within or external)

Osteoblasts

Bone-building cells: - Synthesise and secrete collagen fibres - Lay down organic components that form extracellular matrix of bone. - Initiate calcification = hardening of bone tissue

Pneumatic bones

Bones surrounding the air spaces in the skull (sinuses)

Irregular bones

Bones that don't fit into other categories: eg. vertebrae

Tubercle of rib

Bony bumps that are lateral to neck of rib. 2 parts: - smooth = smooth impression = articular facet that forms joint - rough = provides attachment for ligament

Pancreas

Both exocrine and endocrine glands. - acini produce enzymes; secreted into ducts, leading to hollow viscus. - islets produce insulin; secreted into blood stream

Nerves of lungs and visceral pleura

Both lungs and visceral pleura receive innervation from ANS - Arise from pulmonary plexus (at lung root), containing both sympathetic + parasympathetic nerves.

Axillary nerve

Brachial Plexus: C5-6, Superior trunk, posterior division, posterior cord Motor: Deltoid Sensory: Deltoid skin Location: Axillary nerve and artery come penetrate the same quadrangular space to posterior side. Injury: shoulder dislocation (since nerve wraps around humerus neck.

Musculocutaneous nerve

Brachial Plexus: C5-7, Anterior Division, Lateral Cord Motor: Innervates all muscles in anterior arm (flexors). Sensory: Innervates lateral skin of forearm Location: Penetrates coracobrachialis, under biceps, above brachialis Injury: N/A; it is very well protected

Median Nerve

Brachial Plexus: C5-T1, Anterior Division, Lateral + Medial cords Motor: Innervates anterior forearm muscles (flexors) + most thumb muscles Sensory: Innervation of digits I-III & half of IV (palm side) Location: Descends near brachial artery (no innervation in upper arm). Branches as it descends through forearm (motor). Goes through carpal tunnel and branches again (cutaneous) Injury: Carpal tunnel syndrome

Radial Nerve

Brachial Plexus: C5-T1, all trunks, posterior divisions, posterior cord Motor: All posterior arm and forearm mucles (extensors) Sensory: Posterior compartment of arm, forearm and some of hand (dorsal digits I-III) Location: Enter posterior compartment via triangular interval. Runs between medial & lateral heads of triceps (radial groove). Descends down forearm in 3 branches: cutaneous/superficial branch, deep forearm muscle branch, lateral branch. Injury: humerus shaft fracture, compression of nerve in radial groove, wrist drop

Ulnar nerve

Brachial Plexus: C8-T1, inferior trunk, anterior division, medial cord Motor: Most intrinsic hand muscles. A few forearm muscles too. Sensory: Half of digit IV and V (palmar side). Half of III, IV, V on dorsal side. Location: Descends anterior aspect of upper arm without branching. Goes posterior to elbow, returning anteriorly in forearm. Goes over flexor retinaculum, and branches. Injury: Ulnar claw

Branches of aortic arch

Brachiocephalic trunk Left common carotid artery: supplies left head, left neck Left subclavian artery: supplies upper left limb

Dural herniation

Brain herniates/squeezes underneath falx cerebri = cell damage/inflammation. Especially bad if herniation occurs through tentorium cerebelli.

Anterior Ramus

Branching of mixed spinal nerve; this ramus innervates most skeletal muscles (eg. brachial plexus) and areas of skin.

Posterior Ramus

Branching of mixed spinal nerve; this ramus innervates only intrinsic back muscles, facet joints (Zygapophyseal joints), overlying back skin

Osteoclasts

Break down bones/Resorption: - Break down matrix by lysosomal enzymes - Acids digest any proteins/minerals if they need to be released.

Pathological fracture

Break in a bone that is already weakend by disease (eg. osteoporosis)

Scaphoid fracture

Break in scaphoid bone; hard to detect in X-ray - check via snuff box. May lead to loss of blood supply and thus, scaphoid death = severe impact on wrist ROM

Brain Stem

Bridge between brain and spinal cord. 3 parts: - Midbrain (rostral) - Pons = bridge - Medulla oblongata (joined to spinal cord, caudal). Controls breathing & other vital functions

Development of stomach

Bud (at caudal end) of foregut starts dilating/growing at different rates: 1) Differential Growth: Dorsal growth > ventral growth = curvature of stomach 2) While growing, tube rotates 90 degrees clockwise = greater curvature on the left & lesser curvature on right. 3) 90 degree upward rotation = C-shape of duodenum

Development of lung

Budding off ventral side of endodermal foregut forms respiratory diverticulum (eventually forms trachea). Then, a series bifurcations (branches) - 1st branch = tracheal buds (forms bronchi) - 2nd branch = secondary bronchial buds: 3 on right side, 2 on left (forms lung lobes) - 14 more branchings of lengthening/branching

Development of Gut (after formation)

Buds from gut form into endodermal organs, depending on region: - Foregut: Thyroid, Parathyroid, Thymus, Lung, Stomach - Midgut: Liver, Pancreas - Hindgut: Intestines - Foregut itself becomes: pharynx, oesophagus, stomach, proximal duodenum - Midgut itself becomes: Distal duodenum, half of colon - Hindgut becomes: distal half of colon and anus

Disc prolapse

Bulges, herniations or extrusions of the intervertebral disc's nucleus through the anulus fibrosus. Can result from poor lifting practice or if the anulus becomes thin and/or weak (with aging) This may in turn damage anterior/posterior nerve roots & dorsal root ganglion = compromised sensory, motor and reflex functions.

Limb buds

Bumps of tissue that appear in 6th week of human embryo. Upper limb buds before lower. Initially mesenchyme, then develops first into cartilage, then bones, then joints. Skin & nerves are "dragged" away from trunk to cover limb: C5-T1 for upper limb, L1-S2 for lower limb

Muscle fascicles

Bundles of muscle fibres wrapped in perimysium Muscles can only contract/shorten in the direction of fascicles. Thus, different fascicle patterns = different contractions = different degrees of power: circular, convergent, parallel, pennate

Fascicles

Bundles of nerve fibres/axons wrapped in perineurium

Cervical vertebra

C1-C7 - Foramen in transverse regions - Projections posteriorly that become branched - Support/move head = not too big

distinguishing jejunum vs ileum

Caliber: jejunum has larger diameter Location: (LUQ / RLQ) Circular (mucosal) folds: more prevalent in jejunum for larger SA and absorption Wall: thicker in jejunum due to more mucosa Vascularity: jejunum more vascular Fat in the mesentery (less in jejunum, can see vessels more clearly) CLFWVF

Naming skeletal muscles

Can be named according to several criteria: - Location: temporalis lies over temporal bone - Shape: trapezius = trapezoid - Size: maximus, longus, brevis (short) - Number of origins: biceps = 2 origins - Attachments: origin comes before insertion (eg. sternoclediomastoid = sternum + clavicle = origin, mastoid = insertion)

Lymphatic plexuses/capillaries

Capillaries = lowest calibre vessels of lymphatic system. Blind ending. - Superficial capillaries located under epidermis - Deep capillaries located within reticular layer of dermis. ^both lymph capillaries drain into lymphatics

Carpi/Digit/Indicis in naming

Carpi = relating to wrist (carpal bones) Digit = relating to digits (phalanges) Indicis = relating to index finger

Pulmonary trunk

Carries blood away from right ventricle. Lies just below aortic arch. Ligamentum arteriosum connects aortic arch and pulmonary trunk.

Arytenoid cartilage

Cartilage in larynx = posterior attachment for vocal ligaments (inside/posterior to crycoid cartilage) Function: Abduct and adduct vocal ligaments to produce sound

Pubic Symphysis

Cartilaginous joint that joins pubis together - Reinforced by disc; very stable

Paranasal sinuses

Cavities inside bone that are lined by mucosa. Develop from lateral wall. Development: around 2 years, after teeth form. Growth of space from lateral wall into surrounding walls; drags mucosa with it. Types: 4, named by bone: - Frontal, Ethmoid, Sphenoid sit above nasal cavity = drain down well (rarely infected) - Maxillary = in cheekbones, with opening at top = hard to drain (easily infected). Floored by maxilla bone.

Melanocyte

Cell in stratum basale that produces pigment (melanin): - Pigment transferred to overlying keratinocyte cells - Amount of pigment determines pigmentation (number of melanocytes is the same) Come from migratory neural crest cells

Chondroblast/Chondrocyte

Cell that gives rise to cartilage. Derived from mesenchymal cells; endochondral ossification

Neurons

Cells of nervous system. Contain: - dendrites = extensions around cell body that receive incoming signals. - axon = long projection that conducts information away from cell body.

Oropharynx

Central portion of pharynx; arch Top: made of soft palate (uvula in midline) Floor: made of posterior third of tongue + linguinal tonsil + epiglottis. Lateral walls consist of (paletine) tonsils that sits between two folds (palatoglossal fold & palatopharyngeal fold) During chewing, pharyngeal muscles pull soft palate down to close oropharynx opening. Triggers gag reflex

Bones in adults vs children

Children: - Larger proportion of red marrow for haemopoiesis - More bones - Presence of epiphyseal cartilage Adults: - Larger proportion of yellow marrow - Fewer bones

Phylum

Chordata - Mesodermal Notochord and tail - Ectodermal neural tube - Pharyngeal pouches: lined with endoderm and covered by ectoderm - Segmentation and polarity (body axes)

Close packed vs. Loose packed joint positions

Close packed position = joint position of maximal stability Loose packed position = all other positions

Proximal

Closer to the body trunk/point of attachment. eg) elbow is more proximal than wrist

Taste buds

Cluster of cells in the lateral walls of certain papillae: vallate, funigform, foliate papillae

Superphylum

Coelomate: - 3 germ layers: ectoderm, mesoderm, endoderm - Fluid-filled body cavity that is lined with mesoderm = coelom - Gut tube is suspended in coelom

Fractured humerus

Common fracture sites: Surgical neck (proximal), midshaft and supracondylar (distal end of humerus)

Carpal Tunnel syndrome

Compression of median nerve as it passes through carpal tunnel = loss of innervation to thumb motor muscles & altered sensation in digits I-III and half of IV. N.B. Palm sensation is retained as this branch of median nerve goes over carpal tunnel.

Congenital disorder

Conditions present at or before birth. Can be genetic, infectious, nutritional and/or environmental. May affect structure or function.

Metacarpophalangeal joint

Condylar joint between metacarpals and phalanges = biaxial movemet (abduction/adduction & flexion/extension)

Humerus (distal)

Condyles = articular surfaces with forearm bones. - Trochlea = condyle with ulna (medial) - Capitulum = condyle with radius (lateral) Epicondyles sit above the condyles: - medial epicondyle (larger) - lateral epicondyle

Communicated Ramus

Connect sympathetic chain to mixed spinal nerve. One for preganglionic nueron (myelinated/white) One for postganglionic (not myelinated/grey)

Mesentery

Connecting stalk of double-layered membrane between viscera and body wall. - Provide pathway of nerves/vessels into viscera - Allow viscera to move. - Risk of torsion of viscera near mesentery; cuts of blood supply.

Lung root

Connection between lung and mediastinum. Allows for communication between lung and mediastinum.

Anastomoses

Connections between arteries or arterioles. Provide alternate routes for blood flow = collateral flow = backup in case usual pathway is obstructed. This is common in arteries around joints or arteries close to each other. Joint anastomoses = intramuscular.

Ligamentum arteriosum

Connective tissue b/w inferior aspect of aortic arch and superior aspect of pulmonary trunk. Remnant of fetal circulating system: acted as duct allowing any blood that enters RV to rejoin with aortic arch.

Cartilage

Connective tissue: resilient, semi-rigid. Precursor for many bones in development Location: parts of skeleton where more flexibility is required (ribs) Nourished via diffusion as it is poorly vascularised/innervated Hyaline, Elastic, Fibrocartilage vs. Bone: - Poor vascular/nerve supply.

Lateral Mesoderm (general)

Consists of somatic mesoderm & splanchnic mesoderm. - Vasculogenesis: early on in embryo. Replaced by Angiogenesis

Thoracic vertebra

Contains 2 sites of rib articulation (anterior body of vertebra + transverse region of vertebra) Presence of processes

Lateral Wall of Nasal Cavity: conchae & meatus

Contains 3 conchae = shelf of bone which projects into middle of nasal cavity from lateral wall: superior, middle & inferior Each conchae is lined by mucosa, and only appear on lateral wall. - Superior & middle conchae are part of ethmoid bone - Inferior conchae = separate bone Conchae occupy a lot of space = easily block up during swelling. Each conchae creates a meatus = space underneath. Many openings into meatus space for paranasal sinuses.

Tone

Continuous partial contraction of muscle. Occurs in blood vessels via vasomotor nerves.

Isometric contraction

Contraction but no movement is actually produced, no shortening of muscle fibre. Muscle force = force of gravity eg) Plank

Concentric contractions

Contraction with movement = muscle fibres shortening. Muscle force > force of gravity. eg) Bicep curl

Conus medullaris & Cauda equina

Conus medullaris = spinal cord termination at L2. Cauda equina = number of nerve fibres that continue down to coccyx.

Fractured clavicle

Coracoclavicular ligaments are very strong; clavicle breaks first. Very common: - Distal part of clavicle is in place due to strong ligaments; common fracture occurs slightly medial to this. - Shoulder commonly falls down as there is no longer support.

testicular descent

Critical for normal fertility and sperm production Process where Gonadal development occurs along posterior abdominal wall > testes descend downwards towards Inguinal canal by 7 months gestation > testes go through inguinal canal into the scrotum just before birth & drags blood vessels, nerves, duct system & layers of abdominal wall into the scrotum - all layers = 'Spermatic cord' essentially Gubernaculum pulls testes down into scrotum as it shortens process of making sperm requires cooler temp than body temp otherwise infertility or increased risk of testicular cancer - 'Hidden testes' where testes ≠ make it all the way to scrotum & needs to be surgically corrected before 18 months/2 years of age

Rotator Cuff muscles

Cuff of scapulo-humeral muscles that blend with joint capsule, compressing humerus against scapula = increased stability Supraspinatus = in superspinous fossa, supporting superiorly Infraspinatus = in infraspinus fossa Teres minor = loops around humerus to protect posteriorly (behind) Subscapularis: sits in subscapular fossa to protect anteriorly (from front)

Body of rib

Curved section of rib. Thin and flat. Vertically oriented: - Lateral/external surface - Medial/internal surface Costal Groove = internal surface near interior border is a pathway for nerves/vessels to supply intercostal muscles

Venous valves

Cusps of endothelium in venous lumen that prevent backflow of blood. Often located distally to entry of major tributary - large vein (where 2 medium veins come to meet large vein) Mechanism: When blood tries to flow backwards, it fills the cusps, closing the vein.

Profunda femoris

Deep branch of femoral artery. Supplies medial and posterior compartments of thigh This artery also branches to enter hip joint capsule to supply neck/head of femur = prone to injury

Transversospinalis

Deeper intrinsic back muscles - Function = stabilisers in movement = fixators. Prevent excessive movement - Much shorter and not as strong as erector spinae - Atrophy rapidly after injury

Reticular Layer

Deeper layer of dermis (4/5 of dermis). - Attached to inferior aspect of subcutaneous tissue - Made of collagen fibres in specific planes: creates cleavage/tension lines. - Contains blood vessels from subcutaneous tissue, nerves, hair follicles, sebaceous/sweat glands.

Myotome

Defined areas of muscle that receive sensory information from one spinal nerve

Dermatome

Defined areas of skin that receive sensory information from one spinal nerve; each spinal nerve represents a different area on the skin (except face)

Viscera

Definition: Organs that regulate internal environment Function: Secretion, excretion, digestion, absorption Location: Often occupy body cavities (not testes)

Serous membranes

Definition: Single membrane that lines body cavity, enclosing a space/lumen. Produces fluid = frictionless movement. 2 parts: - Visceral layer lines viscera = serosa = autonomic nervous supply; same nerve/blood supply as organ - Parietal layer lines body wall = somatic = somatic nervous supply. 2 layers are connected by a mesentery stalk.

Deep Fascia (skin)

Dense connective tissue that lies deep to superficial fascia. Separates muscle groups. Connected to superficial fascia by fibrous strands = septa

Compact/Dense bone

Dense, outer shell of all bone. Made of hollow pillars of bone matrix, containing nerves/blood vessels. Covered by periosteum (except at articulations)

Stretch marks

Dermis (collagenous/highly vascularised) is overstretched = collagen fibres are disrupted & blood vessels are ruptured = red stretch marks (leaked blood). Silver scar tissue eventually replaces the red streaks.

Structures passing through diaphragm

Diaphragm closes off inferior abdomen, but hiatus allow structures to pass: - Hiatus at right part of central tendon; T8 level = Inferior Vena Cava - Hiatus within muscular part of diaphragm (around midline); T10 level = Oesophagus - Aorta technically passes behind diaphragm, between two crura ligaments and in front of thoracic vertebra; T12 level This ensures diaphragm movement does not influence pulsatile aortic flow.

Cervical Plexus

Diaphragm is operated by phrenic nerve: inputs from C3, C4, C5

benign prostatic hypertrophy

enlargement of the prostate gland causing compression to urethra - eventually blocking it entirely

inguinal canal

floor = inguinal ligament curvature roof = arching IO and TA muscles deep inguinal ring = in transversialis fascia superficial inguinal ring = fibrous split between pubic tubercle/pubic crest

labia minora/majora

folds of skin that protect the entrance to the vagina

ligament of ovary

folds over ovarian vessels & connects ovary to uterus

rectus sheath

formed by aponeuroses of EO, IO, TA fibrous compartment enclosing rectus abdominus internal oblique aponeurosis passes posteriorly and anteriorly around rectus abdominis

Innermost intercostal muscles

Discontinuous patches of muscle in intercostal space. Fibres run in many directions. Function = not as active during inspiration.

Sagittal Plane

Divides body from the front into left and right - Mid sagittal = straight down middle of body. - Para sagittal = divided off midline

Coronal Plane

Divides body from the side into front and back

Horizontal/Transverse Plane

Divides body into top and bottom.

Lower Limb Fascia

Divides muscle into groups = intermuscular septa (like upper limb) Iliotibial band (ITB) is fascial band running laterally down thigh. Combines with Tensor Fascia Lata (TFL muscle) to form one continuous structure

Typical spinal segment

Dorsal Roots: attach to dorsal horn; for only sensory neurons. Extend to dorsal root ganglion. Ventral roots: attach to anterior horn; for only motor neurons

Follicle

Downward extension of epidermis that surrounds the root of hair.

Azygos vein

Drains everything in thorax (other than heart) Location: posterior, just in front of thoracic vertebra. Function: receives blood from all internal viscera except heart: lungs, airways, intercostal veins, phrenic veins etc. Deposits into SVC Arches over right lung root, leaving impression above right lung hilum.

Orientation of heart

During development, heart turns 40 degrees to left. Right chambers mostly lie anteriorly. Left chambers mostly lie posteriorly. Apex around left 5th intercostal; projects towards the left. Majority of apex formed by LV Base at back of heart

Superficial posterior forearm muscles

ECRL & ECRB extend wrist on radial side ECU extend wrist on ulna side EDC extends digits II-V, EDM extends digit V

Tetrapod limb pattern

Each limb has: - Principal bone proximal = stylopod - Pair of long (distal) bones = zeuogopod - Short bones in hands & Digits

Bronchopulmonary segment

Each lung has about 11 bronchopulmonary segments. Each is functionally independent: - each receives independent blood supply/venous drainage - each is aerated by its own segmental bronchus - base of bronchopulmonary segment sits at surface of lung. It projects into hilum Functional independence provides function even in the case of pathology.

Thoracic vertebra (for rib attachment)

Each side of thoracic vertebra has 3 articulating facets/surfaces: - 2 at ventral body (superior & inferior) = costovertebral joint - 1 at transverse process (transverse costal facet) = costotransverse joint Also a long spinous process

Atrial appendages (auricle)

Ear shaped appendages on each front of each atrium: Right atrium appendage points anteriorly Left atrium appendage projects anteriorly from left Helps differentiate front from back of heart.

Development of integumentary system

Ectoderm --> epidermis Mesoderm --> dermis (like muscle, blood vessels, skeleton, connective tissue). Thus, dermis contains blood vessels

Neural tube

Ectodermal structure that forms from thickening and invaginating of neural plate. Eventually nerual tube becomes CNS: - Cranial end swells --> vesicles --> brain - Remainder becomes spinal cord. *CNS is therefore ectodermal in origin

Cranial nerves

Emanate from cranial cavity = peripheral nerves. 12 different types: Olfactory, Optic, Oculomotor, Trochlear, Trigeminal, Abducens, Facial, Vestibulocochlear, Glossopharyngeal, Vagus, Accessory, Hypoglossal vs. Spinal nerve May be mixed nerve, or completely sensory or motor.

Gastrula

Embryo with 3 primary germ layers: ectoderm, mesoderm, endoderm

Body folding

End of 3rd week: embryo = flat, embryonic disc. 4th week: - Differential growth: upper layer of disc grows more - Since notochord/neural tube are stiff, folding takes place at cranial & caudal end. Also folding from sides. Overall, looks like mushroom. - During this, mesoderm starts swelling.

Principles of endodermal organ growth

Endodermal organs: Lung, Stomach, Liver etc. - Starts with endodermal thickening (like primitive streak) - Cells bud off - Continuous lengthening and branching

Structure of skeletal muscle

Entire muscle group is wrapped in epimysium connective tissue. Each muscle group contains multiple fascicles = bundles of individual muscle cells. Each fascicle is wrapped in perimysium connective tissue. Each fascicle is made up of muscle fibres = individual muscle. Each muscle fibre is wrapped in endomysium

Gastrulation: 3-germ layers from primitive streak

Epiblast cells migrate through primitive streak: - 1st cells push hypoblast to either side, forming endoderm - 2nd cells move into space between epiblast and endoderm, forming mesoderm N.B. Mesoderm ends up spreading across all embryonic disk.

Gross anatomy of long bone

Epiphysis: End region of bone, articulates to form joints: - Proximial epiphysis - Distal epiphysis Metaphysis: Region between epiphysis and diaphysis; where bone grows. Diaphysis: Long shaft of bone Periosteum: Protective membrane that surrounds bone (except joints) Medullary cavity: Hollow space within diaphysis, containing yellow marrow & blood vessels Endosteum: thin membrane that lines medullary cavity, trabeculae, canals of compact bone Articular cartilage: Hyaline cartilage covering of joint surface

vas deferens (ductus deferens)

Excretory duct of testis that joins epididymis with ejaculatory duct - part of spermatic cord penetrates abdominal wall through inguinal canal & descends along lateral wall of pelvic cavity where it meets duct of seminal vesicle to form ejaculatory duct & opens to prosthetic urethra ejaculation mediated by sympathetic NS (smooth muscles help to pump sperm further out)

Extension vs Flexion of knee

Extension of knee = most stable conformation: - Condyles are most congruent with tibial plateau - Crucial ligaments are taut - Collateral ligaments are taut Flexion of knee = prone to injury - ACL rupture is most common (as it is thin) - This often leads to rupture of MCL (due to loss of support) - Meniscus is then damaged (due to loss of support)

Cauda equina

Extension of mixed spinal nerves distal to the termination of the vertebral column.

Flium terminale

Extension of pia mater that runs all the way down, past the conus medullaris, anchoring the spinal cord onto coccyx.

Dura Mater and Dural Folds

Extensions of dura mater that poke into invaginations in the brain to protect/stabilise. Major invaginations: - Falx cerebri: separates 2 cereberal hemispheres - Falx cerebelli: separates 2 cerebellum hemispheres - Tentorium cerebelli: separates cerebelumm from cerebrum

Posterior arm muscles

Extensor arm muscles: Triceps brachii: 3 heads: - Long head: attaches beneath glenoid - 2 other heads (lateral & medial): attach to shaft of humerus. Join together at olecranon process on ulna (for extension) Radial groove runs between lateral/medial heads.

Deep posterior forearm muscles

Extensor indicis: independently extends index finger EPL & EPB extend the thumb Snuffbox tendons = EPL, EPB and APL form depression at base of thumb: can be used to gauge scaphoid fractures

Posterior forearm muscles

Extensor muscles with common extensor origin: lateral epicondyle 2 layers: deep & superficial

Serosa

External layer of hollow viscera. Produces fluid to minimise friction between organs. Derived from lining of body cavities

scrotum

External sac that contains the testes Homologue of labia majora Skin fuses in midline = 'raphe'

Anterior compartment syndrome

Fascia surrounding anterior compartment of leg is particularly strong; any bleeding will increase pressure = compress/close neurovascular structures Can be cut open to decompress.

Pennate Fascicles

Fascicles are short/feather like and attach obliquely. 3 types: Unipennate: fascicle inserts onto only one side of tendon extensor digitorum longus Bipennate: fascicles insert onto opposite sides of tendon rectus femoris Multipennate: Fascicles insert onto muscle from many sides. deltoid

Parallel fascicles

Fascicles of muscle arranged in parallel lines along long axis of muscle Contraction: shortens the most out of any muscle; not as strong as convergent. Shape: Either strap-like (sartorius) or spindle-shaped with expanded belly = fusiform (eg. biceps brachii)

Convergent fascicles

Fascicles of muscle arranged in triangular shape = many fascicles converging on the one spot = strongest contraction (eg. pectoralis major)

Circular fascicles

Fascicles of muscle arranged into concentric rings. Contraction: closes opening (eg. orbicularis oris = mouth muscles)

Speech

Feature of homo sapiens. Organ of speech = larynx. - Lengthened larynx = long air column = ability to form words.

Popliteal artery

Femoral artery becomes this artery when it reaches posterior thigh. Forms 3 major branches as it passes through knee joint to supply leg compartments: - Anterior tibial artery: goes through interosseus membrane b/w T&F to supply anterior leg. - Posterior tibial artery: supplies posterior leg. Continues all the way down through tarsal tunnel to supply plantar foot. - Fibular artery: small branch that supplies lateral leg

Femoral Artery

Femoral artery: supplies all thigh compartments. Begins down anterior thigh after inguinal ligament, immediately forming a deep branch = profunda femoris (medial/posterior thigh + head/neck of femur) Femoral artery descends under sartorius (through subsartorial canal) = well protected. It moves medially + deeper, through adductor hiatus to posterior compartment, where it becomes popliteal artery

Hip joint

Femur + Acetabulum - Ball and socket joint - Very good congruency (vs. shoulder joint) = stable - Strong ligaments reinforcing the joint from each bone of os coxae = very stable Iliofemoral ligament = very strong Y shape that winds around neck of femur during hip extension = femur is compressed into acetabulum = stablising Iliopubic ligament Ischiofemoral ligament

Synovial Joint Accessory Structures: Articular discs & Meniscus

Fibrocartilage structures that partially/completely divides the joint; - Resist compression = more stable - Greater ROM/more movements

Synovial Joint Accessory Structures: Labrum

Fibrocartilaginous lip that deepens the joint socket = stable Typical of ball and socket joints

Flexor Retinaculum

Fibrous band that arches over top of carpal bones: - Functions as fulcrum for tendons - Forms carpal tunnel with carpal bones.

Ligament

Fibrous connection between BONE and BONE (not directly associated with muscles). - Made of collagen fibres - Usually merge with periosteum of bone at joint

Cardiac Skeleton

Fibrous skeleton composed of 2 fibrous rings + 2 fibrous coronets. 2 fibrous rings provide attachment for AV muscles & valves; acts as insulator 2 coronets provide attachment for semilunar valves of great vessels = pulmonary valves, aortic valves.

Tendon

Fibrous tissue linking MUSCLE to BONE. - Origins and insertions refer to the attachment points of tendons. vs. Ligament: attaches between muscle and bone, not bone and bone. Both have poor blood supply

Sympathetic Nervous System

Fight/flight division of autonomic nervous system: - Short preganglion neuron --> Ganglion --> Long postganglion neuron Thoracolumbar outflow: all sympathetic nerves come from thoracic/lumbar spinal cord.

Glenoid labrum

Fiibrocartilaginous rim surrounding glenoid fossa = increases SA = more stable

Phalanges

Finger bones (long) distal to metacarpals. Fingers have 3 phalanges, thumb only has 2

Gastrulation: Formation of Primitive Streak

First step of gastrulation: - On epiblast of embryonic disk, cells start thickening & invaginating to form a groove = primitive streak. - Groove starts on outer end and extends to middle of disk (cranial). Defines major body axes: - Outer end = caudal - Inner end = cranial - Epiblast = dorsal - Hypoblast = ventral

Pharyngeal arches

Flaps of tissue on head of embryo. Each contains: - Ectodermal covering; external is called pharyngeal clefts - Inside is lined with endoderm; inside called pharyngeal pouches, each containing: - Central skeletal element (from neural crest cells) - Muscle from mesoderm - Cranial nerve & aortic arch artery

Scapula

Flat bone providing attachment for strong muscles. Divided into 2 depressions by a ridge = spine: Superspinous fossa and infraspinous fossa - Glenoid fossa = region which articulates with humerus. Usually lined with hyaline cartilage. Quite flat = doesn't complement humerus well. - Subscapula fossa = concaved anterior surface of scapula - Coracoid process = points in anterior position - Acromion process = points in posterior position.

Finger movement

Flexion = curl, Extension = lengthen Abduct = stretch fingers out; Adduct = bring fingers together

Elbow movements

Flexion/Extension = Anterior lifting/posterior dropping of arm. Pronation/Suppination

Wrist movements

Flexion/Extension = Anterior rising/posterior dropping of palm Abduction/adduction = lateral/medial deviation = ulnar/radial deviation

Shoulder movements

Flexion/extension = anterior/posterior movement in sagittal plane Abduction/Adduction = bring arms up/down External/Internal Rotation = Rotating arm away/towards midline Circumduction = combination of all these movements.

Anterior arm muscles

Flexor arm muscles Biceps Brachii = most superficial anterior muscle = flexor 2 muscles below biceps: Coracobrachialis: pulls humerus into midline: small and variable: not that important Brachialis: distal to corachobrachialis; main flexor

Flexor/Extensor in naming

Flexor causes flexion Extensor causes extension

Intermediate Anterior Forearm muscles

Flexor digitorum superficialis (FDS): - flexes digits II-V, not thumb* - becomes tendonous and goes through carpal tunnel - long and powerful

Posterior Leg muscles

Flexor muscles of legs in 2 groups: Superficial: plantarflexors Gastrocnemius (power), Soleus (postural), Plantaris Deep: Tibialis Posterior, Flexor Digitorum Longus, Flexor hallucis longus

Deep Anterior Forearm muscles

Flexor muscles that go to distal phalanges: Flexor Digitorum Profondus = flexes digits II-V Flexor Pollicis longus = flexes thumb

Synergism of flexors and extensors in hand

Flexors and Extensors in hand work synergistically rather than antagonistic: - Long finger flexors aren't long enough to act across all joints - Extensors of wrist contract to promote finger flexion

Curves of vertebral column

Foetus/newborn has anteriorly concave (C-shape) vertebral column = primary curve. Changes with muscle development: - Cervical vertebra has secondary curve - Thoracic vertebra maintain primary curve - Lumbar vertebra develop secondary curve - Sacral vertebra maintain primary curve

Folia

Folds of the cerebellum. NOT gyri Allows for greater surface area = more neurons.

Gyrus

Folds on the surface of the cerebrum: maximises number of neurons (more surface area).

Ovary

Folliculogenesis takes place in the cortex/outer area of the ovary - maturation of oocyte to prepare for ovulation Located: adjacent to lateral wall of pelvis, in peritoneal cavity & posterior to broad ligament - it is attached to uterus by Ligament of Ovary

Talus

Foot bone articulating with malleolar mortise: Structure: number of parts: trochlear surface on top, neck, head that articulates with tarsal bones. Sits on top of calcaneus Function: Articulates at talocrural joint. Distributes all weight from tibia to calcaneus & talus bones

Teeth

For chewing. 32 teeth: 16 on maxilla arch, 16 on mandible arch. On each side of one arch: - 2 incisors = flat for shearing food - 1 canine = anchoring (especially through meat) - 2 premolars & 3 molars = flat surfaces for grinding/macerating food

Obturator Foramen

Foramen formed by pubis and ischium. Filled by membrane and obturator nerve

Lymphangiogenesis

Formation of lymphatic system (part of cardiovascular system). Grows from pre-existing veins (cardinal vein) - Somewhere, cells produce VEGF-C. - VEGF-C gradient causes cardinal vein cells to migrate away to form lymph sac. - Lymph sac sprouts and grows into whole system.

Endochondral ossification

Formation of most bones: 1) Mesenchymal cells develop into chondroblasts which lay down cartilage. 2) Cartilage lenghens/grows into bone shape 3) Development of Primary ossification centre: triggered by nutrient artery, supplying nutrients/oxygen to allow further cell differentiation = bone formation. 4) Development of medullary cavity: triggered by specialisation of cells into osteoclasts. Bone tissue replaces most of cartilage in diaphysis. 5) Secondary ossification centres occur at proximal and/or distal epithyses. Triggered by epiphyseal artery. 6) Formation of articular cartilage.

Lymphatic ducts & final lymphatic drainage

Formed by merging of lymphatic trunks at the neck, which then drain into venous system: - Right lymphatic duct: drains from right head/neck, right limb, right upper abdomen - Thoracic duct: drains rest of body

Supracondylar fracture

Fracture above the condyles = may cause severing of brachial artery = reduced blood flow distal of the upper arm = Volkmann's ichemic contracture = muscles which have lost blood supply come into contracted state

Wrist fracture

Fracture of distal radius and possibly ulna. Occurs when falling onto outstretched hand (usually forearm pronated and wrist extended). Forms a shape called "dinner fork deformity"

Intervertebral foramen

From side, there is a hole formed by stacking of vertebra on top of each other; inferior notch of upper vertebra + superior notch of lower vertebra. Allows for passage of: spinal roots, vessels, dorsal root ganglion

Anterior

Front

Sphincter

Function: Helps passage of material through viscera. Also close off hollow viscus distally to prevent things from getting through. Located typically at END of hollow viscus, near constrictions. Anatomical sphincter & Functional sphincter.

Hand muscles

Functionally arranged: - 4 thenar muscles = muscles at base of thumb - 3 hypothenar muscles = muscles at base of pinky - Intrinsic muscles = muscles within palm of hands for intricate movements (forearm muscles are for power): lumbricals & interossei

Tongue Papillae

Fungiform papillae: small round, mushroom-shaped Vallate papillae: large, round right in front of sulcus terminalis Foliate papillae: grooves in posterior, lateral part Filiform papillae: pointy

Distal

Further from body trunk (eg. wrist is more distal than elbow)

Deep

Further from the body surface

Fertilisation

Fusing of single sperm cell and secondary oocyte (egg) to form fertilised egg = zygote

Gastrointenstinal tract & mesentery

Gastrointestinal tract divided into segments containing mesentery and no mesentery: ensures some motility and some stability.

Types of Glands

Glands are solid viscera. Exocrine glands: Secrete into duct(s) that are found in hilum of viscera. Ducts lead into hollow viscera. Liver and bile duct Endocrine glands: Secrete directly into blood stream = require rich vascular supply. Usually secrete hormones. Adrenal glands

Shoulder joint/Glenohumeral joint

Glenoid fossa and Humerus form ball & socket joint = great ROM, unstable. Stability is supported by 4 structures: - Glenoid labrum increases SA = more stable - Coracoacromial ligament prevents superior dislocation of humerus - Rotator cuff muscles* extend out and pull humerus towards scapula - Long head of biceps holds humerus medially (like rotator cuff muscles)

Microglial cells

Glial cell Controls the immune system of the CNS

Astrocytes

Glial cell Forms blood-brain barrier. Support synaptic transmission.

Gluteus maximus

Gluteal muscle: - Large, Hip extensor - Originate from ilium/sacrum - Insert onto femur via ITB - Only recruited in high power movements: very strong - Throughout evolution, migrated from lateral to posterior position

Basal Ganglia/Basal nuclei/Grey Matter nuclei

Grey matter deep within the cerebrum

Ventral horn

Grey matter horn where motor neuron cell bodies reside.

Posterior horn

Grey matter horn where sensory neurons emerge. Cell bodies of sensory neurons reside in dorsal root ganglion = outside of CNS

Intercostal Groove

Groove at inferior border and internal side of rib. - Protects/allows passage of neurovascular bundles = intercostal vein/artery + intercostal nerve - Innervates thoracic wall and intercostal muscles.

Radial groove

Groove running between lateral & medial heads of triceps. Where radial nerve runs.

Openings/Depressions for nerves or vessels

Groove, Fissure, Foramen, Notch, Meatus, Fossa, Sinus N.B. Sinus is not for nerves or vessels, but a chamber filled with specialised tissue

Sulcus

Grooves between the gyri of the cerebrum. Key Sulci define boundaries between lobes: 1) Central sulcus = separates frontal & parietal lobes: - Precentral gyrus = location of primary motor cortex - Postcentral = primary sensory cortex (feeling) 2) Parieto-Occipital sulcus - Occiptal lobe = vision

Erector spinae

Group of intrinsic back muscles running vertically down back: - Prime movers = very strong, long - More superficial than Transversospinalis - Work concentrically/shortening (to extend/erect body) - Work eccentrically/lengthening to control flexion - Attach to lumbosacral fascia.

Spinal nerves

Grouped & named relative to vertebrae: cervical, thoracic, lumbar, sacral. In general, 1 nerve for every bone: exception in 8 cervical nerves for 7 bones - C1-7: nerve lies above C1-7 bone - C8 nerve lies below C7 bone - Remainder: nerve lies below bone

Developing Gut Structure

Gut is closed at cranial end by oropharyngeal membrane. Gut is closed at caudal end by cloacal membrane. 3 parts (defined by blood supply) - Foregut : supplied by celiac artery - Midgut : supplied by superior mesenteric artery - Hindgut : supplied by inferior mesenteric artery

jejunum and ileum

HOLLOW INTRAPERITONEAL (massive mesentery) Jejunum = LEFT UPPER QUADRANT Ileum = RIGHT LOWER QUADRANT jejunum = proximal 60% ileum = distal 40%

stomach

HOLLOW LEFT UPPER QUADRANT INTRAPERITONEAL 2 orifices (cardiac and pyloric) 2 curvatures (lesser on right, greater on left) = J shape 2 surfaces (anterior/posterior) 4 parts: cardia, fundus (gas), body, pyloric part (includes pyloric antrum (wider), pyloric canal (narrowing towards duodenum) pylorus/pyloric sphincter slows digestion gastric folds (rugae)

large intestine

HOLLOW QUADRANT? Transverse/sigmoid colon = INTRAPERITONEAL (massive mesentery) Ascending/Descending colon = RETROPERITONEAL external longitudinal layer of muscle splits into 3 muscular bands (tenia coli) internal circular layer of muscles still present in large intestine hepatic flexure tucks against the liver splenic flexure tucks against the spleen haustra - baggy structures due to tenia coli being shorter than large intestine tenia coli has fatty tags on it

oesophagus

HOLLOW RETROPERITONEAL majority lives in thorax enters stomach on the right side has external longitudinal layer of muscles and internal circular layer of muscles oesophogastric junction (Z-line) where gastric v oesophageal mucosa meet Constrictions: 1. Cervical (C6): tight anatomical sphincter 2. Thoracic (T4/5): aortic arch and left main bronchus both compress on left side 3. Diaphragmatic (T10): diaphragm forms functional sphincter, prevents acid reflux

appendix

HOLLOW RIGHT LOWER QUADRANT INTRAPERITONEAL Due to mobility, appendix can be very hard to locate. First locate cecum then find appendix from there

caecum

HOLLOW RIGHT LOWER QUADRANT INTRAPERITONEAL blind pouch, inferior to ileocaecum junction 3x tenia coli bands meet at the inferomedial aspect of caecum, which is where appendix attaches to

duodenum

HOLLOW RIGHT UPPER QUADRANT RETROPERITONEAL (tucked on posterior wall, covered on anterior surface) C shaped - head of pancreas tucks in 4 parts 2nd part contains major and minor duodenal papilla major papilla - allows entrance of GI enzymes and bile from common bile duct and main pancreatic duct minor papilla - opening for small proportion of pancreatic enzyme from accessory pancreatic duct

gallbladder

HOLLOW RIGHT UPPER QUADRANT unclear whether INTRA or RETROPERITONEAL (no mesentery, only partially covered in peritoneum) - tucks into visceral surface of liver - produces bile

Metacarpals

Hand bones (long), numbered I-V, starting from thumb

Complex joint

Having 2 or more articulation surfaces and an articular disc/meniscus

Projections that help to form joints

Head, facet, condyle, ramus

Development of heart

Heart buds into pericardium sac during development = brings layer of serous pericardium = serous pericardium lines heart

Coronary veins

Heart drains directly to Right Atrium via these veins (not SVC). Accompany coronary arteries.

Fibrous rings of heart

Heart has 2 fibrous rings that form a figure 8. Left ring surrounds mitral valve, right ring surrounds tricuspid valve. Function: - Provides separate attachment for atrial/ventricular muscles & valves. - Provides separation between atrial and ventricular muscles = insulator = no electrical signal other than conduction system.

Pericardium

Heart, roots of major arteries, terminations of major veins are enclosed within a fibrous sac = pericardium 2 layers of pericardium sac: Fibrous pericardium: outer, thicker layer; covers heart and roots of great vessels, blends inferiorly with central tendon of diaphragm = limits downward descent of diaphragm Serous pericardium: thin, inner layer; divided into parietal and visceral pericardium

Calcaneus

Heel bone that sits below talus: Function Articulates with talus at subtalar joint

Elbow joint

Hinge synovial joint, supported by collateral ligaments. - Articulation between trochlear notch (ulna) and trochlear (humerus) N.B. The head of radius only glides across surface of capitulum.

Os coxae

Hip bone composed of: - Ischium = for hamstrings - Ilium = for gluteal muscles - Pubis = for adductors - Spines = prominances along the bone of the pelvis - Acetabulum

Family

Hominidae - Thumbs (and big opposable toe for non-humans) - Flattened nails - No tail - Complex social behaviour - Facial expression + Complex vocalisation

Species

Homo Sapiens *Upright posture, arises from: - Bipedal locomotion = vertical line of gravity - Peculiar foot: arched platform with non-opposable toe - Non-opposable big toe - Expanded brain Also have speech.

Relaxin

Hormone released late in pregnancy to loosen pubic symphysis and sacroiliac joints

Left-Right Asymmetry Hypotheses

How cells discriminate left and right from fluid flow in primitive node: 1) Morphogen Hypothesis: Molecules are secreted into the fluid. They bind to molecules downstream (left), whereas cells upstream (right) don't have as many bound molecules. 2) Nodal Vesicular Parcel Hypothesis: Same as above, but with vesicles. 3) Two cilia hypothesis: 2 types of cilia: - 1 type sits at bottom of the node and rotates. - 1 type sits at rim of cells and do not rotate. Left cilia bend as fluid is pushed toward them. Right cilia do not bend.

Cerebral hemisphere Cranial nerves

I) Olfactory = smell II) Optic = Sight

Midbrain Cranial nerves

III) Oculomotor = eye movement; Parasympathetic IV) Trochlear = eye movement

Medulla Cranial Nerves

IX) Glossopharyngeal = tongue & pharynx (taste, saliva); Parasymapthetic X) Vagus = internal organs; most abdominal organs and thorax innervated by this; Parasympathetic XI) Accessory = neck muscles XII) Hypoglossal = motor control of tongue

Extension

Increasing angle of joint

Cleavage

Initial mitotic divisions of the zygote as it moves across oviduct. **Cleavage daughter cells are half the size of the mother cells. ^Not the case in later divisions

Nucleus pulposus

Inner layer of articular disc of Intervertebral joint. - Hydrated structure; non-compressible but deformable - Function: Keeps vertebra apart

Dermis

Inner layer of skin, formed after neural tube: - Mesodermal origin

Spongy/Trabecular/Cancellous Bone

Inner section of bone; contains pillars/trabeculae that are aligned in a way to support tensile & compressive stresses. Also filled with red/yellow bone marrow.

Endoderm

Innermost germ layer. Forms: - Mesodermal organs: heart, blood vessels - Primitive gut: tube that runs from mouth to anus. Organs bud off along the way - Pharynx

Internal intercostal muscles

Intercostal muscle. - Muscle fibres run perpendicular to the muscle fibres in external intercostals (infromedial). Muscle fibres are continuous. - Contraction = inactive in (quiet) respiration; theoretically assist in forced expiration

Great veins

Internal jugular vein (left or right) = drains head/neck on both sides. Each runs in parallel with corresponding carotid artery. Subclavian vein (left or right) = drains upper limb, accompanies subclavian artery. These two veins combine just under sternoclavicular joint, forms braciocephalic vein (left or right) - Right shorter than left because SVC lies on right. - 2 braciocephalic veins combine to form SVC

Nerve Plexus

Interwoven network of nerves = peripheral nerves often comprised of multiple spinal nerves. (eg. brachial plexus) Benefits: Essential nerves (like for hand and diaphragm) can still function if one nerve is damaged.

Knee Crucial Ligaments

Intracapsular, extrasynovial ligaments of knee. Name depends on attachment point on tibia: ACL - attaches to tibia anteriorly/laterally (and runs posterior through capsule) - thinner - prevents tibia from moving anteriorly (and femur moving posteriorly) PCL - attaches to tibia posteriorly/medially (and runs anterior through capsule); - thicker - prevents tibia from moving posteriorly (and femur moving anteriorly)

Intraperitoneal vs Retropertioneal viscera

Intraperitoneal: oesophagus, stomach, jejunum/iluem, caecum, appendix, transverse colon, sigmoid colon, liver + biliary tract Retropetioneal: Duodenum, pancreas, ascending colon, descending colon, rectum + anal canal

Costovertebral joint

Joint between head of rib and thoracic vertebra (ventral body) Occurs at/around intervertebral region: - Inferior costal facet (of upper vertebra) articulates with superior demifacet (rib) - Intervertebral disc - Superior costal facet (of lower vertebra) articulates with inferior demifacet (rib) Strong reinforcing ligaments surround + provide structure to joint

Talocrural joint

Joint between talus and tibia/fibula = ankle joint - Hinge joint permits plantarflexion (flexion) & dorsiflexion (extension) - Talus fits well into malleolar mortise - Supported by Medial/ Lateral collateral ligaments + Spring ligament

Costotransverse joint

Joint between transverse process of vertebra and (medial) smooth tubercle of rib. Very strong/stable due to ligaments: - 3 sets of ligaments; attaching above, below and to the side. - 2nd ligament also attaches to rough tubercle & transverse process

Costal margin

Joint costal cartilage of ribs 7-10. Diaphragm attaches to costal margin.

Interphalangeal joints

Joints between phalanges: 2 in fingers, 1 in thumb. Hinge joints = uniaxial movement (flexion/extension) Supported by collateral ligaments.

Intervertebral joint

Joints between ventral bodies - secondary cartilaginous joint formed by articular disc (anulus fibrosus + nucleus pulposus). Contributes about 25% of height. Facilitates movement: - Anulus resists excessive movement - Nucleus moves anteriorly/posteriorly for flexion/extension - Nucleus can deform to facilitate compression

Types of Fibrous joints

Joints united by fibrous tissue: 1) Sutures Bones united by sutural ligament = thin ligament fibre that interlocks/attaches to bones. Only in skull. 2) Gomphosis: Bones united by periodontal ligament = short collagen fibre. Bones between tooth and jaw bone. 3) Syndesmosis: Two adjacent bones united by interosseus membrane. (eg. tibia and fibia/radius and ulna) Length of ligament determines movement

urinary bladder

hollow, muscular sac that holds and stores urine has 3 openings/orifices that form a trigone: - 2 ureteric orifices (superior opening of ureter) - 1 urethral orifice (inferior opening of urethra)

Human classification

Kingdom: Animalia (Superphylum): Coelomate Phylum: Chordata (Subphylum): Vertebrate Class: Mammalia Order: Primate Family: Hominidae Genus: Homo Species: Homo Sapiens

Movements of knee

Knee joint = modified hinge joint: Flexion (posterior) Extension (anterior) A little rotation too, but not active.

Bony framework of abdominal walL

L1-5 and IV discs iliac crest ASIS pubic crest pubic tubercle costal margin (12th ribs)

Teratoma

Large tumours that form if the primitive streak does not regress. - Benign - Assortment of cells

Superior Vena Cava (SVC)

Large vein that drains everything above the diaphragm excluding the heart

Inferior Vena Cava (IVC)

Large vein that drains everything below the diaphragm

Lumbar vertebra

Large, stronger vertebra to bear weight of head, abdomen, beck etc. Block shape to facilitate this Projections.

Large veins

Largest calibre vein: Wide bundles of smooth muscle. Well developed tunica adventitia. Typically seen near heart.

Medial & Collateral Ligaments of knee

Lateral Collateral Ligament - Attaches to head of fibula and femur (laterally) - Narrow, round band - Separate from joint vapsule - Resists adduction = "varus" force Medial Collateral Ligament - Attaches to top of tibia and femur (medially) - Flat, broad - Blends with joint capsule at fascia: innermost fibres of ligament take attachment to medial meniscus = prone to injury - Resists abduction = "valgus" stress

Formation of primitive gut

Lateral folding of embryo. Causes 2 types of mesoderm to fuse: - Parietal/Somatic mesoderm fuses with Parietal/Somatic mesoderm; forms intraembryonic cavity - Splanchnic/Visceral mesoderm fuses with Splanchnic/Visceral, forming outer lining of gut. Inner lining is endodermal

Radius

Lateral, long bone articulating with humerus and ulna. - Radial tuberosity = where biceps attach - Fovea = depression = where radius articulates with capitulum (humerus)

Grooves on lungs

Left Lung: Groove arching above hilum = impression from aorta Right lung: Groove arching above hilum = impression from azygos vein

Left-Right Asymmetry of subclavian artery

Left Subclavian artery comes directly off aortic arch Right Subclavian artery comes off brachiocephalic trunk.

Fissures, Lobes and other features of left lung

Left lung usually only has 1 fissure: - Oblique fissure Separates lung into 2 lobes: - Superior Lobe - Inferior lobe Medially: Cardaic notch = apex of heart produces this Lingula = tongue like process inferior to cardiac notch Cardiac impression = impression of heart on medial surface of left lung.

Eccentric contraction

Lengthening of muscle fibres/fascicles. Muscle force < force of gravity. eg) lowering barbel

Coracoacromial ligament

Ligament connecting coraco process and acromial process = prevents superior (upward) dislocation of humerus

Annular ligament of radioulnar joint

Ligament that sarts (anteriorly) and terminates (posteriorly) on the same bone = ulnar; hugs head of radius into notch = great stability Connects with radial-collateral ligament to produce rotation.

Ligament sprain

Ligaments are stretched beyond their resting length; collagen fibres are torn

Aponeurosis

Like tendon: tissue that links MUSCLE belly to BONE. However: - Broad, flat connective = spread over greater area than tendon.

Lymphatic drainage

Like veins, lymph capillaries drain unidirectionally, facilitated by: - Valves - Accompanying veins and muscles Capillaries --> Lymphatics --> Nodes --> Lymphatics --> Lymph Trunks --> Lymph ducts --> Venous system This drainage is very slow as there is no pump, only smooth muscle contractions. - Slow blood flow enables malignant cells to stay trapped = leads to secondary tumours

Line of gravity in lower limbs

Line of gravity does not go through joints = body weight not on all joints at once - LOG passes behind hip joint - LOG passes in front of knee = knee locked during extension (stable/congruent) - LOG passes long way in front of ankle *Structures help with stability on either side of joint

Axial border

Lines that run through limbs Divide limb into pre-axial (cranial) and post-axial (caudal) Upper limb: Pre-axial border = lateral side Lower limb: Pre-axial border = medial side - This is due to the way elbow flexion brings hand forward but knee flexion brings foot backwards

Anatomical Sphincter

Localised muscle thickenings around wall of viscus. Controls passage of contents (and prevents passage the wrong way). Involuntary = smooth muscle, ANS = 1st line of defense Voluntary = skeletal muscle = 2nd line of defense N.B. Often two sphincters are located together: anal sphincter

greater vestibular glands

Located at the opening of the vagina to the outside, lubricates the vaginal surface for intercourse

Crude touch/Stretch/Pressure receptor (locations)

Located deeper within dermis = source originates internally. Ruffini Corpuscle, Pacinian Corpuscle (deepest, pressure receptor)

Free nerve ending: tactile, thermal, pain (location)

Located near epidermal layer: detects light sensations (itch, tickle, pain, cold/warm)

Epiphyseal Plate

Location of longitudinal bone growth via chondrocytes in metaphysis: Split into 4 zones, each marking a different chondrocyte stage: 1) Zone of resting cartilage: chondrocytes grow and get ready 2) Zone of proliferating cartilage: chondrocytes activate, increasing in size, laying down cartilage models 3) Zone of hypertrophic cartilage: chondrocytes stack in close proximity 4) Zone of calcified cartilage: chondrocytes calcify into new bone. Epiphyseal cartilage is evident in growing/juvenile bones, but not in adults.

Skeletal muscle

Location: Attaches to and covers the skeleton. Contraction: Voluntary Appearance: Long, cylindrical, multinucleate, striated

Tibial nerve

Location: Branch from sciatic nerve. Descends posteriorly alongside popliteal vessels. Passes through tarsal tunnel to footl. Motor: Deep and superficial posterior leg muscles. Intrinsic, plantar foot muscles Injuries: - Tarsal tunnel syndrome = compression on tibial nerve - Joggers foot = compression on plantar foot nerves

Obturator nerve

Location: Descends from lumbar nerve roots through obturator foramen, straight into medial muscles. Branches. Motor: medial thigh muscles = adductors. Cutaneous: skin overlying adductor region (medial thigh) Injury: - Runs alongside ovaries; if ovaries expand, they compress on obturator nerve. - Through foramen, it is close to hip; any hip pathology may present in obturator pain

Femoral nerve (& Saphenous nerve)

Location: Forms in psoas muscle (pelvis), runs under inguinal ligament and branches in anterior thigh. One branch extends medially from femoral nerve = saphenous nerve Motor: supplies iliopsoas and quadriceps Cutaneous: supplies anterior quadriceps. Saphenous nerve supplies medial leg/foot. Injury: rare

Sciatic Nerve

Location: From lumbosacral plexus, runs through greater sciatic foramen, emerging under piriformis. Delves deep and descends in posterior thigh, branching at the same time. At knee, sciatic nerve branches into tibial nerve + common peroneal/fibular nerve Motor: 3 hamstring muscles. Cutaneous: Supplies skin overlying posterior hamstrings (posterior) Injuries: Hamstring tightness. Sciatica = sciatic nerve goes over or through piriformis. Spasms in piriformis can lead to sciatic pain

Gluteal nerves

Location: Go from anterior to posterior through greater sciatic foramen, next to piriformis: - Superior gluteal nerve = above piriformis - Inferior gluteal nerve = below piriformis Motor: 2 nerves that innervate 3 gluteal muscles

Cardiac muscle

Location: Only exists in heart Contraction: Involuntary; has its own conduction system Appearance: Branching chains of cells; less organised than skeletal. Uni/binucleate, striated

Smooth muscle

Location: Present in the walls of hollow organs. Contraction: Involuntary contractions (ANS) Appearance: Single, fusiform, uninucleate, non-striated.

Cerebellum

Location: Underneath occipital lobes, attached to dorsal side of brainstem. Function: Coordination of movements & posture. Divided into 2 hemispheres.

Superficial anterior forearm muscles

Long + powerful muscles. Extending from medial epicondyle to wrist: - Flexor carpi ulnaris (FCU): flexes wrist medially - Flexor carpi radialis (FCR): flexes wrist laterally

Humerus (proximal)

Long bone articulating with glenoid cavity (poor fit). Structure: - Head - Anatomical neck = where hyaline cartilage finishes - Surgical neck = after anatomical neck - Traction epiphyses = point of muscle attachment: lesser tuberosity and greater tuberosity, divided by bicipetal groove (where tendon of long head of biceps runs)

Clavicle

Long bone, slightly curved, that supports upper limb. Pushes limb outward = better ROM. - Medial/sternal end = smaller & rounder: attachment point to axial skeleton via sternoclavicular joint: costoclavicular & sternoclavicular ligaments. - Lateral/acromial end: = broader & flatter, acromioclavicular joint

Subcutaneous Tissue/Superficial Fascia/Hypodermis

Loose connective tissue of variable thickness, lying deep of the dermis. Connected to deep fascia via fibrous strands = septa. Contain: - Subcutaneous fat - Muscles of face (facial expression muscles directly attach to skin), neck, palm, scrotum

Tibia and Fibula

Lower leg bones; connected by interosseus membrane; articulate with each other at both ends. However, cannot pronate/suppinate = more stable & less movement (vs. radius and ulna)

Laryngopharynx

Lower part of pharynx (below epiglottis), behind larynx. Uppermost part of trachea.When food comes through, epiglottis closes posteriorly. Piriform recess: allows fluid to pass down side of laryngeal inlet instead of going through it

Callus

Lump that forms around a healing fracture. Initially soft, fibrous tissue, becoming ossified by osteoblasts.

Lung development

Lung develops from mediastinum, growing into thoracic cavity. This growth into thoracic cavity will bring pleura, airways, nerves and arteries/veins along with it.

Lymphatics of lung

Lymph from lung is collected at superficial and deep levels: - Superficial lymphatics drain lung surface + visceral pleura - Deep lymphatics drain rest of lung Eventually, lymph from both vessels are drained collectively into Hilar nodes (at hilum) --> tracheobronchial nodes --> bronchomediastinal lymph trunks

Lymph nodes

Lymph vessels traverse multiple lymph nodes (via smooth muscle contractions). Role: Defend against foreign antigens & act as a filter to tract particualtes Location: Near areas of possible pathogen entry. Can be superficial or deep (depending on type of drainage) (digestive/respiratory system, skin surface)

Lymphatics of lower limb

Lymphatics occupy superficial fascia in lower limbs, accompanying saphenous veins - Lymphatics form junction at inguinal region; here, nodes filtrate lymph: superficial inguinal nodes --> deep inguinal nodes --> pelvic nodes - Lymph from both legs (and abdomen) then drains to a pouch called cisternae chyli. - CC feeds into thoracic duct which deposits all lymph back into venous system. N.B. 3/4 of body's lymph is drained in thoracic duct = good for detecting pathogens.

Articular System

Made up of joints, associated ligaments and accessory structures.

External intercostal muscles

Main intercostal muscle used in inspiration Origin: Inferior border of upper rib Insertion: Superior border of lower rib Muscle fibres run infromedially = downwards & inwards (towards midline). Muscle fibres run continuously. Contraction pulls lower rib upwards and out & pushes sternum forward = increased thoracic volume = inspiration

Prime Mover/Agonist

Main muscle responsible for producing a specific movement - concentric contraction eg) Biceps brachii is responsible for elbow flexion

Medium Muscular arteries (distributing arteries)

Majority of arteries. More smooth muscle fibres = capable of vasoconstriction = blood flow regulation

Class

Mammalia 3 groups: monotremes (oviparous = lay eggs), marsupials (viviparous, development completes in pouch) and eutherians (viviparous, complete development) - Mammary glands - Hair, sweat, sebaceous glands - Muscular cheeks - Placenta - Warm blooded - 4-chambered heart - Expanded forebrain + cerebral cortex

Anterior forearm muscles

Many of these muscles all have a common attachment point = medial epicondyle of humerus 3 groups of these muscles: superficial, intermediate and deep

Branches of descending aorta

Many parietal and visceral branches: Parietal branches: - Intercostal artery supplies intercostals & covering tissue - Pericardial artery supplies pericardium - Phrenic artery supplies diaphragm Visceral branches - Oesophageal artery supplies oesophagus

Inner Cell Mass

Mass of cells inside blastocyst; cells differentiate into 2 germ layers: - Epiblast: cells + amniotic cavity - Hypoblast: cells + yolk sac (cavity) Gives rise to embryonic disc --> embryo.

ectopic pregnancy

implantation of the fertilized egg in any site other than the normal uterine location (endometrial lining)

Collateral Ligaments of Talocrural joint

Medial Ligaments: Very strong (deltoid) ligaments; very stable and rarely injured Lateral Ligaments: 3 smaller ligaments = more mobility but not as strong = easily injured Spring ligament = non-collateral ligament

Ulna

Medial, long bone that articulates with humerus & radius. - Trochlear notch = where trochlea (humerus) sits - Radial notch = where radius articulates with ulna - Olecranon process = back of bone = where triceps attach.

Joint/Articulation

Meeting point of two bones, bone-cartilage or bone-teeth. Classified by: - Space between articulating bones (eg. synovial cavity) - Type of connective tissue binding the two bones (eg. cartilage)

Interosseus membrane

Membrane between radius and ulna, tibia and fibula.

peritoneum

Membrane that folds over the top of pelvic viscera

External Oblique

inferomedial fibres attachments to: ribs (superiorly), linea alba (anteriorly) iliac crest & ASIS (laterally), pubic tubercle & pubic crest (medially) free inferior border = inguinal ligament

Muscularis

Middle layer of hollow viscera. Can be circular or longitudinal Function: allows for motility (eg. peristalsis). Allows for expansion (& contraction) for variable storage.

Anatomy of (middle) rib

Middle rib considered typical rib. Split into 4 parts: Head (posterior) of rib with 2 demifacets; attachment to ventral body Neck = narrowing section of rib just after the head Tubercle = smooth and rough Body = curved section; thin & flat. Contains costal groove. Anterior end attaches to costal cartilage

Veins & venae comitantes

More abundant than arteries = 80% of total blood volume. - Thin tunic, large lumen = large capacity for expansion. - Veins are typically present in double/multiple sets alongside arteries = venae comitantes. Each set is wrapped in sheath of connective tissue. - Goes from small calibre to large calibre (near heart)

Blastocyst (day 6)

Morula forms into blastocyst = hollow ball of cells with fluid-filled cavity. Contains 2 types of cells: - Trophoblast = outer epithelial layer; forms into extraembryonic structures (placenta) - Inner Cell Mass: gives rise to embryo

Motor unit

Motor neuron + all the muscle fibres it innervates. - Motor unit exits spinal cord via ventral horn. Its multiple motor nerve fibres reach certain muscle fibres, which when stimulated, contract simultaneously. Multiple motor neurons need to be stimulated to get the whole muscle to contract.

Abduction

Movement away from the midline of the body

Bucket Handle Movement

Movement of lower (8 and lower) move in a bucket handle movement = increases volume of thorax from side to side; due to formation of costal cartilage

Pump-Handle Movement

Movement of upper ribs (1-7) move like a pump-handle; due to formation of costal cartilage

Adduction

Movement toward the midline of the body

Shoulder girdle movements

Movements of clavicle and scapula: - Retract = draw shoulder backwards - Protract = draw shoulders forwards - Elevate = bring shoulders up - Depress = drop shoulders down

Myotomes

Muscle group supplied by a single spinal cord nerve root. - muscles more proximal to axial skeleton are innervated by nerve roots higher up in brachial plexus (eg. C5 & C6 innervating deltoids vs. T1 innervating hand) - muscles with the same action at a joint have the same myotomes.

Antagonistic muscle groups

Muscle groups that work in opposition. Contraction of agonist/prime-mover = relaxation of antagonist

Tongue

Muscle in oral cavity, covered by epithelium with receptors and taste buds. Formed by 2 parts: Anterior (2/3): no tonsils but there are papillae Posterior (1/3): tonsillar tissue (lingual tonsil); sits just under mucosa and has nodular appearance Extrinsic muscles alter tongue position. Attach on the tongue, but also outside the oral cavity; alter tongue position Intrinsic muscles alter tongue shape. Embedded within the tongue; attach only to each other

Synergist

Muscle that complements action of prime mover by: - Adding extra force of the same movement - Reducing undesirable/unnecessary movements eg) Brachialis is synergist for elbow flexion

Antagonist

Muscle that opposes action of another muscle. Can also regulate action of prime mover by providing resistance = stabilising (eccentric contraction) eg) Triceps brachii = antagonist for elbow flexion

Arrector pili muscle

Muscle that pulls hair to perpendicular conformation with skin. Controlled sympathetically.

Fixator

Muscle that steadies proximal parts of limb while movement occurs in the distal part; engage in isometric contraction. eg) Rotator cuff muscles stabilise the shoulder during elbow flexion

Scapulo-humeral muscles

Muscles attaching from shoulder girdle onto humerus: Rotator cuff muscles Biceps (Coracobrachialis) Deltoids Teres Major

Nerves of lower limb (general)

Muscles in the same compartment have the same nerve supply. Femoral nerve: iliopsoas muscle + quadriceps (anterior) Gluteal nerve: gluteal muscles (posterior) Obturator nerve: adductor muscles (medial) Sciatic nerve, branching into Tibial nerve & Common peroneal nerve: hamstring & leg, foot muscles

2 joint muscles

Muscles that cross 2 joints: Rectus femoris = knee + hip All hamstrings = knee + hip Gastrocnemius = knee + ankle These muscles are susceptible to muscle injury as they can be insufficiently long if stretched across two joints. Location of stress/tear: - Muscle belly = good vascular supply so repairs quickly - Musculotendinous junction - Tendon = poor blood supply = repairs slowly. - Sometimes bone can fracture = heals quite quickly.

Axio-appendicular muscles (general)

Muscles with attachments on axial and appendicular skeleton (upper limb): posterior or anterior.

Intercostal muscles

Muscles within intercostal space. Come in 3 layers: external intercostals, internal intercostals, innermost intercostals

Musculi pectinati

Muscular ridges in anterior, right atrial wall.

Trabeculae carnae & Papillary muscles

Muscular ridges on internal wall of ventricles. Papillary muscle = specialised trabeculae carnae present in ventricles. Attach to wall of ventricle, project to lumen and cusp of AV valve via chordae tendinae.

Trachea

Musculo-membranous tube; starts from C6 and descends to T4/5 - Sits anterior to oesophagus - Supported by a series of C-shaped cartilage rings = tracheal rings. Open posteriorly to oesophagus; closed off by trachealis muscle (smooth) Superiorly: begins at cricoid cartilage. Inferiorly: bifurcates into left and right main bronchi

Naming Digitorum/Hallucis msucles

Named based on length and function: - FHL/FDL = plantarflexors, long - EHL/EDL = dorsiflexors, long

Naming Tibialis muscles

Named based on position: - Tibialis Anterior (dorsiflexion) - Tibialis Posterior (plantarflexion)

Upper Respiratory System (overview)

Nasal cavity = smell, breathing, sound production Oral cavity = eating, breathing, talking Pharynx = area at back of system; formed by sling of muscle; swallowing & immune tissue (tonsils) Larynx = system of cartilages, breathing, phonation (vocal cords)

Tactile/Pressure receptor (locations)

Near epidermis: closer to the source = external Tactile discs & Meissner corpsucle

Superficial

Near the surface

Injuries at hip joint

Neck fracture Lack of trabeculae in neck of femur = inability to bear weight = prone to fracture If this neck fracture occurs, blood supply is lost to head of femur = avascular necrosis = death of femoral head Traumatic Dislocation Femur is pushed (posteriorly) out of acetabulum. This is more likely when sitting, as ligaments are relaxed and femur is not compressed into acetabulum.

Peripheral axon

Nerve fibre in a peripheral nerve that has one long axon as its core element. Afferent peripheral axons

Brachial Plexus

Nerve plexus arising from anterior rami of C5, C6, C7, C8, T1 Roots form into trunks Each trunk divides into a posterior and anterior division - Posterior divisions innervate posterior extensors - Anterior divisions innervate anterior flexors Divisions become cords: - 3 posterior divisions unite to form posterior cord = axillary + radial nerves - 2 anterior divisions form lateral cord = musculocutaneous - Final anterior division forms medial cord = ulnar nerve N.B. Median nerve = lateral cord + medial cord Cord(s) form 5 terminal branches

Common fibular/peroneal nerve

Nerve that branches from sciatic nerve. Moves laterally, hooks around and under head of fibula to anterior leg. 2 branches: - Superficial branch supplies lateral leg muscles (everters: Fibularis longus, Fibularis brevis - Deep branch supplies anterior leg muscles (extensors/dorsiflexors) Injuries: - Fracture at top of fibula may damage deep branch = foot drop - Anterior compartment syndrome from deep nerve compression (due to swelling)

Neurovascular hilum

Nerve, artery and vein break off from adjacent larger vessels and enter the muscle belly through this. They then branch into many smaller branches to supply each fibre.

Cutaneous nerves

Nerves that go to skin (just below epidermis); develop from ectodermal neural crest. eg) Meissner Corpuscle = mechanoreceptor

Intercostal nerves

Nerves that innervate all intercostal muscles. Location: emerge from anterior rami of spinal nerves, run between internal and innermost intercostals in intercostal groove. Branching of nerves covers all 3 layers of tissue in thorax

Enteric nervous system

Nervous system of the digestive system.

Neural Crest derivatives

Neural Crest cells are ectodermal: - melanocytes --> pigment + epidermis - glial cells + ganglia --> neurons - skeletal element of pharyngeal pouches

CNS axis*

Neural axis is mainly vertical in humans: - Ventral = anterior - Dorsal = posterior - Caudal-Cranial But rotated when we reach the head: - Rostral = anterior - Dorsal = superior - Ventral = inferior

Interneurons

Neurons in the CNS that target other neurons. Majority of neurons in CNS.

Primary sensory neuron/primary afferent

Neurons with a peripheral axon that are afferent (input)

Lower motor neurons

Neurons with a peripheral axon that are efferent to skeletal muscles.

Neurosome vs. Dermatome/Myotome

Neurosome = peripheral nerve innervation Dermatome/Myotome = nerve innervation of a region because of its nerve root To discriminate b/w peripheral nerve injury or nerve root injury, compare dermatome/myotome distribution against neurosome.

Somatic nervous system

Non-autonomic part of PNS: sensory (afferent) & motor (efferent) - Cell body is found in ventral horn

Teres Major

Not rotator cuff muscle; this muscle attaches around bicipital groove of humerus + inferior scapula, allowing for internal rotation of shoulder joint

Posterior axio-appendicular muscles

Not true back muscles (because they're also attached to upper limb): Trapezius Latissimus dorsi Levator Scapula Rhomboid Major + Minor

Nuclei vs. Ganglion

Nuclei = Cluster of nerve cell bodies in CNS Ganglion = Cluster of nerve cell bodies in the PNS.

Right Ventricle

Occupies majority or anterior heart. Walls: Thicker than RA. Most of internal surface is not smooth; covered by trabeculae carnae + 3 papillary muscles Tricuspid valve with chordae tendinae attaching to papillary muscles Pulmonary valve (semilunar) leads to pulmonary trunk

Lumen of hollow viscus

Often have dilations and constrictions (varying diameter). - Constrictions usually beginning/end = limits movement of contents in lumen. N.B. constrictions may lead to accumulation of unwanted material (eg. kidney stones = calculus)

Oligodendrocytes & Schwann cells

Oligodendrocyte = Glial cell that myelinate axons in CNS. Schwann = Glial cell that myelinate axons in PNS Both are cells not neurons. They wrap their cell membrane around discrete segments of axon

Suprapatellar bursa

One of many bursae of the knee joint. - Communicates directly to knee joint capsule = swelling of knee can extend into this bursa - Moves when knee flexes and extends

Piriformis

One of many rotator muscles in posterior hip muscles: - Landmark muscle; many structures nearby. - Origin = sacrum - Runs through greater sciatic foramen

Vocal ligaments

One on each side of the body. Mucosa folds around these. - one attachment on arytenoid cartilage (back) - one attachment on thyroid cartilage (front) Function - When vocal ligaments are adducted together in midline = vocal sounds (phonation) - When vocal ligaments are abducted open = breathing (inspiration)

Blood supply of skin

Only dermis is vascularised; Blood vessels from the subcutaneous tissue project up into the dermis. Epidermis receives nutrients via diffusion.

Dermatome development

Originally, all cutaneous innervation was around singular tube. As arms bud off, nerves are pulled with them. Dermatomal principle: Dermatomes go out and then back. Dermatomal principle: Dermatome (spinal nerve root) innervation is consistent with peripheral innervation (neurosome) from nerves of brachial plexus This allows us to distinguish between pathology in periphery or spinal root.

Intramembranous Ossification

Ossification of facial bones, flat bones of skull, mandible, parts of clavicles: 1) Mesenchyme develops into osteoblasts which lay down a matrix = ossification centre 2) Calcification: minerals are deposited into matrix 3) Matrix forms into trabeculae 4) Periosteum develops directly from mesenchyme

Anulus fibrosus

Outer layer of articular disc of Intervertebral Joint. - Concentric circles of fibrocartilage. Each circle has fibres in perpendicular direction - Attached to epiphyseal ring. - Function: Keeps vertebra together

Epidermis

Outer layer of skin - for protection and pigmentation; divided into 5 distinct layers: 1) Stratum corneum: mostly dead cells; thickest layer. 2) Stratum lucidum: absent in thin skin 3) Stratum granulosum: 1-5 layers of flattened cells 4) Stratum spinosum: several layers of keratinocyte cells unified by desmosomes 5) Stratum basale = deepest layer; 1 row of newly formed stem cells that undergo continuous mitotic divisions. Source of pigment Moving from deep to superficial, cells go from living to dead

Epidermis

Outermost layer of skin, formed after neural tube is formed. - Ectodermal origin - Colonised by melanocytes (from neural crest cells) & Langerhan cells (from bone marrow)

Motor (efferent) signals

Outputs from CNS to PNS.

Fossa ovalis

Oval-shaped impression on posterior wall of RA. Remnant of fetal foramen (foramen ovale) that allowed blood to pass directly from RA to LA (when there was no pulmonary circulation)

Somatic Pain

Pain from skin = sharp and well-localised. Detected by deep sensory receptors in dermis.

Visceral pain

Pain that is deeper = dull and poorly localised (can't exactly pinpoint). Usually accompanied by referred pain = pain elsewhere in the body but in the same dermatome

pancreatic ducts

Pancreas produces: - endocrine secretion into the blood - exocrine secretion into the duodenum via its 2 ducts: - Main pancreatic duct (into major papilla) - Accessory pancreatic duct (into minor papilla) (note common bile duct also enters major papilla)

Autonomic Nervous System

Part of PNS and related CNS components that are responsible for function of internal organs = visceral function. Composed of sympathetic and parasympathetic.

Cardiovascular system

Part of circulatory system. 2 sections: Pulmonary = circulation to lungs; O2 poor blood goes to lungs and returns as O2 rich blood Systemic = circulation to body; O2 rich blood goes to capillary beds, returning as O2 poor.

Lymphatic system

Part of circulatory system: - Drains surplus tissue fluid from interstitial space = space b/w cells - Drains plasma proteins, cellular debris, infection materials - Contains lymph plexuses, vessels, nodes and tissues

Referred pain

Perception of pain in areas other than site of stimulation (eg. heart attack causing pain in arm) Cause: common spinal segmental origin of nerves of nerves from organ and body wall. Brain refers pain to body wall, even if it comes from organ, because it has a better map of somatic rather than visceral nerves.

Vascular Supply of bone

Periosteal Arteries supply blood to periosteum and outer compact bone; enter through many small canals. Nutrient Artery enters via a nutrient foramen in the centre of the diaphysis, penetrating through medullary cavity and moves towards either epiphyses = main nutrient supply. Enters obliquely AWAY from growing end of bone. Ends of the long bone are supplied by epiphyseal and metaphyseal arteries.

Peritoneum & Peritoneal cavity

Peritoneum = serous membrane lining cavity in abdomen (peritoneal cavity)

Lateral leg muscles

Peroneal AKA Fibularis Muscles: - Longus - Brevis Structure: Muscles extend down leg laterally, behind lateral malleolus (of fibula) and attach to foot. Function: Foot eversion ^Prone to injury in ankle sprains.

Nerve innervation of Diaphragm

Phrenic nerve: - pair of phrenic nerves innervates motor aspect of diaphragm - Right phrenic nerve innervates right dome; vice versa Pathology: Phrenic nerve is quite deep in thorax = rarely injured. If either phrenic nerve is damaged, that side of lung will be paralysed.

Proximal radioulnar joint

Pivot synovial joint between head of radius and radial notch of ulnar = rotation Supported by annular ligament

Distal radioulnar joint

Pivot synovial joint: functionally paired with proximal radioulnar joint; synchronised movement of radius pivoting around ulnar = pronation and supination

Acromioclavicular joint

Planar synovial joint at lateral end of clavicle = gliding motion. Very weak joint capsule (commonly injured) Extrinsic ligament support: coracoclavicular ligaments stabilise this joint.

Zygapophyseal (facet) joint

Plane synovial joint formed between inferior articular process of upper vertebra and superior articular process of lower vertebra. Function: guides movement by sliding; not weight-bearing. Movement is along ONE axis & depends on orientation of processes, which varies between vertebra groups: - Cervical vertebra = orientated in horizontal plane = movement in all directions - Thoracic vertebra = orientated in coronal plane = slide + rotation (no flexion/extension) - Lumbar vertebra = sagittal plane = flexion/extension but no rotation.

Innervation of pleura

Pleura receives same type of innervation as the structures they cover Visceral Pleura innervated by ANS = poor/dull pain Parietal Pleura innervated by somatic nervous system = sharp/severe/well-localised pain

Parietal pleura

Pleura that covers different parts of thoracic wall. It is divided further, depending on location: Mediastinal pleura covers lateral wall of mediastinum Costal pleura covers intercostal space agaisnt ribs Cervical pleura covers cervical inlet Diaphragmatic pleura covers superior diaphragm

Pulmonary Ligament/Pleural sleeve

Pleural sleeve = edge of visceral pleura that surrounds lung root very loosely. This allows pleural sleeve to go inferiorly, hook around and wrap around lung root again. Pulmonary ligament = double-folded pleura when it descends down (not true ligament)

Pollicis/hallucis in naming

Pollicis = relating to thumb Hallucis = relating to big toe

distinguishing large intestine vs small intestine

Position (large frames small) Omental appendices (fatty tags) Tenia Coli Haustra Diameter (larger in large) POTHD

Latissimus dorsi

Posterior axio-appendicular muscle: - Large muscle attached to thoracic and lumbar vertebra. - Inferior to trapezius. - Blends with deep fascia

Trapezius

Posterior axio-appendicular muscle: large, trapezoid shape: many axial attachment points from skull down to spine; other attachment is to scapula.

Rhomboid major & minor

Posterior axio-appendicular muscles: - Rhomboid shape near midline. - both retract scapula to midline.

Levator scapulae

Posterior axio-appendicular muscles: - Attaches to cervical vertebra (neck) and scapula - Elevates scapula

Gluteal Muscles

Posterior hip muscles: Gluteus maximus Gluteus medius Gluteus minimus Also many rotator muscles: Piriformis

Hamstring muscles

Posterior muscles of thigh - Powerful; knee flexors + hip extensors Originate from ischial tuberosity, then extend down and split to form: Medial hamstring muscles: attach to tibia - Semimembranosus - Semitendinosus Lateral hamstring muscles: attach to fibula - Biceps femoris: 2 heads: long head attaches to ischial tuberosity, short head attaches to shaft of femur. Then both attach to head of fibula. Since attachment is past knee and hip, these muscles can be overstretched (when knee is extended and hip is flexed)

Keratinocytes

Predominant cell of epidermis. Produce keratin.

Accessory structure of skin: Hair

Present on all areas of thin skin, except nipples and lips. Hair consist of dead, keratinised cells bounded together in 3 concentric circles: Medulla: deepest layer; 2-3 rows of cells. Inner medulla is sometimes lacking in thinner hair. Cortex: Major part of shaft = elongated cells Cuticle: Outer layer of hair = single layer of thin, flat cells. Hair follicle = a root sheath that surrounds 3 concentric circles. Hair shaft refers to the part of hair that projects out of the skin. Root of hair refers to the part of hair that is deep to the shaft, penetrates into dermis and sometimes superficial fascia.

Order

Primate - Binocular vision - Clavicle = free movement of upper limb - Opposable thumbs - Greater brain/visual capacity ^^These allow for better hand-eye coordination

testes

Produce immature/immobile sperm within seminiferous tubules Divided into ~250 lobules by connective tissue septa > each lobule contains 3-10 seminiferous tubules > each tubule forms a highly convoluted loop within lobule Contains: - Tunica vaginalis: extension of abdominal peritoneum during descent - Tunica albuginea: dense connective tissue capsule

Muscle crossing lateral side of joints

Produces abduction away from midline: deltoids at shoulder joint

Muscle crossing medial side of joints

Produces adduction towards midline: teres major at shoulder joint

Muscle crossing posterior side of a joint (not lower leg)

Produces extension: latissimus dorsi at shoulder joint

Muscle crossing on anterior side of joint (not lower leg)

Produces flexion: pectoralis major at shoulder joint

Periosteum

Protective membrane surrounding compact bone (except at joints; replaced by hyaline cartilage). Rich blood + nerve supply - Outer, tough, fibrous layer - Inner osteogeneic layer

Dislocation

Proximity of articular surfaces is lost due to displacement Subluxation = partial/incomplete dislocation

mnemonic for muscles of the posterior abdominal wall

Psoas major/minor Quadratus lumborum Iliacus (protect the queen indefinitely)

Semilunar valves

Pulmonary valve Aortic valve Both have no attachment to chordae tendinae = passively open/close. Both have 3 semilunar cusps. Difference: Above aortic valve, there are two small openings = coronary artery

Great vessels

Pulmonary vessels = pulmonary trunk and pulmonary veins Aorta = elastic artery Veins = Superior vena cava, inferior vena cava; N.B. the vena caval system is valveless, and so relies on the thoracic venous pump to maintain blood flow.

Thoracic Venous Pump

Pump mechanism linked to respiration: Heart is fixed to diaphragm and moves with it: - Inspiration: heart + diaphragm pulled down = stretching SVC (filling up with blood) & shortening IVC (squeezing blood into right atrium) - Expiration: heart + diaphragm ascends = shortening SVC (squeezing blood into right atrium) & lengthening IVC (filling up with blood)

Vastus muscles & Patellar dislocation

Quadricep muscles that extend knee: Vastus medialis, vastus lateralis, vastus intermedius - Vastus lateralis and rectus femoris pull patella laterally (due to angular femur) = prone to lateral dislocation - Vastus medialis counteracts this: its muscle fibres attach obliquely to pull patella medially N.B. this is aided by asymmetrical femoral condyles

Anterior thigh muscles

Quadricep muscles. Generally, origin = thigh (or pelvis) & insertion = quadricep tendon & tibial tuberosity. Sartorius = exception - Origin on iliac spine (pelvis) - Inserts past knee on tibia

Cardiac Chambers

RA: Part of right atrium forms right border of heart RV: Front of heart mostly formed by RV. Inferior border formed by RV. LV: Forms left border of heart. Majority of apex formed by LV. LA: Small proportion present at front of heart

Wrist drop

Radial nerve is injured, either through a humerus shaft fracture or a compression (Saturday Night Palsy). Results in wrist drop = failure to extend wrist. N.B. Elbow can still extend because the radial nerve innervates elbow extensors quite high up the arm (above radial groove).

Linear aspira

Raised ridge of bone on posterior aspect of femur = attachment point for medial thigh muscles/adductors.

Left Atrium

Receiving chamber for oxygenated blood from pulmonary circuit. Enter heart posteriorly. 4 pulmonary veins: 2 left, 2 right Wall: thin Fossa ovalis: on anterior wall of left atrium (LA is behind RA).

Site of Muscle or Ligament Attachment

Referred to by the following terms: Tuberosity, Crest, Trochanter, Line, Tubercle, Epicondyle, Spine, Process N.B. Sites of muscle attachment will grow in response to more mechanical stress (= more osteoblasts). The larger the area, the larger the attached muscle.

Prefrontal cortex

Region at the front of frontal lobe: conscious intellect, feelings, identity etc.

Axilla

Region between axial skeleton and appendicular skeleton. Contains axillary artery, axillary vein, parts of brachial plexus, lymph nodes.

Diancephalon

Region forming the walls of 3rd ventricle. Thalamus: major sensory processing site. Hypothalamus Pineal gland

Primary Cortices

Regions located around the deepest sulci/fissures that are responsible for certain functions: - Primary motor/sensory cortex @ precentral & postcentral gyrus - Primary auditory cortex @ temporal lobe - Primary gustatory cortex @ parietal lobe

Bone healing

Requires adequate immoblisation (early on), good alignment, extensive remodelling of bone over many months

Parasympathetic Nervous System

Rest/Recovery division of ANS. - Long pre-ganglion neuron that project to organ. - Ganglion within organ - Short postganglion within organ Craniosacral: All parasympathetic nerves come from cranial or sacral nerves

Cleavage/Tension lines in reticular dermis

Reticular layer = collagen fibres running in specific planes creates lines of tension. - Lines run longitudinally in skin of head/limbs - Lines run circular around trunk/neck Incisions parallel to tension lines gape less = less scaring. Incisions perpendicular to tension lines gape and scar more.

Left lung vs Right lung

Right = larger & heavier. Has 3 lobes and 2 fissures. Left = smaller & lighter - during development, heart occupies a lot of space on left side. Has 2 lobes and 1 fissure. Right lung is vertically shorter than left lung - right dome of diaphragm sits slightly higher. Right lung is still bigger overall Left lung: cardiac notch, lingula, cardiac impression

Fissures and Lobes of right lung

Right lung usually has two fissures - Horizontal fissure: between superior and middle lobe - Oblique fissure: between superior and inferior, middle and inferior Divides right lung into 3 lobes: - Superior lobe - Middle lobe - Inferior lobe most of inferior lobe sits at the back of chest

Situs invertus

Right-left symmetry gone wrong. Some or all organs are mirrored from their original position.

Grey matter

Role: Make synaptic connections Contains all neuron cell bodies. Also contains dendrites, short axons and glia. Location: - In spinal cord, mainly on the inside. - In brain, mainly on outside. Basal nuclei lie on the inside

White matter

Role: link regions of grey matter. Contains myelinated axons (and glia). White because of myelin. Location: - In brain, on the inside. - In spinal cord, on the outside.

External Rotation

Rotate limb away outwards (away from midline)

Internal rotation

Rotating limb/joint inwards (towards the midline)

Movement of Rotator cuff muscles

Rotator cuff muscles are prime movers = rotate & abduct - Infraspinatus & Teres minor can externally rotate the shoulder - Subscapularis internally rotates shoulder - Supraspinatus abducts shoulder

Long head of biceps

Runs over shoulder joint and attaches to scapula from top: supports AC joint

Lymph system

Runs parallel to the venous system: Contains valves, thin walls, and more numerous than veins. Location: Very widely distributed throuhgout body. Role: Clears interstitial spaces of surplus fluid/cellular debris Composition: lymph plexuses, lymph vessels, major trunks, lymph nodes, lymph organs

spleen

SOLID LEFT UPPER QUADRANT INTRAPERITONEAL - 2 surfaces: diaphragmatic, visceral (has a hilum) - reservoir of RBCs (very vascular) - very delicate

pancreas

SOLID LEFT UPPER QUADRANT RETRAPERITONEAL 4 parts: - head (surrounded by duodenum) - neck - back -tail (tucked against hilum of spleen)

liver

SOLID (largest solid viscus) RIGHT UPPER QUADRANT (mainly) INTRAPERITONEAL partially protected by thoracic cage and diaphragm 2 surfaces: diaphragmatic (anterior and superior) and visceral (posterior and inferior) peritoneum covers diaphragmatic surface and visceral surface

Parasympathetic Outflow from CNS

Sacral outflow. - Pre-ganglionic cell body in lateral horn. - Neuron leaves via ventral roots & enters into mixed spinal nerve. - Neuron extends to tissue (containing ganglion) - Synapse to post-ganglionic neuron within wall of tissue

Thumb movement

Saddle carpometacarpal joint; rotated 90 degrees to finger plane of motion: - Flexion = draw thumb across palm, Extension = draw thumb away from palm - Abduction/Adduction = movement to the front/back of palm

Superficial veins of lower limb

Saphenous veins = easily seen. Run in superficial fascia. Formed by dorsal arch of foot, which branches into: Great Saphenous vein: runs anterior to medial malleolus and up medial leg to inguinal region --> femoral vein Small Saphenous vein: runs laterally, feeding into politeal vein

Scapulothoracic joint

Scapula moves across thoracic cage (eg. upwards rotation when raising arm). - Allows for much greater ROM (adds 1 degree to every 2 degree of shoulder joint) - Preserves rotator cuff muscle tension. Prevents impingement of certain rotator cuff muscles during movement of limbs - Not true joint: no hyaline cartilage, joint capsule, synovial membrane

Deltoids

Scapulo-humeral muscle: - broad attachment on scapula, acromion process and clavicle. - attachment on humerus via deltoid tuberosity

Raphe

Seam of fibrous tissue that joins MUSCLE to MUSCLE. - Usually a long attachment - eg) muscles of pelvic floor

Accessory structures of the skin: Sebaceous/Sweat glands

Sebaceous glands: secrete oil = sebum. Connected to hair follicles but absent on thick, hariless skin. Sweat glands: release sweat either into hair follicles or onto surface of skin via sweat pores. - Ceruminous glands: modified sweat glands that produce wax in the ear canal. - Eccrine/Merocrine/Sudoriferous glands: secrete sweat directly onto skin

Somatic sensation

Sensations from sensory receptors of skin to CNS 1) Sensory receptor activates 2) Sensory neuron conducts impulse to integrating centre of CNS 3) Centre processes information

Peripheral Nervous System

Sensory and motor nerves that connect CNS to rest of body; Somatic Nervous System Autonomic Nervous System: - Sympathetic - Parasympathetic

Major pelvis arteries

Series of bifurcations: Abdominal artery --> right & left Common iliac artery --> Internal & External iliac artery - External iliac artery supplies external structures and becomes femoral artery after passing inguinal ligament - Internal iliac artery supplies internal structures

Patella

Sesamoid bone that sits between higher lateral condyle and smaller medial condyle. - Lateral condyle is larger as it prevents lateral dislocation of patella (due to inward angulation of femur)

Tibia

Shin bone, accompanying fibula (but more medial): Proximal - Plateau on top with a ridge = where femoral condyles sit - Tibial tuberosity = traction epiphyses/bump where quads attach Middle - Larger, long bone - Shaft is subcutaneous on anterior aspect = shin Distal 2 articular surfaces with ankles: - Trochlear surface - Medial malleolus (distal bulge)

Sesamoid bone

Short bones that form within tendons: patella

Upper limb

Shoulder/shoulder girlde (connecting to axial skeleton), arm (proximal long bone), forearm (distal paired bones), wrist/carpal region, pentadactyl hand This structure is common to all mammalia + reptilia. Upper and lower limb fundamentals are common: girdle attaching to axial skeleton, single long bone, paired bones, digits.

Capillaries

Simple endothelial tubes without any tunics. - Allows for exchange of both nutrients and waste. - Connect venous and arterial sides of circulation - Named according to body region

Pleura

Single layered, serous membrane that covers the surface of lung + thoracic wall. Continuous, but divided into: - Visceral pleura covers lung - Thoracic/Parietal pleura covers thoracic walls, diaphragm and mediastinum. Visceral and thoracic pleura meet at lung root

Suprapleural membrane

Sits on top of cervical pleura. Closes of superior thoracic aperture.

Muscle attachment

Skeletal muscles at joints must have at least 2 attachment points to bone (via tendons): Origin - attachment point that stays in place during contraction = immovable/less movable bone (proximal) Insertion - attachment point to movable bone. Moves towards origin (distal) in contraction. N.B. Can have more than one origin or insertion

mnemonic for layers of the anterior abdominal wall

Skin Superficial fascia (fat) External oblique Internal oblique Transversus abdominis Transversalis fascia (deep inguinal ring) Extraperitoneal fascia (fat - primordial testes) Peritoneum (serous membrane)

Integumentary system

Skin, hair, nails, sweat and sebaceous glands; highly innervated with sensory receptors.

Pharynx

Sling of (constrictor) muscles at the back of upper respiratory tract. Structure: 3 parts, named according to airway region: nasopharynx, oropharynx, laryngopharynx. Muscles: superior constrictor, middle constrictor, inferior constrictor. These attach laterally to nasal/oral cavities + larynx, and combine posteriorly at midline. Contraction occurs sequentially to facilitate peristaltic swallowing

Pericardial space

Small potential space b/w parietal and visceral pericardium. Normally contains only small amount of serous fluid to minimise friction. Pathology: inflammation of pericardium can result in excessive pericardial fluid.

Pleural cavity

Small, fluid-filled space between visceral and parietal pleura (fluid minimises friction). - Usually only potential space = no air. Space will increase if there is pathology.

Fibula

Smaller leg bone that accompanies tibia: - Long bone - Non weight bearing - Long shaft for muscle attachment Main Function: Distal aspect extends beyond fibula to a lateral malleolus (ankle)

Venules & small veins

Smallest calibre veins. Venules = smallest vein that drains capillary beds. Small veins = unite to form venous plexuses. ^Both are unnamed (like arterioles)

Acetabulum

Socket formed by ilium, ischium and pubis that articulates with femur. - Surrounded by labrum - Not completely articular: requires Transverse Acetabular Ligament to complete ring

Paraxial mesoderm forms

Somites. From somite differentiation: 1) Dermamyotome --> Dermatome --> Dermis 2) Dermamyotome --> Myotome --> Muscles (axial & limb) 3) Sclerotome --> Axial skeleton

Intercostal space

Space between ribs. Contains 3 intercostal muscles, nerves, arteries/veins.

Choroid Plexus

Specialised capillary in ventricular system; produces CSF - Blood comes into ventricles - Some of the fluid exits the blood vessels This fluid then drains through ventricular system, arriving into subarachnoid space to bathe the whole CNS. It is eventually reabsorbed by arachnoid villi.

Functional Sphincter

Sphincter without localised muscle thickening; operate by some other, functional mechanism. eg) Ureter (through bladder wall) - When bladder expand, ureter is open - When bladder contracts, ureter is closed ^allows unidirectional flow of fluid OUT of bladder

Spinal Cord development

Spinal cord grows slower than vertebral column (bone). Thus, below L2, there are only a few axons.

Perineal membrane

layer of fascia attached to pubic arch that covers the urogenital triangle - Female: contains opening for urethra & vagina - Male: contain opening for urethra Levator ani perineal membrane can be injured during child birth

Bony framework of ribs (thorax)

Sternum articulates anteriorly with 10/12 ribs via costal cartilage. - Ribs 1-7 = true ribs = each rib has costal cartilage that directly articulates with sternum anteriorly - Ribs 8-10 = false ribs = each rib has costal cartilage that attaches to costal cartilage of rib above - Ribs 11, 12 = floating ribs = do not articulate with sternum, no costal cartilage. Increase capacity to expand and increase volume. Each rib articulates with 12 thoracic vertebrae

Collateral ligaments of elbow joint

Strong ligaments that support elbow joint: - Medial or Ulnar CL - Lateral or Radial CL

Femur

Structure - Long bone - Head (sitting in acetabulum) tapers down to neck - Greater and Lessor Trochanters (proximally) - Lateral and Medial Condyles (distal) - Patella lives in tendon distal to femur Front of bone is smooth, back is ridged: - Linear aspira = ridge-line down posterior side where group of muscles attach

Nerve

Structure collection of axons & connective tissue in the PNS Endoneurium: tissue wraps around individual axon Perineurium: tissue wraps around groups of axons, forming fascicles. Epineurium: tissue wraps around entire nerves. One nerve contains thousands of individual axons. 2 different types: - Spinal: originates from spine - Cranial: originates from brain/brainstem

pelvic diaphragm

Structure that separates pelvis and perineum (area between thigh & beneath pelvic diaphragm) Formed largely by Levator Ani muscle & contains opening for pelvic viscera contains Urogenital triangle - above from midline of pelvis diaphragm to pubic symphysis & continas urogenital hiatus contains Anal triangle - below from midline to coccyx & contains anal aperture

Thoracic walls (overview)

Structure: - Bony structures/framework - Muscles - Covering tissues Function - Protect structures within - Mechanical facilitation of respiration (via volume/pressure)

Typical (lumbar) vertebra

Structure: - Ventral body = Anterior body; weight-bearing. Large for lumbar vertebra (due to large weight) - Epiphyseal ring = ring around vertebral body; important in intervertebral joint - Vertebral arch = part of vertebra excluding vertebral body; protects spinal cord. Contains 2 pedicles + 2 laminas - Vertebral foramen = where spinal cord runs - 2 Transverse Processes. 1 spinous process = sites of muscle attachment; movement control. - Articular processes = facet joints; guide movement direction: 2 superior and 2 inferior - Inferior notch (large) + superior notch (small) formed by pedicles. Form foramen

Superficialis in naming

Superficial

Palmer Arterial arches

Superficial and deep branches of radial + ulnar arteries anastomose with each other, forming one superficial and one deep palmer arterial arch. - Digital arteries extend from palmer arches = end arteries. Each digit is supplied by 2 digital arteries on either side of finger.

Papillary layer

Superficial layer of dermis (1/5 of dermis). - Forms dermal ridges (in area of thick skin) = fingerprints! - Contains blood vessels, capillaries and free nerve endings

Lymphatic vessels of upper limb

Superficial network of vessels that drain interstitial fluid lost from circulation. - closely associated with venous network - Superficial lymphatic network typically drains to axillary nodes. - Eventually drains into lymph trunks, and then lymph ducts: Right lymphatic duct drains right upper limb Thoracic duct drains left upper limb (and most of body). - Left supraclavicular node drains most of the body before lymph enters ducts

Soleus

Superficial posterior leg muscle, just below gastrocnemius Function: Attaches distally to calcaneal tendon = plantarflexion; maintains posture and has many slow twitch fibres. This supports against LOG. Venous sinuses in soleus allow for enlarged venous capacity = pooling of blood

Plantaris

Superficial posterior leg muscle: - Attaches to calcaneal tendon - May be involved in proprioception

Gastrocnemius

Superficial posterior leg muscle: "calf" Proximally: Medial and Lateral muscle heads attach to medial and lateral femoral condyles. Distally: Two heads unite to form gastrocnemius tendon. This then attaches to calcaneal tendon to act on ankle. Function: covers both knee and ankle joints (so prone to sprain), but mainly acts on ankle: plantarflexion (power muscle)

Extensor Retinaculum

Superior and inferior thickenings of deep fascia. Superior: holds down extensor tendons proximal to anterior ankle = tibialis anterior, extensor hallucis/digitorum longus, fibularis tertis.

Thoracic apertures

Superior aperture made up of top part of manubrium, internal border of rib 1, top part of T1 - Partially closed off by suprapleural membrane Inferior aperture = bottom of thorax completely closed off by diaphragm

Celiac artery

Supplies foregut of embryo with blood

Inferior mesenteric artery

Supplies hindgut of embryo with blood

Superior mesenteric artery

Supplies midgut of embryo with blood

Serous pericardium

Surrounds pericardial cavity + heart; continuous structure that can be divided based on what structure it lines: - Parietal serous pericardium = lining of wall - Visceral serous pericardium = lining of heart Pericardial space b/w visceral and parietal pericardium

Saddle Joint

Synovial Joint formed by saddle-shaped bones. Allows for biaxial movement (flexion/extension & abduction/adduction) eg) Carpometacarpal joints in thumb

Sacroiliac joint

Synovial joint between sacrum and ilium: Plane joint that is locked together by = minimal movement Supported by many strong ligaments: - Interosseus ligament stabilises sacrum and ilium together - Sacrospinous ligament connects sacrum to ischial spine - Sacrotubeous ligament connects sacrum to ischial tuberosity

Plane joint

Synovial joint between two sliding/gliding bones = planar/non-axial movement eg) Intercarpal/Intertarasal joints

Ball-and-socket joint

Synovial joint formed by ball and socket. Allows for multi-axial movement. Highly unstable; requires accessory structures for stability eg) Shoulder and hip joints

Condylar Joint

Synovial joint formed by oval surface with cup on top. Allows for biaxial movement (flexion/extension & abduction/adduction) eg) knuckle joints = metacarpophalangeal joints

Pivot joint

Synovial joint formed by sleeve and axle. Allows for uniaxial rotation. eg) proximal radioulnar joints

Hinge Joint

Synovial joint that works as cylinder-trough. Allows for uniaxial flexion and extension eg) Humerus and Ulna

Ventricles of brain

System of 4 spaces filled with CSF: - 2 lateral ventricles - 3rd ventricle - 4th ventricle (most caudal) *Site of CSF production

Lymbic System

System that governs emotional processing. Features Insular Cortex

Systole-Diastole & Bleeding

Systole = ventricle contraction Diastole = ventricle relaxation Reflected by pulsatile and high pressure flow in elastic and muscular arteries. N.B. Arterial bleeding is pulsatile and high pressure vs. Venous bleeding = continuous and low pressure

vasectomy

ligating duct of vas deferens to produce sterility in the male by preventing sperm from reaching the penis

rectum and anal canal

located in the pelvis rectum has no tenia coli, these merge to form a complete muscle coat, no haustra or omental appendices

Motor neuron (efferent)

Take signal from CNS to PNS. Exit via anterior/ventral root and rejoin with sensory neuron to form mixed spinal nerve Cell body is always WITHIN CNS: - Ventral horn for somatic PNS - Lateral horn for autonomic PNS

Sensory neuron (afferent)

Take signal from PNS to CNS. Enter via posterior/dorsal from mixed spinal nerve and dorsal root ganglion Cell body is always OUTSIDE of CNS

structure of kidney

organised in Medulla/Renal pyramid (lobes), separated by a continuous structure = Cortex urine produced from apex of medulla > collected in minor calyx > major calyx > renal pelvis > ureter

Bulbospongiosus muscles

originate on the central tendon and then run anteriorly to surround each bulb of the vestibule, supports pelvic floor, assist in erection of clitoris, compress greater vestibular gland

renal fascia

outer layer of dense fibrous connective tissue that covers the perinephric fat & anchors the kidney

vesico-uterine pouch

peritoneal fold anterior to uterus, between bladder and uterus

recto-uterine pouch

peritoneal fold posterior to uterus, between uterus and rectum

recto-vesical pouch (male)

peritoneal pouch located between the rectum & bladder

inguinal hernias

protrusion of abdominal contents into the inguinal canal indirect: contents travels through inguinal canal (most common, and more common in males than females) direct: contents travels directly through lower abdominal wall may cause bladder obstruction

peritoneal membrane & pubic arch

provide attachment roots of external genitalia

quadratus lumborum

rectangular muscles arise from 12th ribs and tips of lumbar transverse process lateral to psoas major insert to iliac crest

diaphragmatic surface of the liver

smooth (because diaphragm is smooth)

Deep perineal pouch

space below levator ani muscle & above perineal membrane that contains skeletal muscles that form sphincters around urethra & vagina (female), glands & neurovascular structures that supply penis (male)

Internal Oblique

superomedial fibres lowermost fibres: - arise from inguinal ligament - arch up - insert into pubic crest via conjoint tendon

visceral surface of the liver

takes shape of adjacent structures gallbladder and IVC sit in grooves hilum (portal hepatis): - portal vein* (delivers venous blood from GI tract for metabolism) - hepatic artery* - bile duct* - nerves - lymphatics * make up portal triad hepatic veins (not in hilum) are used for venous drainage into IVC (In situ, imagine this digram rotated)

bulbourethral glands

the two glands below the prostate in the deep perineal pouch that opens into spongy urethra & secrete a sticky fluid that becomes a component of semen to lubricate the urethra - forms pre-ejaculate

inguinal ligament

thick, under-curving fibrous band attaches from ASIS to pubic tubercle/pubic crest fibrous split between tubercle/crest

Transversus Abdominis

transverse fibres lowermost fibres: - arise from inguinal ligament - arch up - insert into pubic crest via conjoint tendon

iliacus

triangular fills space of iliac fossa inferior to quadratus lumbordum

urethra

tube leading from the urinary bladder to the outside of the body - females have short (~4cm) urethras - males have long (~20cm) urethras that bend twice along its course & divided into 4 parts (preprostatic part, prostatic part, membranous part, spongy part)

seminal vesicles

two small glands that secrete a fluid rich in sugar that nourishes and helps sperm move - secretes fluid into vas deferens and empties into the prostatic urethra

Rectus Abdominis

vertically orientated 4 x shorter stronger muscles tendinous intersections enclosed by rectus sheath