ANTR 350 EXAM 2

Specify the locations where the spinal cord begins and ends

Begins at foramen magnum of the skull; extends down from medulla oblongata, tapers off of L1 or L2 vertebra; the vertebral column of adults is longer than the spinal cord, because the vertebral column grows for a longer period of time

Explain the function of the blood-brain barrier

Interface between plasma and CSF. Protects the brain from foreign substances in the blood, protects brain from hormones and neurotransmitters in the rest of the body, maintains constant environment for the brain

Specify the clinical problem that can develop with weakness of the rectus sheath

It is the result of bleeding into the rectus sheath from damage to the superior or inferior epigastric arteries or their branches or from a direct tear of the rectus muscle

Describe the function of myelin

an insulating layer, or sheath that forms around nerves, including those in the brain and spinal cord. It is made up of protein and fatty substances. This myelin sheath allows electrical impulses to transmit quickly and efficiently along the nerve cells.

Identify the following on Figure 10.19 Anterolateral Abdominal Wall Muscles:

- Anterolateral abdominal wall muscles and broad tendons provide stability for the abdomen - Three flat muscles run from lateral to medial (1-3) - Aponeurosis: broad, flat muscles and tendons, white o Aponeurosis forms rectus sheath - The 4th abdominal muscle located within the rectus sheath -Rectus abdominis- anteromedial i. Vertical muscle fibers ii. Six pack iii. Paired: left and right 1. Runs on either side of midline -External abdominal oblique- superficial, anterolateral i. Fiber direction 1. Oblique- diagonal 2. Superior lateral to inferior medial- hands in pocket 3. Ribs to linea alba 4. Muscle fibers transition to aponeurosis (flat tendon) 5. Contributes to anterior recuts sheath -Internal abdominal oblique- middle, anterolateral i. Fiber direction 1. Oblique 2. Runs inferior lateral to superior medial- up and in 3. Hip bone to linea alba 4. Contributes to anterior and posterior rectus sheath -Transversus abdominis-weak i. Deepest layer of muscle ii. Fibers run horizontal iii. Ribs and pelvis to linea alba iv. Also transitions to aponeurosis v. Forms posterior rectus sheath -Linea alba- midline of aponeurosis -Rectus sheath- formed when the muscle fibers of the external and internal oblique muscles and the transversus abdominis muscle transition to aponeurosis. These layers run over the anterior and posterior surfaces of the rectus abdominis muscle to completely enclose it in aponeurosis. These helps to add strength to the anterolateral abdominal wall while still allowing for expansion and contraction of the abdominal cavity volume -Pectoralis major- thick, fan-shaped muscle contributing to the thoracobrachial motion. It consists of a clavicular part and a sternal part, both converging to a flat tendon that inserts on the humerus. It's innervated by both medial and lateral pectoral nerves -Pectoralis minor- The pectoralis minor muscle originates from the front surfaces of the third, fourth, and fifth ribs on each side of the rib cage. From these three locations, the muscle extends up the chest and inserts on the coracoid process of the scapula (shoulder blade). -Serratus anterior- The serratus anterior is a muscle that originates on the surface of the 1st to 8th ribs at the side of the chest and inserts along the entire anterior length of the medial border of the scapula. The serratus anterior acts to pull the scapula forward around the thorax.

Compare and contrast axial and appendicular muscles.

- Axial: attach on the axial skeleton at both ends (except a couple that attach to the pelvic girdle), Move head and neck and vertebral column/spine, produce facial expressions, eye movements, chewing talking. Assist w breathing and support pelvic and abdominal organs - Appendicular: attachments are proximal and distal, Proximal attachment: axial skeleton, girdle or limbs, move the limbs and pectoral girdle.

List and compare the two main categories of back muscles.

- Intrinsic- axial muscles, deeper, only attach to and move axial skeleton. Moves neck, vertebrae/spine - Extrinsic- appendicular muscles, superficial, distal muscle attachment is to the appendicular skeleton/girdle. Moves the limbs and pectoral girdle

List the structures innervated by the

- Ventral primary rami- anterolateral body wall, appendicular muscles, skin on limbs- form plexuses - Dorsal primary rami- intrinsic back muscles, skin on back- do not form plexuses

Describe the function of the cerebellum as it relates to movement.

-"little brain" -Both gray and white matter, has its own cortex and lobes -Located posteriorly, inferior to the occipital lobe, and posterior to the pons, medulla oblongata, and 4th ventricle -Functions i. Communicates w cerebrum and brainstem ii. Coordination of skeletal muscle contractions to produce smooth movements iii. Involved in control of equilibrium w inner ear iv. Damage or disease produces a condition known as "ataxia", the inability to coordinate voluntary motor control

Specify the cranial nerves that carry general senses and the special sense of taste for the anterior 2/3 and posterior 1/3 of the tongue

-2/3 Anterior i. Taste: CNVII facial nerve ii. Touch (general sensation): V3 mandibular division of trigeminal -1/3 Posterior i. Taste and touch (general sensation): IX glossopharyngeal nerve

List the muscles that contribute to the following actions of the eye

-Abduction: lateral rectus, inferior oblique, superior oblique -Adduction: superior rectus, inferior rectus, medial rectus -Depression: inferior rectus, superior oblique -Elevation: inferior oblique, superior rectus

List the three major arteries that supply the cerebrum with blood

-Anterior cerebral artery: midline frontal and parietal lobes, and medial side of brain in frontal and parietal lobes, if blocked: numbness and paralysis of lower limbs and pelvis on the opposite side of the body -Middle cerebral artery: lateral parts of frontal and parietal lobes, as well as anterior temporal lobe, if blocked: numbness and paralysis of face and arm on opposite side of the body; language problems -Posterior cerebral artery: occipital lobe, if blocked: visual deficits

Identify the following on Figure 10.21 Transverse Abdominal Wall:

-Anterior rectus sheath- above posterior rectus sheath -Posterior rectus sheath- below posterior recuts sheath -Linea alba- center line, between rectus abdominis -Aponeurosis- next to rectus abdominis -Rectus Abdominis- small circle o Superior- Xiphoid process or sternum and costal cartilage o Inferior: Pubic crest and pubic symphysis o Bilateral- flexes vertebral column, compresses abdominal wall to increase intra-abdominal pressure, controls tilt of pelvis o Innervation- anterior primary rami of T6-T12 spinal nerves -Internal Abdominal Oblique- center o Superior Attachments- inferior ribs and costal cartilage o Inferior Attachment- linea alba via aponeurosis o Bilateral- flexes vertebral column, compresses abdominal wall to increase intra-abdominal pressure, aids in forced exhalation o Unilateral- lateral flexion and rotation of vertebral column o Innervation- anterior primary rami of T6-L1 spinal nerves -Transverse abdominis- deepest o Superior Attachment- inferior ribs and costal cartilage o Inferior Attachment- linea alba via aponeurosis, iliac crest, pubic crest o Bilateral- flexes vertebral column, compresses abdominal wall to increase intra-abdominal pressure, aids in forces exhalation o Unilateral- lateral flexion and rotation of vertebral column o Innervation- anterior primary rami of T6-L1 spinal nerves -External Abdominal Oblique- superficial o Superior Attachments- external inferior borders of ribs o Inferior Attachments- linea alba via aponeurosis, iliac crest o Fibers run from superior lateral to inferior medial o Bilateral: flexes vertebral column, compresses abdominal wall to increase intra-abdominal pressure, aids in forced exhalation o Unilateral: lateral flexion and rotation of vertebral column o Innervation: anterior primary rami, T8- L1 spinal nerves -Erector spinae- but a group of muscles and tendons which run more or less the length of the spine on the left and the right, from the sacrum or sacral region (the bony structure beneath your lower back [lumbar] vertebrae and between your hips/glutes) and hips to the base of the skull. o left, next to transverospinalis -Transversospinalis- deep layer of the intrinsic back muscles. These muscles lie between the transverse and spinous processes and are grouped by length of the fascicles, as well as region covered. The groups are rotators, multifidus, and semispinalis. o Under L3 -Psoas major- posterior o Functions- joins the upper body and the lower body, the axial to the appendicular skeleton, the inside to the outside, and the back to the front. o Muscle that can be found on the side of the lumbar region of the vertebral column. It is also adjacent to the brim of the lesser pelvis area. It connects the iliacus muscle to the iliopsoas o Directly next to L3 -Quadratus lumborum- posterior o Axial muscle o Unilateral action: ipsilateral lateral flexion o Posterior abdominal wall muscle that originates from the posteromedial iliac crest and inserts into the medial border of the twelfth rib and the transverse processes of the first to fourth lumbar vertebrae. o Next to/underneath psoas major

For the following terminal nerve branches listed below, identify the somatic sensory innervation from the upper limb skin

-Axillary nerve- o Posterior brachial plexus o Wraps around surgical neck of humerus o Motor innervation: deltoid muscle o Sensory innervation: skin over shoulder -Radial nerve- o Posterior brachial plexus o Motor innervation: muscles in the posterior compartment of arm and forearm o Sensory innervation: skin over posterior arm, forearm, and posterior hand -Musculocutaneous nerve- o Anterior brachial plexus o Middle of arm to the lateral forearm o Motor innervation: muscles in the anterior compartment of the arm o Sensory innervation: skin on lateral forearm d. Median nerve- o Anterior brachial plexus o Travels in the middle of the arm to the lateral palm and fingers o Motor innervation: muscles in anterior forearm, thenar muscles o Sensory innervation: skin on lateral palm (thumb/thenar) and lateral digits e. Ulnar nerve- o Anterior brachial plexus o Travels behind medial epicondyle to the medial hand o Motor innervation: hypothenar muscles and other intrinsic hand muscles o Sensory innervation: skin on medial hand (palm)

List the primary innervated structures (sensory and motor) for the brachial, lumbar and sacral plexi.

-Brachial: i. Motor innervation: upper limb muscles ii. Sensory innervation: skin of the upper limb -Lumbar: i. Motor innervation: anterior and medial thigh muscles ii. Sensory innervation: skin of anterior thigh, medial thigh, medial leg and foot -Sacral: i. Motor innervation: gluteal muscles, posterior thigh, and all leg and foot muscles ii. Sensory innervation: skin of posterior thigh and leg, plantar foot surfaces

Describe the function related to speech and language, location of, and defects associated with damage to the following areas:

-Broca's area: makes possible the production of speech sounds, in front of primary cortex (frontal lobe), if damaged, can't pronounce/explain what is going on -Wernicke's area: makes possible the parsing of language from speech sounds, in parietal and temporal lobe, "word salad" if damaged

List the names of the twelve cranial nerves and be able to match their name to the Roman Numeral associated with each nerve

-CN I Olfactory -CN II Optic -CN III Oculomotor -CN IV Trochlear -CN V Trigeminal -CN VI Abducens -CN VII Facial -CN VIII Vestibulocochlear -CN IX Glossopharyngeal -CN X Vagus -CN XI Accessory -CN XII Hypoglossal

Describe the basic function of the twelve cranial nerves.

-CN I Olfactory i. Sensory only: smell ii. Fibers pass through the cribriform plate of the ethmoid bone to olfactory bulb -CN II Optic i. Sensory only: sight ii. Passes through the optic canal of sphenoid bone iii. Two optic nerve converge -CN III Oculomotor i. Motor only: all eye muscles except superior oblique and lateral rectus ii. Passes through superior orbital fissure in sphenoid bone -CN IV Trochlear i. Motor only: superior oblique muscle- this muscle goes through the trochlea ii. Passes through superior orbital fissure in the sphenoid bone to enter the orbit -CN V Trigeminal i. Mixed- both sensory and motor ii. Three divisions -CN VI Abducens i. Motor only: lateral rectus- this muscle abducts eye ii. Exits cranial vault via the superior orbital fissure in the sphenoid bone to the eye orbit -CN VII Facial i. Mixed: sensory (taste- to the anterior 2/3 of tongue) motor (to muscles of facial expression) ii. Enter petrous portion of the temporal bone via the internal auditory meatus (within CNVIII) 1. Motor roots exits stylomastoid foramen 2. Sensory root exits within the temporal bone to enter infratemporal fossa -CN VIII Vestibulocochlear i. Sensory only: vestibular branch= equilibrium, cochlear branch= hearing ii. Travel to the inner ear via the internal auditory meatus (with CNVII) iii. Damage: disequilibrium and vertigo, hearing loss or tinnitus (ear ringing) -CN IX Glossopharyngeal i. Mixed: sensory (to pharynx and posterior 1/3 tongue) taste (to posterior 1/3 of tongue) motor (to stylopharyngeus muscle- involved in swallowing) ii. Exit the cranium through the jugular foramen -CN X Vagus i. Mixed: sensory (to the thoracic and abdominopelvic viscera- conveys nausea) motor (to the muscles of the pharynx and larynx) visceral motor (to be discussed later) ii. Exits the cranium via the jugular foramen iii. Travels on the surface of the esophagus into the abdominal cavity -CN XI Accessory i. Motor only: to sternocleidomastoid and trapezius ii. Passes superiorly through foramen magnum iii. Exits skull via the jugular foramen -CN XII Hypoglossal i. Motor only: to almost all intrinsic and extrinsic tongue muscles ii. Exit the cranium via the hypoglossal canal in the occipital bone- hooks around occipital artery

List the structures that compose the

-Central Nervous System (CNS)- brain and spinal cord, integrates and processes nervous info -Peripheral Nervous System (PNS)- cranial nerves, spinal nerves, ganglia, carries info from the body to CNS and receives info from the CNS to cause a response in the body

Describe the function of the basal ganglia as it relates to movement

-Collection of structures inside the brain to advise motor cortex on whether to move or not, help facilitate voluntary movements and inhibit involuntary movements -Disorders: Parkinson's disease, huntingtins disease, hemiballismus

Describe the nerve involved in carpal tunnel syndrome and the somatic impairments associated with carpal tunnel syndrome; both somatic sensory and motor impairments should be included

-Compression of median nerve bc inflammation of structures in the carpal tunnel can lead to medial nerve compression, overuse -Somatic symptoms of impairment: weak handgrip, loss of thumb opposition, loss of sensation in lateral digits

Describe the location of the following

-Conus medullaris: tapered, terminal end of the spine -Cauda equina: extends inferiorly from the conus medullaris; composed of anterior (ventral) and posterior (dorsal) roots

Identify the following on BioDigital 13.1 Interactive Neuron:

-Dendrite- extend from cell as projections, act as receivers and conduct nerve impulses to the cell body- on the cell body -Soma (cell body)- control center of neuron- center -Axon- single long projection, carry nerve impulses to other neurons, muscle tissues, or gland cells- middle long strand

Specify the two compartments of the arm/brachium

-Divides limbs into regions by deep investing fascia (connective tissue) -Brachium: i. anterior (action: elbow flexion, innervation: musculotendons nerve) ii. posterior (action: elbow extension, innervation: radial nerve) -Compartments share common: action and nerve innervation -All muscles in arm have root "brach" in the name a. Anterior- elbow flexion i. Biceps Brachii- superficial 1. Attachments: proximal: superior scapula, distal: radial tuberosity 2. Primary action: supination 3. Secondary action: arm/shoulder flexion, elbow flexion 4. Innervation: musculocutaneous nerve ii. Brachialis- distal, deep 1. Attachments: proximal: mid-humerus, distal: ulnar tuberosity 2. Primary action: elbow flexion 3. Innervation: musculocutaneous nerve b. Posterior- elbow extension i. Triceps- three heads 1. Attachments: proximal: humerus and scapula, distal: olecranon(ulna) 2. Primary action: elbow extension Innervation: radial nerve

Describe the role the following structures play in hearing and balance

-Ear canal and external acoustic meatus: directs, collects, and amplifies sound waves- outer ear -Tympanic membrane (eardrum): converts and amplifies sound waves to mechanical force and movement of small bones- middle ear -Auditory ossicles: malleus, incus, stapes (convert mechanical force and movement to fluid pressure waves inside the cochlea)- middle ear -Eustachian (auditory) tube: helps drain fluid and helps normalize air pressure within the middle ear- middle ear -Cochlea: houses specialized hair cells that convert fluid pressure waves into electrical/neurochemical impulses- inner ear -Semicircular canals: detect linear and angular acceleration in multiple planes (gravity)- inner ear -Vestibulocochlear nerve (CN VIII): sound transmitted through this to the brainstem, analysis of sound in terms of location, timing, complexity- acoustic reflex

Describe the primary actions of selected axial muscles

-Erector spinae 1. Bilateral: back extension 2. Unilateral: lateral flexion of vertebral column -Transversospinalis 1. Bilateral: extension of back and neck 2. Unilateral: contralateral rotation of back and neck -Anterolateral wall muscles (rectus abdominis, external and internal abdominal oblique, transverse abdominis) 1. Bilateral: trunk flexion 2. Unilateral: lateral flexion, rotation of trunk -Sternocleidomastoid 1. Bilateral: flexion of head -Quadratus lumborum 1. Unilateral: ipsilateral flexion of trunk

Identify the following on BioDigital 10.4 Back Muscles:

-Erector spinae group a. Vertical axial muscles fan out across neck b. Attachments: skull to pelvis c. Action: bilateral (extension of vertebral column) and unilateral (ipsilateral lateral flexion) d. Innervation- posterior primary rami -Transversopinalis group. a. Axial muscle layers, superficial to deep b. Attachments- transverse and spinous process of vertebrae c. Actions: bilateral (extension of vertebral column and head) and unilateral (contralateral rotation) d. Innervation- posterior primary rami

List the number of spinal nerves found in each of the following regions:

-Formed by posterior/dorsal and anterior/ventral roots joining, paired -Cervical: 8 -Thoracic: 12 -Lumbar: 5 -Sacral: 5 -Coccygeal: 1

Describe the function of the following structures:

-Frontal lobe: executive/ intellectual functions: personality; voluntary motor control of skeletal muscle -Parietal lobe: sensory; understanding speech and expressing thoughts and emotions -Temporal lobe: primary auditory cortex; interpretations of olfactory sensations -Occipital lobe: primary visual cortex

Define the following terms:

-Gyrus- ridge like portions of the brain -Sulcus- valley between gyrus

Specify the space CSF is sampled from in a lumbar spinal puncture.

-Insert needle midline between L3 and L4 spinous processes in adults; lower in infants and children -Needle pierces dura mater and arachnoid mater, pushes aside fibers of cauda equina -Withdraw 3-9 mL of CSF from subarachnoid space

Describe the function and location of the Hippocampus

-Inside the medial temporal lobe -Involved in turning short term memories into long term memories -Damage or disease produces anterograde amnesia, inability to make new memories. Most notably destroyed early on in Alzheimer's disease

Describe the function of the amygdala

-Inside the temporal lobe -Involved in attaching emotions to experiences and memories, particularly fear -Damage or disease produces a loss of appropriate emotional responses to stimuli

Specify the nerves that innervate the extrinsic eye muscles and list which muscles are innervated by each nerve.

-Lateral Rectus= CN VI Abducens -Superior Oblique= CN IV Trochlear -All other eye muscles (the medial, inferior, and superior recti, the inferior oblique, and levator palpebrae muscles)= CN III Oculomotor

Describe the function of the three regions of the brainstem

-Midbrain: connects diencephalon to the rest of brainstem, communicates w cerebellum, involved in eye movements and visual/auditory reflex -Pons: connects midbrain to the rest of brainstem, communicates w cerebellum, involved in breathing and cranial nerve function, houses 4th ventricle -Medulla oblongata: connects brainstem to spinal cord, communicates w cerebellum, involved in breathing and cranial nerve functions, damaged in downward compression due to foramen magnum and cerebellum

Identify (list) the muscles that move the shoulder joint

-Muscles that move arm/shoulder joint -Proximal: attach on the axial skeleton or pectoral girdle -Distal: attach on humerus -Deltoid- 3 heads (anterior, mid, posterior) i. Attachments: proximal: spine of scapula and clavicle, distal: deltoid tuberosity ii. Primary actions: abduct arm (middle head) iii. Secondary actions: arm flex, extend, medial rotation, lateral rotation iv. Innervation: axillary nerve -Latissimus dorsi- strong back muscles i. Attachments: proximal: thoracic vertebrae to hip bone, distal: intertubercular groove of humerus ii. Primary actions: extend arm, adduct arm iii. Secondary actions: medial rotation iv. Innervation: brachial plexus -Rotator cuff muscles -Pectoralis major- chest muscle i. Attachments: proximal: sternum, clavicle, distal: humerus (intertubercular groove) ii. Primary actions: arm flexion, adduction iii. Secondary actions: arm medial rotation iv. Innervation: brachial plexus

Define the following terms

-Nerve- A bundle of neuron axons located in the peripheral nervous system -Ganglion- Collection of neuron cell bodies located in the peripheral nervous system.

Identify (list) the muscles that move the scapula at the scapulothoracic joint

-Proximal: attach on axial skeleton -Distal: attach on the scapula (pectoral girdle) this is what moves -Trapezius: superficial, large, triangular, spans most of back i. Attachments: proximal: base of skull-T12, distal: pectoral girdle ii. Primary Action: elevate scapula iii. Secondary actions: depress scapula, retract scapula, upward rotation scapula iv. Innervation: spinal accessory nerve -Rhomboids- major/minor i. Attachments: proximal: thoracic vertebrae, distal: scapula (medial border) ii. Primary Action: retract scapula iii. Innervation: brachial plexus -Serratus anterior i. Attachments: proximal: most ribs, distal: scapula (medial border) ii. Primary actions: protract scapula- jabbing motion, holds scapula in place against thoracic wall iii. Secondary Action: upward rotation of scapula iv. Innervation: brachial plexus -Pectoralis minor i. Attachments: proximal: ribs 3-5, distal: scapula (coracoid process) ii. Primary action: depress scapula iii. Secondary action: protract scapula iv. Innervation: brachial plexus

Identify the nerve most likely to be damaged and describe the somatic impairments that could result from a fracture to each of the following areas of the humerus

-Somatic sensory impairment: pain, numbness, tingling -Somatic motor impairment: muscles weakness, paralysis -Surgical neck o Damage axillary nerve bc it travels around surgical neck o Somatic symptoms of impairment: weak abduction or arm, numbness over shoulder -Mid-shaft of the humerus / radial groove o Damage radial nerve bc it travels in radial groove at mid-shaft of humerus o Somatic symptoms of impairment: weak wrist extension, wrist drop, numbness of posterior forearm and hand -Medial epicondyle o Damage to the ulnar nerve bc ulnar nerve travels near the medial epicondyle o Somatic symptoms of impairment: weak grip, numbness of medial digits

Define dermatome and describe the location of the following dermatome levels

-T4- nipple -T10- umbilicus's -T12/L1- iliac crest/hips -Dermatome- area of skin innervated by single spinal nerve (or 2)

Describe the function of the following portions of the diencephalon:

-Thalamus: receives all sensory info coming into the body, processes and conveys info going to the cortex, the "executive assistant" to the cortex, damage or disease produces sensory or motor or behavioral abnormalities -Hypothalamus: communicates w cerebrum and brainstem, responsible for changing the body to keep it in homeostasis, receives info about food intake, water levels, blood pressure, temp, etc. (visceral functions), controls the secretion of hormones, works to create bodily reaction to emotional stimuli

For the following terminal nerve branches listed below, describe the somatic impairments that could result from damage to the following nerves; both somatic sensory and motor impairments should be included

-Tibial nerve. o Medial branch of sciatic nerve o From posterior thigh to medial leg near tibia to the plantar foot surface o Motor innervation: posterior thigh compartment, posterior leg compartment, most foot muscles o Sensory innervation: skin on plantar foot surface -Common fibular nerve. o Lateral branch of sciatic nerve o Begins posterior o Travels around head of fibula from posterior to anterior o When anterior splits into superficial fibular nerve and deep fibular nerve o Most commonly damaged nerve in lower limb- the nerve is superficial and wraps around fibular neck § Deep fibular nerve involvement: · Foot drop (cannot dorsiflex) · Numbness between 1st two toes § Superficial nerve involvement: · Inversion ankle sprains (cannot evert foot) · Numbness over foot dorsum, except between 1st two toes § Both involved: · Inversion ankle sprains (cannot evert) · Foot drop (cannot dorsiflex) · Numbness over all foot dorsum -Superficial fibular nerve. o Travels in lateral leg compartment near fibula to the dorsum of foot o Motor innervation: muscles in lateral leg compartment o Sensory innervation: skin on the dorsum of foot, except between 1st and 2nd toe (1st interdigital cleft) -Deep fibular nerve. o Travels anterior leg to the dorsum of foot, between the first two toes o Motor innervation: muscles in the anterior compartment of the leg o Sensory innervation: skin b/t the great toe and second toe (1st interdigital cleft)

Specify the two compartments of the forearm/antebrachium

-Two compartments formed by deep fascia and interosseous membrane -Anterior and Posterior compartments share- action, innervation, attachment site -Anterior Forearm Muscles: wrist flexion, radioulnar joint i. Anterior compartment 1. Attachments: proximal: medial epicondyle 2. Primary action: wrist flexion, forearm pronation 3. Innervation: median nerve d. Posterior Forearm Muscles: wrist extension, radioulnar joint supination i. Posterior Compartment 1. Attachments: proximal: lateral epicondyle 2. Primary action: wrist extension, forearm supination 3. Innervation: radial nerve

List the three divisions of the trigeminal nerve and describe the function of each division.

-V1- ophthalmic i. Sensory only: innervation to areas around orbit, forehead, anterior scalp, sinuses, upper nasal cavity, lacrimal gland ii. Passes through the superior orbital fissure -V2- maxillary i. Sensory only: innervation to mid-face, lower eyelid, nasal cavity, nose, cheeks, maxillary teeth, gums, upper lip, palate ii. Exits through foramen rotundum -V3- mandibular i. Mixed: sensory (lower lip, mandibular teeth, and gums, anterior 2/3 of tongue and TMJ) motor (supplies the muscles of mastication) ii. Passes through foramen ovale

Specify the type of neuron cell body located in the following structures

-Ventral horn: movement/action (somatic and visceral motor), contains the cell bodies of somatic motor neurons, near anterior of spinal cord -Lateral horn: only present from the T1-L2/L3 levels of the spinal cord and contains the cell bodies of preganglionic sympathetic neurons which are part of the autonomic nervous system, between ventral and dorsal horn -Dorsal root ganglion: function: detection/perception (somatic and visceral sensory), contains the cell bodies of interneurons and axons from somatic sensory and visceral sensory neurons, small bump near posterior of spinal cord on the root

Explain the significance of a muscle location; in particular the importance of an anterior location compared to posterior location

-location tied to action -Anterior: forward motion -EX: Anterior neck muscles: flex neck. Anterior abdominal muscles: flex trunk Chest muscles: flex the arm/shoulder. Anterior arm muscles: flex elbow. Anterior forearm: flex wrist and fingers. Anterior thigh: flex hip. Anterior thigh: extend knee. Anterior leg: dorsiflex ankle. -Posterior- backward motion -EX: Deep back muscles: extend the vertebral spine. Superficial back muscles: extend the arm/shoulder. Posterior arm muscles: extend elbow. Posterior forearm: extend wrist, fingers. Gluteal (posterior): extends hip. Posterior thigh: flex knee. Posterior leg: plantar flexes ankle.

Define a reflex arc, listing the steps and CNS structures involved.

-steps: sensor, sensory neuron, control center, motor neuron, and muscle. These five parts work as a relay team to take information up from the sensor to the spinal cord or brain and back down to the muscles. -Reflex Arc: 2 components i. Afferent limb= sensory- CNS ii. Efferent limb= motor- effector organ (skeletal muscle)

Explain why the biceps brachii is a strong supinator compared to the brachialis, which does not supinate the arm

-the bicep brachii is on the anterior surface of the humerus. It is distally connected to the radius by the radial tuberosity. Radius moves when supinating.-the brachialis (strongest flexor) is deep to the bicep brachii. It is distally connected to the ulna at the ulnar tuberosity of ulna. Ulna does not move when supinating. only muscles that attach to the radius can move the radioulnar joint. b. Describe the distal attachment point of each muscle and identify the bony sites on Figure 7.5: Radius and Ulna. i. Brachialis: ulnar tuberosity ii. Biceps brachii: radial tuberosity

Describe the flow of cerebral spinal fluid (CSF) through the central nervous system

CSF produced in lateral ventricle, flows to third ventricle (smaller midline cavity) via the interventricular foramen. The cerebral aqueduct (narrow canal) lets CSF flow between the third and fourth ventricle. It then goes to the fourth ventricle (continuous w the spinal cord central canal which extends almost the spinal cord full length) which goes outside brain, through a drain called the arachnoid granulation which flows into the dura mater through channels or superior sagittal sinus

List the layers of meninges from superficial to deep.

Dura mater, arachnoid mater, pia mater

Describe the importance of a nerve plexus.

Each new nerve branch created by the plexus is innervated by more than one spinal nerve- damage to a single spinal nerve likely will not lead to complete loss of motor innervation of specific muscle or compartment- redundancy

Specify the cranial nerve involved in Bell's palsy

Facial nerve paralysis causes facial droop- very easy to damage

Explain how the spinal nerves exit the vertebral column.

Intervertebral foramen -Between adjacent vertebrae -Formed by superior and inferior vertebral notches -Allow the passage of spinal nerve -Each spinal nerve exits the vertebral column through an intervertebral or sacral foramen (except C1) -Spinal nerves C1-C7: exit superior to same number vertebrae -Spinal nerve C8 exits inferior to C& -Spinal nerves T1-Co1: exit inferior to same-number vertebrae -Spinal nerves below the L2 vertebra have very long dorsal/post and ventral/ant roots which for cauda equina

Describe the function of the corpus callosum

Main connection between left and right cerebral hemispheres and allows the halves to communicate w each other

Specify the body cavities that contain the organs of the central nervous system.

The brain and spinal cord are the organs of the central nervous system. Because they are so vitally important, the brain and spinal cord, located in the dorsal body cavity, are encased in bone for protection. The brain is in the cranial vault, and the spinal cord is in the vertebral canal of the vertebral column.

Define accommodation and describe how the lens changes shape to see close objects.

When ciliary muscle is relaxed, the zonular fibers of the choroid pulls the lens into a flat shape that is good for distance vision. When it contracts, the ciliary muscle releases the tension of zonular fibers and the lens becomes more spherical, better close up vision

Review the following terms

a. Afferent- info from the body traveling to the CNS (pain, touch, temp) b. Efferent- info traveling from the CNS to muscle tissue in the body (muscle tissue contracting) c. Somatic- structures you have voluntary/conscious control over (skeletal, skin, joints, bones) d. Visceral- structures you do not have conscious control over e. Synapse- junction between two nerve cells, consisting of a minute gap across which impulses pass by diffusion of a neurotransmitter.

Define rectus sheath. Explain what structures form the rectus sheath and specify what muscle it encloses

a. Anterior rectus sheath- aponeurosis of 1.5 muscles i. The anterior rectus sheath is formed by the aponeurosis of the external abdominal oblique and internal abdominal oblique (which actually splits in half)- b. Posterior rectus sheath- aponeurosis of 1.5 muscles i. The posterior layer of the rectus sheath is formed by the internal abdominal oblique and the transversus abdominis aponeurosis in the superior part of the rectus sheath c. Change in rectus sheath inferior to the navel(bellybutton) i. No posterior rectus sheaths ii. Contributes to weak abdominal wall in lower abdomen

Specify the three major compartments of the thigh

a. Anterior- primary action: knee extension, innervation: femoral nerve o Iliopsoas- anterior thigh compartment -2 muscles: iliacus and psoas major (posterior abdominal muscle) -Primary action: hip/thigh flexion - Innervation: femoral nerve o Sartorius- anterior thigh compartment, obliquely crosses anterior thigh -Proximal attachment: ASIS -Distal attachment: tibia -Actions: numerous, helps cross leg - Innervation: femoral nerve o Quadriceps- anterior thigh compartment, four muscles - Proximal attachment: · Rectus femoris: AIIS · Vastus medialis, lateralis, intermedius: anterior and posterior femur - Distal: tibial tuberosity - Primary action: knee extension - Secondary action: RF also flexes hip - innervation: femoral nerve b. Posterior- primary action: knee flexion, innervation: tibial nerve o Hamstrings o 2 medial "semis" - Semitendinosus - Semitendinosus o 2 lateral bicep femoris - Long head - Short head o Primary action: knee flexion o Secondary: hip extension o Proximal attachments: ischial tuberosity o Distal attachments: semis (tibia medial condyle), biceps femoris (fibular head) o Innervation: tibial nerve c. Medial- primary action: thigh/hip adduction, innervation: obturator nerve o Adductor longus o Adductor brevis o Adductor magnus o Gracilis o Proximal attachment: pubis o Distal attachment: linea aspera o Primary action: hip adduction o Innervation: obturator nerve

Describe the first function listed for, and the location (CNS or PNS) of, the following glial cells:

a. Astrocytes- most common CNS neuroglia, star-shaped cells that perform many functions within the CNS i. Contribute to the blood-brain barrier ii. Secretion and absorption of neurotransmitters in the synaptic cleft iii. Establishment of the physical structure of the brain by holding neurons in the correct 3-dimensional space iv. Glycogen storage and glycogenesis, providing glucose and lactate to neurons v. Regulation of the internal CNS environment, especially fluid surrounding axons and synapses, by controlling ion concentrations in the extracellular space vi. Release of ATP, which stimulates oligodendrocytes to produce the myelin sheath vii. Repair of damage to nerve cells b. Ependymal cells- line ventricles of the brain and assist in the production and circulation of cerebrospinal fluid, form choroid plexus, basal membrane attached to astrocytes c. Microglial cells- 10-15% of the CNS and act similar to macrophages in the immune system in order to defend neurons against pathogens i. Removal of damaged neurons or neuroglia as well as infectious agents ii. Recognition of infectious agents and action as antigen-presenting cells iii. Prevention of inflammation within the CNS by rapid removal of infectious agents d. Oligodendrocytes- provide support and insulation to axons within the CNS by creating the myelin sheath that surrounds them, produce growth-inhibitory proteins e. Schwann cells- a re long flat cells that wrap around axons forming a myelin sheath around axons located in the peripheral nervous system, peripheral nervous system glial cells

Identify the following on Figure 14.13 The External Lobes of the Cerebrum:

a. Brainstem- bottom b. Central sulcus- separates the frontal and parietal lobes c. Cerebellum- little brain d. Lateral fissure- between frontal and temporal e. Frontal lobe- front part f. Parietal lobe- middle portion g. Occipital lobe- back h. Temporal lobe- side/bottom i. Spinal cord- below brainstem

Identify the following on Figure 14.11 Lateral View of the Brain:

a. Brainstem- bottom, transitions into spinal cord b. Central sulcus- top of brain near the back c. Cerebellum- "little brain" at the bottom and back d. Cerebrum- largest portion, middle e. Gyri- elevated ridges f. Lateral fissure- horizontal, split brain in superior and inferior g. Longitudinal fissure- split brain in half h. Sulci- small grooves or valleys

Identify the following on Figure 14.6 Brain Ventricles:

a. Central canal- by brain stem b. Cerebral aqueduct- narrow canal, thin above fourth ventricle c. Fourth ventricle- between central canal and cerebral aqueduct d. Interventricular foramen- connect paired lateral ventricles with the third ventricle at the midline of the brain e. Lateral ventricles-top, two portions Third ventricle- center

Identify the following on Figure 14.12 Midsagittal View of the Brain:

a. Cerebellum- back b. Cerebrum- top near back c. Corpus callosum- directly in the middle d. Hypothalamus- under thalamus e. Medulla oblongata- below the pons, right above the spinal cord f. Midbrain- above pons g. Pons- small bump on brainstem h. Spinal cord- inferior part i. Thalamus- below corpus callosum

Identify the following on Figure 14.24b Spinal Cord (Posterior View):

a. Cervical part- top of spinal cord b. Thoracic part- middle section c. Lumbar part- bottom of spinal cord d. Sacral part- below lumbar e. Conus medullaris- tapered, lower end of the spinal cord f. Cauda equina- hangs within meninges below end of the spinal cord

Identify the following on the Figure 15.4 Cross-Section of Spinal Cord:

a. Dorsal horn- termination of primary afferent fibers b. Lateral horn- between dorsal and ventral c. Ventral horn- center part, two d. Dorsal root- spinal nerves that connect to body on top e. Ventral root- spinal nerves that connect to body on bottom f. Dorsal root ganglion- little bump g. Spinal nerve- side that splits off h. Dorsal primary ramus- innervate the segments of muscle and skin that cross their level as each dorsal primary ramus continues horizontally from the spinal nerve it branched from i. Ventral primary ramus- larger, split into additional branches to innervate the muscles and skin of anterolateral body wall and limbs

Explain which space each of the following hematomas would be located within and briefly describe the key symptoms associated with each

a. Epidural hematoma- when the skull is damaged at pterion and the sharp edges of the bone damage the middle meningeal artery, which normally supplies the dura mater with blood. When this artery is cut, it releases blood that begins pushing the dura mater away from the skull, pooling into a mass of blood that can compress the brain. b. Subdural hematoma- symptoms can take days to be noticed, when the skull is damaged at pterion and the sharp edges of the bone damage the middle meningeal artery, which normally supplies the dura mater with blood. When this artery is cut, it releases blood that begins pushing the dura mater away from the skull, pooling into a mass of blood that can compress the brain. c. Subarachnoid hematoma- arteries supplying blood to the brain burst or are otherwise damaged. These arteries are found in the subarachnoid space, and one of the most common causes of arterial rupture in the brain is hypertension. When an artery in the subarachnoid space bursts, there is a huge spike in intracranial pressure, because of all the new fluid that is being sprayed into the CSF, thunderclap headache

Identify the following on Figure 14.24a Spinal Cord (Cross-Sectional View):

a. Epidural space- superficial space, near spinous process b. Subdural space- underneath epidural space c. Subarachnoid space- underneath subdural space d. Spinal cord- center e. Ventral root- connects from spinal cord to the spaces f. Dorsal root- connects from top of spinal cord g. Dorsal root ganglion- underneath superior articulating surface h. Dorsal primary ramus- extends from dorsal root ganglion, extends up i. Ventral primary ramus- extends from dorsal root ganglion, extends down j. Spinal nerve- between dorsal root ganglion and ventral primary ramus

Differentiate the fiber direction and location of the following muscles

a. External abdominal oblique- These muscle fibers from in the same direction as if you were to put your hands in your pockets, diagonally downward from lateral to medial. When both sides contract, it flexes the trunk. When only one side contracts, it helps you rotate and/or laterally flex the trunk. b. Internal abdominal oblique- Its fibers run perpendicular to the external oblique muscle, beginning in the thoracolumbar fascia of the lower back, the anterior 2/3 of the iliac crest (upper part of hip bone) and the lateral half of the inguinal ligament. ... In males, the cremaster muscle is also attached to the internal oblique. c. Rectus abdominis- The fibers run vertically and help stabilize the pelvis while walking, and of course help flex and/or rotate the trunk. The origin is the pubic crest and the pubic symphysis. The insertion is the xiphoid process and costal cartilages of ribs 5-7. d. Transversus abdominis- It is a thin sheet of muscle whose fibers run horizontally anteriorly. It arises as fleshy fibers from the deep surface of the lower six costal cartilages, the lumbar fascia, the anterior two-thirds of the iliac crest and the lateral third of the inguinal ligament.

List the three tunics (layers) of the eye

a. Fibrous tunic (outermost) -Sclera: white of the eye, provides structure and site for attachment of extrinsic eye muscles -Cornea: transparent fibrous layer through which light can enter the eye b. Vascular tunic (middle): provide nutrient and gas exchanges, highly vascularized -Choroid: vascular layer of the eye -Iris: "eye-color" part, involved in determining size of pupil -Ciliary body: part of the eye that controls shape of the lens and produces aqueous humor c. Nervous tunic (inner) -Lens: focuses light onto the retina (not true tunic) -Retina home of the first cells responsible for encoding the presence of light -Fovea: area of retina that is most high-acuity and color sensitive

Specify the three compartments of the leg

a. Formed by tight crural fascia, interosseus membrane b. Anterior- primary action: ankle dorsiflexion, innervation: deep fibular nerve o Tibialis anterior- most anterior, superficial -Distal attachment: medial foot -Primary action: dorsiflexion, inversion -Innervation: deep fibular nerve o Extensor digitorum longus- deep o Extensor hallucis longus-deepest, same as above just deeper -Distal attachment: distal phalanges(dorsum) -Primary action: toe extension, secondary: dorsiflexion -innervation: deep fibular nerve o Proximal Attachments (ALL): tibia, fibula, interosseous membrane c. Posterior- largest, primary action: ankle plantar flexion, innervation: tibial nerve o Superficial muscles -Gastrocnemius: superficial · Proximal attachments: femoral condyles -Soleus: deep · Proximal attachments: Tibia and fibula -Distal attachments: calcaneus -Primary actions: plantar flexion of ankle -Secondary actions: knee flexion -Innervation: tibial nerve o Deep muscles -Tibialis Posterior · Proximal attachment: tibia/fibula · Distal attachment: tarsals (plantar) · Primary action: foot inversion · Innervation: tibial nerve -Flexor Hallucis Longus · Proximal attachment: tibia/fibula · Distal attachment: hallux distal phalange · Primary action: toe flexion · Innervation: tibial nerve -Flexor Digitorum Longus · Proximal attachment: tibia/fibula · Distal attachment: distal phalanges · Primary action: toe flexion · Innervation: tibial nerve d. Lateral- primary action: foot eversion, innervation: superficial fibular nerve o Fibularis longus: superficial o Fibularis brevis: deep -Proximal attachments: fibula -Distal attachments: metatarsals(plantar) -Travels behind lateral malleolus -Primary Action: eversion of foot -Innervation: superficial fibular nerve

Identify the following on Figure 11.14 Lateral View of the Leg

a. Gastrocnemius- superficial, calf muscle b. Soleus- below gastrocnemius c. Fibularis longus- between soleus and tibialis anterior d. Fibularis brevis- thin, small muscle, below fibularis longus e. Extensor digitorum longus- thin, small muscle underneath tibialis anterior f. Tibialis anterior- anterior, shin muscle g. Calcaneal tendon- back ankle/heel muscle

Identify the following structures on Figure 11.11 Muscles of the Posterior Thigh, Gluteal Region, and Posterior Leg:

a. Gluteus medius- near hip, most lateral portion, small b. Gluteus maximus- anterior, large top area of thigh c. Iliotibial band- below gluteus maximus, stretches from middle thigh to knee d. Semimembranosus- middle of thigh, medial to body, outer layer e. Semitendinosus- next to semimembranosus, closer to center thigh f. Biceps femoris- between semitendinosus and iliotibial band, the long head is the center and the short head is small and next to it g. Gastrocnemius- below knee

Identify the following Figure 11.10 Muscles of the Anterior Thigh:

a. Iliopsoas (psoas major and iliacus)- right by the bone, goes over the hip bone b. Sartorius-long, connects from the hip bone to the knee c. Tensor fascia lata- attaches to hip bone underneath, lateral d. Rectus femoris- large, center of thigh e. Vastus lateralis- lateral, next to rectus femoris f. Vastus medialis- between sartorius and rectus femoris g. Vastus intermedius- underneath rectus femoris h. Quadriceps tendon- connects to rectus femoris, extends over kneecap i. Patellar ligament- below kneecap j. Adductor longus- upper right, medial, near sacrum k. Gracilis- external point of the ischiopubic ramus (on the pubic bone) and extends down to the upper medial (middle) shaft of the tibia

Describe the primary actions of selected upper limb muscles

a. Major muscles that move the scapula: i. Trapezius= elevation ii. Rhomboids= retraction iii. Serratus anterior= protraction iv. Pectoralis minor= depression b. Major muscles that move the elbow i. Brachialis= flexion ii. Triceps brachii= extension c. Major muscles that move the glenohumeral joint i. Latissimus dorsi= extension, adduction ii. Pectoralis major= flexion, adduction iii. Supraspinatus= adduction iv. Infraspinatus= lateral rotation v. Subscapularis= medial rotation vi. Deltoid= abduction d. Major muscles/regions that move the radioulnar joint i. Biceps brachii= supination ii. Anterior forearm= pronation iii. Posterior forearm= supination e. Major muscles/regions that move the wrist joint i. Anterior forearm= flexion ii. Posterior forearm= extension

Review what structures/tissues are innervated by the following four neurons and what type(s) of information each neuron carries

a. Somatic sensory- sensory info you can move b. Somatic motor- carry nerve impulses to skeletal muscle (walk, run) c. Visceral sensory- conveyed to the brain and spinal cord to maintain homeostasis of the body. (stretch/dissection of hollow organs) d. Visceral motor- carry nerve impulses to smooth, cardiac muscle tissue and glands

Identify the following on Figure 11.4 Muscles of the Shoulder:

a. Sternocleidomastoid: neck muscle b. Serratus anterior: large muscle that spans most of the rib cage. It is named for its serrated (saw-like) appearance. This muscle attaches to the anterior ribs and then spans the rib cage to attach to the medial (vertebral) border of the scapula c. Trapezius: top, inner shoulder towards neck d. Deltoid: triangular shaped muscle, shoulder e. Subscapularis: large triangular muscle which fills the subscapular fossa and inserts into the lesser tubercle of the humerus and the front of the capsule of the shoulder joint. f. Pectoralis major: muscle is a fan-shaped muscle on the anterior chest g. Pectoralis minor: small muscle, located deep to pectoralis major. It attaches proximally to the axial skeleton along the ribs then distally to the coracoid process of the scapula h. Biceps brachii: inner, top portion of arm i. Brachialis: near elbow j. Triceps brachii: back of humerus between shoulder and elbow

List the four muscles that make up the rotator cuff

a. Supraspinatus- posterior scapula in the supraspinous fossa and inserts on the greater tubercle of the humerus 1. Attachments: proximal: supraspinous fossa, distal: greater tubercle 2. Primary action: arm abduction 3. Innervation: brachial plexus b. Infraspinatus- infraspinous fossa of the scapula and inserts on the greater tubercle of the humerus 1. Attachments: proximal: infraspinous fossa, distal: greater tubercle 2. Primary action: arm lateral rotation 3. Innervation: brachial plexus c. Subscapularis- subscapular fossa on the anterior scapula and inserts on the lesser tubercle of the humerus 1. Attachments: proximal: subscapular fossa, distal: lesser tubercle 2. Primary action: arm medial rotation 3. Innervation: brachial plexus d. teres minor muscles e. Identify the muscle most commonly injured in a rotator cuff tear i. Tear of supraspinatus tendon ii. Supraspinatus: travels between acromion process and head of humerus

Identify the following on Figure 11.3 Extrinsic Muscles of the Back:

a. Trapezius: large triangular muscle, spans most of back b. Rhomboid Major: located deep to the trapezius with the much narrower rhomboid minor muscle located superior to the rhomboid major muscle c. Latissimus dorsi: triangular-shaped muscle located inferior and deep to the trapezius muscle. d. Deltoid: shoulder muscle e. Supraspinatus: between spine of scapula and clavicle f. Infraspinatus: below spine of scapula g. Serratus anterior: lays over ribs

Define compartment syndrome and explain why the anterior leg compartment is most commonly affected by describing the anatomical structures that surround the anterior compartment

o Anterior compartment boundaries: -Bones (tibia and fibula), interosseous membrane, tight crural fascia o Caused by overuse/trauma -Excessive inflammation -mild case: shin splints -severe: anterior compartment syndrome o Outcome -Compress blood vessels and nerves, can cause tissue death

Describe the primary actions of selected lower limb muscles

o Major Muscles that move hip joint § Gluteus maximus: extension § Gluteus medius/minimus: abduction § Piriformis: lateral rotation § Iliopsoas: flexion § Adductor magnus: adduction § Adductor longus: adduction o Major muscles/regions that move subtalar joint § Tibialis anterior: inversion § Tibialis posterior: inversion § Fibularis longus/brevis: eversion o Major muscles that move the knee joint § Quadriceps: extension § Hamstrings: flexion o Major muscles/regions that move the ankle joint § Tibialis anterior: dorsiflexion § Soleus: plantarflexion § Gastrocnemius: plantarflexion o Major muscles/regions that move the toes § Flexor digitorum longus: toe flexion § Extensor digitorum longus: toe extension