Anatomy Exam 1

What could cause anterior shoulder pain? How could you test your hypothesis?

biceps tenosynovitis- inflammation of the synovial sheath inclosing our proximal tendon of the long head. Test by having patient flex arm against resistance.

What is Peau d' orange

orange peel skin associated with disruption of the lymphatic drainage of skin in the breast...not always cancerous

What is the most common type of arthritis?

osteoarthritis -known as degenerative joint disease -progressive loss of articular cartilage and osteophyte formation -joint pain, reduced mobility, crepitus (grating) with motion, joint effusions=(increased fluid) and swelling, deformity

The pulmonary veins carry ________ blood?

oxygenated

Common signs of breast cancer include:

painless lump inverted nipple change in breast size/shape nipple tenderness

name of bridge of bone bw sup and inf articular processes? what happens here commonly?

pars interarticularis -helps bear and transmit weight from the lumbar spine to the sacrum Scotty Dog Fracture!!!

Describe the function of the lymphatic system

part of the circulatory system, carries extracellular fluid lost my capillary beds back to the venous system

What is an avulsion fracture and where do they occur?

Avulsion fractures are usually due to violence and they occur in the vertebral column on the body near the ALL (anterior longitudinal ligament)

What is the name for C2?

Axis

What happens if the tendon of the long head of the biceps ruptures?

Popeye's Muscle, tendon rolls up, fixed with surgery

What drains into the Right Lymphatic Duct?

R bronchomediastinal trunk R subclavian trunk R jugular trunk

Locate the chambers of the heart with chest surface anatomy.

RA- right 3rd-5th costal cartilages and the right sternal border RV- posterior to sternum and extends to left under the 4th, 5th, & 6th costal cartilages LV- on left under costal cartilages/ribs (apex at 5th in midclavicular line)

Where on the chest are the breasts located?

Rib 2-Rib 6 at the midclavicular line

Name the margins of the heart within the chest.

Right Superior- 3rd costal cartilage Right Inferior- 5th or 6th costal cartilage Left Superior- 2nd intercostal space (below rib 2) Left Inferior- Apex is located at the 5th intercostal space, 6cm left of the sternum (midclavicular line)

Where does the dural sac end?

S2

Acronym for muscle/tendons in the rotator cuff. What is the action of the rotator cuff

SITS Supraspinatis Infraspinatis Teres minor Subscapularis -Help to keep the humerus in place firmly against the glenoid cavity -De-accelerate movement at the GH joint

...

SVC & IVC feed into the right atrium to bring blood back to the heart. The superior vena cava is formed from the R & L brachiocephalic veins. The brachiocephalic is formed by the joining of the subclavian and internal jugular on each side. The subclavian becomes the axillary vein as it crosses the first rib. ***Remember the thoracic duct joins at the junction of the subclavian and the internal jugular veins on the left. The R lymphatic duct joins at this point on the right. The most medial tributary to the axillary v. is the lateral thoracic vein. The next moving laterally is the subscapular vein (drains the scapular musculature & posterior scapular wall) The internal thoracic/mammary v. joins the brachiocephalic v. inferiorly on either side just after the tribute of the int. jugular and just before the brachiocephalics tribute into the SVC

Dorsal primary rami, if damaged, would affect the function of each of the following muscles except: A. Semispinalis capitis B. Splenius C. Serratus anterior D. Iliocostalis

Serratus Anterior

Bones of the upper limb Shoulder: Arm: Forearm: Hand:

Shoulder: Clavicle, Scapula, Proximal Humerus Arm: Humerus Forearm: Radius, Ulna Hand: Carpals, Metacarpals, Phalanges

What is the name for the dark circle around the nipple?

areola

Brachium= Antibrachium=

arm forearm

Describe the flow of the lymphatic system

unidirectional flow toward the lymph nodes

What is scoliosis?

"crooked back"; lateral deviation of the vertebral column

Where does the thoracic duct dump into the venous system?

At the junction of the L subclavian vein and the L internal jugular vein

What is the name for C1?

Atlas

A 33-year-old accountant presents with severe right shoulder weakness. He indicates that he has played in a tennis league for the past 6 months, but recently quit because of increased right shoulder pain during play. Physical testing demonstrates striking muscular atrophy to his supraspinatus and infraspinatus muscles with severe weakness in initial abduction and external rotation. All other shoulder movements were normal. Which of the following nerves has likely been injured in this individual? Axillary nerve Suprascapular nerve Middle subscapular nerve Spinal accessory nerve

****Muscles that are denervated or paralyzed undergo atrophy

What tethers the heart to the chest

-4 pulmonary veins -aorta -pulmonary trunk -IVC & SVC

Semispinalis Capitis

-Deep to the splenius capitis & cervicis -arises by a series of tendons from the tips of the transverse processes of the upper 6 or 7 thoracic and the 7th cervical vertebrae, and from the articular processes of the three cervical vertebrae above this (C4-C6). The tendons, uniting, form a broad muscle, which passes upward, and is inserted between the superior and inferior nuchal lines of the occipital bone. -The fibers run longitudinally -give paramedian ridges along the back of the neck

Name/Describe the components of the breast

-Nipple/areola Circular smooth muscle richly innervated Supplied by sensory nerves Under neuroendocrine stimuli it prepares the breast for nursing -Glandular/Parenchyma Main lactiferous ducts/alveoli Lactiferous sinus=milk storage duct -Stromal Supporting tissue, fat & connective tissue Suspensory ligaments on the deep surface of fascia

Neural Tube Defects

-abnormal neural folding during the 3rd & 4th week -may involve meninges, vertebrae, overlying muscles and skin -1/1000 births -spina bifida=general term for NTD involving the spinal region -most occur in the lumbosacral region ~70% of NTD can be prevented by use of folic acid prior to and during pregnancy

Describe the milk lines

-accessory mammary glands that atrophy in the adult -some adults can have accessory nipples -they are derived from ectoderm and run from the axilla to the groin region

Describe neural crest cells

-derived from the dorsal portion of the neural tube -migrate into the body and differentiate into multiple organs and tissues *****KNOWN AS THE 4TH GERM LAYER BC IT GIVES RISE TO UNIQUE TISSUES

Describe synovial joints

-diarthroses -have synovial fluid bw skeletal elements -free movement Ex. Shoulder, elbow, hand, knee, hip, ankle

Describe non-synovial joints

-synarthroses -knitted together 2 Types (Fibrous and Cartilaginous)

What percent of breast cancers occur in men?

1%

Outline the flow of blood in the heart including the passage through specific valves

1. Deoxygenated blood enters the RA via the inf & sup vena cavas 2. During diastole blood leaves the RA and travels through the right atrioventricular valve (TRICUSPID) to enter the RV 3. During systole, the ventricles contract and blood leaves the RV via the pulmonic (semi-lunar) valve and travels through the pulmonic trunk (arteries) to the lungs. 4. In the lungs, the blood becomes oxygenated and travels back to the heart via the pulmonic veins. 5. Blood enters the LA from the pulmonic veins. During ventricular diastole,the LA contracts and blood leaves through the bicuspid (MITRAL) atrioventricular valve and enters the LV. 6. Once the LV has filled, the heart enters systole and the LV contracts sending blood through the aortic (semilunar) valve, out the aortic arch and to the body.

Name the three layers of the spinal meninges starting with the outermost layer.

1. Dura mater- outermost layer (means tough mother) 2. Arachnoid mater-spider web like -held loosely against the inner surface of the dura mater by pressure in the subarachnoid space 3. Pia mater- inseparable, tender/delicate, covers the spinal cord

Name the 4 structures found within the vertebral canal.

1. Extradural fat 2. Blood vessesls within the fat 3. Spinal cord 4. Meningeal covering of the cord

Outline lymphatic drainage of the breast

1. Pectoral/Anterior nodes -lateral aspect of the pec minor -deep to axillary tail ****-receive 75% of lymph drainage from the breast primarily from lateral quadrant 2. Subscapular/Posterior nodes -drain scapular region, posterior thorax wall 3. Brachial/Lateral nodes -associated with terminal aspect the of axillary vein -drain lymph from the arm 4. Central nodes -nodes 1-3 drain into the central node -just deep to pec minor -armpit area, arm, shoulder, lateral breast ****-intercostal brachial nerve (fibers from T2) passes through central nodes. Enlargement of nodes can produce pain in armpit 5. Apical nodes -lymph fluid from central nodes ultimately arrives here -located at junction of axillary & subclavian vein -enters R lymphatic or thoracic duct where the subclavian trunk arises B. Parasternal Node Group -not part of axilla contained within chest -located deep to intercostal spaces on either side of the sternum -located along the internal thoracic vessels ****-receives remaining 25% of lymph from medial quadrant of the breast

What layers does the needle pass through during a spinal tap?

1. Skin 2. Superficial fascia 3. Thoracolumbar fascia 4. Supraspinous ligament 5. Interspinous ligament 6. Ligamentum flavum = POP ------------------------------------------- Now in Vertebral Canal 7. Dura mater = second POP 8. Arachnoid mater Draw out CSF from subarachnoid space

Name the contents of the vertebral canal

1. Spinal Cord 2. Meninges-outermost=dura mater 3. epidural/extradural fat 4. Internal Vertebral Plexus of veins (Blood Vessels)

Name the main factors of joint stability

1. shape of articular surfaces 2. joint capsule and capsular ligaments 3. tone of muscle surrounding a joint

Describe Somite development and the three types of tissues somites give rise to

1.Dermis of the Skin (Dermatome) 2. Skeletal muscle (Myotome) 3. Bone and hard tissue (Sclerotome) The condensation of sclerotome forms the body of our vertebrae. It continues to migrate around the neural tube to become the vertebral arch. Meanwhile the notochord is regressing and begins to disappear, the remaining notochord tissue becomes the nucleus pulposis (jelly like substance in middle) of our IV discs. The myotome migrates ventrally and dorsally. The dorsal portion gives rise to our deep back muscles

How much lymph fluid is recovered each day by the lymphatic system?

2-4L per day

What is the period of fetal vulnerability during development?

3-8 weeks of gestation ***Known as the embryonic period

What is an average heart beat?

60-70bpm

When is the fetal period of development?

9-38 weeks Period of manly growth of the fetus

What percent of breast cancers are invasive?

95%

What unique structure can grow at C7? How common is this condition, and does it have any symptoms?

A cervical rib can grow from the transverse process of C7. It is relatively common ~.5% of the population has one. -can lead to thoracic outlet syndrome and produce neurovascular symptoms in the upper limb due to compression of the subclavian artery

Name a possible source of compression for the interscalene triangle.

A cervical rib could impinge on the triangle and cause compression of the subclavian artery or traction on the lower trunk of the brachial plexus

Describe the Sacral Canal

A continuation of the vertebral canal. It transmits the dural sac and nerve roots within it.

what does nulliparous mean?

A female who has never bore children

How does a disc herniation affect the nerve roots and which root does it affect?

A herniated disc impinges the nerve root as they descend toward their IV foramena. The bulged disc affects the nerve root of the number below the herniated disc. Ex. If the disc bw T5 and T6 is herniated, T6 nerve root would be affected.

What is the most common type of disc herniation?

A posterolateral herniation is the most common type this is bc the nucleus pulposus is naturally located closer to the back of the disc.

The subarachnoid space contains ________, and the epidural space contains ________. A) CSF; fat, connective tissue, and blood vessels B) fat, connective tissue, and blood vessels; blood C) CSF; pia mater D) fat, connective tissue, and blood vessels; CSF

A) CSF; fat, connective tissue, and blood vessels

The tapered inferior end of the spinal cord is called the A) conus medullaris. B) filum terminale C) cauda equina. D) posterior root.

A) conus medullaris.

Lower limbs are supplied by neurons from the______ of the spinal cord. A) lumbar enlargement B) thoracic region C) cervical enlargement D) all of the above

A) lumbar enlargement

Which of the following is a posterior boundary of a cervical intervertebral (IV) foramen? A. A facet (zygapophyseal) joint. B. The posterior longitudinal ligament. C. An intervertebral disc. D. A joint of Luschka (uncovertebral joint).

A. A facet (zygapophyseal) joint.

Which of the following muscles is innervated by the dorsal scapular nerve? Correct A. Rhomboid major B. Latissimus dorsi C. Trapezius D. Semispinalis capitis

A. Rhomboid Major

Another name for ABduction and ADduction

ABduction- lateral deviation ADduction- medial deviation

Movement of the arm associated with the pectoralis major?

ADductor Flexor of the arm Medial rotator

What test helps identify scoliosis?

Adam's Forward Bend Test Notice rib hump -uneven shoulder or hip height is also a good indication

Describe the difference bw a swollen node that is a sign of infection, and one that is a sign of malignancy.

An enlarged, soft, tender, painful node=sign of infection An enlarged, hard, non-tender=possible malignancy

What is lordosis?

An exaggerated curve of either the lumbar of cervical spine Often associated with late pregnancy or obesity

ALL

Anterior Longitudinal Ligament Resists hyperextension of the vertebral column

What is arthritis? Arthrosis?

Arthritis is joint inflammation Arthrosis- a site of union bw 2 or more skeletal elements -Classes of joints are based on the type of tissue interposed bw the skeletal elements

Features of Synovial Joints

Articular (hyaline) cartilage Fibrous joint capsule Joint space with synovial fluid Synovial membrane lining (produces synovial fluid) Capsular ligament (reinforces joint capsule) Sensory nerves and blood vessels to capsule and periosteum

I cover the end of long bones and synovial joints?

Articular hyaline cartilage

Where does the subclavian vein change its name?

As the subclavian crosses the first rib, it changes names to the axillary vein

Identify the meningeal layer immediately deep to the subdural space. A) pia mater B) arachnoid C) epidural space D) dura mater

B) arachnoid

The spinal cord, in adults, usually ends inferiorly at this vertebral level. A. Upper border of the coccyx B. L2 C. S4 D. S2

B. L2

Of the following congenital abnormalities of the vertebral column, which is the least serious? A. Rachischisis B. Spina bifida occulta C. Spina bifida cystica with meningocele D. Spina bifida cystica with meningomyelocele

B. Spina bifida occulta

Where is the transverse pericardial sinus of the heart?

Behind the pulmonary trunk and the aorta

Name the location of the first IV disc

Between C2 and C3

What is another name for the bicuspid? The Tricuspid?

Bicuspid=mitral, left atrioventricular Tricuspid=right atrioventricular

Define cardiomegaly

Big heart. Usually not a good thing

Which structure provides motor innervation to the deep back muscles and receives sensory information from the skin of the back? A) anterior ramus B) anterior root C) posterior ramus D) posterior root

C) posterior ramus

Name the characteristics of the typical lumbar vertebrae

Body- Larger in size Transverse Processes- more slender project out laterally Vertebral Foramen- Larger than thoracic region b/c the cord enlarges here in order to feed out to the limbs Spinous Processes- Hatchet Shaped **** Dead give away -There is a natural spacing bw the spinous processes, this region is an area utilized for spinal taps

Difference bw visceral & parietal pericardium?

Both are layers of the serious pericardium located within the fibrous pericardial sac. The visceral pericardium is the "saran wrap" around the heart (part of the epicardium). The parietal pericardium is the inner lining of the fibrous pericardium

What is the most commonly diagnosed cancer in women?

Breast cancer

Edema

Build up of excess fluid in the tissues

Where is the bicipital radial bursa?

Bw the tendon of the biceps brachii and its distal attachment on the radial tuberosity

Which statement is true about intercostal nerves? A) They are formed from the posterior rami of spinal nerves. B) They form a thoracic plexus of nerves. C) They originate from the thoracic region of the spinal cord. D) They innervate the deep back muscles of the thoracic region.

C) They originate from the thoracic region of the spinal cord.

Axons cross from one side of the spinal cord to the other through a gray matter region called the A) lateral horn. B) posterior horn. C) gray commissure. D) white commissure.

C) gray commissure.

The white matter of the spinal cord is composed primarily of A) unmyelinated axons. B) neurolemmocytes and satellite cells. C) myelinated axons. D) cell bodies of neurons.

C) myelinated axons.

A hiker discovered an isolated bone and presents it to you for identification. You believe it is a lumbar vertebra. The following are characteristics of lumbar vertebrae except: A. Spinous processes are short, flat, and quadrangular in appearance. B. Bodies are massive, for weight-bearing. C. Transverse processes are short and thick. D. Transverse processes do not bear foramina.

C. Transverse processes are short and thick.

What provides sensory innervation to the posterior half of the scalp? Describe this nerves landmark path

C2 more specifically the greater occipital nerve -passes through the trap & through the semispinalis capitus, then wraps around the lower border of the inferior oblique. Emerges at C1/C2 level travels to occiput to provide sensory innervation.

Innervation of the diaphragm?

C3, C4, C5 keep the heart and diaphragm alive phrenic nerve

You want to count vertebrae on a patient's back. At which of the following vertebral levels should you begin for making an accurate counting? A. C1 B. C7 C. T1 D. T8 E. L1

C7

When the pericardial sac fills with fluid greater than the normal10-50mL of pericardial fluid

Cardiac Temponade -100-150mLs fluid usually blood can be due to a ruptured wall -inhibits normal beating, the ventricles are not able to expand fully during diastole Symptoms: Hypotension Faint heart beat (sounds as if heart is under water) Increased jugular pressures (pop out of neck) IVC is unable to fully expand

Describe Cartilaginous Joints

Cartilage b/w skeletal elements ***Slight movement permitted (DO NOT MISTAKE AN AREA WITH CARTILAGE AS A CARTILAGINOUS JOINT....THE KNEE FOR EXAMPLE HAS SUCH GREAT MOVEMENT IT MUST BE SYNOVIAL) Hyaline Cartilage-synchondrosis ex. epiphyseal growth plates (end of long bones) Fibrocartilage-symphysis ex. IV discs, pubic symphysis

What are the regions of enlargement in the spinal cord?

Cervical C4-T1 Lumbosacral L1-S3

Name the secondary curves of the vertebral column and at what age they occur

Cervical-3 to 6 months Lumbar-12 to 18 months concave (open) posteriorly

Associate these parts of the VC with the abnormal back curves experienced in the area: Cervical Thoracic Lumbar Sacral

Cervical-Lordosis Thoracic-Kyphosis Lumbar-Lordosis Sacral-Kyphosis ***Just remember Lumbar Lordosis and they alternate that they alternate with each segment of the VC

Name the heads of the pectoralis major and their attachments

Clavicular head- medial 1/2 of the clavicle, lateral lip of the bicipital/intertubercular groove (lower portion) Sternocostal portion- lateral border of the sternum & costal cartilages of the upper 6-7 ribs, tendon attaches along the upper portion of the later lip of the bicipital/intertubercular groove

What is the name of the terminal end of the spinal cord? Where does this termination occur?

Conus medullaris -terminates at the L1 or L2 vertebral level ****In newborns it terminates at L3

The anterior root of a spinal nerve contains A) axons of both motor and sensory neurons. B) axons of sensory neurons only. C) interneurons. D) axons of motor neurons only.

D) axons of motor neurons only.

The radial nerve originates from the ________ plexus. A) cervical B) lumbar C) sacral D) brachial

D) brachial

Which of the following is true regarding the extradural space? A. It contains cerebrospinal fluid. B. It is located between the spinal dura and arachnoid layers. C. It is bounded posteriorly by the posterior longitudinal ligament. D. It contains fat and a plexus of veins.

D. It contains fat and a plexus of veins.

You are performing your first lumbar puncture. If successful, you will pierce all of the following structures except the: A. Arachnoid mater B. Ligamentum flavum C. Dura mater D. Posterior longitudinal ligament E. Supraspinous ligament

D. Posterior longitudinal ligament

Which of the following is true regarding intervertebral discs? A. The nucleus pulposus is the peripheral part of an iv disc. B. The nucleus pulposus in a young person is composed mostly of fibrocartilage. C. Disc herniations commonly occur through anterolateral defects in the annulus fibrosis. D. The nucleus pulposus is derived from remnants of the notochord.

D. The nucleus pulposus is derived from remnants of the notochord.

Describe the horns of the spinal cord gray matter

DORSAL- entry zone of central (Short) processes of sensory neurons LATERAL- contains cell bodies of preganglionic autonomic neurons -axons pass through ventral horn and enter ventral root ****Seen in spinal cord T1-L2 & S2-S4 VENTRAL- location of cell bodies of somatic motor neurons -Also the exit zone for preganglionic autonomic neurons & axons of somatic motor neurons.

I am a branch of spinal nerve that supplies deep back muscles and a horizontal strip of skin on the back?

DPR

I am the "body" of the atlas?

Dens of the axis

Describe Fibrous Joints

Dense fibrous connective tissue b/w skeletal elements ***Little or no movement permitted Ex. Sutures of skull

Describe these vocab words associated with the spinal meninges: Denticulate Ligament Ganglion Dorsal Root Ventral Root Spinal Nerve

Denticulate Ligament- thickening or condensation of pia mater Ganglion- collection of nerve cell bodies Ex. the dorsal root ganglion contains cell bodies of sensory neurons Dorsal Root- Sensory Fibers Ventral Root- Motor Fibers *****NOTE: When trying to ID, the invagination of the the horns occurs on the anterior side at the ant. median fissure Spinal Nerve- Where the VPR & DPR meet briefly to create a mixed nerve with both motor and sensory

The right side of the heart carries _________ while the left side of the heart carries ________ blood.

Deoxygenated oxygenated

I am an area/strip of skin supplied by a single spinal nerve?

Dermatome

What is the difference b/w myotome and dermatome?

Dermatome-an area of skin supplied by a single spinal nerve Myotome - the mass of skeletal muscle innervated by a single spinal nerve

What are some unique features of articular (hyaline) cartilage?

Devoid of nerves, blood vessels, and lymphatics -nutrition and waste removal provided by the synovial fluid (lunch pail and garbage disposal) ***If damaged does not regenerate (think knees) defects replaced by fibrous tissue

What are the two stages of the heart and what occurs during these stages?

Diastole- ventricles are at rest, ventricles are filling from atria Systole- ventricular contraction (pumping) Mnemonic- when you DIE- astole you are at REST

What is the cisterna chyli?

Dilated sac located on the abdomen wall -drains lymph from lower limbs, pelvic viscera, abdominal viscera -everything below the diaphragm drains into the cisterna chyli

I supply motor innervation to the deep back muscles?

Dorsal Primary Rami in a segmental fashion

I contain cell bodies of sensory neurons associated with spinal nerves?

Dorsal Root Ganglia

Locate the Facet Joints

Each vertebra has a paired joint on its right side and a second paired joint on its left side, allowing a connection with the vertebrae above and below it. The pair that faces upward is the superior articular facet. The pair that faces downward is the inferior articular facet. The facet complex is surrounded by a watertight synovial capsule, much like the small joints in the fingers that allow for smooth movement.

Locate pedicles

Each vertebra has two cylinder-shaped projections (pedicles) of hard bone that stick out from the back part of the vertebral body, providing side protection for the spinal cord and nerves. The pedicles also serve as a bridge, joining the front and back parts of the vertebra.

What tissue are the breast derived from developmentally?

Ectoderm

What are the three germ layers and what do they give rise to?

Ectoderm- Nervous system, epidermis, hair, nails Mesoderm- muscle, bone, connective tissue, blood, gonads, kidneys Endoderm- epithelial lining of respiratory, GU, and GI systems

What are the three layers of the heart?

Endocardium Myocardium Epicardium

Describe the layers of the heart: Epicardium Myocardium Endocardium

Epicardium- outer surface of the heart covered by visceral pericardium. This layer appears smooth and often contains some fat. Myocardium- Muscular layer of the heart (majority of the heart) Endocardium- Smooth lining of the cavities

Describe how to know the number of a rib and the associated number of the vertebrae it attaches to

Ex. Rib 5 would attach to the superior demifacet of vertebra 5 and the inferior demifacet of vertebra 4. It would also attach to the IV disc b/w vertebrae 4 & 5. and the transverse process of vertebra 5.

What is the axillary tail?

Extension of breast tissue that extends around the pec minor and into the axilla itself, passes through fascia and communicates with contents in the axilla

Name the function of each receptor: exteroceptors propioceptors interoceptors

Exteroceptors - mediate general sensations of pain, touch, temperature, pressure Proprioceptors - in muscles, ligaments, joint capsules; provides body its sense of position Interoceptors - within internal organs and convey sensory information, e.g., ischemia, constriction, dilation

Muscle action in the arm move the forearm in what ways?

F, E, Supination

True/False Spinal nerves are made up of both motor and sensory fibers from VPR and DPR, but once the spinal nerve branches into rami, the fibers segregate once again.

FALSE The spinal nerves are made up of mixed fibers, but the rami are mixed as well.

Name the fake joint of the upper limb, and the three real synovial joints.

Fake Joint=scapulothoracic joint Real Joints= 1. sternoclavicular joint 2. acromioclavicular joint 3. glenohumeral joint

What is a "FOOSH" injury?

Fall On an Outstretched Hand Clavicle fracture

True/False The notochord is located more dorsally than the neural tube

False, the notochord is located ventral to the neural tube/groove

What movements can occur at the shoulder joint?

arm F, E, ABduction, ADduction, LR, MR, C

I am not a nerve root, but I am found within the cauda equina?

Filum terminale

Name the 1.5 muscles of the flexor forearm that the median nerve does not supply motor innervation

Flexicarpiulnaris or the medial/ulnar 1/2 of FDP (flexor digitorum profundus)

Neurulation

Formation of the neural tube Neural Plate-thickening of ectodermal tissue Neural Fold-lateral thickenings of the neural plate ***Fusion occurs cranial → caudal Somites- block-like elevations Start with 42-44 pairs end up with 35 pairs

Collection of nerve cell bodies located outside the CNS

Ganglia

What is a hydrocephalus and why is it associated with spina bifida?

Hydrocephalus is associated in at least 80% of cases of myelomeningocele. This malformation consists in engaging of the cerebellum tonsil in the medullary canal, compressing foramen magnum. The result is that the compression produced over the foramen magnum prevent the leakage of the cerebrospinal fluid. This prevent of leakage produces an excessive accumulation of cerebrospinal fluid which will compress the brain, resulting in different degrees of retardation. Basically the vertebral column becomes tethered to the spinal cord and growth causes herniation. The hydrocephalus occurs when CSF builds up due to blockage.

I am located immediately posterior to an IV disc and immediately anterior to a facet joint?

IV foramen

Where are cell bodies of sensory neurons located?

In ganglia

What part of the IV foramen do spinal nerves usually exit? Why?

In the T and L regions, the spinal nerve usually exits just below their respective pedicles as they exit the IV foramen. This is bc the inferior 1/2 of the IV foramen is blocked off by the IV disc.

Describe the exit of the spinal nerves in each vertebral level. Why is it this way?

In the cervical region, the spinal nerves exit prior to the associated disc number. For example C1 exits bw C1 and the occipital bone. C2 nerve exits above the C2 vertebra. C8 exits bw C7 and T1. Every subsequent nerve exits below the same # vertebra. T1 exits bw T1 and T2 vertebrae. This is bc there are more "somites" therefore spinal nerves than there are cervical vertebrae.

Where is the vertebral plexus located?

In the spinal canal and surrounding the vertebral column from the skull to the sacrum

Why are the spinal cord segments not aligned with the spinal nerves and vertebral levels in the adult?

Initially everything is lined up, but as the fetus develops, the cord shifts with growth and the nerves are forced to curve down caudally in order to exit at the correct IV foramena.

Injury of the suprascapular nerve would cause atrophy to which muscles?

Injury to the suprascapular nerve would cause the subscapularis and the supraspinatus muscles to atrophy. There would be loss of ABduction initiation and lateral rotation ***Think of how it was hard for Dad to ABduct and rotate his arm after surgery

What lymph nodes are associated with the veins below: Internal thoracic/mammary Lateral thoracic Subscapular Brachial as it tributes into axillary

Internal thoracic/mammary- Parasternal lymph nodes ***These are the nodes that were carbonated in our cadaver (smoker) Lateral thoracic- Pectoral lymph nodes Subscapular- Subscapular lymph nodes Brachial as it tributes into axillary- brachial/lateral lymph nodes

Where does blood of the vertebral column and spinal cord drain?

Into the vertebral venous plexus

____________ muscles begin and _____ in the hand.

Intrinsic muscles begin and end in the hand -responsible for movement of the digits

What is the function of the retromammary space?

It allows for the smooth movement of the breast on the fascia of the pec major

Where does the line of gravity normally lie?

It descends in front of the vertebral column. This often shifts in pregnant women.

What is one thing to note about a caudal epidural block?

It is done outside of the dural sac (which ends at S2) -The filum terminale extends through the dural sac, exits through the sacral hiatus and attaches to the posterior coccyx

What is the landmark position of the musculocutaneous nerve?

It passes through the coracobrachialis muscle laterally and enters the cubital fossa, once it emerges it becomes cutaneous and is known as the lateral cutaneous nerve of the forearm

What nerves does the straight leg test assess?

It tests for L5 & S1, positive pain indicates the possibility of a disc herniation in this region.

What dumps into the Thoracic Duct?

L bronchomediastinal trunk L subclavian trunk L jugular trunk

Where does the spinal cord end in an adult?

L1 or L2

What are the ending levels in the spinal cord that are important to know?

L1/L2 conus medullaris- end of spinal cord S2- end of dural sac

I am the nerve that passes through the IV foramen bw L3 and L4 vertebrae?

L3

At what level is the spinal tap often performed

L3/L4 or L4/L5 Cauda equina is present here, but spinal cord (conus medullaris has already ended at L1/L2 level)

What does the body of the sacrum articulate with? What does the apex of the sacrum articulate with?

L5 articulates with the body of the sacrum The apex of the sacrum articulates with the coccyx The ala articulates with the ilium The Sacral VPR enter and exit the anterior sacral foramina Superior=broad Inferior=apex, narrow

What parts make up the vertebral arch?

Lamina and Pedicle

Quick overview of the Pathways of Lymph Drainage

Left side of body & below the diaphragm on either side drains by way of the thoracic duct. Right side of body, above the diaphragm, upper limb, head, neck, & thorax drain via the Right Lymphatic Duct

I attach to the superior angle of the scapula?

Levator Scapulae

I am a very well developed supraspinous ligament?

Ligamentum nuchae

What is lymph?

Lymph is a clear to yellowish watery fluid which is found throughout the body. It circulates through body tissues picking up fats, bacteria, and other unwanted materials, filtering these substances out through the lymphatic system. This clear fluid contains white blood cells, known as lymphocytes, along with a small concentration of red blood cells and proteins. The lymph circulates freely through the body, bathing cells in needed nutrients and oxygen while it collects harmful materials for disposal. You could think of lymph as the milkman of the body, dropping off fresh supplies and picking up discarded bottles for processing elsewhere.

Name the order of best detection method for breast cancer.

Mammography>Woman>Physician

What nodes drain the breast?

Medial- 25% Parasternal nodes Lateral- 75% Pectoral nodes

I divide the body into equal right and left halves?

Medial/Midsagital plane

I am a potentially life-threatening condition whose symptoms include severe headache, neck stiffness, and intolerance to light?

Meningitis

What common disease can be diagnosed with CSF? What are the symptoms of said disease?

Meningitis Symptoms: severe headache nuchal rigidity- neck stiffness photophobia- light sensitivity

What is the difference in polarity of motor and sensory neurons?

Motor neurons are multipolar neurons histologically. Sensory neurons are pseudounipolar neurons -has a cell body and a single process structurally/electrically similar to an axon

Describe the difference bw Motor/efferent and Sensory/afferent neurons

Motor/efferent- transmits impulses AWAY from the CNS to various parts of the body ex. skeletal muscle, viscera Sensory/afferent- transmit impulses from the body (internal & external stimuli) TOWARD the CNS ****Just think of it as motor/efferent....what signal needs to be sent to tell the muscle to move...one from the CNS to the muscle. Then Sensory/afferent, what needs to happen for us to feel a burn? The tissue sends a message efferently back to the CNS.

Describe what happens to neural crest cells as the neural tube begins to close.

Neural crest cells are located on the margins of the neural fold. As the neural groove approaches closure, the neural crest cells separate and enter the mesenchymal tissue (mesodermal layer). Eventually these neural crest cells (of ectodermal origin) migrate to the head & neck, body wall, and give rise to cells and other tissue types

I am the hydrated core of an IV disc?

Nucleus Pulposus

How many somites are devoted to each region? Occipital Cervical Thoracic Lumbar Sacral Coccygeal

Occipital-4 Cervical-8 Thoracic-12 Lumbar-5 Sacral-5 Coccygeal-8-10

Technically speaking what part of the body is our arm?

Only the humerus. Shoulder to elbow

I am a "bridge" of bone bw the superior and inferior articular processes of lumbar vertebrae?

Pars Interarticularis Scotty Dog Fracture

Name the innervation of the pec major and pec minor.

Pec Major: Lateral Pectoral Nerve and Medial Pectoral Nerve C5, C6, C7 C8, T1 Pec Minor: Medial Pectoral Nerve -Branch of medial cord of brachial plexus ****So pec major formed from somites of the C4-C8 and T1 levels

What procedure is done to relieve cardiac temponade?

Pericardiocentesis Insert needle to left of xyphoid process, angle at 15% to chest, and aim for left shoulder

Irritation/inflammation of the pericardial sac. Also known as heart rub?

Pericarditis

Sensory neurons have a single process divided into:

Peripheral process-long, serves as a dendrite or specialized receptor ending Central process-short provides sensory impulses to the CNS Cell bodies of the neuron are located within the ganglia Disruption of a sensory neuron leads to paresthesia- pins and needles

I give rise to specialized cells that form dermis, muscle, and skeletal tissue during embryonic development?

Somites

I am the motor nerve supply to the trapezius muscle?

Spinal accessory nerve, cranial nerve X1 (CN11)

Name the characteristics of the typical cervical vertebrae C3-C6

Spinous Process Body-small Vertebral Foramen- triangular in shape Transverse Processes: -Posterior Tubercle-(closest to spinous process) - -True tp of cervical vertebrae -Anterior Tubercle- Rib homolog Uncinate Processes- C3-C6 Help create uncovertebral joints of JOINTS OF LUSCHKA

Review dermatomes (anterior)

Starting at head moving caudally C2,C3 clavicular area C4 down upper lateral arm (thumb side) C5, C6 two middle fingers C7 pinkie and forearm C8 elbow T1 pectoral region and moving down segmentally T2-T12 in umbillical region groin L1 outer thigh L2 knee L2, L3 inner calve L4 outer calve L5 last two toes (most lateral) S1

Review dermatomes (posterior)

Starting at head moving caudally C2,C3 shoulder area C4 C6 - On the dorsal surface of the thumb. C7 - On the dorsal surface of the middle finger. C8 - On the dorsal surface of the little finger. T1 - On the medial (ulnar) side of the antecubital fossa, just proximally to the medial epicondyle of the humerus. T2 - At the apex of the axilla. T3 - Intersection of the midclavicular line and the third intercostal space T4 - Intersection of the midclavicular line and the fourth intercostal space, located at the level of the nipples. ..... T10 - Intersection of the midclavicular line, at the horizontal level of the umbilicus. L2 - On the anterior medial thigh and the posterior lateral thigh L3 - At the medial epicondyle of the femur. L4 - Over the medial calve L5 - On the dorsum of the foot at the third metatarsophalangeal joint. S1 - On the lateral aspect of the calcaneus. ANKLE S2 - At the midpoint of the popliteal fossa. Posterior knee S3 - posterior mid thigh S4 and S5 - In the perianal area, on the bum:)

I am the nerve that supplies the rectus capitis posterior major muscle?

Suboccipital Nerve -DPR C1 -It supplies the suboccipital region muscles

Name the muscles of the suboccipital triangle and their attachment points.

Superior Oblique- lateral mass (tp) of C1 to the occiput Inferior Oblique- sp C2 to the lateral mass (tp) of C1 Rectus Capitus Posterior Minor- Occiput to the sp of C2

Mammary glands are modified ___________ ?

Sweat glands

Classes of Joints

Synovial (diarthroses) Non-Synovial (synarthroses)

What are the names of the pressures? 120/80

Systolic/Diastolic

True/False When joint loading falls below or exceeds needed levels, adverse changes to AC occur.

TRUE Rigid immobilization of a joint leads to degeneration of AC due, in part to reduced diffusion of synovial fluid Excessive joint loading (single impact/repetitive trauma) can induce catabolic effects in AC

How could you tell if a patient with elbow pain had inflammation in their bicipital radial bursa?

Test if pain is increased when the patient supinates the arm against resistance. Biceps brachii is a powerful flexor of the supinated arm (so it flexes the forearm) and a powerful supinator. One we use to screw something to a block of wood

Where is the oblique sinus of the heart?

Tethers the heart by the 4 pulmonary veins....the esophagus is located behind

A fracture of the dens can transect the spinal cord at the C2 level. What is your immediate worry for your patient?

That they have an immediate risk for suffocation bc the diaphragm is innervated below this level by C3, C4, C5 (phrenic nerve)

Location of the nipple in men and nulliparous women?

The 4th intercostal space at the midclavicular line

I may become stretched or torn in a whiplash injury?

The ALL (anterior longitudinal ligament)

Which ligament is thicker/protects more, the ALL or the PLL?

The ALL is thicker than the PLL. The PLL doesn't completely cover/reinforce the IV discs

What does the neural tube become?

The CNS= Brain, and Spinal Cord

What type of thoracic outlet syndrome is associated with compression of the subclavian vein?

The Costoclavicular Space "Nut Cracker" Vein can become impinged bw the first rib and the medial clavicle

Where do the DPR and VPR head after exiting the spinal canal?

The DPR head to supply deep back muscles while the VPR exit and wrap around the front to provide innervation to the body wall skeletal muscle and then head out into the limbs

A cancer cell within me can ride all the way to the cranial cavity?

Vertebral venous plexus -lacks veins and is located in and around the vertebral column

Describe where the rami innervate/head to

The DPR provide segmental innervation to the deep back muscles and then continue outward toward the cutaneous (skin) region of the back. The VPR exit the IV foramen and follow anteriorly with in the intercostal spaces. They give rise to lateral cutaneous branches that head out to the side of the body wall. The VPR follows the ribs all the way to the sternal region.

What is a good landmark to differential a Joint of Luschka's (uncovertebral joint) position from a facet joint (zygapophyseal joint)?

The Facet/Zygapophyseal joint is posterior to the IV foramen. ****Also key to remember that joints of Luschka are only seen in the cervical region of the spine

I give rise to the future CNS?

The Neural Tube

What is the medical way to describe a herniated disc?

The Nucleus pulposus of an IV disc has bulged out of the anulus fibrosus

The vertebral venous plexus lacks valves. Why can this be detrimental?

The VV plexus becomes an avenue for metastatic cells to travel to novel regions of the body.

What part of the breast generates the milk?

The alveoli or acini are the secretory parts of the gland, they produce milk and fat and secrete them into terminal ducts that then drain into a main lactiferous duct that ends at the nipple.

What are the borders of the interscalene triangle?

The anterior scalene, the middle scalene muscle, and the first rib

Where is the heart located in the chest?

The apex is positioned at the midclavicular line and the 5th intercostal space -the heart has a left tendency and is located under the sternum -one intercostal space below the nipple in men and nulliparous women

Describe the location of the atlanto-occipital joint and the atlanto-axial joint. What movement do these joints allow? How can the atlanto-axial joint be viewed radiologically?

The atlanto-occipital joint is a synovial joint bw the atlas and the occiput. It can be seen in the photo at the top arrow. The atlanto-axial joint (bottom arrow) is the synovial joint bw the atlas and the axis. MOVEMENT: a-o= flexion of the head, nod head forward and back a-a= rotation of head, shake head no The a-a joint can be radiographed by having the patient open their mouth

Describe the unique structure of the atlas.

The atlas is a ring of bone with no body -It has a posterior tubercle -lateral mass-containing transverse foramen -transverse ligament -ant. & post. arches

What is the olecranon?

The bony process on the posterior elbow, attachment point for the tendon of the triceps

Locate the spinous process

The bumps that can be felt down the back are the spinous processes. They are bony projections that arise at right angles (perpendicular) to the mid-line of the lamina. Each spinous process is attached to the spinous process above and below it by ligaments. Sometimes these processes are absent or bifid in the cervical spine.

What is the cauda equina?

The cauda equina is a bundle of nerves occupying the spinal column below the spinal cord in most vertebrates that consists of nerve roots and rootlets attached to the spinal cord. It serves the legs 1. Conus Medullaris 2. Filum Terminale 3. Cauda Equina

What are the bones of the shoulder girdle?

The clavicle, proximal humerus, and scapula

Name the blood supply to the heart muscle.

The coronary arteries supply the heart itself with blood

Define the odontoid process

The dens of the axis C2 -held in place by the transverse ligament of the atlas -serves as the body of C1 (atlas)

I'm glistening white, I have teeth, and I stabilize the spinal cord?

The denticulate ligament

What is the function of the denticulate ligament?

The deticulate ligament separates the dorsal and ventral primary rami

I come to an end at the S2 vertebral level?

The dural sac

Where does the dural sac end?

The dural sac ends at level S2

The major vessels are contained in what layer of the heart?

The epicardium

Where is the esophagus located in relation to the heart?

The esophagus is located behind the pericardial sac

What is the floor of the suboccipital triangle formed by?

The floor is formed by the posterior occipito-atlantal membrane, and the posterior arch of the atlas.

What is the general rule concerning disc herniation and nerve compression? What discs are most commonly herniated?

The general rule is that when a disc protrudes, it compresses the nerve root numbered one inferior to the disc. Ex. L4-L5 disc herniation compresses L5 nerve, L5-S1 disc herniation compresses S1 nerve These are the most common examples *****NOTE- in the C region, the IV disc is centrally placed in the anterior border of the IV foramen therefore, a herniated disc in the cervical region affects the nerve of that vertebra (exiting at that level)

What is the name for the shoulder joint?

The glenohumeral joint. Joint bw the head of the humerus and the glenoid cavity of the scapula

What causes female breast enlargement during puberty?

The increase in sex hormones (estrogen and progesterone) lead to proliferation of the ducts and formation of epithelial buds that have potential to mature into acini. There is also an increase in the production of connective tissue & fat cells, which account for the bulk of breast tissue.

What direction do the internal, external, and innermost intercostal muscles run?

The internal and the innermost intercostals run in a superior/medial direction (holding boobs) and the external intercostals run in an inferior medial direction (putting hands in vest)

Which component category of the breast does the lactation apparatus fit into? What comprises the lactation apparatus?

The lactation apparatus is part of the glandular/parenchymal category It is comprised of the Mammary Lobes (Acini & Lobules) and Terminal Ducts

Locate lamina

The lamina is is the roof of the spinal canal that provides support and protection for the backside of the spinal cord.As the lamina come together at the back of the spinal column, they join to form the spinous process, the bony part of the spine that you can feel at the mid-line when you rub your back. There is an interspinous ligament that runs between the spinous processes of the vertebrae and a supraspinous ligament that runs on top of them from the cervical region to the sacrum.

What is the foramen magnum?

The large opening in the occipital bone of the skull. It transmits the: -spinal accessory nerve -vertebral arteries -ant & post spinal nerves

As the musculocutaneous nerve emerges from the cubital fossa it becomes __________.

The lateral cutaneous nerve of the forearm

On which side of the heart is the mitral valve located?

The left side

What ligament connects the lamina?

The ligamentum flavum

Describe the embryonic development of the mammary glands. When does the primary bud form? When do the secondary buds form and how many are there?

The mammary glands begin forming when ectodermal tissue invaginates into mesenchymal tissue during the 6th week. In the 7th week, the primary bud is formed. The secondary buds do not form until the 4th month. At this time 15-20 buds are formed. These buds eventually develop into the lobes of the breast. At 6 months, the mammary pit is formed along with the lactiferous ducts. By 8 months the nipple has formed on the epidermis and development in the fetus is complete.

Describe the posterior sacrum.

The mid-line has a median sacral crest -Sacral DPR spinal nerves exit the posterior sacral foramina -The sacral cornua (horns) border the sacral hiatus. The hiatus is the region where the filum terminale externum (coccygeal ligament) exits. This ligament attaches to the posterior coccyx and provides support to the spinal cord The sacral hiatus is also a region where spinal taps can be performed.

Which axillary nodes receive about 75% of the lymph drainage from the breast?

The pectoral/anterior nodes -they are located along the lateral thoracic vessels

Another name for the embryonic period is

The period of organogenesis

What is the sensory innervation of the parietal pericardium?

The phrenic nerve

Where is the phrenic nerve located and what artery runs with it?

The phrenic nerve runs with the pericardiacophrenic artery (branch of the internal thoracic) in the space bw the parietal pleura and the fibrous pericardium

The long head and short head of the biceps brachii become united as a single belly and insert where?

The radial tuberosity

What are the attachment points for the rectus capitis posterior minor? What region is it found in? What are the other 3 members to this region?

The rectus capitis posterior minor runs from the posterior tubercle of C1 to the base of the skull (occiput). It is part of the suboccipital region of neck muscles. The other members of the region are: 1. Rectus capitis posterior major 2. Superior oblique 3. Inferior oblique

What part of the heart pumps blood to the lungs? The body?

The right ventricle pumps blood to the lungs and the left ventricle pumps blood to the body

Locate the Spinal Canal

The spinal canal is a bony tunnel surrounding the spinal cord. It is composed of: anteriorly the vertebral body, the pedicles on the sides of the vertebral body and the lamina in the back. In the lower back it not only contains the spinal cord, it also contains the nerve roots of the lower spine.

What is unique about C7 and what is it's special name?

The spinous process is particularly long. It is used as a landmark and often called the vertebral prominens.

I am the space from which the needle draws CSF fluid during a lumbar puncture?

The subarachnoid space

What passes through the interscalene triangle and what does not?

The subclavian artery and the brachial plexus cross through the interscalene triangle. The subclavian vein does not cross through the triangle, it crosses the first rib in front of the anterior scalene muscle.

what are the deepest layer of deep back muscles found in the neck?

The suboccipital muscles

What nerve and artery can be found in the suboccipital triangle?

The suboocipital nerve DPR of C1, provides motor innervation to suboccipital muscles. The vertebral artery can also be found within the triangle. It curves on the posterior arch of the atlas and goes to the base of the skull. ---The vertebral artery is accessed here in order to conduct angiography of the circle of Willis. (Circle of arteries that supply blood to the brain)

Right and Left Brachiocephalic Veins unite to form what?

The superior vena cava

Name the largest lymphatic vessel in the body

The thoracic duct -arises from the cisterna chyli

What would happen if a patient had a posterior dislocation of the sternoclavicular joint/costoclavicular ligament?

The trachea could be affected and the airway compromised

The vertebral arteries pass through me before they reach the scull?

The transverse foramena from C6 to C1, wrap around the upper portion of the posterior arch of the atlas, pass through the foramen magnum at the base of the skull

What ligament tethers the long head of the biceps in place?

The transverse humeral ligament

What is the lateral mass?

The transverse process of C1 (atlas) containing the transverse foramena

Locate Transverse Processes

The transverse processes are located at right angles to the junction of pedicles and the lamina. They provide a place for the back muscles to attach to the spine. For the most part, these are absent in the vertebra of the neck (the cervical spine). If present in the cervical spine they occur at the lowest level (C7) and are called a cervical rib. They may impair exiting nerve roots and cause pain.

What quadrant of the breast is associated with the highest rate of breast carcinomas?

The upper lateral quadrant near the axillary tail ~60% of breast carcinomas occur here

What do the R & L subclavian trunks drain?

The upper limb on either side, shoulder regions, & lateral quadrant of the breast.

What runs through the transverse foramen in the cervical vertebrae?

The vertebral artery

Where does the vertebral artery enter the transverse foramena?

The vertebral artery enters at C6

What artery does the vertebral artery branch from?

The vertebral artery is a branch of the subclavian

What is the facet joint bw the superior vertebral notch and the inferior articular process?

The zygapophyseal joint

What is a facet joint?

The zygapophyseal joint is a facet joint. Connection point of the ribs....it is a costovertebral joint

At what age do breasts begin to mature into milk-producing glands?

There is not a specific age, they do not completely mature until late stage pregnancy....therefore, nulliparous women never mature into the milk production stage when terminal ducts develop into functional alveoli

Where are the innervation and blood supply of the intercostals located and in what order?

They are located bw the internal intercostal and the innermost intercostal. Order from top to bottom: V A N Intercostal vein Intercostal artery Intercostal nerve

What is kyphosis?

Think of osteoporotic back hump Exaggerated curve of the thoracic or sacral spine Seen in post menopausal women due to loss of bone mass and compression

What is hyper-abduction Syndrome?

Thoracic Outlet Syndrome associated with the Subcoracoid region. The axillary artery & brachial plexus can become ~90% from under the corocoid process and the pectoralis minor. Arm becomes numb. Can be due to excessive overhead work or even sleeping with arm above head for extended period.

Name the primary curves of the vertebral column

Thoracic and Sacral They concave (open) anteriorly

Name the parts of the vertebral arch

Together, the lamina and pedicles form the vertebral arch.

What direction do dendrites send signals? What direction does the axon send signals?

Toward the cell body The axon sends signals away from the cell body toward the effector tissue ie. skeletal muscle

I contain cell bodies of somatic motor/efferent neurons?

Ventral Horn

Name the characteristics of the typical thoracic vertebrae

Vertebral Foramen- smaller circular b/c thoracic cord narrows Body- heart shaped Spinous Processes- Slope more downward like roof shingles Demifacets- sites of attachment for ribs

Describe the differences bw white and grey matter in the spinal cord

White matter- myelinated, sends info up & down spinal cord to the brain Gray matter- unmyelinated, collection of nerve cell bodies of neurons, has "horns"

Joint bw the acromion process and the clavicle? Joint bw the clavicle and sternum?

achromial clavicular joint sternal clavicular joint

The pulmonary artery carries oxygenated or deoxygenated blood?

deoxygenated

What do the R & L bronchomediastinal trunks drain?

drain thoracic viscera of lungs, and medial quadrant of the breast

Non-cancerous breast conditions:

fibrocystic changes-increase in fibrous/glandular tissue causing lumpiness and tenderness in the breast cysts- fluid filled sacs fibroadenomas- solid, fibrous, benign growths infection- breast abscess trauma

Describe the neuron and its parts

functional and anatomic unit of the nervous system -cell body containing nucleus -single axon -several dendrites

What is mastitis?

inflammation of the mammary gland due to infection

The deep back muscles operate on joints of VC to extend/laterally bend the back what is their innervation?

innervated by DPR segmentally

Name the innervation of the superficial back muscles (5 pairs)

innervated by VPR, EXCEPT trapezius (= CN XI)

What does the lateral thoracic artery primarily supply?

leaves axillary and courses around lat. border of pec minor providing the primary blood supply to the lateral quadrant of the breast lateral mammary branches are tributes off this artery

What is the location of the internal thoracic/mammary vein.

located posteriorly to the costal cartilages of our ribs, attaches to the sternum, branches perforate into the intercostal spaces

What is the filum terminale?

proceeds downward from the apex of the conus medullaris. It gives longitudinal support to the spinal cord and consists of two parts: The upper part, or filum terminale internum reaches as ~ the lower border of S2. It is continuous above with the pia mater and contained within a tubular sheath of the dura mater. In addition, it is surrounded by the nerves forming the cauda equina, from which it can be easily recognized by its bluish-white color. The lower part, or filum terminale externum, closely adheres to the dura mater. It extends downward from the apex of the tubular sheath and is attached to the back of the first segment of the coccyx in a structure sometimes referred to as the coccygeal ligament.

What are retraction signs?

puckering of the skin that indicates a possible invasion of the suspensory ligaments by cancer

Name the neural crest derivatives

sensory=autonomic

SOMATIC=? AUTONOMIC=?

somatic=voluntary autonomic=involuntary autonomic is divided up into sympathetic and parasympathetic

intervertebral foramen

space created between the facet joints and pedicles of one vertebral body and the next, through which the spinal nerves branch out to the rest of your body.

What does spina bifida mean and name the 4 common types.

spina bifida- clefting of the vertebral arches spina bifida occulta- hidden, typically asymptomatic, characteristic hair tuft or dimple spina bifida cystica- herniation of the meningeal sac, spinal cord remains in situ spina bifida cystica meningomyelocele- spinal cord is herniated out with in the sac rachischisis- most severe, opening of the spinal cord to the outside world ***motor and sensory deficits distal to the site

What passes through the intervertebral foramen?

spinal nerves and blood vessels

What is a scotty dog fracture?

spondylolysis- pars defect spondylolisthesis- spine slippage (forward) can lead to stretching of the neural root

What type of joint is an IV disc joint?

symphosis type joint ****IV discs are fibrocartilaginous

What do the R & L jugular trunks drain?

the head and neck on each side