Anatomy Exam #1

deep fascia

dense connective tissue on the surface of individual muscles -no fat- -extensions from internal surface -divide muscles -lie between musculoskeletal walls and serous membranes -retinacula

dermis consists of

dense layer of interlacing collagen and elastic fibers -direction of fibers determines tension lines and skin wrinkles

example of gomphosis

dentoalveolar

Serratus Posterior Inferior

depress ribs during exhalation

hypophysial fossa

depression in the center of the sella turcica

seriousness of burn determined by

depth extent area age general health

heterotropic bones

dermal bones forming in abnormal places -hemorrhagic calcification

example of synchondrosis

epiphyseal plate

crista galli

ethmoid bone ridge

lumbar lordosis

exaggerated concavity in the lumbar region -between 40-60 degrees -weakened abs -tight hip flexors, tensor fascia latae, deep lumbar extensors

longissimus capitis

extend head, laterally flex and rotate head to same side (yellow)

semispinalis cervicis and iliocostalis cervicis

extend neck (orange)

Multifidus (neck)

extends and rotates vertebral column (purple)

alar ligament

extends from sides of the dens to lateral margins of foramen magnum

splenius capitis

extends head (light blue)

semispinalis capitis

extends head, bends head to one side, or rotates head, contralateral rotation (green)

Splenius Cervicis and levator scapulae

extends neck (yellow)

semispinalis

extends neck and vertebral column -cervical region mostly

erector spinae movement

extension lateral flex rotation (ipsilateral)

Rectus Capitis Posterior Major and Minor

extension of head AO joint

superior oblique muscle neck

extension of head AO joint

investing fascia

extensions of deep fascia that surround muscles and neurovascular bundles

denticulate ligaments

extensions of pia mater that secure cord to dura mater go laterally, through sub arachnoid--> arachnoid--> into dura

Flat with aponeurosis

external oblique

Oculomotor (III)

eye movement medial, inferior, superior bodies in midbrain exit superior orbital fissure muscles: sup. inf. med. rectus, inf. oblique, levatator palpae superioris

trochlear (IV)

eye movement inferio-laterally superior oblique muscle bodies in midbrain exit superior orbital fissure

Viscerocranium

facial skeleton

concentric lamellae (disc)

fibers go in all different directions surround nucleus pulposus resist tensile forces in all directions

filum terminale

fibrous extension of the pia mater, from conus medularis ; anchors the spinal cord to the coccyx through sacral hiatus and sacral canal

Bursae

flattened fibrous sacs lined with synovial membrane and containing a thin film of synovial fluid -extension of joint capsule -bursitis (inflammation)

sternocleidomastoid movement

flex/ex neck; rotates head (contralateral)

Longus Colli

flexion and extension of neck; rotation to the contralateral side (dark red)

cervical spine movement

flexion, extension, lateral flexion, rotation

scalenes

flexion, lateral flexion (blue)

pulmonary circulation

flow of blood from the heart to the lungs and back to the heart

dural reflections

folds of dura mater that extend into the fissures of the brain

jugular foramen of temporal bone

foramen for jugular vein and cranial nerves IX, X, and XI

Foramen of Posterior Cranial Fossa

foramen magnum internal acoustic meatus jugular foramen hypoglossal canal condylar canal

anterior cranial fossa

formed by the frontal bone and part of the sphenoid bone

facet joints (zygapophyseal joints)

formed by the right and left superior articular processes of one vertebra and the right & left inferior articular processes of an adjacent superior vertebra

multipennate muscle

forms an angle with a tendon; do not move as far as parallel; contains more myofibrils than parallel muscles; develop more tension than parallel muscles; tendon branches within the muscle; ex: deltoid

Cribiform plate of ethmoid

forms the roof of the nasal cavity and has holes through which axons of the olfactory nerves pass.

bone trauma and repair

fracture -approximating normal position

linear calvarial fracture

fracture lines radiate away from point of impact in 2 or more directions - most common skull fracture -at thick portion of skull

Pterion fracture

fracture that overlies the anterior branches of middle meningeal vessels - ruptures the frontal branches deep to the pterion - epidural hematoma - middle meningeal artery hemorrhage --> untreated means death in a few hours

synovial joints are

freely movable (diarthroses)

diarthoses

freely movable joints -synovial

dorsal root ganglion neuron

from sensory receptors to spinal cord

examples of falx cerebri

frontal crest, crista gali, occipital bone

Bones of the neurocranium

frontal, parietal, occipital, temporal, sphenoid, ethmoid

restriction of movement

function of inferior and superior articular processes

collection of nerve cell bodies PNS

ganglion

costal facets

gliding joints where ribs meet thoracic vertebrae

sulci and gyri

grooves and folds, respectively

depressed fracture (skull)

hard blow to head in thin area -bone depressed inward compressing/injuring brain

cochlear nerve

hearing from spiral organ cell bodies: spiral ganglion exit: internal acoustic meatus

T1-T6 sympathetic innervation

heart and lungs head, upper limb, thoracic viscera

muscle cells provide

heat and form to body

meningeal layer

innermost layer of the dura mater

rotatores insertion

inserts on transverse process so the contraction causes contralateral movement -has a brevis and longus portion -contraction does opposite action

anterior circulation of circle of willis

internal carotid arteries

foramen lacerum

internal carotid artery

All sinuses drain into

internal jugular vein

posterior horn

interneurons that receive somatic and visceral sensory input

confluence of sinuses

intersection of superior sagittal sinus, straight sinus, transverse sinuses, occipital sinus

latissimus dorsi insertion

intertubercular groove of humerus

superior vertebral notch + inferior vertebral notch =

intervertebral foramen

the dorsal root ganglion and spinal nerves are located in the

intervertebral foramina

dorsal ramus innervates

intrinsic back muscles and skin around spinous processes

interspinous ligament

limits flexion connects spinous processes -least overall stiffness

bone consists of

living hard connective tissue

lumbar accessory process

located at the back part of the base of the transverse process, the attachment site for multifidus attachment

lumbar mammillary process

located on the superior articular process, attachment site for multifidus and intertransversarii muscles of the back, helps to stabilize the vertebral joints

skin ligaments on dorsal side of hand are

long and sparse, allow for more movement

intrinsic back muscles are

long columns and wrapped in thoracolumbar fascia

Thoracic spinous processes are

long, slender, slant inferiorly

subcutaneous tissue

loose connective tissue and fat (thickness varies depending on health)

T12-L2(3) sympathetic innervation

lower limb, pelvic viscera

Multifidus (Intrinsic Deep)

lower lumbar region, 2nd from deepest

Iliocostalis regions

lumborum, thoracis, cervicis

protection of spinal cord

pedicles and laminae creating the vertebral arch

bundle of nerve axons in PNS

peripheral nerve -cranial nerves

petrous ridge

petrous portion of the temporal bone that forms a large, triangular ridge in the floor of the cranial cavity, separating the middle and posterior cranial fossae; houses the middle and inner ear structures

spinal tap

placement of a needle through an intervertebral space into the subarachnoid space to withdraw CSF -L3/L4

the brainstem and cerebellum are in what cranial fossa

posterior cranial fossa

retrolisthesis

posterior displacement of a vertebra

anterior and posterior cerebral artery are

medial

lumber facets

medially/laterally -flex/ex -some lateral flex(limited by med/lat facing facet and muscle attachments)

foramen magnum of occipital bone

medulla and meninges spinal root of CN XI vertebral arteries

example of condylar joint

metacarpophalangeal joint

arachnoid mater of spinal cord

middle layer of the meninges

spinal accessory nerve (CNX1)

motor sternocleidomastoid and trapezius cell bodies: spinal cord exit: jugular foramen

abducent nerve (VI)

motor to eye move laterlly lateral rectus bodies: pons exit: superior orbital fissure

hypoglossal nerve (CN XII)

motor to intrinsic and extrinsic tongue muscles Cell bodies: medulla exit: hypoglossal canal

Facial Nerve (VII) Motor portion

motor to muscles of facial expression cell bodies: pons exit: internal acoustic meatus, facial, stylomastoid

functional unit of muscle

motor unit -single neuron and muscle fibers (myotome)

how facets articulate decides

movement of spine

Eccentric contraction

muscle lengthens as it maintains tension "elongating eccentric"

Myotome

muscle or group of muscles supplied by a specific spinal nerve

concentric contraction

muscle shortens as it maintains tension

isotonic contraction

muscle shortens because muscle tension exceeds load

circular muscle

muscle that forms a ring around a body opening (orbicularis oris)

musculovenous pump

muscular contractions become a compressive force propelling venous blood against gravity -valves prevent backflow

thrombus can cause

myocardial infarction stroke gangrene

gray rami communicantes

postganglionic sympathetic axons from sympathetic trunk to spinal nerve UNMYELINATED

Spondololysis

presence of a fracture in the pars interarticularis of the vertebral neural arch -no separation -clinically low back pain

example of symphysis

pubic symphysis, intervertebral discs

thoracic duct

receives lymph from the left side of the head, neck, chest, abdomen, left arm, and lower extremities

visceral sensory

receives sensory information from viscera -ischemia/stretch

muscles moving thoracic/lumbar intervertebral joints

rectus abdominis psoas major errector spinnae gluteus maximus spenius sternocledomastiod rhomboids serratus anterior external oblique quadratus lumborum gluteus medius transversospinalis iliocostalis and longissmus adductor lungus

Trapezius (neck)

neck extension (blue)

bipenate muscle

rectus femoris -tendon on both sides

vascular territory of the posterior cerebral artery

red

lumbosacral angle

neutral 30 degrees--> ASIS and pubic tubericles in vertical plane lordosis over 50 degrees --> anterior shift

are there valves in the veins of spinal cord?

no

Atlas (C1)

no body, no spinous process -posterior and anterior arches instead -image is superior view

Do the veins in the brain have valves?

no, they flow bidirectionally

dermis function

nourishes epidermis; provides strength; contains sebaceous glands, hair follicles, Arrector pili muscles

splenius capitis and cervicus origin

nuchal ligament

collection of nerve cell bodies in CNS

nucleus

Cavernous sinus syndrome

oculomotor trochlear abducent ophthalamic maxillary internal carotid artery

CN exiting cribiform plate

olfactory

bifid spinous process

on cervical vertebrae C3-C5. Forked.

transverse foramen

only found in the cervical vertebrae and allow passage of the vertabral artery, vein, and nerve

disc prolapse

only the outermost fibers of the annulus fibrosus contain the nucleus -bulging disc -some spinal cord impingement- numbness/tingling -go to PT

foramen spinosum of sphenoid bone

opening through which blood vessels pass that feed membranes surrounding the CNS middle meningeal artery and vein

CN exiting optic canal

optic

the ventral and dorsal ramus are located

outside the vertebral column

excessive lordosis

over 75 degrees

when burns exceed 70%

over half of victims die

some cranial nerves have a

parasympathetic component

Primary sematosensory cortex

parietal lobe Involved in basic sensory functions of opposite side of body

glossopharyngeal (IX) parasympathetic

parotid gland, salivary presynaptic cell bodies: medulla postdynaptic cell bodies: otic ganglion

epidural anesthesia

regional anesthesia produced by injecting medication into the epidural space of the lumbar or sacral region of the spine --L4/5

small arteries and arterioles

regulate capillary blood flow

dens

remnant of vertebral body from C1 in development it fuses with C2 to create dens -"no"

iliolumbar ligament

resists anterior sliding of L5 and S1 connects the transverse process of L5 with the ala of the sacrum (iliac crest) -stabilize pelvis

rhomboid major

retracts scapula

rhomboid minor

retracts scapula

posterior spinal arteries

right and left dorsal surface

corpus collosum connects

right and left hemispheres white mater ex. seizures: cut this in half to lessen the severity of seizure so it cannot cross to other side of brain

right lymphatic duct drains into

right venous angle

laminae

roof of the vertebral arch

pivot joint

rotating bone turns around an axis; i.e. connection between radius/ulna and humerus

unilateral contraction of intrinsic back muscles

rotation

inferior oblique muscle neck

rotation of head to ipsilateral side AA joint -transverse process of C1 to spinous process of C2

mastoid process

round projection on the temporal bone behind the ear

transverse sinus

runs horizontally from the rear of the head toward each ear

occipital sinus

runs in the posterior vertical border of the falx cerebelli

inferior sagittal sinus

runs within the inferior margin of the falx cerebri

flexion and extension occur in what plane

sagittal (except thumb)

Axis (C2)

second cervical vertebrae. Allows the head to shake "no" -dens

in venous drainage, medullary veins converge into

segmental spinal veins

cartilage consists of

semirigid avascular connective tissue

transversospinalis group

semispinalis, multifidus, rotatores -between spinous and transverse processes

mandibular branch

sensory and motor skin over mandible, lower teeth, side of head, mandibular teeth, TMJ, mucosa of mouth, anterior 2/3 tongue motor for mastication, mylohyiod, anterior belly digastric, tensor veli, palatini, tensor tympani motor bodies: pons sensory bodies: trigeminal ganglion Exit: foramen ovale

Ophthalamic branch

sensory for cornea, nasal canal, forehead, scalp, eyelids, nose, paranasal sinus bodies: trigeminal ganglion exit superior orbital fissure

maxillary branch

sensory for skin over maxilla, upper lip, maxillary teeth, mucosa of nose, palate, maxillary sinus Bodies: trigeminal ganglion exit: foramen rotundum

Vestibulocochlear (VIII)

sensory, hearing and balance 2 divisions

nerves can be

sensory, motor, or mixed

tentorium cerebelli

separates cerebellum from cerebrum

parieto-occipital sulcus

separates parietal and occipital lobes

falx cerebri

separates the two cerebral hemispheres

Sagittal (longitudinal) fissure

separates the two cerebral lobes

spinous process

sharp, slender projection

thoracolumbar fascia

sheet of connective tissue on lower portion of the back -wraps intrinsic back muscles

lumbar laminae

short and broad

lumbar pedicles

short and thick, project posteriorlaterally

plane joint

short slipping or gliding movements; i.e. carpals

skin ligaments on palm of hand are

short, stout, abundant

stretch marks

silvery white scars caused by extreme stretching of the dermis (meshwork of elastic fibers and collagen in dermis) -white older -red middle age -purple newer

somatic motor system neuron

single neuron with cell body and axon

calvaria

skull cap

fibrous joints

skull, gomphoses, syndesmosis -no top little movement

amphiarthroses

slightly movable joints -cartilagenous

skin ligaments are

small fibrous bands -attach deep dermis to deep fascia -allow for skin mobility

olfactory nerve (I)

smell cribiform plate in ethmoid bone olfactory epithelium

fontanelles

soft spots normally present on the skull of a newborn

anterior horn

somatic motor neurons whose axons exit the cord via ventral roots

epidural space

space between the dura mater and the wall of the vertebral canal

tonic contraction

special type of skeletal muscle contraction used to maintain posture -no movement produced

Glossopharyngeal (IX) sensory (all)

special: taste posterior 1/3 tongue sensory: carotid body and sinus gen. sensory: external ear, pharynx, middle ear cell bodies in sensory ganglion

muscle cells are

specialized for contraction

thoracic and lumbar arteries

spinal arteries supplied by radicular arteries from aorta

radicular arteries follow the

spinal rootlets to supply the spinal cord

vertebral prominens

spinous process of C7

Superficial intrinsic back muscles

splenius capitis and splenius cervicis

vertebral arch

structure that encloses the nerve cord

skin ligaments are in

subcutaneous tissue

associated structures of integumentary system

subcutaneous tissue deep fascia

lymph flows from

superficial to deep vessels

tectorial membrane

superior continuation of posterior longitudinal ligament, starting at the body of Axis (C2) until anterior aspect of FM A

cavernous sinus drains into

superior petrosal sinus--> transverse, inferior petrosal, sigmoid sinus--> internal jugular

cervical facets

superior/inferiorly flex/ex some lateral flex limited rotation

anterior cerebral artery

supplies frontal lobe

posterior cerebral artery

supplies occipital lobe

cutaneous branches

supply the skin and subcutaneous tissues, sensory

anastomosis

surgical joining of two ducts, vessels, or bowel segments to allow flow from one to another

nerve severance

surgical opposition of ends -pns -can get neruomas from this

Epimysium

surrounds entire muscle

Glossopharyngeal (IX) motor

swallowing cell bodies: medulla exit: jugular foramen

lymphedema

swelling due to an abnormal accumulation of lymph fluid within the tissues

Secondary cartilaginous joint

symphysis -midline of body -amphiarthsoses -fibrocartilage -discs

gomphoses are

synarthrotic -cone shaped peg in bony socket

Primary cartilaginous joint

synchondrosis -synarthrosis -hyaline cartilage

cartilaginous joints

synchondrosis, symphysis -allow for some movement

conus medullaris

tapered end of the spinal cord (L1-L2)

Facial Nerve (VII) Sensory function

taste to anterior 2/3 of tongue and palate sensory from external acoustic meatus glands (parasympathetic) cell bodies: geniculate gang. parasympathetic cell bodies: pons

which lobe is under middle cranial fossa

temporal -and pituitary gland

middle cranial fossa contains

temporal and sphenoid bones

Langer lines

tension lines due to orientation of fibers in the dermis -keep skin taut -allow creasing with movement -surgical incisions try to go along these (if not= keloids)

veins have lower blood pressure

than arteries bc of thinner walls

ventral ramus

the anterior division of spinal nerves that communicate with the muscle and skin of the anterior and lateral trunk -mixed

dorsal ramus

the division of posterior spinal nerves that transmit motor impulses to the intrinsic back muscles and skin around the spinous process

the sclera (white of the eye) is an extension of

the dura

right lymphatic duct drains

the right side of the head and thorax, and the right upper extremity

the cerebellum sides control

the same side (all other places in brain control the opposite side)

primary motor cortex

the section of the frontal lobe responsible for voluntary movement -controls opposite side

dorsal root

the sensory branch of each spinal nerve (afferent)

nucleus pulposus

the soft, fibrocartilaginous, central portion of intervertebral disk jelly

laminectomy

the surgical removal of a lamina, or posterior portion, of a vertebra

lamboid suture (bony anatomy of cranium)

the suture between the occipital and parietal bones and temporal

coronal suture

the suture between the parietal and frontal bones of the skull

vagus nerve

the tenth cranial nerve that innervates digestive organs, heart and other areas fight or flight, sensory and motor, parasympathetic Exit: jugular foramen

body of vertebrae

the thick, disc-shaped anterior portion which is the weight bearing portion

Computerized Tomography (CT)

the use of a device that employs a computer to analyze data obtained by a scanning beam of X-rays to produce a two-dimensional picture of a "slice" through the body -can do 3D reconstrcution

fusiform muscles

thick in the middle and tapered at each end (biceps brachii)

Lumbar Transverse Process

thin and tapered -attach to muscles

longissimus region

thoracis, cervicus, capitus

spinalis regions

thoracis, cervicus, capitus

sympathetic system is in what region

thoracolumnar T1-L2-3

trigeminal (V)

three branches (V1, V2, V3) mixed nerve exits are superior orbital fissure, foramen rotundum, foramen ovale

flexion of thumb

tip of thumb directed toward palm

burns are

tissue damage and cell death caused by heat, electricity, UV radiation, or chemicals -denatures proteins

anterior clinoid process

together the clinoid processes deepend the sella turcica and serve as points of attachment for the tentorium cerebelli

posterior clinoid process

together the clinoid processes deepend the sella turcica and serve as points of attachment for the tentorium cerebelli sphenoid

bundle of nerve axons in CNS

tract

muscle attachment and movement

transverse and spinous processes

primary auditory cortex

transverse gyri of heschi -superior surface of each temporal lobe -hearing

longissimus insertion

transverse process at superior vertebral levels and mastoid process

Superior Saggital Sinus drains into the

transverse sinus--> sigmoid sinus--> exit via jugular foramen--> internal jugular vein

Deep layer of intrinsic back muscles

transversospinalis

extrinsic back muscles

trapezius, latissimus dorsi, levator scapulae, rhomboids, serratus posterior superior, serratus posterior inferior

cranial dura mater is innervated by

trigeminal and vagus

cavernous sinus syndrome causes

tumor (pituitary) infection like nasal arterial rupture

Inversion

turning inward

eversion

turning outward

syntosis

two bones completely fused

transverse process

two lateral projections from the vertebral arch

autonomic nervous system has

two neurons

saddle joint

type of joint found at the base of each thumb; allows grasping and rotation -concave/convex

arachnoid trabeculae

web like threads extending from arachnoid to pia mater hold open allow for flow of CSF

L5 Transitional Vertebrae

wedge shaped body 5% greater superior disc surface smaller spinous process transverse process large and oriented superioposterily

medium muscular arteries

-Walls are mostly smooth muscle -Ability to vasoconstrict (decrease diameter), regulates blood flow *i.e. brachial or femoral artery

Posterior Longitudinal Ligament (PLL)

- Limits flexion of the spine - Reinforces posterior aspect of the intervertebral disks -only thin ribbon in lumbar region -stretched in lumbar flexion

CNS damage

-axons do not recover -axon growth blocked by astrocytes -permanent disability

subserous fascia

-between serous membranes and deep fascia -areolar tissue

deep venous drainage of brain

- anterior cerebral + deep middle cerebral --> basal vein of rosenthal + internal cerebral -->great vein of galen --> jugular vein

Lumbar canal stenosis

- narrowing of the lumbar canal - congenital or acquired -can fix via laminectomy

Problems that result from burns

- shock due to water, plasma, and plasma protein loss - circulatory & kidney problems from loss of plasma - bacterial infection

subdural hematoma

-blood that splits dural border layer -created space at dura-arachnoid junction -*blow to head that jerks brain* -hematoma due to venous bleeding -tears of superior cerebral bridging vein -older patients due to brain atrophy SLOW BLEED

syndesmosis joint

-bones connected by a ligament (bundles) -interosseous membrane between ulna and radius (sheets) -amphiarthroses

muscular atrophy

-denervation -disuse -intrinsic disease

nuchal ligament (ligamentum nuchae)

-extends from external occipital protuberance /posterior foramen magnum to spinous processes of cervical vertebrae

burns- when to seek help

-involves face, hands, fingers, genitals, feet, joints -encircles part of body -greater than size of orange -2nd or third degree -victim is less than 5 yrs old or greater than 70 -signs of infection

arachnoid granulations

-large clusters of villi -absorb CSF into venous circulation filter and recycle -ex hydrocephalus - overproduction of CSF or problem with filtering

Circle of Willis

A structure at the base of the brain that is formed by the joining of the carotid and basilar arteries.

superior sagittal sinus

A venous sinus located in the midline just dorsal to the corpus callosum, between the two cerebral hemispheres.

disc degeneration

A wearing down of the discs between vertebrae through everyday wear and tear. -no herniation

frontal crest of the frontal bone

Attachment site for meninges to help stabilize brain within skull

Flexion

Decreases the angle of a joint, decreasing angle between body parts

posterior communicating arteries

The posterior communicating arteries connect the posterior cerebral arteries to the middle cerebral arteries.

nerve fascicles

These are bundles of nerve fibers (axons).

digastric muscle

This muscle depresses the mandible. When one opens their mouth they are depressing the mandible. -omohyoid

Primary curvatures of the spine

Thoracic and sacral Develop during fetal period and are anteriorly concave.

mixed cranial nerves

V, VII, IX, X

CN exiting foramen rotundum

V2

CN exiting foramen ovale

V3

dorsal root ganglion

a nodule on a dorsal root that contains cell bodies of afferent spinal nerve neurons

subarachnoid space

a space in the meninges beneath the arachnoid membrane and above the pia mater that contains the cerebrospinal fluid

scoliosis

abnormal lateral curvature of the spine -lateral deviation

varicose veins

abnormally swollen, twisted veins with defective valves; most often seen in the legs -incompetent valves

paravertebral ganglia

above diaphragm Also known as sympathetic chain ganglia, form a chain that runs along side the vertebral column

synovial joints are typically reinforced by

accessory ligaments

example of plane joint

acromioclavicular joint

Sympathetic trunk exits can be at

all levels

unipennate muscle

all the muscle fibers are on the same side of the tendon

anterior spinal artery

along ventral surface of cord

avascular necrosis

an area of bone tissue death caused by insufficient blood flow

conventional radiography

an imaging technique that passes x-rays through the body, which expose x-ray film to produce a negative image called a radiograph -X-ray -2D -dense structures are whiter

in the cervical region, what arteries are branching from the vertebral to supply blood/nutrients to spinal cord itself?

anterior and posterior arteries

the frontal lobe and olfactory bulbs and tracts are housed under the

anterior cranial fossa

example of syndesmosis

anterior tibiofibular joint and interosseous membrane

Greater wings of sphenoid of the cranium

anterior to temporal bones, sides and floor of cranial cavity, roof of orbits -contains F. Lacerum, F. Ovale, F. Spinosum, F. Rotundum for passage of nerves and blood vessels

thoracic facets

anterior/posterior maximal rotation some lateral flex (limited by ribs)

spinal cord blood is supplied by (except for cervical)

aorta

lateral cutaneous branch

arise near midaxillary line, pierce near in/external intercostals; divide into anterior/posterior branches; supply skin of lateral thoracic & abdominal walls 18

epidural hematoma

arterial bleeding between dura mater and skull (middle meningeal artery hard blow to head brief concussion followed by lucid interval later drowsiness/coma FAST BLEED

synovial joints consist of

articular cartilage, joint capsule, synovial membrane

superior articular process

articulates with inferior articular process of vertebra above

synovial cavity separates

articulating bones

atlanto-axial joint

articulation between the atlas and axis; pivot joint

atlanto-occipital joint

articulation between the atlas and the cranium at occipital condyles flexion and extension

joints are

articulations between two or more rigid components (bone and cartilage)

alar ligament + cruciate ligament =

atlantoaxial joint

example of pivot joint

atlantoaxial joint

language is integrated by

auditory cortex visual cortes wernickes

reflexive contraction

automatic and not voluntarily controlled

Retinacula

bands of deep fascia, which hold tendons of muscles of forearm, blood vessels, and nerves close to wrist

Basicranium

base of skull

drainage of the spinal cord via

batsons plexus, located in epidural space

prevertebral ganglia

below diaphragm

the skin is the

best indicator of health

sagittal suture

between the two parietal bones

vasa nervorum

blood vessels supplying the nerves

vascular territory of the anterior cerebral artery

blue

ribs interact with

body and processes of thoracic vertebrae

T7-T11 sympathetic innervation

body wall, abdominal viscera

the middle meningeal artery is between the

bone and dura, feeds dura with blood supply and nutrients -how you get an epidural hematoma

comminuted fracture

bone breaks into many fragments

bone adaptation

bone reinforces stressed areas to become stronger and thicker -atrophy and hypotrophy

basilar fracture

bones at cranial base CSF leaks into nose and ear possible CN and bld vessel injury -bitter metallic taste in pt if happens

inferior articular process

bony process that extends downward from the vertebral arch of a vertebra that articulates with the superior articular process of the next lower vertebra

sacral hiatus is

bounded by coruna

secondary curvatures

cervical and lumbar, develop after birth -posteriorly concave

spinalis insertion

cervical and thoracic spinous processes

Iliocostalis insertion

cervical transverse processes, posterior ribs

systemic circulation

circulation that supplies blood to all the body except to the lungs

rootlets of dorsal and ventral are apart of which division of nervous system

cns

Lamellae (disc)

collagen fibers of anulus fibrosus are arranged in sheets

Disc Sequestration

complete separation of disc material with rupture through PLL into the epidural space; free fragment herniation -collapsed vertebrae -leakage

shape of each disc is

concave posteriorly- resist tension

Wernicke's aphasia

condition resulting from damage to Wernicke's area, causing the affected person to be unable to understand or produce meaningful language

large elastic arteries

conduct the blood to various locations throughout the body ex. aorta

which sinuses drain into jugular vein?

confluence of sinuses occipital sinus transverse sinus straight sinus

Auditory cortex (temporal lobe)

conscious processing of sounds -when listening

ventral root

contains axons of motor neurons efferent

sacral canal

continuation of vertebral canal

Lesser wings of sphenoid of the cranium

cranial cavity containing optic foramen (optic nerve from eye to brane)

cranial nerves are covered by

cranial meninges

parasympathetic system is in what region

craniosacral

tendon sheaths

cylinders of connective tissue lined with synovial membrane and wrapped around a tendon

flat back posture

decrease lumbar lordosis (20 degrees) center of gravity shift anterior--> lumbar spine and hips

Subcutaneous tissue (superficial fascia) contains

deepest parts of sweat glands bld vessels lymph vessels cutaneous nerves

Sacrum is how many fused vertebrae?

5

condylar joint

-wider range of flex/ex -narrow randle of abd/add, circumduction

pedicles

walls of the vertebral arch

lateral horn

(only in thoracic and lumbar regions) - sympathetic neurons

cervical enlargement

-C4-T1 segments and vertebral levels -nerves that exit here supply shoulder girdle and upper limbs

ligamentum flavum

-limits flexion -extends from lamina to lamina -forms part of roof of vertebral canal

somatic nervous system

-motor to skeletal muscle -sensory from skin -sensory from joints, muscles, tendons

autonomic nervous system

-motor to smooth muscle, cardiac muscle, glands

spondololisthesis

-pars interarticularis fracture with separation' -slips posterior or anterior -most common in lumbar spine -causes spinal stenosis

ball and socket joint

-permits movement in several axes hip and shoulder joints

bone function

-protection for structures -support for body and cavities -salt storage -movement -hematopoiesis

Sacrum (posterior view)

-sacral canal -median sacral crest -lateral sacral crest -posterior sacral foramina -sacral hiatus

sutures

-thin layer of dense fibrous CT -unite bones of skull -irregular interlocking edges = added strenth -synarthrosis

sympathetic signal pathway

1. autonomic cell bodies in lateral horn 2. ventral root 3. spinal nerve 4. white rami communicans 5. sympathetic trunk ganglion 6. para or pre vertebral ganglion 7. target (long post ganglionic fiber)

somatic motor pathway

1. ventral horn (signal statrts here at spinal cord) 2. ventral root 3. spinal nerve 4. ventral or dorsal ramus

somatic sensory pathway

1. ventral or dorsal ramus 2. spinal nerve 3. dorsal root ganglion 4. dorsal root 5. spinal cord (dorsal horn)

how many vertebrae are movable

24

rule of 9s only for

2nd and 3rd degree burns

How many spinal nerves are there?

31 pairs

How many vertebrae are there?

33

quadrate muscle

4 equal sides (rectus abdominis)

Coccyx

4 fused vertebrae -attach to perineum muscles

How many foramina are in the sacrum?

4 pairs (8 total) -allow dorsal and ventral rami to leave

there are _____ cervical spinal nerves and ______ cervical vertebrae

8,7

how many vertebrae are fused

9

second degree burn

A burn marked by pain, blistering, and superficial destruction of dermis with edema and hyperemia of the tissues beneath the burn. -bubble due to leaking lymph fluid

Osteoporosis

A condition in which the body's bones become weak and break easily.

sway back posture

A long outward curve of the thoracic spine with a backward shift of the trunk starting from the pelvis -weakened abs, lower thoracic, hip flexors -tight hip extensors, lower lumbar extensors, upper abdominals -lumbar lordosis + thoracic kyphosis

skeletal muscle

A muscle that is attached to the bones of the skeleton and provides the force that moves the bones. -striated -voluntary

parietal lobe

A region of the cerebral cortex whose functions include processing information about touch.

CN exiting superior orbital fissure

III, IV, V (V1)

trapezius innervation

Accessory nerve (CN XI) all other extrinsic muscles are innervated by ventral rami

uncinate processes

Allow flexion and extension while limiting lateral flexion & translation.

basilar artery

An artery, formed by the fusion of the vertebral arteries, that supplies blood to the brainstem and to the posterior cerebral arteries.

disc extrusion

Annular rupture Expelled nuclear material is attached to rest of disc -need surgery

Anterolisthesis

Anterior displacement of vertebral body relative to the one below. -more common

dermatome

Area of skin supplied by a single spinal nerve

superior orbital fissure of sphenoid bone

Between greater and lesser wing on the sphenoid bone, transmits oculomotor, trochlear, and abducens nerves. Also a branch of opthalmic CN V1 ophthalmic veins

subarachnoid hemorrhage

Bleeding into the subarachnoid space, where the cerebrospinal fluid circulates. -meningeal irritation, stiff neck, headache, LOC -arterial -*rupture from saccular aneurysm* or *head trauma*

appendicular skeleton

Bones of the limbs and limb girdles that are attached to the axial skeleton

motor cranial nerves

III, IV, VI, XI, XII

suboccipital region is superficial to

C1/C2 and deep to semispinalis

CN exiting jugular foramen

CN IX, X, XI

CN exiting internal acoustic meatus

CN VII, VIII

vestibular nerve

CN VIII, nerve that conducts impulses related to maintaining balance to the brain sensation from semicircular ducts, utricle, saccule cell bodies: vestibular ganglion exit: internal acoustic meatus

CN exiting hypoglossal canal

CN XII

where are lymphatic vessels not found

CNS teeth bone bone marrow

What is the subarachnoid space?

CSF major cranial arteries and nerves

lumbar cistern

Cistern that extends from the caudal end of the spinal cord to the second sacral vertebra; because of the large subarachnoid space and relative absence of neural structures, this space is most suitable for the withdrawal of CSF by lumbar puncture.

annulus fibrosus

Composed of fibrocartilage, it is the outer portion of the intervertebral disc.

Perimysium

Connective tissue surrounding a fascicle

Endomysium

Connective tissue surrounding a muscle fiber

anterior communicating artery

Connects anterior cerebral arteries

straight sinus

Connects inferior sagittal sinus to confluence of sinuses

frontal plane (coronal plane)

Divides the body into front and back portions.

Trapezius

Elevates, depresses, retracts, and rotates the scapula; rotates the arm inserts on the lateral third of clavicle, acromion, and spine of scapula.

parasympathetic cranial nerves

III, VII, IX, X

intermediate layer of intrinsic back muscles

Erector spinae (iliocostalis, longissimus, spinalis)

internal acoustic meatus of temporal bone

Facial n. (CN VII) Vestibulocochlear n. (CN VIII) -compression here would result in facial drooping, issues with balance or hearing

foramen rotundum of sphenoid bone

First part of Cowboy Ros, transmits maxillary branch CN V2 (part of trigem)

lumbosacral plexus

Formed of L2-S2 rami. Supplies the lower limb.

Artherosclerosis

Hardening and narrowing of the arteries due to buildup of cholesterol plaques

Rule of 9's

Head and neck = 9% Upper Ex = 9% each arm Lower Ex = 9% each side Front trunk = 18% Back trunk = 18% perineum- 1%

referred pain pathway

High sensory (skin) and low sensory (internal organs) input nerves may converge on the same level of spinal cord. --dermatome-- i.e. During MI nerves from damaged heart tissue convey pain to T1-4 to the left side. This is the same level that receives sensation from the left side of the chest and part of the left arm. The brain interprets the signals as pain in the chest and left arm.

hypoglossal canal of occipital bone

Hypoglossal (CN XII)

sensory cranial nerves

I, II, VIII

smooth muscle

Involuntary muscle found inside many internal organs of the body -weak, slow, rhythmic, sustained tonic -long nuclei -no striations

cardiac muscle

Involuntary muscle tissue found only in the heart. -branched -strong quick continuous rhythmic

hinge joint

Joint between bones (as at the elbow or knee) that permits motion in only one plane -flex/ex

lumbosacral enlargement

L1 - S3 segments T11-L1 vertebral levels Gives rise to nerve roots for lower limbs

illiac crests are at what level of the spine?

L4-L5

periosteal layer

Layer of Dura mater that is attached to the surface of skull.

What is lymph?

Leaked plasma (but contains fewer proteins). Tissue fluid that has entered lymphatic vessels. Clear/watery Similar composition to blood plasma

Greater occipital nerve

Located in the back of the head; affects the scalp as far up as the top of the head. -not in suboccipital triangle -emerges inferior to inferior oblique

suboccipital triangle

MUSCLES: Rectus capitis post maj, Obliquus capitis sup (superior oblique), Obliquus capitis inf (inferior onlique) INNERVATION: motor - Suboccipital n. vertebral artery

pia mater of the spinal cord

Menix that is in direct contact with the spinal cord.

isometric contraction

Muscle contracts but there is no movement, muscle stays the same length

levatator scapulae

O: transverse process I: medial border and superior angle of scapula A: raises medial border of scapula N: Dorsal Scapular Nerve

posterior cranial fossa contains

Occipital bone Petrous portion of temporal bone Posterior portion of the body of sphenoid: Dorsum sellae and posterior clinoid process. Internal occipital protuberance. Internal auditory meatus (petrous temporal) Jugular foramen Foramen magnum Hypoglossal canal Sulci for transverse sinus & sigmoid sinus

Interlaminar space

Only present at lumbar levels. This is the space that we want to go through for LP procedures and it is covered by ligamentum lava. Top of iliac crest --> lines up with the vertebral body of L4 --> move finger down and you will be in the L4/L5 inter laminar space

intervertebral foramen

Opening formed by the inferior and superior notches on the pedicles of adjacent vertebrae. Allows passage of spinal nerves and vessels.

carotid canal of temporal bone

Opens into Foramen Lacerum, transmits internal carotid artery

the cranial nerves exits in middle cranial fossa

Optic canal Superior orbital fissure foramen rotundum foramen ovale foramen spinosum foramen lacerum

Rotatores

Origin: Transverse Processes of all vertebrae Insertion: Spinous process of vertebra superior to the one of the origin Action: Together: Extend Vertebral Column Singly: Rotate vertebral column to the opposite side Innervation: Spinal Nerves

foramen ovale of sphenoid bone

Oval shaped. Almost the most lateral set. mandibular branch of trigeminal

pars interarticularis

Part of the lamina between the superior and inferior articular processes -thinnest part -prone to fracture -scotty dog

axial skeleton

Portion of the skeletal system that consists of the skull, rib cage, and vertebral column

Luschka's joints

Projections of superior lateral vertebral body only seen in cervical spine; make up anteriomedial boundary of neural foramen; spurs here can encroach upon nerve root -bowls stacking -between uncinate process and body of adjacent vertebrae -site of bone spur formation

functions of skin

Protection, Thermoregulation, Cutaneous Sensation, Vitamin D synthesis, Blood Reservoir, Excretion and Absorption.

epidermis function

Protects dermis from trauma, chemicals Controls skin permeability, prevents water loss Prevents entry of pathogens Synthesizes vitamin D3 Sensory receptors detect touch, pressure, pain, and temperature Coordinates immune response to pathogens and skin cancers --avascular --sensory info --renew every 25-25 days

lumbar facet joints

Sagittal plane; flexion/extension (some ex)

Sylvian fissure

Separates the temporal from the frontal lobe, and the temporal from the parietal lobe (aka transverse fissure)

Lumbar Spinous Process

Short; blunt; projects directly posteriorly

Triangle of Auscultation

Small, triangular gap between trapezius and latissimus dorsi muscles and inferior part of medial scapular border

first degree burn

Superficial burns through only the epidermis.

middle cerebral artery

Supplies entire lateral cortex Largest branch of internal carotid artery

cartilage function

Support, covers ends of bones -allow flexibility of skeleton -articular provides gliding between bones

sympathetic trunk entrances at

T1-L2(3)

rib 7 interacts with

T7 body and process T6 body

clivus of occipital bone

The ________ (Latin for "slope") is a part of the cranium, a shallow depression. It forms a gradual sloping process at the anterior most portion of the basilar occipital bone at its junction with the sphenoid bone.

posterior communicating artery

The artery of the Circle of Willis that transports blood from the internal carotid artery to the posterior cerebral artery is the

tunica media

The middle and thickest layer of tissue of a blood vessel wall, composed of elastic tissue and smooth muscle cells that allow the vessel to expand or contract in response to changes in blood pressure and tissue demand.

tunica adventitia

The outer layer of tissue of a blood vessel wall, composed of elastic and fibrous connective tissue.

dura mater of spinal cord

The outermost and toughest layer menix covering the spinal cord.

third degree burn

a burn involving all layers of the skin; characterized by the destruction of the epidermis and dermis, with damage or destruction of subcutaneous tissue -may not hurt -look black -requires skin grafting

epidural hematoma

a collection of blood in the space between the skull and dura mater -middle meningeal artery

contrecoup fracture

a fracture which occurs on the side opposite where the blow was sustained

systemic effects of a burn are

a greater threat to life than local ones

EMG (electromyography)

a measurement technique that records the electrical activity of a muscle or group of muscles. It indicates the muscle activity

Positron Emission Tomography (PET)

a method of brain imaging that assesses metabolic activity by using a radioactive substance injected into the bloodstream

magnetic resonance imaging (MRI)

brain-imaging method using radio waves and magnetic fields of the body to produce detailed images of the brain -better tissue differentiation than CT -reconstruct tissues -moving structures in real time

Neurocranium

braincase

convergent muscles

broad area converges on attachment site (tendon, aponeurosis, or raphe); muscle fibers pull in different directions, depending on stimulation; ex: pectoralis muscles

external occipital protuberance

bump on back of head

vertebral foramen

canal through which spinal cord passes

Wernicke's area

cannot comprehend words coming at you, what you are seeing, lost reference point in memory wernikes aphasia

Pathway of Internal Carotid Artery

carotid canal--> brain--> foramen lacerum--> location of cavernous sinus--> surface of brain --> middle cerebral artery

example of saddle joint

carpometacarpal joint of the thumb

white rami communicantes

carry preganglionic axons to the sympathetic chain

sacral epidural anesthesia

caudal -used in pediatric and special cases -go through sacral hiatus

sinuses along the petrous ridge of the temporal bone

cavernous sinus superior petrosal sinus inferior petrosal sinus

the plexus of veins on either side of the sella turica

cavernous sinus, HUGE vein

cauda equina

dorsal and ventral roots of lowest spinal nerves starts at L1/2

intrinsic back muscles are innervated by

dorsal rami of spinal nerves

Great cerebral vein of Galen

drains internal cerebral veins drains into the straight sinus

Serratus Posterior Superior

elevates ribs 2-5

tunica intima

endothelium

compensatory hypertrophy

enlargement of an organ secondary to an increased workload; often seen when part of an organ has been destroyed or when there is absence or decreased function of paired organs

2 main divisions of integumentary system

epidermis and dermis

ultrasonography (US)

high-frequency sound waves (ultrasound) are directed at soft tissue and reflected as "echoes" to produce an image on a monitor of an internal body structure; also called ultrasound, sonography, and echo -noninvasive, no radiation -viewed in real time

example of ball and socket joint

hip and shoulder

optic canal of sphenoid bone

holes on both sides of optic groove -optic nerve and ophthalamic artery

transverse plane

horizontal division of the body into upper and lower portions -look from feet up

Coruna

horns of sacrum

thoracic kyphosis

humpback, increased thoracic curvature, loss of height over time, dowager hump -50 degrees or greater -compression of visceral organs -normal is 20-45 degrees

intermediate intrinsic back muscles origin

iliac crest, sacrum, lumbar and sacal spinous process

synarthroses

immovable joints -fibrous, ligaments

parasympathetic nervous system targets

in body cavities, head, external genitalia

sympathetic nervous system targets

in body wall and body cavities

medial branch of intercostals

in front of sternum -sternal rub -sensory

Broca's area

in frontal lobe (left for right handed people, both sides for left handed) next to primary motor cortex -can understand what you are trying to say but mouth cannot make the words -stroke, can understand you but cannot form words to respond

the spinal accessory nerve starts

in lower portion of spine, enters cranium via foramen magnum, cranium, exits cranium via jugular foramen (why its a cranial nerve)

primary visual cortex

in occipital lobe alone calcarine fissure

postganglionic neuron

in the autonomic division of the PNS, a neuron that has its cell body located in an autonomic ganglion (where a pre-ganglionic neuron synapses with it) and whose axon synapses with the target organ

preganglionic neuron

in the autonomic nervous system of the PNS, a neuron that has its cell body located in the CNS and whose axon extends into the PNS to synapse with a second neuron at an autonomic ganglion (the second neuron's axon synapses with the target organ)

stroke in cerebellum

increase in neuroplasticity increase chances of it not being permenant

extension

increases the angle of a joint

T7 surface anatomy

inferior angle of scapula

sacral hiatus

inferior opening of the sacral canal

phasic contractions

isotonic and isometric

epidermis consists of

keratinized stratified epithelium

hinge joint example

knee and elbow

lymphatic vessels

large vessels with valves, which collect and carry lymph to lymph nodes -form lymphatic plexi -circulate lymphocytes

middle cerebral artery position

lateral

bilateral contraction of intrinsic back muscles create

lateral flexion

Intertransversarii

lateral flexion of vertebral column (red)

thoracic duct drains into

left venous angle

Where does the dural sac end?

level of S2

cruciate ligaments spine

ligaments that cross each other, forming an X within the notch atlas

intertransverse ligament

limites contralateral lateral flexion -not true ligaments -replaced by iliolumbar ligament at L4

Anterior Longitudinal Ligament (ALL)

limits extension of the spine and reinforces the anterior portion of the intervertebral disks and vertebrae -lumbar

supraspinous ligament

limits flexion -upper limb region -terminates L3-4

parallel muscles

uniform width and parallel fascicles

Superior Saggital Sinus is filled with

venous blood

extrinsic back muscles innervated by

ventral rami

the brachial plexus is a network of

ventral rami to upper extremity

posterior circulation of circle of willis

vertebral arteries

subclavian artery leads into

vertebral artery to supply blood to the brain

the roots + rootlets are located in the

vertebral canal

intermuscular septa

very thick fascia that separate one compartment from another

optic nerve (II)

vision optic canal via spenoid retina

peripheral nerve degeneration

when peripheral nerves are crushed or severed, their axons degenerate distal to the lesion because they depend on their cell bodies for survival -cen regrow via epineuron tract -result from ischemia

Visual cortex (occipital lobe)

when reading

vascular territory of the middle cerebral artery

yellow

lumbar region movement

zygapophyseal joints oriented sagitally - become more coronally oriented down column limits rotation in this region flex/ex easy lateral flex/ex limited

visceral sensory pathway

— carries receptor info from visceral tissue, organs (stretch and ischemia) — info arrives at medulla oblongata -- single neuron --enter at dorsal root

Sacrum (anterior view)

•5 sacral vertebrae fuse by age 26 •Anterior surface -smooth and concave -sacral foramina were intervertebral foramen •nerves and blood vessels -4 transverse lines indicate line of fusion of vertebrae