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170 Cards in this Set
- Front
- Back
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Barium swallow
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drinking Barium sulfate contrast medium to study internal covering layer (mucous membrane) of the digestive tract
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myelography
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using contrast medium injected around spinal cord (subarachnoid space)
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CT
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Computed tomography-intracranial lesions or other parts of body, works like xray, can enhance color with IV
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MRI
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uses hydrogen atoms-better to differentiate btw white and gray matter than CT
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PET
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Positron Emission Tomograpy-produces images by injected radioactive isotopes into body; used to asses blood flow in brain and heart; being replaced by fmri b/c it shows blood oxygen measurements
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What are the functions of the bones?
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1. support
2. movement 3. mineral storage 4. blood-cell formation 5. triglyceride storage |
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compact bone
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dense outer layer of bone
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spongy (cancellous) bone
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internal network of bone
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What are 5 characteristics of long bones?
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1. Diaphysis
2. Epiphysis 3. Blood vessels- well vascularized 4. medullary cavity-hollow cavity filled with marrow 5. membranes-periosteum, Sharpey's fibers, endosteum |
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intramembranous ossification
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bones are directly ossified w/o any pre-existing cartilage (ex: skull bones and clavicle are formed directly from mesenchyme)
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Endochondral ossification
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bones develop from a pre-existing cartilage-most bones develop initially from hyaline cartilage
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What is the process of Intramembranous ossification
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1. An ossification center appears in the fibrous connective tissue and membrane.
2. Bone matrix (osteoid) is secreted w/in the fibrous membrane 3. Woven bone and periosteum form. 4. Bone collar of compact bone forms and red marrow appears. |
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What is the process of enchondral ossification?
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1 Formation of bone collar around hyaline cartilage model
2. Cavitation of the hyaline cartilage 3. invasion of the cavities by the periosteal bud and spongy bone formation 4. Formation of the medullary cavities and secondary ossification centers 5. Ossification of the epiphysis (hyaline cartilage remains in epiphysial plate and articular cartilages (surfaces). |
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Epiphysial plates and ossification of them
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cartilage cells form stacks--chondroblasts are at the top and divide quickly pushing epiphysis away from diaphysis--lengthens bone
Bones lengthen by growth of epiphyseal plates-cartilage is replaced with bone tissue Later on: cartilage stops growing and is replaced by bone tissues; diaphysis and epiphysis fuse |
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growth hormone
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produced by pituitary gland, stimulates epiphyseal plates
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thyroid hormone
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ensures that skeletn retain proper proportions
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sex hormones
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promote bone growht, later induce closure of epiphyseal plates
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Stages of a healing fracture
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1. Hematoma formation
2. Fibrocartilaginious callus formation 3. Bony callus formation 4. Bone remodeling |
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Communiuted fracture
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bone fragments into 3 or more pieces (common in aged)
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compression fracture
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bone is crushed (common in porous bones such as osteoporotic bones) subjected to extreme trauma like fall
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depressed fracture
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broke bone portion is pressed inward; typical of skull fracture
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epiphyseal fracture
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epiphyseal plate tears separating epiphysis from diaphysis
tends to occur where cartilage cells are dying and calcification of the matrix is occuring |
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greenstick fracture
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bone break incompletely, only one side of shaft splits and other side bends
common in kids whose bones have relatively more organic matrix and are more flexible than those of adults |
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spiral fracture
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ragged break occurs when excessive twisting forces or applied to a bone (common sports fracture)
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osteoporosis
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low bone mass, bone reabsorption outpaces bone deposition (occurs mostly in women after menopause) secretion of estrogens helps maintain bone density
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osteomalacia
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occurs in adults, bones are inadequately mineralized
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rickets
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occurs in kids, analogous to osteomalacia, weakened and bowed legs, malformation of head and ribs (vit d and calcium phosphate deficiency)
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paget's disease
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excessive rate of bone deposition but reduced mineralization leading to bone thickening
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achondroplasia
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congenital (genetic disease) defective cartilage growth and defective enchondral ossification leading to dwarfism
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osteosarcoma
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form of bone cancer
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functions of muscle tissue
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1. movement
2. joint stabilization 3. heat generation |
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3 functions of muscle movement
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skeletal muscle-moves body by moving bones
2 maintenance posture-enables body to remain sitting or standing 3 heat generation-contracts produce heat, keeps normal body temp |
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3 types of muscle
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1. skeletal muscle tissue
2. cardiac muscle tissue 3. smooth muscle tissue |
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skeletal muscle tissue
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packaged into skeletal muscles, cells are striated, makes up 40% of weight
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cardiac muscle tissue
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occurs only in walls of heart
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Arrangements of fascicles
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1. parallel-parallel to long axis of muscles and terminate inf lat tendons on both sides
2. Fusiform-nearly parallel to long axis, belly is narrowed toward tendons 3Circular 4Trianglular Pennate- 5. unipennate:fascicles are one side of tendon 6. bipenate-fascicles on both sides of a centrally positioned tendon (rectus femoris) 7. multipenate0fascicles are attached obliquely to tends from many diretions |
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Parts of a muscle
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belly, tendon, intermediate tendons
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neuromuscular junction
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where nerve contacts the muscle
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origin
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on bone at less moveable attachment
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insertion
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is on more moveable attachment
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insertion of bone
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more moveable attachment
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kyphotic curve
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concave anteriorly -increases with aging
thoracic and sacral regions |
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lordotic curve
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convex anteriorally
cervical and lumbar regions |
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scoliosis
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lateral curvature, slight degree is okay
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7th cervical vertebrae
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vertebrae prominnens
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hangman fracture
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arch of axis pushes dens posteriorly and compresses the brain stem leading to death
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vertebral arteries
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pass through the transverse foramen of the 5 upper cervical vertebrae--enters skull through foramen magnum
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axis
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odontoid process w/ anterior articular facet to articulate w/ atlas and a posterior articular facet for transverse ligament of atlas
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atlanto-occipital joint
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btw atlas and occipital bone
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atlanto-occipital articulation (upper head joint)
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btw superior articular facet of atlas and occipital condyles; forward and backward movement are permitted by this joint
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atlanto-axial articulation (lower head joint)
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consists of median and lateral atlanto-axial articulations btw c1 and c2 vertebrae; lateral joints are found btw the inferior articulate facets of the atlas and superior articular facets of axis; median joints located btw anterior articular facet of dens of axis and posterior surface of anterior arch of atlas
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apical ligament of dens
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attaches to anterior margin of foramen magnum
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alar ligaments
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from dens to lateral margin of foramen magnum
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cervical rib and disorders
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when the costal element is preserved independently. usually bilateral, if one sided usually on left side;remnant or development of a costal process on c7 vertebra which may lead to compression of subclavian artery leading to ischemic pain
may cause thoracic outlet syndrome-may lead to lower brachial plexus compression which can cause muscle weakness and pain in upper limb mass may be palpable in lower neck triad of disorder: 1. ischemic muscle pain due to compression of the subclavian artery 2. pain in ulnar side of the forearm and hand 3palpable mass over clavicle |
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costo-vertebral joints
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head of each rib articulates w/ 2 adjacent vertebrae and disk btw them
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costo-transverse joints
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btw the tubercle of the rib and transverse process of it's own vertebra
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lumbar puncture
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done at l3-l5 region
increstal line (iliac crests) is at the level of l4 approx (safe region) |
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costal groove
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contains intercostal nerve and vessels
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sternal puncture
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bone marrow needle biopsy for transplantation or cytological analysis
in midline in the body of sternum btw 2-3 ribs sattchments*never try in lower 2/3 of sternal body |
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median sternotomy
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in coronary bypass surgery
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congenital anomalies in sternum
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1. complete sternal cleft-associated w/ ectopia cordis
2. pectus excavatum (funnel chest) 3. pigeon chest 4. congenital sternal fissue (sternal foramen-makes hole in body) 5. aneurysm of the aorta-pulsatile mass at suprasternal notch (t2); arch is behind manubrium |
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zygapophysial joints (a-b)
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small vertebral joints btw articular processes
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unconvertebral joints
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btw cervical vertebrae-deelop by age and may become pathologic and permit disk herniation especially in c5 region
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herniation
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mostly posterolaterally where the anulus fibrosus is thinner
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fibrocartilage tissue
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anulus fibrosus (outter tense part ) and nucleus pulposus (soft jelly like tissue from notochord-embryonic tissue)
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ligamentum flavum
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yellowish in color due to elastic fibers, facilitate movement
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ligaments of vertebral column
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anterior long lig, post long lig, ligamentum flavum, ntertrans ligs, interspinous lig, supraspinal lig
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epidural anesthesia
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given through sacral hiatus to block pelvic nerves
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injury to coccygeal vertebrae
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falling on butt, can lead to painful delivery
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coccydyna
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pain in coccyx
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spina bifida
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failure of vertebral arches to form or fuse-usually in lumbar or sacral vertebrae
leading to meningocele-meninges bulge out of the verteral canal or meningomyelocele-meninges plus spinal cord bulge out |
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spina bifida occulta
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milder form in which some vertebrae do not close completely, and the malformation is covered by skin
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sacralization of l5
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fusion of l5 to sacrum
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lumbarization
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when s1 separates from sacrum
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spina bifida cystica
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associated w/ meningocele (herniation of meninges) or meningomyelocele (herniation of meninges and roots/spinal cord) sensory motor and autonomic syndromes including paralysis of limbs
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trapezius m
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elevation, retraction and rotation of scapula
innervation: spinal root of accessory nerve and c3-c4 (propioception and pain) |
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rhomboid m.s
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press scapula to the thoracic wall, retraction of scapula medially
dorsal scapular nerve |
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levator scapulae
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elevates scapula
dorsal scapular n. |
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latissimus dorsi m
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adduction and lowering the arm, medial roation and extension of arm, raises body toward arm when climbing
thoracodorsal n (c6,c7) |
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serratus post m.s
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intercostal nerves
rib elevation and acessory muscle of respiration (in copd) |
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lateral (superficial group)-illiocostalis m.s, logissimus m.s, splenius m.s
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for erect posture of the body and 2 splenii rotate the head
extensors when both sides contract and flexion when one side contracts primary spinal dorsal rami |
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interspinales muscles, intertransver muscle (cervicis and lumbar) spinalis thoracis and cervicis, capitis
rotator brevis and longus thoraciss, multi fidus, semispnalis cervics and capitis |
extensors when both sides contract and flexion when one side contracts;some stabilize and some rotate the vertebral column
various primary dorsal rami |
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suboccipital triangle
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3rd part of vertebral artery
suboccipital nerve c1 innervating all3 m.s suboccipital plexus of veins 9sensory innervation is greater occipital nerve c2) turning head backward of laterally |
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vertebrobasilar syndrome
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caused by atherosclerosis of veretbral arteris in and around triangle, due to insufficent blood supply to the hindbrain (this can happen when turning the head up and backfrom a period of time leading to dizziness and light-headednesss)
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bone marrow biopsy/transplantation
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l4 from above-intercrestial line), -used for bone marrow extraction, screw in needle and you feel hollow space and aspirate fluid (like blood but more viscous) do this for people with lukeimia-diff blood cells don’t function very well, they have blast cells-immature, which are released into circulation and they can’t function well , and platlets can’t stop bleeding
2. take bone marrow and put in another or same person, bone marrow transplantation-inject bone marrow and inject it into vessels—patient will no longer have blast cells 3. also take bone marrow to the sternum |
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bone grafting
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used to repair bone fractures that are extremely complex, pose a significant risk to the patient, or fail to heal properly
usually in iliac crest or sometimes fibula |
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angle of inclination
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degree btw neck and head of femur
wider in small children |
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congenital dislocation of hip
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common birth defect, more in female infants
acetabulum fails to form completely or the ligaments of hip joint ar loose to treat: splint or harness of straps to hold femur in proper place |
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metatarsals stress fractures
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repetitive stress on foot
2nd and 3rd are mostly affected treat: rest and wearing stiff or well cushioned |
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sacral plexus
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sciatic nerve, l4-5, s1-3
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sciatic nerve
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thickest nerve of body, compoed of common peroneal and tibial n.s
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com peroneal n.
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composed of dorsal rami
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tibial n.
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composed of ventral rami
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lumosacral trunk
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l4 and l5
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tensor fascia lata
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superior gluteal n.
abduction, medial rotation and flexion of thigh, protects knee joint |
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glut max
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inferior gluteal n. (l5-s2)
powerful extensor of hip joint ,lateral rotator, active in rising, sitting, climbing |
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gluteus medius
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superior gluteal n.
abduction, medial rotation of thigh, keeps pelvis level when opp leg raised |
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gluteus minimus
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superior gluteal n.
abduction, medial rotation of thigh, keeps pelvis level when opp leg raised |
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positive trendelenberg sign
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patient can't abduct pelvis on left femur-right buttock droops
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waddling gait
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e "waddling" is due to the weakness of the proximal muscles of the pelvic girdle
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piriformis m
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n. to priformis (sacral plexus s1-2)
lateral rotator and abductor of thigh, keeps femur head ina cetabulum muscle may be partially or totally absent |
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obturator internus
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n. to obturator internus
lateral rotators,stronger than medial rotators and control balance |
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ventral hip muscles
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obturaturs internus,sup/inf gemellus, quadratus femoris
lateral rotators,stronger than medial rotators and control balance lateral rotator when thigh is extened, abductor when flexed |
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superior/inf gemellus
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sup-n. to obturate int.
inf-n. to quadratis femoris lateral rotators,stronger than medial rotators and control balance |
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quadratis femoris
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n. to quadratus femoris
lateral rotators,stronger than medial rotators and control balance |
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hamstring m.s
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long head of biceps, semitendinous, semimembranous, adductor mag (ischial part)
tibial brand of sciatic n. flexors of knee joint (strong), extensors of hip joint (weak) |
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biceps femoris
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long: tibial n. , extension at hip
short: common peroneal n., flexor and lateral rotator at knee joint short head may be absent |
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semitendineous
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tibial n.
extension at hip, flexion and medial rotation at knee |
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semimembraneous
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tibial n.
hip extensor, knee flexor, medial rotator *extenion is the oblique popliteal lig |
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adductor magnus and minimus
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powerful adductor, lateral rotator (part inserted to linea aspera), medial rotator at knee joint, extensor at hip joint
hiatus tendineus innervation:tibial n. to part inserted to linea aspera, obturator n. to part inserted to adductor tubercle (puberty and conception) |
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adductor hiatus
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5th hiatus, contains: popliteal artery and vein
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triceps surae
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soleus, gastrocnemius and plantaris
all tibial n. |
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soleus m.
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hard and sustain motion (red fiber)
tibial n. |
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gastrocnemius
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fast movements (white fiber)
tibial n. |
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plantaris m.
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best plant flexors, active in walking
tibial n. |
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achille's tendon
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most powerful tendon and important in walking
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post deep leg muscles
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tibialis post, flexor hallusis long, flexor digit long
plantar flexiona nd supination of foot tibial nerve |
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popliteus m.
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tibial n.
flexion of knee, unlocking of knee joint, protection of lateral meniscus |
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peroneal group
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strongest pronator of foot
*eversion-standing on medial margin of foot while lateral margin is up superficial peroneal n. |
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greater sciatic forament
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divided by priformis m.
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suprapriformis hiatus
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superior gluteal vessels
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infrapiriformis hiatus
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inferior gluteal vessels--- (all of below reenter pelvis through lesser sciatic foramen)
internal pudendal artery and vein pudendal n. posterior cutaneous n. of thigh sciatic n. nerve to obturate internus |
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lesser sciatic forament
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internal pudendal vessels, pudendal n. n. to obturate int. and tendon of obturator int.
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popliteal region (sup)
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greater saphenous v.n, saphenous n. small saph vein, medial sural cutaneous n., branches of post femoral cutaneous n.
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popliteal fossa
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diamond shaped
contents: pop artery and vein, tibial n. common peroneal n, genicular arteries and veins floor composed of: pop surface of femur, knee joint and upp tibial bone, oblique pop lig and pop muscle w/ covering fascia gastrocnemius is imferior, and semitend/semimem/biceps are superior |
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medial retromalleolar region
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flexor retinaculum
great saph vein, and saph n. under : tibialis post tend, flex digit long, post tib artery and vein, tibial n, flex hallucis long |
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lumbar plexus
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obturate n., femoral n., lumosacral trunk subcostal n, iliohypogastricn. ilioinguinal n genitofamoral n, lateral cutaneous n of thigh
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gracilis m
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obturate n.
adductors of thigh, flexor at hip and knee jints |
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pectineous m.
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femoral/obtuartor n.
adductors of thigh and flex hip joint |
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adductor brevis m.
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obturate n.
adductor of thigh and flexor of hip joint |
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adductor long
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obturate n.
adduction of thigh , hip flexion |
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iliopsoas m
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chief flexor of hip
lumbar plexus to psoas and femoral to iliacus |
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quad. femoris
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rectus femoris,vastus intermedius, vastus medialis, vastus lateralis
chief extensor of knee joint rectus fem-flexes hip femoral n. |
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sartorious
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acts on 2 joints, flexes at both hip and knee joints
femoral n. |
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femoral triangle
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content: lateral femoral cutaneous n., femoral n, structres inside femoral sheath
borders: sartorious(lat) add long (med) ilioinguinal lig (sup) floor: iliopsoas, pectineus and add long |
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femoral ring
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fem artery and genitofemoral n.
fem vein lymph nodes and areolar tissue (fem canal)) rosenmuller nod-drain glans penis and clitoris |
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femoral hernia
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painful, more in female
below and lateral to pubic tubercle |
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arteris to pelvis
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internal iliac artery and branches
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subinguinal region
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exteneral pudendal vessels, superifical epigastric vessels, sup circumflex iliac vessels
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saphenous hiatus
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is an oval opening in the superomedial part of the fascia lata,
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subsartorious(adductor, Hunter's) canal
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starts distal to femoral triangle
femoral a. and v. , saph nerve, n. to vastus medialis, small branches of obturator n. and great saph. v. |
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tibalias ant.
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dorsiflexion and supination w/ peron. l., keep transverse arch on foot
deep peroneal n. |
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extensor digitorum longus
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dorsiflexion of foot
deep personal n. |
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peroneus tertius
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extensor digitorum's additinal part, may extend to 5th metatarsal, may be muscle
deep peronneal n. |
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extensor hallucis longus
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first toe dorsiflexion
deep peroneal n. |
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extensor digitorum brevis
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dorsiflexion of digits
deep peroneal n. |
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extensor hallucis brevis
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dorsiflexion of 1st digit
deep peroneal n. |
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plantar aponeurosis
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longitudinal and transverse fibers, maintain longitudinal arch of foot and protects vessels/nerves there
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abductor hallucis
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medial plantar n.
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flexor hallucis brevis
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2 heads, medial and lateral
medial plantar n. |
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flexor digitorum brevis
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medial plantar
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lumbricals (4)
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plantar flexion of 2nd-5th digit
medial plantar n. 2 1 and lat plantar n to rest |
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quadratus plantae
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lateral plantar n.
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plantar interossei mm, blue
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1 head, adductors of digits
lateral plantar n. |
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pdorsal interossei mm red
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2 heads
abductors of digits lateral plantar n. |
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adductor hallucis
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lateral plantar n.
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opponens digit minimi
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lat plantar n.
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flexor digit minimi
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lateral plantar n.
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abductors digit minimi
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lateral plantar
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dorsal artery of foot, or dorsalis pedis artery
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when anterior tibial a. passes beneath sup . extensor retinaculum may give the lateral tarsal artery
gives deep branch to join plantar arch |
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arcuate a.
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lateral tarsal and dorsalis pedis arteries
give rise to metatarsal and dorsal digital arteries, |
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pulsation of dorsalis pedis a.
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may be lost in some peripharal vascular diseases such as Burgers disease or in diabetes melitus
occlusion of blood vessels lead to gangrene and autoamputation of first toe scars on skin may develop |
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osteophyte
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type of bone spur,[1] are bony projections that form along joints.[
can happen as you age Osteophytes form because of the increase in a damaged joint's surface area. This is most common from the onset of arthritis. Osteophytes usually limit joint movement and typically cause pain.[1] |
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lumbar rib
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A rib articulating with the transverse process of the first lumbar vertebra;
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sacral hiatus
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a normally occurring gap at the lower end of the sacrum, exposing the vertebral canal, due to failure of the laminae of the last sacral segment to coalesce. It is closed by the sacrococcygeal ligament and provides cannular access to the sacral epidural space for administration of anesthetics (caudal nerve blocks).
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tube thoracostomy and thoracocentsis
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in intercostal space--drain pathologic air/gas or fluid from pleural cavity
usually close to upper border of rib to avoid injury to intercostal n. and vessels all layers of skin down to parietal pleura (but not visceral pleura) are punctured in this intervention |
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intercostal n. block
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in intercostal space--intercostl n.s can be anesthetized during painful conditions (ex: fracture of rib, shingles)
needle is inserted close to lower border of rib in order to reach n.s ** must be careful b/c nerve and vessels pass beneath ribs and we don't want to sever them |
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gynecomastia
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enlarged male breasts--
may develop during neonatal stage from mom's hormones, adolescene or older people may be small lump under areola and mass can be tender secondary to hormonal inbalances can be from klinefelters, cirrhosis, malnutrion, testicular suprarenal caner, gynecomastia, drugs, pubertal abnormality |
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muscles which elevate thoracic cage
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scalene m.s, sternocleidomastoi,d interocstal, pectoralis major and minor
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musculocutaneous n. damage
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Although rare, the musculocutaneous n. can be affected through compression due to hypertrophy or entrapment between the biceps aponeurosis & brachialis fascia or it may be injured through stretch as occurs in dislocations & sometimes in surgery.
Isolated injury, causes weakness of elbow flexion & supination of the forearm. A discrete sensory disturbance is present on the radial side of the forearm. The nerve is usually involved in an upper brachial plexus palsy |
