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125 Cards in this Set
- Front
- Back
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Median (midsagital) plane
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Directly down midline
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Saggital plane
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Line from front to back
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Coronal (frontal) plane
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Line from left to right
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Horizontal (transverse) plane
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Across body in a belt-like fashion
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Longitudinal section
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Run lengthwise or parallel to the long axis of the body
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Transverse section
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Cross section, slices cut at 90 degree angles to long axis of body
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Oblique sections
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Not longitudinal and not transverse - angled to those
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Axial skeleton
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Skull, spine, sternum, ribs
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Appendicular skeleton
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Shoulder and pelvic girdles and extremity bones
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Fibrous joint
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United by fibers, minimal movement (i.e. suture in skull, sacroiliac joint)
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Primary cartilaginous joint
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Epiphysial plate
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Secondary cartilaginous joint
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Intervertebral disks
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What is included in the epidermis (2 layers)?
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Superficial cellular level - protection, deep basal level - regenerative, pigment (small amount of vascularization)
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What is the function of the dermis?
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Collagen and elastin - very regenerative, skin tone, protection, nourishment, Langer's lines
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What are Langer's lines?
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Collagen fibers that are set in a particular pattern that determines the skin tension lines in the body - used to make incisions during surgery
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What are the three types of appendages in the skin?
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Hair follicles in dermis (erector pillae muscle), Sabeceous glands (oil glands about 1/3 the way up the hair follicle), eccrine glands (sweat - thermoregulatory cooling, located in superficial fascia layer)
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What is in the superficial fascia just under the skin?
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Loose connective tissue, fat, superficial vessels and cutaneous nerves
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What is in the deep fascia?
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Invests muscles, nerves and vascular structures, no elasticity, does not contract, not mobile, continues and lines bone as the periosteum
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What travels through the transverse foramen of the cervical vertebrae?
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Vertebral arteries
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What holds the dens of axis in place?
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Transverse foramen
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The fracture of what bone may disrupt the transverse ligament allowing for dens to herniate toward the spinal cord? Can happen in a driving accident
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Atlas
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What is the "hangman's fracture"?
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Fracture of the axis - vertebral arch fracture common in cervical fracture - hyperextension of head on neck
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What is the vertebrae prominens?
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C7, can be palpated during PE to estimate anatomical region of complaint
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What structure does the level of T3 correlate with?
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Spine of scapula
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What structure does the level of T7 correlate with?
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Inferior angle of scapula
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What is the most commonly fractured vertebrae?
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T12
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What structure does the level of L4 correlate with?
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Iliac crest
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What is the annulus fibrosis?
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Outer fibrocartilage ring of intervertebral disc (if it tears, nucleus pulposus leaks out - herniated disc)
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What is the nucleus pulposus?
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Central gelatinous portion of intervertebral disc
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What is the outer fibrocartilage ring of the intervertebral discs called?
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Annulus fibrosis
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What is the central gelatinous portion of the intervertebral discs called?
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Nucleus pulposus
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Where is the posterior longitudinal ligament located?
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Lines anterior spinal canal - connects vertebral bodies, prevents hyperflexion of spine and prevents disc herniation
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Where is the anterior longitudinal ligament?
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Connects the vertebral bodies on anterior surface, prevents hyperextension of spine
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Where is the supraspinous ligament of the vertebrae located?
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Runs from spinous process to spinous process
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Where is the ligamentum flavum located?
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Runs from adjacent lamina to help preserve normal curvatures of spine
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Where is the ligamentum nuchae located?
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Provides area of muscle attachment in neck
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Where is the transverse ligament (alar ligament) located?
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On the atlas, prevents dens from herniating inito spinal cord
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What is kyphosis?
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Primary curvatures maintained from fetal development - hunchback appearance
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What is lordosis?
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Secondary curvatures - excessive inward curvature of lumbar region of spine - think of infant learning to walk or pregnant woman
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What is cauda equina syndrome?
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Narrowing of spinal canal puts pressure on cauda equina - pt may experience bowel and bladder incontinence and "saddle" anesthesia - surgical emergency
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What are dermatomes?
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Sensory regions served by one single spinal nerve
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What are myotomes?
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Motor regions served by single spinal nerve
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Within what area is the CSF contained?
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Subarachnoid space
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What is the dermatome T10 a landmark for?
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umbilicus
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What is the dermatome T12 a landmark for?
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iliac crest, inguinal ligament, pubis symphysis
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What is the dermatome L4 a landmark for?
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patella, medial malleolus
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What is the dermatome L5 a landmark for?
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Lateral aspect of leg, big toe, plantar aspect to heel
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What is a common strain that causes low back pain?
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Thoracolumbar fascia
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What are four characteristics of the glenoid labrum?
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Fibrocartilagenous rim, long head of biceps tendon insertion, poor blood supply - may be injured in overhead throwing, tendon of biceps muscle attaches superior to it
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What borders the quadrangular space? What goes through it?
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Teres major, long head of triceps, teres minor, humerus. Transmits axillary nerve, post humeral circumflex artery and vein
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What muscles make up the rotator cuff?
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Supraspinatus, infraspinatus, teres minor
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What are the main branches off of the sciatic nerve?
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Tibial, common fibular, superficial and deep fibular
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What seven structures exit the pelvic cavity through the greater sciatic foramen?
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Piriformis, Pudendal, Nerve to obturator internus, posterior femoral cutaneous nerve, internal pudendal vessels, sciatic, gluteal nerves and vessesl (superior and inferior)
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What ligament primarily forms the greater sciatic foramen?
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Sacrotuberous ligament
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What ligament primarily forms the lesser sciatic foramen?
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sacrospinous ligament
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What structures enter the perineum through the lesser sciatic foramen?
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Pudendal nerve, internal pudendal artery and vein, obturator internus muscle
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What is the largest muscle in the body?
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Gluteus maximus
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Where should intramuscular injections be given into the gluteal region and why?
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Superior lateral quadrant to avoid sciatic and superior gluteal nerves
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What muscle can put pressure directly on the sciatic nerve causing sciatica?
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Piriformis
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What is the name of the axillary tail?
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Tail of Spence
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What is the retromammary space?
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Loose adipose tissue that separates the breast from the pectoral muscle, allows for mobility, may be one location of placement of breast implants
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What is the name for the connective tissue in the breast that helps to maintain structural integrity?
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Cooper's ligament, aka sensory ligaments of cooper aka fibrocollagenous septa
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What arteries supply the breast?
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Brances off axillary and branches off internal mammary
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What veins drain the breast?
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Mainly branches to axillary, also branches to internal mammary
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What are is the main lymphatic drainage of the breast (75%)?
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Axillary nodes
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What is the smaller areas of lymphatic drainage of the breast (25%)?
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internal thoracic (parasternal) and a small amount to subdiaghragmatic
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What is Peau d'orange?
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Condition in which the cooper's (suspensory) ligaments of breast are held tight while the remaining breast tissue becomes edematous resulting in the look of an orange peel
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What are the two areas for breast implants?
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Sublandular - retromammary space - more mobile - can change with gravity, submuscular - between pec major and minor
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What damage would cause a winged scapula?
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Damage to the long thoracic nerve
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What are the four walls of the axilla pyramid?
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Anterior: pec major/minor, Posterior: scapula/subscapularis, Lateral: humerus, Medial: thoracic wall/serratus anterior
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What lies within the axilla?
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Adipose tissue, axillary sheath (1st part of axillary artery, axillary vein, brachial plexus cords, axillary lymph nodes
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What vein is often used for central venous access?
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Axillary vein
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What are the possible adverse outcomes when inserting central venous access?
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Pneumothorax, cannulation of axillary artery instead of ven
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What does the dorsal venous arch drain into?
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Cephalic and basilic veins
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What branches of the axillary artery are in the 1st part?
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Superior thoracic artery
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What branches of the axillary artery are in the 2nd part?
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Thoracoacromial, lateral thoracic arteries
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What branches of the axillary artery are in the 3rd part?
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Subscapular to thoracodorsal, posterior circumflex humeral, anterior circumflex humeral
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What are the three trunks of the brachial plexus?
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Superior, Middle, Inferior
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What would cause a winged scapula?
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Lesion of the Long thoracic nerve
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What would a lesion to the long thoracic nerve cause and what could be a mechanism of injury?
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winged scapula, damage during mastectomy/axillary dissection
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What nerve lesion would cause a loss of horizontal abduction of shoulder, loss of deltoid shape and a sensory loss in the lateral arm below shoulder?
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Lesion of the axillary nerve
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What functions and sensations would be lost with an axillary nerve lesion? What is possible mechanism of injury?
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Loss of horizontal abduction of shoulder, loss of deltoid shape and loss of sensation in the lateral arm below shoulder. Could occur with anterior shoulder dislocation, humeral neck fracture, or rotator cuff surgery
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What nerve lesion would cause a decreased elbow flexion and supination and cause sensory loss of the lateral forearm?
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Musculocutaneous nerve
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What functions and sensations would be lost with a musculocutaneous nerve lesion? What is a possible mechanism of injury?
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Decreased elbow flexion, supination, loss of sensation in lateral forearm. Could occur with anterior shoulder dislocation, entrapment at coracobrachialis
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What nerve lesion would cause a drop wrist and sensation loss in the posterior later arm and lateral dorsum of hand?
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Radial nerve
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What functions and sensations would be lost with a radial nerve lesion? What is a possible mechanism of injury?
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Drop wrist, sensation loss at posterior lateral arm and lateral dorsum of hand. Could occur with humeral shaft fracture (radial groove), penetrating wound to forearm, "saturday night palsy"
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What nerve lesion would cause "ape hand" or active "hand of benediction" (loss of pronation of forearm, decreased wrist flexion, weakness of opposition of thumb to fingers, loss of finger flexion at PIPs and DIPs of index and middle finger? Also radial portion of palm, dorsum of tips of lateral 3 fingers
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Median nerve at elbow
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What functions and sensations would be lost with median nerve lesion at the elbow? What is a possible mechanism of injury?
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Ape Hand, Hand of benediction, radial portion of palm, dorsum of tips of lateral 3 fingers. Could occur by a penetrating wound at elbow "pronator teres syndrome"
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What nerve lesion would cause weakened opposition of thumb to fingers "ape hand" and loss of sensation at radial portion of palm and dorsum of tips of lateral three fingers?
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Median nerve at wrist
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What functions and sensations would be lost with median nerve lesion at the wrist? What is a possible mechanism of injury?
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Weakened opposition of thumb to fingers, "ape hand", loss of sensation of radial portion of palm and dorsum of tips of lateral 3 fingers. Could occur with wrist laceration (attempted suicide) or carpal tunnel syndrome
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What nerve lesion would cause a passive "claw hand" of medial two digits, loss of finger abduction/adduction, loss of flexion of DIP of medial two fingers and sensation loss of ulnar side of palm and dorsum of hand?
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Ulnar nerve lesion at elbow
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What function and sensations would be lost by an ulnar nerve lesion at the elbow? What is possible mechanism of injury?
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Passive claw hand, sensation loss at ulnar side of palm and dorsum of hand. Could occur with trauma to elbow, entrapment at cubital tunnel
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What nerve lesion would cause a loss of function at deltoid, rotator cuff, biceps, brachialis and brachioradialis "waiter's tip" position. Also would cause sensation loss at posterior and lateral arm, radial side of forearm thumb and first finger
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Superior Trunk (Erb's Palsy)
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What function and sensations would be lost by a superior trunk lesion (Erb's palsy)? What is a possible mechanism of injury?
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Loss of deltoid, rotator cuff, biceps, brachialis and brachioradialis "waiter's tip" position, loss of sensation at posterior and lateral arm, radial side of forearm, thumb and first finger. Could occur with traction between neck and shoulder, chronic use of heavy backpack
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What nerve lesion would cause a loss of function of short muscles of hand, complete "claw hand" and sensation loss on ulnar side of forearm and hand?
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Inferior trunk (Klumpke's palsy)
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What function and sensations would be lost by an interior trunk lesion (klumpke's palsy)? What is a possible mechanism of injury?
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Loss of function of short muscles of hand, complete "claw hand", sensation loss of ulnar side of forearm and hand. Could occur with sudden pull of upper extremity upwards, obstetric injury during breech delivery
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What structures make up the anatomical snuffbox?
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Extensor pollicis longus, extensor pollicis brevis, abductor pollicis longus, base is the scaphoid bone with overlaying radial artery
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What is contained in the flexor retinaculum and carpal tunnel?
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median nerve, tendons of flexor digitorum superficialis, flexor digitorum profundus, and flexor pollicis longus
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What passes anteriorly to the flexor retinaculum?
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ulnar artery and nerve, palmaris longus tendon
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What is avascular necrosis of the femur and how does it happen?
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Because the artery to the head of the femur travels through the ligamentum teres (round ligament of the femur), there is a risk of avascular necrosis with dislocation or fracture of the hip. Can also be caused by exposure to a lot of steroids over time
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Anterior cruciate is taught in....
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Extension
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Posterior cruciate is taught in....
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flexion
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What is the test to look for torn cruciate ligaments of the knee?
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Drawer tests/Lachman's
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What is the unhappy triad?
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Injury to medial miniscus, ACL, medial colateral (MAM)
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What is a "housemaid's knee?"
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Prepatellar bursitis
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What is an intra-articular knee injection?
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Injection commonly performed for the treatment of DJD. Usually a coricosteroid or hyaluronic acid derivative injected into the join capsule
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What is the implications of fibular fracture?
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Because it's non-weight bearing a fracture of the fibular at the proximal end or shaft is often not casted and generally heals without intervention.
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What foot bone is most likely to get avascular necrosis and is difficult to heal?
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Navicular
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What is the most common ankle sprain?
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Inversion injury causing damage to the anterior talofibular ligament, posterior talofibular ligament and calcaneofibular ligament
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What is compartment syndrome?
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Increased pressure in compartments that can damage internal structure caused by fracture and swelling
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What is the main difference between injuring the patellar tendon versus the quadriceps tendon?
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The patellar tendon is functionally a ligament so it has less blood supply than the quadriceps tendon and therefore takes longer to heal.
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What is a "groin pull" commonly caused by?
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Over stretch and subsequetn spasm or strain of the adductor muscles of the thigh
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What are the boundaries of the femoral triangle? What are the contents?
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Boundaries: inguinal ligament, sartorius and adductor longus. Content: Femoral nerve, femoral artery, femoral vein
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What results from abdominal structures passing through the femoral canal? It may present as a mass inferior to inguinal ligament and has a high risk of strangulation?
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Femoral hernia
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What artery may be cannulated to gain access to coronary arteries, chambers, etc during cardiac catheterization?
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Femoral artery
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What is the popliteal fossa bound by?
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Semitendinosis/membranosis, biceps femoris, lateral and medial head of gastrocnemius
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What are the contents of the popliteal fossa?
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fat, small saphenous vein, popliteal artery and vein, tibial nerve with common peroneal nerve branch, cutaneous nerves, lymph nodes, popliteus muscle
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What vein is a common place for a DVT to corm especially following lower extremity or pelvic surgery?
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Popliteal vein
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What is tarsal tunnel syndrome?
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Caused by pressure on the tibial nerve from compression in the tarsal tunnel which contains the tendons of the deep posterior compartment of the leg. Causes pain in sole of foot.
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What are some signs of fibular nerve injury?
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Footdrop, loss of eversion
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What causes shin splints?
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Forecful action of the tibialis anterior muscle, often because of exertion with stretching
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What is superficial peroneal (fibular) nerve entrapment?
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Chronic ankle sprain, traction injury to nerve, pain at lateral leg and dorsal ankle, parasthesia ("pins and needles")
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What is the location to cause knee jerk (deep tendon reflex)?
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Patella tendon - impulse comes from L2-4
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What is the location to cause ankle jerk (deep tendon reflex)?
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Calcaneal tendon - impulse comes from S1-2
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What is Morton's Neuroma?
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Compression on plantar nerve between 3rd and 4th metatarsal bones. Causes metatarsalgia, pain worse with ambulation. Can be caused by wearing narrow shoes/heels
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