Anatomy Exam 2: The Reckoning

Front 1

alternative name for ANS

Back 1

also known as the Visceral Motor System

Front 2

ANS fxn

Back 2

Controls automatic, involuntary functions

Front 3

2 divisions of ANS and fxns

Back 3

1. Parasympathetic Division - maintains homeostasis (a stable physiological state).
2. Sympathetic Division - prepares for stressful situations ("fight or flight" reactions).

Front 4

Motor neurons of ANS innervate these structures

Back 4

1. Cardiac muscle (in heart)
2. Smooth muscle (in most hollow organs)
3. Glands (both endocrine and exocrine)

Front 5

How motor neurons are organized between CNS and target organ

Back 5

2-neuron chain
1. First motor neuron has its nerve cell body in the CNS - it is known as a preganglionic neuron.
2. Second motor neuron has its nerve cell body in a ganglion in the peripheral nervous system (PNS) - it is known as a postganglionic neuron

Front 6

Sympathetic Division (Thoracolumbar Outflow) of ANS origin

Back 6

Originates in spinal cord levels T1 - L2.

Front 7

Preganglionic nerve cells location

Back 7

located in the intermediolateral (IML) cell column

Front 8

Sympathetic division (thoracolumbar outflow) Preganglionic nerve cells path

Back 8

1. Located in the intermediolateral (IML) cell column.
2. Exit the CNS via ventral spinal nerve roots to enter spinal nerves T1 - L2.
3. Pass through the white communicating rami (14 pairs) associated with spinal nerves T1 - L2.
4. Fibers enter the sympathetic chain ganglia

Front 9

Fibers enter the sympathetic chain ganglia to:

Back 9

a. Synapse with postganglionic neurons at the same level.
b. Ascend to a higher level or descend to a lower level to synapse.
c. Continue on to a collateral ganglion in the abdominal or pelvic cavity before synapsing.

Front 10

Sympathetic Chain ganglia characteristics

Back 10

1. Bilateral structures located adjacent to (parallel) the vertebral column.
2. Extend vertically from the base of the skull to the coccyx.
3. Connected to spinal nerves by:
a.White communicating rami - 14 pairs (preganglionic) associated with spinal nerves T1 - L2.
b. Gray communicating rami - 31 pairs (postganglionic) associated with all spinal nerves

Front 11

Components of the Visceral Reflex Arc

Back 11

1. Sensory neuron, classified as general visceral afferent (GVA)
2. Connecting neuron (in spinal cord)
3. Two motor neurons, classified as general visceral efferent (GVE), including preganglionic and postganglionic neurons.

Front 12

Parasympathetic Division (Craniosacral Outflow) origins

Back 12

Cranial portion originates in brain stem

Sacral portion originates in spinal cord levels S2 - S4

Front 13

Parasympathetic cranial portion pathway

Back 13

1. Preganglionic parasympathetic neurons originate in brain stem motor nuclei associated with CN III, VII, IX and X.
2. Preganglionic nerve fibers are distributed to the cranial region in conjunction with four parasympathetic ganglia associated with CN III, VII (two ganglia) and IX.
3. Preganglionic nerve fibers are also distributed to the thoracic and abdominal viscera via CN X. These fibers synapse in the walls of target organs.
4. Short postganglionic fibers are contained entirely within the walls of the target organs.

Front 14

Parasympathetic Division sacral portion pathway

Back 14

1. Preganglionic nerve fibers exit the CNS via ventral spinal nerve roots of S2 -S4 to enter the pelvic splanchnic nerves (nervi erigentes).
2. Pelvic splanchnic nerves are distributed to the pelvic viscera and external genitalia.
3. Preganglionic fibers synapse in the walls of the target organs with short postganglionic neurons.
4. The postganglionic neurons are contained entirely within the walls of the target organs.

Front 15

Neurotransmitters

Back 15

chemicals released at synapses between pre- and postganglionic neurons and between postganglionic neurons and effector organs

Front 16

Parasympathetic preganlionic and postganglionic NT

Back 16

both Acetylcholine

Front 17

Sympathetic preganlionic and postganglionic NT

Back 17

Pre- Ach

Post- Norepinephrine

Front 18

Sympathetic (sweat glands) pre and post gangionic NT

Back 18

both Ach

Front 19

Sympathetic (adrenal medulla) NT

Back 19

Preganlionic- epinephrine into bloodstream

Front 20

great saphenous vein location

Back 20

begins at the medial side of the dorsal venous arch of the foot, ascends on the medial side of the leg and thigh, and terminates in the femoral vein on the anterior thigh, after passing through the saphenous opening in the deep fascia

Front 21

tributaries of great saphenous vein

Back 21

1. External pudendal v.
2. Superficial circumflex iliac v.
3. Superficial epigastric v.

Front 22

external pudental vein drains

Back 22

drains the penis and scrotum in the male, the vulva (external female genitalia) and lower vagina in the female, and the lower half of the anal canal

Front 23

superficial circumflex iliac vein drains

Back 23

drains the lateral thigh

Front 24

superficial epigastric vein drains

Back 24

drains the anterior abdominal wall inferior to the umbilicus

Front 25

Lymph nodes of LE location and fxn

Back 25

Located behind knee (popliteal nodes) or inguinal region. The superficial inguinal nodes are divided into two groups, a superior, horizontal group and an inferior, vertical group. The superior nodes drain the structures drained by the three tributaries of the femoral vein described above, while the inferior nodes drain the remaining superficial tissues of the lower extremity.

Front 26

cutaneous nerves of anterior and medial thigh

Back 26

1. lateral, intermediate, and medial femoral cutaneous nerves of the thigh
2. the ilioinguinal nerve
3. the femoral branch of the genitofemoral nerve
4. obturator nerve

Front 27

Fascia Lata characteristics

Back 27

the deep fascia of the thigh. Thin, dense layer of connective tissue surrounds the two thighs like pantyhose. Form septa that effectively divide the thigh into three muscular compartments (medial, anterior and posterior). Most of the fibers are horizontal; except on the lateral surfaces of the thigh and proximal tibia its fibers are vertically oriented forming ileotibial tract. The aponeuroses of the gluteus maximus and TFL muscles contribute to the formation of this tract.

Front 28

Anterior compartment of thigh contents

Back 28

Quadriceps femoris
Sartorius muscles
Femoral artery and its branches
Femoral vein with its tributaries
deep inguinal lymph nodes

Front 29

Femoral sheath compartments and contents

Back 29

Lateral compartment - contains the femoral artery.
Middle compartment - contains the femoral vein.
Medial compartment or femoral canal - contains some lymph nodes and lymphatic vessels. The femoral canal is continuous with the abdominal cavity via the femoral ring, or superior opening of the femoral canal

Front 30

femoral hernia

Back 30

Abdominal viscera such as the small intestine, protrudes through the femoral ring into the femoral canal. Three times more frequent in women than men, due in part to sexual differences in the osteology of the os coxae (hip bones)

Front 31

Femoral artery location

Back 31

the continuation of the external iliac artery, enters the thigh beneath the inguinal ligament, midway between the anterior superior iliac spine and the pubic tubercle

Front 32

branches of femoral artery

Back 32

1. External pudendal
2. Superficial circumflex iliac
3. Superficial epigastric
4. Profunda femoris

Front 33

external pudental artery supplies

Back 33

supplies the penis and scrotum in the male, the vulva and lower vagina in the female, plus the lower half of the anal canal in both sexes

Front 34

Superficial circumflex iliac artery supplies

Back 34

the lateral thigh

Front 35

Superficial epigastric artery supplies

Back 35

supplies the anterior abdominal wall inferior to the umbilicus

Front 36

profunda femoris artery supplies

Back 36

lateral and medial circumflex branches- supply the hip joint and gluteal region

four perforating arteries- supply the posterior and medial compartments of the thigh

Front 37

tributaries of great saphenous vein

Back 37

correspond to some of the branches of the femoral artery, including the superficial circumflex iliac, superficial epigastric and external pudendal veins

Front 38

tributaries of femoral vein

Back 38

veins draining the muscles in the anterior and medial compartments of the thigh and the profunda femoris vein

Front 39

lymphatics of fascia lata

Back 39

one to three lymph nodes located medial to the femoral vein, within the femoral canal or just inferior to it. Drain lymph from the deep structures of the lower extremity, the penile urethra, the glans penis, and the glans clitoris. Drain to the external iliac nodes, adjacent to the external iliac artery

Front 40

Femoral triangle boundaries

Back 40

Base - formed by the inguinal ligament.
Lateral side - marked by the medial border of the sartorius m.
Medial side - formed by the lateral border of the adductor longus m

Front 41

Femoral triangle contents

Back 41

femoral artery and its branches
femoral vein and its tributaries
femoral nerve
lymphatics
femoral sheath and its contents

Front 42

Medial compartment of thigh muscles blood supply

Back 42

obturator and profunda femoris arteries

Front 43

Adductor canal boundaries

Back 43

Lateral wall - formed by the vastus medialis.
Medial wall - formed by the adductor longus and adductor magnus.
Roof - formed by the sartorius
6 inches long

Front 44

Contents of adductor canal

Back 44

1. Femoral a. and v.
2. Saphenous a.
3. Saphenous n.
4. Nerve to the vastus medialis

Front 45

saphenous artery and nerve characteristics

Back 45

The saphenous artery and nerve become cutaneous as they pass between the gracilis and sartorius to the medial side of the knee. The saphenous nerve accompanies the great saphenous vein to terminate on the medial side of the foot

Front 46

femoral artery becomes ________ after passing through adductor hiatus of adductor canal

Back 46

popliteal artery, is located in the popliteal fossa

Front 47

Cutaneous innervation of gluteal region

Back 47

Lateral cutaneous branches of T12 and the iliohypogastric (L1) nerves
The superior cluneal nerves-lateral branches of dorsal primary rami of L1-L3
The middle cluneal nerves are the lateral branches of dorsal primary rami of S1-S3
The inferior cluneal nerves are branches of the posterior femoral cutaneous nerve.

Front 48

superficial fascia of gluteal region characteristics

Back 48

the buttock is endowed with a relatively thick superficial layer of fat. It is continuous with adjoining regions including the superficial fascia of the back, abdomen, perineum and the thigh

Front 49

deep fascia of gluteal region characteristics

Back 49

this fascia is attached above to the crest of the ilium and the sacrum. It covers the gluteus maximus and gluteus medius and can be traced laterally or inferiorly to become continuous with the fascia lata of the thigh

Front 50

gluteal region blood supply

Back 50

branches of internal iliac artery

Front 51

superior gluteal arteries deep branches supply

Back 51

gluteus medius
gluteus minimus
tensor fasciae lata

Front 52

inferior gluteal artery supplies

Back 52

gluteus maximus
obturator internus
gemelli
quadratus femoris
superior part of the hamstring muscles

Front 53

cruciate anastomoses vessels

Back 53

inferior gluteal aa.
lateral femoral circumflex aa.
medial femoral circumflex aa.
1st perforating branch of profunda femoris

Front 54

HS muscles characteristics

Back 54

semitendinosus, the long head of the biceps femoris, and the semimembranosus.
Originate on the ischial tuberosity
Biceps femoris is positioned laterally, while the medially located muscles are the semimembranosus and semitendinosus

Front 55

vasculature of posterior thigh

Back 55

supplied by the four perforating branches of the profunda femoris artery.
Inferior gluteal artery supplies several small branches to the muscles attached to the ischial tuberosity.
Femoral artery continues as the popliteal artery as it enters the popliteal fossa

Front 56

Applied anatomy of posterior thigh

Back 56

HS gluteus maximus in extending the thigh. Since HS normally maintain more tone than does the gluteus maximus, patients with paralyzed posterior HS tend to fall forward. It is a common experience that the HS are not long enough to allow free simultaneous flexion of the thigh and extension of the leg (movements involved in bending over with the knees straight to touch the floor). In other words, sharp flexion of the thigh produces flexion of the leg as a result of the resistance of the HS, and extension of the leg produces extension of the thigh for the same reason

Front 57

basic characteristics of the leg

Back 57

the portion of the lower extremity that extends between the knee and ankle. The skeleton of the leg consists of the tibia and fibula, which are firmly held together by an interosseous membrane. The leg functions in weight bearing and propulsion for locomotion.

Front 58

lesser saphenous vein location

Back 58

ascends posteriorly to the lateral malleolus and then continues on the back of the leg to become a tributary to the popliteal vein

Front 59

cutaneous innervation of the leg supplied by

Back 59

posterior femoral cutaneous
saphenous
superficial peroneal
lateral and medial sural cutaneous

Front 60

crural fascia characteristics

Back 60

- the deep investing fascia of the leg is attached to the anterior and medial borders of the tibia. Two intermuscular septa (anterior and posterior) extend from the crural fascia to the fibula. The interosseous membrane together with the intermuscular septa divide the leg into three muscular compartments (anterior, lateral and posterior), which contain groups of muscles that provide movement at the ankle and foot

Front 61

blood supply anterior compartment of the leg

Back 61

anterior tibial artery, a terminal branch of the popliteal artery

Front 62

muscles of the anterior compartment of the leg

Back 62

tibialis anterior
extensor digitorum longus
peroneus tertius
extensor hallucis longus

Front 63

blood supply lateral compartment of leg

Back 63

fibular circumflex arteries, branches of the peroneal artery

Front 64

muscles of lateral compartment of leg

Back 64

peroneus longus

peroneus brevis

Front 65

posterior compartment of leg blood supply

Back 65

posterior tibial artery and one of its branches, the peroneal artery

Front 66

muscles of posterior compartment of leg

Back 66

gastrocnemius
soleus
plantaris
popliteus
flexor digitorum longus
flexor hallucis longus
tibialis posterior

Front 67

7 tarsal bones of the foot

Back 67

the talus, calcaneus, navicular, cuboid, and three cuneiforms

Front 68

Ankle (talocrural) joint

Back 68

includes articulations of the talus, tibia and fibula. The weight of the body rests upon the top of the talus. Movements occurring at this joint include dorsiflexion (raising the toes off the ground) and plantar flexion (raising the heel off the ground)

Front 69

Joints of the foot

Back 69

include several gliding joints in the tarsal and metatarsal areas, and condyloid joints in the metatarsal-phalangeal and interphalangeal areas. Movements such as inversion and eversion of the foot occur at the subtalar and mid-tarsal joints

Front 70

fascia of the foot

Back 70

the deep fascia that covers the musculature in the sole of the foot is the plantar aponeurosis

Front 71

cutaneous branch of medial cutaneous nerve supplies

Back 71

both sides of the big toe, 2nd and 3rd toes, and the tibial side of the 4th toe

Front 72

cutaneous branch of lateral plantar nerve supplies

Back 72

lateral side of the 4th toe and both sides of the 5th toe

Front 73

blood supply of foot

Back 73

Principal artery of the sole of the foot is the lateral plantar artery, a continuation of the posterior tibial artery. Forms the plantar arch, which arises the plantar metatarsal arteries. The dorsalis pedis artery, the continuation of the anterior tibial artery, supplies the dorsum of the foot

Front 74

Arches of the foot

Back 74

longitudinal and transverse arches. The longitudinal arch is made up of all the tarsal and metatarsal bones and is divided into a medial and a lateral arch. The medial arch is more pronounced and is made up of a short posterior pillar formed by the calcaneus and body of the talus, a keystone formed by the head of the talus and a long anterior pillar formed by the navicular, cuneiforms and the three medial metatarsals.

Front 75

keystone of medial arch supported by

Back 75

(1) tendons of the deep muscles on the back of the leg
(2) the small muscles in the sole of the foot
(3) the plantar aponeurosis
(4) plantar ligaments of foot joints, especially the plantar calcaneo-navicular ligament (spring ligament)
and the long and short plantar ligaments

Front 76

Type and mechanical design of hip joint

Back 76

ball and socket joint like the glenohumeral joint

mechanically designed' to provide greater stability and security. This increased stability allows the lower extremity to carry and balance the trunk

Front 77

Articulating parts of hip joint

Back 77

include the head of the femur and the acetabulum of the os coxae

Front 78

characteristics of acetabulum

Back 78

acetabulum is cup-shaped, 2 areas
(1) the articular surface with the acetabular notch and (2) the acetabular fossa which is filled with fat
-articulating parts are covered with hyaline cartilage
-socket is deepened by a fibrocartilaginous Iabrum which accommodates more than Vz of the head of the femur

Front 79

capsule of hip joint attachments

Back 79

attached to the bony brim of the acetabulum and to the neck of the femur. Anteriorly, the capsule is attached to the base of the whole neck of the femur. Posteriorly, the line of attachment runs across the middle of the neck of the femur.

Front 80

synovial membrane of hip joint covers

Back 80

intracapsular neck of the femur
inner side of the capsule
the Iabrum
ligament of the head of the femur
fat pad of the acetabular fossa

Front 81

knee joint type, bones, and movements

Back 81

hinge, but modified with three joints in one capsule.
Bones - femur, tibia and patella (a sesamoid bone).
Movements - flexion and extension, small amount of rotation and gliding action to lock extension.

Front 82

internal ligaments of the hip joint

Back 82

(1) transverse acetabular ligament which spans the acetabular notch

(2) ligament of the head of the femur

Front 83

external ligaments of hip joint

Back 83

(1) iliofemoral ligament (the most important ligament and one of the strongest ligaments of the body)
(2) ischiofemoral ligament
(3) pubofemoral ligament

Front 84

nerve supply of hip joint

Back 84

sensory branches of the gluteal, obturator, and femoral nerves

Front 85

vasculature of hip joint

Back 85

medial and lateral femoral circumflex arteries
inferior gluteal artery
first perforating artery of the profunda femoris
obturator artery

Front 86

movements of hip joint

Back 86

include flexion, extension, abduction, adduction, rotation, and circumduction. Flexion is very extensive; when the leg is extended, the overstretched hamstring muscles limit this movement

Front 87

type and bones of knee joint

Back 87

-largest joint in the body
-include the distal femur (medial and lateral condyles), proximal tibia (medial and lateral condyles), and patella (a sesamoid bone which articulates only with the femur)
-modified hinge joint, which allows flexion and extension, medial and lateral rotation and gliding

Front 88

articular discs of knee joint characteristics

Back 88

-the articular surfaces of the femur and tibia are adapted more closely to each other by two articular discs of fibrocartilage called menisci
-menisci cover the periphery of the tibial articular surface. The outer or peripheral border of the menisci is thicker than the inner border

Front 89

medial meniscus characteristics

Back 89

-sets on top of the medial tibial condyle
- "C" shaped and attached medially to the interarticular area by two horns
-peripherally it is attached to the synovial membrane, fibrous capsule and medial collateral ligament of the knee

Front 90

lateral meniscus characteristics

Back 90

-sets on top of the lateral tibial condyle
-more circular in shape than the medial meniscus and attached medially to the interarticular area
-Peripherally attached to the synovial membrane, popliteus muscle, and capsule of the knee joint, but has no attachment to the lateral collateral ligament of the knee
-popliteus muscle lies between it and the lateral collateral ligament.

Front 91

menisci fxn

Back 91

function to adapt the articular surfaces to each other as the femoral condyles move. They also aid in lubrication of the articular surfaces

Front 92

fibrous capsule of knee strengthened posteriorly by

Back 92

(1) the oblique popliteal ligament, an extension of the semimembranosus tendon
(2) the popliteus muscle, which emerges within the capsule and interrupts the attachment of the capsule to the tibia. In addition, the origin of the gastrocnemius muscle strengthens the posterior aspect of the capsule

Front 93

anterior fibrous capsule characteristics of the knee

Back 93

-attached around the articular margins of the condyles and is reinforced by the patella and extensions of the vasti muscles by the ligamentum patellae
-normally a deficiency in the capsule anteriorly which allows the supra-patellar bursa to communicate with the joint cavity

Front 94

boundaries of posterior cervical triangle

Back 94

base- middle of the clavicle

posterior boundary- trapezius

anterior boundary- sternomastoid

Front 95

Roof of posterior cervical triangle

Back 95

skin

superficial fascia (containing a portion of the platysma)

investing fascia with the spinal accessory nerve (CN XI) embedded therein

Front 96

Floor of posterior cervical triangle

Back 96

A. Splenius capitis
B. Levator scapulae
C. Posterior scalene
D. Middle scalene
E. Anterior scalene
Covered with prevertebral fascia

Front 97

Spinal accessory nerve origins and fxn

Back 97

dual origin (two roots)
The cranial root is accessory to the vagus nerve (CN X) because it provides part of its motor component; the spinal root, joined by fibers from the ventral primary ramus of C2, supplies the sternomastoid, and joined by fibers from the ventral rami of C3 and C4, supplies the trapezius

Front 98

external jugular vein location

Back 98

external jugular vein lies superficial to the sternomastoid. It is a tributary to the subclavian vein

Front 99

tributaries of external jugular vein

Back 99

retromandibular
posterior auricular
transverse cervical
suprascapular
anterior jugular veins

Front 100

subclavian and internal jugular vein characteristics

Back 100

axillary vein- continues as the subclavian vein where it crosses the lateral border of the first rib.
subclavian vein- passes anterior to the first rib and the anterior scalene muscle to join the internal jugular vein descending from above. The vein formed by the union of the subclavian and internal jugular is the brachiocephalic

Front 101

Right subclavian artery branches off of the

Back 101

brachiocephalic trunk

Front 102

left subclavian artery branches from the

Back 102

aortic arch

Front 103

sublavian arteries parts

Back 103

pass posterior to the anterior scalene which defines their three parts.
1st part - lies medial to the anterior scalene. Its branches include the vertebral and internal thoracic arteries, thyrocervical and costocervical trunks.
2nd part - passes posterior to the anterior scalene.
3rd part - upper surface of the first rib, producing a groove on this bone. No named branches originate from this part.

Front 104

occipital artery location

Back 104

branch of the external carotid, runs deep to SCM, eventually crossing the apex of the posterior cervical triangle on its way to occipital scalp

Front 105

brachial plexus roots and trunks location

Back 105

emerges between the anterior and middle scalene muscles and pass laterally into the axilla

Front 106

lesser occipital nerve (C2 and C3) location

Back 106

cutaneous branch of the cervical plexus, ascends to the scalp posterior to the external ear

Front 107

great auricular nerve (C2 and C3) characteristics

Back 107

a cutaneous branch of the cervical plexus, passes anterior to the sternomastoid to supply the external ear. In addition to innervating the auricle of the ear, it gives branches to the skin of the mastoid, parotid and masseteric regions.

Front 108

transverse cervical nerve (C2 and C3) characteristics

Back 108

a cutaneous branch of the cervical plexus, travels anteriorly to innervate the skin of the anterior cervical triangle

Front 109

supraclavicular nerves (C3 and C4) characteristics

Back 109

cutaneous branches of the cervical plexus, which descend in the neck to cross the clavicle and be distributed to the skin of the supraclavicular triangle, and the pectoral, deltoid and acromial regions.

Front 110

posterior cervical triangle lymph nodes characteristics

Back 110

drain the occipital scalp and back of the neck; they eventually empty into the jugular lymph trunk

Front 111

boundaries of anterior cervical triangle

Back 111

superior- lower border of the body of the mandible

posterior- anterior border of the sternomastoid

anterior- midline extending from the chin to the sternal notch in the manubrium

Front 112

subdivisions of anterior cervical triangle

Back 112

submandibular triangle
carotid triangle
muscular triangle
submental triangle

Front 113

submandibular triangle boundaries

Back 113

body of the mandible

digastric muscle, including its posterior and anterior bellies

Front 114

carotid triangle boundaries

Back 114

SCM

posterior belly of the digastric

superior belly of omohyoid

Front 115

muscular triangle boundaries

Back 115

superior belly of omohyoid

lower anterior margin of sternomastoid

midline of the neck

Front 116

submental triangle boundaries

Back 116

anterior bellies of both right and left digastric muscles

body of the hyoid

Front 117

superficial structures of anterior cervical triangle

Back 117

platysma
anterior jugular veins
cutaneous nerves- great auricular and transverse cervical
motor cervical branch of the facial nerve (CN VII)

Front 118

anterior jugular veins characteristics

Back 118

veins may be present near the midline, oriented in a vertical direction. They course deep to the sternomastoid above the clavicle to empty into the external jugular veins in the posterior cervical triangle

Front 119

investing fascia of neck characteristics

Back 119

fascia which surrounds the SCM continues as a single layer to cover the anterior cervical triangle and fuses in the midline with its counterpart from the other side. Attached to bony structures in the immediate vicinity, including the mandible, clavicle and manubrium

Front 120

floor of submandibular triangle

Back 120

several muscles including:
mylohyoid
hyoglossus
middle pharyngeal constrictor

Front 121

contents of submandibular triangle

Back 121

1. Superficial lobe of submandibular salivary gland.
2. Facial artery and vein.
3. Hypoglossal nerve (CN XII) - provides motor fibers to the muscles of the tongue.
4. Lingual artery - a branch of the external carotid; supplies the tongue

Front 122

common carotid artery characteristics

Back 122

bifurcates at the level of the hyoid bone into its two terminal branches - external and internal carotid arteries

Front 123

internal carotid artery characteristics

Back 123

-no branches in cerv. or facial region
-destined for cranial cavity to supply brain
-posterior and lateral to ext. carotid artery
-carotid sinus at origin contains baroreceptors, which measure blood pressure

Front 124

baroreceptors are connected to

Back 124

the cardiovascular regulating center in the brain stem by the glossopharyngeal nerve (CN IX). Changes in blood pressure are monitored here and acted upon by the brain stem for maintenance of blood pressure

Front 125

carotid body characteristics

Back 125

-located within the area of the common carotid artery bifurcation
-microscopic structure contains chemoreceptors for measuring arterial O2 content. These chemoreceptors are connected to the cardiovascular regulating center in the brain stem by the glossopharyngeal nerve. Changes in the O2 content of the blood are measured here and acted upon by the brain stem for maintenance of adequate respiration and blood pressure regulation

Front 126

branches of external carotid artery

Back 126

1. Superior thyroid artery
2. Lingual artery
3. Ascending pharyngeal artery
4. Facial artery
5. Occipital artery
6. Posterior auricular artery

Front 127

superior thyroid artery supplies

Back 127

supplies the thyroid and parathyroid glands

two branches supplying the larynx (superior laryngeal and cricothyroid arteries)

Front 128

lingual artery supplies

Back 128

the tongue

Front 129

Ascending pharyngeal artery supplies

Back 129

the lateral pharyngeal wall

Front 130

Facial artery supplies

Back 130

the lips, nose and medial angles of eyes

Front 131

occipital artery supplies

Back 131

the scalp in the occipital region

Front 132

Posterior auricular artery supplies

Back 132

the external auditory canal

stylomastoid branch supplies the facial nerve (CN VII) in the stylomastoid canal

Front 133

internal jugular vein characteristics

Back 133

carries blood from the brain, exits the skull via the jugular foramen and ultimately becomes a tributary to the brachiocephalic vein

Front 134

nerves in carotid triangle

Back 134

1. vagus nerve (CN X)
2. spinal accessory nerve (CN XI)
3. hypoglossal nerve (CN XII)
4. ansa cervicalis (C1-C3)
5. motor fibers of C1

Front 135

vagus nerve (CN X) location

Back 135

-exits the skull via the jugular foramen and descends within the carotid sheath

Front 136

vagus nerve (CN X) parasympathetic fibers fxns

Back 136

-parasympathetic fibers supply glands in the esophagus, larynx and trachea
-also provides parasympathetic innervation to many thoracic and abdominal viscera, which will be described in subsequent lectures

Front 137

vagus nerve (CN X) non-parasympathetic fxns

Back 137

-supplies the skeletal muscles of the palate, pharynx and larynx
-Sensory branches arise from the mucosa of the same organs as well as the pharynx and skin of the external ear
-gives a sensory branch, the internal laryngeal nerve, to the laryngeal mucosa above the vocal cords
-motor branch, the external laryngeal nerve, innervates the cricothyroid muscle

Front 138

hypoglossal nerve (CN XII) supplies

Back 138

muscles of the tongue

Front 139

Ansa cervicalis (C1 - C3) provides

Back 139

motor innervation to the geniohyoid and three of the infrahyoid (strap) muscles

Front 140

motor fibers in C1 supply

Back 140

the thyrohyoid muscle

Front 141

veins of muscular triangle

Back 141

1. Anterior jugular vein becomes a tributary to the external jugular vein by coursing deep to the sternomastoid just above the clavicle.
2. A communicating vein connects the anterior jugular vein with the common facial vein.

Front 142

thyroid gland structure

Back 142

has two hemispheres connected by an isthmus which crosses the midline anterior to the 2nd and 3rd tracheal rings (cartilages). Occasionally, a pyramidal lobe is present in the midline ascending toward the hyoid bone

Front 143

thyroid gland arteries and veins

Back 143

superior and inferior thyroid arteries

superior, middle and inferior thyroid veins

Front 144

Thyroid gland secretes what

Back 144

secretes thyrocalcitonin-helps regulate calcium metabolism
tetraiodothyronine (T4) and triiodothyronine (T3)-which together regulate the basal metabolic rate (the rate at which the body consumes oxygen)

Front 145

parathyroid glands characteristics

Back 145

-four in number
-One pair is embedded in the posterior surface of each hemisphere of the thyroid gland
-Supplied by the same vessels which supply the thyroid gland
-secrete parathormone which helps regulate calcium metabolism

Front 146

submental triangle contents

Back 146

contains the beginning of the anterior jugular vein and one or more small submental lymph nodes

Front 147

parotid gland location

Back 147

-lies just beneath the skin in front of the ear
-covers the temporomandibular joint (TMJ) and the ramus of the mandible
-largest of the salivary glands, occupies 3-D space, the parotid bed

Front 148

parotid region boundaries

Back 148

A. Posterior boundary - mastoid process

B. Medial boundary - styloid process

C. Anterior boundary - medial pterygoid and masseter muscles

Front 149

contents of parotid region

Back 149

1. parotid gland
2. External carotid artery and several of its branches.
3. External jugular vein and several of its tributaries.
4. Parts of the facial nerve (CN VII)
5. Parts of the trigeminal nerve (CN V)

Front 150

parts of parotid gland

Back 150

-superificial and deep parts
-superficial part-covers most of the masseter and extends anteriorly along the parotid duct
-dividing line of parts is indicated by the facial nerve and its branches, which pass through gland

Front 151

contents of deep part of parotid gland

Back 151

external carotid artery with several of its branches

retromandibular vein with its tributaries

auriculotemporal nerve, a branch of the trigeminal nerve (CN V)

Front 152

parotid duct fxn and course

Back 152

-single duct that carries secretions of parotid gland

-courses superficially over the masseter to pierce the buccinator muscle and open into the vestibule of the oral cavity adjacent to the second upper molar tooth

Front 153

stimulation of sympathetic nerves to parotid gland effect

Back 153

Stimulation by sympathetic nerves results in reduced saliva secretion, due to vasoconstriction of the vessels supplying this gland

Front 154

Stimulation by parasympathetic fibers in the glossopharyngeal nerve (CN IX) to parotid gland results

Back 154

results in increased salivary production

Front 155

clinical application of parotid gland swelling

Back 155

The parotid gland is tightly covered by a dense connective tissue capsule, which allows little room for expansion due to swelling. With viral infections, such as mumps, edema in this gland compresses the auriculotemporal nerve passing through it, producing much pain.

Front 156

clinical application of parotid gland tumor

Back 156

The surgical removal of the parotid gland is indicated with the presence of tumors. With a benign tumor the parotid gland must be surgically removed piece by piece, without endangering the facial nerve traveling through it.

Front 157

parotid gland arterial blood supply

Back 157

branches of the posterior auricular

superficial temporal

transverse facial arteries

Front 158

veinous drainage of parotid gland

Back 158

tributaries of the retromandibular vein

Front 159

lymphatic drainage of parotid gland

Back 159

1. Superficial cervical lymph nodes adjacent to the external jugular vein.

2. Deep cervical lymph nodes adjacent to the internal jugular vein.

Front 160

Sensory innervation of parotid gland

Back 160

- great auricular nerve (a branch of the cervical plexus) and the auriculotemporal nerve (a branch of the trigeminal nerve - CN V)

Front 161

components of facial nerve

Back 161

A. Special visceral efferent motor fibers (SVE)
B. General visceral efferent motor fibers (GVE)
C. Special visceral afferent fibers (SVA)
D. General somatic afferent fibers (GSA)

Front 162

special visceral efferent (SVE) motor fibers of facial nerve characteristics

Back 162

fibers innervate the muscles of facial expression; their nerve cell bodies are in the motor nucleus of the facial nerve

Front 163

General visceral efferent (GVE) motor fibers of facial nerve characteristics

Back 163

-parasympathetic innervation to the lacrimal gland, mucosa of the palate and nasal cavities, and the submandibular and sublingual salivary glands
-preganglionic nerve cell bodies in the superior salivatory nucleus synapse with postganglionic fibers in two different parasympathetic ganglia (pterygopalatine ganglion and submandibular ganglion)

Front 164

Special visceral afferent (SVA) fibers of facial nerve characteristics

Back 164

for taste (from the anterior two-thirds of the tongue) are present in the chorda tympani branch of the facial nerve

Front 165

General somatic afferent (GSA) fibers of facial nerve characteristics

Back 165

bring cutaneous innervation from a portion of the external auditory meatus and auricle. Proprioceptive fibers also provide for "position sense" for the facial muscles.

Front 166

the motor nucleus of facial nerve

Back 166

is the pons

Front 167

path of the facial nerve

Back 167

-leaves the side of the brain stem, in company with the vestibulocochlear nerve (CN VIII)
-exits the cranial cavity by entering the internal acoustic meatus
-At the end of the internal acoustic meatus the facial nerve turns sharply to enter the facial canal. Its sensory or geniculate ganglion, derives its name from its location at this bend (geniculum)
-facial canal opens externally at the stylomastoid foramen, posterior to the external ear, where the facial nerve exits the skull to enter the parotid gland

Front 168

2 nerves that form the nerve of the pterygoid canal

Back 168

The greater petrosal nerve (preganglionic parasympathetic) joins with the deep petrosal nerve (postganglionic sympathetic) to become the nerve of the pterygoid canal

Front 169

nerve of the pterygoid canal course and fxn

Back 169

-travels anteriorly to join the pterygopalatine ganglion, location nerve cell bodies of postganglionic parasympathetic neurons
-postganglionic parasympathetic fibers distribute to lacrimal gland and mucous glands in the nasal mucosa and palate
-Postganglionic sympathetic fibers pass through the pterygopalatine ganglion to innervate the blood vessels of the lacrimal gland, nasal mucosa and palate.

Front 170

Postganglionic fibers from the pterygopalatine ganglion supply

Back 170

the lacrimal gland and mucous glands in the nasal cavities and palate

Front 171

Postganglionic fibers from the submandibular ganglion supply

Back 171

the sublingual and submandibular salivary glands

Front 172

nerve to stapedius location

Back 172

enters the middle ear cavity to supply this same muscle

Front 173

chorda tympani nerve course

Back 173

-goes through middle ear, on way to the infratemporal fossa, where it joins with the lingual nerve (CN V3)
-After the lingual nerve reaches the tongue, the preganglionic parasympathetic fibers traveling with it peel off and to the submandibular ganglion (contains nerve cell bodies of the postganglionic parasympathetic neurons)
-postganglionic parasympathetic fibers are distributed to the submandibular and sublingual glands
-chorda tympani nerve also contains SVA fibers which bring taste from the anterior 2/3's of the tongue.

Front 174

branches of facial nerve external to the skull

Back 174

A. Upon its exit from the stylomastoid foramen the enters the parotid gland and sends a sensory branch (GSA) to the external auditory meatus and the auricle

Terminal branches of the facial nerve supplying the muscles of facial expression

Front 175

Terminal branches of the facial nerve supplying the muscles of facial expression

Back 175

1. temporal branches
2. zygomatic branches
3. buccal branches
4. mandibular branch
5. cervical branch
6. posterior auricular branch

Front 176

Temporal branches of facial nerve characteristics

Back 176

cross the zygomatic arch to supply all the superficial muscles above it, including the frontal belly of the occipitofrontalis, the corrugator supercilii, the orbicularis oculi and the anterior and superior auricular muscles

Front 177

Zygomatic branches of facial nerve characteristics

Back 177

pass over the zygomatic bone to supply muscles in the infraorbital area including the orbicularis oculi and all muscles associated with the upper lip, external nares, and part of the buccinator muscle

Front 178

Buccal branches of facial nerve characteristics

Back 178

cross the masseter as they go to the angle of the mouth. Supply the buccinator and levators of the upper lip and angle of the mouth, depressors of the lower lip and angle of the mouth, both of which are also innervated by the mandibular branch of CN VII

Front 179

mandibular branch of facial nerve characteristics

Back 179

runs across the lower borders of the masseter and external surface of the mandible. It supplies muscles of the lower lip and chin

Front 180

cervical branch of facial nerve characteristics

Back 180

runs downward and forward below the body of the mandible to supply the platysma

Front 181

Posterior auricular branch of facial nerve characteristics

Back 181

supplies motor fibers to the auricular muscles which can move the auricle (in some people)

Front 182

Applied Anatomy of facial nerve

Back 182

a lesion involving the motor nucleus of the facial nerve produces ipsilateral paralysis of the muscles of facial expression and eventually muscle atrophy as well. Peripheral facial nerve paralysis may result from chilling of the face, middle ear infections, tumors and fractures; these factors account for 75% of all cases of facial nerve (Bell's) palsy. Weakness, rather than complete paralysis of a muscle, usually results from injury to the branches of the facial nerve, because of their overlapping distribution

Front 183

Lumbosacral plexus

Back 183

network of nerves that supply entire LE

Front 184

Sciatic nerve formed by

Back 184

L4-S3

Front 185

components of carotid plexus

Back 185

post-ganglionic sympathetic fibers only

Front 186

most frequently injured nerve in LE

Back 186

common peroneal nerve- superficial and and right next to head of fibula

Front 187

skin of face unique aspects

Back 187

First, the thickness of the skin is less in the facial region and secondly, there are muscles (of facial expression) which insert into the deep surface of the skin

Front 188

skin of the face is innervated by

Back 188

cutaneous branches of the trigeminal nerve (CN V)

Front 189

mimetic muscles characteristics

Back 189

- the muscles of facial expression
- arranged around the eyes, nostrils, and mouth.
-generally function as dilators or sphincters
-innervated by the terminal branches of the facial nerve (CN VII)

Front 190

The supraorbital and supratrochlear nerves (from V1) opthalmic branch of trigeminal nerve supply

Back 190

supply the upper eyelid and skin of the forehead and anterior scalp

Front 191

The infraorbital nerve (from V2) maxillary branch of trigeminal nerve supplies

Back 191

the skin of the nose, lower eyelid, upper lip and most of the cheek

Front 192

The mental nerve (from V3) mandibular branch of trigeminal nerve supplies

Back 192

the skin of the lower lip and chin

Front 193

cranial nerve most susceptible to injury and disease

Back 193

Facial nerve
Facial nerve paralysis is commonly known as Bell's palsy. This disorder usually results in weakness of the facial muscles, or complete paralysis of facial muscles on the affected side. Usually the symptoms are reversible and subside with the over time

Front 194

blood supply of face

Back 194

-transverse facial artery- branch of the superficial temporal, runs horizontally across the zygomatic arch
-facial artery- branch of the external carotid, supplies most of the facial region. Passes through the submandibular triangle before crossing the mandible to reach the facial region. Winds it way to the medial angle of the eye

Front 195

veinous drainage of face

Back 195

The facial vein lies posterior to the facial artery. This vein eventually connects with the common facial vein below the mandible, which then becomes a tributary to the internal jugular vein

Front 196

clinical application of facial vein

Back 196

Facial vein has important connections with several other veins including the superior ophthalmic and the pterygoid plexus. These connections have potential clinical significance due to their communication with the cavernous sinus in the cranial cavity. If infectious material is transported to the cavernous sinus by way of these venous connections, a life-threatening situation may develop, because it is extremely difficult to treat this region with antibiotics

Front 197

five layers of tissue that comprise the scalp, from superficial to deep

Back 197

1. S - Skin, usually covered with hair.
2. C - subCutaneous tissue, containing vessels and nerves.
3. A - galea Aponeurotica, a broad aponeurosis uniting two muscles - frontalis (forehead) and occipitalis (posterior skull).
4. L - Loose areolar tissue, which permits limited movement of the scalp.
5. P - Pericranium, or periosteum of skull.

Front 198

characteristics of veins in the scalp

Back 198

Veins in the scalp have direct connections with venous channels in the cranial cavity by way of emissary veins, which enter the cranial cavity through foramina in the skull, such as the parietal and mastoid foramina. These vascular channels can transmit an infection of the scalp to the cranial cavity

Front 199

characteristics of arteries of the scalp

Back 199

surrounded by a dense layer of connective tissue. When a scalp laceration occurs, these arteries cannot constrict easily to decrease the hemorrhaging. Therefore, scalp lacerations are extremely bloody

Front 200

innervation of the scalp provided by

Back 200

supraorbital and supratrochlear nerves (branches of V1, opthalmic) anteriorly

greater and lesser occipital nerves posteriorly

Front 201

fibrous capsule of knee medially strengthened by

Back 201

semitendinosus
semimembranosus
sartorius
gracilis muscles
medial collateral ligament

Front 202

fibrous capsule of knee laterally strengthened by

Back 202

reinforced by the iliotibial tract

biceps femoris tendon

lateral collateral ligament

Front 203

Collateral ligaments of the knee characteristics

Back 203

-MCL broad flat band attached to the medial femoral epicondyle and the shaft of the tibia; and medial meniscus
-LCL stout cord attached to the lateral femoral epicondyle and the head of the fibula
-LCL not attached to the lateral meniscus due to popliteus
-ligaments resist abnormal side-to-side (tilting) movements

Front 204

ACL characteristics

Back 204

-ACL is attached to the anterior part of the intercondylar area of the tibia. It runs up, back and laterally (UBL) to attach to the medial surface of the lateral femoral condyle
-fxns to prevent backward displacement of the femur and prevent hyperextension of the leg

Front 205

PCL characteristics

Back 205

-PCL is attached to the posterior intercondylar area of the tibia. It runs up, forward and medially (UFM)
-attached to the lateral surface of the medial femoral condyle
-stronger, shorter, and less oblique than the anterior cruciate
-fxns to prevent forward displacement of the femur

Front 206

unique features of synovial membrane of knee

Back 206

A. Above the patella the synovial membrane extends deep to the quadriceps tendon to become the supra-patellar (quadriceps) bursa. This bursa is necessary for flexion.
B. attached to the periphery of the patella.
C. The cruciate ligaments are excluded from the synovial cavity. They are covered anteriorly and laterally, but not posteriorly. It is as if they were pushed into the joint from behind

Front 207

vasculature of knee joint

Back 207

branches from the femoral
profunda femoris
popliteal
anterior tibial arteries

Front 208

movements of knee joint

Back 208

flx, ext, rotation, some gliding

Front 209

extension of knee joint limited by

Back 209

tension of ACL
MCL and LCL
oblique popliteal ligament

Front 210

applied anatomy of knee joint menisci

Back 210

-can be torn in abnormal twisting and rotation which occur when the knee is in the semi-flexed or flexed position
-medial meniscus is more frequently torn because it is more fixed to adj acent structures (medial collateral ligament) and thus less able to adapt to sudden changes in position. The torn fragment becomes displaced and interferes with full extension of the joint; there is also pain and swelling of the joint

Front 211

applied anatomy of knee cruciate ligaments

Back 211

-cruciate ligaments may be torn in sever hyperextension or in adduction or abduction strain. -commonly torn is the anterior cruciate, resulting in abnormal anterior-posterior movement of the femur on the tibia

Front 212

applied anatomy of knee collateral ligaments

Back 212

-collateral ligaments are tight during extension; consequently they are more prone to injury when the knee is in this position and there is twisting, adduction or abduction strain
-torn collateral ligament results in excessive rotation and some abnormal abduction and adduction
-stability of the knee depends mainly on the integrity of the muscles and ligaments, especially the muscles. Consequently, the most skillful surgical repair of torn ligaments is likely to fail unless the muscles are functioning strongly; without their support, reconstructed ligaments will merely stretch once

Front 213

beginning path of trigeminal nerve

Back 213

-originates from the pons
-passes anteriorly to enter the trigeminal cave, which is located in the middle cranial fossa and surrounded by dura
-contained within the trigeminal cave is the semilunar (sensory) ganglion of the trigeminal nerve

Front 214

3 sensory divisions from the semilunar (sensory) ganglion of the trigeminal nerve

Back 214

ophthalmic (CN V1)

maxillary (CN V2)

mandibular (CN V3)

Front 215

Each of the three sensory divisions of the trigeminal nerve supply

Back 215

a sensory branch to the cranial dura (meningeal branches)

sensory component to an autonomic ganglion.

Front 216

ophthalmic division (CN V1) characteristics

Back 216

-smallest of 3 divisions, entirely sensory
-sends a meningeal branch to the tentorium cerebelli (dural covering of cerebellum)
-continues anteriorly through the superior orbital fissure to enter the bony orbit

Front 217

opthalmic division (V1) supplies

Back 217

supplies the eyeball, lacrimal gland and conjunctiva, part of the nasal mucosa and skin of the nose, eyelids, forehead and part of the scalp

Front 218

supraorbital nerve (branch of opthalmic V1) characteristics

Back 218

-supraorbital nerve exits via the supraorbital notch to innervate the upper eyelid and its conjunctiva, plus the scalp anterior to the vertex

Front 219

Maxillary division (CN V2) characteristics

Back 219

-entirely sensory distributing branches to the nose, skin and mucosa of the cheek and upper lip, maxillary teeth and palate
-exits the skull via the foramen rotundum
-passes through the pterygopalatine fossa and infratemporal fossa to enter the inferior orbital fissure as the infraorbital nerve
-infraorbital nerve traverses the infraorbital groove and canal to gain access to the face via the infraorbital foramen

Front 220

Superior alveolar nerves characteristics

Back 220

go through maxillary sinus to innervate gingiva and upper teeth

multiple nerves

Front 221

infraorbital nerve (branch of maxillary nerve) characteristics

Back 221

Infraorbital nerve exits the infraorbital foramen to give branches to the lower eyelid (inferior palpebral nerve), lateral nose (external nasal nerve) and the upper lip (superior labial nerve

Front 222

Mandibular division (CN V3) of trigeminal nerve characteristics

Back 222

-largest division
-both sensory and motor fibers
-exits the skull via the foramen ovale to enter the infratemporal fossa
-trunk of CN V3 gives four branches before it divides into anterior and posterior divisions

Front 223

sensory component of mandibular division supplies

Back 223

sensory component supplies the mandibular teeth and gingiva, skin of the temporal region, part of the auricle of the ear, lower lip, lower part of the face, and the anterior 2/3’s of the tongue

Front 224

motor component of mandibular division supplies

Back 224

motor fibers innervate the muscles of mastication, tensor muscles of the palate and tympanic membrane, plus the mylohyoid and anterior belly of the digastric in the floor of the oral cavity

Front 225

auriculotemporal nerve characteristics

Back 225

provides sensory fibers to the upper part of the auricle of the ear, external auditory meatus, lateral surface of tympanic membrane, TMJ, parotid gland, skin over parotid gland, and skin of temporal region
-carries postganglionic parasympathetic fibers from the otic ganglion to the parotid gland

Front 226

lingual nerve characteristics

Back 226

-joined by chorda tympani nerve
-general sensory fibers contained in the lingual nerve supply the anterior 2/3's of the tongue and adjacent gingiva

Front 227

inferior alveolar nerve characteristics

Back 227

-enters the mandibular foramen after giving off the nerve to the mylohyoid muscle
-This motor nerve innervates the mylohyoid muscle and anterior belly of digastric
-in body of the mandible, the inferior alveolar nerve provides sensory innervation to the teeth and gingiva of the lower jaw

Front 228

mental nerve characteristics

Back 228

-terminal portion of inferior alveolar nerve exits the mental foramen as the mental nerve to provide sensory innervation to the skin of the chin and lower lip