Final Anatomy

Front 1

pedicle

Back 1

1st part of vertebral arch after body; transmits tension and bending forces from posterior elements to body; increase in size cervical to lumbar

Front 2

lamina

Back 2

extends pedicle to form vertebral arch; transmits force from vertebral arch to pedicle

Front 3

superior articular process

Back 3

connects inferior articular process of bone above it to form facet joint

Front 4

spinous process and transverse process

Back 4

important sites for muscle attachment

Front 5

pars interarticularis

Back 5

part of lamina between superior and inferior articular process of same vertebra; part of lamina that takes on most bending forces, therefore susceptible to fx; hypermobile athletes athletes susceptible to fx; spondylosis = fx

Front 6

vertebral canal

Back 6

holes through foramen referring to whole spine

Front 7

interbody joint

Back 7

where 2 bodies connect; cartilagenous (symphysis) joint; accepts a lot of weight/force

Front 8

facet joint/zygoapophyseal joint

Back 8

superior and inferior articular processes come together; synovial joint (synovial fluid, capsule, disk)

Front 9

uncovertebral joint/joints of Von Lushka

Back 9

only exist in cervical spine; start forming after age of 9; form on body on posterior-lateral surface; holds disk in so doesn't protrude into spinal cord; form b/c of wolf's law

Front 10

intervertebral foramen

Back 10

where nerves exit from spinal cord and travel into periphery; dorsal root ganglia live here; superior and inferior articular processes and disk make up intervertebral body

Front 11

intervertebral disk

Back 11

20-25% of height of spinal column; made up of water, allows for fair amount of movement of spine; height of disks determine size of intervertebral foramen; good for shock absorption

Front 12

1st intervertebral disk in btw

Back 12

C2 and C3

Front 13

anulus fibrosus

Back 13

outer ring of disk, made of fibrocartilage, concentric lamellae (layers) which resist tension outward; firmly attached to bone; thinner on posterior aspect than anterior; more common to herniate posteriorly; outer 1/3 = only part of disk that receives sensory innervation, poor vascular supply inside disk; annular tear = one of most painful experiences person can feel

Front 14

innervation of intervertebral disk

Back 14

sinuvertebral/recurrent meningeal nerve

Front 15

nucleus pulposus

Back 15

core of intervertebral disks; 88% water; more cartilaginous than fibrosis, more malleable, changes shape depending on forces put through it; when compressed = nucleus gets broad; when stretched/tensed = thinner; sits more posterior; can move anterior and posterior depending on forces

Front 16

vertebral end plate

Back 16

sandwich for disk, covers superior and inferior portions of disk, made of cartilage, separates nucleus pulpous from vertebral body

Front 17

lordosis curve

Back 17

convex from anterior portion; lumbar, cervical

Front 18

kyphosis curve

Back 18

convex from posterior portion; thoracic, sacral

Front 19

primary curves

Back 19

thoracic and sacral kyphosis, have when we are babies

Front 20

secondary curves

Back 20

form from fxn and position over time; cervical and lumbar lordosis (cervical from crawling, lumbar from walking, crawling)

Front 21

cervical spine characteristics

Back 21

intervertebral disks thin, ratio from disk height to body height = one of greatest in whole spine (1:1); bifid spinous process (2 tails)

Front 22

cervical spine facet joints

Back 22

horizontal (superior and inferior articular processes) moving to 45 degrees above horizontal; btw superior and inferior articular processes

Front 23

foramen transversarium

Back 23

characteristic of c vertebrae; hole w/in transverse processes of spine aka transverse foramen; vertebral artery and veins go through it; vertebral artery goes to circle of willis

Front 24

anterior and posterior tubercle on transverse process of c-spine

Back 24

important attachment for levator scapula and scalenes

Front 25

C6

Back 25

anterior tubercle called carotid tubercle where you would compress if someone was bleeding; on transverse process

Front 26

C1

Back 26

atlas

Front 27

C2

Back 27

axis

Front 28

thoracic spine characteristics

Back 28

transition zone for areas above and below

Front 29

costal facets of thoracic spine

Back 29

attachment points for ribs, on transverse process

Front 30

T1-T4

Back 30

similar to C spine

Front 31

T9-T12

Back 31

similar to lumbar spine

Front 32

vertebral foramen of thoracic spine

Back 32

smaller than C spine

Front 33

transverse process of thoracic spine

Back 33

wider, longer; start pointing posterior and lateral

Front 34

facet joints of thoracic vertebrae

Back 34

vertical (btw superior and inferior articular facets)

Front 35

lumbar spine characteristics

Back 35

bodies significantly larger, vertebral foramen bigger than in thoracic, not as big as cervical, facets in coronal plane (J shaped)

Front 36

transverse process of lumbar spine

Back 36

accessory process: base of transverse process

mammillary process: articulating on process

Front 37

anterior longitudinal ligament

Back 37

covers and connects anterolateral aspects of vertebral bodies and intervertebral disks from head to pelvic surface of sacrum; only ligament that limits hyperext of vertebral column

Front 38

posterior longitudinal ligament

Back 38

posterior side of vertebral bodies and mainly attaches to intervertebral disks C2 to sacrum; more narrow and weaker than ALL; anterior to spinal cord, good for protecting spinal cord from herniated disks; stronger and more central- redirects laterally to protect spinal cord; limits hyperflex

Front 39

ligamentum flavum

Back 39

join adjacent lamina vertebra to vertebra, yellow, stretchy, strong elastic ligament, prevents hyper flexion and separation of lamina; elasticity helps return spine to neutral when already flexed; runs lamina to lamina, important for when doing epidural

Front 40

interspinous ligament

Back 40

connects spinous process to spinous process; after C2 down

Front 41

supraspinous ligament

Back 41

C7 to sacrum, covers most superficial part; mohawk of spine

Front 42

nuchal ligament

Back 42

supraspinous blends w/ nuchal C7 and above, really strong and really broad; extension of spinous processes to allow muscles to attach

Front 43

mamillary processes

Back 43

lumbar; btw transverse process and superior articulating process

Front 44

costal process on lumbar

Back 44

end of transverse process; bump on lamina

Front 45

accessory process

Back 45

inferior to mammillary process; bump on lamina

Front 46

why is it important that lumbar vertebrae made of trabecullar bone?

Back 46

standing = forces redistributed to body, disks in btw bodies of vertebrae; forces go posterior, but redistributed to body

Front 47

pars articularis

Back 47

part on lamina in btw superior and inferior articular process

Front 48

what attaches at accessory process? (lumbar vertebrae)

Back 48

intertransvarii laterales lumborum

Front 49

superior facets of lumbar vertebra face

Back 49

posteriomedial

Front 50

inferior facets of lumbar vertebra face

Back 50

anteriolateral

Front 51

flex and extension good in ____ spine, but ____ is bad here

Back 51

lumbar

rotation

Front 52

function of intervertebral disks

Back 52

major = shock absorption; allows for movement in spine and protection of nerves

Front 53

annulus fibrosus made of

Back 53

fibrocartilage

Front 54

nucleus pulposus

Back 54

water

Front 55

t/f: only outer 1/3 of annulus fibrosus is innervated

Back 55

true

Front 56

how does the lumbar disk get nutrition?

Back 56

weight bearing (like meniscus), inside not well vascularized

Front 57

deep to superficial posterior spinal ligaments

Back 57

ligamentum flavum > interspinous ligament > supraspinous ligament

Front 58

hole in single vertebra

Back 58

vertebral foramen

Front 59

spinal cord

Back 59

lives in vertebral canal; terminates at L1 = conis medlars; spinal canal travels all the way down to coccyx

Front 60

cauda equina

Back 60

nerve roots keep coming down and exit further down in lumbar vertebra

Front 61

gray matter

Back 61

cell bodies here; looks like butterfly; anterior and posterior horn

Front 62

white matter

Back 62

nerve tracts

Front 63

ventral rootlets come from

Back 63

anterior horn

Front 64

dorsal rootlets come from

Back 64

posterior horn

Front 65

dorsal root ganglia

Back 65

cell bodies live here, sensory nerves

Front 66

where do cell bodies of motor nerves live?

Back 66

gray matter

Front 67

spinal nerves are what type of nerve?

Back 67

mixed nerves

Front 68

how do spinal nerves branch?

Back 68

dorsal = dorsal ramus/arm to supply back muscles

ventral = ventral ramus (larger) to become part of plexus to become bigger nerves in extremity

Front 69

other 2 names for meningeal ramus

Back 69

sinuvertebral n or nerve of von Lushka

Front 70

3 primary splits of spinal nerve

Back 70

dorsal primary ramus

ventral primary ramus

meningeal nerve (supplies intervertebral disks)

Front 71

Nerve roots up to ____ exit above that vertebrae. At ____ this switches and nerve root named for vertebrae ____ it

Back 71

C7

C8

below

Front 72

why is it significant that annulus fibrosis is thinner posteriorly?

Back 72

most common herniation = posteriolateral

enters intervertebral foramen

takes away space from dorsal and ventral root ganglion

Front 73

how does posteriolateral herniation affect ventral and dorsal root ganglions?

Back 73

ventral- motor loss/changes in myotomal pattern

dorsal- sensory loss in dermatomal pattern

Front 74

bulging disk at L3 presents as

Back 74

issues w/ knee extension

Front 75

spinal nerve begins as exits

Back 75

intervertebral foramen

Front 76

central herniation

Back 76

effects spinal cord more than peripheral myotomes/dermatomes

Front 77

sinuvertebral nerve innervates

Back 77

outer 1/3 of annulus and PLL

Front 78

anterior ramus

Back 78

medial and lateral branches; innervates facet joints

Front 79

medial branch block

Back 79

numb input coming from medial branch; injects facet w/ lidocaine; medial branch = sensory nerve (from facet to gray matter)

Front 80

lumbar spine what kind of joints?

Back 80

planar

Front 81

3 ways vertebral bodies adapt

Back 81

intervertebral disks (nucleus pulposus can change shape), facet joints (glide on each other), space btw spinous processes

Front 82

what happens during lumbar flexion?

Back 82

bones start separating- pulposus stretched posteriorly, compression anterior disk, tension on posterior ligs and muscles; spinous processes get further apart, limited by soft tissue

Front 83

what happens to facet joints in lumbar flexion?

Back 83

superior and anterior glide superior vertebrae

Front 84

what happens to inter body during lumbar flexion

Back 84

anterior disk compressed, posterior disk stressed, nucleus posteriorly displaced

Front 85

what happens during lumbar extension?

Back 85

spinous processes closer together = approximation; disks = posterior compression, anterior tension, anterior translation of nucleus pulpous, restricted by bone structure

Front 86

what happens to facet joints during lumbar extension?

Back 86

inferior facet of superior vertebrae glides inferior and posterior on superior facet of inferior vertebrae

Front 87

what motions is disk most susceptible to injury?

Back 87

flexion w/ rotation

Front 88

main limitation of lateral flexion/side bend

Back 88

quadratus lumborum, multifidus, intertransversarii

Front 89

lateral flexion: compression on ipsilateral lateral side of disk results in tension on ____ side of disk, nucleus translated _____

Back 89

contralateral lateral; _______

Front 90

ask about mechanics of rotation

Back 90

ask

Front 91

thoracolumbar fascia

Back 91

anterior: thin and derived from fascia of QL, blends w/ intertransverse ligament

middle: lies behind QL, gives rise to aponeurosis of TA

posterior: arises from lumbar spine wraps around back muscles- blends w/ anterior and middle layers at lateral border of iliocostalis lumborum- lateral raphe (where all 3 layers come together)

Front 92

transverse processes are sandwiched btw ___ and ___ in lumbar spine

Back 92

QL and iliosoas

Front 93

transverse abdominis, rectus abdominis, and arcuate line relationships

Back 93

above arcuate line = transverse abdominis posterior to rectus abdominis

below arcuate line = transverse abdominis superficial to rectus abdominis

Front 94

rectus abdominis

Back 94

causes a lot of trunk flex, attaches to little pieces of fascia, global muscle, causes a lot of mvmt; we see 8 pack b/c bottom pair deep to transverses abdominis (10 total portions)

Front 95

how do you "tone" transverse abdominis

Back 95

trunk rotations

Front 96

thoracolumbar fascia

Back 96

covers low back and abdominals; glutes and lats attach to it

Front 97

diaphragm

Back 97

involved in respiration, postural muscle

Front 98

main fxn of pelvic girdle

Back 98

connecting vertebral column to 2 lower extremities

used to bear weight of upper body in sitting and standing; transfers load of axial skeleton to appendicular skeleton when standing and walking; provides attachment site for muscles

Front 99

pelvic girdle protects

Back 99

urinary and reproductive organs

Front 100

inominate

Back 100

1/2 of pelvis (2 inominate bones + sacrum = pelvis)

Front 101

ala

Back 101

wing of ilium

Front 102

sacrum

Back 102

fusion of 5 sacral vertebra

Front 103

auricular surface of ilium

Back 103

where ilium articulates w/ sacrum

Front 104

acetabulum

Back 104

where majority of load transfers occur

Front 105

posteriorly inominates fused by ____ to form ___ joints by bony congruency

Back 105

sacrum; SI

Front 106

pelvic outlet/lesser pelvis/true pelvis

Back 106

lower part of pelvis, contains all of your pelvic organs (pelvic cavity)

Front 107

pelvic inlet

Back 107

houses abdominal cavity (abdominal organs)

Front 108

pubic arch (males vs. females)

Back 108

convergence of 2 inferior pubic rami; males 50-82 degrees (wide and narrow pelvis); females at least 90 degrees (wide and short pelvis)

Front 109

iliac crest may line up w/ ____, but can be as low as ___/____ in females

Back 109

L1; L3/L4

Front 110

dual joints of SI

Back 110

1 anterior = synovial

1 posterior = syndesmosis

Front 111

anterior SI ligaments

Back 111

makes up synovial capsule of anterior SI joint

Front 112

iliolumbar ligament

Back 112

strongest ligament and primary stabilizer between vertebral column and ilium

Front 113

interosseous sacroiliac ligament

Back 113

primarily load transfer structure

Front 114

posterior SI ligaments

Back 114

lock irregular joint surfaces

Front 115

what are the different ways of approximating/giving stability to SI joint?

Back 115

form closure: bony congruency and ligaments

force closure: tension of muscles around area

Front 116

sacrotuberous ligament

Back 116

continuation of proximal HS insertion; closes off sciatic notch to form sciatic foramen

Front 117

pubic symphysis

Back 117

secondary cartilagenous joint; made up of fibrocartilage; covered by ligaments; strengthened by abdominal muscles that attach there

Front 118

what structures form closure of SI joint?

Back 118

vertebral column, iliolumbar ligament, sacrum btw 2 ilium, posterior interosseous ligament, interosseous ligaments

Front 119

coccyx

Back 119

secondary cartilagenous joint: "tailbone"

Front 120

4 functions of muscles of pelvis (4 S's)

Back 120

supportive, sphincteric, sexual, stability

Front 121

sphincteric function of pelvic muscles

Back 121

regulates openings of urethra and rectum to allow urination and defecation; voluntary and involuntary; urogenital diaphragm

Front 122

layers of urogenital diaphragm

Back 122

peripheral membrane, sphincter urethrae, deep transverse perineal muscle

Front 123

urogenital diaphragm innervated by what nerve? how can it become damaged?

Back 123

pudendal nerve; cycling which leads to incontinence

Front 124

sphincteric muscles

Back 124

UGT diaphragm (layer 2), external anal sphincter (layer 1)

Front 125

sexual muscles

Back 125

bulbospongiosus and cavernosus

Front 126

function of external urethral sphincter

Back 126

voluntary and involuntary control; layer 2 of UGTD

Front 127

internal urethral spincter function

Back 127

involuntary control; layer 2 of UGTD

Front 128

___ artery provides blood flow to penis and clitoris

Back 128

internal pudendal

Front 129

males have bulbo___ and females have bulbo____

Back 129

bulbospongiosus; bulbocavernosus

Front 130

layers of sexual muscles

Back 130

1) bulbospongiosus, ischiocavernosus,

Front 131

pelvic diaphragm

Back 131

functional group made up of third layer muscles that support pelvic viscera; levator ani, coccygeus, obturator internus, piriformis

Front 132

pelvic stability muscles

Back 132

abdominal canister, pelvic floor is inferior stabilizer of core, local stabilizer, maintenance of intra-abdominal pressure

Front 133

action of bulbospongiosus/bulbocavernosus

Back 133

assists in erection, ejaculation/compresses urethra

Front 134

ischiocavernosus

Back 134

assist/maintain erection

Front 135

pubococcygeus/puborectalis

Back 135

supports pelvic viscera (PC); voluntary sphincter of anal canal (PR)

Front 136

coccygeus

Back 136

flexes coccyx, supports pelvic viscera, stabilizes SI

Front 137

3 main nerves of pelvis (come from lumbar pelvis)

Back 137

iliohypogastric, ilioinguinal, genitofemoral

Front 138

iliohypogastric n

Back 138

motor: supplies part of transverse abdominis and internal oblique

sensory: posterolateral gluteal and suprapubic regions

Front 139

ilioinguinal n

Back 139

motor: transverse abdominis and internal oblique

sensory: medial skin of thigh and genital region

Front 140

genitofemoral n

Back 140

sensory: genital region and anteromedial skin of thigh

passes under ligament of ovary- can become entrapped in ligament = right knee pain during 1st menstrual period due to inflammation

Front 141

anterior pelvic tilt

Back 141

ASIS forward and down; nutation of sacrum

Front 142

posterior pelvic tilt

Back 142

ASIS posterior; counternutation of sacrum

Front 143

what type of motion does sacrum have?

Back 143

rocking motion

Front 144

nutation

Back 144

top of sacrum moves anteriorly

Front 145

counternutation

Back 145

top part of sacrum moves posteriorly

Front 146

lumbopelvic rhythm

Back 146

how pelvis moves in relation of lumbar spine

Front 147

ipsidirectional lumbopelvic rhythm

Back 147

lumbar spine flexion, sacrum nutation (same direction), anterior pelvic tilt

Front 148

contradirectional lumbopelvic rhythm

Back 148

sacrum nutation, extension of lumbar spine,

Front 149

pelvic torsion

Back 149

nominates go in pop direction; happens when we walk, leading leg PPT, leg trailing APT

Front 150

5 divisions of mediastinum

Back 150

superior

inferior (anterior, middle, posterior)

Front 151

superior mediastinum

Back 151

superior border: superior thoracic inlet

inferior border: sternal angle (ant) to T4-T5 (post)

Front 152

inferior mediastinum

Back 152

superior border: from sternal angle (ant) to T4-T5 (post)

inferior border: diaphragm

Front 153

anterior mediastinum

Back 153

everything anterior to pericardium but posterior to sternum

Front 154

middle mediastinum

Back 154

pericardium + everything inside it (heart, vessels, pericardial fluid)

Front 155

posterior mediastinum

Back 155

everything anterior to spine but posterior to pericardium

Front 156

2 layers of pericardium

Back 156

fibrous (superficial) and serous (deep)

Front 157

fibrous layer pericardium

Back 157

superficial; used to anchor heart into place, prevents over stretching

Front 158

serous layer pericardium

Back 158

deep; has 2 layers = parietal, visceral (pericardial space btw 2 layers which contains pericardial fluid to decrease friction w/ each beat of heart)

Front 159

phrenic nerve

Back 159

nerve roots C3, C4, C5 (3, 4, and 5 keep diaphragm alive)

Front 160

from left to right branches of arch of aorta

Back 160

brachiocephalic trunk, left common carotid, left subclavian a

Front 161

label pics from cardiac ppt

Back 161

ppt

Front 162

normal circulation

Back 162

deoxygenated blood, SVC/IVC, RA, tricuspid valve, RV, pulmonic valve, pulmonary a, lungs, oxygenated blood, pulmonary veins, LA, mitral valve, LV, aortic valve, aorta, rest of body

Front 163

SVC

Back 163

bringsdeoxygenated blood from the upper extremities andhead to the right atrium

Front 164

IVC

Back 164

brings deoxygenated blood from the lowerextremities and abdomen to the right atrium; **largest veins in the body**

Front 165

coronary sinus

Back 165

- brings deoxygenated blood fromthe coronary veins back to the right atrium

Front 166

fossa ovalis

Back 166

- end of the embryonic structure(foramen ovale)connecting the two atria

Front 167

pectinate muscle

Back 167

“rough” muscle on the anterior wallof the atrium; These rough looking muscles increase the amount of force inpumping compared to the actual mass of the muscle that is present (think wovenrope vs. many strings put together next to each other)

Front 168

crista terminalis

Back 168

thickened muscle that forms a lineseparating the pectinate muscle (anterior wall) from the smoothposterior muscle wall

Front 169

tricuspid

Back 169

- valve between the right atriumand right ventricle

Front 170

chordae tendinae

Back 170

.fibrous tendons that prevent thetricuspid valve from inverting from the high pressure created in the ventricleduring systole

Front 171

papillary muscles

Back 171

muscles which anchor into the rightventricular wall. The chordae tendinae are anchored into these muscles. Thesetwo structures prevent the Tricuspid valve from inverting. These DO NOT pull the valve open!! The valve opens and closes due tochanges in the pressure gradient.

Front 172

trabeculae carneae

Back 172

similarto the pectinate (rough muscle) muscles seen in theright atrium; These muscles are thicker andstronger than the pectinate muscles of the right atrium

Front 173

Septomarginal trabeculae (moderator band)

Back 173

runs between the anterior papillarymuscle and the interventricular septum. It makes up part of theRight Bundle Branch which is used in conduction and helps with coordinatedcontraction of the myocytes of the heart; Names moderator band as it wasthought to prevent overdistention of the RV based on its attachment sites.

Front 174

pulmonic valve

Back 174

semilunar valve

Front 175

pulmonary a

Back 175

connects the heart to the lungsin order to allow for oxygenation of the blood; carries deoxygenated blood***The only artery that does this!!•Arteriesalways go Awayfrom the heart, but they do NOT always carry oxygenated blood.

Front 176

left auricle

Back 176

.also known as the left atrial appendage;commonly the origin of arrhythmias– major one is afib1.Often pt have this cauterized to preventirregular electrical activity.

Front 177

has 3 branches (BCS)

Back 177

aortic arch

Front 178

pulmonary arteries

Back 178

contains deoxygenated blood

Front 179

pulmonary veins

Back 179

contains oxygenated blood

Front 180

coronary sinus

Back 180

remember that the coronary sinus emptiesinto the RIGHT atrium but the coronary sinus is located at the posterior sideof the heart at the base of each atrium

Front 181

A-fib

Back 181

most common arrhythmia; disorganized electrical activity of atria; does not allow for full contraction of atria; most common origin is left atrial appendage (left auricle)

considerations for PT: 15-20% decrease in CO, may require anticoagulation therapy to prevent stroke

Front 182

what happens if fossa ovalis does not close after birth?

Back 182

?

Front 183

patent foramen ovale

Back 183

failure of foramen ovale to close; allows for oxygenated and deoxygenated blood to mix

Front 184

atrial septal defect (ASD)

Back 184

failure for walls of atria to form

Front 185

ventricular septal defect (VSD)

Back 185

most common congenital heart defect

Front 186

diastole

Back 186

AV valves open, semilunar valves closed, atria contract, ventricles relaxed, blood flows into ventricles

Front 187

systole

Back 187

AV valves closed, semilunar valves open, atria are relaxed, ventricles contract, blood flows from ventricles to rest of body

Front 188

right coronary artery

Back 188

•Normally (70%) Gives off the PosteriorDescending Artery (Posterior Interventricular Artery) which is the vessel thatdecides coronary dominance•Thismeans that a patient is “right heart dominant”meaning that the RIGHT coronary artery supplies both the SA and AV nodalpacemakers•This is advantageous because BOTHpacemakers are supplied by the RCA and all of the left coronary arteries aremore commonly blocked- this leads to protection of your conduction system

Front 189

left main coronary a

Back 189

•splits into two major branches.- LAD (left anterior descending) and Lcx (left circumflex)

Front 190

left anterior descending a

Back 190

•supplies the septum and apex of the heart;anterior and interventricular of the heart; supplies 70% of the leftventricle; widow maker (supplies majority of LV)

Front 191

left circumflex a

Back 191

left lateral and posterior aspects of heart

Front 192

MI

Back 192

•Blockage of the coronary arteries•

•Decreased blood supply to the myocardium (heart muscle)•

•Results in death of the muscle tissue if intervention does not occur

Front 193

where does coronary sinus empty?

Back 193

right atrium

Front 194

cardiac veins

Back 194

great cardiac vein, middle cardiac, small cardiac, coronary sinus

Front 195

congestive heart failure

Back 195

not supplying blood to tissues adequately, diastolic: HTN, less blood fills ventricles b/c hypertrophied; systolic = too much space

Front 196

people most commonly have left or right CA dominance?

Back 196

right coronary dominance

Front 197

inferior thoracic aperture

Back 197

location of diaphragm

Front 198

manubrium level

Back 198

T3/T4 level

Front 199

body of sternum level

Back 199

T5-T9

Front 200

xiphoid process level

Back 200

T10

Front 201

sternal angle is bony landmark for what 5 things?

Back 201

2 BAAD

2- 2nd rib

B- bifurcation of trachea

A- arch of aorta

A- arch of azygous vein

D- division btw superior and inferior mediastinum

Front 202

inspiration

Back 202

expanding thoracic cavity; larger space = lower pressure inside body, air rushes IN

Front 203

quiet inspiration

Back 203

diaphragm only contracts

Front 204

force inspiration

Back 204

diaphragm, accessory and intercostals contract

Front 205

primary inspiratory muscles

Back 205

diphragm, external intercostals

Front 206

external intercostals

Back 206

inspiratory intercostals, elevate ribs during forced inspiration; think of putting your hands in outer coat pocket to think of what direction fibers of muscles go

Front 207

expiration

Back 207

shrinking thoracic cavity; smaller space = higher pressure inside body, air exits

Front 208

quiet expiration

Back 208

elastic recoil of lungs, gravity lowers ribs, abdominal pressure raises relaxed diaphragm

Front 209

forced expiration

Back 209

contraction of abd muscle forces diaphragm up

Front 210

primary expiratory muscles

Back 210

diaphragm, intercostals = internal intercostals, subcostalis, innermost intercostals, transversus thoracis

Front 211

expiratory intercostals

Back 211

internal intercostals most active during expiration, pulls ribs down, think of putting your hand inside inner coat pocket to think of direction of muscle fibers

Front 212

subcostalis

Back 212

active during expiration; only located on posterior thoracic wall

Front 213

innermost intercostals

Back 213

active during expiration; origin inferior border of ribs; insertion superior border of ribs

Front 214

transversus thoracis

Back 214

weak depression of ribs during expiration

Front 215

layers of pleura

Back 215

parietal (superficial), visceral (deep), pleural space/pleural fluid (decreases friction)

Front 216

pleural effusion

Back 216

pleural fluid accumulates in pleural space due to any number of reasons (bacterial infection, cx, surgery), symptoms include: pleuritic chest pain= pain associated w/ breathing, SOB; tx: may resolve on own, may require chest tube or thoracentesis

Front 217

hilum

Back 217

location on lung where structures of root of lungs enter and exit lung

Front 218

root of lung

Back 218

structures that enter and/or exit lung; attach lung to body = pulmonary a, pulmonary v, bronchi, nerves, lymphatics

Front 219

lung divisions

Back 219

right lung: 3 lobes = superior, middle, inferior (horizontal and oblique fissures)

left lung: 2 lobes: superior and inferior (oblique fissure)

fissures: horizontal and oblique x2

Front 220

most superior structures in lungs

Back 220

pulmonary a's

Front 221

most anterior and inferior structures in lungs

Back 221

pulmonary veins

Front 222

most central and posterior structures in lungs

Back 222

bronchi

Front 223

SVC ___ and ___ to trachea

Back 223

anterior and lateral

Front 224

____ loops over left main bronchus

Back 224

aorta

Front 225

carina

Back 225

bifurcation of trachea into left and right main bronchi

Front 226

types of bronchi

Back 226

primary, secondary, tertiary, bronchioles

Front 227

types of bronchioles

Back 227

conducting, terminal, respiratory, alveoli

Front 228

located on posterior abdominal wall; anteriorly to vertebral column and to right of abdominal aorta

Back 228

IVC

Front 229

runs up vertebral column and connects IVC and SVC and can drain either if one is blocked

Back 229

azygous vein

Front 230

femoral a

Back 230

continuation of external iliac a (terminal branch of abdominal aorta); external iliac becomes femoral artery when crosses under inguinal ligament and enters femoral triangle

Front 231

medial femoral circumflex a

Back 231

wraps around posterior side of femur, supplying neck and head of femur. in fx of femoral neck, this artery can easily be damaged, and avascular necrosis of femur head can occur

Front 232

Thefemoral artery moves throughadductor hiatusand enters the posterior compartment of the thigh, proximal to the knee, now known as

Back 232

popliteal a

Front 233

arteries of leg (from aorta down in order)

Back 233

Aorta> Common Iliac a. > Internal Iliac a. +External a.

ExternalIliac a. > Femoral a. > Deep Femoral a.+ Popliteal a.

Popliteal a. >anterior + posterior tibial a.

Front 234

4 pulse sites of PT eval

Back 234

femoral, popliteal, posterior tib, dorsalis pedis

Front 235

avascular necrosis of femoral neck/head

Back 235

femoral neck fx could cause damage to medial femoral circumflex a; primary blood supply to femoral neck and head

Front 236

.isformed by the dorsal venous arch of the foot, and the dorsal vein of the littletoe. It moves up the posterior side of the leg, passing posteriorly to the lateralmalleolus,along the lateral border of the calcaneal tendon. It moves between the twoheads of the gastrocnemius muscle and empties into the poplitealvein inthe poplitealfossa.

Back 236

small saphenous v

Front 237

great saphenous v

Back 237

.thevein moves up the leg, it receives tributaries from other small superficialveins. The great saphenous vein terminates by draining into thefemoral vein immediately inferiorto theinguinal ligament.

Front 238

deep vein thrombosis

Back 238

blood clot in deep veins, blocking blood return; sx's: pain, redness, swelling, impaired mobility

who's at risk: post op, smoking, diabetes, OW, sedentary

virchow's triad: endothelial damage, period of stasis, hyper coagulable state

Front 239

CABG surgery

Back 239

great saphenous vein harvested; pt may have pain, swelling, and mobility difficulty following CABG if site is used

Front 240

spleen

Back 240

fans mainly as blood filter, removing old RBCs; plays role in immune response

Front 241

thymus

Back 241

responsible for dev't and maturation of T lymphocyte cells

Front 242

red bone marrow

Back 242

responsible for maturation of immature lymphocytes, like thymus

Front 243

lymph fluid

Back 243

transparent and yellow; formed when fluid leaves capillary bed in tissues due to hydrostatic pressure; comp = 95% water, 5% proteins lipids carbs, ions, lymphocytes

Front 244

lymph nodes

Back 244

adults have 400-500

majority located in abdomen

house T lymphocytes, B lymphocytes, other immune cells

Front 245

lymph node groups

Back 245

cervical, mediastinal, axillary, inguinal

Front 246

right lymphatic duct

Back 246

drains right side of head, right arm, and right thorax; dumps into R internal jugular vein

Front 247

thoracic duct

Back 247

drains rest of body; drains into left internal jugular vein

Front 248

ultrafiltration (lymph drainage)

Back 248

fluid leaving arterial capillaries

Front 249

re-absorption (lymph drainage)

Back 249

fluid re-entering venous capillaries or returning to venous system just before heart

Front 250

lymphoma

Back 250

tumor from lymphocytes (non-hodgkin 90%, hodgkin 10%), RFs = epstein-barr virus, AI diseases, HIV/AIDS, large amts meats and fats

Front 251

lyphadema

Back 251

abnormal swelling due to: removal of lymph nodes, blockage of lymph system; tx w/ compression therapy

Front 252

thoracic spine role

Back 252

protection of viscera; provides attachment for upper extremities, muscles of abdomen, back, respiration, and upper limb, resists internal pressure of lungs; most stable part of spine b/c of all the joints

Front 253

transitional zones of thoracic spine

Back 253

upper thoracic T1-T4 = like cervical

mid thoracic T4-T8 = typical thoracic

lower thoracic T9-T12 = like lumbar

Front 254

demifacets

Back 254

bumps posterolateral side of body; heads of ribs articulate here

Front 255

why do heads of ribs cover intervertebral disks?

Back 255

extra protection; hard to herniate disk in thoracic spine; costal facets aka costovertebral joints

Front 256

costotubercular facet

Back 256

on transverse process; where tubercle of rib articulates w/ transverse process = costotransverse process

Front 257

superior articular facets

Back 257

zygoapophyseal joint and inferior articular facets; 60-90 degrees in frontal plane; good at lateral flex

Front 258

head of rib articulates w/

Back 258

demifacets

Front 259

t/f: each rib has own segmental innervation and blood supply

Back 259

T

Front 260

end of rib articulates w/

Back 260

hyaline cartilage (costal cartilages) and articulates w/ sternum

Front 261

radiate ligament

Back 261

anterior support of costovertebral joint

Front 262

costotransverse ligament

Back 262

btw neck of rib, transverse process and costotransverse joint

Front 263

rules of 3's for spinous processes in thoracic spine

Back 263

take 1st 3 thoracic vertebrae spinous processes line up w/ transverse processes (t1-T3); T4-T6 spinous process of vertebrae 1/2 way btw own transverse process and one below it; T7-T9 lines up w/ transverse process full level below it; T10-T12= T10 just like T1 so in line w/ transverse, T11 1/2 way btw own transverse and one below, T12 1 whole vertebrae below

Front 264

sternal angle

Back 264

T4-T5 level

Front 265

manubriosternal joint

Back 265

symphysis joint in most but could be synovial

Front 266

body of sternum

Back 266

T5-T9

Front 267

1st rib attaches at

Back 267

manubrium

Front 268

what ribs attach directly to sternum?

Back 268

1-7 (sternalcostal joint) aka true ribs

Front 269

___,____, and _____ cover each whole rib on inside of "ring"

Back 269

nerve, a, v

Front 270

false ribs

Back 270

T8-T10, attach to costal cartilages, more elasticity for breathing

Front 271

floating ribs

Back 271

T11-T12, no attachment

Front 272

cervical rib

Back 272

articulates w/ C7 (only some people have)

Front 273

1st rib

Back 273

acute arc, broad and flat

Front 274

be able to identify rib level

Back 274

practice identifying ribs

Front 275

ribs 2-7

Back 275

wider and more circular

Front 276

8-11 ribs

Back 276

more circular

Front 277

12th rib

Back 277

short and flat

Front 278

intercostal spaces

Back 278

space btw ribs; named by superior rib (btw 4 and 5 ribs = 4th intercostal space)

Front 279

ext of thoracic spine

Back 279

inferior glide of facets; disk is post compressed, zygoapophyseal slides inferior; costovertebral post roll; costotransverse inferior glide; superior vertebra slide inferior

Front 280

flex of thoracic spine

Back 280

superior glide of facets; disk is stretched posterior and compressed anterior; costovertebral joint rolls anterior, costotubercular joint rolls superior

Front 281

side bending to left thoracic spine

Back 281

ispilateral articulating process glides inferior, contralateral articulating process glides superiorly

Front 282

thoracic spine rotation to left

Back 282

ipsilateral side gapping, contralateral side approximation

Front 283

which spine has largest vertebral foramen

Back 283

cervical

Front 284

vertebral arteries go through ____ in c spine

Back 284

transverse foramen

Front 285

typical cervical vertebrae

Back 285

C3-C7

Front 286

facet orientation in cervical spine

Back 286

45 degrees above horizontal (z-joints)

Front 287

intervertebral foramen

Back 287

where nerves come out

Front 288

flexion of c spine

Back 288

anterior and superior; superior vertebrae inferior, articular facet anterior and superior

Front 289

extension of c spine

Back 289

posterior and inferior; superior vertebrae inferior, articular facet posterior and inferior; post element stretched, anterior compressed, disk shifted posterior

Front 290

rotation of c spine

Back 290

ipsilateral side = post and inferior glide, contralateral = anterior and superior glide; same mechanics as side bending, named by direction of body

Front 291

trap

Back 291

upper, middle, lower; scapulae medially and downward

Front 292

lat dorsi

Back 292

adducts, ext, IR shoulder

Front 293

thoracodorsal fascia

Back 293

blends w/ lat dorsi

Front 294

lat dorsi + thoracolumbar fascia

Back 294

ext and supports lumbar spine

Front 295

serratus posterior inferior, serratus posterior superior

Back 295

respiration

Front 296

superficial muscles of back

Back 296

trap, lat dorsi, serratus muscles

Front 297

deep muscles of back

Back 297

erector spinae (iliocostalis, longissimus, spinalis)

Front 298

deep intrinsic muscles of back

Back 298

rotatores, multifidus, semispinalis, intertransversarii

Front 299

rotatores

Back 299

good at rotation; short and stocky; transverse process to spinous process (1level)

Front 300

multifidus

Back 300

oblique, transverse process 2-4 levels above and attach to spinous process (side bend by themselves and ext)

Front 301

semispinalis

Back 301

6-8 levels transverse process to spinous process

Front 302

intertransversarii

Back 302

in btw transverse processes

Front 303

levator scapulae

Back 303

raises scapula, rotation of neck, side bend and rotation of neck; primary job = resists anterior shear of vertebrae

Front 304

trace anterior thigh vasculature aorta down

Back 304

aorta > internal and external iliac a > external iliac becomes femoral a > profound femoris (goes through adductor canal in add magnus), lateral circumflex a, medial circumflex a

Front 305

posterior thigh vasculature down

Back 305

aorta > common iliac a > internal iliac a > superior gluteal, inferior gluteal, perforating branches profunda femoris > popliteal a (at adductor hiatus) > anterior tibial a which becomes dorsalis pedis/posterior tibial a which becomes fibular a

Front 306

ligamentum teres

Back 306

runs through fovea capitis and supplies blood to head of femur; avascular necrosis (no mechanism of injury); comes from iliac a

Front 307

medial circumflex a

Back 307

supplies lateral part on outside of femoral head; fine unless fx neck of femur then cuts off flow to external femoral head

Front 308

pulse points

Back 308

femoral a, popliteal a, posterior tib a, dorsalis pedis a

Front 309

decrease pulse at post tib a, but pulse at femoral is fine

Back 309

not strong enough to pump down, poor circulation, check popliteal if normal, compartment syndrome (check dorsalis pedis = compartment syndrome if normal)

Front 310

saphenous nerve

Back 310

anterior and medial knee from femoral n; cutaneous n

Front 311

diaphragm O, I, In, A

Back 311

O: lower ribs, vertebral bodies L1-L3 and their disks, ALL, xiphoid process; I = central tendon; In = phrenic n C3-5; A = respiration

Front 312

perforating branches

Back 312

3 or 4 branches that perforate add magnus; supplies muscles in medial and posterior thigh

Front 313

lateral femoral circumflex

Back 313

wraps around anterior and lateral side of femur; supplies some muscles on lateral side of thigh

Front 314

medial femoral circumflex

Back 314

wraps around posterior side of femur; supplies head and neck of femur; can be damaged w/ femoral neck fx

Front 315

superior gluteal a

Back 315

exits above PF and supplies gluteal muscles

Front 316

inferior gluteal a

Back 316

exits below PF and supplies gluteal and muscles of post thigh

Front 317

obturator a

Back 317

descends through obturator canal to medial thigh

Front 318

popliteal a

Back 318

continuation of femoral a; gives off genicular branches that supply knee joint; divides into anterior and post tibial a

Front 319

posterior tibial a

Back 319

splits into medial and lateral plantar a which supplies plantar aspect of foot and toes; branches to fibular a in lower leg

Front 320

cervical forward bending

Back 320

inferior facet glides anterior and superior; increases lateral foramen diameter and vertebral canal widens

Front 321

cervical back bending

Back 321

inferior facet glides inferior and posterior on superior facet

Front 322

rotation of cervical spine

Back 322

ipsilateral: inferior/posterior glide; contralateral: superior/anterior glide (decreases intervertebral foramen diameter on ipsilateral side)