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52 Cards in this Set
- Front
- Back
Explain Naming Rules for spinal nerves,
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1. Superior to C8, spinal nerves are named for vertebrae immediately inferior to it.
2. Beginning at T1, the numbers of spinal nerves correpond to the vertebrae just superior to them. |
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What causes the intervertebral foramen to be compromised?
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1. Osteophytes (excess bone growths)
2. Anything compromising the space is liable to impinge on that nerve and produce pain |
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Name the boundaries of the intervertebral foramen.
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1. Superior & Inferior Boundary: Pedicles of the respective vertebrae.
2. Anterior Boundary: Intervertebral discs and the bodies 3. Posterior Boundary: articular processes or facets |
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Uncinate process
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Corresponds to similar are on cervical vertebrae - often predisposed to develop these excess bony growths.
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Name boundaries of the posterior triangle.
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1. Posterior: Trepezius
2. Anterior: Sternocleidomastoid 3. Inferior: Middle 1/3 of clavicle |
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Why is posterior triangle important?
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If unable to stop bleeding of brachial artery by pushing artery against humerus, there are other places to push artery against the bone (push against 1st rib)
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What can be done for intractable pain in the upper limb?
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Block sensations of the Brachial plexus by anesthetizing the entire brachial plexus at this point (sometimes done in surgery)
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Where is a common place for introduction of a central line?
What is a central line? What is it used for? |
1. In or near the posterior triangle.
2. Catheter into a vein & extending it to the central part of the body = the heart 3. Used to put anesthetics/liquid nutrition/chemo into bodies 4. Usually put in peripherally placed veins (e.g subclavian) |
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What muscle divides the posterior triangle and into how many parts?
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1. omohyoid muscle (attaches to the medial margin of suprascapular notch)
2. two parts 3. Attaches to shoulder blade to hyoid bone |
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Name the regions superior & inferior to Omohyoid
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1. Occipital triangle.
2. Supraclavicular triangle/Subclavian triangle. |
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Name two heads of Sternocleidomastoid?
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1. Sternal head
2. Clavicular head |
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What else divides the posterior triangle and into what zones?
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1. Spinal accessory nerve (CN XI)
2. Superior zone: Find occipital artery in apex of triangle (CAREFREE) 3. Inferior zone: Brachial plexus, Subclavian artery, subclavian vein - CAREFUL |
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What forms the 'floor' of the posterior triangle?
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1. Muscles with fascial covering
2. Scalene muscles: Posterior, Middle, Anterior 3. Levator scapulae (CN XI crosses in front of it) 4. Splenius capitus |
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Where is nerve point located?
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Junction of Superior 1/3 and Inferior 2/3 of posterior border of SCM
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What is gap btwn to heads of SCM used for?
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1. Interval is used for introduction of central line into the Internal Jugular Vein.
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Torticollis
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1. Wry-neck
2. Condition when develop spasms in SCM 3. Cut roots of the spinal accessory nerve that innervates the SCM |
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Contents of Posterior Triangle:
1. Veins 2. Arteries 3. Nerves |
1. External Jugular Vein & Subclavian
2. Subclavian, Transverse cervical, suprascapular & occipital 3. Spinal accessory nerve, great auricular, transverse cervical, supraclavicular |
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Define fascia.
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1. Dense connective tissue that surrounds muscle and is found in between muscles
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Platysma muscle:
1. Define 2. Location |
1. Muscle of facial expression
2. Contained in superficial plasma - 'paper thin' muscle |
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What else is in superficial fascia?
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1. EJV
2. Cutaneous nerves |
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Fascia:
1. Superficial 2. Next layer 3. Relation to posterior triangle |
1. Initial layer of deep fascia = investing layer of the deep fascia
1b. Fascial roof of triangle & envelops SCM 2. Internal to investing fascia, it is called prevertebral fascia (such as scalene muscles) 2b. Forms facial floor of triangle |
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What is most frequently injured neve by doctors?
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-Spinal accessory nerve. When physicians are trying to diagnose pathology by taking a biopsy of lymph nodes, many of which are found along this nerve, they will injure it.
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What does the EJV flow into and where does it lie?
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1. The subclavian vein.
2. External to the SCM |
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What does IJV drain?
Where is it located? |
1. Internal jugular vein drains the head.
2. Deep to the SCM. |
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What 2 veins form the right brachiocephalic vein?
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1. Subclavian (drains brachium/ upper limb)
2. IJV (drains head) |
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What forms SVC (Superior vena cava)?
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1. Right & left brachiocephalic veins
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Name three branches off the aortic arch in order.
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1. Brachiocephalic artery/trunk (right to left) which gives rise to right subclavian artery & right common carotid
2. Left common carotid (2nd) from left side of arch 3. Left subclavian artery (3rd) found laterally to L common carotid |
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Name the branches of the thyrocervical trunk.
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1. Suprascapular artery
2. Transverse Cervical 3. Inferior thyroid 4. Ascending cervical 1&2 run superficial to anterior scalene muscles which attach to the first rib |
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What divides subclavian artery into 3 parts?
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Anterior scalene muscle
1. Proximal is 1st 2. Posterior is 2nd 3. Distal/Lateral is 3rd Note: Thyrocervical trunk branches from subclavian part 1. |
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What divides axillary artery into 3 parts?
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Pectoralis Minor
1. Proximal is 1st. 2. Posterior is 2nd 3. Distal/lateral is 3rd. |
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What are intercostal nerves.
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1. Ventral rami in the thoracic region lie in between ribs
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What do ventral rami form in the cervical & lumbaral regions?
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1. Ventral rami form plexuses (network of nerves)
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Cervical plexus
1. Components 2. How many parts and name them. |
1. Ventral Rami of C1-C4
2. Five parts: Phrenic nerve 4 Cutaneous nerves Sensory contributions to spinal accessory nerve |
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Phrenic nerve
1. Components 2. Location 3. Function |
1. Arises from C3, C4, C5
2. Anterior surface of anterior scalene muscle 2b. Runs accross anteior surface of SCM 2c. Runs inferior to transverse cervical and suprascapular nerves 3. Innervates respiratory diaphragm NOTE: Crushed to cure chronic hiccups |
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Sensory contributions to CN XI
1. Why needed? 2. Importance |
1. CN XI is strictly motor to SCM & Trapezius
2. Generally tell us location of neck |
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Name 4 Cutaneous branches of cervical plexus
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1. Greater auricular - runs posterior with EJV, across anterior surface of SCM
2. Lesser occipital nerve - ventral ramus 3. Transverse cervical nerve - runs transversely across the neck 4. Supraclavicular nerves: 3 parts: Medial, Intermediate, Lateral - they arise from C3, C4 |
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Axilla:
1. Define 2. Contents 3. Location 4. Borders |
1. Armpit
2. Axillary vein & artery, brachial plexus, filled w/ fat, lymphatics, & fascia 3. 4. Shaped like pyramid: Medial border = serratus anterior Posterior border = subscapularis Anterior border = Pec. major/minor Lateral border = Intertubecular groove (where latissimus attaches) |
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Contents of Cervical Axillary Canal Region
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AKA = Axilla
1. Subclavian artery 2. Subclavian Vein 3. Brachial Plexus 4. Apex of lung |
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What divides Brachial plexus?
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Clavicle divides it into supraclavicular part & infraclavicular part
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Brachial Plexus:
1. Origin 2. What does it supply? |
1. Ventral Rami of spinal nerves C5-T1
2. Supplies whole upper limb |
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Path or Brachial plexus.
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1. 5 spinal nerves / roots
2. 3 Trunks 3. 6 Divisions (3 anterior/ 3 posterior) 4. 3 Cords 5. 5 Branches |
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Name 3 Trunks:
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1. Upper/Superior
2. Middle 3. Lower/Inferior |
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Name 6 Divisons:
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1. Anterior div. upper trunk
2. Anterior div. middle trunk 3. Anterior div. lower trunk 4. Posterior div. upper trunk 5. Posterior div. middle trunk 6. Posterior div. lower trunk |
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Name 3 cords and what forms them.
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1. 2 Anterior divisions form Lateral cord
2. Single anterior division from lower trunk forms medial cord 3. 3 Posterior divisions form posterior cord Note: all named according to their relative position to axillary artery |
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Name 5 terminal branches.
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1. Musculocutaneous (5,6,7)
2. Axillary (5,6) 3. Radial (5,6,7,8,T1) 4. Median (5,6,7,8,T1) 5. Ulnar (7,8,T1) |
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Path or Brachial plexus.
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1. 5 spinal nerves / roots
2. 3 Trunks 3. 6 Divisions (3 anterior/ 3 posterior) 4. 3 Cords 5. 5 Branches |
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Name 3 Trunks:
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1. Upper/Superior
2. Middle 3. Lower/Inferior |
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Name 6 Divisons:
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1. Anterior div. upper trunk
2. Anterior div. middle trunk 3. Anterior div. lower trunk 4. Posterior div. upper trunk 5. Posterior div. middle trunk 6. Posterior div. lower trunk |
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Name 3 cords and what forms them.
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1. 2 Anterior divisions form Lateral cord
2. Single anterior division from lower trunk forms medial cord 3. 3 Posterior divisions form posterior cord Note: all named according to their relative position to axillary artery |
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Name 5 terminal branches.
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1. Musculocutaneous (5,6,7)
2. Axillary (5,6) 3. Radial (5,6,7,8,T1) 4. Median (5,6,7,8,T1) 5. Ulnar (7,8,T1) |
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Which spinal nerves does
1. long thoracic nerve, 2. dorsal scapular, 3. suprascapular, 4. N to subclavius 5. Medial/Lateal Pect. Nervescontain. |
1. C5, C6, C7
2. C5 3. C5, C6 4. C5, C6 5. Medial = C5, C6/Lateral = C8, T1 |
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Name attachments of scalene muscles.
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1. Anterior & middle scalene muscles attach to 1st rib.
2. Posterior scalene muscle attaches to 2nd rib. |