Gross Anatomy Fall 08: Anatomical Terms (Pgs 1-9)

Front 1

-prone vs supine?
-describe the anatomical position

Back 1

prone: lying with the face downwards. supine: lying on the back with the face upwards.

anatomical position: body is an erect, standing position, with arms at side, palms turned forward, the lower limbs parallel and the toes pointing forward.

Front 2

1) toward the head end of the body, or upper
2) toward the midline of the body or structure
3) toward the tail end of the body, or lower
4) toward the surface of the body
5) the front surface of the body
6) toward the midline of the body
7) away from a point of reference, usually the trunk or midline of the body, or the source of a part.
8) away from the midline of the body
9) near or toward a point of reference, usually the trunk or midline of the body, or the beginning source of a part.
10) the back surface of the body
11) the actual midline directly at the center.

Back 2

1) superior, cephalic, or cranial
2) deep, central, or internal
3) inferior or caudal
4) superficial or external
5) anterior or ventral
6) medial
7) distal. ex: the hand is located at the distal end of the forearm, the elbow at the proximal end.
8) lateral
9) proximal.
10) posterior or dorsal
11) median

Front 3

1) the vertical plane dividing the body into two apparently symmetrical halves
2) any lengthwise vertical plan running from front to back, dividing the body or any part of of it into right and left sides
3) any lengthwise vertical plane running from side to side, dividing the body or any part of it into anterior and posterior portions
4) a crosswise plane dividing the body or any part of it into upper and lower parts

Back 3

1) median
2) sagittal
3) frontal or coronal
4) transverse or horizontal

Front 4

Back 4

Front 5

Back 5

Front 6

(insert number) cranial nerves and (insert number) spinal nerves form the (?).

-DESCRIBE the parts of central nervous system (CNS) and peripheral nervous system (PNS)

-Af- vs Ef-?

Back 6

12 pairs of cranial nerves and 31 pairs of spinal nerves form the peripheral nervous system.

CNS= brain and spinal cord
PNS= the spinal cord has two parts:
1) Afferent (sensory) system from receptors in periphery to CNS
2) Efferent (motor) system: from CNS to effectors in periphery

The Efferent (motor) system breaks down into:
A) Somatic nervous system (SNS): from CNS to skeletal muscles
B) Autonomic nervous system (ANS): from SNC to smooth muscle, cardiac muscle, and glands. We have no control over the ANS.
The ANS then breaks down into:
a) Sympathetic nervous system (fight or flight)
b) parasympathetic nervous system (rest and digest)


af-= toward
ef-=away

"SAME DAVE"="Sensory Afferent, Motor Efferent. Dorsal Afferent, Ventral Efferent."

Front 7

1) smooth vs striated? (how are they controlled in the PNS?)

2) define what a spinal nerve does?

Back 7

1) smooth-autonomic
striated-sensory, motor

2) it's a nerve that carries information to or from the body to the spinal cord (like a telephone)

Front 8

list the cranial nerves in order, with correct roman numeral, and what it controls (motor, sensory, or both). And correct initials/designations for each.

Back 8

I Oh (Olfactory)
II Oh (Optic)
III Oh (Oculomotor)
IV To (Trochlear)
V Touch (Trigeminal)
VI And (Abducens)
VII Feel (Facial)
VIII Vagina (Vestibulocochlear aka Auditory)
IX Gives (Glossopharyngeal)
X Victor (Vagus)
XI A (Accessory)
XII Hard-on (Hypoglossal)


I Some (Sensory)
II Say (Sensory)
III Marry (primarily Motor)
IV Money, (primarily Motor)
V But (Both)
VI My (primarily Motor)
VII Brother (Both)
VIII Says (Sensory)
IX Big (Both)
X Boobs (Both)
XI Matter (primarily Motor)
XII More (primarily Motor)

"You have I nose & II eyes"
I - Olfactory n.; II - Optic n.

Cranial nerves: CN I, CN II, CN III....

Spinal nerves
a) cervical apical nerve: Cn1, Cn2...
b) thoracic nerve: Tn1, Tn2....
c) Lumbar: Ln1, Ln2....
d) Sacral: Sn1, Sn2....
e) Coccygeal: Con1

Front 9

sensory, motor, or both?
1) dorsal root
2) ventral root
3) spinal nerve
4) dorsal ramus
5) ventral ramus

Ramus vs Root?

Back 9

1) sensory
2) motor
3) both sensory and motor
4) both sensory and motor (mixed)
5) both sensory and motor (mixed)

Root=only sensory or motor
Ramus=has mixed

Front 10

30 pairs of spinal nerves have both (mixed) sensory and motor fibers except...

Back 10

except ONE: Cn1
the cervical nerve 1 only has motor fibers

Front 11

define Splanchnic nerves and list them

Back 11

Nerves that synapse OUTSIDE the sympathetic chain
a) T5-T9 Greater Splanchnic-celiac ganglion
b) T10-T11: Lesser Splanchnic- Superior mesenteric ganglion
c) T12: Lowest Splanchnic- Aortico- Renal Ganglion
d) L1-L2: lumbar splanchnic- Inferior mesenteric ganglion


note: pelvic splanchnic nerves are located at sacral spinal nerves 2,3,4 ("sacral 234 keeps the penis off the floor")

Front 12

Where are the cell bodies located at in the cranial nerves?

Back 12

CN III, VII, IX, and X and spinal nerves S2,3,4 which are the pelvic splanchnics

Front 13

the autonomic nervous system consists of the parasympathetic system and the sympathetic system. the cell bodies for these systems are located in specific areas of the nervous system, list where they are located for both systems.

Back 13

parasympathetic system- cell bodies located in cranial nerves III, VII, IX, and X, and sacral spinal nerves 2, 3, and 4 ("S2,3,4 keep the penis off the floor") which are the pelvic splanchnics (rest/DIGEST--hindgut, genitals, bladder, rectum, etc).

sympathetic system- also called the thoracolumbar part of the autonomic nervous system. it all occurs in thoracic and lumbar region:
T1-L2 (L3) contribute fibers toward the formation.

Front 14

for the sympathetic nervous system the preganglionic __1__ fibers from the spinal cord enter the __2__ rami communicantes of the sympathetic trunk then:
1) synapse at the __3__ level (postganglionic sympathetic fibers leave through the __4__ rami communicantes).
2) go up the chain and synapse at a __5__ level (ex: superior, middle, and inferior cervical ganglion)
3) passes through the sympathetic trunk __[with/without] synapsing but __[do/do not]__ synapse with other ganglia outside the chain...ex:
a) T5-T9=______
b) T10-T11=_____
c) T12=_____
d) L1-L2=_____

Back 14

1) myelinated
2) white
3) same
4) grey
5) different
6) without
7) do

a) greater splanchnic- celiac ganglion
b) lesser splanchnic- superior mesenteric ganglion
c) lowest splanchnic- aortico-renal ganglion
d) lumbar splanchnics-inferior mesenteric ganglion

Front 15

pre-ganglionic vs post-ganglionic

Back 15

pre=fibers from the CNS to the ganglion

post=fibers from the ganglion to the effector organ

*EVERY nerve has to synapse somewhere in the body. there are hundreds of fibers in these nerves, not just 1. some fibers synaps at one level and others at other levels.

Front 16

3 fibers of skin and functions of skin

Back 16

elastic, collagen, reticular.

protection, reception, excretion/absorption (topicals), regulation of body temperature

Front 17

1) skin freely movable over superficial fascia, maybe wrinkled or pulled up into folds--except palm and soles. over joints.

2)skin is not smooth, geometric pattern of creases, follows bundle of collagen fibers in dermis of skin

3) found in palm of hand and sole of foot--alternate ridge and grooves and give finger and foot prints

Back 17

1) flexure lines
2) tension line or langer's lines
3) friction line

Front 18

1) what is a dermatome?

2) (adjacent/nonadjacent) dermatomes overlap

3) __(#)__ contiguous spinal nerves are needed to be anesthesized during surgical intrusion of the skin

4) it is impt to know the dermatomes because they help detect ____

Back 18

1) an area of skin supplied by the sensory fiber of a dorsal root through dorsal and ventral rami of the spinal nerves
"tome"=section
"derma"=skin

2) adjacent
3) 3
3) neurological lesion (ex: chicken pox becomes shingles)

Front 19

during surgery always cut along _____. because if you cut ____ it does not heal and it scars.

Back 19

cut along the collagen lines aka tension lines.

if you cut collagen fibers it does not heal and it forms scars.

Front 20

stetch marks vs keloid

Back 20

stretch marks- seperation of the collagen fibers -- use oil to avoid stretch marks

keloid-excessive scarring, collagen secreted by fibroblast cells-- inject an antifibroblastic proliferation in area of scarring

Front 21

key dermatomes:
1) nipple
2) navel
3) above the pubic bone
4) hallux (big toe)
5) middle finger
6) little finger

Back 21

1) T4
2) T10
3) T12
4) L4
5) C7
6) C8

Front 22

what is fascia and the diff b/w superficial and deep fascia

Back 22

fascia=mixture of fat and connective tissue ("packaging material")

superficial fascia-usually contains more FAT than fibers--under skin

deep- usually contains more FIBERS than fat

Front 23

1) the mammary gland is composed of what?
2) the breast is located b/w the ___ and ___ and between ribs ____
3) nipple is in intercostal space ___ on top of the pectoralis major and minor muscles

4) a nipple is a ____
5) the two major contents of breast are ___ and ___. a non-lactating breast is mostly ____
6) 60% of carcinoma of the breast is located in the ______ quadrant

Back 23

1) breast and axillary tail
2) sternum and mid-axillary line between ribs 2-6
3) 4 (b/w ribs 4 and 5)
4) modified sweat gland
5) fat and glands. fat.
6) superolateral

Front 24

75% of the lympatic drainage of the breast is into the ____
-name the the other lymphatic drainages

Back 24

axillary lymph nodes--75%

transpectoral, parasternal (internal thoracic artery), to opposite breast, ligamentum teres (to liver)

Front 25

the lympatic drainages of the thorax/breast allow the spread of carcinoma to what 3 areas?

Back 25

lungs, mediastinum (middle of sternum), and liver

Front 26

in a radical mastectomy what is removed?

Back 26

breast, axillary lymph nodes, muscles both major and mino pectoralis muscles, medial and lateral nerves, medial and lateral arteries, minor arteries, opposite breast

Front 27

thoracic inlet starts and ends where and consists of what?

Back 27

a) 1st rib, manubrium sterni, 1st thoracic vertebra

structures located in inlet:
trachea
esophagus
nerves (vagus, phrenic)
apex of lung

Front 28

probability of daughter getting breast cancer if mother or aunt has it?

Back 28

mother-5x
aunt-3x

Front 29

thoracic outlet

Back 29

T12, rib 12, costal margin

Front 30

landmarks:
1) xiphoid process is at what level?
2) sternal angle is where?

Back 30

1) level of T10 or T11
2) lower border of T4 (impt in respiration bc it tells us the thoracic cage is NOT horizontal but is tilted forward and downward)

Front 31

how many ribs? identify true/false ribs and the typical/atypical ribs

Back 31

12 pairs
Rib 1-7 articulate DIRECTLY through their costal cartilages with sternum aka TRUE RIBS

Ribs 8-9-10 articulate with ADJACENT costal cartilage aka FALSE RIBS

Rib 11-12 aka floating ribs aka FALSE RIBS end among the muscles of the body wall

Typical ribs- Ribs 3-9 with head, neck, shaft, costal groove shelters the nerve, artery and vein (aka the neurovascular bundle).

atypical- ribs 1,2 and 10-12 are unique for each one.

RIBS DO NOT ARTICULATE WITH THE STERNUM DIRECTLY BUT THROUGH COSTAL CARTILAGE

Front 32

functions of thoracic cage

Back 32

1) protects internal organs
2) attachment of muscle
3) assist in breathing

Front 33

muscles of thoracic wall and what ribs they go to

Back 33

*1) serratus anterior ('serratus'='jagged')
-forms medial wall of axilla from ribs 1-8

-inserts in costal surface of scapula including:
i: superior angle
ii: inferior angle
iii: medial border

Front 34

what nerve is found inside the AXILLA and what are its functions and what happens if you cut it?

Back 34

LONG THORACIC NERVE

fcn: rotates scapula, abductor of arm and elevation above the horizontal plane and respiration

cut nerve?
-winging of scapula
-loss of elevation
-problems in respiration

Front 35

what are the 3 muscle intercostals and their attachment, fcn, and corresponding nerve

Back 35

1) EXTERNAL INTERCOSTAL MUSCLE
attachment: lower borders of the ribs 1-11 to the upper borders of ribs 2-12
-*fibers run down and forward at the costochondral joint are replaced by the external intercostal membrane
fcn: elevate the rib cage--muscle of inspiration
nerve: corresponding intercostal nerves

2) INTERNAL INTERCOSTAL MUSCLE
-*fibers run down and backward
-attachment: same as external intercostal muscle
-internal intercostal membrane is near the vertebrae
fcn: muscle of expiration
-nerve: corresponding intercostal nerve

3) INNERMOST INTERCOSTAL MUSCLE
has 3 parts:
i) the innermost intercostal per se. it is mostly membrane
ii) subcostalis muscle--found at the ANGLE OF RIB ONLY; attachment- b/w the ribs posteriorly and may cross 1 or 2 ribs and attach to the third rib; fcn- expiration
iii) sternocostalis muscle (transversus thoracis muscle)- attachment- back of xiphoid process and sternum; inserts- in the cotal cartilages; nerve-intercostal nerves; fcn- expiration

*INNTERMOST INTERCOSTAL MUSCLE FIBERS RUN DOWN AND BACKWARD ALSO

Front 36

nipple of the breast is in intercostal space __

Back 36

4

Front 37

how many intercostal spaces are there?

Back 37

11 intercostal spaces--space below the 12th rib is the subcostal space

Front 38

posterior intercostal neurovascular bundle is bw the _____ and ____

Back 38

internal intercostal muscle and the innermost intercostal muscles

Front 39

what is the arterial blood supply of the anterior aspect of intercostal spaces?

Back 39

internal thoracic artery (a branch from the subclavian artery)

Front 40

what is the arterial blood supply of the posterior aspect of the intercostal spaces?

Back 40

a) 1st intercostal space- highest intercostal artery (from the costocervical trunk which is a branch from the subclavian artery)

b) 2-11- by posterior intercostal arteries (from thoracic aorta directly)

c) subcostal space ("12th")- by the subcostal artery (from the thoracic aorta directly)

Front 41

what is the venous blood supply of the anterior aspect of the intercostal spaces?

Back 41

internal thoracic vein drains into the brachiocephelic vein

Front 42

what is the venous blood supply of the posterior aspect of the intercostal spaces?

Back 42

the right and left side are different and examined seperate:
RIGHT SIDE
-1st intercostal space- highest intercostal vein drains into the brachiocephalic vein
2-3- higher intercostal drains into azygos (right side)
4-11- intercostal veins drain directly into the azygos vein

subcostal vein (12) drain directly into the azygos vein
NOTE: THE AZYGOS VEIN DRAINS INTO THE SUPERIOR VENA CAVA


LEFT SIDE:
1st- highest intercostal vein drains into the brachiocephalic vein
2-3-4 intercostal veins join to give the Accessory Hemiazygos Vein
5-11 intercostal veins and the subcostal vein (12) join together to give the Hemiazygos vein.

NOTE: THE ACCESSORY HEMIAZYGOS AND THE HEMI-AZYGOS CROSS OVER TO THE RIGHT SIDE INDEPENDANTLY OR JOIN AS A SINGLE UNIT AND DRAIN INTO THE AZYGOS VEIN

NOTE: THE ACCESSORY HEMI-AZYGOS MAY DRAIN INTO THE BRACHIOCEPHALIC VEIN ALSO

Front 43

what are the layers of penetration in the mid-axillary line (in order)?

Back 43

1) skin
2) superficial fascia
3) deep fascia
4) serratus anterior
5) external intercostal muscle
6) internal intercostal muscle
7) innermost intercostal muscle
8) endothoracic fascia
9) parietal pleura
10) pleural cavity
11) visceral pleura
12) lungs

note: fascia is not a muscle, it is fat and connective tissue

Front 44

1) what is the fcn of endothoracic fascia?
2) thickening of the fascia over the apex of the lung is called ____

Back 44

1) to prevent parietal pleura (surrounds lungs) from rubbing against the innermost intercostal muscles
2) Sibson's Fascia

Front 45

what does the thoracic cavit contain?

Back 45

1) a) two pleural cavities, seperate and enclosed spaces (has pleural fluid) and one
b) mediastinum
Other structures inside the thoracic cavity include:
1) heart
2) lungs
3) trachea
4) esophagus
5) vagus and phrenic nerves, etc

Front 46

pleural reflections:
1) fcn of pleural fluid?
2) ___ is not covered by pleural membrane
3) remove fluid with ____
4) ___ lines the muscle wall
5) ___ covers the organ
6) ___ is an area of parietal pleura reflected on apex of lung

Back 46

1) minimize friction bw the parietal pleura and visceral pleura
2) root of lung
3) mid-axillary tap
4) parietal pleura
5) visceral pleura
6) cupola

Front 47

pleural recess':
____ is found at the junction of the costal and diaphragmatic parietal pleura near the mid axillary line. a pleural cavity tap can be done here in the intercostal space #___

what is the fcn of these recess'?

Back 47

costo-diaphragmatic recess (space). intercostal space 9

other 2: costo-mediastinal recess and costo-vertebral recess

fcn: it allows expansion of the lungs during inspiration

Front 48

pleural blood and nerve supply:
1) parietal-
2) visceral-
3) nerve-
4) visceral pleural-
5) phrenic-

Back 48

1) parietal- intercostal artery, internal thoracic artery
2) visceral--bronchial artery (supply the lung)
3) nerve--parietal pleura--*VERY sensitive to pain, supplied by intercostal nerves T1-T11, subcostal and phrenic nerve (Cn 3,4,5)
4) Visceral pleural--*insensitive to pain. no sensory innervation
5) phrenic- motor nerve to the diaphragm

Front 49

what is the mediastinum?

Back 49

the medial region bw the two pleural cavities contains all the structures in the chest except the lungs and pleural sacs

Front 50

*sternal angle is at what level?

Back 50

T4 level- a line through the sternal angle divides the mediastinum into superior above and inferior below

Front 51

contents of superior mediastinum

Back 51

1) arch of aorta and branches
these brances are: brachiocephalic trunk, left common carotid, left subclavian
2)*brachiocephalic vein(s) is formed by the joining of the subclavian vein and internal jugulary vein
3) superior vena cava is formed by the joining of the right and left brachiocephalic veins
4) thymus (children) becomes fat in adults
5) esophagus
6) trachea
7) thoracic duct (bile and fat)

Front 52

contents of inferior mediastinum

Back 52

3 compartments:
1) anterior mediastinum- from the posterior surface of the sternum to the anterior surface of the pericardial sac
contents: fatty tissue, thymus, lymph nodes

2) middle mediastinum
contents: heart, pericardium, main bronchi, great vessels,

3)*POSTERIOR MEDIASTINUM-- TO PERICARDIAL SAC AND DIAPHRAGM AND ANTERIOR TO THE THORACIC VERTEBRAE (5-12) LOWER EIGHT.
contents: esophagus, thoracic aorta, azygos system, thoracic duct, vagus nerve, splanchnics nerves are from the sympathetic chain

Front 53

1) the posterior mediastinum goes from the pericardial sac and diaphragm and anterior to the thoracic vertebra #____.

2) is the trachea in the posterior mediastinum?

3) _____ is formed by the joining of the subclavian vein and internal juglar vein

4) ___ is formed by the joining of the right and left brachiocephalic veins

5) splanchnics nerves are from the ____

Back 53

1) 5-12
2) no
3) brachiocephalic vein
4) superior vena cava
5) sympathetic chain. the sympathetic chain is NOT in the posterior mediastinum only the splanchnics

Front 54

mediastinoscopy?

Back 54

to remove tissue from the anterior and superior mediastinum to examine the lymph nodes. incision is made at the jugular notch

Front 55

trachea:
1) how many C bars of cartilage?
2) begins in the neck at what location?
3) bifurcates at ____ into right and left main bronchi

Back 55

1) 15-20. 9-15cm long and 2.3 cm in diameter
2) CV6
3) sternal angle (TV4)

Front 56

compare the right and left bronchus

Back 56

right: wider-shorter and more in vertical plan then left bronchus. divides into superior lobar bronchus, middle and inferior lobar bronchi (3 branches!)

left bronchus: narrower, l onger, and more horizontal plane than that of the right bronchus. passes in front (anterior to) of the exophagus. divides into superior and inferior lobar bronchii (TWO branches)

Front 57

*lateral view of the lungs:
-what are the fissures of the lungs? (levels)

how many lobes and segments in the lungs?

Back 57

fissures-OBLIQUE begins 2.5" from the apex of lung and ends at COSTAL CARTILAGE 6

horizontal-costal cartilage LEVEL 4. found ONLY in the RIGHT lung

the right lung has 3 lobs where as the left has only 2. the right lung has 10 segments and the left lung has 8 segments.

Front 58

lobes of the lung:
1) the ___ lobe is found above the horizontal fissure
2) the middle lobe is found bw the ___ and ___ fissures
3) inferior lobe is found below the ____ fissure

Back 58

1) superior lobe
2) oblique and horizontal fissures
3) oblique fissure