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53 Cards in this Set
- Front
- Back
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Anatomical planes - median - sagittal - frontal - transverse |
Median -plane that is vertical, front-to-back, through the mid-line which divides the body into left and right halves.
Para-median plane - to the side of the median plane (plane dividing body into left and right halves).
Sagittal - any plane parallel to the median plane
Frontal - vertical, side-to-side plane that divides the body into anterior (front) and posterior (back) halves
Transverse - planes at right angles to the long axis of the body into superior (upper) and inferior (lower) regions. The transverse plane is not locked to any position - it can be placed in any height in the body |
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Terms of relationship - medial - lateral - ulnar - radial - ipsilateral - contralateral |
Direction in terms of relationship to the median plane:
Medial - toward the median plane Lateral - away from the median plane
Ulnar - side of the forearm, wrist or hand near the radius, lateral. (the arm bone on the pinky side is the ulna)
Radial - side of the forearm, wrist or hand near the radius, therefore lateral (the arm bone on the thumb side is on the thumb side)
Analogous bones in the leg: Tibia - on the inside (Tibular, terms incorporated to indicate direction) Fibula - on the lateral side (Fibular, on the lateral side of the leg)
Ipsilateral - on the same side of the median plane ( the left ear and eye are ipsolateral to each other)
Contralateral - on the opposite side of the median plane -(across the midline, across from each other on the median plane). |
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Related to the Frontal or Coronal plane: Terms of relationship (continued)
- Anterior or ventral
- Posterior or dorsal |
Anterior, ventral - in front of the frontal plane
Posterior, dorsal - behind the frontal plane (means towards the back)
We could say the nose is more anterior than the ear, the neck is posterior to the lips.
Near the front of the hand - palmar or volar
Near the back of the hand - called dorsum
The back of the foot - we call this the plantar surface (the sole of the foot)
The top of the foot is called the dorsum of the foot |
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The transverse plane divides the body into superior or rostral or cranial and Inferior or caudal regions.
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Direction in terms of relationship to the transverse plane:
Superior would be above the transverse plane. Inferior would mean below the transverse plane. Cranial means towards the skull. Caudal means "towards the tail"
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How to describe structures along the length of the arm relative to each other?
Proximal
Distal |
Based on attachment points For the arm, the attachment point is near the shoulder
Close to the attachment point, use the term proximal. Further from the attachment point is distal
The elbow is proximal in relation to the wrist The elbow is distal in relation to the shoulder
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Motions: - flexion - extension - hyperextension - dorsiflexion - ankle, toes - plantarflexion - ankle, toes |
Flexion reduces the angle of a joint. (the arm starts out at about 180 degrees, can flex to about 30 degrees, elbow joint) Flexion of the fingers, wrist, neck, appendages. Direction of flexion of the knee will be posterior, however most flexions are anterior.
Extension refers to the increasing the angle between two bones that form a joint.
The opposite of flexion is called extension.
Hyperextension is extension beyond the normal limit, which is usually pathological
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Ankle motion terms |
Terms of motion with regards to the foot: We call all movements of the ankle, flexions. The ankle can flex in an upward direction (dorsiflexion) or a downward direction (plantarflexion). |
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Arm motion terms |
The movement of the humerus at the shoulder - raising the arm is called flexion. When flex humerus at the shoulder, it rises anteriorly. When extend the humerus, put arm back near the body. |
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Neck, trunk, and limbs |
Abduction or adduction.
Abduction - ab for "away from" or "removed from" - can abduct the humerus (but cannot abduct the elbow). Can abduct your hip or thigh, but not the ankle - the ankle is a fixed joint, can only dorsiflex or plantarflex.
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In terms of the wrist: |
Abduction, away from the medial plane; moving the wrist away from the median plane of the forearm.
Can be called radial abduction (toward the radius or the thumb) or ulnar abduction (toward the ulna or the pinky) |
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The positioning of the hand - involves a rotation of the forearm |
The rotation of the forearm -
At the proximal end, there is a full rotation of the radius (it pivots around), but at the bottom or distal end, it sort of goes around in an orbit around the ulna (orbital movement)
Supination (when the palm is facing upwards, hand is in the supine position)
When the palm is facing forwards - called protonation of the forearm.
The forearm can pronate or suponate |
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The scapula (shoulder blades) are anchored to the axial skeleton in the front - there is a joint between the collarbone and the scapula so that it is able to pivot - the clavicular or chomial joint anchors the scapula - the scapula moves along with the upper extremity |
For example, when you elevate upper extremity (by reaching upwards, behind, forward) All those movement involve movement of the scapula |
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Movements of the scapula |
Virtually impossible to elevate the humerus above 90 degrees due to acromion (bony process on the scapula/shoulder blade)
When move arm in upward rotation - the bottom of the scapula moves laterally, the top of the scapula moves medially.
Extending the arm means moving it back to the body, to its normal resting position
Rotation of the scapula means pivoting the scapula |
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Rotation of the thigh/femur bone. |
Medially rotate - rotate towards the medial plane
Laterally rotate - rotate toward the outside of the body |
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The ankle joint |
Rotation of the foot
Foot can rotate in medial or lateral direction
When rotate foot medially, it is called inversion
When rotate foot laterally, called eversion
When you walk, for example, gait can be divided into various phases: heel strut... when you put your foot down when walking; at that point, foot is inverted. When push off for the next step, your foot is in an everted position. |
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Protraction |
to push forward
For example, when we reach forward, scapulas are protracted towards the front of the ribcage |
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Retraction |
to pull back |
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Hand movements |
If you keep hand in anatomical position and flex fingers - flexion
Spreading fingers apart - moves them away from the median plane within the hand, called abduction
Squeezing fingers together - called adduction |
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Thumb movements |
The thumb is not oriented along same planes as the fingers...
All described in relation to the palmar plane of the hand - if move thumb away from the plamar plane of the hand - abduction If move thumb toward the palmar plane of the hand - adduction
Flexion - move thumb to inside of palm Extension - move thumb to outside of palm
Oppositional motion - moving the thumb so that it opposes fingers
Moving thumb back to resting position - reposition |
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Types of joints - suture |
Some joints are located on the edges of the skull so that the skull bones fit together tightly - fit together by interdigitations; extremely small strands of small connective tissue that span the gap - called a suture - bones in close proximity around the suture; almost stitched together |
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Types of joints - Fibrous |
immovable (sutures of the skull), slightly movable (ankle, tooth).
Tiibula and fibula hend together by interossifiied and two ligaments on above and on the bottom - are designed not to move very much in relation to each other |
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Cartilaginous joints - bones joined by hyaline cartilage or fibrocartilage |
Large pieces of bone are separated by cartilage (intervertebral disks) the whole array is held together by layers of connective tissue and ligaments on the front - these cartilaginous joints provide a small degree of movement - couple of degrees of flexion or extension (or rotation) between bones making up the vertebral column. Small degree movements, due to segmental organization of those joints, allow larger movements. |
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Types of joints - synovial joint |
At the articular joint - lined with articular cartilage, a very spongy, rubbery, slippery cartilage, so that bones can slide with minimal friction.
Joint made up of fibrous connective tissue capsule (may limit range of movement for joint).
Synovial membrane - secretes a glycoprotein that lubricates the articular parts of the joint - makes it easier to move without damaging the joint. |
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Types of Synovial joints |
Ball and socket in the hip. Can do a combination of motions called circumduction.
Saddle in the thumb (less range of motion than in the ball and socket). The thumb joint can flex, extend, abduct, adduct, and can rotate a little bit.
The elbow joint is a pure hinge and allows even less motion. |
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Types of Synovial Joint - Condyloid joint |
Condyloid joint - looks much like a ball and socket, however, can really only do flexion and extension. Found in our knuckles. The soft structures around the joint (joint capsule, ligaments and muscles near the joint also contribute to what the joint can do). The soft structures in the muscle limit what the joint can do. |
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Types of synovial joints, continued.
- pivot
-gliding |
Pivot Joint - one bone pivots within a sleeve or orbits around another bone. Motion is an axial rotation
Gliding Joint - moves in several directions Many of these gliding joints are found between the bones of the foot. |
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Types of muscle |
Skeletal, Cardiac, Smooth |
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Bicep muscle |
Baceps brachii.
Bicep means two heads - bicep muscle has four tendons. Bottom tendon is attached to radial tuberosity (bump on the radius). When contracts, pulls on the radius. The bicipital aponeurosis pulls on the sleeve and pulls the elbow into flexion - is a flexor of the elbow.
Biceps, in flexing the elbow, prime mover. Will also suponate the forearm (the pronator muscle has a role in acting as an antagonist, will subtract movement from the agonist muscle). When the shoulder muscles become active, called fixators. A muscle that is beneath the biceps and also a flexor of the elbow, is called the brachialis, called a synergist.
The bicep has two functions: it flexes the elbow and it suponates the forearm. |
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Attachments of the biceps brachii muscle |
Proximal attachment: - Short head: tip of coracoid process of scapula - Long head: supraglenoid tubercle of scapula
Distal Attachment: - Tuberosity of radius and fascia of forearm via bicipital aponeurosis. |
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Describe the Spinal Nerves: cervical, lumbar, thoracic, coccygeal |
There are 8 cervical nerves, referred to as C1 to C8. 12 are in the thorax - referred to as T1 - T12 Five in the sacrum, and one in the coxxyx.
There are eight pairs of cervical nerves, twelve pairs of thoracic nerves, five pairs of lumbar nerves, five pairs of sacral nerves, and one pair of coccygeal nerves |
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How does the last, C8, cervical spinal nerve exit the spinal canal (passing in between the vertebrae)? |
The last cervical spinal nerve passes below the C7 vertebra to communicate with the periphery (there are 8 cervial nerves and only seven vertebrae) in the cervical region |
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Explain the arrangement of the spinal nerves, and how they exit the spinal or vertebral canal to reach the periphery. |
Nerves exit in between the vertebrae - the spinal cord is the same length as the vertebral column early in development; the vertebral column elongates faster than the spinal cord during development - the bottommost nerves have to grow and elongate so they can exit the spinal cord. |
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Spinal nerve |
Dorsal root - sensory fibers that carry electrical signals representing sensation that travel from the periphery that travel toward the spinal card up to the brain.
On the ventral or anterior side - carry motor signals to the muscles. Cells that generate these signals in the ventral half of the spinal cord - the axon carries the signal to contract the muscle. |
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If one injures the axon of a neuron, the signal can eventually travel all the way to the muscle. How does the process of nerve regeneration work/occur? |
The axon will degenerate, since no longer working, muscle will no longer contract, consequence is that muscle will shrink.
The proximal end of the process will try to sprout and regrow; path created by cells that were in the nerve can eventually achieve a new contact with the muscle - then nerve can successfully connect, sends signals, and leads to regeneration of muscle.
If the axon does not fully regenerate, the muscle remains paralyzed/atrophied. |
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Key principles of radiology: |
- one needs two views (optimally at 90 degree angles to each other) to be able to construct a 3D view of an object in three-dimensional space
- radiological imaging is non-invasive (able to detect anatomical abnormalities in a non-invasive way)
Radiologic imaging allows one to detect anatomic abnormalities, informed by knowledge of anatomy. |
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Principle of Radiological imaging: |
The higher the density, the more photons will be absorbed by the structure, and less of the x-ray will hit the detector. Tissues, etc. that have little absorptive capacity will be dark on an x-ray. |
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Density/Contrast |
Need at least 5% difference in the absorption between muscle of the heart and adjacent tissues in order to be able to discern them.
Must have at least 5% difference in absorption coefficient to be detectable on plain x-ray. |
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Structures in the body give different brightness on radiograph |
Lead and barium sulfate have a high reflection coefficient absorbs the most x-ray photons (therefore appears white on radiograph).
Bone also absorbs many x-ray photons (appears white on radiographic image).
Water does not absorb many photons (appears dark or black on radiograph). Therefore, fluid-filled, low-density tissues are likely to appear dark on an x-ray. |
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Distinguish between x-ray and fluoroscopy. |
An x-ray is like taking a snapshot - it takes an instantaneous record of what is going on in the body at that instant in time.
A fluoroscope is able to couple the screen to an X-ray image intensifier and video camera allowing the images to be recorded and played on a monitor. |
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Contrast agents |
Agents or substances that are injected, ingested, put into the patient in order to increase the contrast of the target structure relative to surrounding tissues in order to make that structure appear in imaging.
Such contrast agent allow one to see the GI tract/colon, to see the tubules of the kidney, the vasculature (detect narrowing of artery, hypoxia). |
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Angioplasty |
Angioplasty is the technique of mechanically widening narrowed or obstructed arteries, the latter typically being a result of atherosclerosis.
An empty and collapsed balloon on a guide wire, known as a balloon catheter, is passed into the narrowed locations and then inflated
Employs angiography to detect the narrowed artery. |
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CAT scan |
An X-ray image made using computerized axial tomography.
X-ray beam travels around the patient in a circle. The detector is much more sensitive than a piece of film (now only need 0.5% in order to distinguish between adjacent tissues).
The computer compiles all these images and creates a three-dimensional image - looks at each area and assigns a grayscale to each region.
CONS: Considerably more radiation compared to a plain x-ray. |
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Ultrasound |
Derived from sonar technology, sound waves. This modality does not use ionizing radiation. A modern ultrasound machine uses a pizoelectric crystal that creates a high frequency sound wave - creates a high frequency sound wave sent into the patient, the waves are reflected back.
The transducer is responsible for sending and receiving the waves.
There are different types of ultrasound. |
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Define different echoes that come back in ultrasound |
Less echoes come back - hypoechoic Isoechoic - same Hyperechoic - fat |
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How is ultrasound used? |
To look at development of fetus during pregnancy. To look at kidneys, heart. Useful for looking at vasculature. Echocardiography is ultrasound of the heart. Aneurysm (dilated aorta) balooning of an artery.
Able to detect abnormal masses in. |
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The advantages of ultrasound |
Has no ionizing radiation. Much less expensive than a CAT scan. Can look at blood flow. |
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MRI - magnetic resonance imaging |
Uses the same principles as NMR! - Does not using ionizing x-rays. - Uses the atomic structure of tissue would like to image. Take slices of whatever area interested in. - MRI is dependent on atoms (hydrogen because most abundant in the body, has one proton). Abundance. - uses magnetic properties to record the differences between nuclei. Must behave suitably in magnetic field. Disturbable to observe properties.
Atoms will align when subjected to the force of a strong magnet. Introduce a radiofrequency pulse (sound wave) on a particular slide of the body. This atom spinning around normally is hit by the RF pulse, and deviates from north-south axis and turns on its' side. The atom now gives off energy and returns to its' normal resting state (return of an atom to its equilibrium state). Can either be spin-lattice (T1 relxation time) or spin-spin (T2 relaxation time). |
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On a T1 weighted image, anything that is water, turns black |
T1 weighted MRI image: Subarachnoid system in the brain is black. The vertebrae of the spinal column would appear white |
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On a T2 weighted image (different way of sending radiofrequency signal in), water appears white |
T2 weighted image of the spine would show white spaces between the vertebrae. Nerve roots would appear as white.
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MRI |
High contrast resolution - great ability to look at soft tissue |
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What is nuclear medicine? |
Medical subspecialty which uses radioactive materials for both diagnosis and treatment.
Nuclear medicine is a unique form of imaging. Tells us about structure and function, relates it to physiology and anatomy. |
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Radiopharmaceuticals |
Tag molecule containing radionuclei - a chemical molecule tagged with radioactive atoms.
Able to see distribution of drug in different parts/compartments of the body. Useful for metabolic studies. Radiotracer looked at by gamma camera. |
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PET scan |
glucose is tagged with radioactive isotope - Fluorine 17
Able to see oxygen consumption within different tissues.
Because tumors use more oxygen, able to detect. |
