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130 Cards in this Set
- Front
- Back
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Innervation of the tongue (motor, general sensory, special sense - taste) |
motor - CN XII Hypoglossal Nerve ORAL 2/3 general sensory - CN V3 Trigeminal mandibular special sensory - CN VII Facial PHARYNGEAL 1/3 all sensory - CN IX Glossopharyngeal |
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3 salivary glands and their innervation |
Parotid Gland - CN IX (Glossopharyngeal) Sublingual Gland - CN VII - parasympathetic Submandibular Gland - CN VII - parasympathetic |
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Tooth: 3 parts, outer/middle/inner layers, opening |
Parts: crown, neck, root Outer Layer: enamel (crown) or cementum (root) Middle Layer: dentine - calcified Inner Layer: pulp cavity - loose connective Opening at bottom: apical foramen |
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What makes up the nasal septum? lateral wall of nose? floor? roof? |
Septum: cartilage, ethmoid & vomer bones Lateral Wall: Maxilla, palatine, and ethmoid Floor: palatine process of maxilla, palatine Roof: Ethmoid Bone (cribiform plate) |
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What innervates the nasal cavity mucosa? What innervates the olfactory epithelium? |
Nasal cavity mucosa: CNV2 (trigeminal maxillary) Olfactory epithelium: CN I (Olfactory) |
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What innervates the pharyngeal elevators? What innervates the pharyngeal constrictors? What innervates sensory of mucosal membrane? |
Elevators: CN X Constrictors: CN X Mucosal Membrane (sensory): CN IX |
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The pharynx is stretched between ___ and ___. The nasopharynx is between ___ and ___. The oropharynx is between ___ and ___. The laryngopharynx is between ___ and ___. |
Pharynx: Base of skull and start of the esophagus (C6) - Nasopharynx: Base of skull and hard palate - Oropharynx: Hard palate and hyoid bone - Laryngopharynx: Hyoid and C6 |
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Contents of the Anterior Triangle, Lateral Region/Posterior Triangle, and Posterior Region |
Anterior Triangle: supra-/infra-hyoids, thyroid, trachea, pharynx Lateral Region: brachial plexus, scalenes, CNXI, phrenic nerve Posterior Region: traps, splenius cerv/cap, lev scap |
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SCM innervation and function |
CN XI (spinal accessory) bends neck ipsilaterally and rotates head contra-laterally |
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Lateral Cervical cardiovasc. contents: Arteries:(1) and(2). These arteries are usually arising from (3) trunk which is a branch of (4) artery. veins:(5) vein, that usually joins the (6) veinjust before (7) vein. |
Arteries: (1) cervicodorsal and(2) supra-scapular. These arteries are usually arising from (3) thyro-cervicaltrunk which is a branch of (4) sub-clavianartery. Veins: (5) External jugular vein, that usually joins the (6) sub-clavian vein just before (7) internal jugular vein. |
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Supra-hyoid muscles and innervation |
Mylohyoid: CNV Geniohyoid (not important) Digastric: post=CN VII, ant=CN V Sylohyoid: CN VII |
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Infra-hyoid muscles and innervation |
All innervated by branches of the cervical plexus (C1-C3) Superficial: Sterno-hyoid, Omo-thyroid Deep: Sterno-thyroid, Thyro-hyoid |
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Deep neck muscles (2) and vague origins/insertions |
Longus Coli O: vert. bodies I: mid. cerv. TVPs + upper cerv. vert. bodies Longus Capitis O: TVPs of mid cerv vert I: occipital bone |
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Scalenes: 3 divisions, O/I, innervation, what might they compress? |
All innervated by C2-C8 Ventral Rami Anterior O: TVPs of mid cervical vert I: first rib Middle O: TVPs of all cervical vertebrae. I: first fib PosteriorO: TVPs of lower cervical vertebrae. I: second rib. Brachial Plexus and Subclavian Artery (COPD, etc) |
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Arteries of the head and neck: (1) arterydivides into (2) and (3) arteries at the level of (4). (2) supplies ____ (3) supplies _____, with these 3 main branches |
The common carotid artery divides into external carotid and internal carotid arteries at the level of CIV vertebra. - Internal carotid supplies CNS - Exernal carotid supplies face/neck. Branches: Facial Maxillary (deep facial cavities) Superficial Temporal |
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What veindrains the venous blood of the CNS, scalp, and deep parts of the face? What large vein that drains the upper limb will it join, and what do they form? |
Internal Jugual joins the subclavian vein to form the brachiocephalic vein. |
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What innervates the mucosal lining of the larynx and skeletal muscles that change the tension of the vocal cords? |
CN X - Vagus Nerve |
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What vertebral column regions are static/dynamic and what does this mean? |
If they can change their curve (dynamic) or not (static). This helps them resist compressive forces. Static: Sacral (5) Dynamic: Cervical (7), Thoracic (12), Lumbar (5) |
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Primary vs Secondary curves of the vertebrae |
Primary Curves (Convex posteriorly) born with Sacral and Thoracic Secondary Curves (Convex anteriorly) develop Cervical (3-6mo) and Lumbar (10mo-12yrs) |
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What passes through the inter-vertebral foramen? |
Spinal Nerves |
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What is the inter-vertebral disc composed of and how does it function? |
Nucleus Pulposus (middle) gel centre with lots of water for shock absorption. Anulus Fibrosus (outside) collagen bundles (even more in lumbar region) to hold nucleus pulposus in place. |
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What is worse - posterio-lateral, or posterior disc hernia? |
Posterior is worse because is bulges into spinal cord. Posterio-lateral (more common) compromises spinal nerves. |
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What are the most important supportive vertebral ligaments? |
ALL & PLL |
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What is the proximal end of the PLL called and where does it attach? |
Tectorial Membrane - attaches to occipital bone |
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Where would you find an unco-vertebral joint? |
(Synovial Joint) in Cervical Vertebrae |
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Describe spinal cord to rami and if each step is sensory, motor, or mixed. |
Dorsal and ventral rootlets arise from the posterior (sensory) and anterior (motor) horns respectively of the spinal cord's grey matter. These rootlets forms the dorsal root ganglion (sensory) and ventral root (motor) combine to form a spinal nerve (mixed), which then splits into a ventral and dorsal ramus (both mixed). |
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What are the 3 meninges and what are they involved in? |
Dura Mater - mechanical protection Arachnoid Mater - CSF circulation (subarachnoid space containing CSF) Pia Mater - blood vessels |
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How many pairs of spinal nerves are there? |
31: 8 cervical, 12 thoracic, 5 lumbar, 5 sacral, 1 coccygeal |
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Where does the spinal cord end and what is blow that? |
L1/L2, below L1 is the cauda equina |
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What is a somite and what does it develop into? |
a block of mesodermal tissue, will differentiate into muscles and bones and associated structures Dermato-myotome: a group of somites that will differentiate to give rise to skin and muscles The spinal nerves travel with them through development, leading to "Somatic Nervous System" |
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What are the 4 plexuses and what are their spinal segments? |
Cervical C1-C4 Brachial C5-T1 Lumbar T12-L4 Sacral L4-Co |
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Dermatome: back of leg/thigh |
S2 |
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Dermatome: lateral foot, heel |
S1 |
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Dermatome: bum |
S3 S4 S5 Co |
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Dermatome: lateral thigh |
L2 |
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Dermatome: medial thigh |
L3 |
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Dermatome: lateral leg |
L5 |
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Dermatome: medial leg |
L4 |
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Dermatome: medial foot |
L4 |
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Dermatome: mid-dorsum of foot |
L5 |
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Myotome: flexion of hip |
L1, L2 |
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Myotome: extension of leg |
L3, L4 |
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Myotome: flexion of leg |
L5, S2 |
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Myotome: adduction of toes |
S2, S3 |
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Myotome: plantar-flexion of foot |
S1, S2 |
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What do the difference fibres of the trapezius do? Which fibres of the trapezius are involved in the upward rotation of the scapula? Which fibres of the trapezius are involved in the downward rotation of the scapula? |
Upper Fibres: elevation of scapula (and rotate superiorly) Middle: adduction (retraction) of scapula (no rotational movements) Lower: depress scapula (and rotate inferiorly) Which fibres are involved in the upward rotation of the scapula? UPPER AND LOWER Downward rotation of the scapula? NONE (rhomboids) |
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Prime mover for extension of the shoulder joint? |
Latissimus dorsi |
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What muscles are involved in the downward rotation of the scapula? |
Rhomboids (major BELOW root of spine of scapula, minor ABOVE) |
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What is the prime mover for extension of the vertebral column? |
Erector Spinae |
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3 groups in Erector Spinae, and where to find them? |
Iliocostalis - cervical, thoracic, lumbar (NOT head) Longissimus - head, cervical, thoracic (NOT lumbar) Spinalis - head, cervicis, thoracic (NOT lumbar) |
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What muscles rotate the spinal column? |
Transverso-spinalis group |
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What are the 3 other deep back muscles (besides transverso-spinalis) |
Interspinalis Intertransversarii Levatores Costarum |
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What are the contents of the sub-occipital triangle? |
- vertebral artery - greater occipital nerve (C2) - sub-occipital nerve (C1) |
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What is the prime mover for extension of the hip? |
Gluteus Maximus |
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Gluteus Maximus O/Ins/Innervation |
O: ilium/sacrum Ins: gluteal tuberosity of the femur via IT band Inferior Gluteal Nerve (L5-S2) |
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What is the prime mover for abduction of the hip? |
Gluteus Medius |
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What is trendelenburg's sign? What is waddle? |
When you lift your R leg, bend your pelvis to the L to balance it out - a sign of weak or paralyzed Glut Medius. If both sides are affected, you get a waddle |
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Gluteus Medius: O, Ins, Innervation |
O: ilium b.w. ant and post gluteal lines Ins: "lateral surface of the greater trochanter" (so an abductor) Superior Gluteal Nerve (L4-S1) |
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Gluteus Minimus: O, Ins, Innervation |
O: ilium, b.w. ant and inf gluteal lines Ins: "anterior surface of the greater trochanter" (so an abductor AND flexor) Superior Gluteal Nerve (L4-S1) |
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Piriformis passes through _____, function, innervation |
- passes through the greater sciatic foramen/notch - function: lateral rotation - innervated by branches of sacral plexus |
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What is the prime mover for lateral rotation of the hip? |
Quadratous Femoris (inserts into quadrate tubercle of inter-trochanteric crest) |
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What is Steppage Gait and what causes it? |
Where a person lifts one foot very high because the foot does not dorsiflex properly. This is because the sciatic nerve is not fused and the common fibular nerve passes through the piriformis, pinching it during lateral rotation of the hip. |
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What is Legg Calves Perthes? |
- vascular necrosis of the head of the femur caused by the blood supply being cut - the femur is supplied by a branch of the obturator artery |
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What bridges the acetabular notch? |
transverse acetabular ligament |
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Positions of most and least ligament support of hip joint? |
Position of most ligament support of hip joint: Extension, Abduction, Lateral Rotation Least supported positions: flexion, adduction, medial rotation (crossing legs basically) offside: not intrinsic ligaments since they're outside the joint capsule |
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Support of hip in anterior vs posterior? |
Posterior: The hip joint receives better support from muscles (and less from ligaments) Anterior: Ligaments play more important role |
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What 5 arteries supply the hip joint? |
Ages 10+ - Medial Femoral Circumflex Artery - Lateral Femoral Circumflex Artery - 1st Perforating Artery - Inferior Gluteal Artery Before age 10 (others not yet well developed) - Obturator Artery |
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True vs False Pelvis |
False (greater) Pelvis is continuous with the abdominal cavity (no specific boundary b.w.) True (lesser) Pelvis is bound by the sacrum, hip bones, and superior pubic aperture aka pelvic inlet |
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What forms the Superior Pubic Aperture? |
- Sacral Promontory - anterior border of Sacral Ala - Terminal Line = Arcuate line + pecten of publis (+iliopubic eminence) = boundary between false + true pelvis = superior pubic aperture - Symphysis Pubis |
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What forms the Inferior Pubic Aperture? |
- symphysis pubis - ischio-pubic ramus - ischial tuberosity - sacro-tuberous ligament - coccyx |
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What movement is there in the sacroiliac joint and when/why do we start losing that movement? |
Nutation - promotory is moving anteriorly and inferiorly Counter-nutation - promotory is moving superiorly and posteriorly We start to lose movement at age 35/40 as the joint changes from synovial to fibrous. |
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What hip angle is wider in females? |
sub-pubic angle formed b.w. the inferior pubic rami |
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Where do you tend to find symphesis joints (fibrocartilagenous) |
at the mid-line! (exception - atlanto-axial joint) |
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What are the 3 Levator Ani Muscles? |
1. pubo-rectalis 2. pubo-coccygeus 3. Ilio-coccygeus |
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What muscles make up the Pelvis Diaphragm and what innervates it? |
Levator Ani (pubo-rectalis, pubo-coccygeus, Ilio-coccygeus) + Ischio-coccygeus Innervated by branches from sacral plexus (NOT pudendal) |
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What are the 5 Perineal Muscles and what supplies them? |
Pudendal Nerve (S2-4 keeps poop off the floor) - external anal sphincter - sup. transverse pereneii (site of attachment) - bulbospongiosus (M drains urine/F closes vag) - ischiocavernosus (maintains erection) - deep transverse pereneii (supports perineal body and penis/clitoris) |
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Sacral Plexus branches (formed by anterior/ventral rami of L4-Co) |
Sup Gluteal and N. to Quadratous Femoris (L4-S1) Inf Gluteal and Obturator Internus (L5-S2) Post Cutaneous nerve of thigh (S1-S3) Pudendal (S2-S4) - a mixed nerve N. to Piriformis Perforating Cutaneous N. to Levator Ani |
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Artery branches from pelvic region |
Abdominal Aorta ends at LIV, splitting into L and R Common Iliac Artery, which split into External and Internal Iliac Artery. External Iliac becomes the Femoral Artery Internal Iliac Artery branches out. |
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Branches of the Internal Iliac Artery |
sup gluteal, inf gluteal, internal pudendal artery, obturator artery, and visceral branches |
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Lumbar Plexis (T12-L4) branches |
Iliohypogastric Ilioinguinal (ant ext genetalia - post innervated by pudendal) Genitofemoral (mix: skin of thigh + cremasteric) Lateral Femoral Cutaneous (sensory: lateral skin of thigh) Femoral (L2-4) (mix: ant thigh muscles and some skin) Obturator (L2-4) (mix: med thigh and some skin) |
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Which branches of the lumbar plexus will never enter the pelvis cavity? |
Subcostal Iliohypogastric Ilioinguinal |
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What is MERALGIA PARAESTHETICA and what causes it? |
Tingling on the lateral side of the thigh caused by the lateral femoral cutaneous nerve being pinched behind inguinal ligament. Caused by pregnancy, belt, obesity, etc. |
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3 Femoral Nerve Branches (superficial sensory of thigh) |
Medial Cutaneous Nerve of the thigh Anterior Cutaneous Nerve of the thigh Saphenous (medial leg) |
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What innervates the bum? |
Superior Cluneal Inferior Cluneal (branch of post. femoral cut. N) Medial Cluneal |
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What are the superficial sensory branches of the Tibial Nerve? |
Sural (post leg/lateral foot) Calcaneal (heel) Lateral Plantar (lateral bottom foot) Medial Plantar (middle bottom foot) |
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What are the superficial sensory branches of the Common Fibular Nerve? |
Lateral Sural (top 1/2 lateral leg) Superficial Fibular (top of foot except big toe web) Deep Fibular (web of bit toe) |
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What are the superficial veins of the lower limb? |
Greater Saphenous arises from medial side of dorsal venous arch in foot, passes in front of medial malleolus, just behind medial knee, and through saphenous opening Lesser Saphenous arises from lateral side of dorsal venous arch, passes behind lateral malleolus, and empties into popliteal vein |
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What accompanies superficial veins and where are they located in lower limb? |
Lymph nodes! Located in popliteal and inguinal regions. Popliteal lymph nodes drain foot/leg and drain into the inguinal lymph nodes, which also receive thigh, external genitalia, and lower abdominal wall. This in turn drains into the external iliac nodes. |
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What is the prime mover for extension of knee joint? |
Vastus Lateralis |
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What muscle is the VMO part of and what is its relevence? |
- Vastus Medialis - VMO helps to stabilize the knee, preventing it from dislocating laterally on extension (which it tends to do) |
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What innervates the iliacus? |
Femoral Nerve (L2-L4) |
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What innervates the psoas major? |
L1-L4 |
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Where does the pectineus arise and what innervates it? |
- O: pectineal line of pubis Innervated by Femoral and Obturator Nerves (L2-L4) |
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Which adductor of the thigh passes the knee joint? |
Gracilis |
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Adductor Magnus O, Ins, Innervation |
O: Ischiopubic Ramus (adductor) O: Ischial Tuberosity (hamstring) Ins: gluteal tuberosity, linea aspera, medial supra-condylar line (adductor) Ins: Adductor Tubercle (hamstring) Innervation: Obturator (L2-L4) (adductor) Innervation: Tibial division of Sciatic (L4-S3) |
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What forms the femoral triangle and what does it house? |
- Sartorius - Adductor Longus - Inguinal Ligament Houses: Femoral vein, artery, and nerve. Ends in Adductor Hiatus |
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What is in the 3 compartments of the Femoral Sheath? |
Lateral - Femoral Artery Middle - Femoral Vein Medial - Empty other than lymph nodes! Femoral ring important as can cause hernia (femoral or inguinal) |
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Femoral Artery Pathway and branches |
External Iliac Artery > Femoral Artery > Popliteal Artery Branches: Deep Femoral Artery - Medial and Lateral Circumflex Femoral - Perforating (supply posterior comp of thigh) Muscular branches and Descending Genicular (to knee) |
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What vessels pass through the adductor hiatus? |
Only the Femoral Artery and Vein pass through the adductor hiatus. |
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After femoral triangle, where do the femoral artery nerve and vein go? |
Apex of femoral triangle, after that there is a muscular tunnel, "sub-sartorial canal" or "adductor canal". Within the sub-sartorial canal you find the FEMORAL VESSELS (artery + vein), and the SAPHENOUS NERVE and NERVE TO VASTAS MEDIALIS. |
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Which branch of the femoral nerve passes the knee joint? |
Saphenous Nerve - it goes on to supply the medial side of the foot |
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What is the path of the Obturator Nerve and what does it supply? |
Passes through obturator canal and on either side of adductor brevis Anterior Branch: Motor: for all adductor muscles except adductor magnus. Sensory: skin on medial side of the thigh (middle 1/3) Posterior Branch:Motor: Adductor MagnusSensory: supplies hip and knee joints. |
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What is the prime mover for flexion of the knee joint? |
Biceps Femoris |
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What is the prime mover for inversion of the foot? |
Tibialis Anterior |
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What is the prime mover for extension of the big toe? |
Extensor Hallucis Longus (EHL) |
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What might cause pain to the lateral side of the foot? |
Lateral piece of 5th metatarsal bone failing to fuse, and instead forming a synovial joint - the bone is called "vesalius" bone. The Fibularis Tertius insert here, so it can cause pain for patient with this abnormal joint. |
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How do the retinacula avoid friction with tendons? |
the muscle tendons are wrapped in a synovial sheath which produces synovial fluid! |
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What is the prime mover for eversion of the foot? |
Fibularis Longus |
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What nerve is vulnerable to damage at head of fibula? What gait would this cause? |
Common Fibular Nerve (anterior and lateral compartments of leg) Steppage Gait |
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What supplies blood to the leg? |
2 branches of the Popliteal Artery are: - Anterior Tibial Artery supplies the ant. compartment of leg + top of foot as Dorsalis Pedis. - Posterior Tibial Artery supplies the posterior compartment, and has another branch, the Fibular Artery which supplies the lat. compartment of the leg |
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What is the prime mover for plantar-flexion of the foot? |
Soleus (Tibial % of Sciatic Nerve - S1/S2) |
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What makes up the "triceps sure", or triceps of the calf? |
- Soleus - 2 heads of gastrocnemius |
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What muscle maintains the medial longitudinal arch of the foot? |
Tibialis Posterior |
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What are the 3 Tibio-Fibular Joints? |
Superior T-F Joint: synovial planar Middle T-F Joint: syn-desmosis Inferior T-F Joint: syn-desmosis |
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What type of joint is the knee joint, and what are the 2 menisci made of? |
Bi-condylar synovial joint, the medial and lateral menisci are made of fibro-cartilage |
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Describe movement in the knee joint for the first 90 degrees of flexion. |
0-20 degrees: pure rolling 20-90 degrees: both over 90 degrees: pure gliding Gliding provides more mechanical stress due to more friction. First 20-degrees is therefore the "safe range". Should avoid bending knees more than 90-degrees. |
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What is the sensory innervation of the foot? |
Plantar: Medial Plantar and Lateral Plantar (via Tibial Nerve) Dorsum: Superficial Fibular Nerve (except web of big toe = deep fibular nerve) lateral border = sural nerve medial border = saphenous nerve |
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What is Hallux Valgus? |
Deformation/inflammation between Big toe metatarsal and proximal phalanx. Can lead to collapse of the medial longitudinal arch. Caused by: high tone in adductor hallucis OR high tone in EHL + FHL - can start to pull on an already not-straight toe angle |
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What is the function of the dorsal vs plantar interossei and how many are there of each? |
Dorsal Interossei - Abduction of toes 2-4 (big and little toes have their own abductors) Plantar Interossei - Adduction of metatarsals 3-5 |
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Arteries of the dorsum of the foot |
Anterior Tibial Artery becomes Dorsalis Pedis at the ankle, forming the Arcuate Arch which branches into 5 Dorsal Metatarsal Arteries and Deep Plantar Arteries (to from deep plantar arch with lateral plantar artery of plantar aspect) It also has Lateral Tarsal and Medial Tarsal branches at the ankle |
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Arteries of the plantar aspect of the foot |
Posterior Tibial Artery splits into the Lateral and Medial Plantar Arteries behind the medial malleolus. The lateral plantar artery joins with the deep plantar arteries of the dorsum to form the Deep Plantar Arch, which gives rise to Plantar Metatarsal Arterties and perforating branches. |
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What are the medial collateral ligaments of the ankle? |
Starts with Tibio- Posterior tibio-talar Anterior tibio-talar Tibio-calcaneal Tibio-navicular |
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What are the lateral collateral ligaments of the ankle? |
Ends with -fibular Posterior talo-fibular Anterior talo-fibular Calcaneal-fibular |
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What is the spring ligament? |
Plantar calcaneo-navicular ligament (aka spring ligament) supports the talus |
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Name 2 muscles whose tendons are important in supporting the arch of the foot. |
- Fibularis Longus (lateral to medial) - Tibialis Posterior (medial to lateral) |
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What is it called when the arch is exaggerated? Diminished? |
Exaggerated: Pes Cavus Diminished: Pes Planus |
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What are the names of the cervical nerves (4 cutaneous and 3 muscular) and what spinal segments (generally) do they all come from? |
C2-C4 Cutaneous: Great Auricular, Transverse Cervical, Lesser Occipital, Supraclavicular Muscular: Phrenic (C3-C5), Ansa Cervicalis (C1-C3, goes to infahyoids) |
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Phrenic Nerve spinal segments |
C3-C5 |
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Ansa Cervicalis spinal segments |
C1-C3 |
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Posterior Cutaneous Nerve of the Thigh spinal segments and what nerve branches arise from it? |
S1, S2, S3 (from sacral plexus) Cluneal Nerves (bum) arise from it. |
