Anatomy Dissection Quiz 1

Front 1

Introduction to Skin

Back 1

1) Epidermis - Thin outer layer of the skin
2) Dermis - Underlying balance of the skin
3) Superficial Fascia - Under the dermis and also known as the subcutaneous tissue. Has loose connective tissue and adipose tissue
4) Deep Fascia - Clearly shows muscle boundaries and conveys nerve and vessels to them. Left this layer intact during class 1. Should be smooth and shiny. Can go into muscle and divide individual muscles into fasciculi.

Front 2

Underneath the Skin

Back 2

1) Mammary Gland - Confined to the skin and subQ and made of modified sebaceous glands. There is loose CT between pectoral fascia and deep breast allowing it to move on the deep fascia. The breast has fat compartmentalized btw connective and glandular tissue. There are lactiferous ducts that go to the lactiferous sinus and then nipple. The breast has suspensory ligament that anchor it to the deep fascia. Arterial supply from mammary branch of the axillary artery

2) Anterior Cutaneous Nerve - Come from intercostal nerve and go into the deep fascia.

3) Vessels - From the subclavian comes the internal thoracic and lateral thoracic artery. Off of the internal thoracic is the intercostal (anterior) and epigastric

Front 3

Shoulder and Chest

Back 3

1) Clavicle - Runs from the manubrium of the sternum to the acromion of the scapula

2) Platsyma - Most inferior of muscles of facial expression

3) Lateral Cutaneous Branch - Comes off of ventral rami to get lateral and then anterior thoracic

4) Anterolateral Abdominal Wall - Has 2 superficial layers. A outer fatty layer known as Camper's Fascia, and a deeper membraneous layer known as Scarpa's Fascia

Front 4

Thorax

Back 4

Thorax - Diaphragm to the first rib
-12 pairs of ribs for the 12 thoracic vertebrae
-Sternum - Manubrium and body connected by jugular or suprasternal notch, and then the xiphoid

Front 5

Ribs

Back 5

-Costal cartilage of first 7 connect to sternum. 8-10 connect to 7, and 11-12 are floating
-Head articulates with body of thoracic vertebrae
-Tubercle - articulates with transverse process of a thoracic vertebrae.
-joins sternum by its own costal cartilage
-subcostal groove - internal inferior surface which shelters the intercost nerve + vessels

Front 6

Shoulder or Pectoral Girdle

Back 6

-made of the scapula and clavicle. Scapula anchored to posterior thoracic cage by muscle. Clavicle attach to sternum through sternoclavicular (strong) and acromioclavicular joints (weak)

Scapula - Scapular spine divides it into supraspinous and infraspinous fossa. Lateral expansion of the spin is the acromion. Coracoid process extends from anterolateral border. And laterally is the glenoid fossa

2) Clavicle - It is subQ.

Front 7

The Scalp

Back 7

5 Layers of the Scalp - Skin, Connective Tissue, Aponeurosis, Loose areolar tissue, pericranium.
-Frontalis and epicranial aponeurosis are part of the scalp. The blood vessels are in the connective tissue layer.
-Sagittal sutures between the parietal bones and the coronal suture is between the frontal and parietal bones.
-Diploe is between the inner and outer tables of compact bone
Middle Meningeal Vessels - Make grooves on the inside of the calvaria
Arachnoid Granulation - Lay around the superior sagittal sinus and release CSF back into circulation
Falx Cerebri - Dural partition which separates cerebral hemispheres.

Front 8

Scalp 2

Back 8

Sella Turcica - Houses the pituitary gland. The tip of the pituitary gland, the infundibulum, pierces the diaphragma sellae and connects with the hypothalamus

Tentorium Cerebelli - Separates the cerebellum from the occipital lobes

Tentorial Notch - Brainstem passes during life from posterior to middle cranial fossa.

Sinuses - The superior sagittal, straight, and occipital come together at the confluence of sinuses and release to the transverse sinus. The transverse and superior petrosal join to make the sigmoid sinus. The sigmoid and inferior petrosal sinuses join to make the internal jugular sinus

Front 9

Scalp Terms 1

Back 9

1) Olfactory Bulb - Lays on the cribiform plate and turns into the olfactory tract
2) Interior Carotid - Gives off the ophthalmic artery and ends at the cirlce of wilis to form the anterior and middle cerebral arteries
3) Clinoid Process - Surround the sella turcica and part of the sphenoid bone.
4) Oculomotor Nerve - Courses the cavernous sinus
5) Trochlear - Control superior oblique. Found anteromedial to CN V
6) Abducen - Control the lateral rectus. May be seen at the clivus which is the slope between dorsum sella and foramen magnum. The pons and basilar arteries live hear during life

Front 10

Scalp Cranial Nerves

Back 10

1) Cranial Nerve 9-11 exit the skull through the jugular foramen.

2) Hypoglossal Nerve - Rootlets converge on the hypoglossal canal and exit the skull

3) Middle Meningeal Artery - Goes through the foramen spinosum to the squamous of the temporal bone btw the dura and inner table of bone

4. Falx Cerebelli - Separates the cerebellar hemispheres during life. Small crest from the internal occipital crest to the posterior foramen magnum and has the occipital sinus run through it as it leaves the confluence of sinus

5) Vertebral Arteries - Enter the skull through the foramen magnum and combine to make the basilar artery.

4) Circle of Willis - Vertebral arteries to the basilar which gives off the posterior cerebral and posterior communicating. Posterior communicatring connects with the internal carotid which gives off the anterior cerebral. Anterior cerebral connect via anterior communicating

Front 11

Dural Venous Sinus

Back 11

-found between the periosteal and meningeal layers of the dura mater. The falx cerebri is an extension of the dura mater. Blood vessels can course through the arachnoid space

Cavernous Sinus - Side of the sella turcica. Receives blood from the ophthalmic veins, cerebral veins, and the sphenoparietal sinus which runs under the lesser wings of the sphenoid bone

Intercavernous Sinus - Connects the cavernous sinuses. Has the CN 3-6 and the carotid artery

Internal Carotid Artery - Enters through the foramen lacerum and carotid canal and goes to the cavernous sinus. In the cavernous sinus it gives off the cavernous, hypophyseal, and meningeal branches. After this it turns upward, leaves the cavernous sinus, and gives off the opthalmic, posterior communicating, and anteior choroidal arteis. Finally it looks on itself and gives off the anterior cerebral and middle cerebral terminal branches

Front 12

Veins Continued

Back 12

1) Inferior Sagittal Sinus - Starts around the crista galli and follows inferior border to the tentorium cerebelli. Here it join with the great cerebral vein (vein of galen) to make the straight sinus

2) Cavernous Sinus Detail - Large communication point. Connects to veins of the face through the pterygoid plexus. Gives off the superior and inferior sagittal sinus which communicate wtih the sigmoid sinus. Inferior and superior opthalmic veins communicate with the pterygoid venous plexus through the intercavernous sinus

Front 13

Pectoralis Major Green Book

Back 13

-Pectoralis major inserts into the humerus head and has 3 origins, the clavicle, sternum, and abdomen. It has a clavicular, sternocostal, and abdominal head
-The cephalic vein separates the pectoralis major and the deltoid. It is located in the deltopectoral triangle/groove. The cephalic goes from the hand to the axilliary vein and it is used to introduce peripherally inserted central catheter

Front 14

Pectoralis Minor Green Book

Back 14

-Originates from ribs 3-4-5 and inserts on the coracoid process of the scapula
-helps move the scapula, and when the scapula is stationary it elevates the ribs during forced inspiration

Front 15

Axillary Fossa Intro

Back 15

Anterior Border - Pectoralis Muscles
Posterior Border - subscapularis, teres minor, and latissimus dorsi

Front 16

Deltoid Muscle

Back 16

-Origin is the scapula and clavicle and it inserts at the deltoid tuberosity of the humerus
-Helps move the shoulder and stabilize the joint and it is innervated by the axillary nerve

Front 17

The Orbit 1

Back 17

-We excised the periorbita carefully and reflected the membrane to expose the orbit
-The eye is innervated by the trochlear, adbucent, and oculomotor nerves which go through the superior orbital fissure
-All the rectus and superior oblique attach to the tendinous ring, the inferior oblique goes from the floor of the orbit to the posterior orbital crest

Front 18

The Orbit Nerves

Back 18

-The orbit is innervated by CN V division 1, the opthalmic nerve. It is divided into 3 branches, the nasociliary, the frontal, and the lacrimal

1) Frontal Nerve - Divides into the supraorbital (forehead, scalp, frontal sinus) and supratrochlear (conjunctiva of upper lid) nerves after the orbit

2) Levator Palpebrae Superioris - Innervated by the oculomotor nerve and its elevates the eyelid

3) Nasociliary Nerve - Enter orbit through annular tendon.Anterior and Posterior Ethmoidal, Infratrochlear (lacrimal sac), and Long Ciliary. The long ciliary carries sympathetic fibers to the cornea and responsible for the afferent limb of the corneal reflex

4) Superior Ophthalmic Vein - Return blood to area of cavernous sinus through the superior orbital fissure

5) Ophthalmic Artery - From ICA enter OPTIC FORAMEN with optic nerve

6) Lacrimal Nerve - Go to lacrimal gland.

Front 19

The Orbit Nerves 2

Back 19

1) Ciliary Ganglion - From the oculomotor nerve it is a parasympathetic fiber that controls ciliary muscle and pupillary sphincter

Front 20

Extraocular Muscle Attachments

Back 20

1) Levator Palpebrae Superioris - Lesser wing of sphenoid to the skin of superior eyelid
2) Rectus - Common tendinous ring to the sclera
3) Superior Oblique - Body of sphenoid to the trochlea, to the sclera deep to superior rectus
4) Inferior Oblique - anterior orbit floor to the sclera deep to lateral rectus

Front 21

Lacrimal Gland

Back 21

-lacrimal gland lies in the lacrimal fossa of the frontal bone
-Orbitcularis oculi and palpebral musculature help drain it into the sac through the lacrimal canaliculi. From the sac it oes to the nasolacrimal suct which empties into the inferior meatus of the nose.
-Right after the lacrimal gland it goes to the lacrimal lake (lacus lacrimalis) and then the lacrimal puncta before the canaliculi and sac
-The lacrimal sac is just above the medial palpebral ligament which anchors the orbicularis oculi
-The lacrimal gland has GVE fibers from CN VII via the pterygopalatine ganglion that join the lacrimal nerve of CN V

Front 22

Axilla Dynamics

Back 22

-pyramid with the following walls
base - skin and superficial fascia of the arm pit
anterior - pectoralis muscles
medial - lateral thoracic wall (ribcage) covered by serratus anterior muscle
posterior - scapula, subscapularis, teres major, and latissimus dorsi

Apex - Interval btw clavicle and 1st rib

Lateral Wall - Intertubulcular sulcus

Front 23

Axilla Contents

Back 23

-Axillary vein which goes to the subclavian
-Axillary artery which is 3 parts is determined by its relation to the pectoralis muscles. Covered in a axillary fascia
-Brachial plexus

Front 24

Muscles of the Axilla Area

Back 24

Serratus Anterior - Origin from the anterior chest wall and into vertebral border of the scapula. Moves the scapula. Inn. by the long thoracic nerve

Latissimus Dorsi - Thoracic vertebra to the humerus. It moves the arm and is inn. by the thoracodorsal nerve

Subscapularis - Goes from the scapula to the humerus. Moves the arm and stabilizes the shoudler. Inn by the upper and lower subscapular.

Teres Major - Scapula to the humerus. Extends arm and inn. by lower subscapular

Rotator Cuff Muscles - Teres minor, subscapularis, infraspinatus and supraspinatus

Front 25

Arm Muscles

Back 25

1. Biceps Brachii - Attach to radial tuberosity. The short head starts at the coracoid process and the long at the supraglenoid tubercle of the scapula. Inn. by musculatotaneous nerve. Flexion.

Coracobrachialis - Coracoid process ot the middle 3rd of the humerus. Inn by musculocutaneous nerve. Help flexion

Brachialis - Distal humerus to the coronoid process and tuberosity of ulna. Flexion.. Runs across the elbow

Triceps Brachii - Extensor that is inn. by radial nerve of plexus. Has 1 head on the scapula and 2 on the humerus, they fuse and go posterior across the elbow to the ulna.

Front 26

Brachial Plexus 1

Back 26

-comes from C5 - T1 ventral rami of spinal nerves. As the numbers increase the innervation becomes distal
C5/C6 - Shoulder
C7 - Elbow/wrist
C8-T1 - Hand

1) Roots of the ventral rami -5
2) Trunks - 3
3) Divisions -6
4) Cords - 3
5) Terminal Branches - 5

-also 11 offshoots

Front 27

Roots

Back 27

-superclavicular and lye deep in the neck
1) C5 gives off the dorsal scapular nerve which innervates rhomboid muscles
2) C5-C7 give off the long thoracic which goes to serratus anterior

Front 28

Trunks

Back 28

-supraclavicular and deep in neck

-C5+C6 make the superior (upper trunk)
-C7 makes the middle trunk
-C8-T1 make the inferior (lower trunk), most pathological and felt in hand

3) Superior trunk gives off the subclavius
4) Suprascapular Nerve - Superior trunk inn. supraspinatous and infraspinatous of the scapula

Front 29

Divisions

Back 29

-Combine to make anterior divisions to anterior muscle of flexion and posterior division for muscle of extension

-The superior and middle trunks give off a upper anterior and lower posterior division. The inferior trunks gives off a upper posterior and lower anterior division.

Front 30

Cords

Back 30

-found in the axilla and named after relation to axillary artery

1) Lateral Cord - Anterior fibers from superior/middle trunk. C5 - C7
5) Lateral Pectoral Nerve - To pectoralis major

2) Middle Cord - Anterior fiber from inferior trunk. C8 - T1
6) Medial Pecorali - Inn pecs
7) Medial brachial cutanous - shoulder/elbow skin
8) Medial antebrachial cutanous - forearm skin

3) Posterior Cord -Posterior fiber from 3 trunks. C6 - C8
9) Thoracodorsal - Latissimus dorsi
10_ Upper subscapular nerve - Subscapularis
11) Lower subscapular - Subscapularis and terest major

Front 31

Terminal Braches

Back 31

a) Musculocutaneous - Off of the lateral cord it goes to skin/muscle of anterior arm and elbow. Bicep brachii, brachialis, and coracobrachialis

b) Axillary Nerve - Off o the posterior cord and inn. deltoid, teres minor, glenohumeral jint

c) Radial Nerve - Come off of posterior cord. Inn muscles of posterior arm and forearm and hand (triceps)

d) Median Nerve - Come from C6-T1 joining of the lateral and medial cords. Inn. forearm muscles, hand muscles (base of thumb, median palm, and lateral 3.5 digits. Passes carpel tunnel

e) Ulnar Nerve - Come off of the median cord. Inn. intrinsic hand muscle and skin of medial 1.5 digits

Front 32

Axillary Artery

Back 32

Part 1 has the superior thoracic

Part 2 has the thoraco-aromial and lateral thoracic artery

Part 3 has the subscapular and anterior/posterior circumflex humeral