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136 Cards in this Set

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What are the (4) functions of skeletal muscle?
1. Movement
2. Maintenance of Posture
3. Joint Stabilization
4. Heat generation

What are the (4) CHARACTERISTIC of SKELETAL muscle that enable it to function?
1. Contractility: Muscles are dumb cells and can only do one thing: contract. Even when you stick out your tongue, you must contract muscles to generate that movement. Muscles never push.

2. Excitability: Action potentials cause muscle contraction.

3. Extensibility: When a muscle contracts, its antagonist will be stretched or extended. We’ll talk more on this later. For now, just know that contracting certain muscles will cause other certain muscles to stretch.

4. Elasticity: Muscles act like rubber bands. Once the load is removed from a muscle, it will recoil back to its original position.

What are the fascicle layers that organize the muscle?
Epimysium=the tissue surrounding the entire muscle

Perimysium=the tissue surrounding each fascicle

Endomysium=the tissue surrounding each myofiber

What anatomical features allow a single muscle to work? How do muscles produce movement?
Each muscle is innervated by one nerve. Removing or severing this nerve will cause a nerve injury, and the muscle will necrose. A muscle will also be supplied by at least 1 artery (sometimes 2), and, because the entry of an artery requires the exit of a vein, a muscle will also have 1 or more veins.

Muscles produce movement by spanning one or more joints.

What sorts of anatomical features do muscles attach to?
raised bumps on bones at the sites of muscle attachment. These bumps are called TUBERCLES, TROCHANTERS, or CRESTS, and an example is the mastoid process where the sternocleidomastoid attaches.

There are also instances where a muscle attaches to another muscle instead of a bone. This attachment is called a RAPHE

Why is the arrangement of fasciales significant? What are the different types? (4)
The arrangement of fascicles in a muscle will determine its STRENGTH and ROM. There are four types of arrangements:

1.) PARALLEL: straplike; can shorten the most, which gives them a great range of motion; generally lack power

2.) CONVERGENT: fascicles from two distinct locations merge on a common tendon

3.) PENNATE: large; many fascicles attach at a common tendon in a slanted, layered orientation, creating a “feathered” arrangement of fascicles on the tendon; very strong with limited range of motion

4.) CIRCULAR: sphincters
the larger the muscle, the more power it will be able to exercise
What type of lever is this?
2ND CLASS LEVERS (ALWAYS MECHANICAL ADVANTAGE) When at a mechanical advantage, the distance between the muscle and the joint is greater than the distance between the joint and the load.
That is, the load is closer to the joint than is the muscle. This allows the muscle to be strong but slow. This will always be the case in 2nd class levers such as the gastrocnemia of the legs. Here, we sacrifice speed for strength, which gives us the ability to stand.
What type of level is this?

When at a mechanical disadvantage, the distance between the muscle and the joint is less than the distance between the joint and the load. That is, the muscle is closer to the joint than is the load.

Class 3: Effort in the middle: the resistance is on one side of the effort and the fulcrum is located on the other side, for example, a pair of tweezers or the human mandible.
This gives the muscle greater speed and a greater range of motion but limits its strength, as is seen in 3rd class levers such as the biceps
What type of lever is this?

can work at a mechanical advantage or a mechanical disadvantage.

Class 1: Fulcrum in the middle: the effort is applied on one side of the fulcrum and the resistance on the other side, for example, a crowbar or a pair of scissors.
To recap: 1st class levers can work at a mechanical advantage or disadvantage

2nd class levers are ALWAYS at a mechanical advantage

3rd class levers are ALWAYS at a mechanical disadvantage
Which layer do muscles come from?
Muscles from MESODERM layer of embryo
The smooth muscle of our visceral organs is derived from the splanchnic mesoderm. The somitomeres, myotomes, and limb buds also arise from the mesoderm. It is these structures that will give rise to our skeletal muscles.
Pharyngeal (Branchiomeric) Arch Muscles
These muscles develop from the 4th-7th SOMITOMERES
and end up in the head or neck. We should know that they are developed from branchiomeres and are innervated by cranial nerves.

Axial Muscles
There are two distinct lines of development for axial muscles:
MYOTOMES give rise to the skeletal muscles of the head neck, thorax, abdomen, and pelvis. These muscles function to move the trunk and maintain our posture.

1st-3rd SOMITOMERES give rise to the extrinsic eye muscles and the muscles of the tongue. These muscles are histologically unremarkable but are given special attention because they’re involved in the senses.

Limb Muscles
The myotomes also give rise to the limb buds. The dorsal part of the limb bud will become the extensors of our limbs and the ventral part of the limb. limb bud will become the flexors of our limbs. At birth, our legs face outward. In this position, the extensors of both our arms and our legs are dorsally located and the flexors, ventrally located dorsally. As we learn to walk and become biped, our lower limbs rotate, changing the orientation of our extensors and flexors to opposite that of our upper limbs. This is why once we are able to walk, the extensors of our lower limbs are ventrally located and the extensors of our upper limbs are dorsally located. Likewise, the flexors of our lower limbs are dorsally located and the flexors of our upper limbs are ventrally located. More simply,
this is why our elbows and knees bend in opposite directions.

What is the path of blood flow to the heart?
Right Atrium →
Tricuspid Valve →
Right Ventricle →
Pulmonary Trunk (Splits into Right and Left
Pulmonary Artery) →
Lungs →
Pulmonary Veins →
Left Atrium →
Bicuspid/Mitral Valve →
Left Ventricle →
Aorta →
Systemic Circulation.
Pulmonary circulation receives 100% of cardiac output (blood flow) unlike systemic circulation.
What is unique about pulmonary circulation vs systemic circulation?
Pulmonary circulation receives 100% of cardiac output (blood flow) unlike systemic circulation.

What are the only arteries that carry deoxygenated blood? Where is that blood coming from? Where is it going to?
The PULMONARY ARTERIES are the only arteries that carry deoxygenated blood.

Right Ventricle →
Pulmonary Trunk (Pulmonary Arteries) →
Lungs →
Pulmonary Veins →
L. Atrium.

The heart is always full of blood.... Why does the heart even need it's own blood supply (coronary arteries)?
CORONARY ARTERIES arteries are vital, as the blood in the chambers of the heart do not have enough time to diffuse nutrients though the thick chamber walls.

Lack of coronary artery blood supply causes death of cardiac tissue and can lead to heart attacks.
This diversion of blood is also why systemic circulation does not receive 100% of cardiac output
What are the four main arteries that supply the head, neck and brain?
Common Carotid Arteries: Branches into the external*carotid*artery supplying the neck and face, and the internal*carotid*artery supplying the brain.

Vertebral Arteries: Cervical vertebra have an opening for these, traveling to the brain ultimately to form the circle of willis

Thyrocervical Trunk: Delivers blood to the thyroid (thyro) and the neck (cervix)

Costocervical Trunk: Supplies the ribs (costal) and the neck (cervical).
The internal carotid artery travels directly into the cranium, supplying the brain. This is particularly important as plaques can build up in this artery, occluding blood flow, causing a stroke and death of brain tissue. This would be treated by a
carotid endarectomy in order to remove the plaque. The external carotid artery branches into the temporal branch and the maxillary branch, supplying the neck and face respectively.
What are some places that have a retrograde blood supply and why is this significant?
Hip joint, wrists, ankles.

hen you fracture a hip, you are fracturing the neck of the femur. Due to the retrograde blood supply, the location of the fracture along the neck of the femur will determine if a hip replacement is needed or not. The closer to the head the more likely you will need a hip replacement. The farther or more distal it is, however, the better the chance that the blood supply to the femur head and neck is intact and thus the replacement is unnecessary.

When should one be careful about popping pimples? What about blood circulation makes this dangerous?
When they are in the danger triangle of the face.

The face is supplied by the EXTERNAL CAROTID ARTERIES and drained by the FACIAL VEIN. There are areas where the venous return from the cranium meets the venous return of the face.

Sooo... If you pop pimples on your face, the ace can enter the facial vein that has a direct connection to the venous return of the skull. This in turn can travel to the cavernous sinus and lead to meningitis. AHHH!!

Which vein do you usually draw blood from?
The MEDIAN CUBITAL VEIN is of particular importance as this is where you insert an IV or draw blood.

What is unique about the venous return of the GI system?

A portal system is
simply blood flow traveling through two capillary beds.
Any time there is blockage at the liver you are going to impact anything that goes to the GI tract, causing engorgement of the capillary bed which can rupture causing internal bleeding.

This type of blockage is can happen to ALCOHOLICS due to liver damage.
What can we use the SAPHENOUS VEIN for (right lower limb)? Why is it useful clinically?
It can be harvested for coronary bypass and is a convenient location to inject IVs (venous cutdown).
*In the case of harvesting the vein for coronary bypass, remember that veins have valves unlike arteries. Thus you need to reverse the polarity
of the vein insert it inside out so the valves don’t impede coronary blood flow.*
What are the basic features of skeletal muscle? What is the signification of the # of motor neurons that innervated one muscle? Why would this be useful?
Connective tissue SHEATHS hold several fibers together

Nerves and Blood vessels: In general, each skeletal muscle is supplied by ONE NERVE, ONE ARTERY, and ONE (or more) VEINS, entering near the middle of the muscle.

One nerve = one concerted effort at the same time!

What are the 4 characteristics of the skeletal muscle? What are the 4 main functions of skeletal muscle?
*Muscles only PULL
*Muscles are excited by ONE nerve
*muscles can be stretched back

Name the 3 types of muscles (Duh)

Where do you find them in the body?
Focus on skeletal in gross anatomy

What specific anatomical feature do muscles span over? How do muscles attach? What does it attatch to? WTF is a raphe?
*Muscle attached to bone
As it pulls on bone, creates groves on it skeleton

A muscle will always move the _________ bone. Muscles _______ from one another (spanning a joint).
A muscle will always move the DISTAL bone (Furthest away from trunk).

Muscles EXTEND from one another.

A muscle will always move the _________ bone. Muscles _______ from one another (spanning a joint).
A muscle will always move the DISTAL bone (Furthest away from trunk).

Muscles extend from one another.

What are these types of broad tendons called?
Broad tendon

*ie. latissumus dorsi
*palmar tendon
*plantar tendon

The arrangements of which three elements determine the functions (speed of contraction/ ROM/ strength) of muscles in the body?
Fulcrum/ lever/ effort
Joint/ bones/ muscles

Why not just make all muscles be mechanically advantageous? Wouldn't it just make sense to have all muscles arranged to be a strong as possible?
Mechanically disadvantaged= greater ROM and speed in exchange for less power.

What do they mean when they say a first class lever be both mechanically advantageous OR mechanically disadvantageous at the same time?
*Effort is either much farther away (or closer to) fulcrum AKA scissors vs bolt cutters.

Demonstrate each type of movement at synovial joints.
(angular, gliding, rotation)

Demonstrate each type of "special movement" at the synovial joints.

What are the 4 types of muscle fibers in the human body? Why is this arrangement significant?
Arrangement of fascicles influences range of motion and power of muscle
Parallel arranged fascicles can shorten the most (great range of motion), but generally lack power
Power of muscles depends more on total number of fibers (pinnate and multipennate).
Parallel, e.g., straplike or fusiform muscles
Convergent: Fascicles converge towards the tendon
Pennate (Bipennate, Multipennate): fascicles are short and attach obliquely to a tendon running length of muscle
Circular: sphincter muscles
What are:

Give and example of each.
Agonist (PRIME MOVER): muscle responsible for producing a specific movement (Bicep)

ANTAGONIST: Reverses a particular movement (muscles cannot push) (Tricep)

SYNERGIST: Help agonists – work with or
can dampen undesirable movement, e.g., making a fist yet not flexing the wrist (biceps brachii)

FIXATORS ("POSTURE MUSCLES"): Hold bone firmly in place so that agonist has a stable point to serve as an “origin”, e.g., scapula.

Muscles can be named after a bunch of different properties. What is an example of muscle being named after:
Size of muscle?
Direction of fascicles/ muscle fiber?
location of attachments?
Number of orgins?
Location: e.g., brachial and intercostal muscles
Shape: e.g., deltoid, trapezius
Relative size of muscle: e.g., maximus, minimus, longus, brevis
Direction of fascicles and muscle fibers: e.g., rectus, transversus, oblique
Location of attachments: origin and insertion, origin always named first e.g., brachioradialis
Number of origins: e.g., biceps, triceps, quadriceps
Action: e.g., flexor, extensor, adductor, or abductor

What is the STRONGEST MUSCLE in the body??
The BUCCinator, massetor and temporalis are all involved in chewing (mastication).
What are all these muscles involved in? And why are there so damn many?!
Facial expression... requires more fine motor skills. Hence more control of fine movement with more muscles.

What are these muscles involved in? What are the two big ones she pointed to? What do they do precisely?


*SCALENE MUSCLES- turn head side to side. (attatch to 1+2nd ribs and cervical vertebrae)
(Black suits comin...)

Which bone cells are the bone FORMING/ building cells?

What are the bone cells that are involved in bone breakdown/ reabsorption?

What are osteocytes?
Mature bone cells

Name them!!
Know cold

Name the shoulder bones/ features
Scapula (glenoid cavity, coracoid process, acromion)
Humerus (humeral head)

What are the 6 steps of cadaver dissection?
Exposure of the pectoral region. Make the following incisions:

From jugular notch, Sagittaly, to xiphoid process (1)
From jugular notch, along clavicle, to Acromion (2)
From sternal angle, laterally to axilla (3)
From body of sternum, laterally, circumscribe nipple, to edge of table (4)
From xiphoid process, laterally to edge of table (5)
From xiphoid process, obliquely, along costal margin (6)

Describe (using proper anatomical terms) what to do for each step.

Which surface features do you use for each one?

Exposure of the pectoral region. Make the following incisions:
4. From body of STERNUM, laterally, nipple (CIRCUMSCRIBE) , to edge of table
5. From XIPHOID PROCESS, to edge of table (LATERALLY)

What are three functions of the lymphatic system?
I: Drain interstitial fluid.
- The CV system is only 90% efficient. The 10% of fluid is typically lost in capillary beds at the cellular level. It is returned to the venous circulation by the lymphatic system

II: Transport dietary lipids.
- The lacteals carry chyle out of the GI tract and dump it directly into the bloodstream, BYPASSING THE LIVER.

III: Protect against infection.
- Really??? Do I really have to explain this!?

What is the composition of the lymphatic system?
1. Fluid (lymph)
2. Vessels (lymphatics)
3. Structures and organs that contain lymphatic tissue
4. Red bone marrow (site of lymphocyte production)

Describe how lymph is formed

What does lymph pick up?
What about plasma protiens in blood? What if they esacpe?
Lymph (tissue fluid) picked up by capillaries

**Most plasma proteins are too large to leave blood vessels

**Proteins that escape, must return to circulation

**At a certain point, after tissue pressure builds, lymphatic capillaries open up and allow return

Lymph is everywhere throughout the body EXCEPT:
Avascular tissues (e.g., cartilage, epidermis, cornea of eye)
Central nervous tissue
Portions of spleen
Red bone marrow

Describe basic direction of lymph flow.

Which direction does lymph flow? Which way do lymph valves point? Which direction is it drained from?Where does it come from/ go to?

Describe basic direction of lymph flow.

Which direction does lymph flow? Which way do lymph valves point? Which direction is it drained from?Where does it come from/ go to?

Why might it be useful to know which lymph nodes drain from which tissues?

Why do doctors always palpate your inguinal area? What could you tell by touching lymph nodes?
LYMPH NODES= Site where lymphatic and immune systems intersect

Location & direction of flow important in diagnosis/ prog-nosis of cancer spread by metastasis

Cancer in lymph nodes not tender

Inflamed lymph nodes feel tender
Lymph nodes appear throughout body in groups (~500)
Filter lymph: enters at one end, out the other
What is this figure pointing to?

So how do clinicians see the lymphatic system?
Positron Emission Tomography (PET) scans
combined with a radio-labeled glucose analogue known as Fludeoxyglucose (FDG). Metabolically active cells, for example, cancer cells, will take up FDG and appear black on the PET scan. Slide #10
shows a patient with myeloma, or cancer of the bone marrow. Myelomas frequently metastasize to the
lymph nodes; we can see bilateral axillary lymph node involvement in this patient.
Note that black spots indicate hypermetabolism NOT cancer; slide 11 shows that cells damaged
by radiation therapy also show up as black spots.
FDG PET scan of a patient with multiple myeloma with severe diffuse and focal disease
Lymph flow is passive and unidirectional... so then what drives it to move??

(4 things)
- Contractions compress the lymphatic vessels, driving lymph flow
- Inhalation creates a pressure differential between the abdomen and thorax. Abdominal
pressure increases, forcing lymph upwards
- Contractions of smooth muscles around blood and lymph vessels (see I)
- This one is simple. Ever have a swollen ankle? Elevation assists flow!

What are the causes of this?
Excessive accumulation of interstitial fluid

DIRECT Causes:
*Obstruction of lymph node or vessel
*Pregnant uterus
*Excessive lymph formation and increased permeability of blood capillary after injury
*Increased capillary pressure (hypertension)

May be liver cancer/ cirrosis-- alcoholics have trouble making albumin
Treatment: RICE
drainage, diuretics, paracentesis
When does lymph flow in?
When interstitial fluid pressure greater than lymph, cells separate some
Fluid enters lymphatic capillary

Lymph can only go in, and not back out. So how can cells get more fluid then? Where does it come from? Mechanically, how does this work?
When pressure of lymph is greater, cells adhere more closely so lymph cannot flow out
Anchoring filament: edema causes pulling and greater opening of capillaries
More interstitial fluid can then return

Lymphadenopathy: Any DISEASE of the lymph node
Lymphedema: SWELLING due to accumulation of lymphatic fluid in loose connective tissue
Lymphoma: Any NEOPLASM (TUMOR) of the lymphoid tissue, whether benign or malignant
Lymphangitis: INFECTION caused by severe trauma, elephantitis, parasitic infiltration all of which damage the lymphatic vessels causing severe Lymphedema.

Again, why is it so damn important to know which lymphs are draining which tissue?
The concept of the SENTINEL lymph node is important because of the advent of the sentinel lymph node biopsy technique, also known as a sentinel node procedure. This technique is used in the staging of certain types of cancer to see if they have spread to any lymph nodes, since lymph node metastasis is one of the most important prognostic signs. It can also guide the surgeon to the appropriate therapy


Where are they located and what do they do?
Medulla-continguous with spinal cord-respiration and heart rate
Pons-relay between cerebrum and cerebellum
Midbrain-relay between cerebrum and spinal core
Thalamus-integration of sensory input before proceeding into the hemispheres
Hypothalamus-controls the visceral nervous system.

How much cerebral spinal fluid can we make in a day? What does

What is something that is very unique about the drainage of the lymph system?

Hint- asymmetry with the quadrants? What parts of the body drain to which areas???
Right Jugular trunk
right subclavian trunk
and right bronchomediastinal trunk all drain the right upper quadrant (belly button and up).


What do you call the lymph capillaries that drain the interstitial fluid from the small intestine?

What are the functions of the skeletal system?
FXN of skeletal system

1. Shape and Form of body
2. Protection of vital organs
3. Movement via attachments for muscle
4. Hematoposis in bone marrow/ spongy bone
5. Mineral Storage

What is the AXIAL skeleton?
Bones that support the head, neck and trunk

skull, sternum, ribs vertebral column ONLY

What is considered the APPENDICULAR skeleton?
Bones that anchor appendages to axial skeleton


The bone has a lot of inorganic material. So why does it still hurt so bad when you fracture it? What specifically on the bone enables you to feel this pain?

What is the function of cartilage?
Where are different places you can find it in the body? What does it do?
ear- structural support
meniscus- smooth gliding surface
epiphysis- growth of long bone

CARTILAGE is extra-cellular fibers embedded in a matrix... both the AMOUNT and TYPE of extracellular fibers vary greatly from tissue to tissue.

That being said...How does the composition of cartilage differ depending on its function in the body?

Hint-- What would you expect to see in a weightbearing area (meniscus)? Less stressed area (ear)?
in more weight-bearing areas (MORE STRESS), you will have MORE COLLAGEN, making the cartilage MORE RIGID

In less weigh-bearing areas, you will have increased elastic fibers and fewer collagen fibers, increasing the flexibility of the cartilage.

BIG ONE know cold!!

What type of axial movements do each of these joints have? Give examples of each.
1. Plane joint- nonaxial (Gliding) carpals/ AC joint
2. Hinge joint- uniaxial- (flexion/extention) knee/elbow/ankle
3. Pivot joint- uniaxial- (Rotation) vertebra/ medial radius
4. Condylar/ Ellipsoid joint- biaxial (flex/extend+ abd/add+ circumduct) wrist/ fingers
5. Saddle joint- biaxial- (flex/ext + abd/add + circumduction) THUMB ONLY
6. Ball and Socket Joint- Multiaxial (flex/ext + abd/add + circumduction+ ROTATION) hip/shoulder

Synovial joints based on SHAPE and MOVEMENT. Name the movements with each shape....
1. Plane joint- nonaxial (Gliding) carpals/ AC joint
2. Hinge joint- uniaxial- (flexion/extention) knee/elbow/ankle
3. Pivot joint- uniaxial- (Rotation) vertebra/ medial radius
4. Condylar/ Ellipsoid joint- biaxial (flex/extend+ abd/add+ circumduct) wrist/ fingers
5. Saddle joint- biaxial- (flex/ext + abd/add + circumduction) THUMB ONLY
6. Ball and Socket Joint- Multiaxial (flex/ext + abd/add + circumduction+ ROTATION) hip/shoulder

What type of tissue is our skeletal SYSTEM composed of?
1. bones
2. cartilage
2. ligaments
4. tendons
5. enamel

What happens to the bone density during menopause (decrease in estrogen)?

hint-- What specifically does estrogen do?
Estrogen increases osteoClast activity.

When osteoClast activity > osteoBlast activity = more bown breakdown (or mineral deficient state)

Bone density decreases

What can happen when you RESORB too much bone?

Hint-- High osteoclast activity/ dissolving bone activty

Hint hint-- higher levels of estrogen or calcetonin would help prevent this from happening...

What is compact bone? Describe its functions.

What is cancellous (spongy) bone? What are its functions?

Which one would show up lighter on Xray?

Which is more affected by osteoblast/ osteoclast activity and hormones?
COMPACT- heavier- stronger- denser (difficult for x-ray to penetrate through) protection/ structure/ movement

Cancellous- lighter/weaker more frequently broken- MORE SURFACE AREA- PTH release calcium from this area... (Estrogen and clacitonin build more bone in this area) Mineral storage/ hematoposis
Cancellous bone, synonymous with spongy bone, is one of two types of osseous tissue that form bones. Compared to compact bone, which is the other type of osseous tissue, it has a higher surface area but is less dense, softer, weaker, and less stiff. It typically occurs at the ends of long bones, proximal to joints and within the interior of vertebrae. Cancellous bone is highly vascular and frequently contains red bone marrow where hematopoiesis, the production of blood cells, occurs. The primary anatomical and functional unit of cancellous bone is the trabecula.
Its Latin name is substantia spongiosa or substantia spongiosa ossium.[1] The words cancellous and trabecular refer to the tiny lattice-shaped spicules that form the tissue.[1] It was first illustrated accurately in the engravings of Crisóstomo Martinez.[2]
Cancellous bone has a greater surface area in comparison with cortical bone, and as a consequence cancellous bone is ideal for metabolic activity e.g. exchange of calcium ions.
In osteoporosis, cancellous bone is more severely affected than cortical bone.
from wiki
What is the composition of compact bone?
HARD MATRIX- very little collagen fibers, very little organic material

What makes up 80% of the weight of the human skeleton?

Which bone makes up the ARM?

hint-- just the arm, NOT the FOREarm

Which forearm bone (in anatomic position) is more medial?

Which distal inferior bone is more medial?


The FIBULA sits _________ to the tibia

Which bone type is the STRONGEST BONE in the body? The one we typically see in cartoons/ halloween decorations?
Long bone

Which bones are mostly spongy bone, with a thin layer of compact? (easier to fracture) Which need more flexibility for fine movement?

Cuboidal bones... of wrist bones... what are they called

Which bones are REALLY good at protecting vital organs?

in cranium and sternum

What do the bones of the vertebra and the bones of the face have in common with each other?

What are irregular bones with a specific location inside tendons of the joint and help make the joints more efficient?

Where do ossification centers of bone end to?
Synchondroses (Fiborous joints)

Two ossification centers in a developing bone remain separated by a layer of cartilage
Ribs and sternum
Head and shaft of developing long bones
Which (FIBROUS) joint type is specific to the skull?

Hint- its a solid joint.

What do you call the (FIBROUS) joint of bone and teeth (enamel)?

Which (FIBROUS) joints are similar to cell junctions at desmosomes where they hold two adjacent bones together?

Which (CARTELAGENOUS) joints connect bone on bone joints directly with cartilage?

What are the two different types of reflexes in the body? What are the differences between them? Which one forms a memory? When would this be useful?
POSTSYNAPTIC REFLEX- 3rd neuron- send signal to hippocampus to make memory associated with that stimulus--- good for survivial. stay away from dangerous/ painful things

Each SPINAL nerve has two components to it. What are they, where do they integrate, an what do they do?
Motor/efferent (anterior)
Sensory/afferent (posteriorl)

What are dermatomes?

Which area is the only branch not innervated by dermatomes?

What are MYOTOMES? What do they innervate?

What are myotomes? what can cause foot drop?
Groups of muscle innervated by a single spinal nerve
C3,4 and 5- supply the diaphragm
C5-supplies the shoulder muscles and the muscle that we use to bend our elbow .
C6 -bending the wrist back.
C7 -straightening the elbow.
C8- bends the fingers.
T1-spreads the fingers.
T1 –T12 supplies the chest wall & abdominal muscles.
L2 bends the hip.
L3 straightens the knee.
L4 pulls the foot up.
L5 wiggles the toes.
S1 pulls the foot down.
S3,4 and 5 supply the bladder. bowel and sex organs and the anal and other pelvic muscles.
What is a rami? a Roolet?

What is greg's favorite nerve?

Cranial nerve X
Stimulate Vagus Nerve
Slows heart rate, respiratory rate, constricts bronchial passageways, increases their secretion, enhances peristalsis.

Induces secretomotor activity of the alimentary canal from the esophagus to anal canal but more emphasis on upper 2/3 of GI tract.

NOTE-Only talking about the effector function right now--CNX is a mixed nerve—has a sensory component. 80-90% are sensory fibers conveying information about organs back to brain. Creates a loop.

Can be caused by GI illness, pain, stress

Excessive activation of vagal nerve during emotional stress—fainting, seizure-like activity

Parasympathetic system overcompensates. Drop in blood pressure and heart rate.
Do a Comparison of Autonomic and Somatic Motor Systems
Characteristics of SNS
Lower motor neurons of SNS (GSE) exert direct control over skeletal muscle
Axons are heavily myelinated – conduction of impulse is rapid

Characteristics of ANS
ANS unit exists as a chain of two motor neurons: preganglionic and postganglionic
Preganglionic neurons are slightly myelinated, postganglionic neurons lack myelin
Conduction of impulse in ANS is slower than in SNS
Considerable divergence exists in the ANS

which two locations does the parasympathetic system exit the CNS?
The parasympathetic system exits the CNS at two location: from the brain through cranial nerves
III, VII, IX, X and the sacrum, making the cranial-sacral system. The cranial nerves innervate all
visceral organs until the upper GI, while the sacral portion
covers the lower GI and reproductive organs. This system is
active during the “rest and repose” response.

Which fibers use which types of transmitters?
Biochemically for neurotransmitters, preganglionic fibers use acetylcholine and postganglionic use

What are the four major plexuses?
What forms the root of the plexus? Why is there so much overlap in innervation? Why might this be useful?
The other ANTERIOR RAMI (excluding intercostal nerves) form the PLEXUSES NETWORK or tangle of nerve axons that project to the neck, upper and lower limbs, and pelvis.

4 major plexuses-Anterior rami form the roots of the plexus

Each plexus contains fibers from several spinal nerves and each limb muscle receives innervation from more than 1 spinal nerve.

Backup in case of injury.

An infection of what is causing this to happen?
Infection of DERMATOMES: Herpes Zoster (shingles) Hurt like hell.

More frequent in older patients an immunocompramised individuals. Infection correlates with dermatomes.

(5 levels)
Root (Ventral Rami)
Branches (nerves)

What type of injuries do we see in motor cycle accidents and other trauma? Which part of brachial plexus injury do we see (most common brachial plexus injury)?

Hint- C5-C6
most common type
you see "Waiter's tip?"

Injuries to brachial plexus result in paralysis and anesthesia.
C5 and C6 injuries may result from excessive increase in the angle between the neck and the shoulder, e.g., being thrown or when excessive force is used at delivery.
Resulting condition is known as “waiter’s tip”, the limb hangs by the side in medial rotation and partial extension.

Which area of BRACHIAL PLEXUS injuries are less common? How do the happen? What sorts of symptoms can you have?

Hint- results in "Klumpke Hand"
-C8 and T1

Basically your arm gets pulled violently upward, and the bottom of your brachial plexus gets stretched out.

These types of injuries are more infrequent.
Occur when upper limb is suddenly pulled superiorly and affect C8 and T1.
Results in a “Clawed Hand” appearance (infants-Klumpke paralysis).

What are the (5) big BRACHIAL PLEXUS (upper limb) nerves to know? What do they do?Which one involved in carpal tunnel?
BRACHIAL PLEXUS- Major nerves directed to shoulder, arm, forearm and hand:

1. Musculocutaneous nerve
2. Median nerve*
3. Ulnar nerve
4. Radial nerve
5. Axillary nerve

Formed by the ANTERIOR RAMI of C5- T1 (area of neck to armpit)

Formed by the anterior rami of C5- T1 (area of neck to armpit)

Major nerves directed to shoulder, arm, forearm and hand

Musculocutaneous nerve-innervates biceps brachii (flexor) and some overlying skin (C5,C6,C7)

Median nerve-muscles of the anterior forearm (flexor) and thumb and skin of anterior forearm and 2/3 of the hand (C5, C6, C7, C8, T1).

Ulnar nerve- muscles of lateral forearm and hand and skin of the fourth and fifth digits (C8,T1).

Radial nerve-innervates Triceps brachii and overlying skin (C5,C6,C7,C8,T1).

Axillary nerve- innervates the deltoid muscle and skin of shoulder and upper arm (C5,C6)
Describe the three letter function classification of neurons (spinal and cranial nerves)?

1. General/ Special
2. Somatic/ Visceral
3. Afferent/ Efferant
3 letter system for classification of nerves
G=General-types of neurons found in both spinal and cranial nerves
S=Special-types of neurons only found in cranial nerves not spinal nerves (taste)

S=Somatic-types of neurons innervating structures derived from somites (muscles, cartilage, tendon, skin, fascia). Think segmental.
V=Visceral-types of neurons innervating gut, vascular system, smooth muscle, internal organs and glands.

A=Afferent-sensory neurons
E=Efferent-motor neurons to skeletal and smooth muscle, secretomotor neurons to glands.

Stare long and hard at this... What are some examples of these the combinations/ classification of neurons
GSE-General Somatic Efferent—motor to somatic voluntary skeletal muscles

GSA-General Somatic Afferent—sensory to skin, joints, muscle and tendon receptor endings, nasal and oral cavity

GVE-General Visceral Efferent—autonomic efferents—motor to smooth muscles in general and smooth muscles of skin (erector pillae muscles) and blood vessels, secretomotor to glands.

GVA-General Visceral Afferent--sensory to gut and its derivatives, pharynx, blood vessels, glands, and internal organs.

SSA-Special Somatic Afferent—special senses of vision, auditory, vestibular

SVA-Special Visceral Afferent—chemical sense of taste and smell.

SVE-Special Visceral Efferent—voluntary skeletal muscles derived from branchial arches.

How are the muscles, fascia and skin inneravated in the THORAX?

Spinal nerves of the body torso-arranged segmentally in series of beltlike patterns.

The POSTERIOR/DORSAL RAMI turn posteriorly and penetrate the fasciae, deep muscles, and skin of the back.

Anterior rami of spinal nerves T2-T12 form intercostal nerves

Arranged segmentally between the ribs

Branches to muscles, fascia, skin

What sorts of symptoms do you need a patient to present before an inaurance company will authorize MRI of the back? How does it change with the area?

If patient has an accident- what level will impact the level of function....

Hint- think about the myotomes.
C3,4 and 5- supply the diaphragm
C5-supplies the shoulder muscles and the muscle that we use to bend our elbow .
C6 -bending the wrist back.
C7 -straightening the elbow.
C8- bends the fingers.
T1-spreads the fingers.
T1 –T12 supplies the chest wall & abdominal muscles.
L2 bends the hip.
L3 straightens the knee.
L4 pulls the foot up.** foot drop/ sciatica
L5 wiggles the toes.
S1 pulls the foot down.
S3,4 and 5 supply the bladder. bowel and sex organs and the anal and other pelvic muscles.

What happens if you cut the PHRENIC NERVE?

Where is the Phrenic nerve located? Which plexsus?

Formed by anterior rami of C1-C4/5.

Most of the branches innervate the skin of neck and deep neck muscles.

Phrenic nerve (C3, C4, C5) innervates the top of the diaphragm. If both phrenic nerves are cut or the spinal cord is severed at C3, breathing stops.

What are the (2) major branches of the LUMBAR PLEXUS?

How would Diabetes affect the lumbar plexus?

Which plexus is affected when you have sciatica? When/ why/ where does this happen?
In the military 80-100lbs backpacks...

Which level is the ONLY spinal nerve level that does not participate in dermatomes?
C1- only exception

ALL (OTHER) SPINAL NERVES PARTICIPATE IN DERMATOMES...(area of skin innervated from single spinal nerve)

DRAW OUT how the NERVOUS SYSTEM is organized

What is the primary action of the pronator teres?

How many muscles make up the quadriceps muscles? What are they?
QUADriceps = (4 mucles)
1.) RECTUS FEMORIS- occupies the middle of the thigh, covering most of the other three quadriceps muscles. It originates on the ilium. It is named from its straight course.
The other three lie deep to rectus femoris and originate from the body of the femur, which they cover from the trochanters to the condyles:
2.) VASTUS LATERALIS- is on the lateral side of the femur (i.e. on the outer side of the thigh).
3.) VASTUS MEDIALIS- is on the medial side of the femur (i.e. on the inner part thigh).
4.) VASTUS INTERMEDIUS- lies between vastus lateralis and vastus medialis on the front of the femur (i.e. on the top or front of the thigh), but deep to the rectus femoris. Typically, it cannot be seen without dissection of the rectus femoris.

lateral (intermedial) medial
hamburger+ hotdog

What does the lateral compartment of the inferior leg do?

What does the anterior compartment do? Posterior?

What does the medial compartment of the proximal lower extremeity do?

What action(s) do the ANTERIOR compartment do?

What about the Posterior compartment?

Which side of heart do we see more coronary plaques on? Why?
The Left side-

It's bigger! Has to pump to ENTIRE systemic circut. Larger arteries due to increased metabolic demand.

Larger arteries= greater chance of plaque formation
usually harvest SAPHENOUS vein or INTERNAL MAMMARY ARTERY/ [aka THORACIC ARTERY] (minimally invasive) instead for bypass surgery.
What are the four main arteries that supply blood to the head neck and brain?

Identify the ones marked in pink here

Bonus questions-- Which side are we looking at? How can you tell?
Four pairs of arteries supply the head
1 Common carotid arteries
2 Vertebral arteries
3 Thyrocervical trunks
4 Costocervical trunks
Brachiocephalic artery = right side
What is significant about the arteries of the brain? What are they called? What else can travel along the same path to the head and neck as well?

**EXTERNAL CAROTIDartery supplies neck
**INTERNAL CAROTID artery has no branches in the neck

**Blood supply comes from below

**SYMPATHETIC NERVES use int. & ext. carotids to travel to head/neck

What artery feeds the menigies? What are some possible problems with this when you bash your skull in?
Lots of bleeding (artery very high pressure blood squirting out). Lots of blood building up with no where to go. EXTRADURAL HEMATOMA-- Can damage brain.

Which TYPE of arteries (paired or unpaired) are the ONLY ones that feed into the GI Tract? What are their names?

What types of arteries in the abdomen (paired or unparired) supplies blood to everything that is NOT in the GI tract?

Name four of them. what do they supply blood to?
Gonad arteries are so high because of EMBRYOLOGICAL orgin.

Start high, then descend down.
As the ILLIAC artery continues to travel down the body , its name changes to the _______ artery.

As the SUBCLAVICULAR artery continues traveling down the arm, its name changes to the to the ________ artery.
FEMORAL artery


What is the SLIGHT difference in the VENOUS drainage of the blood supply of the ABDOMEN?

Hint: left/ right
Hint: gonads
Right gonadal vein--> Vena Cava

Left gonadal vein--> Renal vein----> Vena cava

The NEURAL TUBE closing during formation make the NEUROPORE. Folate is needed for neural tube development.

Which area (anterior or posterior) forms the brain? Which area forms the spine?

What can happen to these areas when the neural tube does not form/ close properly?
anteiror- brain
posterior- spine

Failure of ANTERIOR neuropore closing is ANCEPHALY (no brain)- Fatal

Failure of POSTERIOR neuropore (spine) closing is SPINA BIFIDA

Cadavers must meet this criteria:
o Not pre-embalmed
o Not badly damaged (e.g. trauma)
o No organs donated
o No infectious diseases

What do you do for cadavers with blue covers?

What about tan covers?
Blue- extra- you may toss it

Tan- SAVE EVERYTHING- throw away nothing