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UTSW lecture midterm
Anatomy lecture class midterm studying for fall 09
| Question | Answer |
|---|---|
| Sympathetic nerves are found at which spinal vertebrae? | T1 to L2 or L3 |
| The superior ulnar collateral artery branches from which artery? | Brachial Artery (rejoins ulnar artery as posterior ulnar recurrent artery) |
| An injury causing lateral hyperextension of the neck to the left would most affect which nerve with what effect? | (C5 root!) Causes nerve damage of lateral rotators and abductors @ the shoulder, and flexors @ the elbow. Causes chronic extension of the right elbow (waiter's tip!) |
| Which structures pass through the interscalene triangle? | Subclavian artery + Brachial Plexus |
| What is the course of the nerve supplying parotid gland innervation? | Glossopharyngeal Tympanic nerve exits the internal auditory meatus via the Lesser Petrosal Nerve at the Foramen Ovale, synapses on the Otic ganglion, and postsynaptic fibers travel with the auriculotemporal nerve to the parotid gland. |
| Arterial supply to the hand would be most impaired by ligation of which brachial artery? | Axillary artery between the profunda brachii and subscapular artery branch points. |
| Adduction at the Glenohumeral joint involves which muscles? | 1. Pectoralis Major, 2. Latissimus Dorsi, 3. Teres Major |
| Extension of the arm at the Glenohumeral joint involves which muscles? | 1. Posterior head of the deltoid, 2. Latissimus Dorsi, 3. Teres Major, 4. Triceps Brachii (long head), 5. Pectoralis Major |
| Lateral rotation of the arm at the Glenohumeral joint involves which muscles? | 1. Infraspinatus 2. Teres Minor 3. Posterior Deltoid |
| Medial rotation of the arm at the Glenohumeral joint involves which muscles? | 1. Subscapularis 2. Pectoralis Major 3. Teres Major 4. Latissimus dorsi 5. Anterior deltoid |
| Abduction of the arm at the Glenohumeral joint involves which muscles? | 1. Deltoid 2. Supraspinatus |
| Flexion of the arm at the Glenohumeral joint involves which muscles? | 1. Anterior deltoid, 2. Pectoralis major (clavicular head), 3. Coracobrachialis, 4. Biceps Brachii, |
| Which artery is likely to be damaged when the midshaft of the humerus is fractured? | Profunda Brachii |
| Which structures are supplied by the deep branch of the ulnar nerve? | 1. Hypothenar muscles. 2. All the interosseous muscles 3. 3d and 4th lumbricals. 4. Adductor pollicis 5. Medial (deep) head of the flexor pollicis brevis |
| The recurrent branch of the median nerve supplies which muscles? | Thenars 1. Flexor Pollicis Brevis 2. Abductor Pollicis Brevis 3. Opponens Pollicis |
| The superficial branch of the ulnar nerve innervates which structures? | 1. Palmaris Brevis 2. Ulnar cutaneous regions (5th digit, half of 4th digit, ulnar half of palm) |
| Give the location, tissue constitution, and purpose of the denticulate ligament. | Location: Spinal Cord Constitution: Pia Mater Purpose: Protects spinal cord from injury |
| What are the origins of the flexor digitorum superficialis & profundus? | Superficialis origin = Median epicondyle of the humerus + parts of radius & ulna. Profundus origin = proximal ulna |
| Which bone is most likely injured by falling on an outstretched hand? | Scaphoid |
| Which nerve passes through the supinator? | Deep Branch of the Radial Nerve |
| Which nerve generates the posterior interosseus nerve and what does it innervate? | Originates as the Deep Branch of the Radial Nerve. Innervates radial & dorsal muscles of the forearm, except: 1. Anconeus 2. Brachioradialis 3. Extensor carpi radialis longus |
| What structures are innervated by the radial nerve in the forearm? | 1. Anconeus 2. Brachioradialis 3. Extensor carpi radialis longus |
| Which artery gives rise to the anterior & posterior interosseus arteries? | The Ulnar Artery sends a common interosseus artery that splits into the anterior and posterior interosseus arteries. |
| Which structure does the cephalic vein pierce in between pectoralis minor & the clavicle? | Clavipectoral fascia |
| What is the action of the thyroarytenoideus? | Pulls together the thyroid and arytenoid cartilages, relaxes the vocal chords |
| The tegman tympani separates which spaces? | epitympanic space middle cranial fossa |
| Which additional sinuses are contained in the cavernous sinus? | superior and inferior petrosal sinuses |
| Which structures are contained in the cavernous sinus? | Cranial Nerves 3, 4, 5 (V1 and V2), 6, and the internal carotid |
| Which cutaneous nerves of the cervical plexus lie near the posterior edge of the sternocleidomastoids? | Greater Auricular Supraclavicular Lesser Occipital |
| The corneal reflex involves which nerves? | Sensory = Nasociliary (V1 of the Trigeminal) Motor = Temporal Branch of the Facial Nerve (CN VII) |
| Deviation in a protruded tongue to the left is caused by a defect in which nerve? | Right hypoglossal (CN XII) |
| Deviation of the uvula to the left is caused by a defect in which nerve & muscle? | pharyngeal plexus + musculus uvulae |
| The foramen rotundum opens to which cranial space? | Pterygopalatine fossa |
| Which nerve runs alongside the Lingual nerve? | Chorda Tympani (CN VII) |
| Which nerve supplies taste and which supplies sensation to the anterior 2/3 of the tongue? | Taste = Chorda Tympani Nerve (VII) Sensation = Lingual Nerve (V) |
| Which nerve supplies taste and which supplies sensation to the posterior 1/3 of the tongue? | Taste = Glossopharyngeal (IX) Sensation = Glossopharyngeal (IX) |
| Postganglionic fibers from the submandibular ganglion reach the sublingual gland via which chaperone structure? | Lingual Nerve (Trigeminal V3) |
| What structure on the humerus articulates with the radius? | Capitulum |
| Which structures form the distal arch of the hand? | Metacaropphalangeal joints |
| Which structures form the proximal arch of the hand? | Carpometacarpal joints |
| Which muscle opens the pharyngotympanic canal and what is its innervation? | Tensor Veli Palatini Innervated by the medial pterygoid nerve (Trigeminal nerve V3) |
| Which muscles flex the elbow? | 1. Biceps Brachii, 2. Brachioradialis, 3. Brachialis, ( the 3 B's!!!) 4. Extensor carpie radialis longus, 5. pronator teres |
| What are the branches of the Axillary Artery | Screw the Lawyers Save a Patient (Part I)Superior Thoracic. (Part II) Thoracoacromial, Lateral Thoracic. (Part III) Subscapular, Anterior Circumflex Humeral, Posterior Circumflex Humeral. |
| Which muscle tenses the vocal cords? | Cricothyroid |
| Which 3 muscles insert on the styloid process and what innervates each? | 1. Stylohyoid (Facial Nerve) 2. Styloglossus (Hypoglossal) 3. Stylopharyngeus (Glossopharyngeal) |
| Which hand muscles are innvervated by the median nerve? | LLOAF! 1. Lumbricles 1 & 2 2. Opponens Pollicis 3. Abductor Pollicis Brevis 4. Flexor Pollicis Brevis |
| Where do the medial and lateral pterygoid muscles insert? | Medial Pterygoid inserts on the angle of the mandible, on a common tendon with the masseter. Lateral Pterygoid inserts on the condylar process of the mandible. |
| Which arm flexor is divided between the median and ulnar nerves? | Flexor Digitorum Profundus. Damage of median or ulnar nerve makes (a different) 2 fingers "clawed". |
| What does the musculocutaneous nerve innervate, and which nerve does it turn into? | Innervates the "BBC": Brachioradialis, Biceps Brachii, Coracobrachialis. Turns into the lateral cutaneous nerve of the forearm. |
| Which arteries anastamose with the dorsal scapular artery across the scapula? | 1. Suprascapular 2. Posterior Circumflex Humeral 3. Circumflex scapular (branch of Subscapular) |
| Which two muscles of the neck are innervated by C1 alone? | 1. Thyrohyoid (Strap Muscle) 2. Geniohyoid |
| Where is CSF born and where does it go to die? | Born in the choroid villi Dies in the arachnoid granulations of the superior saggittal sinus. |
| Which nerves provide cutaneous sensation to the back of the scalp? | Greater Occipital (C2, spinal nerve dorsal ramus) Lesser Occipital (cervical plexus) |
| What are the borders of the quadrangular space? | Viewed from posterior arm: Teres Minor superior Teres Major Inferior Long head of the triceps brachii medial Surgical head of the humerus lateral |
| Which structures are found within the quadrangular space? | 1. Axillary Nerve 2. Posterior Circumflex Humeral Artery |
| Which structures are found within the triangular interval? | 1. Radial Nerve 2. Profunda Brachii |
| What are the borders of the triangular interval? | Viewed from posterior arm: Teres Major Superior Long head of the triceps brachii medial Surgical head of the humerus lateral |
| What are the borders of the triangular space? | Teres Minor Superior Teres Major Inferior Long head of the triceps brachii lateral |
| What structures are found within the triangular space? | 1. Circumflex scapular artery |
| Which structures are found in the occipital triangle of the neck? | 1. Accessory Nerve (from deep to SCM to levator scapuli to deep trapezius) 2. Cutaneous sensory nerves of cervical plexus (emerge posterolaterally to SCM) |
| What are the contents of the supraclavicular triangle of the neck? | 1. Brachial Plexus 2. External Jugular Vein |
| What are the contents of the submandibular triangle? | 1. Hypoglossal nerve (CN XII) 2. Facial artery |
| Which veins are: (1) medial in the arm, (2) lateral in the arm, (3) medial in the face? | 1. Basilic medial 2. Cephalic lateral (sometimes antebrachial median vein from cubital vein connection) 3. Retromandibular |
| The lingual artery passes medially to which structure in the tongue? | Hyoglossus |
| What passes through the diaphragma sella? | This circular foramen in the dura mater enables ONLY the neurohypophyseal stalk of the hypothalamus to pass through to the pituitary |
| A brain tumor causing herniation through the tentorial incisure causes what effects (via which nerve)? | Chronic dilation of the pupil due to compression of cranial nerve III. |
| Describe drainage of the Sphenoparietal sinuses: | 1. sphenoparietal sinus 2. cavernous sinuses 3. petrosal sinuses 4. transverse sinus 5. sigmoid sinus 6. internal jugular vein |
| Describe drainage of the inferior saggital sinus: | 1. inferior saggital sinus 2. straight sinus 3. confluence of sinuses 4. transverse sinus 5. sigmoid sinus 6. internal jugular vein |
| Which sinuses contribute to the confluence of sinuses? | 1. Superior Saggital 2. Straight 3. Occipital |
| What does C1 innervate independent of the ansa cervicalis? | 1. Genoihyoid 2. Thyrohyoid |
| What does the ansa cervicalis innervate? | 1. Sternohyoid 2. Sternothyroid 3. Omohyoid |
| Which structures go through the incisive canal? | 1. Greater palatine artery anastamosis with Sphenopalatine artery 2. Greater palatine nerve communication with nasopalatine nerves (both V2) |
| Which "glossus" is not innervated by CN XII, and what nerve does innervate it? | Palatoglossus pharyngeal plexus |
| Which muscle wraps around the pterygoid hamulus, and which nerve innervates it? | Tensor Vili Palatini innervated by V3 (CN5) |
| Name the sympathetic muscles of the face | 1. Superior Tarsal 2. Dilator Papillae |
| Which orbital muscle does not insert onto the annulus of zinn? | inferior oblique |
| How does hearing work in the inner ear? | Tapping from the stapes is converted into pressure at the fenestra vestibuli. endolymph moves from scala vestibuli through the cochlear duct to the scala tympani. The basilar membrane vibrates. |
| Which structures respond to gravity? | 1. Utricle (large, attached to each semicircular canal) 2. Saccule (smaller, attached to cochlea) |
| Name the major structures crossing the 3 gaps in the cartilaginous larynx. | 1. (between base of skull and superior)= pharygotympanic tube & levator veli palatini 2. (b/tw superior & middle) = Glossopharyngeal nerve, stylopharyngeus. 3. (b/tw middle & lower) = internal laryngeal nerve & superior laryngeal artery |
| Where does the dura end and where does the spinal cord end in the spinal vertebrae? | 1. Dura ends at S2 2. Spinal Cord ends at L1 or L2 (sample CSF at lumbar cistern, estimate by iliac crest = L4) |
| Name the blood sources of the spinal cord | 1. Vertebral Artery 2. anterior and posterior spinal arteries 3. Segmental Medullary arteries 4. Thoracic aorta 5. Lumbar arteries |
| What is one route by which infection can spread into the cranium via the spinal cord? | Veins (3 anterior, 3 posterior + internal and external vertebral plexuses) |
| Which type of autonomic nerve is unmyelinated? Which has postganglionic cells using epinephrine? | unmyelinated = preganglionic parasympathetic using epinephrine = postganglionic sympathetic (except for sweat glands) |
| Which postganglionic autonomic neurons follow arteries and which catch rides with nerves? | sympathetic follow arteries. parasympathetic follow nerves. |
| Which part of the brachial plexus is infraclavicular? | Roots, some trunks, suprascapular nerve, long thoracic nerve |
| What are the causes and etiology of thoracic outlet syndrome? | T1 roots damaged by hyperextension of the arm (lifting infant by arm), causes weakness in muscles innervated by ulnar nerve (hand weakness, tingling) |
| Which nerve is commonly injured at the head of the humerus, and what are the effects? | Axillary nerve (crosses surgical head @ quadrangular space). Causes deficits in abduction of arm (deltoids & teres minor) |
| Radial nerve damage causes which effects? | Inability to extend the wrist. Can be damaged if supinator is damaged (pierces supinator), or if midshaft break in humerus. |
| Which nerve innervates a tiny spot of skin on the posterior hand medial to the anatomical snuffbox? | Superficial Radial Nerve. |
| Which muscles of the arm are innervated by the median nerve, and what are the symptoms of median nerve damage? | Innervates ALL FLEXORS except Flexor Carpi Ulnaris & 1/2 of flexor digitorum profundus. Damage leads to "benediction hand". |
| What is the difference between "ape hand" and "benediction hand"? | Benediction hand = loss of median nerve innervation of palmar lumbricles, causing hyperextension of first 3 digits. Ape hand = only recurrent branch of median nerve was damaged. loss of opponens & abduction of thumb. |
| What causes "claw hand"? | Ulnar nerve damaged @ medial epicondyle of humerus.Innervation lost to medial 2 lumbricles & medial flexor digitorum profundus= 4th & 5th digits remain extended. |
| Which are the rotator cuff muscles? | SITS = 1. Supraspinatus, 2. Infraspinatus 3. Teres Minor 4. Subscapularis |
| What is the action of the palmar vs. dorsal interosseus muscles? | Palmar = adduction, Dorsal = abduction |
| What are the ligamentum flavum. What is affected by hypertrophy of this ligament? | Connect laminae of adjacent vertebrae (in between body & spinal processes). Hypertrophy can impinge on the spinal cord because the vertebral foramen lies adjacent. |
| What is the supraspinous ligament? | Runs over & around spinous processes of vertebrae (continuous along length of spinal cord). |
| What is the anterior longitudinal ligament and how is it damaged? | Continuous on anterior side of spinal cord, along vertebral bodies. Frequently damaged via whiplash (also the ligamentum nuchae is damaged) |
| What are the interspinous ligaments? | Join adjacent spinous processes. Hyperflexion of the head (forward) can tear them. |
| What is the posterior longitudinal ligament? | Runs the length of the spinal cord within the vertebral canal |
| What is the action of the dorsal vs. palmar interossei and what innervates each? | Both are innervated by the deep branch of the ulnar nerve. Dorsal interossei = bipennate --> adduct the fingers. Palmar interossei lie on only the 2nd, 4th, and 5th digits, on the edge facing the long digit. Their action is to abduct the fingers. |
| What signaling pathway causes pupillary dilation in response to light changes? | Nasociliary (V1) transmits light information, the Oculomotor (CN3) constricts the sphincter pupillae muscle. |
| Which muscle adducts (closes) the vocal ligaments? | 1. Lateral Cricoarytenoids, 2. Artytenoideus |
| Which muscle abducts (opens) the vocal ligaments? | Posterior Cricoarytenoids |
| Which muscles elevate the scapula? | 1. Rhomboid major, 2. levator scapulae, 3. trapezius |
| Where is the otic ganglion located? | inferior to the foramen ovale, in the infratemporal fossa |
| What structures does the cauda equina contain? | Spinal ventral and dorsal roots |
| Which structure is hardest to palpate in the posterior triangle of the neck? | Internal Carotid Artery (found in Carotid Triangle) |
| Give 2 examples of a first class lever in the human body. | (Force applied on opposite side of fulcrum) 1. triceps brachii @ olecranon process to extend the arm 2. rectus capitis acting on the occipital ridge of the skull to tilt the head backward |
| What travels in the foramen magnum besides the spinal cord? | Spinal Accessory Nerve, Vertebral Artery |
| Which structure passes over the anterior scalene and the first rib? | Subclavian vein!!! |
| Name the axillary lymph nodes: | Brachial (distal), Apical (medial, implicated in spread of breast cancer), Central (in the middle), Subscapular (posterior), Pectoral (anterior) |
| Give an example of eccentric, concentric, and isometric muscle contraction: | eccentric = one muscle, one action (eg. flexor pollicis longus flexes thumb). Concentric = balanced forces from 2 opposing muscles (eg. triceps balances contraction of biceps). Isometric = force is generated with no muscle shortening (eg. grip) |
| Which muscles cause superior rotation of the scapula? | 1. Serratus anterior, 2. trapezius |
| Which muscle is the most powerful supinator of the forearm? | Biceps Brachii |
| What is the location of the brachial artery in the cubital fossa? | Medial to the tendon of the biceps brachii, lateral to the median nerve |
| What is the path of the ulnar artery in the forearm? | 1. Receives anterior ulnar recurrent, 2. goes deep to the pronator teres, 3. sends off common interosseous artery, 4. receives posterior ulnar recurrent, 5. goes medial to the flexor digitorum profundus (lateral to the ulnar nerve) |
| What is the major source of the superficial and deep palmar arterial arches? | Superficial arch = mostly ulnar artery, Deep arch = mostly radial artery. |
| What is the path of the radial artery in the forearm? | 1. Passes deep to the biceps aponeurosis, 2. passes deep to the brachioradialis, 3. Receives radial recurrent artery, 4. travels medial to the brachioradialis tendon, & superior to the flexor pollicis longus. |
| Where does the radial nerve divide into superficial and deep branches? | medial epicondyle of the humerus |
| What are the layers of tissue in the eyelid, from top to bottom? | 1. skin, 2. orbicularis oculi, 3. orbital septum 4. levator palpebrae superioris, 5. tarsal plates, 6. conjunctiva |
| Injury to what nerve & muscle would cause the scapula to deviate laterally? | Nerve = dorsal scapular (superior trunk of brachial plexus), muscle dysfunction = rhomboid major & erector spinae |
| The medial wall of the infratemporal fossa is formed by which bone? | Lateral Pterygoid plate! |
| Where are the valleculae located? | Between the epiglottis and the tongue(!) |
| Name the arteries supplying the scalp. | FROM OPHTHALMIC: 1. supratrochlear = middle forehead , 2. supraorbital = lateral forehead to top of head. FROM EXTERNAL CAROTID: 3. superficial temporal = frontal/parietal scalp, 4. occipital = posterior, 5. posterior auricular = around ear. |
| Which muscles elevate the floor of the tongue? | 1. Digastrics, 2. palatoglossus, 3. Mylohyoid |
| Where does the Facial artery cross over the mandible into the face? | anterior border of the masseter |
| Which are transversospinalis muscles? | 1. semispinalis, 2. multifidus, 3. rotatores |
| What is a secondary cartilaginous joint? | = "symphysis"!! (type of fibrocartilaginous joint usually occurring in the midline) |
| Which muscles cause depression of the scapula? | 1. pectoralis major (sternocostal head), 2. Pec minor, 3. Latissimus dorsi, 4. serratus anterior, 5. Trapezius |
| What are the functional divisions of the oculomotor nerve? | Inferior = to medial & inferior rectus, and inferior oblique (From the last a branch goest to the ciliary ganglion). Superior = supplies Superior rectus & Levator palpebrae superioris. |
| What type of joint is the acromioclavicular (AC)? | Plane-type synovial joint |
| What maintains the integrity of the AC joint? | AC ligament (not very strong), 2. coracoclavicular ligament (conoid + trapezoid ligaments) |
| Which muscles cause elevation of the scapula? | 1. Levator scapulae, 2. Rhomboids, 3. Trapezius (superior part) |
| Which muscles cause inferior rotation of the scapula? | 1. Pectoralis major (sternocostal head), 2. pectoralis minor, 3. latissimus dorsi, 4. Rhomboids, 5. Levator scapulae, 6. gravity |
| Which muscles cause protraction of the scapula (eg. punching)? | Pectoralis minor & major, serratus anterior (holds scapula against chest wall) |
| Which muscles cause retraction of the scapula? | 1. Rhomboids, 2. trapezius, 3. latissimus dorsi |
| Which roots of the brachial plexus enact medial rotation of the arm, and which lateral? | C5 = lateral C6-T1 = medial |
| Name the parts of the axial skeleton, appendicular skeleton, and pelvic girdle | Axial = skull, vertebral column, ribs, sternum / Appendicular = pectoral girdle, scapula, clavicle / Pelvic Girdle = pubis, ischium, ilium |
| Which type of muscle has greater speed, and which has greater force? | long muscles = greater speed, bipennate muscles = greater force |
| Describe the ligaments of the elbow: | 1. ulnar collateral prevents medial displacement of the humerus onto the ulna, 2. radial collateral prevents the opposite, 3. Anular collateral secures the head of the radius to the humerus & ulna (circular, permits pivoting) |
| Which cranial nerve supplies each of the digits? | thumb = C6, Index + Middle = C7, Ring + Pinky = C8 |
| Which joint contributes most to wrist flexion? | midcarpal joint |
| When can digital flexors & extensors aid in wrist flexion/extension? | Flexors can aid when the fingers are extended / Extensors can aid when the hand is in a fist |
| The carpo-metacarpal joint of the thumb is what kind of joint? | Saddle-shaped synovial |
| What type of joint is the metacarpo-phalangeal? | Condylar synovial (no rotation permitted, weak joint) |
| What is the longitudinal arch of the hand? | Runs from 2nd & 3d digit longitudinally, including metacarpals & phalanges. |
| Which are the visceral cranial nerves? | Derived from neural crest, endoderm of gut, & lateral plate mesoderm: V2, V3, CN7, CN9, CN10 |
| What are the layers of the neurocranium of the skull? | outer cortical, Diploe (contains blood vessels, shock absorber), inner cortical |
| What makes up the Circle of Willis? | 1. Anterior communicating, 2. Anterior cerebral, 3. internal carotid, 4. posterior communicating, 5. posterior cerebral, 6. basilar |
| What serves as the chaperone for post-pterygopalatine ganglion fibers? | greater petrosal (CN7) nerve jumps on zygomatic branch of V2 post-pterygopalatine ganglion |
| What is the socket within which the eyeball rests? | Tenon's capsule/bulbar fascia (60% fat) |
| Visual accommodation involves which events? | 1. Adduction of eyeballs 2. Mitosis by sphincter pupillae 3. Relaxation of suspensory ligament of lens leading to rounding |
| What are the borders of the investing fascia? | 1. muscles: SCMs & Trapezius, 2. glands: Parotid & Submandibular glands (Rule of 2's!) |
| Which structures run through the parotid gland? | 1. CN7, 2. Superficial termporal artery, 3. retromandibular vein, 4. auriculotemporal nerve |
| Which muscles open your mouth? | temporalis, masseter, medial & lateral pterygoid (elevate the mandible) |
| What are the trunk division trigeminal nerves? | 1. tensor veli palatini, 2. tensor tympani, 3. medial pterygoid, 4. middle meningeal |
| What are the anterior divisions of the trigeminal nerve? | 1. temporalis, 2. masseter, 3. lateral pterygoid, 4. long buccal |
| What are the posterior divisions of the trigeminal nerve? | 1. auriculotempral, 2. inferior alveolar, 3. lingual, 4. mylohyoid |
| Which blood vessels are in the infratemporal fossa? | 1. pterygoid plexus (venous), 2. maxillary artery |
| Describe the muscles that separate the nasopharynx and oropharynx | 1. levator veli palatini & uvula (pre-bolus), 2. palatopharyngeus, palatoglossus (post-bolus) |
| What are the anterior and posterior blood supplies of the nasal cavity? | Anterior = ethmoidal arteries (from ophthalmic) , Posterior = sphenopalatine artery (from maxillary artery) |
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