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Monday DLA
MSK
| Question | Answer |
|---|---|
| consists of heart and blood vessels | Cardiovascular system |
| carry blood away from heart; have thick walls that can withstand high pressure of blood ejected from heart | arteries |
| transport blood toward heart; thin-walled vessels w/large and irregular lumens | veins |
| connect arteries and veins; where oxygen, nutrients, and waste are exchanged w/in tissues | capillaries |
| inner endothelial lining of blood vessel | Tunica intima |
| middle smooth muscle layer of blood vessel; may have elastic fibers | Tunica media |
| outer connective tissue layer of blood vessel | Tunica externa (adventitia) |
| heart-arteries-arterioles-capillary bed-venules-veins-heart | most common circulatory route |
| blood flows through to consecutive capillary beds before returning to heart; btw intestines & liver; anterior pituitary | Portal system (circulatory route) |
| artery flows directly into vein; found in fingers, toes, ears; decreases heat loss, allows blood to bypass exposed areas during cold | Arteriovenous shunt (circulatory route) |
| union of branches of 2/more vessels | Anastomosis |
| allows for alternative drainage of organs; union of branches of 2/more vessels | Venous anastomosis |
| collateral circulation- alternative routes for blood to reach tissue/ organ; union of branches of 2/more vessels | Arterial anastomosis |
| Consists of lymphatic vessels, lymph nodes and lymphatic organs; Drains excessive interstitial fluid | Lymphatic system |
| Excessive interstitial fluid flows into ______________ located amongst the tissues. | lymphatic capillaries |
| Lymph eventually drains into | lymphatic vessels |
| Larger groups are found near the mammary glands, axilla and groin | lymph nodes |
| Eventually all lymphatic fluid drains back into the cardiovascular system via the | right lymphatic duct and thoracic duct |
| Relating to the body (muscles, skin, bones) | Somatic |
| Relating to the organs (heart, vessels, digestive etc.) | Visceral |
| The vertebral column, skin and skeletal muscles of the body and limbs develop embryologically from | somites |
| Somites form from the paraxial; develop alongside the developing neural tube as paired segments | mesoderm |
| vertebral column | Sclerotome |
| Dermatome - skin Myotome – muscles of trunk and limbs | Dermomyotome |
| that the dermatome and myotome develop from a single segment and is innervated by a | single spinal nerve |
| Exits the intervertebral foramen as a mixed, motor and sensory nerve | Typical spinal nerve |
| supplies intrinsic back muscles (motor) and skin over that area (sensory); Also contains the postganglionic sympathetic fibers that innervate the skin glands and vessels of the back | Dorsal (Posterior) ramus |
| supplies all other muscles (motor) and skin over that area (sensory) | Ventral (Anterior) ramus |
| At levels T1 – L2 Ventral (Anterior) ramus contains the | preganglionic sympathetic fibers |
| Ventral (Anterior) ramus receives visceral afferents from organs at levels T1-L2 via the | white rami communicans |
| A network of intersecting nerves from different levels or sources that combine to form new nerves with specific targets | Plexus |
| Form from the ventral rami of spinal nerves • C1 – 5 – Cervical plexus • C5 – T1 – Brachial plexus • L1 – 4 – Lumbar plexus • L5 – S4 – Sacral plexus | Somatic plexuses |
| • Combination of sympathetic, parasympathetic and visceral afferent fibers • e.g. hypogastric, celiac | Visceral plexuses |
| general arrangement is a three neuron chain | afferent (sensory) fibers |
| arises at the organ (or muscle) and has two processes, one on either side of the cell body | 1st neuron in afferent chain |
| arises from the grey horn of the spinal cord or brainstem nucleus and synapses in the thalamus | 2nd neuron in afferent chain |
| arises from the thalamus and ends in the cortex | 3rd neuron in afferent chain |
| general arrangement is a two-neuron chain | efferent (motor) fibers |
| upper motor neuron - UMN) arises in the cortex and synapses in the ventral horn of the spinal cord or in the brainstem on the nucleus of the corresponding cranial nerve | 1st neuron in efferent chain |
| (lower motor neuron – LMN) arises from the brainstem nucleus and ends in the muscle it supplies | 2nd neuron in efferent chain |
| 1. Synapse and exit through grey rami communicants 2. Travel up or down the chain to synapse in a different location 3. Exit without synapsing (regardless of whether it travels up or down the chain) = splanchnic nerves | Sympathetic chain ganglion T1-L2 |
| Target tissue ( visceral motor fibers ) through named nerves or plexuses -All organs except pelvic -organs -constrictor pupillae m. -lacrimal gland -salivary gland -minor glands along the -mucous membrane | CN Nuclei PS efferent fibers |
| Target tissue via plexuses -Blood vessels -Organs -Smooth muscles -Glands | Spinal cord PS efferent fibers |
| area of skin supplied by a single spinal nerve; There is a degree of overlap between the | dermatomes |
| – Lateral upper arm | C5 dermatome |
| thumb | C6 dermatome |
| middle finger | C7 dermatome |
| little finger | C8 dermatome |
| medial arm | T2 dermatome |
| nipple | T4 dermatome |
| xiphoid | T7 dermatome |
| umbilicus | T10 dermatome |
| big toe | L5 dermatome |
| heel | S1 dermatome |
| back of thigh | S2 dermatome |
| When pain is felt in an area that is different to where the injury occurred; often happens with organ injury which may be felt on the skin of a limb or the wall of the abdomen | Referred pain |
| • The visceral pain fibers synapse on the same 2nd order neurons as the somatic pain fibers • Visceral pain fibers are lower threshold and exceed the somatic fibers in number by a factor of 10 | Reasons for referred pain |
| there are __ cervical vertebrae | 7 |
| there are _ thoracic vertebrae | 12 |
| there are __ lumbar vertebrae | 5 |
| • Transverse foramina • Bifid spinous process except C1 and C7 • Uncinate process • Small vertebral body • Large vertebral foramen | Cervical Vertebrae |
| • Superior and inferior costal facets along posterior-lateral vertebral body • Transverse costal facets • Long spinous process oriented inferiorly • Heart shaped vertebral body | Thoracic Vertebrae |
| • Largest vertebrae • Short horizontal transverse process • Short spinous process • Mamillary processes comes from posterolateral margin of superior articular process • Accessory processes tubercle on dorsal aspect of base of __ transverse process | Lumbar Vertebrae |
| • Fused bones • L-shaped facet on lateral ala that articulates with hip bone (Sacroiliac Joint) • Spinal nerves exit from sacral foramina | Sacrum and Coccyx |
| best visualized from the lateral view. Radiological landmark! | Sacral Promontory |
| • Assist in stabilizing the vertebral column • Weight bearing support • Adds flexibility to the spine • Facilitates the curvature of the spine • Outer anulus fibrous surrounding an inner/central nucleus pulposus (a remnant of the notochord) | Intervertebral Disc |
| Stabilizing joint in spine | Fibrocartilaginous Joints |
| formed between superior and inferior articular processes | Facet Joints (zygapophyseal joint) |
| formed between thoracic vertebral body costal facet and costal facet of the ribs head | Costovertebral Joints |
| formed between thoracic rib and the transverse process costal facet of the thoracic vertebrae | Costotransverse Joints |
| formed between the C1 vertebra, superior articular facet and condyles of the spine. Responsible for the “yes” motion of head | Atlantooccipital Joint |
| 3-point articulation, formed between the C1 vertebrae, inferior articular process and superior articular process of C2 AND C1 vertebrae anterior arch with the Odontoid process of C2. Responsible for the “No” motion of head. | Atlantoaxial Joint |
| helps to hold dens in place during rotation of head. Superior and inferior longitudinal bands pass from the transverse ligament to occipital bone superiorly, and inferiorly to body of C2 | Cruciate Ligament |
| horizontal component of cruciate ligament. Strongest and thickest ligament that supports atlantoaxial joint | Transverse Ligament |
| located deep to cruciate ligament, attaching dens to skull | Apical Ligament |
| runs laterally from dens to skull | Alar Ligament |
| prevents hyper- extension | Anterior longitudinal ligament |
| Posterior longitudinal ligament, interspinous ligament and supraspinous ligament prevents Nuchal ligament (ligamentum nuchae) located in cervical region also prevents | hyperflexion |
| assist with repositioning of the vertebral column from the flexed position | Ligamentum Flavum |
| Develop during fetal period in relation to the fetal (flexed) position | Primary curvatures |
| • Result from extension from flexed fetal position • Maintained by differences in thickness between anterior and posterior parts of IV discs • Control of head (1-2 months), sitting at about 6 months and walking about 1 year old | Secondary curvatures |
| Newborn conus medullaris ends at | L3/L4 |
| Adult Conus medullaris ends at | L1/L2 |
| Cervical, Thoracic, and Lumbar spinal nerves exit through | interverbal foramina |
| exit above their respective vertebrae | C1 – C7 Spinal nerves |
| exit below their named vertebrae | Thoracic and Lumbar spinal nerves |
| Location: one anterior and two posterior spinal arteries | Blood Supply Spinal Cord |
| originates from vertebral artery • Supplies Anterior 2/3 of spinal cord • Anterior and Lateral horns and columns | Anterior Longitudinal or Anterior Spinal Artery |
| originates mostly from the Posterior Inferior Cerebellar Artery • Supplies posterior 1/3 of spinal cord • Posterior Horns and columns | Posterior Longitudinal Artery or Posterior Spinal Artery |
| Feeder arteries entering via | IV foramina |
| anastomose with longitudinal spinal arteries | Segmental medullary arteries |
| supply dorsal and ventral roots | Segmental Radicular branches |
| Veins drain into | Batson's Plexus located in epidural space |
| Great anterior segmental medullary artery; Largest segmental medullary artery; Arises from lower thoracic or upper lumbar region | Artery of Adamkiewicz |
| Important source of blood supply to lower lumbar and sacral parts (conus medullaris) of spinal cord | Artery of Adamkiewicz |
| Spinal cord circulatory impairment ensues if there is damage to | segmental medullary arteries |
| Spinal veins drain into | internal vertebral venous (Batson’s) plexus |
| communicates with pelvic veins, Dural venous sinuses of cranial vault, and external vertebral venous plexus; Can serve as collateral pathway for venous flow to systemic veins (caval & azygos veins) | Batson’s plexus |
| • Valveless veins located in the epidural space • Connected to venous vasculature of the pelvis • Metastasis of pelvic organ cancers to CNS and the vertebral column • Spread of infection from pelvic region to CNS and vertebral column | Venous Drainage of Spinal Cord (Batson's) |
| • Derived from neural crest cells • Creates Denticulate Ligament • Creates Filum Terminale | Pia Mater |
| • Epidural Space → Contains nerves, Batson's plexus • Subarachnoid space → Contains Cerebrospinal Fluid (CSF) | Spaces created between membrane |
| • Spinal cord ends at a higher the vertebral level compared to meninges. • CSF accumulation caudal to termination of spinal cord → Lumbar cistern • Lumbar cistern contains filum terminal and cauda equina. | Dural Sac |
| Procedure to draw out CSF from lumbar cistern for diagnostic and/or therapeutic reasons | Lumbar Puncture |
| between L3/L4 or L4/L5 | Lumbar Puncture Site in an adult |
| between L4/L5 | Lumbar Puncture Site in children |
| palpate for the top of the iliac crest and imagine a horizontal connecting the two crests (lumbar puncture) | Supracristal line |
Created by:
Zariea
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