ALL-ORAL-ANATOMY-QUESTIONS-2014-2020.pdf

With tears and hate PRESENTS: ALL ORAL ANATOMY QUESTIONS All the questions are from year 2014 to 2020 2018 → Polish division + English division 1. What is the nucleus that looks like a tooth called + function? Nuclei of the cerebellar cortex + picture of them? (Deep cerebellar nuclei) → Fastigal nucleus/ nucleus medialis cerebelli Function in execution (act of performance), have a vestibular function and contributes to vestibular neuronal activity = body motion and places it on special planes to estimate the movement of the body in space → Globose nucleus/ posterior interpositus nucleus Function in execution, regulate the precision of limb movements → Emboliform nucleus/ anterior interposed nuclei Function in execution, regulate the precision of limb movements → Dentate nucleus/ nucleus lateralis cerebelli Is the largest and the most lateral of the cerebellar nuclei, with characteristic tooth-like outline. Function in planning, programming and control of voluntary movement 2. Explain the Nucleus Accumbens? Point out where it is in the picture? (NOTE: nucleus accumbens is not the same as nucleus ambiguus) The nucleus accumbens is located in the basal forebrain together with the olfactory tubercle and is part of the limbic system. Function in REWARD, MOTIVATION, REINFORCEMENT (behavior), SLEEP and ADDICTION 1 3. Motor center? Sensory center are? Precentral gyrus → primary motor cortex Postcentral gyrus → primary somatosensory cortex 4. Where is the nucleus for primary motor center located? Opercular and angular gyrus 5. Where do the spinal nerves exit from the spinal cord? We have 31 spinal nerves exiting from the spinal cord through intervertebral foramen corresponding to the vertebral body, for example C8 nerve root exit above body of T1 and below body of C7 vertebrae. → 8 CERVICAL (We have 8 cervical nerves because first spinal nerve exit above the atlas) → 12 THORACIC → 5 LUMBAR → 5 SACRAL → 1 COCCYGEAL 6. Name the cisterns/corners in the brain? Prepontine Cerebellomedullary Quadrigeminal cistern Interpeduncular 7. Picture of the pyramidal decussation, what is it? Represent crossing of the fibers of the corticospinal tracts (MOTOR FIBERS) from one side to the other. Also it marks the end of medulla oblongata and is located on the anterior side. 8. How many gyruses does the frontal lobe have and name them? Inferior frontal gyrus Middle frontal gyrus Superior frontal gyrus Precentral gyrus Medial frontal gyrus Paraolfactory gyrus (also know as subcallosal area) Orbital gyrus Straight gyrus cingulate gyrus (9) 9. Point out the speech center and name the sensory center of speech? We have two very important areas for speech Wernicke's area and Broca's area, both very important for language development and production The sensory center of speech is the Wernicke's area, it is located in the superior temporal lobe in brodmann area 22, (angular gyrus and supramarginal gyrus) 2 This area is very important for language DEVELOPMENT, it is responsible for comprehension of speech meaning understanding of written and spoken language. The motor center of speech is the Broca's area, it is located in the inferior frontal gyrus in the brodmann's area 44 and 45 and divides into pars opercularis and pars triangularis This area is very important for language PRODUCTION, as it activates the mouth and tongue region of the motor cortex for the articulation of speech production (dvs muscles). Lesion of wernickes → fluent nonsens Lesion of broca's → halting speech (slow speech) 10. Point the location of the Brodmann field/ area of the motor speech center on the picture and the primary cortex? (look at question above) Motor speech center → pars opercularis (44) and pars triangularis (45) and are located in broca's area which is in the inferior frontal gyrus Possible follow up questions for Q:9 + Q:10 Q: what are brodmann's areas? cytoarchitectonic areas, meaning the regions connecting with the function of some areas in the brain Q: which types of brodmann's areas do we have? (naming just the important once) Brodmann area 44 → pars opercularis Brodmann area 45 → pars triangularis Brodmann area 47 → pars orbitalis Operculum Q: brodmann area 44 and 45 are important for? 44 → language production and phonological processing due to the connections with motor areas like the mouth and tongue 45 → part of the anterior inferior frontal gyrus and is involved in semantic processing Q: how many brodmann's areas do we have? 3 47 Q: name other brodmann's areas that are important? 1, 2 and 3 = are the primary somatosensory cortex 4 = are the primary motor cortex 17 = is the primary visual cortex 41 and 42 = primary auditory cortex 11. What is the innervation of the esophagus? Parasympathetic innervation → right - left vagal trunk giving esophageal plexus which is a branch of the Vagus nerve Sympathetic → sympathetic trunk 12. Picture of the brain, point out the facial nerve (CN VII 7th)? 13. Where does the cranial nerves exit? Cranial nerve Exit in skull Exit in brain Trochlear nerve (IV) Superior orbital fissure Posterior side of 4 Midbrain/mesencephalon Oculomotor nerve (III) Superior orbital fissure Midbrain pontine junction Ophthalmic division of Superior orbital fissure Pons trigeminal nerve (V1) Mandibular division of Foramen ovale Pons trigeminal nerve (V3) Maxillary division of Foramen rotundum Pons trigeminal nerve (V2) Abducens nerve (VI) Superior orbital fissure Pontine medullary junction Facial nerve (VII) Stylomastoid foramen Pontine medullary junction Vestibulocochlear nerve Internal auditory canal Pontine medullary junction (VIII) Glossopharyngeal nerve (IX) Jugular foramen Posterior to olive in medulla oblongata Vagus nerve (X) Jugular foramen Posterior to olive in medulla oblongata Accessory nerve (XI) Jugular foramen Posterior to olive in medulla oblongata Hypoglossal nerve (XII) Hypoglassal canal Anterior to olive in medulla oblongata 14. How does the food flow through our body? Mouth → pharynx → esophagus → stomach → small intestine (duodenum jejunum the ileum) →large intestine (cecum ascending transverse descending sigmoid) → ampulla of rectum → rectum → anal canal 15. What are the cluneal nerves and how does it work? + Innervation of buttocks? Cluneal nerves are cutaneous nerves innervating the buttocks Superior cluneal nerve (Dorsal rami of L1 - L3) : innervates superior part of buttocks Middle cluneal nerve (Dorsal rami of S1 - S3) Inferior cluneal nerve ( posterior femoral cutaneous nerve): innervates inferior part of buttocks Lateral branch of iliohypogastric nerve (from lumbar plexus): innervates lateral part of the buttocks 16. What will you touch when you stick your finger through the epiploic foramen? Nothing 5 17. What area of the face has the biggest nucleus in primary sensory cortex? Lips 18. Explain the division of L2 and L4 ventral rami? Part of the lumbar plexus making the obturator and femoral nerves 19. Muscles of mastication and innervation? During mastication the masseter, temporalis and medial pterygoid adduct the jaw whereas the lateral pterygoid abduct the jaw. They all move the jaw laterally Name Innervation Origin Insert Function Masseter Masseteric nerve Zygomatic arch Masseteric Elevation of from the anterior (superficial part) tuberosity on mandible trunk of the lateral surface of Mandibular nerve Maxillary process of ramus of the zygomatic bone/ mandible posterior third of zygomatic arch (deep part) Temporalis Deep temporal Inferior temporal Coronoid Elevation + nerves from the line of temporal process of Retraction of anterior trunk of fossa mandible and mandible the Mandibular anterior margin nerve of ramus of mandible (to the last molar tooth) Medial pterygoid Nerve to medial On the lateral plate Medial surface Elevation and pterygoid from the of pterygoid process of mandible near side to side Mandibular nerve and pyramidal the angle movement of process of palatine (pterygoid the mandible bone tuberosity) Lateral pterygoid Nerve to lateral Superior part on Capsule of Protrusion and pterygoid directly articular disk of the temporomandib side to side from the anterior temporomandibular ular joint in the movement of trunk of the joint also Inferior region of mandible Mandibular nerve part on condylar attachment to or the Buccal process of mandible the articular disc (opens the branch and to the mouth) Pterygoid fovea on the neck of mandible 20. Tell me about the great saphenous vein? 6 Originates: from the medial side of dorsal venous arch, ascends up to the medial side of the leg, knee and thigh. Inferior to the inguinal ligament it drain into femoral vein terminates: from Medial marginal vein → to Femoral vein Tributaries: - External pudendal veins - Superficial circumflex iliac vein - Superficial epigastric vein - Superficial dorsal veins of penis/ clitoris - Accessory saphenous vein - Anterior scrotal veins - Anterior labial veins 21. Tell me about the veins of the posterior compartment of the leg? Great saphenous vein = Medial marginal vein → Femoral vein Small saphenous vein = lateral marginal → popliteal vein Posterior tibial vein = fibular → popliteal vein 22. Which veins forms the popliteal vein? Anterior tibialis, Posterior tibial and Fibular. Popliteal vein enter thigh via the adductor canal 23. Which Cardiac veins do we have and where do they drain into? Great, middle + small + smallest → drains into coronary sinus and then enters right atrium (marginal vein can also drain directly to the right atrium by joining anterior cardiac vein and posterior cardiac vein drains either in the coronary sinus or joins the great cardiac vein) Anterior → drain directly into right atrium 24. What is the conjoined tendon? conjoined tendon is a common tendon for internal oblique and transversus abdominis muscle 25. Inguinal ligament? is formed by the external oblique aponeurosis and runs from pubic tubercle to anterior superior iliac spine. 26. Inguinal canal, deep inguinal ring/ superficial inguinal ring and inguinal triangle? Borders? Content? Inguinal TRIANGLE IS THE SPACE OF DIRECT HERNIA and contain NOTHING Medial → linea semilunaris inferolateral → inguinal ligament superior lateral → inferior epigastric artery Inguinal CANAL Is a oblique passage through lower part of anterior abdominal wall. 7 The inguinal canal starts at the deep inguinal ring in transversalis fascia and end at the superficial inguinal ring in aponeurosis of external oblique Deep inguinal is oval and superficial is triangular ANTERIOR WALL → aponeurosis of external oblique POSTERIOR WALL → transversalis fascia and medial third by CONJOINED tendon INFERIOR WALL → inguinal ligament and medial end of lacunar ligament SUPERIOR WALL → arch of the lowest fibers of internal oblique and transversus abdominis muscle FEMALE MALE round ligament spermatic cord genital branch of genitofemoral nerve genital branch of genitofemoral nerve branch of the ilioinguinal nerve branch from ilioinguinal nerve → DEEP INGUINAL RING lies in the level of midinguinal point, it is formed when the process vaginalis invaginates the transversalis fascia. (indirect hernia) MEDIAL → it is related to inferior epigastric vessels SUPERIOR LATERAL → by arch fibers from transversalis fascia → SUPERFICIAL INGUINAL RING formed by aponeurosis of external oblique (is palpebrae in superior lateral to the pubic tubercle) (Place of direct hernia) (also indirect hernia) BASE → pubic crest. LATERAL → medial and lateral crus from aponeurosis of external oblique SUPERIOR MEDIAL → intercrural fibers from inguinal ligament Anterior crus = intercrural fibers Posterior crus = reflected inguinal ligament Lateral crus = lateral fibers of aponeurosis Medial crus = medial fibers of the aponeurosis 27. Epiploic foramen/ omental foramen? Continent? Borders? Is the communication between the greater sac and lesser sac/omental bursa contains NOTHING Posterior → IVC Anterior → hepatoduodenal ligament Superior → caudate lobe of liver Inferior → superior part of duodenum 28. Tarsal sinus? Sinus between the calcaneus and talus, is located on the lateral view of the foot, have structures deep to it such as talocrural interosseous ligament which help stabilize the subtalar joint 8 29. Branches of celiac trunk? Left gastric, common hepatic and splenic 30. Deep and superficial palmar arch? Superficial palmar arch Is formed by the Ulnar artery and Superficial branch of radial artery Gives the following branches: - Common palmar digital arteries - Proper palmar digital artery Deep palmar arch Is formed by the Radial artery and Deep branch of Ulnar artery Gives the following branches: - Princeps pollicis artery - Radialis indicis artery - Palmar metacarpal arteries - Perforating arteries 31. What is spring ligament? Are ligament that provides support of the arches during walking they connects calcaneus (sustenticulum tali) to navicular bone under head of talus thats why its also called the plantar calcaneonavicular ligament 32. Tell me about the talocalcaneonavicular joint It is a poly axial joint (ball and socket) Stabilized by: interosseous talocalcaneal ligament and talocalcaneal ligament (posterior), talonavicular ligament (superior), plantar calcaneonavicular ligament (which are the spring ligaments, inferior) and calcaneonavicular part of bifurcate ligament (lateral) 33. Korni – obturator nerve? Innervation? Branches? Supply? Arises from anterior rami of nerve L2 and L4 (lumbar plexus) Enters the obturator canal and to gain access to the medial compartment of the tight Motor Innervation Sensory Innervation Anterior division → , gracilis + adductor Anterior division → brevis and longus Skin on medial aspect of the thigh Posterior division → Posterior division → Pectineus + adductor magnus + Obturator Auricular branch to knee joint externus Auricular branch to hip joint 34. Posterior intercostal artery comes from? 9 Upper two posterior intercostal arteries are derived from the supreme intercostal artery (which branches to the neck as the costocervical trunk) The rest 9 pair arises from the posterior surface of the thoracic aorta 35. What are white and gray rami communicantes? Sympathetic or parasympathetic? It is the communication between the SPINAL NERVES (lesser + greater splanchnic nerves) and the SYMPATHETIC TRUNK Is sympathetic (preganglionic sympathetic ganglion = anterior rami = white rami communicantes) (postganglionic sympathetic ganglion = posterior rami = grey rami communicantes) 36. Which area of the brain is the sensory part for the head? Inferior - lateral part 37. Axillary artery? Origin? Branches? Supply? Starts at the lateral margin of first rib and passes through the axilla and becomes the brachial artery at the inferior margin of the teres major first part → Superior thoracic artery = supply upper region of the medial and anterior axillary walls Second part → Thoracoacromial artery = pectoralis minor muscle and anterior axillary wall - pectoral branch - deltoid branch - clavicular branch - acromial branch → Lateral thoracic artery = pectoralis minor and medial and anterior walls of the axilla Third part → Subscapular artery = posterior wall of axilla and posterior scapular region - circumflex scapular artery - thoracodorsal artery = supply posterior and medial axillary walls → Anterior circumflex humeral artery = branches to the surrounding tissues, glenohumeral joint and head of humerus → Posterior circumflex humeral artery = supply muscles near neck of humerus and glenohumeral joint 38. What is a ganglion? A ganglion is a nerve cell cluster or a group of nerve cell bodies located outside the CNS 39. Trigeminal ganglion? Is it sensory or motor? 10 The trigeminal ganglion is a sensory ganglion of the trigeminal nerve. It is located on the trigeminal impression near the apex of petrous part of temporal bone lesion: trigeminal neuralgia 40. What is the order neuron in the trigeminal pathway? Terminal location of the trigeminal pathway? 1st (trigeminal ganglion) 1st order neuron comes from the trigeminal ganglion enters medulla and synapse in the principal/chief sensory nucleus 2nd (trigeminal nucleus) 2nd order neurons axons decussates to enter the trigeminal lemniscus in midbrain and ascend to the ventral posteromedial nucleus of the contralateral thalamus forming the posterior trigeminothalamic tract 3rd (ventral posteromedial nucleus in thalamus/ ventral thalamic nuclei) 3rd order neuron in thalamus it ascend to the sensory cortex of the postcentral gyrus (terminal location) 41. Mediastinum? Borders? Continent? Superior med. → Retrosternal structures sternohyoid sternothyroid longus colli thymus gland (young people!) brachiocephalic veins SVC → Intermediate structures AORTIC ARCH + branches Vagus n. Phrenic n. cardiac branches of sympathetic chain → Prevertebral structures prevertebral muscles Esophagus Trachea Thoracic duct recurrent laryngeal nerve (left) Inferior med. Anterior mediastinum Posterior mediastinum Middle mediastinum Anterior med. Sternopericardial ligament Mediastinal branches from internal thoracic artery Fat and lymph vessels 11 Middle med. HEART !! and Pericardium Ascending aorta Lower half of superior vena cava and Azygos vein Main bronchi Pulmonary trunk and veins Phrenic nerve Cardiac plexus Tracheobronchial lymph nodes Posterior med. Descending aorta Azygos and hemiazygos vein Posterior mediastinal lymph nodes Esophagus Thoracic duct Vagus and splanchnic nerves 42. The lesser sac/ omental bursa and greater sac? Continent? Is subdivision of the peritoneal cavity and is separated by folds of peritoneum. Greater sac forms the greater part of this cavity and lesser sac represent the primary right cavity of the celoma. It communicates with each other via the epiploic foramen and contain nothing. 43. Left atrium? Receives oxygenated blood from the 4 pulmonary veins which drain into the left atrium, and goes to the left ventricle (Mitral valve) and gets pumped out through the ascending aorta which later becomes arch of aorta. Anterior wall: Left auricle Posterior wall: Openings of pulmonary veins Inferior wall: Left atrioventricular orifice Medial wall: Interatrial septum 44. Bronchopulmonary segment of lung RIGHT LUNG LEFT Lung SUPERIOR LOBE SUPERIOR LOBE Apical Apical anterior anterior posterior posterior superior lingual inferior lingual MIDDLE LOBE medial lateral 12 INFERIOR LOBE INFERIOR LOBE basal anterior basal anterior basal posterior basal posterior basal medial basal medial basal lateral basal lateral superior superior 45. Division of the lung: Lobar bronchi → segmental bronchi → subsegmental bronchi → terminal bronchioles → respiratory bronchioles → alveolar sac + pulmonary alveoli → air cells 46. What is above and below the zygapophyseal joint? Superior articular process of one vertebrae and the inferior articular process of the vertebra below it 47. What is the thoracic duct? The thoracic duct arises from the cisterna chyli at the level of T12 – L 1 and ascends through the aortic hiatus. It lies on the right side until the level T4 (sternal angle) where it crosses to the left to drain into the left venous angle (between the subclavian and internal jugular veins) It drains lymph from ¾ of the body 48. Internal thoracic artery branches? Most important branch? Arise from the subclavian artery - Anterior intercostal artery - Mediastinal branches - Thymic branches - Sternal branches - Perforating branches - Pericardial branches - Pericardiophrenic artery → Terminal branches - superior epigastric artery - musculophrenic artery 49. Saphenous nerve? Origin? Innervation? Saphenous nerve is the largest cutaneous branch of the femoral nerve, it courses on the medial side of the thigh and innervates skin on the medial side of the thigh, medial side of the knee and medial side of the leg. 50. Sciatic nerve? Arise from the ventral rami of L4 - S3 from the sacral plexus It enters posterior compartment of the thigh where it divides into common fibular (posterior division L4 – S2) and Tibial (anterior division L4 – S3) 13 51. Borders of thalamus? Process motor and sensory imput to the cerebral cortex Superior - 3rd ventricle Inferior - hypothalamus Medial - Interthalamic adhesion Lateral - posterior limb of internal capsule 52. Borders of 4th ventricle? Roof – cerebellum Floor – rhomboid fossa Walls – cerebellar peduncles Roof of 4th ventricle Floor of 4th ventricle (rhomboid fossa) Fastigum Median sulcus Tela choroidea Median eminence Choroid plexus Facial colliculus Lateral Recess —> lateral aperture Locus caeruleus Superior medullary velum Medullary Stria Frenulum of superior medullary velum Triangle of hypoglossal nerve Inferior medullary velum Triangle of vagus nerve Median aperture Vestibular area Area postrema Funiculus separans Obex Grey line/ tenia cinerea 53. Borders of 3rd ventricle? Superior – corpus callosum Inferior – hypothalamus Anterior – anterior commissure + Lamina terminalis + Columns of fornix Posterior – habenular commissure Lateral – thalamus 54. Borders of lateral ventricle? (mostefs said he wants borders of central part only) Central part/ body Roof – corpus callosum Floor – body of caudate nucleus and stria terminalis Lateral wall – body of caudate nucleus Medial wall – septum pellucidum Anterior horn Posterior horn Temporal horn Roof – corpus callosum Roof – radiation of corpus Inferiormedial wall – pes of Medial wall – septum callosum hippocampus, fimbriae of pellucidum Floor – collateral trigone hippocampus and collateral eminence 14 Lateral wall – head of Medial wall – calcar avis Superolateral wall – tapetum, tail of caudate nucleus Lateral wall – fibers of caudate nucleus and amygdaloid body tapetum 55. What is the cerebrospinal fluid? Where is the circulation of the cerebrospinal fluid produced? What openings are there? From which opening is it going? The cerebrospinal fluid is a fluid found subarachnoid space in the brain and spinal cord; it is produced by specialized ependymal cells in the choroid plexuses of the ventricles Lateral ventricle —> interventricular foramen —> 3rd ventricle —> aqueduct of midbrain —> 4th ventricle —> medial and lateral aperture of 4th ventricle —> subarachnoid space —> arachnoid Villi —> superior Sagittal sinus 56. What is in front of choroid? What is in the back of Choroid? Infront → sclera Behind → retina ISBR 57. Lateral sulcus? The lateral sulcus is a sulcus located between the frontal and temporal lobe, it is divided into posterior ramus, anterior ramus and ascending ramus. (professor prefer branch) 58. Name the ligament of stomach? Hepatogastric (only one from ventral mesentery) Gastrophrenic Gastrosplenic Gastrocolic 59. What types of fluid can you find in the eye? → Aqueous humor → Vitreous humors Ciliary body secrete the aqueous humor by the ciliary process which is located beneath the iris, it is secreted into the posterior chamber drains into venous system in anterior chamber through the pupil and is absorbed into the scleral venous sinus/ canal of schlemm (is the channel at the junction between the cornea and iris). Vitreous humor is located between the lens and retina (posterior ⅘) you are not done there is more … ha … ha... 15 2014 - 2017 → Polish and English division 1. Visual pathway? 1 order neuron → bipolar cells in rod and cones of retina st order neuron → ganglion cell layer of retina 2nd 3rd order neuron → lateral geniculate nucleus and terminates at the calcarine sulcus bipolar cells in retina → ganglions in ganglion cell layer in retina → optic nerve → optic chiasm → optic tract → lateral geniculate body → calcarine sulcus 2. Olfactory pathway? Impulses from sensory mucosa in the upper part of nasal cavity 1st order Neuron → mitral cells in nasal cavity order neuron → olfactory bulb 2nd order Neuron → ends at Piriform areas (cortex, paraamygldaloid cortex and endorhinal 3rd cortex) 3. Vestibular pathway (balance) 1st order neuron → Bipolar cells in organs of balance (utricle and saccule) 2nd order neuron → dorsal vestibular nuclei 3rd order neuron →Fibres to the inferior cerebellar peduncle to the flocculonodular lobe of the cerebellum. 4. Auditory pathway? 1 order neuron (bipolar cells in spiral organ) → starts in the inner ear in receptors on the st cochlear hair cells in the spiral, moves to the cochlear nuclei in the medulla oblongata and synapses in lateral lemniscus to from the superior olivary nucleus in pons and cochlear nuclei ascends to order neuron (dorsal and ventral cochlear nucleus) → decussate in trapezoid body and 2nd forms lateral lemniscus order neuron (medial geniculate body) → medial geniculate body and terminates in the 3rd superior temporal gyrus 5. Spinothalamic tract has two major systems, which? The pain and temperature (lateral spinothalamic tract) Light touch and firm pressure (anterior spinothalamic tract) 6. What is the AFFERENT pathway of special senses? Olfactory 16 Vision Gustatory sensation Auditory sensation Vestibular sensation (equilibrium sensation) 7. How many order neuron does the pyramidal pathway have? They have 2 neurons the upper & lower motor neurons. Possible follow up questions on Q:4 Q: where is the LMN and UMN located? → upper - primary motor areas - premotor area - paracentral lobule → lower - the corticospinal pathway in the anterior horn of spinal cord (cervical, lumbar, thoracic or sacral parts) Q: the LMN giving what type of sensation? General somatic efferent (GSE) Q: what is the pyramidal tract divided into? - corticospinal tract - cortico nuclear/ cortico bulbar 8. Nucleus of hypothalamus? Anterior group Middle group Posterior group Paraventricular nucleus Lateral hypothalamic Posterior hypothalamic Supraoptic nucleus nucleus nucleus Arcuate nucleus Ventromedial nucleus Middle mamillary nucleus Preoptic nucleus Dorsomedial nucleus Lateral mamillary nucleus Suprachiasmatic nucleus IMPORTANT FUNCTION OF MOST IMPORTANT NUCLEI: Paraventricular nucleus → Releases antidiuretic hormone (vasopressin, ADH) and oxytocin Supraoptic nucleus → Releases ADH and Oxytocin Preoptic nucleus → Controls heat loss and parasympathetic excitation Suprachiasmatic nucleus →receives retinal afferentes Dorsalmedial nucleus → control appetite, fat metabolism and aggression Posterior hypothalamic nucleus → controls preservation, sympathetic excretion, mediates sleep - wake cycle and consciousness Arcuate nucleus → regulates hormones released from the pituitary gland such as prolactin and neuropeptide hormone for feeding behavior, cardiovascular regulation and metabolism. 17 9. What is the function of hippocampus? memory and behavior 10. Why is pyramidal tract called pyramidal tract? Because there is pyramidal cells in the cerebral cortex where the pyramidal tract originate from. 11. What are the meningeal layers? Pia mater, Arachnoid mater and Dura mater 12. What is the cerebrum? Part of the telencephalon which controls the whole body together with the cerebellum, contain cerebral cortex with its two hemispheres, Cerebral sulcus and Cerebral gyrus Divided into: frontal, parietal, temporal and occipital lobes + insula 13. Circle of willis? Is a anastomosis of arteries supplying blood to the brain and surrounding structures - Anterior cerebellar artery - Anterior communicating artery - middle cerebral artery - Posterior cerebral artery - Posterior communicating artery If he asks: branches: anterior, posterior and middle cerebral and anterior, posterior communicating if he ask: what makes : branches from basilar + internal carotid 14. Talocrural joint/ankle joint? Synovial hinge joint formed by distal end of tibia and fibula and proximal end of talus) Movements: Dorsiflexion and Plantarflexion Ligaments: medial deltoid ligament, lateral ligament , anterior and posterior talofibular ligament and tibiofibular Arterial supply: Anterior and posterior tibial artery and anterior and posterior fibular artery Innervation: deep fibular/ peroneal, saphenous, sural and tibial nerves Possible question for Q:9 Q: What does medial and lateral deltoid ligament consist of? The medial deltoid ligaments consist of: Tibionavicular part, tibiocalcaneal part, posterior tibiotalar part and anterior tibiotalar part Lateral ligament consist of: anterior talofibular ligament, posterior talofibular ligament and calcaneofibular ligament 15. What structures goes through the flexor retinaculum of the leg/ content of medial malleolar canal? 18 TENDON OF: Tibialis posterior Flexor digitorum longus Flexor hallucis longus Posterior tibial vessels Tibial nerve 16. Bones of taurus? Talus Calcaneus Navicular Medial, intermediate, lateral cuneiform Cuboidal 17. Hip joint the synovial articulation is btw the head of femur and lunate surface of the acetabulum of the pelvic bone and is a multiaxial ball and socket joint Movement Flexion, extension, abduction, adduction, medial and lateral rotation and circumduction Ligaments: externally are iliofemoral ligament, pubofemoral ligament and ischiofemoral ligament. Internally it is held by the ligament of head of femur Arterial supply: branches of obturator artery, medial and lateral circumflex femoral arteries, superior and inferior gluteal arteries and first perforating branch of deep artery of tight (ALL OF THEM FORMS ARTICULAR BRANCHES AROUND THE HEAD OF FEMUR) Innervation: articular branches from femoral, obturator, superior gluteal and nerve to quadratus femoris. 18. Knee joint? Is a the articulation between the femur and tibia forming the tibiofemoral joint and articulation between the patella and femur forming the patellofemoral joint and is the largest synovial hinge joint Movements: flexion and extension (I s held by meniscus for the articulation of the joint during movements) Ligaments: patellar ligament, fibular collateral ligament (cord like ligament, attaches superior to lateral epicondyle), tibial collateral ligament (broad like ligament, attaches inferior to adductor tubercle), anterior cruciate ligament and posterior cruciate ligament Arterial supply: Descending genicular branches, Anterior tibial recurrent branches, Circumflex fibular artery, Descending branch of lateral circumflex femoral artery, Inferior/superior/ middle medial genicular branches and Inferior/superior lateral genicular branches (ALL OF THEM FORM ANASTOMOSING BRANCHES) Innervation: obturator, femoral, tibial and common fibular nerves 19. Borders and continent of the femoral canal, ring and triangle? 19 Femoral canal/ ring (Lamp) Anterior - inguinal ligament Posterior - pecten pubis Lateral - femoral vein Medial - lacunar ligament Femoral triangle (msl) Superior – inguinal ligament Lateral – Sartorius Medial – adductor longus muscle Roof - fascia lata of thigh - Femoral nerve - Femoral artery - Femoral vein - Lymphatics 20. Pes anserinus? Is the common tendon for sartorius muscle, gracilis muscle and semitendinosus muscle. This common tendon inserts on the medial side of the leg on the medial condyle of tibia. 21. Lumbar plexus? terminal branches (6) Formed by ventral rami of spinal lumbar nerve 1 to 4 also the 12 thoracic nerve (subcostal) gives a branch to the lumbar plexus. Terminal branches are the Obturator nerve and Femoral nerve Branches Origin/ spinal Motor Sensory segments Iliohypogastric Anterior rami of L1 Internal oblique Posterior lateral gluteal nerve Transversus abdominis skin and skin of pubic region Ilioinguinal nerve Anterior rami of L1 Internal oblique Skin of upper medial Transversus abdominis thigh, skin of root of penis and anterior scrotum and mons pubis and labia majora Genitofemoral nerve Anterior rami of L1 Genital branch → Genital branch → skin and L2 Cremaster muscle of anterior scrotum or skin of mons pubis and labia majora Femoral branch → skin of upper anterior thigh Lateral femoral Anterior rami of L2 Skin of the anterior and cutaneous nerve and L3 lateral thigh to the knee 20 Obturator nerve Anterior rami of L2 Anterior division → , Anterior division → to L4 gracilis + adductor Skin on medial aspect brevis and longus of the thigh Posterior division → Posterior division → Pectineus + adductor Auricular branch to magnus + Obturator knee joint externus Auricular branch to hip joint Femoral nerve Anterior rami of L2 Iliacus Skin on anterior thigh to L4 Pectineus and medial surface of Muscles of anterior leg compartment of thigh (via saphenous nerve) 22. Sacral plexus? terminal branches? Ventral rami of L4 - S4 lies on anterior surface of piriformis muscle in the gluteal region The sacral nerves pass through the anterior sacral foramina Terminal branches are the pudendal nerve Branches Origin Motor Sensory Sciatic nerve Tibial part → L4 - S3 → Tibial part → Tibial part All muscles of Skin of posteriorlateral posterior compartment and lateral surface of Common fibular part of thigh and leg foot and sole of foot → L4 - S2 All muscles in sole of foot → Common fibular part → Common fibular skin of anteriorlateral part surface of leg and short head of biceps dorsal surface of foot all muscles in anterior and lateral compartment of leg Extensor digitorum brevis Pudendal nerve S2 - S4 skeletal muscles in most skin of perineum perineum, external penis and clitoris urethral and anal sphincter and levator ani Superior gluteal L4 - S1 Gluteus medius nerve Gluteus minimus Tensor fascia latae 21 Inferior gluteal L5 -S2 Gluteus maximus nerve Nerve to obturator L5 - S2 Obturator internus and internus and superior gemellus superior gemellus Nerve to quadratus L2 - S1 Quadratus femoris and femoris and inferior inferior gemellus gemellus Posterior femoral S1 - S3 Skin on the posterior cutaneous nerve aspect of thigh Skin over gluteal fold Nerve to piriformis S1 - S2 Piriformis muscle Pelvic splanchnic S2 - S3 → Visceral motor to → visceral efferents nerves pelvic part of from pelvic viscera and prevertebral plexus distal part of colon → Stimulate erection → pain from cervix, modlaye mobility in from bladder and gastrointestinal system proximal urethra distal to left flexure → Inhibitor to the internal urethral sphincter 23. Cutaneous innervation of dorsum of foot? Superficial fibular nerve Deep fibular nerve Saphenous nerve Sural nerve 24. Plantar innervation of foot? Tibial nerve (by Lateral plantar nerve and Medial plantar nerve) Sural nerve Saphenous nerve 22 25. Innervation of the forearm? Motor Median nerve - deep flexor muscles and thenar muscles Ulnar - medial half of flexor digitorum profundus and flexor carpi ulnaris, hypothenar Radial nerve - supplies posterior muscles of forearm (extensor muscles) Cutaneous/ sensory Medial antebrachial cutaneous nerve - from medial cord of brachial plexus Lateral antebrachial cutaneous nerve - from the musculocutaneous Posterior cutaneous nerve of forearm - from radial nerve 26. Lesion of nerves in upper limb? Median nerve → Ape hand/ blessed hand paralysis of the thenar muscles and the first two lumbricals, opposition of thumb is not possible and fine control movements of 2nd and 3rd digits are impaired. Sensation is also lost over the thumb and adjacent two and half fingers Radial nerve → wrist drop global paralysis of the muscles of posterior compartment, resulting in wrist drop. Reduction of sensation in the cutaneous distribution by the posterior aspect of the hand also will cause paralysis of muscles in the posterior compartment of forearm. Patient will not be able to extend fingers Ulnar nerve → claw hand resulting in numbness of the little finger and weakness of flexion and adduction of wrist. 27. Borders and contents of the anatomical snuff box Medial - tendon of extensor pollicis longus Lateral - tendon of abductor pollicis longus and extensor pollicis brevis Posterior/proximal - styloid process of radius Floor - Scapoid + trapezium Roof - skin - Radial artery 23 28. Borders and content of cubital fossa? This fossa is also called the anticubital fossa Superior - imaginary line between epicondyle of humerus Medial - pronator teres Lateral - brachioradialis Floor - brachialis and supinator muscle Roof - bicipital aponeurosis - Brachial artery + vena communicantes - biceps tendon - median nerve - radial nerve - recurrent radial artery 29. Borders and content of triceps hiatus? This hiatus is also called the Triangular interval and it's a passage between anterior and posterior compartment of arm and axilla Superior - teres major Medial - long head of biceps brachii Lateral - shaft of humerus - deep brachial artery and vein - radial vein 30. Triangular space/ medial axillary region of forearm Superior - Teres minor Inferior - Teres major Lateral - Long head of triceps - circumflex scapular artery + vein 31. Tell me about quadrangular space? Superior - Teres minor Inferior - teres major Lateral - neck of humerus Medial - long head of triceps brachii - posterior circumflex humeral artery and vein - axillary nerve 32. Cutaneous innervation of the forearm? Lateral antebrachial cutaneous nerve Medial antebrachial cutaneous nerve Posterior antebrachial cutaneous nerve 33. Borders and continent of carpal tunnel? 24 Roof – flexor retinaculum Floor – carpal arch (lateral: scaphoid and trapezium and medially hook of hamate and pissiform) - Flexor digitorum superficialis tendon - Flexor digitorum profundus tendon - Flexor pollicis longus tendon - Median nerve 34. Thenar and hypothenar muscles of hand? → Thenar muscles NAME Origin Attachment Innervation Function Opponens Pollicis Tubercle of Lateral Recurrent Medially rotates trapezium and margin and branch of thumb flexor adjacent median nerve retinaculum palmar surface of metacarpal 1 Abductor Pollicis Tubercle of Proximal Recurrent Abducts thumb at scaphoid and phalanx and branch of metacarpophalang trapezium and extensor median nerve eal joint adjacent flexor hood of retinaculum thumb Flexor pollicis Tubercle of proximal Recurrent Flex of thumb at brevis trapezium and phalanx of branch of metacarpophalang flexor thumb median nerve eal joint retinaculum → hypothenar muscles NAME Origin Attachment Innervation Function Opponens Hook of hamate Medial aspect Deep branch of Laterally rotates digiti minimi and flexor of metacarpal 5 ulnar nerve metacarpal 5 retinaculum Abductor digiti Pisiform, the Proximal Deep branch of Abducts little finger at minimi pisohamate phalanx of little ulnar nerve the ligament and finger metacarpophalangeal tendon of flexor joint carpi ulnaris Flexor digiti Hook of hamate Proximal Deep branch of Flexes little finger at minimi brevis and flexor phalanx of little ulnar nerve metacarpophalangeal retinaculum finger joint 25 35. What muscles consist in levator ani? Puborectalis Pubococcygeus Iliococcygeus 36. Tell me about the camera oculi Is also known as the chambers of the eye we have the …→ → Anterior chamber which lies behind the cornea and iris → Posterior chamber which lies - behind iris - in front of zona ciliary/ suspensory ligament of lens - medial to the lens - lateral to the ciliary body The chambers of the eye is very important because it contains the aqueous humor which is secreted by the ciliary process in posterior chamber drains into scleral venous system 37. What consist between the meatuses in conchas? Superior nasal concha → superior nasal meatus → posterior ethmoidal air cell Middle nasal concha → middle nasal meatus → middle + anterior ethmoidal air cells Inferior nasal concha → inferior nasal meatus → nasolacrimal duct *above superior nasal concha → sphenoethmoidal recess = sphenoid sinus *above inferior nasal concha → semilunar hiatus + ethmoidal infundibulum = anterior ethmoidal air cells, maxillary sinus and frontal sinus 38. What connects the arteries of Kisselbach? region in the anteroinferior part of the nasal septum where four arteries anastomose to form a vascular plexus. The arteries are: (ASSG) - Septal branch of the Superior labial (from the facial artery) - Anterior ethmoidal (branch of the ophthalmic artery) - Sphenopalatine (terminal branch of the maxillary artery) - Greater palatine arteries (from the maxillary artery) 39. What does the broad ligament consist of? Mesovarium(to ovary) Mesosalpinx(to fallopian tubes) Mesometrium(to uterus) 40. Anterior scalene fissure Anterior - SCM muscle Posterior - anterior scalene muscle Inferior - first rib - subclavian vein - subclavian duct - intermediate tendon of omohyoid muscle 26 41. Posterior scalene fissure Anterior - Anterior scalene muscle Posterior - Middle scalene muscle inferior - First rib - Subclavian artery - Superior cervical plexus - Inferior brachial plexus 42. Borders and content of infratemporal fossa? Superior - Greater wing of sphenoid bone Anterior - body of maxilla Lateral - Ramus of mandible Medial - Lateral pterygoid plate - otic ganglion !! - maxillary artery branches 43. Where do you feel the radial artery? The flexor carpi radialis tendon and anatomical snuffbox 44. Digastric muscle? The digastric muscle is divided into an anterior belly and posterior belly and they are attached to each other by an intermediate tendon Innervation of Anterior belly is mylohyoid nerve and posterior belly is facial nerve Function of Anterior belly is that it opens mouth and posterior belly pulls hyoid bone upward and backward 45. Omohyoid muscle? Originates at the scapula and attaches at hyoid bone Is innervated by the ansa cervicalis It is divided into superior and inferior belly function in depressing and flexing hyoid bone 46. Tell me about the carotid triangle? Superior - posterior belly of digastric muscle Inferior - superior belly of omohyoid muscle Lateral - SCM muscle - common carotid (bifurcates in the carotid triangle) - internal jugular - vagus nerve 47. Tell me about the hypoglossal nerve? Is the 12th cranial nerve its nucleus is the hypoglossal nucleus in medulla innervates dura, occipital sinus, extrinsic and intrinsic muscles of the tongue and submandibular gland 27 48. Branches of the maxillary artery? → Mandibular portion (5) - Deep auricular artery - Anterior tympanic artery - Middle meningeal artery - Accessory meningeal artery - Inferior alveolar artery → Pterygoid portion (4) - MASSETERIC artery - Pterygoid artery - Deep temporal artery - Buccal artery → Pterygomaxillary portion (8) - Sphenopalatine artery - Descending palatine artery - Pharyngeal artery - Anterior superior alveolar artery - Posterior superior alveolar artery - Middle superior alveolar artery - Artery of the pterygoid canal - inferior labial artery 49. Name the carpal bones? Scaphoid Lunate Triquetrium Pisiform Trapezium Trapezoid Capate Hamate 50. Tell me about adult circulation? Deoxygenated blood to the → IVC, SVC, coronary sinus and small cardiac veins It goes to the → right atrium, right ventricle, pulmonary trunk and to the lungs From lungs oxygenated blood goes to → left atrium, left ventricle and arch of aorta and to the body 51. Tell me about the fetal circulation? 1 → oxygenated blood from the placenta is carried by the umbilical vein, it travels to the underdeveloped liver of the fetus, and goes to the ductus venosus in the liver the ductus venosus connects with the hepatic vein and then IVC and goes up to the right atrium 28 2 → at the right atrium deoxygenated blood from SVC and oxygenated blood IVC is mixed The fetal lungs are not developed yet and are filled with fluid and contain high pressure + high resistance and that's why in fetal circulation blood do not enter the lung but enters the left atrium via the foramen ovale 3 → blood travels to the pulmonary trunk via ductus arteriosus (which connects the pulmonary trunk to aorta) goes to the aorta 4 → aorta gives blood to the rest of the body and the deoxygenated blood will return to the placenta via internal iliac arteries connecting with the umbilical arteries 52. right lymphatic duct Drain fluid from: - Right thoracic cavity via the right bronchomediastinal trunk - Right arm via right subclavian trunk - Right side of the head and neck via right jugular trunk 53. Where can you hear tricuspid valve? Left of the lower part of the sternum near the 5th intercostal space 54. Where can you hear mitral valve? Apex of the heart in the left 5th intercostals space 55. Where can you hear pulmonary valve? Over the medial end of the left second intercostals space 56. Where can you hear the aortic valve? Heard over the medial end of the right second intercostals space 57. Muscles of bony orbit? We have ocular and extraocular muscles → extrinsic muscles/ extraocular Name Origin Insertion Innervation Function Levator palpebrae tarsal plate of oculomotor draws the eyelid superioris the superior nerve upward when the eyelid eyeball is elevated Superior rectus Common anterior oculomotor primarily elevates the tendinous ring superior aspect nerve eyeball, it also acts of eyeball into the nasal side and rotates the eyeball medially Inferior rectus Common anterior inferior oculomotor lowers eye tendinous ring aspect of nerve downwards and into eyeball the nasal side and also 29 rotates laterally Medial rectus Common Anterior medial oculomotor adducts the eye tendinous ring aspect of nerve eyeball Lateral rectus Common Anterior lateral Abducens nerve abducts the eye tendinous ring aspect of eyeball Superior oblique Sphenoid bone frontal bone at Trochlear nerve draws posterior the anterior portion of the eyeball superior aspect upward, inward and of the medial lateral and inward part of the depressing the eye margin and also rotates medially Inferior oblique Anterior posterior lateral oculomotor draws posterior inferior aspect quadrant of nerve eyeball downwards, of medial inferior surface elevating eye orbital margin of eyeball → Intrinsic/ ocular muscles Name Origin Insertion Innervation Function Ciliary muscle base of ciliary scleral spur at Oculomotor nerve contract the lens body limbus Spincter pupillae on pupil on pupil Oculomotor nerve contraction of lens Dialator pupillae on pupil on pupil superior cervical dialation of lens ganglion 58. Ischioanala fossa Base → deep fascia and perineal skin Anterior → anterior recess of ischioanal fossa Medial → inferior fascia of urogenital diaphragm Lateral → obturator fascia (contains the pudendal canal) - inferior rectal artery - inferior rectal nerve - fatty and CT 59. Name the layer of neck: Investing layer Carotid sheath 30 Pretracheal layer Prevertebral layer 60. Urogenital triangle? - LEVATOR ANI - DEEP/ SUPERFICIAL TRANSVERSE PERINEAL MUSCLE - ISCHIOCAVERNOSUS - BULBOSPONGIOSUS 61. Tributaries of IVC 3 hepatic veins Inferior phrenic v Suprarenal v Renal v Lumbar arteries Right Gonadal v Right/left common iliac External iliac Internal iliac Median sacral 62. Musculocutaneous nerve? Origin: nerve root of anterior rami, c5 – c7, the lateral cord of brachial plexus Motor function: innervates muscles in the anterior compartment of arm→ coracobrachialis, biceps brachii, brachialis Sensory function: gives lateral cutaneous nerve as a terminal branch that innervates lateral side of forearm 63. What are the borders of triangle of auscultation? The triangle is very important for the auscultation of the 6th intercostal space, in left triangle you can hear fluid into cardia of stomach also esophageal obstruction can be localized here Medial - trapezius Lateral - scapula Inferior - latissimus dorsi Floor - rhomboid major 64. What happens in diastole? Aortic is closed, Ventricle are relaxed 65. What happens in systole? (ss) Contraction of the ventricle, close 66. Cardiac plexus, what it is made of? It is formed by superior, middle, inferior cervical and thoracic cardiac nerves from sympathetic trunks and vagus nerve 31 Innervates the conducting system of the heart → which activates the cardiac muscle fibers (w/o motor endings). Supplies heart with sympathetic fibers → increasing heart rate dilated coronary a. Supplies the heart with parasympathetic as well → decreasing heart rate constricting coronary a 67. Tell me about the conducting system of the heart? Action potential is created by SA nodes. The SA impulses spreads through atrial myocardium to reach atrioventricular node. When AV is joined with the SA node it initiate ventricular systole. AV node initiate contraction with approximately 40 depolarization a min and goes then via AV bundle (bundle of HIS) down the interventricular septum. Descends to reach inferior border of membranous part of the ventricular septum to divide into left and right branches that become the purkinje fibers of the purkinje plexus purkinje fibers spread the av along the ventricles causing them to contract. 68. What can we find in the peritoneal cavity? Where is it located? Between the parietal and visceral layers of peritoneum it is a potential space meaning ANSWER IS NOTHING 69. External and internal pudendal arteries? External pudendal artery → femoral Internal pudendal artery → internal iliac posterior labial arteries inferior rectal artery artery of vestibule bulb posterior scrotal anterior scrotal perineal artery artery of bulb urethral artery deep artery of penis/ clitoris dorsal artery of penis / clitoris 70. Pudendal canal/ allocks canal? content? formed by? Is formed by the obturator internus fascia - internal pudendal vessels - pudendal nerve 71. What are the boundaries and contents of deep pelvic space? Inferior - perineal membrane Superior - urogenital diaphragm and superficial transverse perineal fascia - Deep transverse perineal muscle - Membranous part of urethra - Bulbourethral glands - Internal pudendal vessels - Pudendal nerve 32 72. What are the boundaries and contents of superficial pelvic space? Superior - perineal membrane Inferior - Colles fascia, membranous layer of superficial perineal fascia - Bulb of penis - Corpus spongiosum - Corpus cavernosum - Bulbospongiosus - Ischiocavernosus - Internal pudendal vessels - Posterior scrotal/ labial nerves 73. Portocaval anastomosis, what is it? Is an anastomosis between veins of the hepatic portal circulation and the systemic circulation (from heart etc to heart), it is clinically important for during portal obstruction. The anastomosis is between esophagus, rectum, paraumbilical region - esophageal branches from left gastric + azygos vein → superior vena cava - superior rectal + middle rectal → inferior mesenteric vein + splenic vein = portal vein = IVC - Paraumbilical veins → portal vein → IVC - paraumbilical veins → superficial veins → external iliac → IVC - other systemic contributes are lumbar, renal and phrenic veins https://www.youtube.com/watch?v=JccN2XZN_IE&list=PLrSF4J33FBEjtWaLRVW6DNy6BKCOat f0A&index=6&t=0s 74. What is the retromandibular vein formed by? Superficial temporal vein and maxillary vein 75. What are the tributaries of Portal hepatic vein? Union of splenic, superior mesenteric, right and left gastric vein 76. Which rib bones are classified as true ribs false ribs and floating ribs? True ribs = 1 to 7 connected to sternum + maubrium (1st and 2nd) False ribs = 8 to 12, 8 and 10 are connected costal cartilage immediately above. Floating ribs = 11 to 12 are not connected. 77. Difference between atypical and typical ribs? → The atypical 1st = broadest and shortest, single articular facet on the head, consist a scalene tubercle and 2 grooves. 2nd = tuberosity for serratus anterior and 2 articular surfaces of the head 10th = has a single articular facet 11th and 12th = have no neck or tubercle and have a single articular facet → Typical Ribs 3 – 9 78. Muscles of the scapula 33 Muscle Insert Function Deltoid muscle (axillary) On scapula : Acromion and abducts, adducts, flex, extends, spine of scapula medial and lateral rotation of arm Supraspinatus muscle On scapula: supraspinatus Abducts arm (rotator cuff (suprascapular nerve) fossa muscle) Infraspinatus On scapula: Infraspinous fossa Laterally rotates arm in the (suprascapular nerve) of the scapula shoulder (rotator cuff muscle) Subscapularis (subscapular On scapula: subscapular fossa Rotates the upper arm in nerve) shoulder medially (rotator cuff muscle) Teres minor On scapula: Middle part of Laterally rotates and adducts (Axillary) lateral border of the scapula (rotator cuff muscle) Teres major On scapula: inferior angle of Adducts (lower subscapular) the scapula Coracobrachialis On scapula: Coracoid process Flexes (forwards) the arm in the (musculocutaneous) of the scapula shoulder Biceps brachii Origin of the long head: Flexes the arm in the shoulder (musculocutaneous) Supraglenoid tubercle (lateral and elbow, supinates the angle) of the scapula forearm (which results in rotation of the palm upwards) Origin of the short head: Coracoid process of the scapula Triceps brachii (long head) Infraglenoid tubercle (lateral Extends the upper arm (axillary) angle) of the scapula backwards at the shoulder Omohyoid (ansa cervicalis) Suprascapular ligament and Depresses hyoid bone and superior border of the scapula larynx Pectoralis minor Coracoid of scapulae Draws the scapula forward and (thoracodorsal) downward, elevates ribs (during breathing in) Serratus anterior anterior surface of medial abducts (protracts) the scapula, (LOOOOONG thoracic) border of the scapula upwardly rotates it while abducting the upper arm, stabilizes the scapula by holding it to chest wall 34 Levator scapulae Upper part of medial border of Elevates medial border of the (DORSAL sacpular) the scapula scapula and rotates lateral angle downwards, bends neck to the side Trapezius Spine and acromion of the Elevates, depresses, retracts (accessory) scapula, lateral third of (moves toward the spine) and clavicle upwardly rotates the scapula, bends the neck backwards Romboid major Lower two thirds of medial Retracts and elevates the (dorsal scapular) border of the scapula medial border of the scapula, rotates lateral angle downwards Rhomboid minor Upper third of medial border Retracts and elevates medial (dorsal scapular) of the scapula border of the scapula, rotates lateral angle downwards 79. What are the layers of testicle? - Skin - Dartos fascia - external spermatic fascia - cremaster fascia - internal spermatic fascia - tunica Albuginea - tunica vaginalis - testis 80. At what angle should the angle of neck of femur be? 125 degrees 35 81. What is facial palsy? It's a lesion of the facial nerve and it is classified as peripheral facial palsy and central, central facial palsy is a lesion in the nucleus of facial nerve. Periphery is a lesion of the nerve outside the nucleus/ brain. Lesion in the nucleus (upper motor neuron) will lead to contralateral paralysis of lower face muscle Peripheral lesion will lead to lesion of the same side as the nerve causing loss of taste in anterior 2/3 of tongue, inability to close eyelid, decreases secretion of lacrimal gland, dropping of mouth and pain behind ear. Temporal branch → rise the eyebrows and wrinkle the brow zygomatic branch → close the eye, eye is opened during examination Buccal branch → smile, show to much teeth and the cheeks are puffed out Mandibular branch → pout and purse the lip Cervical branch → sneer 82. The position of the uterus? Anteverted at 90 degrees and anteflexed 160 or 170 degrees. 83. Name all the organs of the gut? Foregut (BIll and Peg on Midgut (Jailed Cat) Hindgut (Descending RATS) LSD) Esophagus Duodenum 2,3, 4 part Transverse colon Stomach Ileum Descending colon Duodenum 1st part Jejunum Sigmoid colon Pancreas Cecum Rectum Liver Appendix Anus Gallbladder Ascending colon Billary apparatus Transverse colon ⅔ 84. What is the circuit of papez/medial limbic circuit? It is a neural circuit for the control of emotional expression Connects the hypothalamus to the limbic lobe for the emotional experiences, major connections in (5) - entorhinal cortex - hippocampal formation - cingulate gyrus - mammillary body - thalamus Pathway: Hippocampal formation/subiculum → fornix → mammillary bodies → mammillothalamic tract → anterior thalamic nucleus → cingulum → entorhinal cortex → hippocampal formation 36 85. Sneeze reflex? Sneezing occurs in response to irritation in the nasal cavity. SENSORY/Afferent → Olfactory and Trigeminal (OPHTHALMIC + MAXILLARY) MOTOR/ Efferent → Trigeminal (OPHTHALMIC + MAXILLARY) and Vagus Efferent fibers goes to the pharyngeal, laryngeal and respiratory muscles and mucous glands to produce a sneeze 86. Gag reflex? The gag reflex involves an elevation of the soft palate and contraction of pharyngeal muscles by touching the posterior pharyngeal wall. Sensory limb → mediated predominantly by CN IX (glossopharyngeal nerve) Motor limb → by CN X (vagus nerve) 1. Soft palate stimulation sends afferent sensory fibers via glossopharyngeal nerve to sensory nucleus of spinal trigeminal nucleus and the solitary tract nucleus which excites motor neurons in nucleus ambiguus 2. nucleus ambiguus excites the vagus nerve to send efferent motor fibers to produce pharyngeal constriction, also the nucleus ambiguus stimulates the trigeminal motor nucleus and hypoglossal nucleus 3. Trigeminal motor nucleus excites the mandibular division of the trigeminal nerve for jaw opening 4. Hypoglossal motor nucleus for excitement of hypoglossal nerve for tongue thrust 87. Tell me about the brachial plexus The brachial plexus arises from the ventral Ramus/branch of C5 - T1, it divides into roots, trunks (superior, middle and inferior) , division (anterior and posterior), cords (lateral, medial and posterior) and branches (musculocutaneous, ulnar, median axillary and radial nerve) 88. What is brachial plexus formed by? Ventral primary rami/branch of lower nerves of C5-t1 89. What are the branches of the root in brachial plexus? Dorsal scapular N and long thoracic N 90. What are the branches of the upper trunk of brachial plexus? Suprascapular and nerve to subclavius 91. What are the branches of the lateral cord of brachial plexus? Lateral pectoral N and musculocutaneus N, Lateral root of median N 92. What are the branches of medial cord? - Medial pectoral N - Medial brachial cutaneous nerve 37 - Medial antebrachial cutaneous nerve - Ulnar nerve - Medial root of medial nerve 93. What are the branches of posterior cord? - Axillary nerve - Radial nerve - upper and lower subscapular 94. Tell me about greater omentum Its built of four layers of dorsal mesentery grown in one. It goes from Greater curvature of stomach to the transverse colon and it consist of - gastro phrenic ligament - gastro colic - gastro splenic - phrenico splenic ligament - splenorenal 95. Tell me about the Lesser omentum? The lesser omentum is formed by ventral mesentery and is a double layer of peritoneum that connects the lesser curvature of the stomach and 1 part of duodenum to the liver. Composed hepatogastric and hepatoduodenal ligament (hepatic artery, portal vein and bile duct) 96. Trapezoid body? trapezius body is the acoustic stria that is part of the auditory pathway. It is located in the tegmentum between the pontine nucleus and medial lemniscus. 97. Tell me about the pterygopalatine fossa? Superior - Greater wing of sphenoid bone Inferior - Pyramidal process of palatine bone Medial - perpendicular palatine bone Lateral - pterygomaxillary fissure Anterior - body of maxilla Posterior - pterygoid process of sphenoid bone - maxillary artery + its branches - maxillary nerve - pterygopalatine ganglion Communications: it communicates with the orbit, nasal cavity, oral cavity and middle cranial fossa Medially → sphenopalatine foramen = nasal cavity Laterally → infratemporal fossa = pterygomaxillary fissure Anteriorsuperior → inferior orbital fissure = orbit Posterior → foramen rotundum = middle cranial fossa foramen lacerum + pterygoid canal = middle cranial fossa 38 Palatovaginal canal/pharyngeal canal = nasopharynx Inferior → Great palatine canal = oral cavity 98. Anterior triangle of neck subdivision and borders? - Carotid - Muscular - Submandibular - Submental Anterior: anterior midline of neck Posterior: SCM muscle Superior: Mandible 99. Borders of submandibular triangle? Superior - body of mandible Anterior - anterior belly of digastric muscle Posterior - posterior belly of digastric muscle submandibular gland - lymph nodes - facial artery - facial vein - submandibular gland 100. Border of submental triangle? Inferior - hyoid bone Medial - midline of neck Lateral - anterior belly of digastric 101. Posterior triangle of neck subdivision and borders? - Occipital triangle - Subclavian tringle/ omoclavicular triangle Anterior: SCM muscle Posterior: trapezius Inferior: clavicle Roof: platysma, investing layer of deep cervical fascia Floor: Splenius capitis, levator scapulae and scalene muscles (anterior, posterior and middle), prevertebral fascia 102. Subclavian triangle / Omoclavicular? Inferior: Clavicle Anterior: sternocleidomastoid muscle Superior: Inferior belly of omohyoid - Subclavian artery - Lower part of the external jugular - deep cervical fascia - brachial plexus 39 103. Tell me about metathalamus? Is located in the Procephalon and is developed from the diencephalon The metathalamus consist of medial and lateral geniculate bodies and are located under the pulvinar The medial and lateral geniculate bodies function in auditory (medial) and visual (lateral) pathways 104. Sympathetic trunk tell me about it? Is the sympathetic division of the autonomic system. It lies on each side of the vertebral column. Its divided into cervical, thoracic and lumbar. We have 3 cervical, 12 thoracic and 4 lumbar, Sacral usually 4-5 small ganglia ON EACH SIDE OF THE BODY!! The 3rd cervical (inferior cervical) fuses with the 1st thoracic forming stallate/ thoracocervical ganglion at the level of C7 from which the inferior cervical nerve originates. Its an intermediate communication between the spinal nerves and the splanchnic nerve = grey and white rami communicantes 105. Tell me about Metencephalon? It is the embryonic part of the hindbrain/Rhombencephalon that differentiate into pons and cerebellum. 106. What are the boundaries of anal triangle? Anterior - deep transverse perineal muscle Posterior - sacrotuberous ligament Lateral - Obturator internus m and fascia. - obturator internus - external anal sphincter - levator ani - coccygeus 107. What type of ganglion is thoracic splanchnic nerve? Sympathetic ganglion fused with inferior cervical ganglion forming the stellate ganglion. The thoracic splanchnic nerve from this ganglion is preganglionic sympathetic GVE 108. Sensory branches of the trigeminal ganglion? Ophthalmic, maxillary and mandibular 109. Branches of mandibular nerve - Auricotemporal nerve - lingual nerve - Inferior Alveolar nerve 110. What are the branches of Ophthalmic Nerve? - Nasociliary - Lacrimal Nerve - Frontal nerve 40 111. What are the branches of Maxillary Nerve? (9) - Superior Labial N - Superior alveolar N - Infraorbital N - Inferior Palpebral N - Middle meningeal N - Pharyngeal N - Greater palatine - Lesser palatine - Nasopalatine N 112. Function of hypothalamus (6) - endocrine system - Temperature - appetite - emotion - fluid balance - sexual activity 113. Tell me about the pathway for parasympathetic ganglions of the head: Nucleus Preganglionic Ganglion Postganglionic Innervation Superior Great petrosal Lacrimal nerve Lacrimal gland salivatory nerve (Facial nucleus nerve) Mucous glands of Pterygopalatine submucosa of the ganglion nasal cavities /geniculate ganglion Maxillary sinus Plate = promote secretion Accessory Branch to ciliary Short ciliary Sphincter pupillae nucleus ganglion nerves (oculomotor Ciliary ganglion ciliary muscle nerve) = constriction Inferior Lesser petrosal Auriculotemporal Parotid gland salivatory nerve nerve nucleus (Glossopharyngeal Otic ganglion = increase secretion nerve) 41 Superior Lingual nerve Lingual nerve Submandibular gland salivatory (facial + chorda Submandibular and Sublingual gland nucleus tympani) Ganglion = increase secretion 114. Function of amygdala Primary role in the processing of MEMORY, EMOTION AND DECISION MAKING. Located between the temporal pole and the inferior horn of lat. vent. If damaged, it may cause autism. 115. What is the name of the receptor organ of hearing in the ear? Its called Spiral organ and its located in the scala media of the inner ear in the cochlea, (auditory pathway). Its function is to transduce sound waves. 116. Diencephalon? parts? The diencephalon also called the thalamencephalon is a division from the procephalon and it consist of: - Thalamus(motor and sensory signal) - Metathalamus (geniculate bodies, for visual and auditory pathway) - Epithalamus (pineal body for manufacture of melatonin and habenula for feeding behavior) - Hypothalamus (endocrine system) - Subthalamus 117. Stellate ganglion? Inferior cervical ganglion fuses with 1st thoracic ganglion to become the stellate ganglion. The Stellate ganglion lies on the level of C7 and it gives rise to inferior cervical cardiac nerve. 118. Right atrium The right atrium receives deoxygenated blood from: - Superior vena cava - Inferior vena cava - Coronary sinus - small cardiac veins - anterior cardiac vein 119. Walls of right atrium Superior wall → opening of SVC (gets blood from upper part of the body) Inferior wall → right atrioventricular orifice Anterior wall → opening of small cardiac veins Posterior wall → IVC + coronary sinus (with the coronary valve) Medial wall → interatrial septum and fossa ovalis 42 Lateral wall → crista terminalis 120. Nucleus of trochlear nerve? where is it located? in midbrain, between the superior and inferior colliculus Is a motor nucleus innervates superior oblique muscle 121. What innervates tongue? Anterior ⅔ Posterior ⅓ General sensation → lingular nerve General sensation → Glossopharyngeal Sensory/Taste (SVA) → chorda tympani Sensory/ Taste (SVA) → Glossopharyngeal Motor → Hypoglossal nerve Motor → Hypoglossal nerve 122. Spinothalamic tract pathway? This pathway can be divided into Anterior and lateral spinothalmic tract → anterior spinothalamic tract (light touch) 1st order neuron → spinal root ganglion 2nd order neuron → posterior horn of the spinal cord (decussate in the anterior commissure and ascends in anterior funiculus) 3rd order neuron → ventral nucleus of thalamus to terminate in the postcentral gyrus →lateral spinothalamic tract (pain and temperature) 1st order neuron → spinal ganglion 2nd order neuron → posterior horn of spinal cord (also decussate at the anterior commissure but rather than ascending directly to VPL nucleus it goes through lateral funiculus and reticular formation) 3rd order neuron → ventral posterolateral nucleus They ascend in lateral fasciculus of spinal cord. What seperates the tract from the anterior carrying LIGHT TOUCH and firm pressure 123. Pathway of pain and temperature 1st order neuron → spinal root ganglion 2nd order neuron → posterior horn of the spinal cord 3rd order neuron → ventero posterior lateral nucleus of thalamus to the postcentral gyrus 124. Medial Lemniscus pathway Is the pathway for Fine touch + vibration and proprioception 1st order neuron → Spinal root ganglion (pseudounipolar, bc they run in two directions) 43 2nd order neuron → Gracile or Cuneate nucleus 3rd order neuron → Ventral posterolateral nucleus 125. Corticospinal tract is part of the pyramidal pathway. It is divided into Lateral corticospinal tract and Anterior corticospinal tract. It's a descending pathway and consist of two neuron, upper and lower motor neurons. Both innervate skeletal muscles. 1st order neuron → Precentral gyrus (Primary motor cortex), anterior corticospinal tract and lateral corticospinal tract goes via upper motor neuron to 2nd order neuron → spinal cord → Lateral corticospinal: to the interneurons of anterior horn, controls the muscles of the limb + proximal joint (IS A CROSSED PATHWAY) → Anterior corticospinal: to dorsal column , controls trunk muscles and proximal joint (UNCROSSED) 126. Tectum? Is part of the mesencephalon, composed of the tectal plate which have inferior colliculus for the auditory fiber pathway and it also have superior colliculus for visual pathway The tectum also consist of the brachium which connects the superior and inferior colliculi superior brachium connects with lateral geniculate body, inferior colliculus brachium joins medial geniculate body 127. Axillary vein? Is a continuation of the brachial vein and ends on the external margin of the first rib draining into the subclavian vein. The axillary vein is located on the medial side of the axillary artery. - Subscapular vein - Circumflex humeral vein - Lateral thoracic vein - Thoracoacromial vein 128. Dorsal vagal nuclei? One of the important nuclei of the vagus nerve, is located in medulla anterior to the floor of 4th ventricle It is a parasympathetic nucleus giving GVE fibers to the heart, lungs and alimentary tract 129. Tell me about nuclei of Vagus nerve? Have dorsal vagal nucleus which is a parasympathetic nucleus giving GVE fibers to the heart, lungs and alimentary tract Have medial part of the nucleus ambiguous for motor SVE fibers to the muscles of larynx, pharynx and plate Nucleus of solitary tract have sensory GVA to pharynx, larynx , heart, lungs and alimentary tract also taste SPECIAL VISCERAL SENSORY fibers to vallecula and epiglottis also 44 Nucleus of spinal tract of trigeminal nerve giving somatic sensory fibers from posterior part of external auditory meatus 130. Pathway of the vagus nerve? In the Head → The vagus nerve originates from the medulla of the brainstem. It exits the cranium via the jugular foramen. This supplies sensation to the posterior part of the external auditory and canal external ear. In the Neck → In the neck, the vagus nerve passes into the carotid sheath together with common carotid artery and internal jugular vein. Gives pharyngeal branches, superior laryngeal branches and recurrent laryngeal nerve In the Thorax → In the thorax, the right vagus nerve forms the posterior vagal trunk, and the left forms the anterior vagal trunk. Forming the esophageal plexus. Goes through the esophageal opening of the diaphragm at the level of T10. Gives left recurrent laryngeal nerve and cardiac branches In the Abdomen → the vagal trunks terminate by dividing into branches that supply the foregut and midgut. (oesophagus, stomach and the small and large bowel (up to the splenic flexure)) 131. Colon blood supply? What are the parts of colon? Parts: Ascending colon + Transverse colon + Descending colon + Sigmoid colon + Rectum + (Cecum & appendix) Blood supply: Ascending colon → right colic artery (superior mesenteric artery). ⅔ Transverse colon → m iddle colic artery (superior mesenteric artery) 1/3 of transverse colon + descending colon → left colic artery (inferior mesenteric artery). Sigmoid colon → sigmoid artery (inferior mesenteric artery) Rectum → ⅔ superior rectal artery (inferior mesenteric artery) and 1/3 of rectum is middle rectal artery (internal iliac artery) 132. Cervical plexus? The cervical plexus is formed by the ventral rami of cervical nerves C1-C4 and is located in the posterior triangle of neck. → Muscular branches: - Phrenic nerve (C3, C4 and C5 keeps the diaphragm alive) - Ansa cervicalis (sternohyoid, sternothyroid and omohyoid) → Cutaneous branches: - Lesser occipital nerve (C2 - C3) - Great auricular nerve (C2 - C3) - Transverse cervical nerve (C2 - C3) - Supraclavicular nerve (C3 - C4) note: greater occipital is from the dorsal rami of spinal nerve 2 133. Walls of middle ear/ tympanic cavity Lateral - tympanic membrane, epitympanic recess 45 Medial - lateral semicircular canal, facial canal, oval window and round window superior- tegmen tympani Floor - petrosal fossula , jugular fossa Posterior - mastoid air cells Anterior - carotid canal, musculotubarine canal and caroticotympanic canaliculi 134. Tell me about the larynx? It is a musculoligamentous structure with cartilaginous framework that caps the lower respiratory tract Arterial supply: superior laryngeal artery (external carotid artery) and inferior thyroid artery (thyrocervical trunk) Innervation: recurrent laryngeal Muscles of the larynx: - Posterior cricoarytenoid (abduct, opens) - Lateral cricoarytenoid (adduct close) - Transverse arytenoid (adduct close) - Oblique arytenoid (adduct close) - Cricoarytenoid (only one that is supplied by the superior laryngeal external branch) - Thyroarytenoid - Thyroepiglottic - Aryepiglottic - Vocalis 135. Blood supply of the pancreas Anterior + posterior superior pancreaticoduodenal artery (from gastroduodenal artery) Anterior + posterior inferior pancreaticoduodenal artery (from superior mesenteric artery) Body and tail = branches of splenic artery 136. Difference between the Typical and Atypical cervical vertebrae? Atypical Typical Atlas (no spinous process, no body) from C3 - C6 Axis (have a dens) have uncovertebral joints (btween the Prominence (NON BIFID spinous process) uncinate process of adjacent vertebrae) have zygapophyseal joint 137. Large intestine innervation? Parasympathetic innervation via the pelvic splanchnic nerves Sympathetic innervation via the lumbar splanchnic nerves 138. Muscles of expiration and inspiration Muscles of inspiration Muscles of expiration 46 Accessory muscles Accessory muscles - SCM - transverse thoracic - scalene - pectoralis Principal muscles - serratus anterior, serratus posterior rectus abdominis inferior external oblique internal oblique Principal muscles transversus abdominis - diaphragm internal intercostal (except intercartilaginous - external intercostal part) - internal intercostal 139. Which Cerebellar peduncles are efferent and afferent? Superior peduncle → efferent Middle peduncle + inferior peduncle → Afferent 140. What are the symptoms for damaged Cerebellum? - Vertigo (objects around them are moving when they are not) - Ataxia (lack of voluntary coordination of muscles) - Nystagmus (involuntary eye movement) - Intention tremor - Slurred speech - Exaggerated broad based gait (clumsy, staggering movem

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