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What are branchial arches?
pharyngeal arch - pharyngeal pouches from lateral walls of the anterior portion of the foregut form branchial arches (Arches are NOT the same as Pouches!)
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What is the first arch?
CN V (mandibular), forms on day 22 --> muscles of mastication (Temporalis, Internal pterygoid, Masseter, External ptyergoid "TIME"), tensor tympani, tensor veli palantini, mandible, maleus, incus
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What is the 2nd arch?
CN VII (hyoid), forms on day 24 --> muscles of facial expression, stylohyoid, stapedius, posterior belly of digastric, stapes, styloid process, cornu of hyoid
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What is the 3rd arch?
CN IX (glossopharyngeal) --> stylopharyngeus (only muscle that CN IX is motor for), body of the hyoid, greater cornu, thymus
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What is the 4th or 5th arch?
CN X --> cricothyroid, levator veli palatini, muscles of the larynx, laryngeal cartilages
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What is the 6th arch?
same as 4th and includes recurrent laryngeal nerve
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What structures come from the mesoderm?
- notochord --> nucleus pulposus
- Mesodermal somites:
- slcerotome --> membranous vertebral column
- myotome --> muscle (somatic - skeletal, splanchnic - smooth, epimere - dorsal/posterior, hypomere - ventral/anterior)
- dermatome - nerves
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What is chondrification? ossification?
chondrification is mesoderm being replaced by cartilage, ossification is cartilage being replaced by bone (primary occurs before birth, secondary after birth)
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What is the foregut? midgut? hindgut?
foregut is from mouth to beginning of the duodenum, midgut is from duodenum to the first 2/3 of transverse colon, hindgut is from last 1/3 of transverse colon to the anal canal
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What does the vagus nerve supply? S2 to 4?
vagus is parasympathetic supply to the first 2/3 of transverse colon, S2 to 4 is parasympathetic to the last 1/3 of transverse colon
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What are the embryonic shunts?
foramen ovale, ductus arteriosus, ductus venosus, present in the fourth to eighth weeks of development
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What are the three germ layers?
mesoderm, endoderm and ectoderm
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What does the endoderm give rise to?
epithelial parts of the trachea, bronchi, lungs, pharynx, thyroid, tympanic cavity, pharyngotympanic tube, tonsils, parathyroid; epithelium of GI tract, liver, pancreas, urinary bladder and
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What does the mesoderm give rise to?
- Head --> skull muslces and connective tissue, teeth
- paraxial --> muscles of trunk, skeleton, dermis, connective tissue
- intermediate --> urogenital system including gonads, ducts and accessory glands
- lateral --> connective tissue and muscle of viscera and limbs, serous membranes of pleura, pericardium and peritoneum, blood and lymph cells, cardiovascular and lymphatic system, spleen, adrenal cortex
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What does the ectoderm give rise to?
- surface ectoderm --> epidermis, hair, nails, cutaneous and mammary glands, anterior pituitary gland, enamel of teeth, inner ear, lens
- neuroectoderm:
- nerual crest --> cranial and sensory ganglia and nerves, medualla of suprarenal gland, pigment cells, branchial arch cartilages, head mesenchyme
- neural tube --> central nervous system, retina, pineal gland, posterior pituitary
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What are the cell types?
- Simple - one layer - squamous (lines blood vessels, lymph), cuboidal and columnar (lines glands and digestive tract)
- pseudostratified columnar - lines respiratory tract
- Stratified - several layers - squamous (lines oral cavity, esophagus, rectum, vagina), columnar (reproductive tract), transitional (urinary tract)
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Where are simple squamous cells?
alveoli, capillaries, blood and lymph vessels, allows air diffusion
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Where are stratified squamous cells?
vagina, esophagus, skin, oral cavity, anal canal "satisfying stratified"
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Where are simple cuboidal cells?
kidney tubules, choroid plexus, glands and digestive tract - CSF production, ependymal cells
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Where are transitional cells?
Urinary bladder, ureters, kidney - allows expansion
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Where are simple columnar cells?
stomach, intestinal tract, glands and digestive tract
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Where are stratified columnar?
reproductive tract
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Where are pseudostratified ciliated columnar cells?
respiratory tract (cilia = filter)
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What are the three planes of the body?
coronal (divide anterior from posterior), sagittal (divide left from right), transverse/horizontal (divide top from bottom)
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What is the cervical curve of the spine? Body shape? Canal?
secondary curve which forms when baby begins to lift head, circular body, triangular canal
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What is the thoracic curve of the spine? body shape? canal?
present at birth, heart shaped body, oval or circular canal
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What is the lumbar curve? body shape? canal?
secondary curve, forms when begin crawling, kidney shaped body, triangular/trefoil canal, apex is at L3, L5 spinous is the smallest
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What laryngeal cartilages are paired?
thyroid (C4-C5), cricoid (C6) and epiglottis are single; arytenoids (forms attachment for vocal cords), corniculates, cuneiforms are paired
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What ducts are present in the GI tract?
Stenson's (opposite 2nd molar - parotid gland), Wharton's (submandibular gland), Bartholin's (sublingual), wirsung (main pancreatic), santorini (accessory pancreatic)
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What are the stages of mitosis?
interphase (resting), prophase (nuclear membrane disappears), metaphase (chromosomes toward poles), anaphase (chromatids toward poles), telophase (separation of chromosmones)
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What are the boundaries of the anterior triangle? What are the contents?
SCM, midline/neck, inferior border of mandible are the boundaries, salivary glands, larynx, thyroid glands are inside
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What are the boundaries of the carotid triangle? What are the contents?
SCM, posterior digastric muscle and omohyoid are the boundaries, carotid arteries, inferior jugular vein, vagus nerve are inside
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What are the boundaries of the submandibular triangle? What are the contents?
Digastric muscle (both parts) and inferior border of mandible, salivary glands are inside
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What are the boundaries of the muscular triangle? What are the contents?
SCM, omohyoid muscle, midline of neck are boundaries, larynx, trachea, thyroid are inside
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What are the boundaries of the suprahyoid triangle? What are the contents?
digastric muscle and hyoid bone are the boundaries, muslces of the floor of the mouth, salivary glands and ducts are inside
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What are the boundaries of the posterior triangle? What are the contents?
SCM, trapezius muscle and clavicle are boundaries, nerves and vessels are inside
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What are the boundaries of the occipital triangle? What are the contents?
SCM, trapezius muscle, omohyoid muscle are boundaries, cervical plexus and accessory nerve are inside
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What are the boundaries of the subclavian triangle? What are the contents?
SCM, omohyoid muscle, clavicle are boundaries, brachial plexus and subclavian artery are inside
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What are the boundaries of the suboccipital triangle? What are the contents?
RCP major, RCP minor, Oblique capitus superior, oblique capitus inferior are boundaries, suboccipital nerve is dorsal primary ramus of C1, vertebral artery are inside
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What organs are retroperitoneal?
kidneys, adrenal glands, colon (ascending and descending), most of duodenum, aorta, Inferior vena cava and pancreas
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What is mesentery? ligaments? omentum? epiploic foramen?
- mesentery - connects organs to the posterior abdominal wall
- ligaments - connects one organ to another
- greater omentum - connects the greater curvature of the stomach to the transverse colon
- lesser omentum - connects the lesser curvature of the stomach to the liver
- epiploic foramen - opening between the greater and lesser peritoneal sacs, also called foramen of Winslow
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What is in the anterior mediastinum?
no major structures, areolar tissue and lymph nodes
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What is in the middle mediastinum?
heart and pericardium, ascending aorta, lower 1/2 of the superior vena cava, phrenic nerve, pulmonary artery and vein
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What is in the superior mediastinum?
trachea, esophagus, thymus, arch of aorta, superior vena cava superior 1/2, thoracic duct, vagus nerve, cardiac nerve, phrenic nerve, recurrent laryngeal nerve
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What is in the posterior mediastinum?
thoracic and descending aorta, carini, bronchi, esophagus, azygous and hemiazygous veins, throacic duct, vagus nerve, splanchnic nerve
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What is the sinus venarum? fossa ovalis? pectinate muscle? chordae tendinae? papillary muscles?
- sinus venarum - smooth space between openings of the inferior and superior vena cava
- fossa ovalis - depression on the interatrial septum, a remnant of foramen ovale
- pectinate muscles - comblike ridges only found in the atria
- chordae tendinae - tendinous strands attached to papillary muscles and valve cusps
- papillary muscles - processes off the muscular walls of ventricles
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What fissures are in the lungs?
right lung has horizontal fissure (at T6 vertebral level), right and left lung both have oblique fissures
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Where does air travel in the lungs?
trachea --> bronchus (1, 2, 3) --> bronchioles --> respiratory bronchioles --> alveolar duct --> alveolar sac --> alveolus
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How does the right primary bronchi compare to the left?
the right is shorter, more vertical and broader
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What does omo mean? mylo? geni?
omo means shoulder, mylo means molar, geni means chin
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What are the suprahyoid muscles?
Mylohyoid, Stylohyoid, Geniohyoid, Digastric "MSG Die"
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What are the infrahyoid muscles?
Thyrohyoid, Omohyoid, Sternohyoid, Sternothyroid "TOSS"
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What are the muscles of mastication?
Temporalis, Masseter, Internal pterygoid (medial pterygoid), External (lateral -depresses the jaw) pterygoid
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What are the hamstring muslces?
biceps femoris, semitendinosus, semimembranosus
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What are the triceps surae?
Gastrocnemius, Achilles tendon, Soleus "step on the GAS"
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What are the rotator cuff muscles?
Supraspinatus (abduction, supracapular nerve), Infraspinatus (external rotation, suprascapular nerve), Teres minor (external rotation, axillary nerve), Subscapularis (internal rotation, subscapularis nerve) "SITS"
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What nerve innervates the Latissimus dorsi?
thoracodorsal
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What nerve innervates the Serratus Anterior?
Long Thoracic (SALT)
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What muscles does the dorsal scapular innervate?
rhomboids and levator scapulae
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What muscles does the suprascapular nerve innervate?
supraspinatus and infraspinatus
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What muscles does the axillary nerve innervate?
deltoid and teres minor
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Biceps
Musculocutaneous nerve, two heads (long and short), flexion and supination of arm
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Coracobrachialis
Musculocutaneous nerve, adduction of arm
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Triceps
Radial nerve, three heads (long, medial, lateral), extension and abduction of arm, extension of forearm
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Brachialis
Musculocutaneous and radial nerve, flexion of forearm
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What muscles are in the anterior compartment of the arm?
biceps and coracobrachialis
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What muscles are in the posterior compartment of the arm?
Triceps and brachialis
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Brachioradialis
radial nerve, flexion of forearm
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Flexor digitorum sup.
Median nerve, flexion of fingers and wrist
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Pronator quadratus
Anterior interosseous nerve, pronation of forearm
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Pronator teres
Median nerve, Pronation of forearm
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Flexor carpi radialis
Median nerve, flexion and abduction of wrist
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Flexor carpi ulnaris
Ulnar nerve, flexion and adduction of wrist
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Flexor digitorum profundus
Median and ulnar nerve, flexion of fingers and wrist
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Flexor pollicus longus
Median nerve, flexion of thumb and wrist
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Palmaris longis
median nerve, flexion of wrist and tension of palmar fascia
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What muscles are in the anterior compartment of the forearm?
Brachioradialis, Pronator quadratus and teres, palmaris longus and flexor muscles
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Aconeus
radial nerve, extension of forearm
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Supinator
Radial nerve, supination of forearm
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Abductor pollicus longus
radial nerve, abduction and extension of thumb, abduction of wrist
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Extensor carpi radialis brevis
Radial nerve, Extesnion and abduction of wrist
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Extesnor carpi radialis longus
radial nerve, extension and abduction of wrist
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Extensor carpi ulnaris
radial nerve, extesion and adduction of wrist
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Extensor digitorum minimi
radial nerve, extension of little finger and wrist
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Extensor digitorum
radial nerve, extension of fingers and wrist
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Extensor pollicus brevis
radial nerve, extension and abduction of the thumb
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Extensor pollicus longus
radial nerve, extension of thumb
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What muscles are in the posterior compartment of the forearm?
Anconeus, supinator, abductor pollicus longus, extesnor muscles
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Quadriceps
Rectus femoris, vastus lateralis, vastus intermedius, vastus medialis, femoral nerve, flex thigh, extend leg
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Sartorius
fermoral nerve, flex thigh and leg, laterally rotate thigh and medially rotate leg
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What are the muscles of the anterior thigh?
Quadriceps (rectus femoris, vastus lateralis, vastus intermedius, vastus medialis), sartorius
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Adductor brevis
obturator nerve, adduction, flexion and lateral rotation of thigh
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Adductor longus
obturator nerve, adduction, flexion and lateral rotation of thigh
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Adductor magnus
obturator and tibial nerves, adduction, extension and lateral rotation of thigh
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Gracilis
obturator nerve, adduction of thigh, flex leg
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Pectinius
obturator and femoral nerves, adduction and flexion of thigh
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What muscles are in the medial thigh?
adductor brevis, adductor longus, adductor magnus, gracilis, pectinius
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Biceps femoris
Long head (tibial nerve) and short head (peroneal nerve), flexion and lateral rotation of leg, extension of thigh
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Semimembranous
tibial nerve, flexion and medial rotation of leg, extension of thigh
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Semitendinous
tibial nerve, flexion and medial roatation of leg, extension of thigh
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What muscles are in the posterior thigh?
biceps femoris, semimembranosis, semitendinosis
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Tensor fascia lata (TFL)
Superior gluteal nerve, tense fascia lata
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Gluteus maximus
inferior gluteal nerve, extension and abduction and lateral rotation of thigh
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Gluteaus medius
superior gluteal nerve, abduction and medial rotation of thigh
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Gluteus minimus
superior gluteal nerve, abduction and medial rotation of thigh
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What muscles are in the lateral thigh?
TFL, gluteus muscles
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Extesnsor digitorum longus
deep peroneus nerve, extension of 4 lateral toes, dorsiflexion and eversion of foot
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Extensor hallicus longus
deep peroneus nerve, extension of big toe, dorsiflexion and inverion of foot
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Tibialis anterior
deep peroneus nerve, dorsiflex and invert foot
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Peroneus tertius
deep peroneus nerve, dorsiflex and evert foot
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What muscles are in the anterior lower leg?
Extensor digitorum and hallicus longus, tibialis anterior, peroneus tertius
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Peroneus brevis
superificial peroneus nerve, eversion and flexion of foot
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peroneus longus
superficial peroneal nerve, eversion and flexion of foot
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What muscles are in the lateral compartment of the lower leg?
Peroneus brevis and longus
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Gastrocnemius
Tibial nerve, Plantar flexion of foot, flexion of leg
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Plantaris
Tibial nerve, plantar flexion of foot, flexion of leg
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Soleus
Tibial nerve, Plantar flexion of foot
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Flexor digitorum longus
Tibial nerve, flexion of 4 lateral toes, plantar flexion and inversion of foot
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Flexor hallicus longus
Medial plantar nerve, flexion of big toe, plantar flexion and inversion of foot
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Popliteus
tibial nerve, flexion and medial rotation of the leg
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Tibialis posterior
tibial nerve, plantar flexion and inversion of foot
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What muscles are in the posterior lower leg?
Gastrocnemius, Plantaris, Soleus, Flexor digitorum longus, flexor hallicus longus, popliteus, tibialis posterior
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What muscles are in the pelvic diaphragm?
pubococcygeus, iliococcygeus, coccygeus, puborectalis, piriformis
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Epiphysis
end of long bones
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Metaphysis
between epiphysis and diaphysis - most vascular growth
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Diaphysis
Shaft of long bone
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Epiphyseal plate
cartilage between end and shaft of bone
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Osteoblast
bone forming cell derived from mesenchyme
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Osteoclast
multinucleated cell that breaks down bone
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Lamella
concentric matrix around osteoblast
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Lacuna
small space or cavity around cells (contains osteocytes), also called lacuna of Howship
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Trabeculae
fibrous strands in medullary compartment that are interconnected
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Haversian system
canal and lamellae concentrically arranged - basic structural unit of compact bone
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volkman's canal
transverse canal in bone - contains nutrient artery
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Clavicle
lateral 1/3 is trapezius attachment, lateral end is acromion process, first bone to begin ossification, trasmits force to the arm, trapezoid line and conoid tubercle are also part of clavicle
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Scapula
spine of scapula at the superior end, root of spine is at T3, coracoid and acromion process and supraglenoid and infraglenoid tubercle are also on scapula
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Humerus
anatomical neck is immediately distal to the head, surgical neck is immediately distal to the anatomical neck, deltoid tuberosity is on the lateral surface of the humerus (deltoid attachment), capitulum, trochlea, lesser tubercle, greater tubercle
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Radius
head articulates with the capitulum of humerus, radial tuberosity, styloid process (part of wrist)
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Ulna
coronoid process, olecranon process, ulnar tuberosity (trochlear notch), head and styloid are part of wrist, radial notch
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Male vs. female pelvis
male pelvic bowl is wider, obturator formaen is circular, upside down martini glass; female pelvic bowl is wider, obturator foramen is cat eyes, upside down margarita glass
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Femur
adductor tubercle on the medial femoral condyle (adductor magnus attaches here), lesser trochanter is the insertion for psoas major muscle, fovea capitus is a small indentation in the head of the femur, the femoral head is directed anterior, superior and medial, greater trochanter, intertrochanteric line, medial and lateral condyles
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Tibia
medial and lateral condyles, medial malleolus, intercondylar eminence and soleal line (posterior tibia)
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Fibula
too short to make up part of the knee joint, lateral malleolus, head of tibia articulates, apex
-
What are the carpal bones?
Scaphoid (proximal row, by thumb, also called navicular), Lunate, Triquetrum, Pisiform (seasmoid bone), Trapezium (greater multangular, distal row), Trapezoid (lesser multangular), Capitate, Hamate, "Some Lovers Try Positions That They Can't Handle"
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Joints of the hand - node - disease
- DIP - Heberden's - OA
- PIP - Bouchard's - RA or OA
- MCP - Haygarth's - RA
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Bones of the foot
Talus (superior), Calcaneus, Navicular (medial), Cuneiforms (medial, middle, lateral), Cuboid (most lateral bone of foot)
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Merti's joint
between tibia and talus
-
Main ankle joint
talocrural joint
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Shoulder ligaments
- Acromioclavicular - acromion --> clavicle
- Coracoacromial - coracoid --> acromion
- Coracoclavicular - Conoid and trapezoid (more lateral) ligaments
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Ligaments of the foot
- Deltoid ligament - medial malleolus --> tarsus (talus, navicular, calcaneous) (tibiotalar, tibionavicular, tibiocalcaneuos)
- Lateral ligament - lateral malleolus --> tarsus (most commonly injured (anterior talofibular, posterior talofibular, calcaneofibular)
- Spring ligament - sustentaculum tali --> navicular (plantar calcaneonavicular)
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Ligaments of the spine
- ALL (anterior longitudinal ligament) - front of anterior bodies from atlas to occiput = anterior atlanto-occipital
- PLL (posterior longitudinal ligament) - back of vertebral bodies (in anterior portion of canal), wider in cervicals, thinner in lumbars, becomes sacrococcygeal, from C2 to occiput = tectoral membrane
- LF (ligamentum flavum) - lamina to lamina (posterior portion of canal), high elastic fiber content
- IS (interspinous) - between the spinous processes
- SS (supraspinous) - from SP to SP, from C7 to occiput = ligamentum nuchae
- TL (transverse ligament) - holds dens in fovea dentalis of atlas (fovea dentalis is on post. side of ant. tubercle of atlas), part of cruciate ligament
- CL (cruciate ligament) - runs from occiput to body of C2 and includes TL
- AL (alar ligament) - from sides of dens to occiput, limits rotation, also called "check ligament"
- AD (apical dental) - from apex of dens to foramen magnum of occiput
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Left coronary artery branches
Muscular, Anterior interventricular, Circumflex "MAC"
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Right coronary artery branches
Muscular, Posterior interventricular, Marginal
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Coronary veins (7)
Great cardiac, middle cardiac, marginal, anterior cardiac, small cardiac, oblique, coronary sinus (most veins empty into this sinus)
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Thoracic aorta supplies
bronchial, esophageal, posterior intercostal arteries --> pharynx and lower respiratory tract
-
Abdominal aorta supplies
left gastric, splenic and hepatic arteries (celiac trunk) --> stomach, duodenum, liver, pancreas, spleen
-
Superior mesenteric artery supplies
midgut, right side of abdomen, small intestine, cecum, appendix, ascending colon, first 2/3 transverse colon
-
Inferior mesenteric artery
hindgut, left side of abdomen, last 1/3 of transverse colon, descending colon, rectum, anus
-
Internal iliac artery supplies
bladder and urethra
-
Pudental artery supplies
genitalia
-
What drains into the superior vena cava (SVC)?
azygous (right abdomen, right and left intercostals and lumbars, begins at L1-2) and hemiazygous (drains left abdomen, begins L1-2, crosses over at T8 to join azygous vein)
-
What drains into the inferior vena cava (IVC)?
external and internal iliac, common iliac (testicles/ovaries, phrenic, suprarenal, renal, hepatic)
-
What does subclavian artery become?
axillary --> brachial (--> profunda brachii) --> radial (--> deep palmar arches) and ulnar (--> superificial palmar arches)
-
What does the axillary artery branch into?
superior thoracic, thoraco-acromial, lateral thoracic, subscapular, anterior and posterior circumflex humeral
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Veins of the arm
Basilic (medial arm), Median (middle arm), and cephalic (lateral arm) all drain into brachial vein --> axillary --> subclavian --> brachiocephalic
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Arteries of the legs
- L4 abdominal aorta --> common iliac --> internal (supplies pelvis) and external iliac --> femoral --> popliteal --> anterior and posterior tibial
- Anterior tibial (front of leg) --> dorsal pedis --> arcuate
- Posterior tibial (back of leg) --> peroneal --> medial and lateral plantar --> plantar arch
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Deep veins of the legs
Medial and lateral plantar --> posterior and anterior tibial --> popliteal --> femoral --> external iliac --> common iliac --> IVC
-
Superificial veins of the legs
- Small saphenous (lateral leg) --> popliteal
- Great saphenous (medial and posterior leg) --> femoral
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Lateral cord of brachial plexus
Anterior division of upper and middle trunk (C5-7) --> ulnar and median nerve
-
Medial cord of brachial plexus
Anterior division of inferior trunk (C7-T1) --> musculocutaneous and lateral head/median nerve
-
Posterior cord of brachial plexus
Posterior divison of all trunks (C5-T1) --> axillary, radial, upper subscapular, middle subscapular (thoracodorsal), lower subscapular nerves
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Lumbar plexus
T12 to L4 --> Ilioinguinal (L1), genitofemoral (L2), lateral femoral cutaneous nerve (L2,3), femoral (L2,3,4), Obturator (L2,3,4) nerves
-
Sacral plexus
L4-S3 --> common peroneal nerve and tibial nerve (together make sciatic nerve)
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