I. Back I
a. Sacralization of lumbar vertebrae- fusion of L5 w/ S1
b. Lumbarization of S1- separate S1 vertebrae
c. Vulnerability of occipito-atlantoaxial joint- broken dens often drives back into spinal cord and paralysis/death
d. Spina bifida- posterior arch of vert(s) missing; can be “silent” save tuft of hair over lumbar region (s.b.occulta)
i. Meningocele- meninges [...]
ARM, AXILLA & BRACHIAL PLEXUS
I. Arm [N.402-3]
Aka. brachium
Extends from the gleno-humeral joint to the elbow (olecranon)
Types of movement
Flexion-extension
Pronation-supination
Contains:1 muscles
4 bones
terminal branches of brachial plexus
brachial artery and branches
facial septum divides arm into two compartments
See attached chart
1. Anterior Compartment (flexor)
Coracobrachialis
Biceps brachii
Brachialis
2. Posterior Compartment (extensor)
Triceps (long, lateral, medial heads)
Anconeus
3. Neurovascular Compartment
Medial aspect of arm
Contains median nerve [...]
I. Boundaries of the Thorax
1. Upper boundary-
Thoracic inlet separates the thorax from the neck
Formed by sternum, first rib, first thoracic vertebra
2. Lower boundary-
Outlet
Formed by diaphragm
II. Subdivision of the Thoracic Cavity
1. Mediastinum
Superior
Inferior: anterior- little, middle- heart, posterior-
2. Pleural cavities
III. Skin
1. Clinically Important
mid-axillary line, clavicle, mid-clavicular line, costal margins, ribs, sternum, sternal angle
2. Cutaneous Innervation/Dermatones [...]
I. Curvatures of the Vertebral Column [N.142]
Early embryo, vertebral column is C-shaped
A. Normal
1. Primary curvatures:
Posterior convexities present at birth
Immobile: attach. to skeletal components (rib cage and pelvis)
Thoracic and Sacral
2. Secondary curvatures:
Anterior convexities that develop after birth
Flexible: lack of skeletal connections
Cervical (child hold head erect) and Lumbar (child stand erect/walk)
B. Abnormal
1. Kyphosis
Exaggerated [...]
Boundaries and Divisions of the Pharynx
§ The pharynx is a muscular tube, which serves as an upward extension of the digestive tube.
§ It also has regions in common with the respiratory systems.
§ It is generally divided into three parts:
(1) nasopharynx, behind the nasal cavity
§ The nasopharynx extends from the pharyngeal recess superiorly to the [...]
HEAD: PAROTID, TEMPORAL, INFRATEMPORAL
Temporal Fossa
§ The temporal fossa is a depression in the lateral skull.
§ It is bordered by the superior temporal line, which is the site of attachment for the fascia investing the temporalis muscle.
§ The area bounded by the inferior temporal line is the site of attachment of the temporalis muscle [...]
Objectives
§ Describe the boundaries of the oral cavity and oropharynx, and their relationships to the soft and hard palate.
§ Describe the muscular organization of the tongue in terms of extrinsic and intrinsic muscles.
§ Describe the relations of the hyoglossus muscle.
§ Describe the sensory and motor innervation to the tongue and structures of the oropharynx.
§ [...]
Neck: Introduction
Boundaries of the Neck
Fascial Compartments of the Neck
Subdivisions of the Posterior Triangle
Nerve Supply
Arterial Supply
Venous Drainage
Boundaries of the Neck
§ The superior boundary of the [...]
NASAL CAVITY
OBJECTIVES
§ Describe the main regions and features of the nasal cavity, including the various points of draining from the nasolacrimal duct and the nasal sinuses.
§ Describe the development and organization of the paranasal sinuses, and the significance of the maxillary sinus.
§ Describe the relationship of the tonsillar tissue of the oropharynx and [...]
LYMPHATICS
OBJECTIVES
§ Describe the major structures of the lymphatic system and the roles that it plays in disease fighting and the distribution of metabolic products.
§ Describe the anatomical relationship to the venous system, and the physiological relationship to the portions of the nervous system mediating the stress response.
§ Describe the major nodal sites in [...]
The skeleton of the larynx
§ The skeleton of the larynx consists of various cartilages plus the hyoid bone.
§ There are three unpaired cartilages:
(1) epiglottic,
(2) thyroid (’shield’)
(3) cricoid.
§ Major paired cartilages are:
(1) arytenoid
(2) corniculate.
§ Pair of cuneiform cartilages within the aryepiglottic folds.
The cartilages function as points of origin and insertion of muscles,
but also provide [...]
THORAX
ANTERIOR MEDIASTINUM AND HEART
(MIDDLE MEDIASTINUM)
Mediastinum
Superior
Inferior : anterior, middle, posterior
Anterior Mediastinum
Posterior to sternum and anterior to pericardium
Contains fat, sternopericardial ligaments, thymus
Middle Mediastinum
Space bounded by pleura containing pericardium, heart, & phrenic nerve
Phrenic nerve [N.182]
From anterior rami of C4 (C3, C5)
Contains postganglioinc symp. axons
Provides motor and sensory nerves to diaphragm
Provides sensory nerves to pericardium
Pericardiacophrenic vessels accompany [...]
FACE
I. Cutaneous Innervation: Trigeminal Nerve (C V) - Main sensory nerve of face
A. Ophthalmic N. (CN V1)- Superior Subdivision / Sensory
1. Frontal n.
a. Supratrochlear n.
b. Supraorbital n.
B. Maxillary N. ( CN V2)- Intermediate Subdivision / Sensory
1. Infraorbital n
a. External nasal n.
b. Superior labial n.
c. Superior alveolar n..
2. Zygomatic n.
a. Zygomaticofacial n.
b. Zygomaticotemporal n.
C. Mandibular N. [...]
ORBIT
The Bony orbit
§ The Orbit is shaped like a cone, with the apex pointing posteromedially.
§ The medial walls of the orbits (M) are parallel
§ lateral walls (L) are perpendicular to one another–important in understanding action of extra-ocular muscles.
Surface Anatomy
§ picture
The Eyelids: Layers
§ Skin
Thin and delicate
§ Muscular layer
Made up of orbicularis oculi [...]
The Bright Light Effect - Pupillary Reflex:
Sensing the light
retinal ganglion
optic nerve
optic canal
optic chiasm
optic tract
lateral geniculate ganglia and midbrain
Constricting the pupil
somatic complex of Oculomotor nerve sends parasympathetic fiber toward left AND right eye
superior orbital fissure
ciliary ganglion
short ciliary nerves of V1
sphincter muscle of pupil
Sensing particles touching cornea
cornea sends afferent fibers through long [...]
Parts of the Ear
§ The external ear
consists of the auricle and the external auditory canal, which leads to the tympanic membrane.
§ The middle ear
consists of the tympanic membrane and the tympanic cavity
connected to the nasopharynx through the auditory (Eustachian) tube.
§ The inner ear
consists of the bony labyrinth, which encloses the cochlea and the [...]
MUSCLES OF THE BACK
Extrinsic Back Muscles (superficial and intermediate) Superficial m: [N.160] attach upper extremity to vertebral column
Trapezius m. deep to surface: Spinal accessory nerve (CN XI)
Superficial branch of the transverse cervical artery & vein
Latissimus dorsi m.
Levator scapulae m.
Rhomboid major and minor m.
Triangle of ascultation
trapezius m., latissimus dorsi m, medial [...]
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