Download Complete Dream Sheet II Spr. 04

Dream sheet for exam II. Know the following:
1) 20% of this exam is from exam I material
2) Know your vocabulary words
3) What is the tectorial membrane
Membrana-tectoria - occipito-axial ligament, tectorial membrane - continuation of the posterior
longitudinal ligament; attaches on the occipital bone medial to the hypoglossal canal; closely adherent to the cranial
dura (line of brain) once inside the cranial vault. From C2 to Sacrum.
4) What are the attachments for the inguinal ligament
Inguinal ligament - fallopian ligament; Poupart's ligament;a fibrous band formed by the inferior border of
the aponeurosis of the external, ASIS to pubic tubercle, inferior aspect of external abdominal oblique muscle. A
thickened aspect of the EAO. N 243
5) Know the components of the cruciate ligament of the upper cervical spine
Cruciate ligament “cross-shaped”, AKA cruciform lig. - 3 components
–
–
–
transverse ligament of the atlas - lateral mass over posterior aspect of dens to lateral mass
cranial crus (SLB) - attaches central portion of the transverse ligament to ant. margin of FM
caudal crus (ILB) - attaches central portion of the transverse ligament to posterior body of axis
6) Be able to give examples of the various synovial joint classifications
Z-Joints -Synovial, Diarthrodial, Plane, Gliding, Multiaxial
TMJ- Synovial, diarthrodial, hinge, gliding, multiaxial
Sternoclavicular Joint - Synovial, diarthrodial, gliding, multiaxial
Glenohumeral Joint - Synovial, diarthrodial, ball and socket, spheroid, multiaxial
7) Know the ligaments of the hip joint
Synovial, diarthrodial, spheroid, ball and socket, multiaxial
Ligaments of the hip
– Iliofemoral ligament - “Y” ligament of Bigelow
• AIIS to intertrochanteric line, prevents hyperextension
– Pubofemoral ligament
• pubis to intertrochanteric line, limits hyperextension and abduction
– Ischiofemoral ligament
• ischium to greater trochanter, limits hyperextension
– Round ligament - ligamentum teres –ligament of the head of the femur- intrinsic ligament, fovea capitis of femur to transverse acetabular ligament
–Transverse acetabular ligament
- crosses the acetabular notch, connects joint capsule to ligamentum capitis femoris
8) Know Dr. Jim’s principles
No philosophy by which a person can do a thing, if he thinks he can’t.
9) What are the characteristics of skeletal muscle
Irritability
Contractibility
Extensibility
Elasticity
Respond to a stimulus
Muscles contract (shortened)
Stretch
Recoil
10) Define agonist and antagonist as relates to muscle
** MUSCLES ONLY PULL **
Concept of agonist and antagonist and other muscle groups
Agonist
Antagonist
Synergist
Flexors
Extensors
Fixators
The primary mover of a joint (i.e. biceps brachii)
Actions opposite of agonist (i.e. triceps brachii)
Muscles work together
Flex a joint
Extend a joint
Steady the proximal portions of a limb while movement
is occurring in the distal part.
11) Know examples of muscles architecture and fiber arrangement
Parallel
Strap-like, good endurance, not strong; ie. Sartorius m.,
rectus abdominis m.
Fan shaped, focuses force of contraction to a single
point; gluteal mm.
Close body openings; orbicularis oris m.
Fibers converge on a tendon, 3 types, unipennate,
bipennate and multipennate
w/ parallel fibers, often associated with an aponeurosis,
external oblique m.
Has a specific shape, round and thick and tapers at the
ends, biceps brachium
Convergent
Sphincter
Pennate
Flat (strap)
Fusiform muscle
12) Know the action and innervation of the muscles of facial expression
MUSCLE
Epicranius
frontalis
Orbicularis
oculi
Nasalis
MUSCLE
GROUP
Facial
Expression –
axial
skeleton
Facial
expression –
axial
skeleton
Facial
ACTION
ORIGIN
INSERTION
INNERVATION
Wrinkles
the forehead
CN VII
Closes the
eye
CN VII
Widens the
CN VII
Risorius
Orbiucularis
oris
Procerus
Levator labii
superioris
Zygomatic
Depressor
anguli oris
Depressor labii
inferioris
Levator
palpebreae
superioris
expression –
axial
skeleton
Facial
expression –
axial
skeleton
Facial
expression –
axial
skeleton
Facial
expression –
axial
skeleton
Facial
expression –
axial
skeleton
Facial
expression –
axial
skeleton
Facial
expression –
axial
skeleton
Facial
expression –
axial
skeleton
Facial
expression –
axial
skeleton
nostrils
Draws angle
of mouth
laterally
CN VII
Pucker
muscle
CN VII
Pulls
eyebrows
medially
and down
“Elvis”
muscle
CN VII
Smile
muscle
CN VII
Frown
muscle
CN VII
“pout”
muscle
CN VII
Raises
upper lid
CN III
CN VII
13) Know the action, attachments and innervation of the muscles of mastication
Muscles that elevate the mandible
MUSCLE
MUSCLE
GROUP
Masitication –
axial skeleton
Elevates the
mandible
Masseter
Masitication –
axial skeleton
Elevates the
mandible
Medial
pterygoid
Masitication –
axial skeleton
Elevate the
mandible
and move
mandible
laterally
Temporalis
ACTION
ORIGIN
Temporal
fossa,
temporal
lines
Zygomatic
arch
Sphenoid
bone
INSERTION
INNERVATION
Coronoid
process of the
mandible
(V3) of CN V
Lateral portion
of the ramus of
the mandible
Medial aspect of
mandible
(V3) of CN V
(V3) of CN V
14) Which muscles depress the mandible
MUSCLE
Platysma
MUSCLE
GROUP
Muscles of the
neck – axial
skeleton
Digastric
Muscles of neckSuprahyoid
muscle – axial
skeleton
Lateral pterygoid
Masitication –
axial skeleton
ACTION
ORIGIN
INSERTION
INNERVATION
Depresses the
mandible and
lower lip and
tenses the skin
of the anterior
neck, shriek
Opens mouth
(depresses
mandible) and
elevates hyoid
bone
Fascia of the
neck
Inferior border of
the mandible
CN VII
Anterior bellyinferior border
of anterior
mandible
Posterior belly
– mastoid
process of
temporal bone
Hyoid bone
Anterior belly – CN
V (V3)
Posterior belly – CN
VII
Protracts the
mandible
Slightly
depresses
Sphenoid bone
Anterior side of
condylar process
of mandible
(V3) of CN V
15) What muscles attach to the mastoid process of the temporal bone
MUSCLE
Sternocleidomastoid
MUSCLE
GROUP
Muscles of the
neck – axial
skeleton
ACTION
ORIGIN
INSERTION
INNERVATION
Flexes neck,
extends head,
turns head to
side
Extend and
laterally flex
head and neck,
slight rotation
Manubrium and
clavicle
Mastoid
process of the
temporal bone
CN XI, C 2,3
(spinal nerves)
Lower ½ of
nuchal
ligament, SP’s
of C7 to T4
Anterior bellyinferior border
of anterior
mandible
Posterior belly
– mastoid
process of
temporal bone
Articular
process of C5C7, TP’s of T1T5
Lateral aspect
superior
nuchal line
and mastoid
process
Hyoid bone
Splenius capitis
Superficial
intrinsic muscle
group
Digastric
Muscles of neckSuprahyoid
muscle – axial
skeleton
Opens mouth
(depresses
mandible) and
elevates hyoid
bone
Longissimus capitis
Intrinsic back
muscle –
intermediate
intrinsic - Erector
spinae group –
intermediate
column
Extend and
laterally flex the
spine
Mastoid
process of the
temporal bone
Anterior belly –
CN V (V3)
Posterior belly –
CN VII
Sternocleidomastoid
Muscles of the
neck – axial
skeleton
Flexes neck,
extends head,
turns head to
side
Manubrium and
clavicle
Mastoid
process of the
temporal bone
CN XI, C 2,3
(spinal nerves)
16) Know the action and innervation of the extrinsic ocular muscles
MUSCLE
Superior oblique
Lateral rectus
Inferior oblique
MUSCLE
GROUP
Extrinsic
ocular – axial
skeleton
Extrinsic
ocular – axial
skeleton
Extrinsic
ocular – axial
skeleton
ACTION
ORIGIN
INSERTION
INNERVATION
Rotates pupil
down and out
CN IV
Pulls pupil
laterally
CN VI
Rotates pupil
up and out
CN III
17) What nervous tissue structures are associated with the scalene mm.
Brachioplexus nerve – supplies feeling to the upper limbs; if this nerve is pressed by scalene m. spasms patient will
feel tingling sensation down their arm
Phrenic nerve – between anterior and middle scalene m. - associated with diaphragm, breathing problems,
hiccups…
Diaphragm m. - separates thorax from abdomen; ↑ volume of thoracic cavity and ↓ pressure; pulls air in; breathing
in is active; breathing out is passive; innervated by the phrenic nerve – C 3, 4, 5 keep the diaphragm alive; attaches
to the sides of the 1st 3 lumbar vertebrae
Muscles of inspiration
External intercostals m
Interchondral m (of internal intercostals)
Muscles of expiration
Internal intercostals m
18) Know the muscles of the abdominal wall and associated structures
MUSCLE
External
abdominal
oblique
Internal
abdominal
oblique
MUSCLE
GROUP
Muscles of
the
abdominal
wall – axial
skeleton
Muscles of
the
abdominal
wall – axial
ACTION
Compresses
abdominal
contents,
lateral
rotation,
draws thorax
downward
Compresses
abdominal
contents,
lateral
ORIGIN
INSERTION
Lower 8 ribs
Iliac crest and
linea alba
Iliac crest,
inguinal
ligament,
fascia of
Linea alba and
costal
cartilage of
last three ribs
INNERVATION
NOTES
Fibers
obliquefibers run
superior
lateral ;
inferior
medial
Fibers go
posterior
medial to
anterior
skeleton
Transverse
abdominis
Muscles of
the
abdominal
wall – axial
skeleton
rotation,
draws thorax
downward
Compresses
the abdominal
contents
back
Iliac crest,
inguinal
ligament,
lumbar
fascia, costal
cartilage or
last 6 ribs
medial
Xyphoid
process, linea
alba, pubis
(love
handle
area)
19) What is the function of the diaphragm
Diaphragm m. - phrenic nerve, C3, 4, 5 (“C3, 4, 5 keep the diaphragm alive.”) ( Beef fajitas are made of skirt
steak which is nothing but diaphragm. ) - posterior aspect of xyphoid process, lower 6 ribs, right crus attaches to
sides of 1st 3 lumbar vertebrae and associated IVD’s and the left crus attaches to sides of bodies of first 2 lumbar
vertebrae and IVD’s.
External intercostal mm. - elevate ribs, increasing width of thoracic cavity for inspiration, thereby increasing the
volume of the thoracic cavity and creating negative pressure, drawing air in.
Internal intercostal mm. - two parts
•interchondral part - elevates the ribs for inspiration. In quiet breathing, expiration is a passive process due to the
recoil of these muscles.
•intercostal part - decreases width of thoracic cavity for active (forced) expiration. Asthmatics have well developed
internal intercostals to help them force the air out.
20) Know the muscles that attach to the atlas, the axis.
Muscles that attach to the upper cervical vertebrae
MUSCLE
Splenius
cervicis
Interspinalis
MUSCLE
GROUP
Intrinsic back
muscle-Superficial
intrinsic muscle
group- splenius m.
Intrinsic back
muscle –
interspinal
ACTION
ORIGIN
Laterally
flex neck
and extend
neck
Extend and
laterally
flex the
spine
Spinous
processes
of T3 to T6
Spinous
process
INSERTION
Posterior
tubercles of
TP’s of C1 to
C3 (C4)
Spinous
process
NOTES
Fibers run
superior and
lateral - bandage
Well developed
in the cervical
region from C2
to T1, relatively
lacking in the
thoracic region
and then well
developed in the
lumbar region
Multifidus
Intrinsic back
muscle transversospinalis
-multifidus
Extend and
laterally
flex the
spine
Semispinalis
cervicis
Intrinsic back
muscle transversospinalis
– semispinalis
Intrinsic back
muscle –
intermediate
intrinsic - Erector
spinae group –
intermediate
column
Extend and
laterally
flex the
spine
Extend and
laterally
flex the
spine
Longissimus
cervicis
TP’s from
L5 to T1,
lamina of
vertebrae
from S4 to
C2, and
articular
processes
from C6 to
C4
TP’s of T1T6
Spinous
process 2-4
vertebral
segments
superior to
origin
TP’s of
upper 4
thoracic
vertebrae
TP’s C2-C6
Thickest in the
lumbar region,
basically one
single muscle
SP’s of C2-C5
Muscles of the suboccipital triangle
MUSCLE
Rectus capitis
posterior
major
MUSCLE
GROUP
Muscle of the
suboccipital
triangle
Rectus capitis
posterior
minor
Muscle of the
suboccipital
triangle
Obliquus
capitis
Muscle of the
suboccipital
triangle
Obliquus
capitis
superior
ACTION
Extend and
rotate head
ORIGIN
INSERTION
INNERVATION
Spinous
process of the
axis
Inferior
nuchal line of
the occipital
bone
Medial
portion of
inferior nuchal
line of
occipital bone
Transverse
process of the
atlas
Suboccipital
nerve, dorsal
ramus of C1
Posterior
tubercle of
the atlas
Extend and
rotate the
atlantoaxial
joint
Spinous
process of the
axis
Transverse
process of the
atlas
Occipital one
between
superior and
inferior nuchal
lines
21) Understand the composition and classifications of sutural joints
Synarthrosis, Fibrous joints – joined by fibrous connective tissue
Suture - found only in the skull
•serrate suture - sawlike interlocking articulations
•squamous - edges overlap
•plane - edges are smooth and do not overlap
NOTES
Superior
medial leg
of SOT
Superior
medial leg
of SOT
Inferior
leg of
SOT
Superior
leg of
SOT
22) Understand the composition of cartilaginous joints
Cartilaginous Joint
•Primary Cartilaginous Joint - synchondrosis
–Synostosis, epiphyseal plates, costochondral articulations of first rib and manubrium
•Secondary Cartilaginous Joint – symphysis, or amphiarthrosis
–symphysis pubis, *intervertebral joint*, manubriosternal joint
23) Know the ligaments of the spine
Syndesmosis of the spine
– Interspinous ligament - between spinous processes
– Supraspinous ligament - connects tips of spinous processes from C7 - S1 (first sacral tubercle)
– Ligamentum nuchae - direct continuation of the supraspinous ligament, from EOP and median nuchal crest to
C7
– Ligamentum flavum, Anterior longitudinal ligament and
Posterior longitudinal ligament
25) Understand the uncovertebral joint
Joint of Luschka
•
•
•
•
Uncovertebral joint
Diarthrosis, synovial
Between the uncinate processes and a small indentation found on the inferior surface of the vertebra it articulates
with
Typically undergo degeneration with resulting bony outgrowth which may encroach on neighboring structures
such as the vertebral artery and the exciting spinal nerves “bone spurs”
26) Know the composition of an IVD
•
Intervertebral Disc
– 23 total
–
–
•
25% of the height of the vertebral column
lordotic curve areas - disks are thicker anterior
Components
–
–
Annulus fibrosus - peripheral portion, fibrocartilage
Nucleus pulposus - 88% H2O at birth, 70% at age 70
27) Classify and understand the movements of the TMJ
•
•
•
•
Synovial, diarthrodial, hinge, gliding, multiaxial
Components - articular disc fibrocartilage
Articular surfaces lined with fibrocartilage
Movement – depression and elevation - hinge
– protraction and retraction - gliding
– lateral rotation
28) Which joints become synostotic with age?
Primary Cartilaginous Joints - synchondrosis
29) Classify the hip joint
Synovial, diarthrodial, spheroid, ball and socket, multiaxial
30) Understand the composition of the knee joint and its classifications
Tibiofemoral - Stifle Joint
•
•
•
Largest and most complex joint of body,
Synovial, diarthrodial, “modified hinge”, biaxial
Classified as a double condyloid joint, capable of flexion, extension and medial and some lateral rotation
• Hyperextension of knee –
- foot on ground - medial rotation of femur ( pull knee back)
- foot NOT on ground – lateral rotation of the tibia ( kick ball)
•
•
•
•
•
Ligaments
– Function
• control excessive knee extension
• control abduction and adduction stresses
• control anterior and posterior displacement of tibia on femur
• control medial and lateral rotation of tibia beneath femur
• give rotatory stabilization
Lateral and medial patellar retinacula - tendinous insertion of quadriceps femoris m. Gives anterior stability.
Attaches to patella and tibial tuberosity
Oblique popliteal ligament - posterior aspect of joint capsule, provides posterior stability and limits
hyperextension.
Arcuate popliteal ligament - Head of fibula over tendon of popliteus m. to intercondylar area of tibia and lateral
epicondyle of femur. Limits hyperextension of knee, and posterior stability.
Collateral Ligaments - provide medial and lateral stability
– Medial (tibial) collateral ligament
– Lateral (fibular) collateral ligament
31) Understand the cruciate ligaments of the knee joint
•
Cruciate ligaments
–
–
Anterior cruciate ligament
• Anterior tibia to posterior medial aspect of the lateral condyle of the femur
• Prevents anterior displacement of the tibia on the femur
• During extension of the knee the ACL is pulled taut
• Torn ACL = Anterior drawer sign
Posterior cruciate ligament
• Posterior tibia to lateral aspect of medial condyle of femur, prevents posterior displacement of the tibia.
• Shorter and less oblique than ACL
• During flexion of the knee the PCL is pulled taut
• Torn PCL = Posterior drawer sign
32) How do you tell a right patella from a left one?
Place patella on flat surface with the apex pointed away from you. As if you were to take the patella and
place it on you knee (pointed side towards your foot). After that let go of patella and it will lean to one side either
Left or Right. The side it leans to is the correct patella.
33) Understand the shoulder joint
•
•
•
•
•
•
Synovial, diarthrodial, ball and socket, spheroid, multiaxial
Components
– head of the humerus and the glenoid fossa of the scapula, most freely moveable joint in the body
Ligaments
– coracohumeral ligament - coracoid process to greater tubercle of humerus
– glenohumeral ligament - thickenings of joint capsule
– transverse humeral retinaculum - from greater tubercle to lesser tubercle of humerus, holds bicipital tendon in
place
Protected from trauma from above by:
– acromion, coracoid process, lateral aspect of the clavicle
Bursae
– subdeltoid bursa - between deltoid m and joint capsule
–
subacromial bursa - between acromion and joint capsule
Rotator cuff muscles - musculotendinous cuff
–
–
–
–
Supraspinatus m. - support from above
Infraspinatus m. - support from posterior
Teres minor m. - support from posterior
Subscapularis m. - support from anterior