Anat Mcq 25, 26, 27

Front 1

clinical significance of maxillary sinus roof fracture

Back 1

-maxillary sinus roof is the orbital floor

-anterior superior alveolar nerve closely relates to this

-damage to this can cause reduced sensation of maxillary incisors and canines

Front 2

course of spinal accessory nerve in neck

Back 2

-virtually bisects the posterior triangle, running in the floor deep to pre-vertebral fascia and superior border of trapezius

Front 3

CNIV

Back 3

-trochlear nerve

-super oblique of the eye (via GSE axons)

-smallest CN, with greatest intracranial length

-only nerve that exits from the dorsal aspect of brainstem

Front 4

afferent path of sneeze reflex

Back 4

maxillary nerve V2

Front 5

motor nuclei of facial nerve

Back 5

pons, ventrolateral part

Front 6

sensory root of facial nerve

Back 6

-nervus intermedius

-located between the motor component of CNVII and CNVIII

-sensory and parasympathetic fibers of CNVII

-upon reaching the facial canal, it joins with the motor root of the facial nerve at the geniculate ganglion

Front 7

occulomotor nerve palsy

Back 7

'down and out'

temporal deviation - weakness of MR

downward deviation - unopposed SO (IV)

ptosis - weakness of levator palpebrae

mydriasis- weakness of spinchter pupillae

(vertical deviation) - weakness of SR/IO/IR

Front 8

surgical third nerve palsy vs medical third nerve palsy

Back 8

-surgical 3rd nerve palsy has mydriasis

-medical 3rd nerve palsy does not

-surgical 3rd nerve palsy is compressive, medical more often ischaemic

-SNS fibres that innervate iris are on the outside of the nerve bundle

Front 9

where does the nasolacrimal duct open into?

Back 9

inferior meatus of nose

Front 10

branches of opthalmic division of trigeminal nerve

Back 10

5 branches

2 of which have sympathetic and sensory fibres

Front 11

muscles of mastication

Back 11

-masseter, temporalis, pterygoids

-supplied by trigeminal nerve V3

Front 12

BLOOD SUPPLY TO NOSE

5 principal vessels

Back 12

-anterior ethmoidal artery

-posterior ethmoidal artery

-sphenopalatine artery

-greater palatine artery

-septal branch of superior labial artery

Front 13

origin of ant/post ethmoidal artery

Back 13

opthalmic artery

Front 14

origin of septal branch of superior labial artery

Back 14

facial artery

Front 15

what is Kiesselbach/Little's area?

Back 15

-anastomosis between arterties of nose

-anterioinferior part of nasal septum

-90% of epistaxis occurs from here

Front 16

arteries anastomosing at Kiesselbach/Little's area

Back 16

anterior/posterior ethmoidal

sphenopalatine

greater palatine

septal branch of superior labial artery

Front 17

venous drainage of nose

Back 17

-submucosal venous plexus deep to nasal mucosa drains into sphenopalatine, facial and opthalmic vv

-important for thermoregulation

-external nose drains into facial vein via angular/lateral nasal vv

-communicates with cavernous sinus

Front 18

ARTERIAL SUPPLY TO NOSE

course of sphenopalatine artery

Back 18

-originates from maxillary artery

-passes through sphenopalatine foramen

Front 19

PARANASAL SINUSES

frontal sinus location, drainage, innervation

Back 19

-lie between outer/inner tables of frontal bone

-drain through frontonasal duct into ethmoidal infundibulum

-ethmoidal infundibulum opens into semilunar hiatus of middle nasal meatus

-innervated by supraorbital nn (CNV1)

Front 20

PARANASAL SINUSES

ethmoidal sinus location, drainage, innervation

Back 20

-invaginations of mucous mb of middle/superior nasal meatus into ethmoid bone

-between nasal cavity and orbit

-anterior cells drain into middle meatus

-middle cells drain into middle meatus

-posterior cells drain into superior meatus

-innervated by nasociliary nerve (CNV1)

Front 21

PARANASAL SINUSES

frontal sinus location, drainage, innervation

Back 21

-located in body of sphenoid, unevenly divided

-posterior ethmoidal arteries and posterior ethmoidal nerve supply the sinuses

-closely relate to optic nerves, optic chiasm, pituitary gland, ICAs and cavernous sinuses

Front 22

PARANASAL SINUSES

maxillary sinus

Back 22

-largest paranasal sinuses, occupy bodies of maxilae

-communicate with middle nasal meatus via the maxillary ostia

-arterial supply via maxillary artery

-innervation via maxillary nere

Front 23

PARANASAL SINUSES

maxillary sinus boundaries

Back 23

ROOF; formed by floor of orbit

APEX; extends toward and often into zygomatic bones

BASE; forms inferior part of lateral wall of nasal cavity

FLOOR; formed by alveolar part of maxilla

Front 24

origin of sphenopalatine artery and greater palatine arteries

Back 24

maxillary artery

Front 25

PARANASAL SINUSES

maxillary sinus arterial supply

Back 25

-superior alveolar branches of maxillary artery

-branches of descending and greater palatine arteries supply the floor of the sinus

Front 26

PARANASAL SINUSES

maxillary sinus innervation

Back 26

-anterior, middle and posterior superior alveolar nerves

-branches of maxillary nerve CNV3

Front 27

TYPICAL CERVICAL VERTEBRAE

Back 27

-small vertebral body, longer in transverse than AP dimension

-superior surface concave, inferior convex

-large triangular vertebral foramen

-transverse foramina for vertebral vessels

-superior facets directed superoposteriorly

-inferior facets directed inferoposteriorly

-short, bifid spinous processes

Front 28

ATYPICAL CERVICAL VERTEBRAE

C1 : ATLAS

Back 28

-ring-like, kidney-shaped bone

-no spinous process

-two lateral masses connected by ant/post arches

-concave superior articular facets receive occipital condyles

Front 29

ATYPICAL CERVICAL VERTEBRAE

C2 : AXIS

Back 29

has peg-like dens (odontooid process) prokecting superiorly from body

Front 30

ATYPICAL CERVICAL VERTEBRAE

C7: VERTEBRA PROMINENS

Back 30

-long spinous process, not bifid

-transverse processes are large, transverse foramina are small

Front 31

ATLANTO-OCCIPITAL JOINTS

Back 31

-between superior articular surfaces of the lateral masses of the atlas and the occipital condyles

-permit forward and lateral flexion

-synovial joints

-cranium/atlas connected by anterior and posterior atlanto-occipital membranes

-anterior ligaments stronger than posterior

Front 32

ATLANTO-OCCIPITAL JOINTS

attachments of atlanto-occipital membranes

Back 32

-anterior and poterior arches of C1

-inferior margins of foramen magnum

Front 33

ATLANTO-AXIAL JOINTS

Back 33

-three articulations (right, median, left)

-lateral between inferior facets of lateral masses of C1/superior facets of C2 (gliding synovial joint)

-median between dens of C2/anterior arch of atlas (pivot type of joint)

Front 34

ATLANTO-AXIAL JOINTS

ligaments (5)

Back 34

-transverse ligament of the atlas

-longitudinal bands

-cruciate/cruciform ligament

-alar ligaments

-tectorial membrane

Front 35

tectorial membrane

Back 35

-continuation of posterior longitudinal ligament

-runs from body of C2 to internal surface of occiptal bone

Front 36

anterior atlanto-occipital membrane

Back 36

-continuation of anterior atlanto-axial membrane (and anterior longitudinal ligament)

Front 37

posterior atlanto-occipital membrane

Back 37

-continuation of posterior atlanto-axial membrane (and ligamentum flavum)

Front 38

what are the alar ligaments?

Back 38

-extend from sides of dens to lateral margins of foramen magnum

-short, rounded cords, approx 0.5cm in diameter

-attach cranium to vertebra C1

-prevent excessive rotation of head

Front 39

in which plane do the facet joints in the lumbar spine face?

Back 39

AP plane

directed posteromedially

Front 40

structure of sacrum

Back 40

-five fused sacral vertebrae

-sacral canal is continuation of vertebral canal

-sacral canal contains cauda equina

-four pairs of sacral foramina for exits of the posterior and anterior rami of spinal nerves

Front 41

transverse ligament of the atlas

Back 41

-strong band extending between the tubercles on the medial aspects of the lateral masses of C1

-cross with longitudinal bands to form cruciform ligament

Front 42

longitudinal bands

Back 42

vertically oriented

SUPERIOR; from transverse ligament to occiput

INFERIOR; from transverse ligament to C2 body

together with transverse ligament forms cruciform ligament

Front 43

ligamentum flavum

Back 43

posteriorly located

joints borders of adjacent laminae

Front 44

which ligaments does the needle pass through for a lumbar puncture?

Back 44

SUPERFICIAL

supraspinous ligament

interspinous ligament

ligamentum flavum

DEEP

Front 45

anatomical relationship of uncovertebral joint and intervertebral foramina

Back 45

the uncovertebral joints lie just anterior to the intervertebral foramina

Front 46

what is meant by the term secondary lordotic curvature

Back 46

a normal lordotic curvature e.g. C and L spine

Front 47

what type of joint is the atlanto-occipital joint?

Back 47

synovial

Front 48

movements of atlanto-occipital joint

Back 48

-flexion-extension

-minor lateral flexion

-no rotation

Front 49

arterial supply to vertebral areas

Back 49

-vertebral/ascending arteries in neck

-segmental arteries in trunk

-posterior intercostal arteries in thoracic region

-subcostal and lumbar arteries in abdomen

-iliolumbar, lateral, medial sacral arteries in pelvis

Front 50

venous drainage of vertebra

Back 50

-enters external/internal venous plexuses

-anterolateral drainage from external aspects of the vertebrae into segmental veins

-vertebral canal contains dense internal vertebral venous plexus

-basivertebral veins from the vertebral body drain primarily into anterior internal vertebral venous plexus

Front 51

arteries supplying spinal cord

Back 51

vertebral

ascending cervical

deep cervical

intercostal

lumbar

lateral sacral

Front 52

longitudinal arterties supplying spinal cord

Back 52

anterior spinal artery

left posterior spinal artery

right posterior spinal artery

Front 53

surgical relevance of pyramidalis muscle

Back 53

while making a longitudinal incision for classical caesarean section the pyramidalis is used to determine the midline and location of linea alba

Front 54

structures passing through deep inguinal ring

Back 54

spermatic cord

genital branch of genitofemoral nerve

Front 55

contents of spermatic cord

3 arteries, 3 veins, 3 nerves, 3 facias, 3 others

Back 55

aa: testicular, cremasteric, artery to vas
vv: pampiniform plexus, cremasteric, vein of vas
nn: genital branch of genitofemoral, sympathetics, ilioinguinal
fascias: external spermatic, cremasteric, internal spermatic
others: vas deferens, lymphatics, tunica vaginalis

Front 56

where do fibres of the transversus abdominus arise from on the inguinal ligament?

Back 56

lateral 1/3 of inguinal ligament

Front 57

inguinal canal boundaries mnemonic

MMAALLTT

Back 57

superior wall/roof has 2 muscles

-internal oblique Muscle

-transverse abdominus Muscle

Front 58

inguinal canal boundaries mnemonic

MMAALLTT

Back 58

anterior wall has 2 aponeuroses

-Aponeurosis of external oblique

-Aponeurosis of internal oblique

Front 59

inguinal canal boundaries mnemonic

MMAALLTT

Back 59

lower wall/floor has 2 ligaments

-inguinal Ligament

-lacunar Ligament

Front 60

inguinal canal boundaries mnemonic

MMAALLTT

Back 60

posterior wall has two 'Ts'

-Transversalis fascia

-conjoint Tendon

Front 61

which of these structures does the transversalis fascia contribute to?

- anterior wall of inguinal canal

- deep inguinal ring

- sac of indirect inguinal hernia

- superficial inguinal ring

Back 61

deep inguinal ring

Front 62

appendix testis

Back 62

-also called hydatid cyst of morgagni

-vestigial remnant of mullerian duct

-upper pole of testis

-attached to tunica vaginalis

-present in 90% of people

Front 63

layers of abdominal wall

Back 63

skin

camper's fascia

scarper's fascia

rectus sheath

EOM / IOM / TAM

transversalis fascia

extraperitoneal fat

parietal peritoneum

Front 64

rectus abdominis OINA

Back 64

O- pubic symphysis/pubic crest

I- xiphoid process, 5/6th costal cartilages

N- thoracoabdomninal nn

A- forward flexor of lumbar vertebrae, antilordotic

Front 65

transversus abdominis OINA

Back 65

O- internal surfaces of 7-12th ccs, thoracolumbar fascia, iliac crest, lateral 1/3 inguinal ligament

I- linea alba w/ aponeurosis of IOM, pubic crest, pecten pubis via conjoint tendon

N-thoracoabdominal nn

A- compresses/supports abdominal viscera

Front 66

internal oblique OINA

Back 66

O- thoracolumbar fascia, anterior 2/3 of iliac crest, lateral 1/2 of inguinal ligament

I- inferior borders of 10-12th ribs, linea alba, pecten pubic via conjoint tendon

N- thoracoabdominal nn

A- compresses/supports abdominal viscera, flexes and rotates trunk

Front 67

external oblique OINA

Back 67

O- external surfaces of 5-12th ribs

I- linea alba, pubic tubercle, anterior 1/2 iliac crest

N- thoracoabdominal nn

A- contralateral rotation of trunk

Front 68

transpyloric plane landmarks

Back 68

-transverse plane

-midway between sternal notch and pubic symphysis

-midway umbilicus and xiphisternum

Front 69

transpyloric plane intersections: neural

Back 69

terminus of spinal cord

Front 70

transpyloric plane intersections: bony

Back 70

L1 vertebra

Front 71

transpyloric plane intersections: intraperitoneal

Back 71

pylorus of stomach

fundus of gallbaladder

pancreatic body

D1

duodenojejunal flexure

root of transverse colon

spleen

Front 72

transpyloric plane intersections: retroperitoneal

Back 72

pancreatic body

Rt/Lt flexure of colon

Lt/Rt renal hylum

Front 73

retroperitoneal organs mnemonic

SAD PUCKER

Back 73

Suprarenal gland/Aorta/IVC/ Duodenum (D2/D3)

Pancreas

Ureters

Colon (ascending/descending)

Kidneys

Oesophagus

Rectum

Front 74

transpyloric plane intersetions: vascular (2)

Back 74

-origin of SMA from Ao

-termination of superior mesenteric vein at hepatic portal vein

Front 75

ANTEROLATERAL ABDOMINAL WALL VESSELS

branches of internal thoracic vessels

Back 75

superior epigastric

musculophrenic

Front 76

ANTEROLATERAL ABDOMINAL WALL VESSELS

branches of external iliac vessels

Back 76

inferior epigastric

deep circumflex iliac

Front 77

ANTEROLATERAL ABDOMINAL WALL VESSELS

branches of femoral artery and greater saphenous vein

Back 77

superficial circumflex

superficial epigastric

Front 78

ANTEROLATERAL ABDOMINAL WALL VESSELS

branches of subcostal vessels

Back 78

anterior branches of subcostal vessels

Front 79

deep inguinal ring

Back 79

-mid point of pubic tubercle and ASIS

-envagination of transversalis fascia

-extraperitoneal ductus deferens and testicular vessels (males)/round ligament (females) pass into inguinal canal through it

-transversalis fascia forms internal fascia of inguinal canal

Front 80

superficial inguinal ring

Back 80

-exit through which spermatic cord or round ligament emerges from inguinal canal

-split occuring in diagonal, paralell fibres of external oblique aponeurosis

-margins of superficial rings formed by crura

-lateral crus attaches to pubic tubercle

-medial crus attaches to pubic crest

-intracrural fibres keep aperture open

Front 81

layers of scrotum mnemonic

Some Damn Englishman Called It The Testis

Back 81

Skin

Dartos/fascia

External spermatic fascia

Cremaster/fascia

Internal spermatic fascia

Tunica vaginalis

Tunica albuginea

Front 82

vertebral level for testicular branch of AA

Back 82

L2