Module 2 Saturday

Front 1

Back 1

Front 2

blood supply to the rectum

Back 2

superior rectal an (caval) from IMA, aorta
-supplies the viscera portion superior to the pectinate line
middle rectal from int iliac
-anastamoses with both superior and inferior
inferior rectal av (caval)from internal pudendal, int iliac
-supplies below the pectinate line, somatic area

Front 3

blood supply to female genitalia

Back 3

uterine artery from int iliac (traveling via broad ligament)
--uterus, fallopian tube, #ovarian artery
ovarian artery from abd aorta (traveling via suspensory ligament made from traveling through perineum
-ovaries, uterine fundus
vaginal artery from int iliac (fem's inf vesicle a)
-vaginal canal and adj.bladder and rectum
internal pudendal from int iliac
-supplies inferior vagina

Front 4

what is the lymphatic drainage of the rectum?

Back 4

*rectum lymph (and superior most aspect of anal canal) drains to the inferior mesenteric nodes and the intestinal trunk (most of perineum doesn't go here!!!)
*superior anal lymph drains deeply to internal iliac nodes
*inferior (post pectinate) anal lymph drains superficially to superficial inguinal nodes

Front 5

lymphatics of the uterus

Back 5

fundus of the uterus
-take the round ligament to the superficial inguinal nodes
most of uterus and ovaries
-drains to depp inguinal nodes

Front 6

lymphatics of the vagina
inferior somatic vs. superior visceral?

Back 6

-the vestibule and inferior somatic (pudendal innv.) part drains superficially to superficial inguinals
-remainder drains to deep inguinal

Front 7

what is the lumbrosacral plexus and what spinal nerve' vental rami does it include?

Back 7

L4-S4
-L4-L5 is the lumbar plexus
-connecting lumbrosacral trunk (L4-L5)
-S1-S4 is the sacral plexus

Front 8

what nerves from the lumbosacral plexus are destined to innervate the lower limb?
6 nerves, 2 pathways

Back 8

-obdurator nerve (obdurator canal)
Exit lumbosacral plexus via greater sciatic foramen-->glut region
-superior gluteal nerve
-inferior gluteal nerve
-sciatic nerve
-n. to quadratus femoris
-posterior femoral cutaneous nerve
-nerve to quadratus femoris

Front 9

lumbar plexus: I, I get laid on fridays
or Interested in getting laid on fridays?
11,22,33

Back 9

Iliohypogastric(L1)
Ilioinguinal (L1)
Genitofemoral(L1,L2)
Lateral Femoral Cutaneus (L2, L3)
Obdurator (L2,L3,L4)
Femoral (L2,L3,L4)

Front 10

What branches from the lumbosaccral plexus will innervate pelvic and perineal structures?
4 Nerve to's
1 other with offshoots

Back 10

Nerve to piriformis
n. to obdurator internus (not obdurator n)
n. to levator ani
n. to coccygeus
Pudendal nerve:
-assists in levator ani innv.
-inferior rectal nerve
-perineal nerves

Front 11

pudendal nerve:
-what spinal nerves?
-what does it innervate

Back 11

S2,3,4 ventral rami
-innervates skin and muscles of urogenital triangle

Front 12

pudendal nerve:
how does it travel to skin/UG triangle

Back 12

-travels with internal pudendal a/v: out greater and in lesser sciatic foramina (between sacroischial and sacrotuberous ligaments), through pudendal canal, which is fascia of the obdurator internus m

Front 13

pudendal nerve:
what does it give off on the way?

Back 13

-inferior rectal nerve
-perineal nerve
-motor branches to skeletal muscle in UGtriangle
-dorsal n. to penis/clit, scrotal n./post labial n.
-external urethral and anal sphincters!
**** off the floor, screaming for more

Front 14

where does the sciatic nerve come from?

Back 14

the sciatic nerve is the largest in the body
-comes from L4-S3 (entire lumbosacral trunk except S4,5Co1)
-actually composed of distinct common fibular (lateral) and tibial(medial) parts

Front 15

where are pelvic splanchnic nerves coming from?

Back 15

originate from S2-S4 to deliever preganglionic parasympathetic fibers to the pelvic part of the paravertebral plexus

Front 16

what is pudendal block?

Back 16

childbirth anesthesia
-palpate ischial spine to find pudendal nerve
-perineum is anesthetized

Front 17

superior gluteal nerve?
-spinal nerves?
-muscles innv?
-path?

Back 17

L4-S1
supplies gluteus medius, minimus and tensor fascia latae
leaves pelvic cavity superior to periformis and out of the greater sciatic canal

Front 18

inferior gluteal nerve
-from?
-innv?
-path?

Back 18

-dorsal flex L5-S2
glutteus maximus
-accompanied by superior gluteal av
-through greater sciatic above piri

Front 19

nerve to obdurator internus (not obdurator n!)
-from?
-innv?
-path?

Back 19

-from ventral extens L5-S2
-associated with superior gemellus muscle
-same path as pudendal nerve: leaves greater sciatic inf to piri, passes ischial spine, returns via lesser into perineum
-innv. obdurator internus (medial thigh), gemellis superior(flanking above obdurator internus

Front 20

nerve to quadratus femoris

Back 20

innv quadratus femoris, which connects the head of the femur to the ischial tuberosity

Front 21

what does the tibial part of the sciatic nerve do for motor function?

Back 21

-posterior leg, hamstring muscles including adductor magnus, except short head of the biceps femoris
-all muscles in posterior compartment of the leg
-all muscles on sole of foot tibial plantar(tibial was ventral)

Front 22

what does the tibial part of the sciatic nerve do for foot sensory cutaneous function?

Back 22

sole of foot where tibial n. terminates
also contributes to sural n.

Front 23

tibial nerve details branching and innervation

Back 23

Front 24

common fibular(lateral) part of sciatic nerve motor fxn

Back 24

(fibular artery a bit diff, comes off of femoral/popliteal)
-short head of biceps femoris in posterior thigh (all else there is tibial)
-all muscles in anterior and lateral leg
-extensor digitorum brevis in foot

Front 25

common fibular (dorsaldivision/lateral part) of sciatic nerve cutaneous fnx

Back 25

anterolateral/ surface of leg and dorsal surface of foot

Front 26

where does sensory cutaneous function of the posterior thigh come from?

Back 26

posterior femoral cutaneous nerve of the thigh from S1, S3
perforatin cutaneous nerve also innv a bit of gluteal fold, overlapping with the posterior femoral cutaneous nerve

Front 27

how is piriformis innervated?

Back 27

it's own nerve from the lumbosacral plexus, nerve to piriformis

Front 28

what do pelvic splanchnics do?
types of abdominopelvic splanchnics

Back 28

from S2-S4
-motor: visceral motor to preganglionic part of prevertebral plexus
-stimulate erection, inhibit internal urethral
-modulate GI mobility
Sensory:
visceral afferents from distal colon and pelvic viscera, pain from cervix, bladder, urethra

Front 29

what are the prevertebral ganglions of the pelvic splanchnics?

Back 29

inferior and superior hypogastric plexuses
-presynaptic lumbar and saccral spinal nerves synapse here if symathetic and not if parasymathetic. postsynapic sympathetic neurons follow vasculature or not to targets in the perineum and pelvis

Front 30

how does visceral pain work above and below the pain line?

Back 30

*above the pain line, visceral pain afferents travel to DRGs of segments T5-L2 with SYMPATHETICS
*Below pelvic pain line, visceral pain travels to DRG of S2-4 with PARASYMPATHETICS

Front 31

superior gluteal a

Back 31

*post trunk of internal iliac bcms superior gluteal a
*takes gsf above piri
*suppleis gluts

Front 32

umbilical a

Back 32

*from anterior trunk of internal iliac a
*gives off superior vesicle artery on the way to the umbilicum
*not so imp after fetal time, becomes ligament, but superior vesicle a is very imp!

Front 33

superior vesicle artery

Back 33

*supplies superior aspect of bladder
*ureters
*sometimes supplies vas defs

Front 34

obdurator artery

Back 34

*from internal iliac
*travels through obdurator canal with obdurator van through obd internus in obd formamen
*supplies medial thigh

Front 35

general overview of bones of the arm, forearm, hand

Back 35

arm: humerus from glenoid fossa of scapula
forearm: radius near thumb (lateral)
ulna medial
*Radius makes wRist contact
*uLna makes eLbow contact
hand:
distal radius/scaphoid and lunate
carpals (8)
metacarpels (5)
phalanges (14)

Front 36

carpals (8)

Back 36

some lovers try positions that they can't handle

Front 37

developmentally ventral muscles are.....

Back 37

found in posterior/medial compartments
flexors

Front 38

developmentally dorsal muscles are...

Back 38

found in the anterior/lateral cmpartments and are extensors

Front 39

what 5 nerves innervate the muscles of the arm?
make me understand RX

Back 39

the branches that come off of the brachial plexus:from lateral to medial (was superior to inferior at the shoulder)
make me understand Rx

Lateral and Medial derived (ventral)
musculocutaneous
median
ulnar
Posterior derived (dorsal)
radial
axillary

Front 40

ulnar is..

Back 40

ulone.

only ventral division of inferior trunk contributes, whereas musclocutaneous gets ventral divisions of superior and middle trunks to form lateral cord and branch

Front 41

what is flexion of the hip?

Back 41

hip flexes forward

Front 42

what is flexion of the knee ankle and toes?

Back 42

knee flexes backwards

Front 43

what is foot flexion?

Back 43

both are flexion for the foot

Front 44

flexion is usually more movement...

Back 44

hip: you can bend(flex) all the way forward and touch your toes, but not all the way back:flexion is anterior

knees: you can bend your knees all the way back and touch your feet to your butt (flexion is backwards)

arms: you can flex your biceps all the way and touch your fingers to your shoulders in front, but not back.

Front 45

what is the deep fascia of the arm, forearm and hand called?

Back 45

Brachial fascia-arm
antebrachial fascia-forearm
palmar fascia

Front 46

how are compartments formed in the limbs?

Back 46

-Intermuscular septa: deep fascia extending inward to create fascial compartments
-in the leg and arm, interosseous membranes help

Front 47

what compartments does the arm have?
red=dorsal
blue=ventral

Back 47

anterior and posterior upper arm

Front 48

what is the primary blood supply, innervation and muscle action of the:

anterior arm?

Back 48

-Brachial artery
-musclulocutanous nerve
-flexors of the shoulder and elbow

Front 49

what is the primary blood supply, innervation and muscle action of the:
posterior arm?

Back 49

-Profunda Brachii artery
-radial nerve
-extensors of the shoulder and elbows

Front 50

what is the primary blood supply, innervation and muscle action of the:

anterior forearm?

Back 50

ANTERIOR FOREARM
-Ulnar, radial and anterior interosseus arteries
-median nerve and ulnar nerve
-flexos of the elbow and digits
-pronators of the radioulnar joints

Front 51

what is the primary blood supply, innervation and muscle action of the:
Posterior forearm

Back 51

-posterior interosseus artery
-radial nerve
-extensors of the elbow and digits
-supinators of the radioulnar joints

Front 52

what is the primary blood supply, innervation and muscle action of the:
Medial (palmar) hand

Back 52

-superficial and deep palmar arterial arches
-ulnar n.
-act of 5th digit

Front 53

what is the primary blood supply, innervation and muscle action of the:
central palmar hand

Back 53

superficial and deep palmar arterial arches
median and ulnar nerves
digit flexion

Front 54

what is the primary blood supply, innervation and muscle action of the:
lateral palmar hand

Back 54

superficial and deep palmar arterial arches
median n
acts on pollex

Front 55

what is the primary blood supply, innervation and muscle action of the:
interosseus palmar hand

Back 55

ulnar n
superficial and deep palmar arterial arches
digit abd/add

Front 56

what is the primary blood supply, innervation and muscle action of the:
posterior dorsal hand

Back 56

radial artery
there are no intrinsic muscles on the hand dorsum

Front 57

what are the compartments of the lower limb? fascia?

Back 57

fascia-lata gluteal and crural leg

Front 58

what is in the superficial fascia of the lower limb?

Back 58

-Great saphenous vien(medial. hallux-->femoral v)
-small saphenous(sural/sm toe-->popliteal v)
-perforating veins that drain deep companion vv
-superficial lymph follows G.Saph to superficial inguinals
-deep lymph follows deep veins to deep ing nodes

Front 59

venous drainage in the leg: 2 tricks

Back 59

-muscle constriction and valves on perforating veins

Front 60

what is the pes anserinus?

Back 60

goose's foot
common insertion point for sartorius(anterior), gracilis (medial) and semitendinosis(posterior)

Front 61

what are the superficial muscles are in the anterior compartment of the thigh? (6)

Back 61

-iliopsoas
-tensor fascia latae
-vastus lateralis
-rectus femoris
-sartorius
-vastus medialis

Front 62

what muscles are in the medial compartment of the thigh?

Back 62

-Pectineus
-adductor longus(over magnus)
-Gracilis
-adductor magnus(makes adductor canal/hiatus)
*adductor magnus has an adductor and hamstring part

Front 63

What is the adductor canal?

Back 63

-a pathway allowing for the femoral VAN and saphenous nerve, nerve to vastus medialis, to pass from the femoral triangle to the popliteal fossa
*begins at intersection of sartorius(lateral) and adductor longus(medial), the apex of the femoral triangle
-ends at the adductor hiatus, a gap between two insertion points of the adductor magnus muscle

Front 64

what do the parts of the adductor longus look like?

Back 64

*notice how the adductors curve, while hamstrings don't

Front 65

what is the femoral triangle, sheath vs. canal vs. ring?

Back 65

triangle=Fem.VANLF
sheath=femVALF
canal=ring=LF, where hernias occur
*nerve is not in sheath
*lymph area is the ring/canal

Front 66

what three arteries enter the thigh?

Back 66

femoral
obdurator
inferior gluteal

Front 67

if you count branching, what are all the arteries?

Back 67

femoral(anterior)
--deep femoral(all)
------medial circumflex femoral(medial thigh)
------lateral circumflex femoral(lateral thigh)
------perforating arteries
obdurator(medial thigh, head of femur)
inf gluteal

Front 68

what passes through the greater sciatic foramen

Back 68

Front 69

what passes through the lesser sciatic foramen?

Back 69

Front 70

what is the OIIA of the gluteus maximus?

Back 70

-origin-post pelvic girdle, acrotuberous ligament
-insertion-gluteal tuberosity and IT band
-innv: inf gluteal n
-action:extends a flexed thigh
-separated from ischial tuberosity and greater trochanter by bursa

Front 71

tensor fascia lata
OIIA

Back 71

Front 72

lesser (medius and minimus) gluteals
OIIA

Back 72

origin:gluteal lines
insertion: greater trochanter
innervation:superior gluteal VAN
action: abduct the thigh

Front 73

lateral rotators of the hip

Back 73

-piriformis(own nerve)
-obdurator internus(own nerve)
-superior (nerve to obd int)and inferior gemellus(nerve toquad fem)
-quadratus femoris (own)

Front 74

superficial muscles of the posterior thigh

Back 74

two ladies tend and mend

biceps femoris semitendinosis and semimembranosis

*tibby tends and mends (tibial hamstrings)
*shorty fibs(short head of biceps femoris)

Front 75

All hamstrings:

Back 75

-arise from tibial tuberosity
-innv by tibial n (tibby tends and mends long time)
HAMSTRINGS
-semitendinosis
-semimembranosis
-long head of biceps femoris (looks lean like others)

Front 76

why is shorty not a ham?

Back 76

short head of biceps femoris is not a hamstring because:
-shorty is innv by common fibular nerve
shorty fibs
-shorty arises from femoral shaft, not ischial tuberosity

Front 77

what are the boundaries of the popliteal fossa?

Back 77

Front 78

what are the contents of the popliteal fossa?

Back 78

-politeal a (deepest)
-pop vein
-lymph
-tibial and common fibular nerves
-surals may come off from fossa
-tibial and small saphenous should come off

Front 79

what is genicalar anastamosis

Back 79

what prevents ischemia if you bend your knee by bypassing popliteal artery

Front 80

what does the talus and calcaneous look like? (ID isolated)

Back 80

connects ankle to foot

Front 81

what are the bones of the foot?

Back 81

Calcaneous
Talus
Cuboid
Navicular
Cuniforms
Metatarsels
Phalanges

Front 82

what are the joints of the foot?

Back 82

Subtalar joint
transverse tarsal joint
MP (Metotarsel-phalangeal) joints
IP (interphalangeal) joints

Front 83

what is in the tarsel tunnel?
Tom Dick And Very Nervous Harry

Back 83

From the Medial Malleolus
Tom 1) tendon of tibialis posterior
Dick 2)tendon of flexor digitorum longus
And 3)posterior tibial artery
Very 4)posterior tibial vein
Nervous 5)tibial nerve
Harry 6)tendom of hallucis longus

Front 84

muscles and tarsel tunnel

Back 84