BMS 448 Final Lecture Exam Study

What are the planes and their corresponding axes?

Sagittal plane - transverse axis

Coronal plane - sagittal axis

Transverse plane - longitudinal axis

What are the functions of cerebrospinal fluid?

Protection from physical injury

Nourishment for the brain

Removes waste

Where are the brain ventricles and what is the flow of CSF from the lateral ventricles to the central canal of the spinal cord?

R & L lateral ventricles, 3rd ventricle, & 4th ventricle.

Lateral ventricles -> 3rd ventricle -> cerebral aqueduct -> 4th ventricle -> central canal of spinal cord

What is the location and function of the primary motor area?

Precentral gyrus

Sends motor info

What is the location and function of the primary somatosensory areas?

Post central gyrus

Receives sensory info

What is the function of the premotor area and motor programs?

"Muscle memory"

Compound actions

Planning area

What is the common location and function of Broca's area?

Left lower anterior area of premotor area

Planning for speech

What is the function of commissures, association, and projection fibers?

Commissures - R/L communication

Association - Anterior/posterior communication

Projection - Superior/inferior communication

What is the function of the basal nuclei?

Controls starting, stopping, & intensity of motor movements

Inhibits antagonistic muscles during movement

What is the location and function of the thalamus?

Surrounds 3rd ventricle

Relays info

What is the location and function of the hypothalamus?

Below the thalamus

Controls body temp, thirst, hunger, sex drive, basic emotions, endocrine system, ANS

What are the 3 parts of the brain stem?

Midbrain

Pons

Medulla Oblongata

What are the functions of the midbrain?

Pathway for communication between lower and upper brain functions

Where is the corpora quadrigemina and what do the superior and inferior colliculi do?

On the posterior aspect of the midbrain

Superior colliculi - visual startle reflex

Inferior colliculi - auditory startle reflex

Where is the pons and what it its function?

Below the midbrain

Regulate respiration, coordinate involuntary skeletal muscle movements and muscle tone, relay info to/from brain/spinal cord

Where is the cerebellum and what is its function?

Posterior and inferior to cerebrum

Adjusts postural muscles of the body to maintain balance, programs and fine-tunes voluntary and involuntary movements

Where is the medulla oblongata and what is its function?

Below the pons

Controls BP, HR, and breathing

What is the anatomy of a spinal nerve and what info is carried through each area?

Dorsal root - sensory

Ventral root - motor

How many spinal nerves are for each section of the spine?

C1-8

T1-12

L1-5

S1-5

Co1

What is the difference between posterior, lateral, and anterior gray horns?

Posterior - sensory processing

Lateral (only in thoracic) - cell bodies of sympathetic NS

Anterior - motor processing

Describe the structure of the conus medullaris and cauda equina?

Conus medullaris - cord begins to fray (distal thoracic)

Cauda equina - Not a cord (lumbar/sacral)

What is the difference between ascending and descending white matter tracts in the spinal cord?

Ascending - sensory info to brain

Descending - motor info from brain

What is somatotropy and how does it relate to the white matter of the spinal cord?

"Body map"

White matter is located in the spinal corresponding to where it is in the body

What is the difference between complete and incomplete spinal cord injuries?

Complete - no feeling or movement below the injury

Incomplete - some feeling or movement below injury

What is the difference between paraplegia and quadriplegia?

Paraplegia - thoracic/lumber injury

Quadriplegia - cervical, high = can't breathe

What's the difference between paresthesia and paralysis (spastic & flaccid)?

Parasthesia - sensory loss

Paralysis - motor loss

Spastic paralysis - upper motor neuron damage, hyperreflexia

Flaccid paralysis - lower motor neuron damage, no reflexes

What are the normal spinal curvatures?

Cervical - anterior

Thoracic - posterior

Lumbar - anterior

What are the spinal pathologies and how to you treat them?

Kyphosis - exaggerated thoracic curvature

Lordosis - exaggerated lumber curvature

Scoliosis - lateral curvature

Treat all with spinal fusion

What is the structure and function of a vertebral disc?

Annulus fibrosis - outer layer of fibrocartilage

Nucleus pulposis - jelly like elastic center

Function to prevent bones from hitting, disperse force

What is the different between degenerative, thinning, bulging, and herniated discs?

Degenerative - loses mass, edge of vertebrae hit when bending -> osteophyte formation

Thinning - caused by aging, loses mass, edge of vertebrae hit when bending -> osteophyte formation

Bulging - weakening of annulus fibrosis -> nucleus pulposus pushes out into spinal nerves in intervertebral foramina

Herniated - torn annulus fibrosis, piece of nucleus pulposus comes out and pushes into spinal nerves in intervertebral foramina

What is the action and innervation of trapezius?

A - scapular elevation, depression, adduction, and stabilization

N - accessory nerve (CN XI)

What is the action and innervation of latissumus dorsi?

A - shoulder extension, adduction, and internal rotation

N - thoracodorsal nerve

What is the action and innervation of teres minor?

A - shoulder external rotation

N - axillary nerve

What is the action of levator scapulae?

A - scapular elevation and adduction

What is the action of teres major?

A - shoulder extension, adduction, and internal rotation

What is the action of rhomboid major?

A - scapular adduction

What is the action of rhomboid minor?

A - scapular adduction

What is the action of infraspinatus?

A - shoulder external rotation

What is the action of supraspinatus?

A - shoulder abduction

What are the rotator cuff muscles and the function?

Supraspinatus, infraspinatus, teres minor, subscapularis

Provides support for glenohumeral joint

What are 2 methods for treating shoulder impingement syndrome?

Strengthen lower trapezius

Remove subacromial bursa

What is the action and innervation of sternocleidomastoid?

A - neck flexion and turns head to opposite side

N - accessory nerve (CN XI)

What is the action of sternohyoid?

A - depress hyoid after swallowing

What is the action of sternothyroid?

A - depress hyoid and larynx

What is the action of thyrohyoid?

A - depress hyoid and elevate larynx

What is the action of omohyoid?

A - depress and retract hyoid

What is the action of anterior and middle scalenes and what runs between them?

A - elevates 1st and 2nd ribs and lateral neck flexion

Brachial plexus

Start at the aortic arch and describe the arteries of the neck.

Aortic arch

Brachiocephalic a. -> r. subclavian a. -> r. thyrocervical trunk

Brachiocephalic a -> r. common carotid a. -> r. external carotid a. & internal carotid a.

L. common carotid a. -> l. external carotid a. & internal carotid a.

L subclavian a. -> l. thyrocervical trunk

Describe the veins of the neck.

R. external jugular v. -> r. subclavian v. -> r. brachiocephalic v.

R. internal jugular v. -> brachiocephalic v.

What is the basic function and pathway of the vagus nerve?

Innervates organs, controls respiration, swallowing, and coughing

Runs with the common carotid and internal jugular, r. recurrent loops around the r. subclavian a., l. recurrent loops around the aortic arch

What is the basic function and pathway of the phrenic nerve?

Innervates the diaphragm

Runs anterior to anterior scalene muscles

What is the role of the transverse ligament of the atlantoaxial joint and consequences if it ruptures?

Prevents anterior/posterior movement of the joint

If it breaks, the dens crushes the medulla oblongata -> instant death

How many pairs of true, false, and floating ribs are there and how do they differ?

True - 7, connect directly to sternum

False - 3, connect to articular cartilage of true ribs

Floating - 2, only connect to thoracic vertebrae

What are the 3 parts of the sternum from superior to inferior?

Manubrium

Body

Xiphoid process

What is the effect of arthritis on costovertebral joints?

Arthritis decreases mobility in the joint which leads to difficulty breathing (decreased chest expansion)

What is the action and innervation of pectoralis major?

A - Shoulder flexion, internal rotation, and adduction

N - medial & lateral pectoral nerves

What is the action and innervation of pectoralis minor?

A - elevate ribs, protration

N - medial pectoral nerve

What is the action and innervation of serratus anterior?

A - protraction & scapular abduction

N - long thoracic nerve

What is the action and innervation of external intercostals?

A - elevate and expand inferior rib

N - intercostal nerves

What vein runs through the deltopectoral groove and where does it start and end?

Cephalic vein

Thumb -> axillary v.

You are a blood cell, start in the aorta and go to the intercostal muscles.

Aorta -> aortic arch -> brachiocephalic a. -> r. subclavian a. -> r. internal thoracic a. -> r. anterior intercostal a. -> r. posterior intercostal a.

What is the action of internal intercostals?

Assist exhalation

What is the action of the diaphragm?

Contract to increase volume in thoracic cavity

What muscles are used in normal inhalation and exhalation?

Inhalation - external intercostals, diaphragm

Exhalation - relaxation of primary muscles

What are the accessory muscles used in forced inhalation and exhalation?

Inhalation - sternocleidomastoid, scalanes, pectoralis minor

Exhalation - internal intercostals, abdominals, quadratus lumborum, latissimus dorsi

What is the structure and function of pleura?

Visceral - on lungs

Parietal - lines thoracic cavity

Functions to reduce friction

Hoes do the pleura keep the lungs in contact with the thoracic cavity?

Pleural fluid in the pleural cavity creates a negative pressure gradient which forces the lungs to expand and push up against the walls of the thoracic cavity

What is a pneumothorax and what is the difference between closed, open, and tension forms?

Collapsed lung due to air in the pleural cavity (atelectasis)

Closed - pleural cavity P < ATM (blow, no wound)

Open - pleural cavity P = ATM (sucking chest wound, puncture, air goes in and out)

Tension (deadly) - pleural cavity P > ATM (jagged wound, air goes in not out, over inflation displaces heart and compresses other lung)

What are the anatomical differences between the right and left lungs?

Right lung has 3 lobes & 2 fissues

Left lung has 2 lobes & 1 fissure

(RALS: right anterior, left superior)

What is the anatomy of the trachea and the role of the trachealis muscle?

Cartilage rings don't go all the way around, allowing for contraction via the trachealis muscle (coughing)

What is the difference in x-rays between bacterial, viral, and Covid pneumonia?

Bacterial - uneven clumping of white

Viral - even white

Covid - even, shattered glass/ice white

What is the location and function of the azygos, hemiazygos, and accessory hemiazygos veins?

Azygos - right side, brings blood from intercostal veins to superior vena cava

Hemiazygos - left interior half, brings blood from intercostal veins to azygos vein

Accessory hemiazygos - left superior half, brings blood from intercostal veins to azygos vein

What 5 conditions can cause an enlarged azygos vein?

Pregnancy

Over-hydration

Congestive heart failure

Portal hypertension

Tricuspid insufficiency

What areas of the body drain into the thoracic duct and right lymphatic duct and what vessel to they drain into?

Thoracic - entire lower body, left half of thorax and head, drains into L. subclavian v.

Right lymphatic - right half of thorax and head, drains into R subclavian v.

What is the location and function of the sympathetic trunk/chain ganglia?

Originates from T1-L2

Where the pre and postgenglionic motor neurons synapse

What are the 6 coronary arteries?

R. coronary a. branches into r. marginal a. and posterior interventricular a.

L. coronary a. branches into l. circumflex a. and anterior interventricular a.

What are the coronary veins and what arteries do they run with?

Great cardiac v. - anterior interventricular a.

Middle cardiac v. - posterior interventricular a.

Small cardiac v. - r. marginal a.

What is the pathway of the blood through the heart?

R. atrium -> tricuspid valve -> r. ventricle -> pulmonary semilunar valve -> pulmonary trunk -> pulmonary arteries -> lungs -> pulmonary veins -> l. atrium -> bicuspid valve -> l. ventricle -> aortic semilunar valve -> ascending aorta

What is the anatomical difference between the right and left ventricles and the significance of it?

Left is more muscular to pump blood to the entire body

What is the difference between semilunar and AV valves?

AV have chordae tendineae and papillary muscles to hold shut, shut with ventricular contraction

Semilunar valves have no strings, shut by blood attempting to flow back into the ventricle

What happens with valve prolapse and it's effect on heart function?

Valve blows backward and allows backwards blood flow

Decreased cardiac output

What is heart hypertrophy and what is the difference between concentric and eccentric forms and causes?

Hypertrophy - muscle growth

Concentric (bad)

- hypertension, congenital heart defects, stenosis

- increased muscle mass, but no increased ventricular volume

Eccentric (good)

- increased physical activity, pregnancy

- increased muscle mass and volume

What is dilated cardiomyopathy, how is it caused, and how does it affect heart function?

Thinning of ventricular wall, decreased stroke volume and cardiac output

Many causes

Organ perfusion becomes difficult

Symptoms - decreased BP, hypoxia during exercise, SOB, chest pain

What is the action and innervation of coracobrachialis?

A - shoulder adduction, flexion, and internal rotation

N - musculocutaneous nerve

What is the action and innervation of the deltoid?

A - anterior - shoulder flexion; middle - shoulder abduction; posterior - shoulder extension

N - axillary nerve

What is the action of subscapularis?

A - shoulder internal rotation

What are the branches of the thoracoacromial trunk and what muscles to they feed?

Pectoral branch - pectoral muscles

Deltoid branch - deltoid muscle

Acromial branch - deltoid muscle

What is the function of the axillary nerve?

Innervates the deltoid and teres minor muscles

What is the function of the radial nerve?

Innervates all muscles on the posterior aspect of the arm

What is the function of the musculocutaneous nerve?

Innervates coracobrachialis, biceps brachii, and brachialis

What is the function of the median nerve?

Innervtes most anterior forearm muscles and lateral hand

What is the function of the ulnar nerve?

Innervates the medial anterior forearm muscles and hand

What is the location and function of the long thoracic nerve?

Comes off the cervical nerve roots or the brachial plexus and innervates serratus anterior

What is the location and function of the thoracodorsal nerve?

Comes off of posterior cord, lateral to long thoracic nerve and innervates latissumus dorsi

What is the action and innervation of biceps brachii?

A - elbow flexion, supination

N - musculocutaneous nerve

What is the action and innervation of brachialis?

A - elbow flexion

N - musculocutaneous nerve

What is the action and innervation of triceps brachii?

A - elbow extension, shoulder adduction

N - radial nerve

What are the veins of the arm?

Basilic - medial

Cehalic - lateral

Median cubital vein - joins basilic and cephalic veins

What is the general function of veins?

Return blood to heart

Thermoregulation - dilate superficial veins to lose heat, constrict to keep

Store blood - 65% of blood in veins, slow flow, access with venous constriction (exercise)

What are the arteries in the brachium starting with the axillary artery?

Axillary a. -> brachial a. -> anterior & posterior circumflex humeral a. -> deep brachial a. -> radial collateral a.

Brachial a. (past deep brachial a.) -> superior ulnar collateral a. OR inferior ulnar collateral a. -> anterior ulnar recurrent a.

Brachial a. splits into radial and ulnar arteries