this lecture looked at the ventricles inside the brain, the dural sinuses outside the brain, the production of CSF, the different types of barriers present in the brain, and the flow of CSF through the ventricles and sinuses. dural sinuses are spaces in between inner and outer dural layers, either at the junction of dural sheets or above the dura. sinuses convey venous blood and as such have a sequence for draining which eventually leads into the internal jugular vein. the superior sagittal sinus drains into the confluence sinus, which drains into the transverse sinus, which drains into the sigmoid sinus, which drains into the jugular foramen, which drains into the internal jugular vein. the internal sagittal sinus drains into the straight sinus and joins the main drainage pathway at the confluence sinus. the cavernous sinus drains into the petrosal sinuses, which joins the main pathway at the transverse sinuses.
along with venous blood, CSF also eventually drains into these sinuses (or goes into the spinal cord). CSF is produced by choroidal epithelial cells which line the choroidal plexus, which surround cerebral arteries on the lining of ventricles. CSF is produced by these choroidal cells and secreted into the ventricles. CSF then flows through the ventricles: lateral to 3rd, 3rd to 4th (by way of the cerebral aqueduct), and then either into the spinal cord or into the subarachnoid space by the foramina of luschka or magendie. from there CSF ascends to the level of the sagittal sinus and exits the subarachnoid space by way of the arachnoid villi, which contain a membranous layer that allows CSF to flow into the sinuses. from there the CSF follows the drainage pathway of the venous blood as described above.
there are 3 unique barriers in the brain relating to blood and CSF. first is the blood brain barrier (see neurocranium part 2 for more detail). second is the blood / CSF layer-- which consists of choroidal epithelial cells. these cells contain tight junctions which does not allow the passage of larger molecules. third is the brain / CSF layer-- essentially the lining of the ventricles, made up of ependymal cells which are not joined by tight junctions. as such, they allow the passage of larger molecules, such as the metabolites of neurotransmitters, which can thus be detected in spinal taps (parkinson disease shows decreased catecholamines in CSF)
one last note: emissary veins transmit blood from the dural sinuses to below the scalp layer. just like venae comitantes, they aid in thermoregulation, in this case by routing the colder outer blood closer to the brain to cool it, or the opposite direction to warm it.
questions
sinuses and veins...
1. cerebral veins drain blood into...
2. what are dural sinuses?
3. where are dural sinuses located?
4. trace the pathway of venous blood from the superior sagittal sinus to the internal jugular vein.
5. trace the pathway of venous blood from the inferior sagittal sinus to the internal jugular vein.
6. trace the pathway of venous blood from the cavernous sinus to the internal jugular vein.
7. what does the cavernous sinus contain?
8. what are emissary veins?
9. how are emissary veins used for thermoregulation?
CSF...
10. where does CSF in the lateral ventricles eventually end up? describe the two possible pathways.
11. what is the choroid plexus? what does it do?
12. what is the brain/CSF barrier composed of? what does it let through?
13. what is the total volume of CSF in the body at any given time?
14. what is the pressure of CSF?
15. what is the total volume of CSF produced per day?
16. how does CSF move from the subarachnoid space to the sagittal sinus?
17. how does CSF support the integrity of the brain?
18. describe the equilibrium that exists between the epidural space and the subarachnoid space.
19. describe the brain/CSF barrier.
20. blockage of the CSF flow causes...
answers
1. dural sinuses.
2. spaces between periosteal and meningeal dural layers that convey venous blood.
3. at the junction of dural sheets or above the dura.
4. superior sagittal sinus -> confluence sinus -> transverse sinus -> sigmoid sinus -> jugular foramen -> internal jugular vein.
5. inferior sagittal sinus -> straight sinus -> confluence sinus -> transverse sinus -> sigmoid sinus -> jugular foramen -> internal jugular vein.
6. cavernous sinus -> petrosal sinuses -> transverse sinus -> sigmoid sinus -> jugular foramen -> internal jugular vein.
7. cranial nerves: IV, V1,V2,V3, VI, and internal carotid artery
8. veins that allow for transport of venous blood between the scalp and the dural sinuses.
9. emissary veins help maintain the temperature of the brain by routing colder blood from the surface of the scalp closer to the brain during hyperthermia and the opposite motion during hypothermia.
10. travels from the lateral ventricle to the 3rd ventricle, through the cerebral aqueduct into the 4th ventricle. at this point it can flow downward into the spinal cord, or through the foramina of luschka and magendie into the subarachnoid space-- and from there into the superior sagittal sinus.
11. the choroid plexus surrounds cerebral arteries and secretes CSF into the ventricles.
12. made of choroid epithelial cells which are joined by tight junctions-- preventing the flow of large molecules.
13. 150mL
14. 10mm Hg
15. 450mL
16. through arachnoid villi, protrusions of the arachnoid layer that have a filtering membrane that allows CSF to pass into the sagittal sinus.
17. by being suspended in CSF, the brain is protected in three ways: the mass (~1400g) is effectively reduced to 40g due to buoyancy. the cranial nerves and veins are protected. lastly, arachnoid trabeculae serve to anchor the brain in place.
18. there is an equilibrium between the pressure of venous blood in the epidural space and the CSF in the subarachnoid space.
19. the brain CSF barrier is made up of ependymal cells which are not joined by tight junctions; hence fluid and larger molecules can flow readily-- this allows metabolites of neurotransmitters, for example, to be present in CSF in ventricles.
20. hydroencephaly
Showing posts with label ms anatomy II. Show all posts
Showing posts with label ms anatomy II. Show all posts
Wednesday, March 18, 2009
Tuesday, March 10, 2009
ms anatomy II: neurocranium part II
[picture courtesy of erica zelfand]
this is the second lecture in the series on the "neurocranium" and dealt with a variety of topics such as structure of the brain, functions of each lobe, blood supply, spinal cord, meninges, glial cells, and the blood brain barrier.
the cerebral portion of the brain is divided up into different lobes, which have been shown to have distinct cognitive and emotional correlates. for example, the frontal lobe is the primary motor area, and is also involved in speech and behavior. the parietal lobes are involved in somatosensory input, prioprioception, sense of self. the temporal lobes are involved in audition, olfaction, and memory. the occipital lobes are involved in vision. cerebellum, midbrain, medulla, are underneath the cerebral portion and are involved more in basic physiological processes. for example, the medulla is involved in autonomic regulation of the cardiovascular system and respiration. the hypothalamus is involved in autonomic, affective, and hormonal activity. the midbrain is involved in motor control. the cerebellum is involved in motor coordination and timing.
the blood supply to the brain comes ultimately from the brachiocephalic branch of the aorta, which branches into the common carotid and the subclavian. the vertebral arteries branch off of the subclavian, travel in the transverse foramen of C1-C6,
and penetrate the atlanto-occipital membrane. from there they ascend on the ventral surface of the brainstem and combine to form the basilar artery, from which other arteries branch out (see diagram) such as the pontine and cerebellar arteries. the common carotid artery, on the other hand, branches into the internal and external common carotid; the internal common carotid branches into the anterior and middle cerebral arteries, which supply blood to the lateral and medial cerebral cortex, internal capsule, basal ganglia, and cingulate gyrus. the occlusions in each of these small branches can produce different effects (see diagram).
a few details about the spinal cord: it extends down to L1, beyond which the dura extends until S2. the spinal cord ends at the conus medullaris, a tapering down of the cord which ends in the caudus equinus, which is a splaying out of a horse tail-like arrangement of nerve rootlets. around the spinal cord, there are the three meninge layers: pia, arachnoid, dura mater. denticulate ligaments are pial "projections" into the arachnoid and dura mater which serve to anchor the spinal cord. the filum terminale is the pial strand that connects from the end of the spinal cord (L1) to the end of the dural sac (S2).
a few notes about glial cells and the blood brain barrier. glial cells were covered briefly in histology as the cells that "support" the neurons. in the central nervous system these cells are astrocytes, oligodendrocytes. oligodendrocytes are the cells that produce the myelin sheath that increases the rate of neuronal conduction. whereas schwann cells can only wrap around 1 axon, a single oligodendrocytes can wrap up to 50 different axons. astrocytes provide electrical insulation between neurons, secrete neuronal growth factors and cytokines, and absorb neurotransmitters. they can be further divided into protoplasmic and fibrous- fibrous astrocytes are involved in repairing damaged neuronal tissue. astrocytes also aid in the maintenance of the blood brain barrier, which is made up of astrocyte foot processes, basal lamina, pericytes, and endothelium.
questions
general anatomy and fissures...
1. cerebral hemispheres include...
2. the cerebral cortex is the site for...
3. what are gyri and sulci/fissures?
4. what are the three main fissures in the brain?
5. what does the longitudinal fissure separate?
6. what does the lateral fissure separate?
7. what does the central fissure separate?
functions of...
8. frontal lobe
9. parietal lobe
10. occipital lobe
11. temporal lobe
12. medulla
13. cerebellum
14. pons
15. midbrain
16. thalamus
17. hypothalamus
cerebral arteries...
18. where does the common carotid artery branch off from?
19. where does the common carotid artery split?
20. what does the internal carotid artery split into?
21. what does the internal carotid artery supply blood to?
22. what is the difference between an ischemic and hemorrhagic stroke?
23. where does the middle cerebral artery run?
24. what do the cortical branches supply blood to and what occurs during a stroke of these arteries?
25. what do the lateral striate branches supply blood to and what occurs during a stroke of these arteries?
26. what does the anterior cerebral artery supply blood to?
27. what happens after stroke in the anterior cerebral artery?
basivertebral arteries...
28. describe the passage of the vertebral artery.
29. vertebral arteries unite to form...
30. where is the path of the basilar artery? what does it branch into?
31. what does occlusion in the anterior and posterior spinal branch lead to?
32. what does occlusion in the posterior inferior cerebellar branch lead to?
33. what does occlusion in the anterior inferior and superior cerebellar branch lead to?
34. what does occlusion in the pontine arteries lead to?
35. what does occlusion in the labyrinthine branch lead to?
36. how do occlusions of the vertebral basilar arteries result in deficits in vision?
37. how do occlusions of the vertebral basilar arteries result in problems with balance?
posterior cerebral and circle of willis...
38. where does the posterior cerebral artery project to?
39. what happens when the posterior cerebral artery is occluded?
40. what is the circle of willis?
41. what does the anterior communicating artery connect?
42. what does the posterior communicating artery connect?
spinal cord...
43. how far down does the spinal cord extend?
44. how far down does the spinal dura extend?
45. what is the conus medullaris?
46. what is the cauda equina?
47. where is the junctional zone between the central and peripheral nervous systems?
48. what does the dura turn into at this point?
meninges and spinal veins...
49. how far down does the dura mater extend?
50. what is in the epidural space?
51. what is arachnoid mater?
52. what are denticulate ligaments?
53. what is the filum terminale?
54. where would one extract CSF from the spinal cord?
55. what are the two ways of administering anesthetic to the spinal cord?
56. what does the basivertebral vein do?
57. what is the connection between the basivertebral veins and prostate cancer?
58. describe the vertebral vein's use as a shunt.
glial cells and blood brain barrier...
59. what are oligodendrocytes and what do they do?
60. "unlike schwann cells, oligodendrocytes do not..."
61. what do astrocytes do?
62. what is the difference between protoplasmic and fibrous astrocytes?
63. what are microglia and what do they do?
64. what cell types line the ventricles?
65. what makes up the blood brain barrier?
66. what is the blood brain barrier maintained and induced by?
67. describe the transport of glucose, amino acids, and gases through the blood brain barrier.
68. which brain regions is there no blood brain barrier?
answers
1. white matter, basal ganglia, cerebral cortex.
2. sensorimotor integration, perceptive quality of our experiences
3. gyri are convolutions of the cortex and sulci are divisions or gaps between the gyri.
4. longitudinal, lateral, central.
5. the left and right hemispheres.
6. the frontal and temporal lobes.
7. the frontal and parietal lobes.
8. primary motor area, speech, behavior
9. sensorimotor, prioprioception, association of sensorimotor-audition-vision, formation of egocentric space, sense of self
10. vision
11. audition, olfaction, memory
12. autonomic control over respiration, cardiovascular systems
13. motor coordination and timing
14. cerebellar connection
15. motor control
16. sensorimotor information to cerebral cortex
17. autonomic, hormonal, affective activity
18. the brachiocephalic branch of the aortic arch.
19. at the carotid sinus into the internal and external carotid arteries.
20. anterior and middle cerebral arteries
21. most of the cerebral hemispheres.
22. ischemic is blockage of the cerebral artery via a thrombus or embolus which leads to necrosis. hemorrhagic is rupture of the artery which causes a hematoma, which leads to necrosis.
23. in the lateral fissure; along the lateral surface of the cerebral cortex.
24. lateral surface of cortex. stroke causes sensory, motor, language deficits.
25. internal capsule and basal ganglia. stroke causes hemiplegia.
26. medial surface of cerebral cortex, including cingulated gyrus.
27. sensory, motor, emotional deficits.
28. branches off the subclavian artery, passes through transverse foramina of C1-C6, and penetrates the atlanto occipital membrane.
29. basilar artery on ventral medulla.
30. the ventral surface of the brainstem; branches into cerebellar, pontine, posterior cerebral arteries.
31. loss of spinal cord function
32. Wallenberg syndrome: loss of sensation of pain, heat, muscle coordination.
33. loss of muscle coordination.
34. cranial nerve dysfunction.
35. deafness and vertigo.
36. torsion/compression of vertebral basilar arteries can reduce blood flow to brain stem, cerebellum, occipital lobe- anoxia in the occipital lobe causes loss of vision.
37. anoxia in cerebellum or inner ear can cause problems with balance.
38. temporal and occipital lobes.
39. visual deficits.
40. the anterior and posterior communicating arteries.
41. anterior cerebral arteries.
42. middle and posterior cerebral arteries.
43. down to L1.
44. down to S2.
45. tapered end of the spinal cord.
46. the “horse’s tail”, the end of the spinal cord which branches into nerve roots that extend to lumbar and sacral foramina.
47. the intervertebral foramina
48. the epineurium that covers the dorsal and ventral rami and ganglia.
49. S2
50. veins and fat.
51. the meninge layer in between the dura and pia mater, with trabeculae inside the subarachnoid space.
52. pial connective tissue that suspends spinal cord to the inside of arachnoid / dura mater.
53. a pial strand that connects down to the end of the dural sac.
54. from the subarachnoid space.
55. to the epidural and subdural spaces.
56. drains vertebral bodies.
57. prostate cancer can metastasize into vertebrae through the basivertebral veins.
58. blood shunts from caval veins into vertebral veins if IVC constricted (while coughing, for example)
59. cells in the CNS that myelinate up to 50 axons.
60. "cover unmyelinated axons, which lay bare in the CNS"
61. electrically insulate neurons from each other, uptake neurotransmitters and ions, and secrete neuronal growth factors and cytokines.
62. protoplasmic interconnect neurons, induce early growth and development of the blood/brain barrier, whereas fibrous form astrocytic scars after brain tissue destruction.
63. phagocytic cells related to monocyte/macrophages which consume debris and secrete cytokines during inflammation.
64. ependymal cells.
65. endothelium, pericytes, basal lamina, astrocyte foot processes.
66. maintained by astrocytes.
67. glucose and amino acids pass through BBB via transport proteins, and gases diffuse through lipid membrane.
68. hypothalamus, area postrema, other periventricular regions.
this is the second lecture in the series on the "neurocranium" and dealt with a variety of topics such as structure of the brain, functions of each lobe, blood supply, spinal cord, meninges, glial cells, and the blood brain barrier.
the cerebral portion of the brain is divided up into different lobes, which have been shown to have distinct cognitive and emotional correlates. for example, the frontal lobe is the primary motor area, and is also involved in speech and behavior. the parietal lobes are involved in somatosensory input, prioprioception, sense of self. the temporal lobes are involved in audition, olfaction, and memory. the occipital lobes are involved in vision. cerebellum, midbrain, medulla, are underneath the cerebral portion and are involved more in basic physiological processes. for example, the medulla is involved in autonomic regulation of the cardiovascular system and respiration. the hypothalamus is involved in autonomic, affective, and hormonal activity. the midbrain is involved in motor control. the cerebellum is involved in motor coordination and timing.
the blood supply to the brain comes ultimately from the brachiocephalic branch of the aorta, which branches into the common carotid and the subclavian. the vertebral arteries branch off of the subclavian, travel in the transverse foramen of C1-C6,
and penetrate the atlanto-occipital membrane. from there they ascend on the ventral surface of the brainstem and combine to form the basilar artery, from which other arteries branch out (see diagram) such as the pontine and cerebellar arteries. the common carotid artery, on the other hand, branches into the internal and external common carotid; the internal common carotid branches into the anterior and middle cerebral arteries, which supply blood to the lateral and medial cerebral cortex, internal capsule, basal ganglia, and cingulate gyrus. the occlusions in each of these small branches can produce different effects (see diagram).a few details about the spinal cord: it extends down to L1, beyond which the dura extends until S2. the spinal cord ends at the conus medullaris, a tapering down of the cord which ends in the caudus equinus, which is a splaying out of a horse tail-like arrangement of nerve rootlets. around the spinal cord, there are the three meninge layers: pia, arachnoid, dura mater. denticulate ligaments are pial "projections" into the arachnoid and dura mater which serve to anchor the spinal cord. the filum terminale is the pial strand that connects from the end of the spinal cord (L1) to the end of the dural sac (S2).
a few notes about glial cells and the blood brain barrier. glial cells were covered briefly in histology as the cells that "support" the neurons. in the central nervous system these cells are astrocytes, oligodendrocytes. oligodendrocytes are the cells that produce the myelin sheath that increases the rate of neuronal conduction. whereas schwann cells can only wrap around 1 axon, a single oligodendrocytes can wrap up to 50 different axons. astrocytes provide electrical insulation between neurons, secrete neuronal growth factors and cytokines, and absorb neurotransmitters. they can be further divided into protoplasmic and fibrous- fibrous astrocytes are involved in repairing damaged neuronal tissue. astrocytes also aid in the maintenance of the blood brain barrier, which is made up of astrocyte foot processes, basal lamina, pericytes, and endothelium.
questions
general anatomy and fissures...
1. cerebral hemispheres include...
2. the cerebral cortex is the site for...
3. what are gyri and sulci/fissures?
4. what are the three main fissures in the brain?
5. what does the longitudinal fissure separate?
6. what does the lateral fissure separate?
7. what does the central fissure separate?
functions of...
8. frontal lobe
9. parietal lobe
10. occipital lobe
11. temporal lobe
12. medulla
13. cerebellum
14. pons
15. midbrain
16. thalamus
17. hypothalamus
cerebral arteries...
18. where does the common carotid artery branch off from?
19. where does the common carotid artery split?
20. what does the internal carotid artery split into?
21. what does the internal carotid artery supply blood to?
22. what is the difference between an ischemic and hemorrhagic stroke?
23. where does the middle cerebral artery run?
24. what do the cortical branches supply blood to and what occurs during a stroke of these arteries?
25. what do the lateral striate branches supply blood to and what occurs during a stroke of these arteries?
26. what does the anterior cerebral artery supply blood to?
27. what happens after stroke in the anterior cerebral artery?
basivertebral arteries...
28. describe the passage of the vertebral artery.
29. vertebral arteries unite to form...
30. where is the path of the basilar artery? what does it branch into?
31. what does occlusion in the anterior and posterior spinal branch lead to?
32. what does occlusion in the posterior inferior cerebellar branch lead to?
33. what does occlusion in the anterior inferior and superior cerebellar branch lead to?
34. what does occlusion in the pontine arteries lead to?
35. what does occlusion in the labyrinthine branch lead to?
36. how do occlusions of the vertebral basilar arteries result in deficits in vision?
37. how do occlusions of the vertebral basilar arteries result in problems with balance?
posterior cerebral and circle of willis...
38. where does the posterior cerebral artery project to?
39. what happens when the posterior cerebral artery is occluded?
40. what is the circle of willis?
41. what does the anterior communicating artery connect?
42. what does the posterior communicating artery connect?
spinal cord...
43. how far down does the spinal cord extend?
44. how far down does the spinal dura extend?
45. what is the conus medullaris?
46. what is the cauda equina?
47. where is the junctional zone between the central and peripheral nervous systems?
48. what does the dura turn into at this point?
meninges and spinal veins...
49. how far down does the dura mater extend?
50. what is in the epidural space?
51. what is arachnoid mater?
52. what are denticulate ligaments?
53. what is the filum terminale?
54. where would one extract CSF from the spinal cord?
55. what are the two ways of administering anesthetic to the spinal cord?
56. what does the basivertebral vein do?
57. what is the connection between the basivertebral veins and prostate cancer?
58. describe the vertebral vein's use as a shunt.
glial cells and blood brain barrier...
59. what are oligodendrocytes and what do they do?
60. "unlike schwann cells, oligodendrocytes do not..."
61. what do astrocytes do?
62. what is the difference between protoplasmic and fibrous astrocytes?
63. what are microglia and what do they do?
64. what cell types line the ventricles?
65. what makes up the blood brain barrier?
66. what is the blood brain barrier maintained and induced by?
67. describe the transport of glucose, amino acids, and gases through the blood brain barrier.
68. which brain regions is there no blood brain barrier?
answers
1. white matter, basal ganglia, cerebral cortex.
2. sensorimotor integration, perceptive quality of our experiences
3. gyri are convolutions of the cortex and sulci are divisions or gaps between the gyri.
4. longitudinal, lateral, central.
5. the left and right hemispheres.
6. the frontal and temporal lobes.
7. the frontal and parietal lobes.
8. primary motor area, speech, behavior
9. sensorimotor, prioprioception, association of sensorimotor-audition-vision, formation of egocentric space, sense of self
10. vision
11. audition, olfaction, memory
12. autonomic control over respiration, cardiovascular systems
13. motor coordination and timing
14. cerebellar connection
15. motor control
16. sensorimotor information to cerebral cortex
17. autonomic, hormonal, affective activity
18. the brachiocephalic branch of the aortic arch.
19. at the carotid sinus into the internal and external carotid arteries.
20. anterior and middle cerebral arteries
21. most of the cerebral hemispheres.
22. ischemic is blockage of the cerebral artery via a thrombus or embolus which leads to necrosis. hemorrhagic is rupture of the artery which causes a hematoma, which leads to necrosis.
23. in the lateral fissure; along the lateral surface of the cerebral cortex.
24. lateral surface of cortex. stroke causes sensory, motor, language deficits.
25. internal capsule and basal ganglia. stroke causes hemiplegia.
26. medial surface of cerebral cortex, including cingulated gyrus.
27. sensory, motor, emotional deficits.
28. branches off the subclavian artery, passes through transverse foramina of C1-C6, and penetrates the atlanto occipital membrane.
29. basilar artery on ventral medulla.
30. the ventral surface of the brainstem; branches into cerebellar, pontine, posterior cerebral arteries.
31. loss of spinal cord function
32. Wallenberg syndrome: loss of sensation of pain, heat, muscle coordination.
33. loss of muscle coordination.
34. cranial nerve dysfunction.
35. deafness and vertigo.
36. torsion/compression of vertebral basilar arteries can reduce blood flow to brain stem, cerebellum, occipital lobe- anoxia in the occipital lobe causes loss of vision.
37. anoxia in cerebellum or inner ear can cause problems with balance.
38. temporal and occipital lobes.
39. visual deficits.
40. the anterior and posterior communicating arteries.
41. anterior cerebral arteries.
42. middle and posterior cerebral arteries.
43. down to L1.
44. down to S2.
45. tapered end of the spinal cord.
46. the “horse’s tail”, the end of the spinal cord which branches into nerve roots that extend to lumbar and sacral foramina.
47. the intervertebral foramina
48. the epineurium that covers the dorsal and ventral rami and ganglia.
49. S2
50. veins and fat.
51. the meninge layer in between the dura and pia mater, with trabeculae inside the subarachnoid space.
52. pial connective tissue that suspends spinal cord to the inside of arachnoid / dura mater.
53. a pial strand that connects down to the end of the dural sac.
54. from the subarachnoid space.
55. to the epidural and subdural spaces.
56. drains vertebral bodies.
57. prostate cancer can metastasize into vertebrae through the basivertebral veins.
58. blood shunts from caval veins into vertebral veins if IVC constricted (while coughing, for example)
59. cells in the CNS that myelinate up to 50 axons.
60. "cover unmyelinated axons, which lay bare in the CNS"
61. electrically insulate neurons from each other, uptake neurotransmitters and ions, and secrete neuronal growth factors and cytokines.
62. protoplasmic interconnect neurons, induce early growth and development of the blood/brain barrier, whereas fibrous form astrocytic scars after brain tissue destruction.
63. phagocytic cells related to monocyte/macrophages which consume debris and secrete cytokines during inflammation.
64. ependymal cells.
65. endothelium, pericytes, basal lamina, astrocyte foot processes.
66. maintained by astrocytes.
67. glucose and amino acids pass through BBB via transport proteins, and gases diffuse through lipid membrane.
68. hypothalamus, area postrema, other periventricular regions.
Monday, February 23, 2009
ms anatomy II: neurocranium pt I
this lecture covered the bones, embryology, meninges, and blood supply to the head. the neurocranium is made up of the frontal, parietal, occipital, temporal, and sphenoid bones. the temporal bone is made up of the squamous portion and the petrous portion, the latter of which makes up part of the cranial base. the sphenoid bone is a winged shaped bone that has lesser and greater "wings" and houses the pituitary in the sellae turcica. between the bones of the skull are sutures, which are fusions of the bones that ossify with age. the coronoid sutures fuse the frontal and parietal bones, the sagittal suture fuses the left and right parietal bones, the lamboidal sutures fuse the occiptal and parietal bones. the intersection of the coronoid and sagittal sutures is the bregma junction, the intersection of the sagittal and lamboidal is the lambda junction, and the intersection of the temporal, parietal, frontal, and sphenoid bones on the lateral sides is called the pteryion junction.
the spine develops from sclerotome cells which migrate medially, surround the notochord, and begin to form cartilaginous "models", from which bones form in the process of endochondrial ossification. the individual vertebrae are formed when loose and dense portions of adjacent somites fuse, and the notocord eventually becomes the nucleus pulposus. primary ossification centers in the vertebrae form the bone that ossify from 3-5 years of age, while secondary ossification centers are at the edge of the vertebrae and are active during bone growth during puberty.
the skull bones are developed from lateral plate mesoderm, neural crest cells, somitomeres, and somites. in contrast to the spine, skull bones are formed by intramembranous ossification, which is direct formation of bone without a cartilage model. fontanelles are the spaces between the developing bones that eventually develop into the sutures. the growth of the skull bones is halted in the mid teens when the spheno-occipital joint and the spheno-ethmoidal joint close. finally, the spheno-occipital synchondrosis is the junction between the sphenoid and the basioccipital bone, and can determine the jaw morphology; a large angle at the synchondrosis can cause overbite and a small angle can cause underbite.
below the skull bones lie the meninges, the connective tissue coverings of the brain- dura mater, arachnoid mater, and pia mater. dura mater is the outermost, and includes a falx cerebri septa that separates the two brain hemispheres, as well as a tentorium cerebelli septa that separates the occipital lobes from the cerebrum. the arachnoid mater is the next layer down, and has a subdural layer right underneath the dura mater which is made up of thick connective tissue, and a "subarachnoid space" which is filled with trabeculae. these connect to the innermost layer, pia mater, which is loose connective tissue that aids in anchoring the blood vessels of the brain.
the epidural space is the space between the dura mater and the skull bones and is the site of epidural hematomas, where the middle meningeal artery (the artery that branches off the external carotid and supplies blood to the bones and dura) ruptures and fills the epidural space with blood. the subdural space is the space between the dura and the arachnoid mater; this can be the site of an subdural hematoma, where blood returning from veins in the brain to dural sinuses rupture and fill the subdural space. epidural hematomas are much more severe and occur faster because of the higher arterial blood pressure.
questions
bones of neurocranium...
1. what are the bones of the neurocranium?
2. what are the two portions of the temporal bone?
3. what are four anatomical features of the temporal bone?
4. what are some anatomical features of the body of the sphenoid bone?
5. what are the bones that make up the cranial base?
sutures and junctions...
6. what are sutures?
7. where is the coronal suture?
8. where is the sagittal suture?
9. where is the lamboidal suture?
10. where is the squamosal suture?
11. where is the bregma junction?
12. where is the lambda junction?
13. where is the pteryion junction?
spine development...
14. describe the development of the spine from the somites.
15. how are intersegmental vertebrae formed?
16. notocord becomes the...
17. what is the explanation for the fact that we have 8 cervical nerves with only 7 cervical vertebrae?
18. describe endochondral ossification of the vertebrae.
19. what is the difference between primary and secondary ossification centers?
skull development...
20. what are the skull bones and cartilage derived from?
21. vault bones are formed by...
22. skull form determined by...
23. what are fontanelles?
24. describe the development of the cranial base.
25. how does the longitudinal growth of the skull end during the mid teens?
26. what is the spheno-occipital synchondrosis?
27. what is a large angle of the spheno-occipital synchondrosis associated with?
28. what is a small angle of the spheno-occipital synchondrosis associated with?
meninges...
29. what are the three layers in the meninges?
30. what are the dura mater septa and what do they separate?
31. what are the two portions to the arachnoid mater?
32. describe the pia mater layer.
33. what is the epidural space?
34. what is the subdural space?
35. what is the subarachnoid space?
blood supply...
36. where is the middle meningeal artery? what does it supply?
37. where is the middle meningeal artery most susceptible to damage?
38. what is a subdural hematoma?
39. what is an epidural hematoma?
40. which type of hematoma develops faster and why?
answers
1. frontal, parietal, occipital, temporal, sphenoid.
2. the squamous portion, which forms part of the neurocranium, and the petrous portion.
3. internal/external meatus, styloid process, mastoid process, zygomatic process.
4. the sellae turcica, dorsum sellae, sphenoid sinuses
5. frontal, sphenoid, temporal (petrous portion), occipital, ethmoid
6. fibrous joints between skull bones that ossify with age.
7. between frontal and parietal bones.
8. between parietal bones.
9. between parietal and occipital bones.
10. between the temporal and parietal bones.
11. between the coronal and sagittal sutures.
12. between the lamboidal sutures and sagittal suture.
13. the junction between the frontal, temporal, parietal, and sphenoid bones.
14. sclerotome cells migrate medially, surround neural tube, and form spinal column.
15. fusion of dense and loose tissues of adjacent somites.
16. nucleus pulposus
17. cranial nerve I is above C1- would have been below the "8th" cervical vertebrae, which divided into the dens of C2 and part of the basioccipital bone early in development.
18. the mesoderm begins to differentiate into a cartilage "model" around the notocord, and eventually is replaced by bone.
19. primary ossification centers form bone that fuse between 3-5 years. secondary ossification centers lie on the periphery of vertebrae and are active in puberty.
20. lateral plate mesoderm, neural crest, somitomeres, somites
21. intramembranous ossification.
22. soft tissues.
23. the cartilage between the vault bones that eventually forms the sutures.
24. cranial base is formed by the intramembranous cartilage that joins to form the chondrocranium.
25. the sphenooccipital and sphenoethmoidal joints close.
26. the fusion of the sphenoid and the basioccipital bone that closes around 12-16 years.
27. square jaws or overbite.
28. wide angled mandibles, protrusion of mandibles.
29. dura mater, arachnoid mater, pia mater.
30. the falx cerebri separates the hemispheres and the tentorium cerebelli separates the cerebellum from the occipital lobes.
31. the thick subdural portion and the subarachnoid space, which contains arachnoid trabeculae, which connect to the pia mater.
32. thin CT layer that supports blood vessels on the surface of the brain.
33. the potential space between the dura and the bone.
34. potential space between dura and arachnoid mater.
35. CSF between arachnoid and pia mater.
36. it branches off the external carotid, comes through the foramen spinosum, and supplies blood to the bone and dura.
37. near pterion.
38. cerebral veins that drain into dural sinuses rupture and blood fills the subdural space.
39. meningeal arteries rupture and blood fills the epidural space.
40. external hematomas, because of the higher arterial pressure.
the spine develops from sclerotome cells which migrate medially, surround the notochord, and begin to form cartilaginous "models", from which bones form in the process of endochondrial ossification. the individual vertebrae are formed when loose and dense portions of adjacent somites fuse, and the notocord eventually becomes the nucleus pulposus. primary ossification centers in the vertebrae form the bone that ossify from 3-5 years of age, while secondary ossification centers are at the edge of the vertebrae and are active during bone growth during puberty.
the skull bones are developed from lateral plate mesoderm, neural crest cells, somitomeres, and somites. in contrast to the spine, skull bones are formed by intramembranous ossification, which is direct formation of bone without a cartilage model. fontanelles are the spaces between the developing bones that eventually develop into the sutures. the growth of the skull bones is halted in the mid teens when the spheno-occipital joint and the spheno-ethmoidal joint close. finally, the spheno-occipital synchondrosis is the junction between the sphenoid and the basioccipital bone, and can determine the jaw morphology; a large angle at the synchondrosis can cause overbite and a small angle can cause underbite.
below the skull bones lie the meninges, the connective tissue coverings of the brain- dura mater, arachnoid mater, and pia mater. dura mater is the outermost, and includes a falx cerebri septa that separates the two brain hemispheres, as well as a tentorium cerebelli septa that separates the occipital lobes from the cerebrum. the arachnoid mater is the next layer down, and has a subdural layer right underneath the dura mater which is made up of thick connective tissue, and a "subarachnoid space" which is filled with trabeculae. these connect to the innermost layer, pia mater, which is loose connective tissue that aids in anchoring the blood vessels of the brain.
the epidural space is the space between the dura mater and the skull bones and is the site of epidural hematomas, where the middle meningeal artery (the artery that branches off the external carotid and supplies blood to the bones and dura) ruptures and fills the epidural space with blood. the subdural space is the space between the dura and the arachnoid mater; this can be the site of an subdural hematoma, where blood returning from veins in the brain to dural sinuses rupture and fill the subdural space. epidural hematomas are much more severe and occur faster because of the higher arterial blood pressure.
questions
bones of neurocranium...
1. what are the bones of the neurocranium?
2. what are the two portions of the temporal bone?
3. what are four anatomical features of the temporal bone?
4. what are some anatomical features of the body of the sphenoid bone?
5. what are the bones that make up the cranial base?
sutures and junctions...
6. what are sutures?
7. where is the coronal suture?
8. where is the sagittal suture?
9. where is the lamboidal suture?
10. where is the squamosal suture?
11. where is the bregma junction?
12. where is the lambda junction?
13. where is the pteryion junction?
spine development...
14. describe the development of the spine from the somites.
15. how are intersegmental vertebrae formed?
16. notocord becomes the...
17. what is the explanation for the fact that we have 8 cervical nerves with only 7 cervical vertebrae?
18. describe endochondral ossification of the vertebrae.
19. what is the difference between primary and secondary ossification centers?
skull development...
20. what are the skull bones and cartilage derived from?
21. vault bones are formed by...
22. skull form determined by...
23. what are fontanelles?
24. describe the development of the cranial base.
25. how does the longitudinal growth of the skull end during the mid teens?
26. what is the spheno-occipital synchondrosis?
27. what is a large angle of the spheno-occipital synchondrosis associated with?
28. what is a small angle of the spheno-occipital synchondrosis associated with?
meninges...
29. what are the three layers in the meninges?
30. what are the dura mater septa and what do they separate?
31. what are the two portions to the arachnoid mater?
32. describe the pia mater layer.
33. what is the epidural space?
34. what is the subdural space?
35. what is the subarachnoid space?
blood supply...
36. where is the middle meningeal artery? what does it supply?
37. where is the middle meningeal artery most susceptible to damage?
38. what is a subdural hematoma?
39. what is an epidural hematoma?
40. which type of hematoma develops faster and why?
answers
1. frontal, parietal, occipital, temporal, sphenoid.
2. the squamous portion, which forms part of the neurocranium, and the petrous portion.
3. internal/external meatus, styloid process, mastoid process, zygomatic process.
4. the sellae turcica, dorsum sellae, sphenoid sinuses
5. frontal, sphenoid, temporal (petrous portion), occipital, ethmoid
6. fibrous joints between skull bones that ossify with age.
7. between frontal and parietal bones.
8. between parietal bones.
9. between parietal and occipital bones.
10. between the temporal and parietal bones.
11. between the coronal and sagittal sutures.
12. between the lamboidal sutures and sagittal suture.
13. the junction between the frontal, temporal, parietal, and sphenoid bones.
14. sclerotome cells migrate medially, surround neural tube, and form spinal column.
15. fusion of dense and loose tissues of adjacent somites.
16. nucleus pulposus
17. cranial nerve I is above C1- would have been below the "8th" cervical vertebrae, which divided into the dens of C2 and part of the basioccipital bone early in development.
18. the mesoderm begins to differentiate into a cartilage "model" around the notocord, and eventually is replaced by bone.
19. primary ossification centers form bone that fuse between 3-5 years. secondary ossification centers lie on the periphery of vertebrae and are active in puberty.
20. lateral plate mesoderm, neural crest, somitomeres, somites
21. intramembranous ossification.
22. soft tissues.
23. the cartilage between the vault bones that eventually forms the sutures.
24. cranial base is formed by the intramembranous cartilage that joins to form the chondrocranium.
25. the sphenooccipital and sphenoethmoidal joints close.
26. the fusion of the sphenoid and the basioccipital bone that closes around 12-16 years.
27. square jaws or overbite.
28. wide angled mandibles, protrusion of mandibles.
29. dura mater, arachnoid mater, pia mater.
30. the falx cerebri separates the hemispheres and the tentorium cerebelli separates the cerebellum from the occipital lobes.
31. the thick subdural portion and the subarachnoid space, which contains arachnoid trabeculae, which connect to the pia mater.
32. thin CT layer that supports blood vessels on the surface of the brain.
33. the potential space between the dura and the bone.
34. potential space between dura and arachnoid mater.
35. CSF between arachnoid and pia mater.
36. it branches off the external carotid, comes through the foramen spinosum, and supplies blood to the bone and dura.
37. near pterion.
38. cerebral veins that drain into dural sinuses rupture and blood fills the subdural space.
39. meningeal arteries rupture and blood fills the epidural space.
40. external hematomas, because of the higher arterial pressure.
Sunday, February 22, 2009
ms anatomy: leg vasculature
this lecture talked briefly about the vasculature of the thigh and leg. the posterior arteries in the leg start with the femoral artery, which goes through the femoral triangle, down the anterior thigh, through the adductor hiatus, and turns into the popliteal artery. the popliteal artery divides into the posterior tibial artery, which supplies blood to the posterior leg muscles, and the fibular artery, which supplies the lateral leg compartment. the posterior tibial artery ends in the medial and lateral plantar arteries on the ventral side of the foot. the anterior leg muscles are supplied with blood via the anterior tibial artery. the dorsal pedis artery is on the dorsal side of the foot and is a location for a palpable pulse.
a couple landmarks in the leg: the popliteal fossa is the space in the back of the knee which is bordered by the lower tendons of the hamstring on the top and the upper heads of the gastrocnemius on the bottom. through it passes the common fibular and tibial nerve, as well as the popliteal artery and vein. the femoral triangle is created by the inguinal ligament, the sartorius, and the adductor longus, and contains the femoral vein, artery, and nerve.
the veins of the leg can be divided into superficial and deep veins; most of the blood returns through the deep veins, venae comitantes, which are bound to the arteries. one important superficial vein is the long saphenous vein, which runs down the medial aspect of the leg and thigh. perforating veins are veins that connect and allow blood to flow from superficial to deep veins. when the valves in the perforating veins start to be defective (due to excessive pressure), backflow is possible, and this can create varicose veins- large, twisted veins, in both the perforating and superficial veins of the leg.
questions
1. describe the path of the femoral artery.
2. what are the two branches of the popliteal artery?
3. what does the posterior tibial branch of the popliteal artery supply blood to?
4. what does the fibular branch of the popliteal artery supply blood to?
5. what does the posterial tibial artery end in?
6. neurovascular bundle of the foot passes...
7. which artery supplies blood to the anterior group of leg muscles?
8. which artery provides a palpable pulse on the dorsal side of the foot?
9. where is the popliteal fossa located?
10. what is contained in the popliteal fossa?
11. what are the boundaries of the femoral triangle?
12. what arteries, veins, and nerves pass through the femoral triangle?
13. which vein enters the femoral vein in the femoral triangle?
14. what are the lymph nodes in the femoral triangle called?
15. what is the site in which femoral hernias can occur?
16. describe the location of the long saphenous vein.
17. the long saphenous vein can be used as...
18. what are the deep veins in the leg?
19. what do perforating veins do?
20. how are varicose veins developed in the leg?
answers
1. passes through the femoral triangle and down the anterior thigh, then through the adductor hiatus to the posterior thigh; becomes the popliteal artery.
2. posterior tibial, fibular.
3. posterior compartment leg muscles.
4. lateral compartment leg muscles.
5. the medial and lateral plantar arteries.
6. posteriorly to the medial malleolus.
7. the anterior tibial artery.
8. dorsal pedis artery.
9. between the lower tendons of the hamstrings and the upper heads of the gastrocnemius.
10. the popliteal artery and vein, the tibial and common fibular nerve.
11. the sartorius, inguinal ligament, and adductor longus.
12. femoral artery, vein, and nerve.
13. the great saphenous vein.
14. inguinal lymph nodes.
15. the femoral canal, the space medial to the femoral vein.
16. the long saphenous vein is a long vein that runs along the medial aspect of the leg and thigh.
17. a "source of bypass vessels"
18. the venae comitantes which surround the arteries.
19. they connect the superficial and deep veins in the leg.
20. when the valves in the perforating veins are defective, allowing backflow to occur through the perforating veins to the superficial veins.
a couple landmarks in the leg: the popliteal fossa is the space in the back of the knee which is bordered by the lower tendons of the hamstring on the top and the upper heads of the gastrocnemius on the bottom. through it passes the common fibular and tibial nerve, as well as the popliteal artery and vein. the femoral triangle is created by the inguinal ligament, the sartorius, and the adductor longus, and contains the femoral vein, artery, and nerve.
the veins of the leg can be divided into superficial and deep veins; most of the blood returns through the deep veins, venae comitantes, which are bound to the arteries. one important superficial vein is the long saphenous vein, which runs down the medial aspect of the leg and thigh. perforating veins are veins that connect and allow blood to flow from superficial to deep veins. when the valves in the perforating veins start to be defective (due to excessive pressure), backflow is possible, and this can create varicose veins- large, twisted veins, in both the perforating and superficial veins of the leg.
questions
1. describe the path of the femoral artery.
2. what are the two branches of the popliteal artery?
3. what does the posterior tibial branch of the popliteal artery supply blood to?
4. what does the fibular branch of the popliteal artery supply blood to?
5. what does the posterial tibial artery end in?
6. neurovascular bundle of the foot passes...
7. which artery supplies blood to the anterior group of leg muscles?
8. which artery provides a palpable pulse on the dorsal side of the foot?
9. where is the popliteal fossa located?
10. what is contained in the popliteal fossa?
11. what are the boundaries of the femoral triangle?
12. what arteries, veins, and nerves pass through the femoral triangle?
13. which vein enters the femoral vein in the femoral triangle?
14. what are the lymph nodes in the femoral triangle called?
15. what is the site in which femoral hernias can occur?
16. describe the location of the long saphenous vein.
17. the long saphenous vein can be used as...
18. what are the deep veins in the leg?
19. what do perforating veins do?
20. how are varicose veins developed in the leg?
answers
1. passes through the femoral triangle and down the anterior thigh, then through the adductor hiatus to the posterior thigh; becomes the popliteal artery.
2. posterior tibial, fibular.
3. posterior compartment leg muscles.
4. lateral compartment leg muscles.
5. the medial and lateral plantar arteries.
6. posteriorly to the medial malleolus.
7. the anterior tibial artery.
8. dorsal pedis artery.
9. between the lower tendons of the hamstrings and the upper heads of the gastrocnemius.
10. the popliteal artery and vein, the tibial and common fibular nerve.
11. the sartorius, inguinal ligament, and adductor longus.
12. femoral artery, vein, and nerve.
13. the great saphenous vein.
14. inguinal lymph nodes.
15. the femoral canal, the space medial to the femoral vein.
16. the long saphenous vein is a long vein that runs along the medial aspect of the leg and thigh.
17. a "source of bypass vessels"
18. the venae comitantes which surround the arteries.
19. they connect the superficial and deep veins in the leg.
20. when the valves in the perforating veins are defective, allowing backflow to occur through the perforating veins to the superficial veins.
Monday, February 2, 2009
ms anatomy: leg and foot
this unit talked about the many muscles in the leg below the knee, including all the muscles of the foot. most of these muscles can be grouped into the actions they have on the foot. plantar flexion of the foot, which is the pointing of the toes, is accomplished by the muscles that originate on the back of the tibia and fibula and wrap underneath the foot: gastrocnemius, soleus, flexor hallucis longus, flexor digitorum longus, tibialis posterior, fibularis longus and brevis. the opposite motion, dorsiflexion of the foot (pulling back of the foot) is done by the muscles that attach to the anterior tibia and fibula and insert onto the top of the foot: extensor digitorum longus, extensor hallucis longus, tibialis anterior, fibularis tertius.
inversion of the foot (basically sticking out your outer ankle) is done by the tibialis posterior and anterior, both of which insert onto the medial bottom of the foot- 1st metatarsal and medial cuneiform for the tibialis anterior and the navicular and other tarsals for the tibialis posterior. eversion of the foot is the opposite motion, sticking out the medial ankle, and is done by the fibularis longus and brevis, as well as the fibularis tertius.
the medial longitudinal arch is formed by the bones of the foot on the medial side: calcaneus, navicular, talus, cuneiforms, and 3 metatarsals. it is stabilized by the plantar aponeurosis, the spring ligament, and plantar ligaments, as well as the tendons of the flexor hallucis longus, abductor hallucis, tibialis anterior/posterior. the lateral longitudinal arch is formed by the calcaneus, cuboid, and the lateral 2 metatarsals. it is stabilized by the plantar aponeurosis and the plantar ligaments as well, and also by the abductor digiti minimi, fibularis longus, brevis, tertius.
questions
1. what are the bones of the foot?
origins, insertions, innervations, actions...
2. tibialis anterior
3. extensor hallucis longus
4. extensor digitorum longus
5. fibularis tertius
6. extensor digitorum brevis, hallucis brevis
7. fibularis longus
8. fibularis brevis
9. gastrocnemius
10. soleus
11. plantaris
12. flexor digitorum longus
13. flexor hallucis longus
14. tibialis posterior
15. abductor hallucis
16. flexor digitorum brevis
17. abductor digiti minimi
18. quadratus plantae
19. lumbricals
20. flexor hallucis brevis
21. adductor hallucis
22. flexor digiti minimi
23. plantar interossei
24. dorsal interossei
25. describe the location of the common fibular nerve.
26. what does the superficial fibular nerve innervate?
27. what does the deep fibular nerve innervate?
28. what is the "foot drop" and what does it result in?
29. in a standing position, where does the line of gravity fall in relation to the rotational axes of the knees and ankles?
30. standing posture is maintained by contraction of the...
31. what is the plantar chiasm?
which muscles produce these actions...
32. plantar flexion
33. dorsiflexion
34. inversion
35. eversion
36. tibialis posterior passes through...
37. plantar aponeurosis is a continuation of...
38. what is plantar fascitis?
39. sesamoid bones are embedded...
40. what do the medial and lateral plantar nerves innervate in the foot?
41. where is the acupuncture point LV-3?
42. describe the inferior tibiofibular joint.
43. describe the ankle joint.
44. what are the ligaments that stabilize the medial ankle?
45. what are the ligaments that stabilize the lateral ankle?
46. the head of the talus is inserted between...
47. what does the spring ligament do?
48. what does the long plantar ligament do?
49. what does the short plantar ligament do?
50. what is the medial longitudinal arch formed by?
51. which ligaments support the medial longitudinal arch?
52. which muscles support the medial longitudinal arch?
53. what is the lateral longitudinal arch formed by?
54. which ligaments support the lateral longitudinal arch?
55. which muscles support the lateral longitudinal arch?
56. what is the transverse arch made of and what is it supported by?
answers
1. talus, calcaneus, navicular, cuboid, cuneiforms, metatarsals, phalanges.
2. O: upper 2/3 tibia, IO membrane, I: 1st MT, medial cuneiform N: deep fibular, A: dorsiflex, invert foot
3. O: fibula, I: distal phalanx of the hallucis, N: deep fibular, A: extend big toe, dorsiflex foot.
4. O: upper fibula, I: middle and distal phalanges, N: deep fibular, A: extend lateral 4 toes and dorsiflex foot.
5. O: lower 1/3 fibula, I: 5th metatarsal, N: deep fibular, A: dorsiflex and evert foot.
6. O: upper calcaneus, I: proximal phalanges, N: deep fibular, A: extend toes
7. O: upper 2/3 of fibula, I: medial cuneiform and 1st MT, N: superficial fibular, A: plantar flexion and eversion
8. O: lower 1/3 of fibula, I: 5th MT, N: superficial fibular, A: eversion and plantar flexion
9. O: femoral condyles, I: calcaneus, N: tibial nerve, A: plantar flexion of foot and flexion of knee
10. O: upper tibia and fibula, I: calcaneus, N: tibial nerve, A: plantar flexion (slow) and maintain standing position
11. O: supracondylar ridge, I: calcaneus, N: tibial nerve, A: plantar flexion
12. O: tibia, I: distal phalanges, N: tibial nerve, A: plantar flexion
13. O: fibula, I: distal phalanx of the hallux, N: tibial nerve, A: plantar flexion of foot, flexion of hallucis
14. O: tibia, fibula, IO membrane, I: navicular, other tarsals, N: tibial nerve, A: plantar flexion, inversion
15. O: calcaneus, I: proximal phalanx of the hallucis N: medial plantar nerve A: flex and abduct foot
16. O: calcaneus, I: medial phalanges, N: medial plantar nerve, A: flex the lateral 4 toes.
17. O: calcaneus, I: middle phalanx of little toe, N: lateral plantar nerve, A: flex and abduct little toe.
18. O: calcaneus, I: tendons of the flexor digitorum longus, N: lateral plantar nerve, A: flex lateral four toes
19. O: between the tendons of the flexor digitorum longus, I: extensor expansion, N: medial (1st lumbrical) and lateral (2nd through 4th lumbricals) plantar nerves, A: flex the MTP joint and extend the IP joints.
20. O: cuboid and cuneiforms, I: proximal phalanx of hallucis, N: medial plantar nerve, A: flex MTP joint
21. O: metatarsals, I: proximal phalanx of the hallucis, N: lateral plantar nerve, A: flex MTP joint, adduct big toe
22. O: 5th MT, I: proximal phalanx of the 5th toe, N: lateral plantar nerve A: flexes the MTP joint
23. O: MTs, I: proximal phalanges, extensor expansion N: lateral plantar nerve, A: flexes MTP joint, extends IP joint, abducts toes
24. O: MTs I: proximal phalanges, extensor expansion, N: lateral plantar nerve, A: flex MTP joint, extend the IP joint, adduct toes
25. passes around the head of the fibula, passes through fibularis longus
26. the lateral compartment of leg muscles such as the fibularis longus and brevis.
27. the anterior compartment of leg muscles such as the tibialis anterior and the extensor digitorum longus.
28. damage to the common fibular, loss of the ability to invert/evert foot.
29. anterior
30. erector spinae and soleus muscles.
31. the crossing of the flexor hallucis longus and flexor digitorum longus tendons near the sole of the foot.
32. gastrocnemius, soleus, flexor digitorum longus, flexor hallucis longus, tibialis posterior, fibularis longus and brevis.
33. tibialis anterior, extensor digitorum longus, extensor hallucis longus, fibularis tertius.
34. tibialis posterior, anterior
35. fibularis longus, brevis, tertius.
36. deep and superficial posterior muscles.
37. achilles tendon
38. inflammation of the calcaneus near attachment of the plantar fascia, can develop calcaneal spurs.
39. within tendons of flexor hallucis brevis, to protect tendon of flexor hallucis longus.
40. medial=up to 3.5 medial digits. lateral=1.5 lateral digits (analogous to median and ulnar nerve)
41. the 1st dorsal interosseus muscle.
42. a fibrous joint that forms a U shape that fits over the talus
43. a hinge joint between the talus and the tibia that allows for flexion and extension of the foot. the fibula does not bear any weight.
44. the deltoid ligament.
45. the anterior and posterior talofibular ligament and the calcaneofibular ligament.
46. the navicular and the calcaneus
47. spans between the navicular and the calcaneus and prevents the talus from driving them apart.
48. links the calcaneus to the lateral MT's, forms a tunnel in which tendon of fibularis longus travels.
49. connects calcaneus to cuboid
50. calcaneus, talus, navicular, 3 cuneiforms and 3 MT's.
51. connective tissue: plantar aponeurosis, spring ligament, plantar ligaments.
52. flexor hallucis longus, abductor hallucis, tibialis anterior and posterior
53. calcaneus, cuboid, lateral 2 MT's
54. plantar ligaments, aponeurosis
55. abductor digiti minimi, fibularis longus, brevis, tertius
56. the transverse arch is made of the cuboid, cuneiforms, and the 5 MT's. it is supported by the deep transverse ligaments, fibularis longus, and adductor hallucis.
inversion of the foot (basically sticking out your outer ankle) is done by the tibialis posterior and anterior, both of which insert onto the medial bottom of the foot- 1st metatarsal and medial cuneiform for the tibialis anterior and the navicular and other tarsals for the tibialis posterior. eversion of the foot is the opposite motion, sticking out the medial ankle, and is done by the fibularis longus and brevis, as well as the fibularis tertius.
the medial longitudinal arch is formed by the bones of the foot on the medial side: calcaneus, navicular, talus, cuneiforms, and 3 metatarsals. it is stabilized by the plantar aponeurosis, the spring ligament, and plantar ligaments, as well as the tendons of the flexor hallucis longus, abductor hallucis, tibialis anterior/posterior. the lateral longitudinal arch is formed by the calcaneus, cuboid, and the lateral 2 metatarsals. it is stabilized by the plantar aponeurosis and the plantar ligaments as well, and also by the abductor digiti minimi, fibularis longus, brevis, tertius.
questions
1. what are the bones of the foot?
origins, insertions, innervations, actions...
2. tibialis anterior
3. extensor hallucis longus
4. extensor digitorum longus
5. fibularis tertius
6. extensor digitorum brevis, hallucis brevis
7. fibularis longus
8. fibularis brevis
9. gastrocnemius
10. soleus
11. plantaris
12. flexor digitorum longus
13. flexor hallucis longus
14. tibialis posterior
15. abductor hallucis
16. flexor digitorum brevis
17. abductor digiti minimi
18. quadratus plantae
19. lumbricals
20. flexor hallucis brevis
21. adductor hallucis
22. flexor digiti minimi
23. plantar interossei
24. dorsal interossei
25. describe the location of the common fibular nerve.
26. what does the superficial fibular nerve innervate?
27. what does the deep fibular nerve innervate?
28. what is the "foot drop" and what does it result in?
29. in a standing position, where does the line of gravity fall in relation to the rotational axes of the knees and ankles?
30. standing posture is maintained by contraction of the...
31. what is the plantar chiasm?
which muscles produce these actions...
32. plantar flexion
33. dorsiflexion
34. inversion
35. eversion
36. tibialis posterior passes through...
37. plantar aponeurosis is a continuation of...
38. what is plantar fascitis?
39. sesamoid bones are embedded...
40. what do the medial and lateral plantar nerves innervate in the foot?
41. where is the acupuncture point LV-3?
42. describe the inferior tibiofibular joint.
43. describe the ankle joint.
44. what are the ligaments that stabilize the medial ankle?
45. what are the ligaments that stabilize the lateral ankle?
46. the head of the talus is inserted between...
47. what does the spring ligament do?
48. what does the long plantar ligament do?
49. what does the short plantar ligament do?
50. what is the medial longitudinal arch formed by?
51. which ligaments support the medial longitudinal arch?
52. which muscles support the medial longitudinal arch?
53. what is the lateral longitudinal arch formed by?
54. which ligaments support the lateral longitudinal arch?
55. which muscles support the lateral longitudinal arch?
56. what is the transverse arch made of and what is it supported by?
answers
1. talus, calcaneus, navicular, cuboid, cuneiforms, metatarsals, phalanges.
2. O: upper 2/3 tibia, IO membrane, I: 1st MT, medial cuneiform N: deep fibular, A: dorsiflex, invert foot
3. O: fibula, I: distal phalanx of the hallucis, N: deep fibular, A: extend big toe, dorsiflex foot.
4. O: upper fibula, I: middle and distal phalanges, N: deep fibular, A: extend lateral 4 toes and dorsiflex foot.
5. O: lower 1/3 fibula, I: 5th metatarsal, N: deep fibular, A: dorsiflex and evert foot.
6. O: upper calcaneus, I: proximal phalanges, N: deep fibular, A: extend toes
7. O: upper 2/3 of fibula, I: medial cuneiform and 1st MT, N: superficial fibular, A: plantar flexion and eversion
8. O: lower 1/3 of fibula, I: 5th MT, N: superficial fibular, A: eversion and plantar flexion
9. O: femoral condyles, I: calcaneus, N: tibial nerve, A: plantar flexion of foot and flexion of knee
10. O: upper tibia and fibula, I: calcaneus, N: tibial nerve, A: plantar flexion (slow) and maintain standing position
11. O: supracondylar ridge, I: calcaneus, N: tibial nerve, A: plantar flexion
12. O: tibia, I: distal phalanges, N: tibial nerve, A: plantar flexion
13. O: fibula, I: distal phalanx of the hallux, N: tibial nerve, A: plantar flexion of foot, flexion of hallucis
14. O: tibia, fibula, IO membrane, I: navicular, other tarsals, N: tibial nerve, A: plantar flexion, inversion
15. O: calcaneus, I: proximal phalanx of the hallucis N: medial plantar nerve A: flex and abduct foot
16. O: calcaneus, I: medial phalanges, N: medial plantar nerve, A: flex the lateral 4 toes.
17. O: calcaneus, I: middle phalanx of little toe, N: lateral plantar nerve, A: flex and abduct little toe.
18. O: calcaneus, I: tendons of the flexor digitorum longus, N: lateral plantar nerve, A: flex lateral four toes
19. O: between the tendons of the flexor digitorum longus, I: extensor expansion, N: medial (1st lumbrical) and lateral (2nd through 4th lumbricals) plantar nerves, A: flex the MTP joint and extend the IP joints.
20. O: cuboid and cuneiforms, I: proximal phalanx of hallucis, N: medial plantar nerve, A: flex MTP joint
21. O: metatarsals, I: proximal phalanx of the hallucis, N: lateral plantar nerve, A: flex MTP joint, adduct big toe
22. O: 5th MT, I: proximal phalanx of the 5th toe, N: lateral plantar nerve A: flexes the MTP joint
23. O: MTs, I: proximal phalanges, extensor expansion N: lateral plantar nerve, A: flexes MTP joint, extends IP joint, abducts toes
24. O: MTs I: proximal phalanges, extensor expansion, N: lateral plantar nerve, A: flex MTP joint, extend the IP joint, adduct toes
25. passes around the head of the fibula, passes through fibularis longus
26. the lateral compartment of leg muscles such as the fibularis longus and brevis.
27. the anterior compartment of leg muscles such as the tibialis anterior and the extensor digitorum longus.
28. damage to the common fibular, loss of the ability to invert/evert foot.
29. anterior
30. erector spinae and soleus muscles.
31. the crossing of the flexor hallucis longus and flexor digitorum longus tendons near the sole of the foot.
32. gastrocnemius, soleus, flexor digitorum longus, flexor hallucis longus, tibialis posterior, fibularis longus and brevis.
33. tibialis anterior, extensor digitorum longus, extensor hallucis longus, fibularis tertius.
34. tibialis posterior, anterior
35. fibularis longus, brevis, tertius.
36. deep and superficial posterior muscles.
37. achilles tendon
38. inflammation of the calcaneus near attachment of the plantar fascia, can develop calcaneal spurs.
39. within tendons of flexor hallucis brevis, to protect tendon of flexor hallucis longus.
40. medial=up to 3.5 medial digits. lateral=1.5 lateral digits (analogous to median and ulnar nerve)
41. the 1st dorsal interosseus muscle.
42. a fibrous joint that forms a U shape that fits over the talus
43. a hinge joint between the talus and the tibia that allows for flexion and extension of the foot. the fibula does not bear any weight.
44. the deltoid ligament.
45. the anterior and posterior talofibular ligament and the calcaneofibular ligament.
46. the navicular and the calcaneus
47. spans between the navicular and the calcaneus and prevents the talus from driving them apart.
48. links the calcaneus to the lateral MT's, forms a tunnel in which tendon of fibularis longus travels.
49. connects calcaneus to cuboid
50. calcaneus, talus, navicular, 3 cuneiforms and 3 MT's.
51. connective tissue: plantar aponeurosis, spring ligament, plantar ligaments.
52. flexor hallucis longus, abductor hallucis, tibialis anterior and posterior
53. calcaneus, cuboid, lateral 2 MT's
54. plantar ligaments, aponeurosis
55. abductor digiti minimi, fibularis longus, brevis, tertius
56. the transverse arch is made of the cuboid, cuneiforms, and the 5 MT's. it is supported by the deep transverse ligaments, fibularis longus, and adductor hallucis.
Friday, January 23, 2009
ms anatomy: thigh
this is the second lecture on the bottom half of the body and covers the muscles, nerves, and bones of the thigh region. muscles are grouped according to the actions they produce on the knee joint (extension of the knee is the kicking motion) and the hip joint (extension of the hip is pulling the leg back).
the flexors of the hip include the pectineus, rectus femoris, sartorius, and adductor longus and brevis. the extensors of the hip are the hamstrings: the biceps femoris (long head only, because the short head originates on the femur's linea aspera), the semimembrinosus, the semitendinosus, and the adductor magnus. the adductors are: the adductor longus and brevis, adductor magnus, gracilis, pectineus. the muscles that flex the knee are: sartorius, biceps femoris (both heads), semitendinosus, and semimembrinosus.
the femoral and obturator nerves are looked at briefly- both originate in the lumbar plexus at the L2,3,4 level. the femoral nerve passes through the femoral triangle and innervates the quadriceps, sartorius, iliacus, and pectineus. the obturator nerve passes through the obturator canal and innervates the gracilis, 1/2 of the adductor magnus, and the adductors (besides the pectineus)
a few details about the knee region: the "goose's foot" is a convergence of tendons on the medial upper tibia from the tendons of the sartorius, gracilis, and semitendinosus. two ligaments that stabilize the knee joint: the anterior cruciate ligament goes from the anterior tibia to the inner medial condyle of the femur and limits hyperextension. the posterior cruciate ligament goes from the posterior tibia to the inner lateral condyle of the femur and prevents anterior displacement of the femur.
questions
origins, insertions, actions, innervations...
1. sartorius
2. quadriceps femoris
3. pectineus
4. adductor longus and brevis
5. gracilis
6. adductor magnus
7. semitendinosus
8. semimembranosus
9. biceps femoris
10. where does the femoral nerve originate and where does it pass through?
11. what does the femoral nerve innervate?
12. where does the obturator nerve originate and where does it pass through?
13. what does the obturator nerve innervate?
which muscles produce these actions...
14. flexion of femur
15. extension of femur
16. lateral rotation of femur
17. adduction of femur
18. flexion of knee
19. what constitutes the pes anserinus? what else is it called?
20. what are the tibial plateaus?
21. is the fibula head part of the knee joint?
22. where does the anterior cruciate ligament attach to? what does it do?
23. where does the posterior cruciate ligament attach to? what does it do?
answers
1. O: ASIS, I: medial surface of the upper tibia, N: femoral nerve, A: flex, laterally rotate femur
2. O: rectus femoris-ASIS, vastus lateralis and medialis-linea aspera, vastus intermedius- upper anterior femur, I: tibial tuberosity via patella, N: femoral nerve, A: extend leg, flex femur.
3. O: pubis, I: linea aspera, N: femoral nerve, A: adduct, flex femur
4. O: pubis, I: linea aspera, N: obturator nerve, A: adduct, flex femur
5. O: pubis, I: medial upper tibia, N: obturator nerve, A: adduct femur, flex leg
6. O: pubis, ischium, I: linea aspera, adductor tubercle, N: obturator and sciatic nerve, A: adduct and extend femur
7. O: ischial tuberosity, I: upper medial tibia, N: tibial nerve, A: extend femur, flex and medially rotate leg
8. O: ischial tuberosity, I: medial condyle of tibia, N: tibial nerve, A: extend femur, flex and medially rotate leg
9. O: ischial tuberosity / linea aspera, I: head of fibula, N: tibial nerve and common fibular (long head/short head), A: flex and laterally rotate leg, and extend femur (long head only)
10. L234, passes through femoral triangle
11. iliacus, sartorius, quadriceps, pectineus
12. L234, passe through obturator canal
13. adductors (except pectineus), 1/2 of adductor magnus, gracilis.
14. rectus femoris, sartorius, pectineus, adductor longus and brevis.
15. adductor magnus, biceps femoris long head, semitendinosus, semimembrinosus.
16. sartorius
17. pectineus, adductor longus/brevis, gracilis, adductor magnus
18. sartorius, biceps femoris (long and short heads), semitendinosus, semimembrinosus.
19. "goose's foot" is made up of the common tendon insertions for gracilis, sartorius, semitendinosus.
20. the flat surfaces of the tibia which articulate with the femoral condyles.
21. no
22. anterior tibia to inner surface of lateral femoral condyle. limits hyperextension of knee and posterior displacement of femur on tibia
23. posterior tibia to inner surface of medial femoral condyle, prevents anterior disaplacement of femur.
the flexors of the hip include the pectineus, rectus femoris, sartorius, and adductor longus and brevis. the extensors of the hip are the hamstrings: the biceps femoris (long head only, because the short head originates on the femur's linea aspera), the semimembrinosus, the semitendinosus, and the adductor magnus. the adductors are: the adductor longus and brevis, adductor magnus, gracilis, pectineus. the muscles that flex the knee are: sartorius, biceps femoris (both heads), semitendinosus, and semimembrinosus.
the femoral and obturator nerves are looked at briefly- both originate in the lumbar plexus at the L2,3,4 level. the femoral nerve passes through the femoral triangle and innervates the quadriceps, sartorius, iliacus, and pectineus. the obturator nerve passes through the obturator canal and innervates the gracilis, 1/2 of the adductor magnus, and the adductors (besides the pectineus)
a few details about the knee region: the "goose's foot" is a convergence of tendons on the medial upper tibia from the tendons of the sartorius, gracilis, and semitendinosus. two ligaments that stabilize the knee joint: the anterior cruciate ligament goes from the anterior tibia to the inner medial condyle of the femur and limits hyperextension. the posterior cruciate ligament goes from the posterior tibia to the inner lateral condyle of the femur and prevents anterior displacement of the femur.
questions
origins, insertions, actions, innervations...
1. sartorius
2. quadriceps femoris
3. pectineus
4. adductor longus and brevis
5. gracilis
6. adductor magnus
7. semitendinosus
8. semimembranosus
9. biceps femoris
10. where does the femoral nerve originate and where does it pass through?
11. what does the femoral nerve innervate?
12. where does the obturator nerve originate and where does it pass through?
13. what does the obturator nerve innervate?
which muscles produce these actions...
14. flexion of femur
15. extension of femur
16. lateral rotation of femur
17. adduction of femur
18. flexion of knee
19. what constitutes the pes anserinus? what else is it called?
20. what are the tibial plateaus?
21. is the fibula head part of the knee joint?
22. where does the anterior cruciate ligament attach to? what does it do?
23. where does the posterior cruciate ligament attach to? what does it do?
answers
1. O: ASIS, I: medial surface of the upper tibia, N: femoral nerve, A: flex, laterally rotate femur
2. O: rectus femoris-ASIS, vastus lateralis and medialis-linea aspera, vastus intermedius- upper anterior femur, I: tibial tuberosity via patella, N: femoral nerve, A: extend leg, flex femur.
3. O: pubis, I: linea aspera, N: femoral nerve, A: adduct, flex femur
4. O: pubis, I: linea aspera, N: obturator nerve, A: adduct, flex femur
5. O: pubis, I: medial upper tibia, N: obturator nerve, A: adduct femur, flex leg
6. O: pubis, ischium, I: linea aspera, adductor tubercle, N: obturator and sciatic nerve, A: adduct and extend femur
7. O: ischial tuberosity, I: upper medial tibia, N: tibial nerve, A: extend femur, flex and medially rotate leg
8. O: ischial tuberosity, I: medial condyle of tibia, N: tibial nerve, A: extend femur, flex and medially rotate leg
9. O: ischial tuberosity / linea aspera, I: head of fibula, N: tibial nerve and common fibular (long head/short head), A: flex and laterally rotate leg, and extend femur (long head only)
10. L234, passes through femoral triangle
11. iliacus, sartorius, quadriceps, pectineus
12. L234, passe through obturator canal
13. adductors (except pectineus), 1/2 of adductor magnus, gracilis.
14. rectus femoris, sartorius, pectineus, adductor longus and brevis.
15. adductor magnus, biceps femoris long head, semitendinosus, semimembrinosus.
16. sartorius
17. pectineus, adductor longus/brevis, gracilis, adductor magnus
18. sartorius, biceps femoris (long and short heads), semitendinosus, semimembrinosus.
19. "goose's foot" is made up of the common tendon insertions for gracilis, sartorius, semitendinosus.
20. the flat surfaces of the tibia which articulate with the femoral condyles.
21. no
22. anterior tibia to inner surface of lateral femoral condyle. limits hyperextension of knee and posterior displacement of femur on tibia
23. posterior tibia to inner surface of medial femoral condyle, prevents anterior disaplacement of femur.
Monday, January 19, 2009
ms anatomy: gluteal region
this is the first unit of anatomy on the lower half of the body. we start off looking at the hip bones, which are the fusion of three bones, the ilium, ischium, and pubis. lying on top of the hip bones is the sacrum, which connects via a synovial joint to the hips at the auricular surfaces of the sacrum and the ilium and the iliac tuberosity. the sacroiliac joint capsule is directly stabilized by the iliolumbar and the ventral/dorsal sacroiliac ligaments. the sacrum is generally in a 45 degree angle pointing downwards can undergo "nutation", which is an anterior/posterior rotation on the sacrum's axis, which is the second vertebrae. this movement is limited and stabilized by several other ligaments: the interosseus ligaments attach from the iliac tuberosity to the sacrum, the sacrospinous ligaments which attach from the lower sacrum to the ischial spine, and the sacrotuberous ligaments which attach from the lower sacrum to the ischial tuberosity.
the muscles of the hip joint are then introduced. these muscles are grouped in terms of the actions that they have on the femur. the psoas, iliacus (which attach to the lesser trochanter), and tensor fascia lata are the muscles that flex the femur. the obturators, gemellis, and quadratus femoris are a group of small muscles in the posterior hip bone that all attach to the greater trochanter and laterally rotate the femur. the gluteus maximus starts on the iliac crest / sacrum / coccyx and attaches into the iliotibial band (which inserts onto the lateral condyle of the tibia) and is the only muscle that extends the femur, and also laterally rotates the femur. the gluteus minimus and medius originate on the back of the ilium and insert onto the greater trochanter and medially rotate the femur.
the nerves that branch off of the lumbar and sacral plexuses are looked at. the lumbar plexus are the nerves that branch off of lumbar vertebraes 1-4. the femoral nerve branches off of L2,3,4 and innervates the iliacus, sartorius, and quadriceps. the obturator nerve branches off of L2,3,4 as well and innervate the adductors. the muscular branch of the lumbar plexus innervates the psoas and the quadratus lumborum. the iliohypogastric and ilioinguinal nerves innervate the lower abdominal muscles and skin. the genitofemoral nerve innervates the cremaster muscle and thigh skin. the lateral cutaneous nerve to the thigh innervates the lateral thigh skin.
the sacral plexus is formed from nerves branching off of L4-S4. the largest nerve coming off of it is the sciatic nerve, which comes off of L4,5,S1,2,3 and splits into the tibular and common fibular nerve, and innervates the hamstrings, 1/2 of the adductor magnus, and some other leg/foot muscles. the superior gluteal nerve branches off from L4,5,S1, exits superior to the piriformis, and innervates the gluteus medius/minimus and tensor fascia lata. the inferior gluteal nerve branches off from L5,S1,2, exits inferior to the piriformis and innervates the gluteus maximus. the pudendal nerve originates S2,3,4 and innervates the anal and urethral sphincters and genitalia. the nerve to the quadratus femoris originates in L4,5,S1, while the nerve to the obturator originates in L5,S1,2.
the last section added a few details about the hip joint; it is stabilized by the transverse acetabular ligament and the acetabular labrum, which enlarge the articular surface of the joint. the ligamentum teres attaches from the head of the femur to the transverse acetabular ligament. the blood supply to the hip joint is supplied by the medial and lateral circumflex arteries as well as the artery to the ligamentum teres.
questions
1. hip bone is also called the...
2. hip bone is the fusion of which bones?
3. conjunction of ischium and pubis forms...
4. what are some landmarks in the ilium?
5. sacroiliac joint is formed from...
6. what are the landmarks on the ischium?
7. what are the landmarks on the pubis?
8. what forms the synovial joint in the SI joint?
9. what can happen to the SI joint with age/inflammation?
10. what are the ligaments that stabilize the SI joint?
11. what is the anatomical position of the hip bone in the upright position?
12. where is the interosseus sacroiliac ligament?
13. sacrotuberous?
14. sacrospinous?
15. what do the sacrotuberous/sacrospinous ligaments form?
16. where is the axis of rotation for the sacrum?
17. what is nutation?
18. what is the result of nutation?
origins, insertions, innervation, actions...
19. psoas
20. iliacus
21. (quadratus lumborum)
22. gluteus maximus
23. gluteus medius
24. gluteus minimus
25. tensor fascia lata
26. obturator internus
27. superior and inferior gemelli
28. quadratus femoris
29. obturator externus
30. piriformis
which muscle(s) perform these actions...
31. medial rotation
32. lateral rotation
33. abduction
34. extension
35. flexion
lumbar plexus...
36. where does the femoral nerve originate and what does it innervate?
37. where does the obturator nerve originate and what does it innervate?
38. what innervates the psoas and the iliacus?
39. what innervates the lower abdominal muscles and skin?
40. what does the genitofemoral nerve innervate?
41. what innervates the lateral thigh skin?
42. where does the sciatic nerve originate and what does it split into?
43. where does the superior gluteal nerve originate?
44. where does the inferior gluteal nerve originate?
45. where does the pudendal nerve originate and what does it innervate?
46. where does the posterior cutaneous nerve originate?
47. where does the nerve to the quadratus femoris originate?
48. where does the nerve to the obturator internus originate?
49. what does the sciatic nerve innervate?
50. where does the sciatic nerve enter the thigh?
51. what does the superior gluteal nerve innervate and where is it in relation to the piriformis?
52. what does the inferior gluteal nerve innervate and where is it in relation to the piriformis?
53. what are the ligaments that attach the femur and acetabulum and what do they do?
54. what are the spiral ligaments around the hip joint capsule?
55. femoral head derives blood from...
56. failure of anastomoses can lead to...
answers
1. os coxae and innominate bone
2. ilium, ischium, pubis.
3. obturator foramen
4. greater sciatic notch, ASIS/AIIS, PSIS/PIIS
5. iliac tuberosity and auricular surfaces of ilium and sacrum
6. ischial spine, ischial tuberosity, lesser sciatic notch
7. pubic tuberosity.
8. auricular surfaces of sacrum and ilium.
9. fusion of the sacrum and ilium: "synostosis"
10. ventral/dorsal sacroiliac ligaments, iliolumbar ligaments
11. tilted 45 degrees forward such that the ISIS and pubic
12. iliac tuberosity and sacrum
13. sacrum to ischial tuberosity
14. sacrum to ischial spine
15. greater and lesser sciatic foramina
16. the second sacral vertebrae
17. rotation or tilting of sacrum around axis though interossues ligaments.
18. changes anterior-posterior diameter of pelvic outlet.
19. O: bodies, TVP's of T12-L5. I: lesser trochanter of femur N: lumbar plexus A: lat flex vertebral column, flex femur
20. O: iliac fossa I: lesser trochanter N: femoral nerve A: flex femur
21. O: iliac crest, TVP's of L1-5 I:12th rib N:lumbar plexus
22. O: iliac crest and sacrum, I: gluteal tuberosity and iliotibial tract, N: inferior gluteal, A: extend lat rotate femur
23. O: dorsal ilium, I: greater trochanter, N: superior gluteal, A: abduct, medially rotate femur
24. O: dorsal ilium, I:greater trochanter, N:superior gluteal, A: abduct, medially rotate femur
25. O: ASIS, I:iliotibial tract -> lat condyle of tibia, N:superior gluteal, A: abduct, medially rotate, flex femur, keep knee extended
26. O: obturator membrane I:greater trochanter, N:nerve to obturator internus, A: laterally rotate femur
27. O: ischium, I:greater trochanter, N:nerves to obturator internus and quad fem, A: laterally rotate femur
28. O:ischial tuberosity, I: quadrate tubercle, N: nerve to quadratus femoris, A:lateral rotate femur
29. O:obturator membrane, I:greater trochanter, N:obturator nerve, A: laterally rotate femur
30. O:ant sacrum, I:greater trochanter, N:S1,2 A:abduct, laterally rotate femur
31. tensor fascia lata, gluteus medius, gluteus minimus
32. gluteus maximus, piriformis, obturator internus, obturator externus, gemelli brothers, quadratus femoris
33. tensor fascia lata, gluteus medius, gluteus minimus, piriformis
34. gluteus maximus
35. iliacus/psoas, tensor fascia lata
36. L234, quadriceps, sartorius, iliacus, pectineus
37. L234, adductors
38. the muscular branches of the lumbar plexus.
39. iliohypogastric, ilioinguinal
40. cremaster muscle and thigh skin
41. lateral cutameous nerve to thigh
42. L4,5, S1,2,3. splits into the fibular and tibial nerve.
43. L4,5 S1
44. L5, S1,2
45. S2,3,4, innervates anal and urethral sphincters, external genitalia
46. S123
47. L4,5 S1
48. L5, S1,2
49. hamstrings, 1/2 of the adductor magnus, muscles of the leg/foot
50. between hamstrings and adductor magnus, through the adductor hiatus.
51. gluteus medius and minimus, exits above piriformis
52. gluteus maximus, exits below piriformis.
53. acetabular labrum and transverse acetabular ligament enlarge articular surface, ligamentum teres attaches head of femur to transverse acetabular ligament.
54. iliofemoral, ischiofemoral, pubofemoral.
55. medial and lateral circumflex femoral arteries and the artery to the ligamentum teres.
56. avascular necrosis of femoral head.
the muscles of the hip joint are then introduced. these muscles are grouped in terms of the actions that they have on the femur. the psoas, iliacus (which attach to the lesser trochanter), and tensor fascia lata are the muscles that flex the femur. the obturators, gemellis, and quadratus femoris are a group of small muscles in the posterior hip bone that all attach to the greater trochanter and laterally rotate the femur. the gluteus maximus starts on the iliac crest / sacrum / coccyx and attaches into the iliotibial band (which inserts onto the lateral condyle of the tibia) and is the only muscle that extends the femur, and also laterally rotates the femur. the gluteus minimus and medius originate on the back of the ilium and insert onto the greater trochanter and medially rotate the femur.
the nerves that branch off of the lumbar and sacral plexuses are looked at. the lumbar plexus are the nerves that branch off of lumbar vertebraes 1-4. the femoral nerve branches off of L2,3,4 and innervates the iliacus, sartorius, and quadriceps. the obturator nerve branches off of L2,3,4 as well and innervate the adductors. the muscular branch of the lumbar plexus innervates the psoas and the quadratus lumborum. the iliohypogastric and ilioinguinal nerves innervate the lower abdominal muscles and skin. the genitofemoral nerve innervates the cremaster muscle and thigh skin. the lateral cutaneous nerve to the thigh innervates the lateral thigh skin.
the sacral plexus is formed from nerves branching off of L4-S4. the largest nerve coming off of it is the sciatic nerve, which comes off of L4,5,S1,2,3 and splits into the tibular and common fibular nerve, and innervates the hamstrings, 1/2 of the adductor magnus, and some other leg/foot muscles. the superior gluteal nerve branches off from L4,5,S1, exits superior to the piriformis, and innervates the gluteus medius/minimus and tensor fascia lata. the inferior gluteal nerve branches off from L5,S1,2, exits inferior to the piriformis and innervates the gluteus maximus. the pudendal nerve originates S2,3,4 and innervates the anal and urethral sphincters and genitalia. the nerve to the quadratus femoris originates in L4,5,S1, while the nerve to the obturator originates in L5,S1,2.
the last section added a few details about the hip joint; it is stabilized by the transverse acetabular ligament and the acetabular labrum, which enlarge the articular surface of the joint. the ligamentum teres attaches from the head of the femur to the transverse acetabular ligament. the blood supply to the hip joint is supplied by the medial and lateral circumflex arteries as well as the artery to the ligamentum teres.
questions
1. hip bone is also called the...
2. hip bone is the fusion of which bones?
3. conjunction of ischium and pubis forms...
4. what are some landmarks in the ilium?
5. sacroiliac joint is formed from...
6. what are the landmarks on the ischium?
7. what are the landmarks on the pubis?
8. what forms the synovial joint in the SI joint?
9. what can happen to the SI joint with age/inflammation?
10. what are the ligaments that stabilize the SI joint?
11. what is the anatomical position of the hip bone in the upright position?
12. where is the interosseus sacroiliac ligament?
13. sacrotuberous?
14. sacrospinous?
15. what do the sacrotuberous/sacrospinous ligaments form?
16. where is the axis of rotation for the sacrum?
17. what is nutation?
18. what is the result of nutation?
origins, insertions, innervation, actions...
19. psoas
20. iliacus
21. (quadratus lumborum)
22. gluteus maximus
23. gluteus medius
24. gluteus minimus
25. tensor fascia lata
26. obturator internus
27. superior and inferior gemelli
28. quadratus femoris
29. obturator externus
30. piriformis
which muscle(s) perform these actions...
31. medial rotation
32. lateral rotation
33. abduction
34. extension
35. flexion
lumbar plexus...
36. where does the femoral nerve originate and what does it innervate?
37. where does the obturator nerve originate and what does it innervate?
38. what innervates the psoas and the iliacus?
39. what innervates the lower abdominal muscles and skin?
40. what does the genitofemoral nerve innervate?
41. what innervates the lateral thigh skin?
42. where does the sciatic nerve originate and what does it split into?
43. where does the superior gluteal nerve originate?
44. where does the inferior gluteal nerve originate?
45. where does the pudendal nerve originate and what does it innervate?
46. where does the posterior cutaneous nerve originate?
47. where does the nerve to the quadratus femoris originate?
48. where does the nerve to the obturator internus originate?
49. what does the sciatic nerve innervate?
50. where does the sciatic nerve enter the thigh?
51. what does the superior gluteal nerve innervate and where is it in relation to the piriformis?
52. what does the inferior gluteal nerve innervate and where is it in relation to the piriformis?
53. what are the ligaments that attach the femur and acetabulum and what do they do?
54. what are the spiral ligaments around the hip joint capsule?
55. femoral head derives blood from...
56. failure of anastomoses can lead to...
answers
1. os coxae and innominate bone
2. ilium, ischium, pubis.
3. obturator foramen
4. greater sciatic notch, ASIS/AIIS, PSIS/PIIS
5. iliac tuberosity and auricular surfaces of ilium and sacrum
6. ischial spine, ischial tuberosity, lesser sciatic notch
7. pubic tuberosity.
8. auricular surfaces of sacrum and ilium.
9. fusion of the sacrum and ilium: "synostosis"
10. ventral/dorsal sacroiliac ligaments, iliolumbar ligaments
11. tilted 45 degrees forward such that the ISIS and pubic
12. iliac tuberosity and sacrum
13. sacrum to ischial tuberosity
14. sacrum to ischial spine
15. greater and lesser sciatic foramina
16. the second sacral vertebrae
17. rotation or tilting of sacrum around axis though interossues ligaments.
18. changes anterior-posterior diameter of pelvic outlet.
19. O: bodies, TVP's of T12-L5. I: lesser trochanter of femur N: lumbar plexus A: lat flex vertebral column, flex femur
20. O: iliac fossa I: lesser trochanter N: femoral nerve A: flex femur
21. O: iliac crest, TVP's of L1-5 I:12th rib N:lumbar plexus
22. O: iliac crest and sacrum, I: gluteal tuberosity and iliotibial tract, N: inferior gluteal, A: extend lat rotate femur
23. O: dorsal ilium, I: greater trochanter, N: superior gluteal, A: abduct, medially rotate femur
24. O: dorsal ilium, I:greater trochanter, N:superior gluteal, A: abduct, medially rotate femur
25. O: ASIS, I:iliotibial tract -> lat condyle of tibia, N:superior gluteal, A: abduct, medially rotate, flex femur, keep knee extended
26. O: obturator membrane I:greater trochanter, N:nerve to obturator internus, A: laterally rotate femur
27. O: ischium, I:greater trochanter, N:nerves to obturator internus and quad fem, A: laterally rotate femur
28. O:ischial tuberosity, I: quadrate tubercle, N: nerve to quadratus femoris, A:lateral rotate femur
29. O:obturator membrane, I:greater trochanter, N:obturator nerve, A: laterally rotate femur
30. O:ant sacrum, I:greater trochanter, N:S1,2 A:abduct, laterally rotate femur
31. tensor fascia lata, gluteus medius, gluteus minimus
32. gluteus maximus, piriformis, obturator internus, obturator externus, gemelli brothers, quadratus femoris
33. tensor fascia lata, gluteus medius, gluteus minimus, piriformis
34. gluteus maximus
35. iliacus/psoas, tensor fascia lata
36. L234, quadriceps, sartorius, iliacus, pectineus
37. L234, adductors
38. the muscular branches of the lumbar plexus.
39. iliohypogastric, ilioinguinal
40. cremaster muscle and thigh skin
41. lateral cutameous nerve to thigh
42. L4,5, S1,2,3. splits into the fibular and tibial nerve.
43. L4,5 S1
44. L5, S1,2
45. S2,3,4, innervates anal and urethral sphincters, external genitalia
46. S123
47. L4,5 S1
48. L5, S1,2
49. hamstrings, 1/2 of the adductor magnus, muscles of the leg/foot
50. between hamstrings and adductor magnus, through the adductor hiatus.
51. gluteus medius and minimus, exits above piriformis
52. gluteus maximus, exits below piriformis.
53. acetabular labrum and transverse acetabular ligament enlarge articular surface, ligamentum teres attaches head of femur to transverse acetabular ligament.
54. iliofemoral, ischiofemoral, pubofemoral.
55. medial and lateral circumflex femoral arteries and the artery to the ligamentum teres.
56. avascular necrosis of femoral head.
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