Anatomy Review Block 1

8/19/2019 Anatomy Review Block 1

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Welcome to Anatomy!!!Block 1 Review: Back and Thorax


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Vertebral Column

33 vertebrae

cervical 1 thoracic " lumbar " #u$ed $acral % #u$ed coccy&eal

Curvature$ 'rimary( thoracic and $acral )econdary( cervical and lumbar When*why do we develo+ the$e curvature$,


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Abnormal )+inal Curvature$

)colio$i$( lateral deviation o# the$+inal column -ne.ual &rowth o# VC/

ero$ion/ or weakne$$*+araly$i$o# vertebral mu$cle$

0y+ho$i$( increa$ed +rimarycurvature o# the thoracic re&ion unchback/ can be a re$ult o#

o$teo+oro$i$

2ordo$i$( increa$ed $econdarycurvature o# the lumbar re&ion 're&nant women and obe$e

+eo+le!


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)+ina Bi da

Re$ult$ #rom abnormal clo$ure o# the vertebral arch

durin& develo+ment 4olic acid de ciency What dru&$ can cau$e thi$,

Ty+e$ include )+ina Bi da 5cculta( #ailure o# vertebral arch to clo$e/ $mall

tu#t o# hair on lower back 6enin&ocele( +rotru$ion o# menin&e$ throu&h the unclo$ed

vertebral arch 6enin&omyelocele( +rotru$ion o# menin&e$ and $+inal cord

throu&h the unclo$ed vertebral arch


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)+ina Bi da 7xam+le$


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Whi+la$h 8n9ury

4orce drive$ trunk #orwardand cau$e$ the head to la&behind which re$ult$ inhy+erexten$ion o# the

u++er +art o# the neck andhy+er exion o# the lower+art o# the neck


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Axi$ and Atla$ Remember

C1( Atla$/ articulate$ with

the $kull C ( Axi$/ den$/ articulate$

with the atla$ ;5 V7RT7BRA2 the mo$tim+ortant li&ament in thebody, Tran$ver$e li&ament o#

atla$!!


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4racture$ o# C1 and C

?e@er$on $

Anterior and +o$terior #racture o# the arche$ o# C1 Think o# $omeone divin& head r$t into a +ool 6edical emer&ency i# the tran$ver$e li&ament o# atla$ i$

com+romi$ed why,

an&man $ 4racture o# the +edicle$ o# C 4orcible hy+erexten$ion o# the neck


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4racture$ o# C1 and C =con t>

C1( ?e@er$on $

C ( an&man $


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and cervical re&ion$ =C"(E or CE( > Remember our ca$e!

2ower back +ain


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Vertebral Venou$ 'lexu$ ?u$t kee+ in mind that the venou$

+lexu$ o# the vertebral $y$tem


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Ca$e )tudy

)cott 9u$t recently $tarted colle&e and ha$ not been

#eelin& well #or the +a$t #ew day$G i$ roommate ha$taken him to your 7R #or hel+G e noted a #ever andcom+lain$ o# headache$/ $ti@ neck/ vomited x thi$mornin& be#ore comin& into the o ce/ and that theHli&ht$ are too bri&htI in the ho$+italG


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2umbar 'uncture


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2un&$!!! Ri&ht main bronchu$

)horter/ wider/ and

more vertical than thele#t main bronchu$ Why i$ thi$ $i&ni cant, Remember: ri&ht lun&

ha$ 3 lobe$!!

2e#t main bronchu$ )maller in diameter butlon&er than the ri&htmain broncu$/ +a$$e$under the aortic arch


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'neumothorax

Accumulation o# air in the thorax that ultimately cau$e$ thelun& to colla+$e

Traumatic +neumothorax( occur$ due to +uncture throu&h thethoracic wall 5+en +neumothorax( air can #reely ow throu&h the +uncture

wound Ten$ion +neumothorax( air enter$ wound u+on in$+iration and

cannot &et out o# throacic cavity durin& ex+iration/ +re$$ure build$

)ym+tom$


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)+ontaneou$ v$G Ten$ion 'neumo$

)+ontaneou$ 'neumo Ten$ion 'neumo: notice the $hi#tin the media$tinal $tructure$AWAJ #rom the colla+$ed lun&!


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'leural 7@u$ion Accumulation o# uid within the +leural

$+ace Remember the +leura i$ the vi$ceral

coverin& o# the lun&$!

'atient will $u@er #rom dy$+nea due touid com+re$$in& the lun&$

What will you nd on +hy$ical exam, Au$cultation: decrea$ed breath $ound$

over area o# the e@u$ion

'ercu$$ion: dull to at $ound$ Treat by thoracente$i$

Kth interco$tal $+ace/ midaxillary line 8n$ert needle above the $u+erior mar&in

o# the lower rib to avoid the interco$tal

nerve!


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Difuse interstitialin ltrates: atypicalpneumonia

Legionella pneumonia:consolidation in lowerlobes

Pneumococcalpneumonia: le tlower lobeconsolidationwith pleural

efusion


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Tuberculo$i$ 8n#ectiou$ lun& di$ea$e/ 6ycobacterium tuberculo$i$ Cou&h/ #ever/ $weat$/ tiredne$$/ wei&ht lo$$ 'rimary TB: look #or in ltrative +roce$$ in middle or lower lun&

re&ion$ )econdary TB: reactivation o# dormant in#ection/ look #or le$ion$

in ri&ht u++er lobe

'ulmonary edema 4luid accumulation within the lun&$ Can be cau$ed by le#t ventricular #ailure

Back u+ o# blood on the le#t $ide o# the heart would cau$eincrea$ed hydro$tatic +re$$ure within the +ulmonary vein$

which would re$ult in uid bein& +u$hed into the alveoli


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2ym+hatic draina&e o# the 2un&


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eart 7mbryolo&y

Embryonic Structure Gives rise to Truncu$ arterio$u$ A$cendin& aorta and +ulmonary

trunk

Bulbu$ cordi$ )mooth +art$ o# 2 M R ventricle$

'rimitive atrium Trabeculated +art o# 2 M R atria

'rimitive ventricle Trabeculated +art o# 2 M Rventricle$

'rimitive +ulmonary vein )mooth +art o# le#t atrium

2e#t horn o# $inu$ veno$u$ Coronary $inu$

Ri&ht horn o# $inu$ veno$u$ )mooth +art o# ri&ht atrium=$inu$ venarum>

Ri&ht common cardinal vein and

ri&ht anterior cardinal vein

)VC


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uman eart


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Con&enital eart 'er$i$tent truncu$ arterio$u$: lack o# #ormation

o# the aortico+ulmonary $e+tum/ mo$t +atient$have a V)<

Tran$+o$ition o# the &reat ve$$el$: aorta and+ulmonary arterie$ are $witched/ #atal unle$$ a$hunt i$ +re$ent What $tructure can +hy$ician$ kee+ +atent

with +ro$ta&landin 7 analo&ue$, Tetralo&y o# 4allot

'ulmonary $teno$i$ 5verridin& aorta V)<

Ri&ht ventricular hy+ertro+hy


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C Ventricular $e+tal de#ect: mo$t common C


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eart O3


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eart Valve$

Anatomy Review Block 1

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