Anatomie

Question 1

A. vertebralis

Accepted Answer

The vertebral artery winds around the superior part of the lateral mass of the atlas and pierces the posterior atlanto-occipital membrane, the dura mater and the arachnoid. The right and left vertebral arteries unite at the caudal border of the pons to form the basilar artery.

Question 2

Muskel

Accepted Answer

The thin filaments are made up of actin, tropomyosin, and troponin. The thick filaments, which are about twice the diameter of the thin filaments, are made up of myosin. Troponin, actin, and tropomyosin all constitute thin filaments. However, during the initiation of muscle contraction, Ca2+ binds to troponin C and tropomyosin is displaced laterally, which exposes the binding site for myosin on actin. Troponin C contains 4 Ca2+ binding sites for the Ca2+ that initiates contraction. Human skeletal muscle is composed of a heterogeneous collection of muscle fibre types. These muscle fibre types can differ histologically, biochemically and physiologically. The biochemical classification is based on muscle fibre myosin ATPase histochemistry into two groups: Type 1 (slow twitch): These muscle fibres usually depend upon aerobic glycolytic metabolism and aerobic oxidative metabolism. These muscle fibres are rich in mitochondria, have a good blood supply, rich in myoglobin and are resistant to fatigue. Type II (fast twitch): These muscle fibres are sub-divided into type IIa also relying on aerobic/oxidative metabolism but type IIb fibres rely on anaerobic/glycolytic metabolism. Fast twitch muscle fibres are more easily fatigued but produce short bursts of power. The twitch speeds of cardiac and smooth muscle are relatively slow compared with skeletal muscle.

Question 3

Spinalnerven, lumbal

Accepted Answer

L1 spinal nerve: iliohypogastric and ilioinguinal nerves. L1/L2: sensory branches lateral cutaneous nerve of the thigh and the obdurator nerve L2/3: flexion of the hip (iliacus and psoas major muscles) L3/4: lower roots of the femoral nerve supply the quadriceps muscle, which is responsible for extension of the knee. L4/5: upper roots of the sciatic nerve have the following motor innervations: L4: Tibial nerve supplying the tibialis anterior muscle responsible for dorsiflexion and inversion of the foot. L5: Superior gluteal nerve supplying the gluteus minimis and medius muscles responsible for abduction and medial rotation of the thigh S1: Tibial nerve suppling the gastrocnemius muscle resulting in plantar flexion.

Question 4

Spinale Gefässversorgung

Accepted Answer

The anterior spinal arteries arise from the vertebral arteries (not carotids) and unite below the foramen magnum to form a single artery. This single artery (not paired) then supplies the pia matter and anterior two thirds of the spinal cord including the anterior and lateral columns (major motor tracts). It anastomoses with the posterior artery over the conus medullaris. The posterior spinal arteries arise from the vertebral arteries, which pass down the spinal cord but they do not unite. They supply the posterior one third of the spinal cord (including the major sensory tracts). The blood supplied by the anterior and posterior spinal arteries is augmented by collateral radicular arteries, the most important being the branches of the posterior intercostals arteries at the sites of the cervical and lumbar cord enlargements. The artery of Adamkiewicz (greater radicular artery) supplies blood to the anterior spinal artery and distal cord. It usually arises from an intercostals branch between T8 and T12.

Question 5

chemorezeptor-Triggerzone

Accepted Answer

The chemoreceptor trigger zone (CTZ) is found in the floor of the fourth ventricle and lies outside the blood brain barrier. Both ondansetron and all the trons and the butryphenones, (for example, haloperidol) can cause prolonged QT intervals. The seventh cranial nerve via its chorda tympani branch can contribute to nausea. Neurokinin 1A is an antagonist in the CTZ, substance P an agonist.

Question 6

Sehnenreflexe

Accepted Answer

The tendon reflexes are ones that are dependent on the integrity of certain nerve roots. REFLEX ROOT MUSCLE biceps C5,C6 biceps triceps C7,C8 triceps supinator C5,C6 brachioradialis finger C8 finger flexors knee L3,L4 quadriceps ankle S1 gastrocnemius plantar S1 plantar abdominal T8-T12 anterior abdominal anal S3,S4 anal cremasteric T12,L1 cremasteric

Question 7

Nervenfasen

Accepted Answer

Class A-alpha fibres provide motor function and proprioception sensation. Class A-beta fibres carry touch and pressure sensation. Class A-gamma fibres provide motor function to muscle spindles. Class A-delta fibres carry pain, cold and touch sensation. Myelinated Class B nerves are autonomic preganglionic fibres. Unmyelinated Class C nerves are autonomic postganglionic fibres which also carry pain and temperature sensation.

Question 8

Trachea

Accepted Answer

The trachea starts at C6 and extends to the level of T4 where the trachea bifurcates. It is approximately 15 cm long in an adult. The trachea has 16-20 C-shaped cartilaginous rings. The right main bronchus separates from the trachea at a 25° angle, whereas the left main bronchus separates at an angle of 45°. The blood supply to the trachea is from the inferior thyroid arteries, which are branches of the thyrocervical trunk, which arises from the first part of the subclavian artery.

Question 9

Augenhöhle

Accepted Answer

Superior Orbital Fissure -lacrimal nerve -frontal nerve of N. ophtalmicus -cranial nerve IV (trochlearis) -cranial nerve III (oculomotorius, superior and inf div) -nasociliary branch of cranial nerve V (trigeminus) -sympathetic roots of ciliary ganglion (arrow) -cranial nerve VI (abducens) -superior ophthalmic vein Inferior Orbital Fissure -maxillary -pterygopalantine ganglion nerve -pterygoid nerves -inferior ophthalmic vein Optic Canal -Optic nerve -Ophthalmic Artery -Sympathetic fibers from carotid plexus

Question 10

N. obturatorius

Accepted Answer

Plexus lumbalis (L2-4), lat. des Ovars Ramus anterior Musculus adductor brevis et longus, M. gracilis, M. pectineus Hautbereich am medialen Oberschenkel Ramus posterior Musculus obturatorius externus, M. adductor magnus sensibel Kniegelenk ventral

Question 11

Nase

Accepted Answer

The walls of the anterior nasal passage are supplied by the anterior ethmoidal branch of the nasociliary nerve, and the floor is innervated by the superior dental nerve. The walls and floor of the posterior nasal passage are innervated by the long and short sphenopalatine nerves and the great palatine nerve. The vestibule is innervated by small braches of the infraorbital branch of the maxillary nerve. The nasopharynx is innervated by the sensory braches of the trigeminal nerve.

Question 12

Bronchien und Alveolen

Accepted Answer

Total ventilation does approximately equal pulmonary blood flow, where alveolar ventilation is 5250 ml/min and pulmonary blood flow is 5000 ml/min. The bronchial circulation supplies blood down as far as the terminal bronchioles (not the respiratory bronchioles). The alveoli are 0.3 mm in diameter and the blood-gas barrier is approximately 0.3 µm thick. The erythrocytes traverse the alveolar capillary in 0.75 seconds.

Question 13

Cerebrale Blutversorgung

Accepted Answer

The arterial blood supply to the brain is provided by the two internal carotid arteries (two thirds) and the two vertebral arteries (one third). The internal carotid artery divides into the anterior and middle cerebral arteries that supply the anterior two thirds of the cerebral hemispheres. The ophthalmic artery is a branch of the internal carotid artery (not anterior cerebral artery). The vertebral arteries unite to form the basilar artery, which supplies the brain stem and cerebellum. The basilar artery then divides into the two posterior cerebral arteries that supply the posterior one third of the cerebral hemispheres. The circle of Willis is formed by anastomoses linking the carotid arterial system to the vertebrobasilar system. The anterior communicating artery links the anterior cerebral arteries and the posterior communicating arteries link the vertebrobasilar system to the carotid system. This provides a collateral blood supply should one or more of the four extracranial arteries supplying the brain become diseased.

Question 14

Epidural space

Accepted Answer

The epidural space extends downwards from the foramen magnum to the sacral hiatus and is triangular in cross-section. The dural sac ends at S2 in an adult and S3/4 in an infant. The pressure in the epidural space is subatmospheric (negative), due to transmission of the subatmospheric intrathoracic pressure through the intervertebral foramina. It is greatest in the upper and middle thoracic regions and lowest in the lumbar and sacral regions, as distance from the thorax increases. The epidural space contains: Fat Epidural veins (Batson's plexus) Small arteries Lymphatics, and Spinal nerve roots.

Question 15

Plexus cervikalis

Accepted Answer

The cervical plexus is formed by the anterior primary rami of C1 to C4 and divides into superficial and deep branches. The superficial branches pierce the deep fascia at the middle of the posterior border of the sternocleidomastoid, and provide sensation from the lower border of the mandible to the level of the second rib. The deep branches supply motor fibres to the neck muscles and diaphragm and are located in the sulci of the transverse processes. Complications of a cervical plexus block include injection of local anaesthetic into the vertebral artery, subarachnoid and epidural spaces, and blockade of the phrenic nerve, recurrent laryngeal nerve and cervical sympathetic plexus.

Question 16

Pupillenreflex

Accepted Answer

The pupillary light reflex is a four neurone arc. The first neurone is an optic nerve fibre that projects from the retina to the pretectal nucleus in the midbrain at the level of the superior colliculus. Therefore, optic nerve fibres to the pretectal nucleus represents the afferent limb of the pupillary reflex arc. The second neurone connects the pretectal nucleus to both Edinger-Westphal nuclei, thus explaining why a unilateral light stimulus evokes bilateral pupillary constriction. The third neurone is a parasympathetic fibre from each Edinger-Westphal nucleus that is conveyed by the oculomotor nerve to the ciliary ganglion in the orbit. The fourth neurone leaves the ciliary ganglion and innervates the sphincter muscle. Sympathetic nerves fibres from the superior cervical ganglion mediate pupillary dilatation and are not involved in the light reflex

Question 17

Herz

Accepted Answer

The atrioventricular node is situated above (not below) the opening of the coronary sinus. The sympathetic nerve supply to the heart is provided by the superficial and deep cardiac plexuses. The superficial cardiac plexus is formed by branches from the left superior cervical sympathetic ganglion and the left vagus. The deep cardiac plexus is formed by branches from both the left and right inferior and middle, cervical sympathetic ganglia, both vagi and the upper four thoracic sympathetic ganglia. The right border of the heart is formed entirely by the right atrium; the left border is formed mainly by the left ventricle; and the inferior border by the right ventricle, the lower part of the right atrium and the apex of the left ventricle. The tricuspid, pulmonary and aortic valves have three cusps, the mitral valve has two.

Anästhesie (Subject) / Anatomie (Lesson)