Applied Anatomy for the FRCA

Bobby Krishnachetty, Abdul Syed, Bobby Krishnachetty, Abdul Syed

• Publisher: CRC Press
• Year: 2020
• ISBN:
  9780429664366
• Topic: Medicine
• Subtopic: Anesthesiology & Pain Management
• Edition: 1

Applied Anatomy for the FRCA covers the anatomical knowledge that trainee anaesthetists who are revising for the Primary and Final FRCA exams will need. The topics covered are derived from the FRCA curriculum and include the most up-to-date version of past exam questions, in order to ensure targeted and successful exam revision.

The content, illustrations and overall layout of this book ensure that common gaps in anatomical knowledge encountered by FRCA trainees are included. This reference is divided into sections pertaining to anatomical regions: head and neck, thorax, abdomen, spine, and the upper and lower limbs. The topics of importance to anaesthetists are presented under 'structures', 'circulation' and 'nervous system' (with relevance to regional anaesthesia). Each topic is extensively researched and presented in a simple format for maximum retention. This book makes learning and remembering applied anatomy as straightforward as possible.

Applied Anatomy for the FRCA supplements the knowledge required by trainee anaesthetists appearing for the FRCA exams. Clinical educators will also find it useful in teaching. It serves as a practical reference for anatomical knowledge at any point in an anaesthetist's career.

About the Editors

Dr Bobby Krishnachetty has been a Consultant Anaesthetist at Southend University Hospital since 2010 and a college tutor for six years. She completed her diploma in medical education and is the author of The Final FRCA Structured Oral Examination: A Complete Guide. She is also the organiser of the regional teaching for Core trainees in the East of England school of anaesthesia, as well as Founder of the 'Southend Viva Club' Primary and Final FRCA SOE revision courses for more than nine years, and Cofounder of MRCS OSCE webinars.

Mr Abdul Syed has been a Consultant Surgeon at Southend University Hospital since 2015. He is Lead for postgraduate teaching of surgical trainees, Cofounder of MRCS OSCE webinars and conducts Core surgical trainee interview skills courses. Mr Syed is also an Assessor for medical school interviews and an active participant in QI projects and research.

Head and Neck

1

Structures

• Scalp and base of skull
• Brain
• Pituitary gland
• Eye and optic tract
• Nose
• Sagittal section of head and neck
• Cross section at C6
• Larynx with grades at laryngoscopy
• Triangles of neck

Circulation

• Arterial supply of head and neck
• Great veins of head and neck

Nervous System

• Cranial nerves – II, V, VII and X
• Scalp blocks
• Eye blocks
  • Sub-Tenon’s block
  • Retrobulbar block
  • Peribulbar block
• Laryngeal nerve blocks
• Cervical plexus block

Structures

• Scalp and base of skull
• Brain
• Pituitary gland
• Eye and optic tract
• Nose
• Sagittal section of head and neck
• Cross section at C6
• Larynx with grades at laryngoscopy
• Triangles of neck

Scalp and Base of Skull

What are the layers of the scalp covering the skull (Figure 1.1)?

Use the SCALP mnemonic

• Skin with hair follicles and sebaceous glands
• Connective tissue with neurovasculature of the scalp
• Aponeurosis (galea aponeurotica)
• Loose areolar connective tissue which serves as a plane of access in neurosurgery. It is also called the ‘danger zone of the scalp’ as infection from scalp can reach the meninges through emissary veins.
• Periosteum

Figure 1.1 Layers of scalp.

Which bones make up the skull?

The skull is made up of eight bones which are interconnected by sutures which are immovable fibrous joints.

• One each of the frontal, sphenoid, occipital and ethmoid bones
• Two of the parietal and temporal bones

Briefly describe the structures that pass through the various foramina in the base of the skull.

Out of the different foramina, there are a few which are easy to remember: foramen caecum in front of the crista galli, cribriform plate, superior orbital fissure, foramen magnum, stylomastoid foramen, hypoglossal canal on either side of the foramen magnum.

The other foramina can be remembered as

OROS LAJ – in order of their appearance as shown in the figures (Figures 1.2 and 1.3).

Figure 1.2 Base of skull – inferior surface.

Figure 1.3 Base of skull – inner surface.

The base of the skull with its foramina and contents is shown in Table 1.1.

Table 1.1 Major Cranial Foramina and the Structures Passing Through

Foramen	Contents
Foramen caecum	Emissary vein from nose to superior sagittal sinus
Cribriform plate	Olfactory nerve Anterior ethmoidal nerve
Superior orbital fissure (Live Frankly To See Absolutely No InSult)	Lacrimal nerve (branch of ophthalmic nerve) Frontal nerve (branch of ophthalmic nerve) Trochlear nerve Superior branch of oculomotor nerve Abducens nerve Nasociliary nerve (branch of ophthalmic nerve) Inferior branch of oculomotor nerve Superior and inferior ophthalmic vein
Optic canal	Optic nerve Ophthalmic artery
Foramen rotundum	Maxillary nerve (V2)
Foramen ovale (O-MALE)	Mandibular nerve (V3) Accessory meningeal nerve Lesser petrosal nerve Emissary vein
Foramen spinosum (S-MEN)	Middle meningeal artery and vein Emissary vein Nervus spinosus
Foramen lacerum (L-GEMI)	Meningeal branch of ascending pharyngeal artery Emissary vein Traversed partially by Internal carotid artery Greater petrosal nerve
Auditory meatus	Facial nerve Vestibulocochlear nerve Labyrinthine vessels
Jugular foramen	Inferior petrosal sinus/sigmoid sinus Glossopharyngeal nerve Vagus nerve Accesory nerve Occ...