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401-600 Flashcards

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USMLE® Step 1 flashcards
1
Q

In females, meiosis is arrested twice - when and at what stages of meiosis?

A
  1. First, in utero at prophase I, 2. Second, at ovulation in metaphase II
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2
Q

What cell is under control of FSH and testosterone; secretes inhibin, MIF, and androgen-binding protein; and phagocytizes the excess cytoplasm of the spermatid?

A

Sertoli cell

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3
Q

What must occur for an egg to complete ovulation?

A

It needs to be fertilized by a sperm. If it is not, the egg is released in metaphase II and meiosis is incomplete.

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4
Q

What is the chromosome number at the end of meiosis I?

A

23 (2n)-it is the reductive phase of meiosis.

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5
Q

What is the major androgen released from the zona reticularis?

A

Dehydroepiandrosterone (DHEA)

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6
Q

What hormone causes an increase in the accumulation of adipose and collagenous tissue of the breast and an increase in the branching of the ducts of the breast?

A

Estrogen

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7
Q

What promotes further prolactin and oxytocin release?

A

Suckling

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8
Q

What part of the placenta is derived from the mother?

A

Decidua basalis

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9
Q

What is the most common site of fertilization?

A

Ampulla of the fallopian tube

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10
Q

What is the only cranial nerve that comes off the dorsal surface of the brain stem?

A

CN IV

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11
Q

What type of fiber is carried in the dorsal root?

A

Sensory or motor. Sensory only

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12
Q

How would a lower motor neuron (LMN) lesion present?

A

Hyporeflexia, fasiculations and flaccid paralysis (always ipsilateral)

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13
Q

What is the name of the brain stem tract in which the dorsal columns run?

A

Medial lemniscus

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14
Q

What is the ability to tell what something is without looking at it and using only your hands?

A

Stereognosis

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15
Q

In what tract do pain and temperature fibers run?

A

Spinothalamic tract

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16
Q

What gyrus in the cerebral cortex receives information from fibers of the dorsal column tract?

A

Postcentral gyrus

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17
Q

What area of the brain is responsible for contralateral gaze?

A

Frontal eye field (Brodmann area 8)

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18
Q

What is the thalamic relay nucleus for the visual system?

A

Lateral geniculate body (LGB)

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19
Q

What is the function of the ossicles?

A

They increase the intensity of sound

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20
Q

What muscle in the eye is responsible for accommodation?

A

Ciliary muscle

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21
Q

What area of the eye has the greatest visual acuity?

A

Fovea (it is made up soley of cones)

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22
Q

What cell type in the eye is for color vision?

A

Cones (Cones and color)

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23
Q

If there is macula sparing in a visual deficit, where is the lesion?

A

In the occipital lobe of the cerebral cortex (optic radiations)

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24
Q

…

A

Which way do the eyes drift in a frontal eye field lesion?

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25
Q

To the side of the lesion

A

What is the thalamic relay nucleus that CN V needs to “speak” to in order to pass its information on to the cerebral cortex?

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26
Q

Ventroposteromedial (VPM)

A

Cell bodies of what fibers are found in the mesencephalic nucleus of CN V?

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27
Q

Proprioception of the face (CN V) and motor (jaw jerk reflex)

A

If a patient presented with an LMN lesion in CN V, CN VII, or CN XII, what would you see?

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28
Q

Ipsilateral paresis

A

What is the motor relay nucleus of the thalamus?

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29
Q

Ventrolateral (VL) nucleus of thalamus

A

What is the only cell type to leave the cerebellum?

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30
Q

Purkinje (inhibitory) - GABA

A

If a patient presented with a right-sided cerebellar lesion, which way would the patient fall if he closed his eyes?

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31
Q

To the right

A

What is the function of the superior olivary nucleus?

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32
Q

To localize and detemine the nature of sounds (Sound and superior start with S.)

A

If a patient presents with a left nystagmus, where is the lesion?

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33
Q

On the right, because the nvstagmus is named for the fast component, and the fast component is to the unaffected side.

A

What region of the cerebellum is responsible for the planning of movements?

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34
Q

Cerebellar hemisphere

A

What is the thalamic relay nucleus for the limbic system?

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35
Q

Anterior nucleus

A

What fluid is found in the anterior chamber of the eye?

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36
Q

Aqueous humor

A

What is the dividing line between the anterior and posterior chambers of the eye?

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37
Q

The lens

A

If there is a total anopsia of the left eye, where is the lesion?

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38
Q

Optic nerve of the left eye

A

What is the center for ipsilateral gaze?

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39
Q

The paramedian pontine reticular formation (PPRF)

A

What fluid of the inner ear has an electrolyte content like that of the extracellular fluid compartment (ECF)?

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40
Q

Perilymph

A

What is the thalamic relay nucleus for the auditory system?

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41
Q

MGB

A

What region of the cerebellum is responsible for balance and eye movement?

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42
Q

Flocculonodular lobe

A

What is the only cell in the cerebellum to have an excitatory neurotransmitter?

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43
Q

Granule cell

A

What does the nystagmus look like if cold water is placed in the right ear?

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44
Q

Slow drift to the right, fast drift to the left

A

COWS

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45
Q

Information from the cerebellum leaves via what?

A

Superior cerebellar peduncle

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46
Q

In what portion of the internal capsule are you if you can see the caudate nucleus?

A

Anterior limb

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47
Q

What type of memory is lost in a hippocampal lesion?

A

Long-term memory

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48
Q

In what region of the brain stem does the corticospinal tract cross over?

A

Medullary decussation

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49
Q

From what gyrus of the brain does the corticospinal tract originate?

A

Precentral gyrus

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50
Q

What type of fibers are carried in the ventral rami?

A

Both sensory and motor (from the spinal nerve on both sensory and motor fibers)

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51
Q

What are the hallmark signs of an upper motor neuron (UMN) lesion?

A
  1. Hyperreflexia 2. Spastic paralysis 3. Positive Babinski sign
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52
Q

What tract carriers fibers for voluntary refined movements of the distal extremities?

A

Corticospinal tract

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53
Q

What is the name of the tract in which the dorsal columns from the lower extremities run?

A

Fasciculus gracilis (It is medial of the two tracts on a cross-section of the spinal cord; the lateral tract is the fasciculus cuneatus.) Remember: Lower extremities dancing-graceful-gracilis.

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54
Q

What is the function of the superior colliculi?

A

Cell bodies that are to be relayed to the thalamus for sight are found there. (Sight and superior start with S.)

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55
Q

In order for sensory information from the dorsal columns and the spinothalamic tract to get to the cerebral cortex, they must use what thalamic relay nucleus?

A

Ventroposterolateral (VPL)

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56
Q

In which region of the spinal cord does the spinothalamic tract cross over?

A

Ventral white commissure (VWC)

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57
Q

Sensory information from the spinothalamic tract sends its information to what region of the cerebral cortex?

A

Postcentral gyrus

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58
Q

In which region of the brain stem do the dorsal columns cross over?

A

Lower medulla (synapse on nucleus gracilis or cuneatus)

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59
Q

What tract carries conscious proprioception,fine touch, two-point discrimination, and vibratory sense?

A

Dorsal column tract (all senses except pain and temperature)

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60
Q

What tract of the spinal cord carries dorsal column information from the upper extremities?

A

Fasciculus cuneatus

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61
Q

If the right side of the corticobulbar tract to the muscles of facial expression were damaged, where would the deficit be seen?

A

In the contralateral lower face (left)

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62
Q

If the corticobulbar tract for CN V and CN XII were cut on the right side, where would the lesion be?

A

There would be no deficit, because the corticobulbar tract receives bilateral input.

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63
Q

What type of fibers are carried in the ventral root?

A

Motor only

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64
Q

What peduncle(s) carry information into the cerebellum?

A

Inferior and middle cerebellar peduncles

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65
Q

Cell bodies of what fibers are found in the trigeminal ganglion?

A

Touch, pain, and temperature

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66
Q

When the head moves, what causes the eyes to move in the opposite direction?

A

Vestibular system

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67
Q

Unconscious proprioception, body sense, and motor execution are functions of what part of the cerebellum?

A

Vermis and intermediate lobe

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68
Q

What three structures contain perilymph?

A
  1. Scala tympani 2. Scala vestibuli 3. Semicircular canals
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69
Q

The gravity receptors for changes in the position of the head are located in what part of the inner ear?

A

Saccule and utricle

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70
Q

What cells are for black and white vision (night vision)?

A

Rods

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71
Q

What is the fluid of the posterior compartment of the eye?

A

Vitreous humor

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72
Q

What type of fluid in the inner ear has the consistency of intracellular fluid (ICF)?

A

Endolymph (high levels of K+)

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73
Q

Name three lesions that can cause left homonymous hemianopsia?

A
  1. Lesion of the right optic tract 2. Lesion of the lateral geniculate body (LGB) 3. Lesion of the optic radiation
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74
Q

What lesion produces a tremor upon movement?

A

A cerebellar lesion

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75
Q

What part of the inner ear is sensitive to angular acceleration and deceleration?

A

Semicircular canals

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76
Q

What is the normal volume of CSF?

A

Approximately 140 ml

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77
Q

What muscle of the eye is under parasympathetic control?

A

Sphincter pupillae (part of iris)

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78
Q

What cranial nerve receives sensory information from the cornea?

A

CN VI (ophthalmic division)

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79
Q

What artery supplies blood to the trunk and the lower extremities on a homunculus map of the cerebral cortex?

A

Anterior cerebral artery

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80
Q

What structures of the inner ear contain endolymph?

A
  1. Scala media 2. Semicircular ducts 3. Saccule Utricle
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81
Q

With what type of lesions do you see tremors at rest?

A

Lesions of the basal ganglia

82
Q

What muscle of the eye is under sympathetic control?

A

Dilator pupillae (part of the iris)

83
Q

Where is the lesion if the patient presents with a right nasal hemianopsia?

A

Right internal carotid artery compression on the optic chiasm

84
Q

What part of the inner ear functions in head movement?

A

Semicircular ducts

85
Q

What part of the internal capsule are you in if you see the thalamus?

A

Posterior limb of the internal capsule

86
Q

What region of the basal ganglia is affected in Parkinson’s disease?

A

Substantia nigra (degeneration)

87
Q

Hemorrhagic destruction of the contralateral subthalamic nuclei results in what disorder?

A

Herniballismus (wild flailing movements)

88
Q

Slow writhing movements (athetosis) are caused by what?

A

Hypermyelinization of the corpus striatum and the thalamus (seen in cerebral palsy)

89
Q

Atrophy of the striatum of the basal ganglia results in what?

A

Chorea (involuntary quick movements)

90
Q

What tracts are found in the genu of the internal capsule?

A

Corticobulbar tracts

91
Q

What tracts are found in the posterior limb of the IC?

A

Corticospinal Spinothalamic Dorsal column Thalamocortical

92
Q

What tracts are found in the anterior limb of the IC?

A

Thalamocortical tracts

93
Q

If warm water is placed in the right ear, what does the nystagmus look like?

A

Slow drift to the left and fast drift to the right (COWS

94
Q

What lesion causes a bitemporal hemianopsia?

A

Optic chiasm lesion

95
Q

What area of the brain is known as the motor speech area?

A

Broca’s area

96
Q

What does Meyer’s loop lesion cause?

A

Contralateral homonymous superior quadrantopia

97
Q

Blood supply to the head/neck area and the upper limb on a homunculus map in the cerebral cortex comes from what artery?

A

Middle cerebral artery

98
Q

What area of the brain is known for language comprehension?

A

Wernicke’s area

99
Q

Where is the lesion if the patient presents with a right homonymous inferior quadrantanopia?

A

Left upper loop lesion

100
Q

What region of the cerebellum is affected if a patient has dystaxia of the legs and trunk during walking?

A

Anterior vermis (It is most commonly caused by chronic alcohol abuse.)

101
Q

Where is the lesion in a patient who presents with a broad-based gait, hypotonia, intention tremors, nystagmus, and ataxia?

A

Cerebellum

102
Q

What are the functions of the external auditory meatus?

A

Sound collection and protection of the tympanic membrane

103
Q

What is the function of the inferior colliculi?

A

To receive bilateral auditory input and arrange the input tonotopically

104
Q

If a patient presents with nystagmus, dystaxia, and hypotonia of the ipsilateral limbs, what area of the cerebellum is affected?

A

Hemisphere

105
Q

What lesion of the cerebellum is usually caused by an ependymoma or medulloblastoma, resulting in dystaxia of the trunk with an inability to maintain an upright posture?

A

Posterior vermis lesion

106
Q

What spinal cord injury results in flaccid paralysis and muscle atrophy?

A

Polio (bilateral ventral horn lesion)

107
Q

What spinal cord lesion results in a lower motor neuron (LMN) lesion at the level of the lesion and an upper motor neuron (UMN) lesion below the level of the lesion?

A

Amyotrophic lateral sclerosis (ALS)-Lou Gehrig’s disease

108
Q

What arterial occlusion would result in a loss of all tracts in the spinal cord except the dorsal columns?

A

Anterior spinal artery occlusion (posterior spinal artery supplies the dorsal columns)

109
Q

What spinal cord lesion results in a bilateral loss of pain and temperature at the level of the lesion?

A

Syringomyelia (VWC lesion)

110
Q

What spinal cord lesion causes a bilateral dorsal column loss below the level of the lesion?

A

Tabes dorsalis (neurosyphilis)

111
Q

What disease is associated with demyelination of the dorsal column, spinocerebellar tract, and corticospinal tract?

A

Subacute combined degeneration

112
Q

What arterial occlusion results in contralateral spastic hemiparesis, contralateral spastic lower face, and ipsilateral oculomotor palsy (dilated, ptosis, eye down and out)?

A

Posterior cerebral artery occlusion (ventral midbrain syndrome)

113
Q

What arterial occlusion results in the following syndromes (Name artery and specific region.): Contralateral spastic hemiparesis of the body?

A

Vertebral artery-pyramid

114
Q

What arterial occlusion results in the following syndromes (Name artery and specific region.): Contralateral loss of position and vibration?

A

Vertebral artery-medial lemniscus

115
Q

What arterial occlusion results in the following syndromes (Name artery and specific region.): Ipsilateral paralysis of the tongue?

A

Vertebral artery-CN XII

116
Q

What arterial occlusion results in the following syndromes (Name artery and specific region.): Ipsilateral limb ataxia?

A

Anterior inferior cerebellar artery-inferior cerebellar peduncle

117
Q

What arterial occlusion results in the following syndromes (Name artery and specific region.): Ipsilateral pain and temperature loss of the face?

A

Anterior inferior cerebellar artery-spinal nucleus of CN V

118
Q

What arterial occlusion results in the following syndromes (Name artery and specific region.): Contralateral pain and temperature of the body?

A

Anterior inferior cerebellar artery- spinotbalamic tract

119
Q

What arterial occlusion results in the following syndromes (Name artery and specific region.): Nystagmus away from the lesion?

A

Anterior inferior cerebellar artery- vestibular nuclei

120
Q

What arterial occlusion results in the following syndromes (Name artery and specific region.): Ipsilateral Horner’s syndrome?

A

Anterior inferior cerebellar artery- descending autonomics

121
Q

What arterial occlusion results in the following syndromes (Name artery and specific region.): Ipsilateral facial paralysis?

A

Anterior inferior cerebellar artery-CN Vll

122
Q

What arterial occlusion results in the following syndromes (Name artery and specific region.): Deafness?

A

Anterior inferior cerebellar artery-CN VIll

123
Q

What is the name for the most prominent spinous process in the spine?

A

Vertebra prominens (C7 in 70% of cases, C6 in 20%, T1 in 10%)

124
Q

What portion of the intervertebral disk is a remnant of the notochord?

A

Nucleus pulposus

125
Q

What three muscles comprise the erector spinae?

A
  1. Iliocostalis 2. Longissimus 3. Spinalis
126
Q

What are the names given to the first and second cervical vertebrae?

A

C1-atlas C2-axis

127
Q

To what vertebral level does the spinal cord extend?

A

LI to L2

128
Q

What is the name of the extension of the dura mater that attaches at the level of S2?

A

External filum terminale

129
Q

How many pairs of spinal nerves exit from the spinal cord?

A

31 pairs

130
Q

What is the name of the region where the manubrium and the body of the sternum articulate?

A

Sternal angle of Louis

131
Q

What muscle originates from the third to the fifth ribs and inserts into the coracoid process?

A

Pectoralis minor

132
Q

Damage to what nerve will give you “winged scapula’.”?

A

Long thoracic nerve To avoid confusing long thoracic nerve and lateral thoracic artery: Long has an “n” for nerve; lateral 3 & has an “a” for artery.

133
Q

The ventral rami of what regions of the spinal cord make up the brachial plexus?

A

C5-TI

134
Q

What bone houses the ulnar groove?

A

Humerus (between the medial epicondyle and the trochlea)

135
Q

What muscle initiates Abduction of the arm?

A

Supraspinakis

136
Q

What muscle acts in all ranges of motion of the arm?

A

Deltoid

137
Q

What nerve is damaged if a patient presents with “wrist drop”?

A

Radial nerve

138
Q

What forms the anatomic snuff box?

A

Extensor pollicis longus, abductor pollicis longus, extensor pollicis brevis

139
Q

What vein, in the antecubital fossa, forms the communica- tion between the basilic vein and the cephalic vein?

A

Median cubital vein (most common site for venipuncture)

140
Q

What two muscles are inner- vated by the axillary nerve?

A

Deltoid and teres minor

141
Q

What nerve is compromised in carpal tunnel syndrome?

A

Median nerve

142
Q

In what compartment of the thigh is the profundus femoris artery found?

A

Anterior compartment (it’s the blood supply to the posterior compartment)

143
Q

Foot drop is caused by a compromise in what nerve?

A

Common peroneal nerve

144
Q

What nerve is damaged if the patient cannot ADduct the thigh?

A

Obturator nerve (nerve to the medial compartment of the thigh)

145
Q

What is the longest muscle of the body?

A

Sartorius

146
Q

What two nerves innervate the pectineus muscle?

A

Femoral and obturator nerves

147
Q

What superficial vein empties into the popliteal fossa?

A

Short saphenous vein

148
Q

What is the artery of the anterior compartment of the leg?

A

Anterior tibia] artery

149
Q

What nerve supplies the lateral compartment of the leg?

A

Superficial peroneal nerve

150
Q

What sensory nerve are you testing when you touch the first web space of the toes?

A

Deep peroneal nerve

151
Q

The peroneal artery is a branch of what artery?

A

Posterior tibial

152
Q

Inflammation of the pre- patellar bursa is often referred to as what?

A

Housemaid’s knee

153
Q

What is the prominent “bump” on the lateral aspect of the knee?

A

Head of the fibula

154
Q

How many ribs articulate with the sternum?

A

Seven (Ribs 8, 9, and 10 articulate with the costal cartilage of rib 7.)

155
Q

What is the part of the lung that extends above the level of the first rib?

A

The cupula

156
Q

What type of pleura is adherent to the surface of the organ?

A

Visceral pleura

157
Q

How many lobes does the right lung have?

A

Three

158
Q

How are they separated?

A

By the oblique and the transverse fissures

159
Q

Into what chamber of the heart do the pulmonary veins empty?

A

Left atrium (Remember-the pulmonary veins carry oxygenated blood.)

160
Q

What is the only valve in the heart that has two cusps?

A

Mitral (bicuspid) valve

161
Q

What vein travels with the right coronary artery?

A

Small cardiac vein

162
Q

At what vertebral level does the trachea bifurcate?

A

T4-T5 (It is known as the carina.)

163
Q

What attaches the cusps of the valves to the papillary muscles in the heart?

A

Chordae tendineae

164
Q

Around what thoracic structure does the right recurrent laryngeal nerve loop before ascending into the larynx?

A

Right subclavian artery

165
Q

At what vertebral level does the esophagus originate?

A

C6

166
Q

At what level does the abdominal aorta bifurcate into the common iliac arteries?

A

L4-L5

167
Q

The obturator artery is a branch of what major artery?

A

Internal iliac artery

168
Q

What is the first branch off the abdominal artery?

A

Inferior phrenic artery

169
Q

Into what vessel does the right gonadal vein drain?

A

The inferior vena cava

170
Q

Into what vessel does the left gonadal vein drain?

A

The left renal vein

171
Q

At what vertebral level does the common carotid artery bifurcate?

A

C4

172
Q

At what vertebral level is the hyoid bone found?

A

C3

173
Q

The ophthalmic artery is a branch of what vessel?

A

Internal carotid artery

174
Q

What forms the portal vein?

A

The union of the superior mesenteric and the splenic veins

175
Q

Where does the inferior mesenteric vein drain?

A

The splenic vein

176
Q

What vein is formed by the union of the right and left brachiocephalic veins?

A

Superior vena cava

177
Q

What is the only muscle in the larynx that is not inner- vated by the recurrent laryn- geal nerve?

A

Cricothyroid (It’s innervated by the external laryngeal nerve.)

178
Q

The folds of the mucosa of the stomach are known as what?

A

Rugae

179
Q

What is the artery of the embryonic foregut?

A

Celiac artery

180
Q

What comprises the portal triad?

A
  1. Common bile duct 2. Hepatic artery 3. Portal vein
181
Q

What structures differentiate the anatomic right and left lobes of the liver?

A

Ligamentum teres and ligamentum venosum

182
Q

What structure “runs” along the transverse processes of the lumbar vertebrae?

A

Ureters

183
Q

To enter into the lesser peri-toneal sac, you must traverse through what foramen?

A

Foramen of Winslow

184
Q

What is another name for the rectouterine pouch?

A

Pouch of Douglas

185
Q

What bones comprise the acetabulum?

A

Pubis, ilium, and ischium

186
Q

What two ligaments of the uterus are remnants of the gubernaculum?

A

Bound and ovarian ligaments

187
Q

What muscles comprise the deep perineal space (the urogenital diaphragm)?

A

Deep transverse perineal and sphincter urethrae

188
Q

What three ligaments com- prise the broad ligament of the uterus?

A
  1. Mesosalpinx 2. Mesovarium 3. Mesometrium
189
Q

What structure traverses the diaphragm at the level of T8?

A

IVC

190
Q

What are the components of the pudendal canal?

A

Pudendal nerve and internal pudendal artery and vein

191
Q

What range of movements can be performed at the metacarpal/phalangealjoint?

A

Flexion/extension, ABduction, and ADduction

192
Q

A fracture of the surgical neck of the humerus will most likely damage what nerve?

A

Axillary nerve

193
Q

What compartment of the lower extremity allows flexion of the hip and extension of the knee?

A

Anterior compartment of the thigh

194
Q

What nerve roots comprise the lumbosacral plexus?

A

L4 to S4

195
Q

What is the function of gray rami communicans?

A

They are postganglionic sympathetic axons.

196
Q

What compartment of the lower extremities allows ADduction of the thigh and flexion of the hip?

A

Medial compartment of the thigh

197
Q

What are the only splanchnics in the body that carry preganglionic parasympathetic fibers?

A

Pelvic splanchnics (P begins preganglionic, parasympathetic, and pelvic.)

198
Q

What postganglionic parasympathetic ganglion is associated with CN III?

A

Ciliary ganglion

199
Q

What is the name of the ganglion that houses the cell bodies for the postganglionic sympathetic fibers to the head and neck?

A

Superior cervical ganglion

200
Q

What two muscles do you test to see if CN XI is intact?

A

Trapezius and sternocleidoinastoid

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