Anatomical Sciences Pt 2 Flashcards by Ch Mora

During the 4'h week of embryonic development the tongue appears in the
form oftwo lateral lingual swellings and one medial swelling, the so-called:
• fo ramen cecum
• sulcus terminalis
• tubercu lum impar
• epiglottic swelling
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SAADDES

tuberculum impar

4th week:
tongue = two lateral swellings and one nedial swelling (tuberculum impar)

all from 1st arch

second median swelling = copula, from 2-3-4 arches

lateral swellings merge –> anterior 2/3 of tongue
posterior 1/3 - 2-4 arches
extreme posterior = 4th arch

V-shaped terminal sulcus
foramen cecum - remnant of thyroglossal duct, apex of sulcus

stomodeum - primitive mouth

branchial arch: core mesenchyme
externally - clefts, internally - pouches

bifid tongue - no fusion of lateral swellings

most tongue mm. - hypoglossal n. (XII) except palatoglossus which is X

6-8 wks salivary begin to develop
parotid develops first, from ectoderm
sublingual and submandibular - from endoderm

median swellings: tuberculum impar (–> body of tongue)
copula –> baase of tongue
epiglottic swelling

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The cartilages of first and second branchial arches are derived from mesoderm.
The cartilages of the fourth through sixth branchial arches are derived from
neural crest cells.
• both statements are t rue
• both statements are fa lse
• the fi rst statement is true, the second is fa lse
• the first statement is false, the second is true

both false

1-2 ctlges - NC
4-6 ctlges - mesoderm

each arch: ctlg, nervem vascular, muscular

1 arch –> Meckel (disappears mostly), malleus, incus
2 arch –> Reichert’s, stapes, styloid, lesser horns and upper half of hyoid
3 arch –> greater horn and lower half of hyoid
4-6 arches –> laryngeal ctlges

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Failure offusion of which ofthefollowing will lead to cleft lip?
• frontonasal process; lateral nasal process
• maxillary process; medial nasal process
•lateral nasal process; medial nasal process
• maxillary process; lateral nasal process
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maxillary and medial nasal

nasal placodes (–> pits –> nares) - frontonasal process

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During the fourth week of embryonic development, the first branchial arch
divides to form:
• the two medial nasal processes
• the mandibular and maxillary processes
• the two lateral nasal processes
• the lateral and medial nasal processes
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mandibular and maxillary during 4th week

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The second branchial pouch gives rise to the:
• eustachian tube
• palatine tonsil
• middle ear cavity
• superi or parathyroid gland
ANATOMIC SCIENCES
embryology
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palatine tonsil

pharyngeal pouches: endoderm, inside between arches

1 –> tympanic membrane, auditory tube, tympanic cavity, mastoid antrum
(1 cleft –> external meatus)

2 –> palatine tonsil
3 –> inferior parathyroid glands (dorsal) + thymus
4 –> superior parathyroid glands (dorsal)

5 –> C cells of thyroid (make calcitonin)

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1 arch derivatives
nerve
pouch

Meckel, malleus, incus (neural crest)
V (mastication mm and two tensors) - V2 and V3
tympanic things, mastoid antrum, auditory tube

cleft –> external meatus

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2 arch derivatives
nerve
mm
pouch

Reichert, stapes, styloid, lesser horns and upper hyoid (neural crest)
VII
facial expression, stylohyoid, posterior digastric
palatine tonsils

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3 arch derivatives
nerve
mm
pouch

greater horns and lower half of hyoid
IX glossopharyngeal, passes between superior and middle pharyng constrictors
stylopharyngeal (but all other pharynx is X)
inferior parathyroids (dorsal) and thymus (ventral)

DiGeorge - no parathyroids and thymus

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4 arch derivatives
nerve
mm
pouch

laryngeal cartilages (mesoderm)
superior laryngeal n. 
external branch innervates cricothyroid
also most pharyngeal constrictors
internal branch - sensation above vocal folds, passes between middle and inferior constrictor

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6 arch derivatives
nerve
pouch

laryngeal cartilages (mesoderm)
recurrent laryngeal n below inferior constrictor
innervates intrinsic mm of laryn (except cricothyroid which is superior laryngeal, external branch)
also sensation below vocal folds

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where does stylopharyngeal muscle pass

between superior and middle constrictors

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The thyroid gland is first identifiable during the fourth week of gestation,
beginning as an endodermal invagination of the tongue at the site of:
• tubercu lum impar
• copula
• terminal sulcus
• fo ramen cecum
• stomodeum

foramen cecum
- between tuberculum impar and copula

thyroid then descends via thyroglossal duct

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The primary palate or median palatal process is formed by the merging of the
frontonasal process with which other processes?
• lateral nasal processes
• medial nasal processes
• maxillary processes
• mandibular processes
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medial nasal

premaxilla = primary palate = medial nasal + frontonasal

secondary palate - palatal shelves;
also soft palate and uvula

palate complete at 12 weeks

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when is palate complete

12 weeks

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All of the following muscles are derived from first branchial arch EXCEPT
one. Which one is the EXCEPTION?
• tensor tympani
• anterior belly of digastric
• temporalis
• masseter
•levator veli palatini
• tensor veli palatini

levator veli palatini

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stylopharyngeal m innervation

passes where with what

between superior and middle constrictors, with IX nerve (YAY)

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stylohyoid m innervation

VII

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The nasal cavities are formed from which embryonic structure?
• stomodeum
• f rontonasal process
• intermaxillary segment
• nasal pits

nasal pits, come from nasal placodes on frontonasal process

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All of the following are neural crest cells derivatives EXCEPT one. Which one
is the EXCEPTION?
• melanocytes
• dorsal root ganglia
• adrenal medulla
• autonomic ganglia
• adrenal cortex
• schwann cells
• sensory ganglia of cranial nerves

adrenal cortex is mesoderm
NC = ganglia, schwann, adrenal medulla, melanocytes

anterior pituitary is ectoderm
parotid also ectoderm

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Which two ofthe following are NOT derived from endoderm?
•lung
•liver
• gut tube derivatives
• pancreas
• spleen
• thymus
• dura mater
• parathyroid gland

dura mater is NC
spleen is mesoderm?

mesoderm: heart, blood, spleen, dermis, muscles, vessels, adrenal cortex, bones, kidneys + ureter
endoderm: guts, liver, thymus, parathyroids, thyroid, lungs, pancreas, submandibular and sublingual glands,
middle ear and auditory tube

umbilical vein –> ligamentum teres
umbilical arteries –> medial umbilical ligaments
allantois –> urachus (medial umbilical ligament)

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derivatives of mesoderm

heart, spleen, blood
muscles, vessels, bones
adrenal cortex

KIDNEY

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derivatives of endoderm

pancreas, guts, liver, lungs
sublingual and submandibular glands
parathyroids, thyroid, thymus
middle ear, auditory tube

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kidney origin

mesoderm

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Which ofthe following arteries accompanies the great cardiac vein?
• ci rcumflex artery
• anterior interventricular artery
• posterior interventricular artery
• right marginal artery
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anterior interventricular artery

great cardiac vein comes from left
middle from posterior interventricular
small cardiac vein comes from right

coronary sinus lies in coronary sulcus = atrioventricular groove; empties into RA

left marginal vein drains into great
anterior cardiac vv drain directly into RA

anterior interventricular a. aka left descending; accompanies great cardiac v
posterior interventricular accompanies middle

branches of left coronary: circumflex and left descending (aka anterior interventricular)
branches of right coronary: sinuatrial, marginal, posterior interventricular

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branches of left coronary

opens at left posterior aortic sinus, passes between pulm trunk and left auricle branches: LAD and circumflex

branches of right coronary

opend at anterior aortic sinus, passes between pulm trunk and right auricle sinuatrial branch, marginal and posterior interventricular (anastomoses with circumflex)

``` Sympathetic stimulation will have which direct effect on the heart? • decreased automaticity • AV block • increased vagal response • bradycardia • increased stroke volume ANATOMIC SCIENCES 160 copynght 0 20 13·2014 Dental Decks SAADDES ```

increased stroke volume overvagus can cause AV block SA at junction of SVC and RA; paccemaker interatrial septum near coronary sinus conducting system is myocardium not nerves

Which of the following is the correct conduction pathway through the heart? • SA node- ventricular muscle- AV node- His bundle- bundle branches- Purkinje fibers -atri al muscle • SA node- atrial muscle- AV node- bundle branches- His bundle- Purkinje fibersventricular muscle • SA node- atrial muscle- AV node- His bundle- bundle branches- Purkinje fibersventricular muscle • SA node- Purkinje fibers- AV node- His bundle- bundle branches- atrial muscleventricular muscle

SA --> atrial mm --> AV --> His --> bundle branches --> Purkinje --> ventricular mm SA: 60-100x/minute AV - 40-60 sinus rhythm: P - atrial depol QRS - ventric depol T - ventric repol

``` The apex of the heart is located at the level of the: • third left intercostal space • fourth left intercostal space • fifth left intercostal space • sixth left intercostal space ANATOMIC SCIENCES heart 162 copynght 0 20 13·2014 Dental Decks SAADDES ```

fifth

Which of the following describes the function of the ductus arteriosus in the fetus? • it shunts blood from the aorta to the pulmonary artery • it shunts blood from the pulmonary artery to the aorta • it shunts blood from the right atrium to the left atrium • it shunts blood from the umbilical vein to the inferi or vena cava ANATOMIC SCIENCES 163 copynght 0 20 13·2014 Dental Decks SAADDES

shunts from pulmonary a to aorta

A worker in the meat-processing industry comes down with an illness, presenting with symptoms of fever, headache, and sore throat. A few days later, he feels chest pain and has pink, frothy sputum. His physician states that the worker has a viral infection caused by coxsackie B. This patient has inflammation of which layer of the heart? • epicardium • myocardium • endocardium • pericardium

myocardium

The left atrium and left ventricle receive their major arterial supply from which artery? • anterior interventricular branch of the left coronary artery • circumflex branch of the left coronary artery • marginal branch of the right coronary artery • posterior interventri cular branch of the right coronary artery ANATOMIC SCIENCES 165 copynght 0 20 13·2014 Dental Decks SAADDES

circumflex of left coronary

``` Which ofthe following does NOT empty directly into the right atrium? • azygous vein • inferior vena cava • superior vena cava • coronary sinus ANATOMIC SCIENCES 166 copynght 0 20 13·2014 Dental Decks SAADDES ```

azygous - to SVC coronary sinus in coronary sulcus = atrioventricular groove

A patient with a "heart-valve problem" comes into the dental clinic for periodontal therapy. She says that her old periodontist always gave her antibiotics before treatment, and insisting that the dentist hear the problem, she places the stethoscope in the left fifth intercostal space medial to the nipple line. Which heart valve is best heard over the apex of the heart? • t ricuspid valve • mitral valve • pulmonary valve • aortic valve

mitral A (second right) P (second left) T (~4th right) M (fifth left) S1 - AV closure S2 - semilunar closure S3 - ventricular filling S4 - atrial contraction

A 1 0-year-old girl comes into the physician suffering from rheumatic fever. She is presenting with aortic valve stenosis, which is causing her dizziness and syncopal episodes. In the healthy heart, after ventricular systole, the aortic valve: • prevents reflux of blood into the right ventricle • prevents reflux of blood into the right atrium • prevents reflux of blood into the left atrium • prevents reflux of blood into the left ventricle ANATOMIC SCIENCES 168 copynght 0 20 13·2014 Dental Decks SAADDES

``` prevents reflux from aorta to left ventricle chordae tendinae (attached to papillary mm) prevent prolapse ``` trabeculae carneae - mm in ventricles pectinate mm - in atria

Which of the following structures prevent the AV valves from everting (or being blown out) back into the atria during ventricular contraction? • crista terminal is and papillary muscles • chordae tendineae and papillary muscles • pectinate muscles and papillary muscles • chordae tendineae and pectinate muscles ANATOMIC SCIENCES 169 copynght 0 20 13·2014 Dental Decks SAADDES

choardae and papillary crista terminalis - attachment of pectinate mm in RA (runs between SVC and IVC) , along right atrial wall pectinate in RA and both auricles SA node at junction of RA and SVC

``` The diaphragmatic surface ofthe heart is formed by: • right atrium and right ventri cle • right atrium and both ventri cles •left ventricle only • right ventricle only • both ventricles ANATOMIC SCIENCES heart 170 copynght 0 20 13·2014 Dental Decks SAADDES ```

both ventricles front = sternocostal surface, all 4 chambers diaphragmatic surface = both ventricles base = left atrium right border = right atrium? left border = left ventricle inferior border = RA, RV, LV

``` The pituitary gland is composed of two distinct tissue types. These tissue types have their embryonic origin in what layer(s)? • ectoderm • mesoderm • endoderm • ectoderm and mesoderm • ectoderm and endoderm • all of the above ```

ectoderm upgrowth from stomodeum (anterior, adeno) = Rathke's pouch neuroectoderm from diencephalon (hypothalamus) = neuro, posterior

``` Diabetes insipidus is characterized by the secretion of large amounts of dilute urine because of a deficiency in antidiuretic hormone. Antidiuretic hormone is secreted from the: • anterior pituitary • posterior pituitary • adrenal medulla • adrenal cortex • thyroid • kidney ```

anterior pituitary: GPA (acidophilic, non tropic) and B-FLAT (basophilic, tropic) posterior: ADH (=vasopressin) and oxytocin secreted in HT, transported via unmyelinated nerves, stored and released by posterior pituitary

A 5O-year-old female was diagnosed with anaplastic thyroid cancer and underwent aggressive surgery to remove most of the thyroid. Unfortunately, the surgeon also excised the parathyroid glands. Which oft he following could result from the excision of the parathyroid glands? • strengthening of muscles • weakening of bones • muscle convulsions • decalcification of bones

muscle convulsions PTH increases Ca and decreases P in blood no Ca --> mm weakness calcitonin opposes PTH

``` The innervation to the parotid gland and its sheath comes from all of the following nerves EXCEPT one. Which one is the EXCEPTION? • auriculotemporal nerve • great auricular nerve • facial nerve • glossopharyngeal nerve ANATOMIC SCIENCES 174 copynght 0 20 13·2014 Dental Decks SAADDES ```

facial parotid: purely serous, Stensen innervated by greater auricular (C2,3) and auriculotemporal (V3) parasymp from glossopharyngeal (otic ganglion, lesser petrosal) ``` external carotid terminates in parotid terminal branches (ST and M) supply drains into deep cervical ```

``` The part of a developing salivary gland destined to become responsible for its functioning is called the: • nephron • fo llicle • adenomere •lobule ```

adenomere - functional subunit of lobule (striated, intercalated, secretory cells)

A death-row inmate who was notorious for aggressive and hyperactive behavior is complaining of abdominal pain. Hospital tests reveal bilateral tumors that are secreting excessive catecholamines. Which of the following glands is involved? • anterior pituitary • pancreatic islets (Langerhans) • adrenal medulla • parathyroids • adrenal cortex

adrenal medulla: 20% norepinephrine, 80% epinephrine from NC cortex (from mesoderm!) = glomer - mineral (Na reabs, aldosterone) fascic - gluco (breakdown and release of sugars and fats, cortisol) retic - adrenal hormones

``` The portion of the pituitary gland that does NOT arise from the hypothalamus is the: • neurohypophysis • pars nervosa • adenohypophysis • infundibulum ```

adenohypophysis

``` Exocrine glands include all of the following EXCEPT one. Which one is the EXCEPTION? • sweat glands • the prostate gland • bile-producing glands of the l iver • the pituitary gland •lacrimal glands • gastric glands ```

pituitary of note: pancreas is merocrine (granules) holocrine - sebaceous apocrine - sweats purely acinar - sebaceous purely tubular - sweats

A young girl presents to the physician with a large, round face, a "buffalo hump:' and central obesity. She also has a history of hypertension and insulin resistance as a result of increased cortisol. Which anterior pituitary hormone controls the production and secretion of cortisol? • follicle-stimulating hormone (FSH) • luteinizing hormone (LH) • adrenocorticotropic hormone (ACTH) • thyroid-stimulating hormone (TSH) • corticotropin-releasing hormone (CRH)

ACTH (= corticotropin) released from pituitary in response to CRH (corticotropin-releasing hormone) from hypothalamus FSH --> Sertoli, spermatogenesis; or ovaries, estrogen LH --> Leydig, testosterone; or estrogen/progesteron

A pancreatic cancer patient has a tumor that presses on the ampulla of Vater. This has been causing him Gl problems because the tumor obstructs the common bile duct and the main excretory duct of the pancreas which is known as: • wharton's duct • the duct of Wirsung • bartholin's duct • wolffian duct • Stenson's duct

Wirsung --> into ampulla of Vater somatostatin from delta inhibits alpha and beta islands

On a patient's panoramic radiograph, the dentist notices a small, well-defined radiolucency that sits inferior to the mandibular canal. The dentist performs a sialogram that rules out a true cyst and makes the working diagnosis a static bone cavity (Stafne bone cyst). Which of the following salivary glands creates the depression in bone that radiographically gives the above appearance? • sublingual gland • von Ebner's glands • submandibular gland • parotid gland

submandibular in digastric trinagle on top of mylohyoid Wharton's duct lingual n. crosses duct, XII parallel supplied by facial and lingual aa parasymp from VII (submandibular ganglion, chorda, lingual)

The thymus is a prominent feature of the middle mediastinum during infancy and childhood. The thymus is the central control organ for the immune system. • both statements are t rue • both statements are false • the first statement is t rue, the second is false • the f irst statement is fa lse, the second is t rue ANATOMIC SCIENCES 182 copynght 0 20 13·2014 Dental Decks SAADDES

first false, second true superior mediastinum

Mature lymphocytes constantly travel through the blood to the lymphoid organs and then back to the blood. This constant recirculation insures that the body is continuously monitored for invading substances. The major areas of antigen contact and lymphocyte activation are the secondary lymphoid organs. These include all of the following EXCEPT one. Which one is the EXCEPTION? • spleen • lymph nodes • thymus gland • tonsils • mucosal associated lymphoid tissue (MALT)

thymus is primary lymphoid

``` All of the following contain mucus-secreting cells EXCEPT one. Which one is the EXCEPTION? • submandibular glands • sublingual glands • parotid glands • glands of the esophagus • mucosa of the t rachea ANATOMIC SCIENCES 184 copynght 0 20 13·2014 Dental Decks SAADDES ```

parotid purely serous

``` Calcitonin is secreted by the: • thyroid gland • parathyroid gland • adrenal glands • thymus gland ANATOMIC SCIENCES endocrine system 185 copynght 0 20 13·2014 Dental Decks SAADDES ```

thyroid - C-cells (aka parafollicular), opposes PTH thyroid follicles colloid thyroxine T4 TSH overproduction - Graves

Hospital tests on a patient identify a tumor in the hypophysis that is excessively secreting growth hormone. Given that the patient is a 4-year-old male, what is the expected outcome if no treatment is performed? • pituitary gigantism • acromegaly • pituitary dwarfism • achondroplasia ANATOMIC SCIENCES 186 copynght 0 20 13·2014 Dental Decks SAADDES

pituitary gigantism before adolescence - gigantism (epiphyses not fused) after - acromegaly

The arterial blood supply of the adrenal glands comes from 3 sources, with branches arising from the inferior phrenic artery, the renal artery, and the aorta. Venous drainage flows directly into the inferior vena cava on the right side and into the left renal vein on the left side. • both statements are t rue • both statements are false • the first statement is true, the second is false • the first statement is fa lse, the second is t rue

both true

Meibomian glands (or tarsal glands) are sebaceous glands located at the rim of the eyelid that function to protect the eyes from drying out. Meibomian glands, release the entire secretory cell. This type of gland is referred to as: • merocrine • apocrine • holocrine • endocrine

holocrine

Which salivary gland(s) can have either numerous small ducts that open onto the floor of the mouth or a single main excretory duct (Bartholin's duct)? • submandibular gland • parotid gland • sublingual gland • von Ebner glands [refer to card 174-1, 175-1 for illustration] ANATOMIC SCIENCES 189 copynght 0 20 13·2014 Dental Decks SAADDES

sublingual

``` Which portal venous system is critical for proper endocrine function? • hypophyseal • renal • hepatic ANATOMIC SCIENCES 190 copynght 0 20 13·2014 Dental Decks SAADDES ```

hypophyseal

A pathologist receives a salivary tissue biopsy of what the dentist believes is pleomorphic adenoma. However, the dentist forgot to mention the site of the biopsy. The pathologist identifies certain histological structures that would indicate that this sample is not from the parotid gland. What structures can be seen in histologic examination of the submandibular and sublingual glands but NOT in the adult parotid gland? • myoepitheli al cells • serous cells • intercalated ducts • serous demilunes • striated ducts

serous demilunes

Thyroid epithelial cells (follicular cells) which are responsible for the synthesis ofthyroid hormone are arranged in spheres called thyroid follicles. These follicles are filled with colloid. • both statements are t rue • both statements are false • the f irst statement is t rue, the second is false • the f irst statement is fa lse, the second is t rue ANATOMIC SCIENCES 192 copynght 0 20 13·2014 Dental Decks SAADDES

both true inactive colloid = thyroglobulin + iodine (stains acidophilic) when activated by thyrotropin, becomes basophilic

After being seen by a neurologist, a patient is diagnosed with a pituitary adenoma. As the neoplasm increases in size, it will most likely affect which cranial nerve? ·CNI ·CN II ·CN Ill ·CN IV

CN II - close to cavernous

Oxytocin and vasopressin are synthesized in the hypothalamus and are transported to the pituitary gland for storage by way of: • myelinated nerve fibers • both myelinated and unmyelinated nerve fibers • unmyelinated nerve fibers ANATOMIC SCIENCES 194 copynght 0 20 13·2014 Dental Decks SA

unmyelinated

``` Which of the following tracts is responsible for coordinating eye and head movements? • tectospinal t ract • rubrospinal tract • vestibulospinal tract • reticu lospinal tract ANATOMIC SCIENCES 195 copynght 0 20 13·2014 Dental Decks SAADDES ```

tectospinal

lateral corticospinal

aka crossed pyramidal, voluntary mm movements

anterior corticospinal

aka direct pyramidal | ipsilateral voluntary mvmts

lateral reticulospinal

potentiates motor reticular formation: pons, medulla, midbrain

medial reticulospinal

inhibitory on motor | mainly medulla

rubrospinal

coordination of body movement and posture | red nucleus of midbrain

vestibulospinal

extensor mm tone

tectospinal = colliculospinal

coordination of head, neck and eye | from midbrain tectum

potentiates motor

lateral reticulospinal

inhibits motor

medial reticulospinal

extensor tone

vestibulospinal

coordination of mvmt and posture

rubrospinal | red nucleus in midbrain

where is red nucleus

midbrain, | coordinates body mvmt and posture

A 56-year-old male patient with type II diabetes comes into the emergency room with a painful blistering skin rash localized over the left side of his forehead. The localized area of skin with sensory innervation from a single nerve root ofthe spinal cord is called what? • fa sci cui us • dermatome • spindle • bundle

dermatome cranial nerves don't overlap spinal nerves overlap ~50%

``` Wernicke's area is located within which cerebral lobe? • parietal lobe • occipital lobe • temporal lobe • frontal lobe ```

temporal

motor area

frontal

visual area

occipital

auditory area

temporal

short term memory area

temporal

somesthetic

parietal

occipital fx

visual

temporal fx

auditory, Wernicke (interpretation)

Wernicke

temporal, interpretation

motor planning

prefrontal

frontal fx

motor

emotional brain

limbic

``` Which structural component of a neuron sends impulses away from the cell body? • neuroglial cell • perikaryon • dendrite • axon ```

axon cell body is aka perikaryon neuroglia - astrocytes (attached to vessels); microglial - phagocytes; ependymal - line ventricles

ventricle lining in brain

ependymal

brain phagocytes

microglia

attached to vessels in brain, for support

astrocytes

perikaryon =

cell body

A 14-year-old female patient presents to the physician with hyperpigmented lesions (cafe-au-fait spots), hamartomas of the iris (Lisch nodules), and axillary freckling (Crowe's sign). The patient had previously been diagnosed with neurofibromatosis, but is now complaining of generalized pain and tingling. The physician discovers multiple neurilemmomas, classifying the disease as a form of neurofibromatosis. Neurilemmomas are a neoplasm of myelin producing cells in the peripheral nervous system known as? • astrocyte • oligodendrocyte • schwann cell • microglial cell • satellite cell

Schwann = neurolemma in CNS no Schwann, myelin there is by oligodendrocytes schwann - only one axon oligodendrocytes - multiple axons

Schwann vs oligodendrocyte

Schwann - PNS, only one axon per Schwann oligo - CNS, can myelinate multiple axons

``` Which of the following ascending tracts of the spinal cord function to carry pain and temperature sensory information to the thalamus? •lateral spinothalamic t ract • anteri or spinothalamic tract • fasciculus gracili s • fasciculus cuneatus • spinocerebellar t ract I refer to card 195-1 for illustration] ANATOMIC SCIENCES 200 copyright Cl 20 13-2014 Dental Decks ```

lateral spinothalamic tract ascending tracts sensory, descending motor

lateral spinothalamic tract

pain, temperature opposite side to thalamus

anterior spinothalamic tract

crude touch and pressire | opposite side to thalamus

fasciculus gracili and cuneatus

= medial lemniscus fine touch and pressure same side, to medulla --> to VPL of thalamus --> to somatosensory cortex

anterior and posterior spinocerebellar

kinesthesia, to cerebellum

crude touch and pressure

anterior spinothalamic | contralateral

fine touch and pressure

gracilis and cuneatus fascicles in medial lemniscus, to medulla --> VPL in thalamus --> somatosensory cortex

unconscious kinesthesia

spinocerebellars (both)

pain and temperature

lateral spinothalamic, contralateral

medial lemniscus

fascicles (gracilia and cuneatus): fine touch and pressure on same side to medulla --> to VPL in thalamus --> to somatosensory cortex

``` Which of the following spinal nerve structures is exclusively composed of sensory fibers? • ventral root • dorsal root • ventral rami • dorsal rami ```

dorsal root sensory neuron bodies in DRG motor - ventral root

A student dozing off in class is unexpectedly called on by the professor to answer a question. Not knowing the answer, the hair on the back of the student's neck stands up, his pupils dilate, and his heart starts to race. This fight-or-flight response is controlled by the: • somatic nervous system • autonomic nervous system • central nervous system • sensory nervous system

autonomic nervous neurotransmitters: somatic - ACh; autonomic - ACh and NE somatic denervation - flaccid paralysis; autonomic denervation - hypersensitivity no ganglia in somatic

diencephalon

thalamus + hypothalamus

midbrain

tectum + tegmentum

``` Which ofthe following separates the occipital lobe and the cerebellum? • fa lx cerebri • fa lx cerebelli • tentorium cerebell i • corpus callosum ANATOMIC SCIENCES 203 copyright Cl 20 13-2014 Dental Decks ```

tentorium cerebelli

epidural hemorrhage

MMA

subdural hemorrhage

veins

subarachnoid hemorrhage

circle of Willis | berrys aneurysm

MMA hemorrhage

epidural

Willis aneurysms

subarachnoid

choroid plexus fx

CSF production

choroid plexus

``` Which of the following cranial nerves arise in the pons? Select all that apply. • trochlear nerve (CN IV) • trigeminal nerve (CN V) • abducens nerve (CN VI) • facial nerve (CN VII) ANATOMIC SCIENCES 204 copyright Cl 20 13-2014 Dental Decks ```

V, VI, VII -- pons I, II, III and IV - anterior portion VIII - inner ear, to pons IX, X, XI, XII attached to medulla oblongata

CNs attached to medulla oblongata

9-12

respiratory centers in brain

pons

reflexes in brain

medulla oblongata

reflexes, reticular formation (sleep/arousal, pain, breathing, heart)

substantia nigra where?

midbrain, motor control (Parkinson)

Parkinson

substantia nigra

``` Which of the following meningeal structures is a ring-shaped fold that allows the passage of the infundibulum of the pituitary gland? • tentorium cerebelli • falx cerebri • falx cerebelli • diaphragma sellae ANATOMIC SCIENCES 205 copyright Cl 20 13-2014 Dental Decks ```

diaphragma sellae dura layers - periosteal and meningeal falx cerebri contains inferior and superior sagittal sinuses falx cerebelli contains occipital sinus tentorium cerebelli contains straight, transverse and superior petrosal sinuses dural sinuses are between periosteal and meningeal layers of dura

sinuses in tentorium cerebelli

transverse, straight, superior petrous

sinuses in falx cerebelli

occipital

sinuses in falx cerebri

sagittals

sagittal sinuses where

falx cerebri

superior petrous sinus where

tentorium cerebelli

layers of dura

periosteal and meningeal

``` The diencephalon lies beneath the cerebral hemispheres and contains which of the following? Select all that apply. • thalamus • pons • medulla • hypothalamus ```

thalamus and hypothalamus

``` Which type of neuroglial cells form myelin in the CNS? • astrocytes • oligodendrocytes • microglia • ependymal cells ANATOMIC SCIENCES 207 copyright Cl 20 13-2014 Dental Decks ```

oligodendrocytes

Cell bodies of preganglionic sympathetic fibers to the head are located in the: • superior and middle cervical ganglia • lateral gray horns of segments Tl to T4 of the spinal cord • anterior gray horns of segments Tl to T4 of the spinal cord •lateral gray horns of segments 52 to 54 of the spinal cord ANATOMIC SCIENCES 208 copyright Cl 20 13-2014 Dental Decks

• lateral gray horns of segments T1 to T4 of the spinal cord sympathetic is T1- L2 preganglionic - relatively short, myelinated; cell bodies in lateral horns; exit ventral into white ramus, synapse ACh postganglionic - unmyelinated, relatively long; cell bodies in peripheral ganglia to visceral ganglia; transmitter NE (except adrenal medulla and sweat glands)

sympathetic preganglionic transmitter

ACh | short

sympathetic postganglionic transmitter

long | NE except adrenal medulla and sweats

parasympathetic preganglionic

myelinated synapse with postganglionic close to organs, relatively long ACh

parasympathetic postganglionic

unmyelinated relatively short ACh

``` The lateral ventricles communicate with each other by: • the two foramina of Luschka • the interventricular foramen • the cerebral aqueduct • septum pellucidum • the foramen of Magendie ANATOMIC SCIENCES 209 copyright Cl 20 13-2014 Dental Decks SAADDES ```

septum pellucidum lateral ventricles in hemispheres interventricular foramen (Monro) --> to III ventricle in diencephalon cerebral aqueduct between III and IV, runs through midbrain ``` IV is dorsal to pons and medulla, ventral to cerebellum median aperture = Magendie lateral apertures (Luschka) - from IV to subarachnoid space ``` absorption of CSH in arachnoid granulations

absorption of CSF

arachnoid granulations

arachnoid granulations fx

absorption of CSF

production of CSF

choroid plexus

lateral ventricles location

hemispheres

aqueduct location

between III and IV in midbrain

III location

in diencephalon

IV location

dorsal to pons and medulla, ventral to cerebellum

Magendie and Luschka

openings of IV: median and two laterals, into subarachnoid

Monro

from lateral to III

from lateral to III opening

Monro

openings of IV

Magendie and Luschka

``` The spinal cord terminates at the: • conus medullari s • subarachnoid space • f ilum terminale • arachnoid space • cauda equina • central canal ```

conus medullaris end at L1-L2 dura and arachnoid continue to S2 as filum terminale

where does spinal cord end

L1-L2

filum terminale

up to S2, dura + arachnoid

The dorsal root ganglion is a collection of cell bodies for afferent nerve fibers (mostly sensory) that exists just outside of the spinal cord. There is no ventral root ganglion because the motor efferent fibers have their cell bodies in the ventral horns (anterior portion of the grey matter) of the spinal cord. • both statements are true • both statements are fa lse • the first statement is true, the second is fa lse • the first statement is fa lse, the second is t rue

both true

``` In the peripheral nervous system, which fibers carry impulses to smooth and cardiac muscle as well as to glands? • somatic afferent f ibers • visceral afferent fibers • somatic efferent fibers • visceral efferent fibers ANATOMIC SCIENCES 212 copyright Cl 20 13-2014 Dental Decks ```

visceral efferent

The ciliary, pterygopalatine, submandibular, and otic ganglia are all: • sympathetic ganglia • parasympathetic ganglia • both sympathetic and parasympathetic ganglia • neither sympathetic nor parasympathetic ganglia ANATOMIC SCIENCES 213 copyright Cl 20 13-2014 Dental Decks

parasympathetic CNIII - ciliary ganglion - eye, ciliary m (lens accomodation), sphncter of pupil CN VII - pterygopalatine ganglion - lacrimal, oral and nasal mucosa; submandibular ganglion - subm and subl salivary glands CN IX - otic ganglion - parotid CN X - organs in thorax and abdomen S2-S4 0 large intestin, rectum, genitalia, ureters and bladder parasymp NT is ACh at both pre and postganglionic

neurotransmitters for sympathatic

preganglionic ACh, postganglionic NE (except adrenal medulla and sweats)

neurotransmitters for parasympathetic

ACh both pre and postganglionic

parotid parasymp

otic ganglion of IX

ciliary ganglion

III, eye things but not lacrimal! postganglionics on short ciliary nn symps from internal carotid plexus

lacrimal parasymp

pterygopalatine of VII

pterygopalatine ganglion

VII parasymp, lacrimal, nasal oral mucosa symps internal carotid plexus

submandibular ganglion

VII parasymp to salivaries (via chorda tympani and lingual nn)

sympathetic ganglia: what's the transmitter?

paravertebral chains: 3 cervicals and T, L, S prevertebral: celiac, SMA + IMA, inferior hypogastric NT is NE!

white rami communicantes

only where preganglionic symps are (T1 - L2)

gray rami

everywhere, postganglionic symps

Neurulation is the stage of organogenesis in vertebrate embryos, during which the neural tube is transformed into the primitive structures that will later develop into the central nervous system. When does the neurulation begin? •1 " week • 3'd week • S'h week • 7'hweek

3 week

An endodontist is performing root canal therapy on his anxious dental patient. His anesthesia has been successful throughout the access preparation, cleaning, and shaping. Just before he starts to obturate, he sticks a paper point in the first canal to dry it out. The patient jumps up in pain from the stimulus. Which type of primary afferent fiber carries information related to sharp pain and temperature? • A-alpha f ibers • A-beta f ibers • A-delta fibers • C -nerve fibers

A-delta all A - myelinated, C - unmyelinated A-alpha - proprioception A-beta - touch A-delta - pain and temperature C - pain, temperature and itch

proprioception fibers

A-alpha

touch fibers

A-beta

touch

A-alpha

proprioception

``` Which ofthe following cells is the only excitatory cell in the cerebellum? • basket cells • stellate cell s • granule cells • purkinje cells • golgi cell s ```

granule cells fxx of cerebellum: coordination, equilibrium, mm tone

layers of cerebellum

molecular (axons of granule, basket [inhibitory, GABA, inhibit Purkinjes], stellate) purkinje (inhibitory, GABA) granular (deepest, granule; glutamate, excitatorym excite Purkinjes)

molecular layer of cerebellum cortex

axons of granule (excitatory) + basket (inhibitory) and stellate

``` Preganglionic parasympathetic fibers reach the otic ganglia through which of the following nerves? • greater petrosal nerve • lesser petrosal nerve • mandibular branch of t rigeminal nerve • vagus nerve ```

lesser petrosal (also tympanic) otic ganglion assoc with glossopharyngeal (IX) located in infratemporal fossa tympanic + lesser petrosal of IX carry pregangl to otic postganglionics = piggy on auriculotemporal

preganglionic of otic

lesser petrosal and tympanic of IX

gag reflex

efferent vagus, afferent IX

Your most recent patient presents to your office complaining of severe pain in his jaws around the temporomandibular (TMJ) joint. He chews three packs of gum a day, and his wife tells him he grinds his teeth at night. What nerve provides major sensory innervation to the TMJ? • masseteric nerve • auriculotemporal nerve • facial nerve (CN VII) • trochlear nerve (CN IV) ANATOMIC SCIENCES 218 copyright Cl 20 13-2014 Dental Decks

auriculotempotal - from V3, supplies posterior TMJ also carries some otic postganglionics

When walking to his car late at night, a professor hears footsteps behind him. His sympathetic response results in dilated pupils, a dry mouth, and constriction of blood vessels in his face resulting in an ashen look. The sympathetic response for the head and neck is mediated by cell bodies located in the: • superior cervical ganglion • middle cervical ganglion • inferi or cervical ganglion • ganglion impar

superior cervical gaglion ganglion impar is coccygeal unpaired symp ganglion

``` Which of the following trigeminal nuclei is involved with the proprioception oftheface? • spinal nucleus • masticatory nucleus • mesencephalic nucleus • chief nucleus ```

mesencephalic nucleus main sensory = chief = pontine - discriminates touch spinal nucleus - pain and temperature from head and neck

discriminative touch of face

pontine/chief/main sensory ganglion of trigeminal, in pons

temperature and pain from head and neck

spinal nucleus of trigeminal

mesencephalic nucleus of trigeminal

proprioception of face

pontine nucleus of trigeminal

discriminative touch of face | aka chief and main sensory

masseteric nucleus of trigeminal

motor to mastication mm

spinal nucleus of trigeminal

pain and touch of face

Preganglionic parasympathetic axons are associated with all oft he following cranial nerves EXCEPT one. Which one is the EXCEPTION? • oculomotor • facia l • t rigeminal • glossopharyngeal • vagus

trigeminal III - ciliary VII - submandibular + pterygopalatine IX - otic

``` Which of the following cranial nerves is the only nerve that emerges from the dorsal aspect ofthe brainstem? • t rochlear nerve (CN IV) • abducens nerve (CN VI) • oculomotor nerve (CN Ill) • optic nerve (CN II) ANATOMIC SCIENCES 222 copyright Cl 20 13-2014 Dental Decks ```

IV Edinger-Westphal nucleus:to pupillary sphincter

pupillary reflex

afferent II, efferent III

``` The splanchnic nerves (greater, lesser, and least) arise from the: • cervical sympathetic ganglion (chain) • thoracic sympathetic ganglion (chain) • lumbar sympathetic ganglion (chain) • sacral sympathetic ganglion (chain) ANATOMIC SCIENCES 223 copyright Cl 20 13-2014 Dental Decks ```

thoracic symp chain greater splanchnic - T5-T9 --> celiac ganglion lesser splanchnic T10-11 --> aorticorenal ganglion least - T12 --> renal plexus

greater splanchnic nerve

T5-T9 --> to celiac plexus

``` Which ofthe following nerves penetrates the cricothyroid membrane? Select all that apply. • recurrent laryngeal nerve • facial nerve • accessory nerve • internal laryngeal nerve ANATOMIC SCIENCES 224 copyright Cl 20 13-2014 Dental Decks SAADDES ```

recurrent laryngeal nerve below inferior constrictor all mm of larynx except cricothyroid which is by external branch of superior laryngeal all sensation below vocal folds (above is internal branch of superior laryngeal) right recurrent laryngeal hooks around subclavian

The hypoglossal nerve travels from the carotid triangle into the submandibular triangle of the neck. This nerve is a motor nerve supplying all of the intrinsic and extrinsic muscles of the tongue, except the palatoglossus, which is supplied by the facial nerve. • both statements are t rue • both statements are false • the first statement is t rue, the second is false • the first statement is fa lse, the second is true

first is true, second is false hypoglossal: hypoglossal canal carotid triangle to submandibular triangle palatoglossus is X

unilateral lesion of XII

deviation towards affected side (genioglossus fx)

After depositing enough lidocaine 2% to anesthetize the nerve entering the mandibular foramen, a dental student removes the needle to approximately half the depth of the initial target, whereupon another bolus of anesthetic is deposited. What nerve is most likely anesthetized by the second bolus? • hypoglossal nerve • long buccal nerve • inferi or alveolar nerve • lingual nerve • glossopharyngeal nerve

lingual nerve descends deep to lateral pterygoid, joined by chorda tympani

``` The lesser petrosal nerve carries preganglionic parasympathetic fibers to which of the following ganglia? • otic ganglia • geniculate ganglia • submandibular ganglia • sublingual ganglia I refer to card 217-1 for illustration] ANATOMIC SCIENCES 227 copyright Cl 20 13-2014 Dental Decks ```

otic STYLOPHARYNGEUS IS THE ONLY M SUPPLIED BY IX

IX fxs

motor - only stylopharyngeus! afferent of gag reflex (efferent is vagus) sensory + taste to posterior 1/3 of tongue baroreceptor of carotid sinus and chemo of carotid body (aortic is chemo+baro and X)

The cervical plexus consists of anterior rami from Cl - C4; some ofthese fibers reach the hyoid muscles by running concurrently with which cranial nerve? • phrenic nerve • vagus nerve • glossopharyngeal nerve • spinal accessory nerve • hypoglossal nerve

XII

ansa cervicalis

C1-C3, all infrahyoid except thyrohyoid which is C1 via XII

phrenic nerve

C3-C5, diaphragm

great auricular nerve

C2-C3, sensory in the area

``` The branch of the trigeminal nerve that innervates the midface, palate and paranasal sinuses exits the cranial cavity through which structure? • superior orbital fissu re • optic canal • fo ramen rotundum • pterygomaxillary fissu re • fo ramen ovale ANATOMIC SCIENCES 229 copyright Cl 20 13-2014 Dental Decks SAADDES ```

foramen rotundum

The mylohyoid nerve is derived from the inferior alveolar nerve just before it enters the mandibular foramen. The mylohyoid nerve descends in a groove on the deep surface of the ramus of the mandible, to supply the mylohyoid and what other muscle? • anteri or digastric • geniohyoid • stylohyoid • genioglossus

anterior digastric

``` Which of the following nerves innervates the medial rectus muscle of the eyeball? • optic • olfactory • oculomotor • trochlear •abducens • ophthalmic (Vl) ```

III

``` The principal types of nerves found in the dental pulp are: • parasympathetic and efferent fibers • sympathetic and afferent fibers • sympathetic and efferent f ibers • parasympathetic and afferent fibers ANATOMIC SCIENCES 232 copyright Cl 20 13-2014 Dental Decks ```

symps and afferents

``` Which ofthe following cranial nerves has visceral sensory innervation? • t rigeminal nerve • facial nerve • vagus nerve • hypoglossal nerve I refer to card 224-1 for illustration] ANATOMIC SCIENCES 233 copyright Cl 20 13-2014 Dental Decks ```

vagus - to thoracic and abdominal organs

``` Which ofthe following is a component ofthe optic disc or papilla? • central artery • cones • sensory efferent fibers • myelinated nerve fibers • oculomotor nerve ANATOMIC SCIENCES 234 copyright Cl 20 13-2014 Dental Decks ```

central artery - branch of phthalmic optic disc is blind spot on surface of retina; no photoreceptors; ummyelinated axons optic tracts synapse in geniculate nuclei --> to calcarine sulcus in primary visual cortex

optic tracts synapse where

geniculate nuclei --> then to calcarine of occipital

calcarine

visual, occipital

Which of the following ganglia receives fibers from the motor, sensory, and parasympathetic components of the facial nerve and sends fibers that will innervate the lacrimal, submandibular, and sublingual glands? • the semilunar ganglion • the geniculate ganglion • the otic ganglion • the ciliary ganglion ANATOMIC SCIENCES 235 copyright Cl 20 13-2014 Dental Decks SAADDES

geniculate greater petrosal carries sensory and preganglionic parasymps (pass to pterygopalatine) chorda tympani joins lingual n

greater petrosal

branch of facial after geniculate nucleus, carries sensory and parasymps to pterygopalatine nucleus

The left optic tract contains: • fibers from the left eye only • fibers from the right eye only • fibers from the nasal half of the left eye and temporal half of the right eye • fibers from the temporal half of the left eye and nasal half of the right eye

• fibers from the temporal half of the left eye and nasal half of the right eye fibers from temporal halves don't cross over, continue on same side nasal crosses over

Which statement concerning the left vagus nerve is FALSE? • it can be cut on the lower part of the esophagus to reduce gastric secretion (termed a vagotomy) • it forms the anterior vagal trunk at the lower part of the esophagus • it passes in front of the left subclavian artery as it enters the thorax • it contains parasympathetic postganglionic f ibers • it contributes to the anterior esophageal plexus

• it contains parasympathetic postganglionic fibers vagus contains parasymp preganglionics to viscera

``` Which of the following nerves penetrates the thyrohyoid membrane? • facia I nerve • internal laryngeal nerve • accessory nerve • recurrent laryngeal nerve ANATOMIC SCIENCES 238 copyright Cl 20 13-2014 Dental Decks ```

internal laryngeal | recurrent laryngeal penetrates criothyroid

``` Which cranial nerve supplies the derivatives ofthe hyoid arch? • glossopharyngeal • t rigeminal • vagus • facial ```

hyoid is second arch -- VII

A lesion of the facial nerve just after it exits from the stylomastoid foramen would result in: • an ipsilateral loss oftaste to the anterior tongue • a decrease in saliva production in the f loor of the mouth • a sensory loss to the tongue • an ipsilateral paralysis offacial muscles • a contralateral paralysis of facial muscles ANATOMIC SCIENCES 240 copyright Cl 20 13-2014 Dental Decks

• an ipsilateral paralysis of facial muscles

``` The spinal part of accessory nerve enters the skull through ____ and then it joins the cranial root. Together they leave the skull through the _____ • carotid canal, jugular foramen • carotid canal, foramen magnum • jugular fo ramen, foramen magnum • foramen magnum, jugular foramen ANATOMIC SCIENCES 241 copyright Cl 20 13-2014 Dental Decks SAADDES ```

• foramen magnum, jugular foramen spinal root - upper 5 cervical segments exits with vagus via jugular spinal part - SCM and trap

``` Which ofthe following nerves innervates the lower lip? • mental nerve • incisive branch of IAN • facial nerve •lingual nerve ```

mental

``` Which of the following nerves is derived from both the medial and lateral cords ofthe brachial plexus? Select all that apply. • musculocutaneous • axillary • ulnar • median • radial ```

median

``` Which sensory receptor is most sensitive to linear acceleration? • cri sta • utricle • saccule • macula • organ of cort ```

macula maculae of utricle and saccule - line of linear acceleration relative to position of head semilunar ducts - rotational acceleration organ of corti - hearing

``` Which of the following organs is retroperitoneal? Select all that apply. • stomach • kidneys •liver • gallbladder • inferi or vena cava • spleen ```

kidney, IVC SPLEEN IS INTRA! S in SAD is suprarenal (adrenal)

A 1 5-year-old patient comes into the emergency room with diffuse abdominal pain, loss of appetite, and a fever. On palpation of the lower right abdomen he feels pain, and even greater rebound pain when the pressure is released. The diagnosis is appendicitis. The appendix is located in which abdominal region? • umbilical • epigastri c • hypogastric •lumbar • hypochondriac • iliac

iliac segments are hypochondriac and epigastric on top lumbars and umbilical in the middle iliacs and hypogastric on the bottom

In an elderly adult, the thymus is mostly atrophied, and the remains lie in the superior mediastinum. In a pubescent boy, the thymus is at its largest, with an average mass of 35 grams. When it is this size, the thymus will be present in which other division ofthe mediastinum? • anterior mediastinum • middle mediastinum • posterior mediastinum ANATOMIC SCIENCES 247 copyright Cl 20 13-2014 Dental Decks

``` The diaphragm is located in the: • pelvic cavity • thoracic cavity • abdominal cavity • vertebral cavity body cavities and regions 243 copyright Cl 20 13-2014 Dental Decks ANATOMIC SCIENCES SAADDES ```

thoracic

``` Extracellular fluid comprises ___ of the amount of total body water. ·25% ·33% ·50% ·66% ```

33% extracellular is interstitial, plasma and transcellular intracellular is 2/3

``` All of the following are anatomic structures of the auricle EXCEPT one. Which one is the EXCEPTION? • tragus • helix • antrum • concha ```

antrum

what is macula of retina

most sensitive part | center = fovea

The ovaries are homologous with the testes in the male. Each ovary lies in a shallow depression, named the ovarian fossa, on the lateral wall of the pelvis; this fossa is bounded above by the external iliac vessels, in front by the obliterated umbilical artery, and behind by the ureter. • both statements are t rue • both statements are false • the first statement is t rue, the second is false • the first statement is fa lse, the second is true

both true female ovaries contain primary oocytes --> one final ovum, three polar bodies in males, every spermatogonium --> 4 sperm ovulation: follicle ruptures, releases ocum to uterine tube empty follicle --> corpus luteum if ovum fertilized, luteum persists and secretes progesteron to maintain pregnancy if not, shrinks into albicans

Consider the following structures: 1. Spongy urethra 2. Ductus deferens 3. Prostatic urethra 4. Epididymis Name the path that sperm travels upon ejaculation. •1, 2, 3, 4 • 2, 4, 1, 3 • 4, 2, 1, 3 • 4, 2, 3, 1

• 4,2, 3, 1 (epididymis, ductus deferens, prostatic urethra, spongy urethra) sperm formed in testes, passes along ductus deferens, joins duct of semina vesicle --> ejaculatory duct combines secretions from prostate gland and seminal vesicles

``` Cooper's ligaments are fibrous bands attached to musculature and function to support: • each testis • each ovary • each body of the epididymis • each breast ```

each breast

The inguinal canal is an oblique passage through the lower part of the anterior abdominal wall and is present in both males and females. In females its primary content is the round ligament of the uterus. In males, which of the following structures does NOT pass through the inguinal canal? • spermatic cord • ductus deferens • testicular veins • ejaculatory duct • lymph vessels

ejaculatory duct inguinal canal contains spermatic cord and iliinguinal nerve spermatic cord: three layers of fascia; begins at deep inguinal ring and ends at testis

contents of spermatic cord

spermatic cord = - ductus deferens (sperm from epidydimis to ejaculatory duct, which is union of vas deferens and seminal vesicle ducts, and opens into prostatic urethra) - testicular artery - testicular veins (pampiniform plexus) - lymps vessles - autonomic nerves

Cystitis is a term that refers to urinary bladder inflammation. It is most commonly caused by a urinary tract infection. It affects females more than males. This is mainly due to the difference in length of the: • ureter • urethra • theca intern a • fa llopian tube • renal pelvis

urethra

``` Where does the fertilization of an oocyte occur? • vagina • ovary • peritoneum • ampulla • uterus ```

ampulla (part of fallopian tube) parts of fallopian tube: fimbriae, infundibulum. ampulla, isthmus bartholins lubricate vag

``` The two tubes on the top side of the penis are called the: • the erectile tissue • spongy tubes • corpus cavernosum • corpus spongiosum • urethra ```

cavernosum urethra runs through spongiosum

When sperm cells are formed, they migrate in an immature state to the long, narrow structure attached to the back of each testicle called the: • vas deferens • prostate • rete testis • seminal vesicles • epididymis

epidydimis sperm is produced is seminiferous tubules and stores in epidydimis until ejaculated

``` Surrounding the gingival portion ofthe root of each tooth is a specialized epithelium known as the: • connective t issue attachment • periodontal ligament attachment • junctional epithelium • external basal lamina ANATOMIC SCIENCES 260 copynght 0 20 13·2014 Dental Decks SAADDES ```

junctional epithelium with hemidesmosomes nonkeratinized squamous no rete pegs (free gingiva has pegs)

``` Which of the following gingival fibers extend between the cementum of approximating teeth? • circular fibers • dentogingival fibers • transseptal fibers • alveologingival fibers • dentoperiosteal fibers ```

transseptal

``` The mucosa found on the hard palate is known as: •lining mucosa • masticatory mucosa • specialized mucosa • none of the above ANATOMIC SCIENCES periodontium 262 copynght 0 20 13·2014 Dental Decks SAADDES ```

masticatory many rete pegs

Scaling and root planning are periodontal treatments that can remove calculus and also stimulate the gingiva. Usually, a periodontist waits four to six weeks after a scaling and root planning procedure for reevaluation of therapy. This allows healing of the connective tissue by what main cellular component of the gingival connective tissue? • osteoblast • odontoblast • fibroblast • ameloblast ANATOMIC SCIENCES 263 copynght 0 20 13·2014 Dental Decks SAADDES

fibroblasts

``` Which structure below is NOT a derivative of the dental follicle? • pulp • cementum • periodontal ligament • alveolar bone ```

pulp - derivative of papilla follicle - same as sac --> dementum, PDL and bone

``` Which periodontal ligament fiber group mainly resists movements of a tooth in an occlusal direction? • alveolar crest group • horizontal group • apical group • interradicular group • oblique group ```

apical group

``` Which ofthe following is the most common cell found in the PDL? • cementoblasts • undifferentiated mesenchymal cells • osteoblasts • f ibroblasts ```

fibroblasts nerve endings in PDL: free (pain) and encaps (pressure)

``` Which of the following epithelia lines the endothelium of the aorta and the mesothelium ofthe peritoneal cavity? • simple squamous epithelium • stratified columnar epithelium • stratified cuboidal • transitional epithelium ANATOMIC SCIENCES 267 copynght 0 20 13·2014 Dental Decks SAADDES ```

simple squamous

``` Which of the following cell layers of the epidermis contains keratohyalin granules? • stratum corneum • stratum lucidum • stratum granulosum • stratum spinosum • stratum basale ```

granulosum layers: come get sun burned lucidum - in palms and solesl right below corneum langerhans in spinosum melanocytes in basale

What is the main difference between parakeratinized and orthokeratinized epithelium? • para keratinized epithelium has keratohyalin granules • parakeratinized epithelium has nuclei • parakeratinized epithelium has more prominent RER • para keratinized epithelium are rich in mitochondria ANATOMIC SCIENCES 269 copynght 0 20 13·2014 Dental Decks SAADDES

has nuclei in top layer basement membrane - two layers; basal and reticular lamina

``` Which type of collagen is found mainly in dentin and bone? • type I • type II • type Ill • type IV ```

I II is ctlg III - reticular IV - basement membrane attachment mechanism: heidesmosomes in collagen, every third AA is glycine Vit C required for hydroxylation of proline and lysine (no Vit C --> scurvy) lysyl oxidase for cross-linking

``` Which of the following epithelial tissues is most often specialized for diffusion and filtration? • simple columnar epithelium • stratified cuboidal epithelium • simple squamous epithelium • pseudostratified epithelium I refer to card 267-1 for illustration] ANATOMIC SCIENCES 271 copynght 0 20 13·2014 Dental Decks SAADDES ```

simple squamous

``` Which of the following cells is the most abundant cell type found in connective tissues? • osteoblast • chondroblast • mast cell • fibroblast • macrophage ```

fibroblast

``` Intervertebral discs are made up of: • elastic cartilage • periosteum • fibrocartilage • hyaline carti lage ANATOMIC SCIENCES tissue 273 copynght 0 20 13·2014 Dental Decks ```

fibrocartilage hyalin - in joints elastic - epiglottis and external ear growth of ctlg - appositional and interstitial

``` All of the following bones are formed completely by intramembranous ossification EXCEPT one. Which one is the EXCEPTION? • clavicles • mandible • maxilla • frontal bone ```

mandible - condyle is endochondral

A patient in the dental clinic states in his medical history that he has heart disease and occasionally takes nitroglycerin for his pain. During treatment, the patient clutches his chest and frantically points to his jacket pocket. The dentist obtains the nitroglycerin bottle from his jacket, removes one tablet, and places it: • on the soft palate • on the gingiva • on the oral vestibule • on the floo r of the mouth • on the buccal tissue • any of the above

sublingually | most permeable

``` Which of the following is the principle component of ground substance of the cartilage? • fibroblasts • collagen fibers • reticular fibers • chondroitin sulfate ANATOMIC SCIENCES 276 copynght 0 20 13·2014 Dental Decks ```

chondroitin sulfate - PGs, GAGs all GAGs are sulfated and have protein core except hyaluronic acid (which binds them into large aggregates)

At the gymnastics center, a 22-year-old male doing flips on the trampoline lands incorrectly on his ankle and dislocates it. In the emergency room, the physician provides traction to correctly relocate the ankle. The patient is told that although there are no fractures the bands of fibrous connective tissue that connect bone to bone are almost definitely torn. These bands are called: • tendons • bursae •ligaments • menisci

ligaments attaching fibers of tendons and ligaments are called Sharpeys

``` Which type of connective tissue is most commonly observed in ligaments and tendons? • loose connective tissue • dense irregular connective t issue • dense regular connective tissue • elastic connective t issue ANATOMIC SCIENCES 278 copynght 0 20 13·2014 Dental Decks ```

dense regular CT

``` The greatest resistance to the movement of the molecules between cells is mainly achieved by which of the following intercellular junctions? • desmosomes • hemidesmosomes • adherens junctions • gap junctions • zonula occludens ANATOMIC SCIENCES 279 copynght 0 20 13·2014 Dental Decks SAADDES ```

occludens desmosome - spot welds between ells hemidesmosomes - cell to noncellular surface occludens = tight, barrier gap jxns - channels, connexons

In contrast to tight and adherens junctions, gap junctions do NOT seal membranes together, nor do they restrict the passage of material between membranes. Gap junctions allow electrical and metabolic coupling among cells so that signals initiated in one cell can readily propagate to neighboring cells. • both statements are t rue • both statements are false • the f irst statement is t rue, the second is false • the f irst statement is fa lse, the second is t rue

both true

components of jxnal complex

tight, intermediate, desmosome

``` Where would you expect to find the fewest matrix-embedded elastic fibers? • nasal cartilage • epiglottis • auricle • eustachian tube ANATOMIC SCIENCES 281 copynght 0 20 13·2014 Dental Decks ```

nasal - hyaline

``` Which layer of skin is mainly composed of areolar connective tissue and adipose tissue? • epidermis • hypodermis • dermis ```

hypodermis main depository of FAT

dermis layers and origin

papillary and reticular (dense irregular CT) | mesoderm

meissner

tactile

Ruffini

stretch

``` When we look at our fingers, we can see fingerprints. Which of the following layers of skin are we looking at in order to see the fingerprints? • papillary layer of the dermis • stratum corneum of the epidermis • reticular layer of the dermis • stratum lucidum of the epidermis ANATOMIC SCIENCES 283 copynght 0 20 13·2014 Dental Decks ```

papillary layer of dermis -- forms dermal ridges that interdigitate with rete pegs of epidermis

A 17-year-old man falls down and chips the incisal edge of his maxillary central incisor, reducing the length of the crown. The dentist informs him that the tooth may erupt a little to compensate for the loss. Which of the following structures will be deposited in the apex of the tooth when the tooth continues to erupt? • cementum • bundle bone • dentin • pulp • enamel • periodontal ligament

cementum compensates for wear on apical third acellular cementum - coronal 2/3 of root, thinnest at CEJ ellular (secondary) - faster, contains cementocytes

Intertubular dentin is formed in peripheral parts oft he mineralized dentin inside the walls of dentin tubules. Peritubular dentin is highly mineralized and it also contains little collagen. • both statements are t rue • both statements are false • the first statement is t rue, the second is false • the f irst statement is fa lse, the second is t rue ANATOMIC SCIENCES 285 copynght 0 20 13·2014 Dental Decks

• the first statement is false, the second is t rue

``` Which of the following areas of the pulp is also known as the "zone of Wei I?" • f ibroblastic layer • odontoblastic layer • cell-rich zone • cell-free zone ANATOMIC SCIENCES 286 copynght 0 20 13·2014 Dental Decks SAADDES ```

cell free contains Korff raschkow is in cell-rich (Hohle) accessory canals form when HERS encouters blood vessel; root forms around vessel

``` All of the following are stages of amelogenesis EXCEPT one. Which one is the EXCEPTION? • presecretory • secretory • transitional • morphogenic • maturation • post-maturational ```

morphogenic

Pulpal involvement of a carious lesion in a young child is much more likely because: • caries progress faster in primary teeth • caries can enter primary teeth from the enlarged apical foramen • the pulp chamber is larger in primary teeth compared to permanent teeth • reparative dentin is not as functional in primary teeth as it is in permanent teeth

pulp chamber is larger

``` The main function of cementum is to: • maintain the width of the PDL • supply nutrition to the pulp • stimulate formation of dentin • attach sharpey's fibers ANATOMIC SCIENCES tooth components 289 copynght 0 20 13·2014 Dental Decks ```

attach sharpeys

An irritating or painful response to cold, hot or pressure stimuli is usually caused by sensitivity of which oral tissue? • dentin • cementum • pulp • enamel

dentin

``` Generally, as the dental pulp ages, the number of cells ___ , and the number of collagen fibers ___ . • decreases, decreases • decreases, increases • increases, decreases • increases, increases ANATOMIC SCIENCES 291 copynght 0 20 13·2014 Dental Decks SAADDES ```

decreases, increases

``` Which ofthe following has the least amount of collagen? • bone • dentin • enamel • cementum ```

enamel oldest enamel at DEJ under cusp or cingulum

``` All of the following age changes in enamel are true EXCEPT one. Which one is the EXCEPTION? • attrition • discoloration • flatten ing of grooves and fissu res • modifications in the surface layer • increased permeability ANATOMIC SCIENCES 293 copynght 0 20 13·2014 Dental Decks ```

increased permeability (reduces actually)

Enamel tufts and lamellae may be likened to geologic faults and have no known clinical significance. The striae of Retzius often extend from the DEJ to the outer surface of enamel, where they end in shallow furrows known as perikymata. • both statements are t rue • both statements are fa lse • the fi rst statement is true, the second is fa lse • the fi rst statement is false, the second is true

both true

``` You would expect to see all oft he following in dentin EXCEPT one. Which one is the EXCEPTION? • incremental l ines of von Ebner • contour lines of Owen • striae of Retzius • granular layer ofTomes ANATOMIC SCIENCES 295 copynght 0 20 13·2014 Dental Decks ```

retzius

``` The organic phase of dentin is about 90% collagen, mainly type __ with small amounts of types __ . •I, II and IV • I, Ill and V •Ill, I and IV • IV, I and Ill ```

I, some III and V

In orthodontic tooth movement, bone remodeling is forced. The bands, wires, or appliances put pressure on one side of the tooth and adjacent alveolar bone, creating a zone of __ in the POL This leads to bone __ . On the opposite side of the tooth and bone, a __ zone develops in the POL and causes the of bone. • tension, deposit ion, compression, resorption • compression, resorption, tension, deposit ion • compression, deposit ion, tension, resorption • tension, resorption, compression, deposition

• compression, resorption, tension, deposition permanent teeth move occlusally and facially when erupting

``` Apical abscesses of which teeth have a marked tendency to produce cervical spread of infection most rapidly? • mandibular central and lateral incisors • mandibular canine and first premolar • maxillary first and second molars • mandibular second and third molars ANATOMIC SCIENCES 298 copynght 0 20 13·2014 Dental Decks ```

cervical as in to actual neck | • mandibular second and third molars

``` The bone directly lining the socket (inner aspect of the alveolar bone) specifically is referred to as: • bundle bone • cancellous bone • osteoid • trabecular bone ANATOMIC SCIENCES 299 copynght 0 20 13·2014 Dental Decks SAADDES ```

bundle bone

``` A newly erupted tooth has a membranous covering. It is derived from which structure? • perikymata • dental papilla • dental follicle • oral epithelium • gubernaculum ```

oral epithelium = nasmyth's membrane, secondary enamel cuticle pellicle - salivary proteins primary cuticle - binding epithelium to tooth during development

``` Dentin is considered a living tissue because of odontoblastic cell processes known as: • triacetate f iber • Tomes' fiber • tag f iber • Korff's f iber ```

Tomes v. Korff is in cell-free zone of pulp

Secondary Dentin comes in attrition, caries, or a restorative dental procedure. Tertiary dentin is produced only by those cells directly affected by the stimulus. • both statements are t rue • both statements are fa lse • the first statement is true, the second is fa lse • the first statement is false, the second is true ANATOMIC SCIENCES 302 copynght 0 20 13·2014 Dental Decks SAADDES

first false, second true tertiary = reactive or reparative; reactive - by preexisting, reparative - by newly differentiated odontoblasts primary dentin - before completion of apical foramen secondary dentin - after completion of apical foramen (slower, less mineralized) junction between primary and secondary - sharp change in direction

The dental lamina, a thickening of the oral epithelium that produces the swellings of the enamel organs, is first seen histologically around the: • second week in utero • sixth week in utero • tenth week in utero • fourth month in utero I refer to AS card 303-1, 308 B-1, 308 C-1 for illustration I ANATOMIC SCIENCES 303 copynght 0 20 13·2014 Dental Decks SAADDES

6th week 3rd week - formation of stomodeum (also neurulation)

``` When enamel maturation is completed, the ameloblast layer and the adjacent papillary layer regress and together constitute the: • cervical loop • epitheli al root sheath • reduced enamel epithelium • junctional epithelium ANATOMIC SCIENCES 304 copynght 0 20 13·2014 Dental Decks SAADDES ```

REE cervically becomes junctional epithelium JE: apical extent to CEJ, to tooth via hemidesmosomes

``` Epithelial cells of the inner and outer epithelium proliferate from the cervical loop of the enamel organ to form a double layer of cells known as: • dental lamina • dental papilla • reduced enamel epithelium • Hertwig's epitheli al root sheath ANATOMIC SCIENCES 305 copynght 0 20 13·2014 Dental Decks SAADDES ```

HERS

Tooth development is dependent on a series of sequential cellular interactions between epithelial and mesenchymal components of the tooth germ. Once the ectomesenchyme influences the oral epithelium to grow down into the ectomesenchyme and become a tooth germ, the histogenesis of a tooth occurs. • both statements are true • both statements are false • the first statement is t rue, the second is false • the first statement is fa lse, the second is true

both true

``` Which ofthe following forms the middle part ofthe enamel organ? • outer enamel epithelium • inner enamel epithelium • stratum intermedium • stellate reticu lum ANATOMIC SCIENCES 307 copynght 0 2013·2014 Dental Decks ```

stellate | lots of intercellulaar fluid

Put the following developmental stages of a tooth in the correct sequence: (1) Bell stage (2) Bud stage (3) Cap stage • 1,2,3 • 3,2, 1 • 2,3,1 • 2, 1,3

2, 3, 1 initiation - 6-7 wk = induction bud stage - 8 wk, proliferation cap stage - 9-10 wks: proliferation, differentiation, morphogenesis bell stage - 11-12 wk, histo and morphodifferentiation then: apposition, calcification, eruption and attrition dentino- and amelogenesis imperfecta occur dyring bell stage (histodifferentiation)

initiation of tooth

6 week, induction

bud stage

7-8 wk, proliferation

cap stage

9-10 wk, proliferation differentiation and morphogenesis

bell stage

11-12 wk: histo and morphodifferentiation

In adults the epithelial cell rests of Malassez persist next to the root surface within the periodontal ligament. Although apparently functionless, they are the source of the epithelial lining of dental cysts that develop in reaction to inflammation of the periodontal ligament. • both statements are t rue • both statements are fa lse • the first statement is true, the second is fa lse • the fi rst statement is fa lse, the second is t rue

both true

``` Histologically, the dentin of the root is distinguished from the dentin of the crown by the presence of: • incremental lines of Retzius • rete pegs • granular layer ofTomes • sharpey's fibers ANATOMIC SCIENCES 310 copynght 0 20 13·2014 Dental Decks SAADDES ```

granular layer of Tomes | just below cementum, globular calcification

``` Which ofthe following products is NOT ectodermal in origin? • junctional epithelium • enamel • hertwig's epithelial root sheath • pulp • ameloblasts ```

pulp - ectomesenchyme of papilla

The portal vein is about 2 inches long and is formed behind the neck of the pancreas by the union of the: • left gastric and the left colic veins • appendicular and the inferior mesenteric veins • superior mesenteric and the splenic veins • right gastri c and the right colic veins ANATOMIC SCIENCES 312 copynght 0 20 13·2014 Dental Decks SAADDES

• superior mesenteric and the splenic veins tributaries of portal vein: splenic, IMA, SMA, gastric veins

``` The right posterior intercostal vein drains blood into: • azygos vein • hemiazygos vein • accessory hemiazygos vein • none of the above ANATOMIC SCIENCES veins 313 copynght 0 20 13·2014 Dental Decks SAADDES ```

azygos azygos = right ascending lumbar vein and right subcostal vein; goes up to fifth thoracic vertebra, drains into SVC SVC = union of two brachiocephalic veins, left is longer

``` The subclavian vein is located anterior to the: • scalenus anterior muscle • scalenus middle muscle • scalenus posterior muscle • none of the above ANATOMIC SCIENCES veins 314 copynght 0 20 13·2014 Dental Decks ```

• scalenus ante rior muscle vein anterior to anterior scalene, artery + brachial plexus between anterior and middle brachiocephalic vein = internal jugular + subclavian

``` Oxygenated blood leaves the placenta and enters the fetus through the: • foramen ovale • ductus venosus • umbili cal arteries • ductus arteriosum • umbili cal vein ANATOMIC SCIENCES 315 copynght 0 20 13·2014 Dental Decks SAADDES ```

umbilical vein (becomes round ligament of liver)

``` The exchange of gases in the lungs takes place between the alveoli and the: • bronchial arteries • pulmonary veins • pulmonary arteri es • capillaries ```

capillaries

``` All of the following nerves are embedded in the lateral wall of the cavernous sinuses EXCEPT one. Which one is the EXCEPTION? • trochlear nerve (CN IV) • ophthalmic nerve (CN Vl ) • oculomotor nerve (CN Il l) • maxillary nerve (CN V2) • mandibular nerve (CN V3) ANATOMIC SCIENCES 317 copynght 0 20 13·2014 Dental Decks SAADDES ```

V3 is not cavrnous sinuses empty into superior petrosal sinuses (in tentorium) --> transverse --> sigmoid --> via jugular foramen to internal jugular vein inferior petrosal also into internal jugular vein contents of cavernoud sinus: III, IV, V1 and V2 + internal carotid + VI

``` Which oft he following veins are found within the marrow spaces oft he skull? • cerebral venules • diploic veins • emissary veins • brachiocephalic veins ANATOMIC SCIENCES 318 copynght 0 20 13·2014 Dental Decks SAADDES ```

diploic vv emissaries connect dural sinuses with scalp; valveless

Which of the following veins join within the parotid gland to form the retromandibular vein? • the facia l and maxillary veins • the facia l and superficial temporal veins • the maxillary and superficial temporal veins • the facia l and mandibular veins ANATOMIC SCIENCES 319 copynght 0 20 13·2014 Dental Decks SAADDES

• the maxillary and superficial temporal veins subclav + int jug --> brachiocephalic vein supfcl to artery and deep to facial nerve, \\

``` Which of the following are considered to be primary resistance vessels? • large arteries • arterioles • capillaries • large veins • venules ```

arterioles

``` At the level of the inferior border of the 1st right costal cartilage, the brachiocephalic veins unite to form the: • external jugular vein • internal jugular vein • retromandibular vein • superi or vena cava • subclavian vein • thoracic duct ```

SVC IVC = junction of common iliacs at L5

Because the facial vein and its tributaries have no valves extracranial infections arising within an area bounded by the bridge of the nose and the angles of the mouth (danger triangle of the face) will reach which of the following sinuses? • cavernous sinus • sigmoid sinus • inferior petrosal sinus • superior petrosal sinus

cavernous

``` Which dural venous sinus lies in the convex attached border of the falx cerebri? • cavernous sinus • transverse sinus • superi or sagittal sinus • straight sinus ANATOMIC SCIENCES 323 copynght 0 2013·2014 Dental Decks ```

superior sagittal confluence of sinuses = sup sagitt + straight + occipital from here to transverse, which become sigmoid, exit through jugular and become internal jugular vein inferior petrosal also through that hole

``` All of the following are characteristic features of veins EXCEPT one. Which one is the EXCEPTION? • muscular tunica media • thick tunica adventit ia • larger lumen • valves • vasa vasorum ```

muscular tunica media | is characteristic of smaller arteries

Stomodeum

4th week

Neurulation

3rd week

Dental lamina

6th week