ANATOMY Flashcards
CN responsible for Anterior 2/3 of tongue
CN responsible for Posterior 1/3 of tongue
anterior 2/3: chorda tympani of CN7
post 1/3: CN9 glossopharyngeal
On median sternotomy, the cardiac surgeon was very careful not to injure a nerve located at the lateral sides of the pericardium. Injury to this nerve will cause:
Loss of sensation of the epicardium
Loss of sensation of the peripheral sides of the diaphragm
Paralysis of the diaphragm on the same side
Paralysis of the intercostal muscles on the same side
Phrenic Nerve - runs posterior to the subclavian vein → anterior to the root of the lung and lateral sides of pericardium → pierces diaphragm; supplies motor fibers to the diaphragm and sensory fibers to the fibrous pericardium, mediastinal pleura, and diaphragmatic peritoneum
LV vs RV
Alin ang may moderator bands?
Alin ang crescenteric?
Alin ang circular?
***Isipin yung drawing
Alin ang may moderator bands? - RV
Alin ang crescenteric cavity? - RV
Alin ang circular cavity? - LV
Structure that serves a landmark in doing segmental resection
of the lung:
A. Pulmonary vein
B. Pulmonary artery
C. Pulmonary nerve
D. Segmental bronchus
Bronchopulmonary segments Anatomic, functional, surgical units of the lungs Each lobar (secondary) bronchus – gives off a segmental (tertiary) bronchi
Each segmental bronchi – with functionally independent bronchopulmonary segment surrounded by a connective tissue
Components of each segment
Pulmonary artery
Lymphatic vessels
Autonomic nerve supply
Respiratory bronchiole, alveolar ducts, alveolar sacs
*Pulmonary veins - run in the connective tissue between adjacent bronchopulmonary segments (lies outside the segment)
That the scrotal skin markedly wrinkles when it is cold is due to the muscle derivative of this structure:
A. Camper’s fascia
B. Scarpa’s fascia
C. Fascia transversalis
D. Peritoneum
CAMPER’S
Campers fascia- dartos muscle contain smooth muscle Scarpas fascia- colles fascia, membranous layer
The referred pain in the shoulder of a patient suffering from acute cholelithiasis is explained by:
A. Spasm of the smooth muscle of the gallbladder to expel a stone
B. Irritation through T7-T9 dermatomes
C. Stimulation of the subdiaphragmatic parietal peritoneum supplied by the phrenic nerve
D. Resulting from frozen shoulder as the patient doubles up in pain
Phrenic Nerve - runs posterior to the subclavian vein → anterior to the root of the lung and lateral sides of pericardium → pierces diaphragm; supplies motor fibers to the diaphragm and sensory fibers to the fibrous pericardium, mediastinal pleura, and diaphragmatic peritoneum
Jejunum vs. Ileum
Which is shorter?
Which is narrower?
Which has more plicae circulares (thiccer)?
Which is more vascular (light red)?
Which has more arcades (short terminal branches)?
Which has only small amount of mesenteric fat?
Has more aggregrations fo lymphoid tissue (Peyer’s Patches)
ahahahaha check mo nalang
Occlusion of the superior mesenteric artery results in the gangrene of:
A. Stomach
B. Spleen
C. Ileum
D. Rectum
Foregut - from esophagus to ligament of treitz (between duodenum and jejunum) = CELIAC ARTERY
Midgut - from ligament of treitz to 1⁄2 tranverse colon = SUPERIOR MESENTERIC ARTERY
Hindgut - 1⁄2 transverse colon to superior 1⁄3 of rectum INFERIOR MESENTERIC ARTERY
Which is the most common location of thyroglossal duct cyst?
A. In proximity to the hyoid bone
B. At the level of the superior parathyroid
gland
C. Juxtaposition to the isthmus of thyroid
D. Anywhere along the migratory path of
the thyroid
A
Thyroglossal Duct Cyst is due to the failure of regression of embryonic anlage as it migrates into the duct. It abuts the hyoid bone since the duct is anatomically attached to the hyoid bone.
Varicocoeles are less common observed on the right because the right testicular vein drains into what structure? A. Common iliac vein B. Inferior vena cava C. Internal iliac vein D. Right renal vein
B
Varicocele develops more on the left since there is a higher pressure in the left testicular vein which drains to the left renal vein. It is less common in the right since it drains directly into the Inferior Vena Cava.
Which of the following physical examination findings would be present in a patient with a common peroneal nerve injury?
A. Loss of ankle dorsiflexion
B. Inability to do flexion of the big toe
C. Loss of sensation on the sole of the foot
D. Numbness over the medial surface of
the foot
A
Common Peroneal Nerve Injury Clinical Presentations:
• Numbness or tingling on the lateral aspect of the leg and dorsum of the foot
• Weakness of invesion, eversion, and dorsiflexion
• Foot drop
• Slapping gait
• Toes drag while walking
The deep fascia together with the interosseous membrane and fibrous intermuscular septa divide the forearm into several compartments. Which statement is correct?
A. Have a common nerve and blood supply
B. Dorsal compartment contains the brachioradialis & extensor carpi radialis
longus
C. Forearm has 4 compartments
D There are 3 layers of the Volar Compartment: Superficial, Intermediate and Deep
D
There are 3 layers of the Volar Compartment: Superficial, Intermediate and Deep
Which of the following is TRUE of the carpal tunnel?
A. Floor is formed by the distal radius and distal ulna
B. Roof is formed by the extensor retinaculum
C. Tunnel contains 9 tendons & 1 nerve
D. Ulnar nerve passes through it
C
Carpal Tunnel • 9 tendons o Flexor Digitorum Profundus o Flexor Digitorum Superificialis o Flexor Carpi Radialis • 1 nerve (Median Nerve)
Ligation of the uterine vessels during hysterectomy may result to unintentional injury to the ureters. What is the anatomic position of the vessel in relation to the ureter? A. Anterior
B. Lateral C. Medial D. Posterior
A
The uterine artery passes forward from the internal iliac artery and crosses the ureter at right angles to reach the cervix at the level of the internal os.
• Uterine artery crosses over the ureter (water under the bridge)
You are called to perform thoracentesis to remove fluid from the pleural cavity. To avoid injuring lung or neurovascular elements, where would you insert the aspiration needle? A. above rib 8 in midclavicular line B. below rib 9 in the midaxillary line C. above rib 9 in midaxillary line D. below rib 11 in the scapular spine
C
Neurovascular structures run along the inferior margin of each rib, so needles and tubes should be placed just at the superior rib margins
A 65 year old man suffered B myocardial infarction at the apex of the heart. Occlusion by atherosclerosis may be found in which of these arteries? A. Marginal B. Anterior interventricular C. Posterior interventricular D. Circumflex branch of the left coronary
Anterior Interventricular
MEMORIZE TABLE
A patient with a history of A pulmonary tuberculosis presents with pus draining from the superomedial part of the thigh. To which muscle did the TB most likely spread? A. Iliacus B. Vastus medialis C. Psoas Major D. Quadratus Lumborum
Iliacus
In performing lumbar puncture, what landmark is used to locate the
point of insertion of the spinal needle between the 4th and 5th lumbar
vertebral spines?
A. Anterior superior iliac spine B. Costal margin
C. Iliac crest
D. Transpyloric plane
Iliac Crest
Prostate cancer is diagnosed in a B 82-year old. Therefore a malignant prostatic origin is found. By what
vascular pathway did the cancerous
cells get to the brain?
A. Anterior Spinal Artery
B. Vertebral Venous Plexus C. Azygos Venous System D. Vertebral Artery
Vertebral Venous plexus
A. ANTERIOR SPINAL ARTERY
- The spinal cord receives arterial blood supply from 2 posterior and 1 anterior spinal artery (this arises from the vertebral arteries. This is usually the one involved in cervical disc protrusions wherein it presses on the spinal cord and anterior spinal artery. (Snell’s Clinical Anatomy, 9th Ed)
B. VERTEBRAL VENOUS PLEXUS
There is a reverse direction of venous blood flow that enter the vertebral veins which is the cause of frequent skeletal metastases in the lower vertebral column and pelvic bones. Cancer cells enter the skull via this route by float up the valveless prostatic and vertebral veins. (Snell’s Clinical Anatomy, 9th Ed)
During herniorrhapy, a surgeon D finds a hernial sac with a small knuckle of intestine projecting through the abdominal wall just above the inguinal ligament and lateral to the inferior epigastric vessels. What type of hernia is this? A. Direct Inguinal hernia B. Femoral Hernia C. Incisional Hernia D. Indirect Inguinal Hernia
DIRECT INGUINAL HERNIA
Pathway of protrusion: Passes through the Hesselbach’s Triangle, rarely enters the scrotum.
FEMORAL HERNIA
it develops in the femoral canal/ring. Palpable BELOW the inguinal ligament and LATERAL to the pubic tubercle. All forms of femoral hernia are ACQUIRED. Usually found in slender women. It’s due to expanded femoral ring and increased intraabdominal pressure.
INCISIONAL HERNIA
Most common cause is due to inadequate facial closure due to poor surgical technique
INDIRECT INGUINAL HERNIA
The most common subtype of groin hernia in men and women. Pathway of protrusion: comes down the inguinal canal and may enter the scrotum. If it reaches the scrotum ALWAYS INDIRECT HERNIA.
If it reaches the scrotum, it’s always _____
INDIRECT HERNIA
During emergency surgery, it was D. found that a chronic gastric ulcer had perforated the posterior wall of the stomach and eroded a large artery
running immediately posterior to the stomach. What artery is this?
A. Gastroduodenal
B. Common Hepatic
C. Left Gastroepiploic D. Splenic
Splenic
A surgeon needs to construct a bypass between the veins of the portal and caval systems to circumvent insufficient drainage through the natural portacaval anastomoses. Which plane is likely to successful? A. Coronary Vein to Right Gastroepiploic Vein B. Inferior Mesenteric Vein to Splenic Vein C. Left Colic Vein to Middle Colic Vein D. Splenic Vein to Left Renal Vein
Portacaval shunts are for the treatment of portal hypertension. It may involve the anastomosis of portal vein, because it lies within the lesser omentum, to the anterior wall of the inferior vena cava behind the entrance into the lesser sac. The splenic vein may be anastomosed to the left renal vein.
(Snell’s Clinical Anatomy, 9th Ed)
- A 20 y/o male falls on his outstretched right wrist. PE in the ER reveals severe pain upon palpation of
the anatomical snuffbox. Radiological studies confirm a fracture. Which
bone is most likely fractured? A. Head of the 1st metacarpal
B. Scaphoid
C. Styloid process of the ulna
D. Trapezoid
B. Scaphoid
Boundaries of the snuffbox?
Lateral: Abd polo, ex po bre
Medial: Expolo
Proximal: distal end of the radius
The importance of the anatomical snuffbox lies in the fact that scaphoid bone is most easily palpated here as well _______
The importance of the anatomical snuffbox lies in the fact that scaphoid bone is most easily palpated here as well as the pulsations of the radial artery.
