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PLAB 1 August 2024 > Anatomy > Flashcards

Anatomy Flashcards

1
Q

Name anatomical landmarks.
- Drain position for pleural tap
- Heart apex
- Kidneys
- Iliac crest
- Diaphragmatic openings
- Umbilicus
- Scapula
- Spinal cord (lower border)

A

Drain position for pleural tap: mid axillary line, 5th intercostal space.

Heart apex: mid clavicular line, 5th intercostal space.

Kidneys: T12-L3

Iliac crest: L4

Diaphragmatic openings
- V: Vena cava (inferior) T8
- O: Oesophagus T10
- A: Aorta T12

Umbilicus: L3-L4

Scapula: T3-T7

Spinal cord (lower border):
Adults - L1
Children - L3

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2
Q

Name the nerve injuries associated with:
- Winging scapula
- Dropped scapula

A
  • Winging scapula: Long thoracic nerve
  • Dropped scapula: Accessory nerve
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3
Q

Describe the sensory innervation branches of the femoral nerve.

A

Saphenous nerve [HIGH YIELD]

  • Medial leg + foot
  • Anterior + Medial aspects of thigh
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4
Q

Describe the motor innervation of the femoral nerve.

A
  • Extension of the knee;
  • Flexion of the hip.
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5
Q

Describe the nerve injuries associated with the following injuries:
- Acetabular #
- Femur neck #
- Neck of fibula #
- Foot drop
- Loss of sensation on lateral and medial side of foot
- Glove and stocking pattern of Paresthesia

A
  • Acetabular #: sciatic nerve
  • Femur neck #: sciatic nerve
  • Neck of fibula #: common peroneal nerve
  • Foot drop: sciatic, common peroneal and deep peroneal nerve
  • Loss of sensation on lateral side of foot: sural nerve
  • Loss of sensation on medial side of foot: saphenous nerve (through the femoral nerve)
  • Glove and stocking pattern of Paresthesia: DM peripheral neuropathy
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6
Q

What is the nerve of which the common peroneal nerve branches off of it?

A

Sciatic nerve.

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7
Q

What are the injuries associated with common peroneal nerve?

A
  • Injury to lateral side of the knee + foot drop;
  • Fracture neck of fibula + foot drop
  • Recent removal of below of knee cast + foot drop
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8
Q

Describe the motor distribution of the brachial plexus?

A

Upper brachial plexus
Superior trunk C5,6:
- Shoulder abduction
- Elbow flexion

C6
- Wrist extension

Middle trunk C7
- Forearm extension

Lower brachial plexus
Inferior trunk C8, T1: Hand function.

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9
Q

Describe the motor distribution of the brachial plexus?

A

Upper brachial plexus
Superior trunk C5,6:
- Shoulder abduction
- Elbow flexion

C6
- Wrist extension

Middle trunk C7
- Forearm extension

Lower brachial plexus
Inferior trunk C8, T1: Hand function.

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10
Q

Describe the motor distribution of the brachial plexus?

A

Upper brachial plexus
Superior trunk C5,6:
- Shoulder abduction
- Elbow flexion

C6
- Wrist extension

Middle trunk C7
- Forearm extension

Lower brachial plexus
Inferior trunk C8, T1: Hand function.

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11
Q

Describe Erb’s palsy/ waiter’s tip deformity.

A
  • Injury to the upper brachial plexus (C5, C6) sometimes including C7.
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12
Q

Describe Klumpke’s palsy?

A
  • Injury to lower brachial plexus (C8-T1)
  • Hand function
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13
Q

What is the nerve associated with winging of scapula?

A
  • Long thoracic nerve
  • C5-C7
  • Weakness of serratus anterior muscle.
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14
Q

What is the nerve that innervates the eye?

A

CN 3 / oculomotor nerve:
- All the muscles of the eye
- Injury causes ptosis and mydriasis

Except

CN4 / Trochlear nerve:
- Superior oblique muscle
- Diploplia looking downwards (high yield)

CN6 / Abducens nerve:
- Lateral rectus muscle
- Injury causes diploplia on looking towards same side

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15
Q

What are the nerves that originate at the midbrain?

A
  • Oculomotor CN3
  • Trochlear nerve CN4
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16
Q

Describe the sensory innervation and the injury seen with infraorbital nerve.

A

Injury: orbital blowout fracture

Sensory innervation:
- Lower eyelid
- Cheek
- Upper lip

17
Q

In biliary colic what is the 2nd part of the duodenum where stones could be lodged?

A

Hepatopancreatic ampulla / Ampulla of Vater.

18
Q

What is the tendon rupture involved in rheumatoid arthritis?

A

Extensor digitorum.

19
Q

What is the tendon involved in extension of the thumb at the interphalangeal joint and extension of the thumb at the metacarpophalangeal joint?

A

Interphalangeal: Extensor pollicis longus.

Metacarpophalangeal: Extensor pollicis brevis.

20
Q

Describe the correct placement of chest drain technique.

A

1. Within the safe triangle:
- Upper border: base of axilla;
- Lower border: 5th intercostal space;
- Anterior border: Pectoralis major;
- Posterior border: Latissimus dorsi

2. Insertion:
- 5th intercostal space
- Mid axillary line
- Superior border of the rib (avoiding VAN at the inferior border)

21
Q

DDx between injuries of the hand muscles:
- Flexor digitorum superficialis muscle
- Flexor digitorum profundus muscle

A

Flexor digitorum superficialis muscle
- Unable to flex MCP joints and proximal interphalangeal joints

Flexor digitorum profundus muscle
- Unable to flex distal interphalangeal joints

22
Q

What is the innervation of the tongue and the salivary glands?

A

Taste:
- CN 7 / Facial nerve: anterior 2/3 of the tongue;
- CN 9 / Glossopharyngeal: posterior 1/3 of the tongue

Movement:
- CN 12 / hypoglossal

Salivation:
- CN 7 / Facial nerve: submandibular & sublingual glands;
- CN 9 / Glossopharyngeal: parotid glands

23
Q

What are the surgeries that cause nerve damage associated with taste?

A

Tympanoplasty:
- Facial nerve (CN 7) damage.

24
Q

Describe the symptoms of rupture of biceps.

A
  • Proximal biceps: popeye’s sign;
  • Distal biceps: sharp pain in cubital fossa.
25
Q

Describe the presentation of Dupuytren’s contracture.

A
  • Thickened palmar fascia;
  • Ring and 5th finger permanently bent and flexed.

➔ Patients with functional disability: fasciotomy.

26
Q

Describe the presentation of C7 spinal nerve impigement.

A
  • Pain from the neck radiating down to the shoulder + middle finger;
  • Numbness of the index and middle finger;
  • Weakness of triceps muscle (elbow extension).
27
Q

DDx between compression sites of:
- L4
- L5
- S1

A
  • L4: Weakness in ankle dorsiflexion
  • L5: Weakness in toe extension
  • S1: Weakness in foot plantar flexion
28
Q

What are the nerves injured in thyroidectomy?

High yield

A

Recurrent laryngeal nerve
- Unilateral: hoarseness
- Bilateral: aphonia

Superior laryngeal nerve
- Decreased pitch

29
Q

During laparascopic cholecystomy, what anatomical structure is pierced during a midline port insertion?

A

Linea alba.

30
Q

During laparascopy, what anatomical structure is pierced during a insertion of a port midway point between umbilicals and anterior superior spine?

A
  • Internal oblique muscle
  • External oblique aponeurosis
31
Q

Describe the features of parietal lobe injury.

A

► Neglects one side of the clock when drawing;

► Struggles to place hands of clock on the correct time;

► Although the patient is very familiar with the neighborhood, loses track of direction;

► Struggles with simple math;

  • Inferior homonymous quadrantonopia (loss of vision on the same quadrants)
32
Q

What is the syndrome associated with parietal lobe?

A

Gerstmann syndrome.

33
Q

Describe the features of frontal lobe injury.

A
  • Disinhibition;
  • Behaviour that is out of character: inappropriate sexual comments.
34
Q

Describe the features of temporal lobe injury.

A

Problems with:
- Memory
- Speech
- Superior homonymous quadrantonopia

35
Q

What is the feature of posterior cerebral artery infarct?

A

Homonyomous hemianopsia.

Visual field loss in the same halves of the visual field of each eye. For example, in right HH, the visual field loss is on the right side in the right eye and on the right side in the left eye.

36
Q

What anatomical structure is involved with extrapyramidal symptoms?

A

Substantia nigra.

37
Q

DDx of foot drop causes?

A
  • Common peroneal nerve injury
  • Sciatic nerve injury
  • L5 nerve root compression

PLAB 1 August 2024 (32 decks)

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