Anatomy 2 Flashcards
Transfer to burns centre
Need burn shock resuscitation
Face/hands/genitals affected
Deep partial thickness or full thickness burns
Significant electrical/chemical burns
IV fluids in burns
Burn of:
10% in children
15% in adults
Volume of fluid = total body surface area of the burn % x weight (Kg) x 4
Half of the fluid is administered in the first 8 hours.
IVC tributaries (no functional valves)
I Like To Rise So High
Iliac Lumbar Testicular Renal Suprarenal Hepatic vein
Lymphatic sarcomas
SCARE:
Synovial sarcoma Clear cell sarcoma Angiosarcoma Rhabdomyosarcoma Epithelioid sarcoma
External Carotid Branches
Some Attendings Like Freaking Out Potential Medical Students
Superior thyroid (ant) Ascending pharyngeal (deep) Lingual (ant) Facial (ant) Occipital Posterior auricular Maxillary Superior temporal
Inhibits cell wall formation
Beta-lactams:
Cephalosporins
Penicillins
Aminoglycosides (gentamicin)
Causes misreading of mRNA inhibiting protein synthesis
Erythromycin (macrolides)
Inhibit protein synthesis
Also tetracycline
Fusidic acid
Chloramphenicol
Rifampicin
Inhibit RNA synthesis
MEN II (RET Cr10)
A:
Medullary thyroid cancer
Phaeochromocytoma
Parathyroid
B: A +
Mucosal neuroma
Marfanoid appearance
MEN I (MENIN Cr11)
Parathyroid
Pancreatic
Pituitary
Quadrate lobe (inferior)
Anatomically on right lobe but part of functional left lobe of liver
Lies anterior to porta hepatis
Caudate lobe (superior)
Supplied by both right and left hepatic artery and bile drains into both ducts (but anatomically in right lobe)
Lies posterior to plane of porta hepatis
Antero-lateral to IVC
Portal Triad
Hepatic artery, portal vein, bile ducts
Porta hepatis (postero-inferior)
Separates the caudate lobe behind from the quadrate lobe in front
Contains:
Common hepatic duct
Hepatic artery
Portal vein
Sympathetic and parasympathetic nerve fibres
Lymphatic drainage of the liver (and nodes)
Falciform ligament
2 layer fold peritoneum from the umbilicus to anterior liver surface
Contains ligamentum teres (remnant umbilical vein) - which joins left branch of portal vein at porta hepatis
On superior liver surface it splits into the coronary and left triangular ligaments
Calot’s triangle
Cystic duct
Hepatic duct
Inferior surface of liver
Contains cystic artery
Ciprofloxacin
Inhibits DNA gyrase
1st Pharyngeal arch
External carotid
Maxillary artery
Mandibular nerve
2nd Pharyngeal arch
Inferior branch of superior thyroid artery
Stapedial artery
Facial nerve
3rd Pharyngeal arch
Common and internal carotid
Glossopharyngeal nerve
Thymus
Inferior parathyroids
4th Pharyngeal arch
Right- subclavian artery
Left-aortic arch
Vagus nerve
Superior parathyroids
6th Pharyngeal arch
Right - Pulmonary artery
Left - Pulmonary artery and ductus arteriosus
Vagus and recurrent laryngeal nerve
Accompanies the posterior interventricular artery within the posterior interventricular groove?
Middle cardiac vein
Coronary sinus
Lies on posterior surface of coronary groove
Receives blood from cardiac veins except anterior cardiac vein
Drains into right atrium
Great cardiac vein
Lies at the left of coronary groove / sinus
GREAT they LEFT me
Middle and small cardiac veins
Lie on the right of coronary groove / sinus
Anterior cardiac vein
Drains directly into right atrium
Right coronary artery (inferior)
Supplies:
Right atrium
Diaphragmatic part of the right ventricle
Posterior third of the interventricular septum
The sino atrial node (60% cases)
The atrio ventricular node (80% cases)
Left coronary artery
Branches are - left circumflex (lateral) and LAD (anterior)
Supplies: Left atrium Most of left ventricle Part of the right ventricle Anterior two thirds of the inter ventricular septum
Middle mediastinum
Pericardium Heart Aortic root Arch of azygos vein (also lies in posterior mediastinum) Main bronchi
Thoracic duct
Lies in superior and posterior mediastinum
Phrenic nerve and superior vena cava
Lies in superior mediastinum
Chorda tympani
Branch of facial nerve
Runs medial to pars flaccida
The umbo
Marks the point of attachment of the handle of the malleus to the tympanic membrane
Tympanic membrane
The medial aspect of the tympanic membrane is lined by mucous membrane
Lateral aspect is stratified epithelium
Diameter of 1cm
Bones of ear
Malleus articulates with the incus (synovial joint)
Incus attaches to stapes (another synovial joint)
Organ of corti
Sense organ of hearing and is located on the inside of the cochlear duct on the basilar membrane
Semicircular canals
Penetrate into petrous temporal bone
Mandibular nerve branches (V3)
Auriculotemporal Mentalis Lingual Inferior alveolar Nerve to mylohyoid
Branches of axillary artery
1st part - superior thoracic artery
2nd part - thoraco-acromial and lateral thoracic
3rd part - subscapular artery, anterior and posterior circumflex humeral arteries
Parts of axillary artery
1st part - lies anterior to pec minor and medial brachial plexus
2nd part - lies posterior to pec minor and follows posterior branch of brachial plexus. The medial branch of BP separates the artery and vein
3rd part - lies inferior to pec minor. Axillary vein is medial and laterally is median nerve (anterior), musculocutaneous and coracobrachialis
Adrenal arteries
Superior - inferior phrenic artery
Middle - direct from aorta
Inferior - renal artery
NB left adrenal vein drains into left kidney right into IVC (like testes)
Branches on internal carotid
Only Press Carotid Arteries Momentarily
Opthalmic Posterior communicating Choroidal Anterior cerebral Middle cerebral
Common cause of pruritus ani
Enterobius vermicularis
Hookworms that anchor in proximal small bowel
Ancylostoma duodenale
From cutaneous penetration
Can migrate to lungs be coughed up and swallowed again
Asymptomatic but can cause IDA
Roundworms that penetrate duodenal wall
Ascaris lumbricoides
From ingestion
Can migrate to lungs be coughed up and swallowed again
Eggs and larva can be seen in faeces
Strongyloides stercoralis
Hookworm from travelling person Cutaneous penetration Move into lungs, then swallowed Can have larvae bursting colon Can have resp and skin symptoms
Cavernous sinus drains
via superior and inferior petrosal sinuses into internal jugular
Cavernous sinus blood supply
Ophthalmic vein, superficial cortical veins, basilar plexus of veins
Sepsis can cause cavernous sinus thrombosis
Contents of cavernous sinus
Lateral wall (superior to inferior):
Oculomotor nerve
Trochlear nerve
Ophthalmic nerve
Maxillary nerve
Contents (from medial to lateral):
Internal carotid artery (and sympathetic plexus)
Abducens nerve
Relation to cavernous sinus
The sinuses are paired and run from superior orbital bone to petrous temporal bone
Medial = pituitary fossa + sphenoid sinus
Lateral = temporal lobe
Ameloblastomas
Rare tumours of the odontogenic epithelium
They are slow growing and expand with a rim of periosteum that surrounds them
Palpation and disruption of this layer that gives rise to the crepitus.
Nasal polyps
Derived from ethmoid sinus mucosa
Usually semi transparent grey mass
Exposure to hard wood dust
Adenocarcinoma of paranasal sinus and nasopharynx
Originate from small salivary glands
Adenoid cystic carcinoma
Majority of nasal cancers
Arise from lateral nasal wall
Secondly in nasal antrum
Maxillary sinusitis causes
Haemophilus influenzae or Streptococcus pneumoniae
Fluid level in antrum
Symptoms - postnasal discharge, headache, toothache
Frontoethmoidal sinusitis
Can have secondary CNS infection via emissary veins
Onufs nucleus
Anterior horn of S2
Origin of neurones of external urethral sphincter
Micturition
Overall control of micturition is centrally mediated via centres in the Pons
Somatic innervation to the bladder is via the pudendal, hypogastric and pelvic nerves
Desiccation
Direct contact - low current and high voltage over a broad area (no protein damage)
Fulguration
No contact - low current and high voltage over a broad area
For local superficial tissue damage
Cutting
Sinusoidal and non modulated waveform
No thermal damage
Coagulation
Modulated current with intermittent dampened sine waves of high peak voltage
Evaporation (not vaporisation)
Layers of scrotum
Some Damned Examiner Called It The Testes
- Skin
- Dartos fascia and muscle
- External spermatic fascia
- Cremasteric muscle and fascia
- Internal spermatic fascia
- Parietal layer of the tunica vaginalis
Layers of spermatic cord
Internal spermatic fascia - from transversalis fascia
Cremasteric fascia - internal oblique
External spermatic fascia - external oblique
Artery of vas deferens
Arise from internal vesical artery
Cremasteric artery
Arise from internal epigastric artery
Ansa cervalis
C1,2,3
Lies anterior to carotid sheath
GOSS
Glenohyoid
Omohyoid
Sternohyoid
Sternothyroid
Weber’s syndrome
Midbrain (posterior circulation) infarction
Ipsilateral III palsy
Contralateral weakness
Superficial to Extensor retinaculum
Basilic vein
Dorsal cutaneous branch of the ulnar nerve
Cephalic vein
Superficial branch of the radial nerve
Radial artery passes between
Lateral collateral ligament of the wrist joint and the tendons of the abductor pollicis longus and extensor pollicis brevis
T2 RCC and above
Radical resection. No need for adjuvant therapy
Lords procedure
Smaller hydroceles (is plicated) Reduced complication rates
Hemicraniotomy indications
Age under 60 years
Clinical deficit in middle cerebral artery territory
Decreased consciousness
> 50% territory infarct
