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Joe - STEP 1 USMLE > Anatomy > Flashcards

Anatomy Flashcards

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USMLE® Step 1 flashcards
1
Q

The vertebral column is composed of 32-33 vertebrae (number cervical, thoracic, lumbar, sacral and coccygeal)…?

A

7 cervical, 12 thoracic, 5 lumbar, 5 fused sacral and 3-4 coccygeal

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2
Q

Each intervertebral disk is numbered by the vertebral body…?

A

ABOVE the disk.

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3
Q

Each intervertebral disk is composed of…?

A

ANULUS FIBROSUS and NUCLEUS PULPOSUS

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4
Q

The nucleus pulposus is the postnatal remnant of the…?

A

NOTOCHORD

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5
Q

The vertebral bodies are strongly supported by two longitudinal ligaments, called…?

A

ANTERIOR LONGOTUDINAL LIGAMENT and POSTERIOR LONGITUDINAL LIGAMENT

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6
Q

The anterior longitudinal ligament prevents (…?…) of the vertebrae and is often involved in “whiplash” accidents.

A

HYPEREXTENSION

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7
Q

The posterior longitudinal ligament limits (…?…) of the vertebral column.

A

FLEXION

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8
Q

Wich is the most common direction herniation of a nucleus pulposus due the posterior longitudinal ligament position and strengh?

A

POSTEROLATERAL

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9
Q

In wich level does the herniation of the nucleus pulposus often occur?

A 
LOWER CERVICAL (C5/C6 or C6/C7)
LOWER LUMBAR (L4/L5 or L5/S1)
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10
Q

The herniated disk will usually compress the spinal nerve roots (…?…) the involved disk.

A

BELOW

Ex.: herniation of the C7 disk will compress the C8 nerve.

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11
Q

The spinal cord terminates at wich level of the vertebral column?

A

L1 or L2

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12
Q

The (…?…) are bilateral thickenings of pia mater that run continuously on the lateral sides of the midpoint of the cord.

A

DENTICULATE LIGAMENTS.

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13
Q

The filum terminale is part of the (…?…) wich is composed of ventral and dorsal roots of lumbar and sacral nerves that extend below the inferior limit of the spinal cord.

A

CAUDA EQUINA

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14
Q

The dura mater and dural sac terminate inferiorly at the…?

A

S2 vertebra

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15
Q

The (…?…) is locatef between the inner walls of the vertebral canal and the dura mater. It contains fat and the internal vertebral venous plexus.

A

EPIDURAL SPACE

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16
Q

The (…?…) is a pressurized space located between the arachnoid and pia mater layers. It contains (…?…), wich bathes the spinal cord and spinal nerve roots within the dural sac, and terminates at S2.

A

SUBARACNOID SPACE and CEREBROSPINAL FLUID (CSF)

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17
Q

Inferior limit of the spinal cord in adult (conus medullaris)?

A

L1 or L2.

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18
Q

Inferior limit of the dural sac and the subaracnoid space (CSF)?

A

S2 vertebra

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19
Q

There are (…?…) pairs of spinal nerves attached to each of the segments of the spinal cord.

A

31 PAIRS
8 cervical, 12 thoracic, 5 lumbar, 5 sacral, and 1 coccygeal.
The spinal nerves with the cranial nerves form part of the peripheral nervous system.

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20
Q

Wich plexuses arises from the ventral rami?

A

BRACHIAL and LUMBOSACRAL plexuses

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40
Q

The cervical nerves C1-C7 exit the intervertebral foramina…?

A

SUPERIOR to the pedicles of the same-numbered vertebrae.

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41
Q

The C8 nerve exits the intervertebral foramen…?

A

INFERIOR to the C7 pedicle.

THIS IS THE TRANSITION POINT.

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42
Q

All nerves beggining with T1 and bellow will exit the intervertebral foramina…?

A

INFERIOR to the pedicle of the same-numbered vertebrae.

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43
Q

A lumbar puncture tap is typically performed at the (…?…) interspace level of the vertebral column.

A

L4-L5 interspace

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44
Q

The autonomic nervous system (ANS) is concerned with the motor innervation of…?

A

SMOOTH MUSCLE
CARDIAC MUSCLE
GLANDS

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45
Q

Anatomically and functionally, the ANS (1) (…?…) and (2) (…?…). In both divisions, 2 neurons form an autonomic pathway.

A

SYMPATHETIC (thoracolumbar) and PARASYMPATHETIC (craniosacral)

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46
Q

Medular lesions at superior cervical ganglion, C3-C4, middle cervical ganglion, T1-T2 root result in ipsilateral Horner syndrome (interruption of sympathetic innervation), wich consists of:

A

PTOSIS, MIOSIS and ANHYDROSIS

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47
Q

Two main mammary gland arterial supply?

A

INTERNAL THORACIC ARTERY (internal mammary) - a branch of the subclavian artery

LATERAL THORACIC ARTERY - a branch of the axillary artery. Also, courses with the long thoracic nerve.

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48
Q

Lymphatic drainage of the breast (mammary gland)?

A

LATERALLY (75%): drains from the nipple and the superior, lateral, and inferior quadrants to the axillary nodes.
MEDIAL: most lymphnodes drains to the parasternal nodes. It is also through this medial route that cancer can spread to the opposite breast.

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49
Q

A lesion of the (…?…) during dissection of axillary nodes after mastectomy (or after stab wounds) may cause winged scapula, a condition that lead the patient to the inability to anchor scapula to thoracic cage and…?

A
  • LONG THORACIC NERVE

- CANNOT ABDUCT ARM ABOVE HORIZONTAL POSITION

50
Q

To separate the initical communication with foregut, the (…?…) forms to separate the esophagus from the trachea.

A

TRACHEOESOPHAGEAL SEPTUM

51
Q

A (…?…) is an abdnormal communication between the trachea and esophagus caused by a malformation of the tracheoesophageal septum.

A

TRACHEOESOPHAGEAL FISTULA

52
Q

A tracheoesophageal fistula is generally associated with…?

A
  • ESOPHAGEAL ATRESIA and POLYHYDRAMNIOS
  • REGURGITATION of milk
  • GAGGING and CYANOSIS after feeding
  • ABDOMINAL DISTENTION after crying
  • REFLUX of gastric contents into lungs, causing PNEUMONITIS
53
Q

Pulmonary hypoplasia occurs when the lung development is stunted. This condition has 2 congenital causes:

A

CONGENITAL DIAPHRAGMATIC HERNIA and BILATERAL RENAL AGENESIS (this causes olygodramnios, wich increases the pressure on the fetal thorax and Potter’s sequence)

54
Q

(…?…) with distal (…?…) is the most common tracheoesophageal anomalie

A

ESOPHAGEAL ATRESIA and TRACHEOESOPHAGEAL FISTULA

55
Q

Esophageal atresia with distal tracheoesophageal fistula cause polyhydramnio in utero, the clinical test to confirm this condition is…?

A

FAILURE to pass NASOGASTRIC tube into STOMACH.

56
Q

List the main types of tracheoesophageal anomalies.

A
  • ESOPHAGEAL ATRESIA (EA) with DISTAL TRACHEOESOPHAGEAL FISTULA (TEF)
  • pure EA (atresia or stenosis)
  • pure TEF (H-type)
57
Q

The passage of instruments theough the intercostal space is done in the (…?…) part of the space to avoid the neurovascular structures (as during a thoracocentesis).
An intercostal nerve block is done in the (…?…) portion of the intercostal space.

A

LOWER and UPPER

58
Q

The intercostal arteries are contributed anteriorly from branches of the (…?…) and posteriorly from branches of the (…?…)

A

INTERNAL THORACIC ARTERY and THORACIC AORTA

59
Q

Respiratory distress syndrome is caused by a deficiency of (…?…), a product of (…?…). This condition is associated with premature infants, infants of diabetic mothers, prolonged intrauterine asphyxia.
(…?…) and (…?…) treatment increase the production of surfactant.

A

SURFACTANT and TYPE II PNEUMOCYTES.

THYROXINE and CORTISOL.

60
Q

Surfactant deficiency may lead to (…?…), whereby repeated gasping inhalations damage the alveolar lining.
Histologically characterized by (…?…) and (…?…) fluid covering the alveoli.

A

HYALINE MEMBRANE DISEASE.

ATLECTASIS and EOSINOPHILIC.

61
Q

Pleurisy produces sharp pain upon respiration.
Costal inflammation produces local dermatome pain of the chest wall via the intercostal nerves; whereby mediastinal irritation produces referred pain via the (…?…) nerve to the shoulder dermatomes of (…?…)

A

PHRENIC and C3-5

62
Q

Righ lung is divided into (…?…) lobes, separated by (…?…) fissures.
Left lung is divided into (…?…) lobes.
The horizontal fissure (right lung) follows the curvature of the (…?…) rib, the oblique fissure (both lungs) projects anteriorly at approximately the (…?…) intercostal space in the middleclavicular line.

A
  • THREE and TWO.
  • TWO.
  • 4TH.
  • 5TH.
63
Q

About breath sounds:

  • superior lobes of the R and L lungs: (…?…) chest wall; (…?…) the 4th rib.
  • middle lobe of the R lung: (…?…) chest wall; (…?…) to the 4th rib and medially toward the sternum.
  • inferior lobes of the R and L lungs: (…?…) chest wall
A
  • ANTERIOR and ABOVE
  • ANTERIOR and BELOW
  • POSTERIOR
64
Q

The enzyme that converts angiotensin I to angiotensin II is produced by (…?…).

A

The LUNG ENDOTHELIAL CELLS.

65
Q

Mesothelioma is a malignant tumor of the (…?…).

Causative agent is (…?…).

A

PLEURA and ASBESTOS DUST.

66
Q

Histologic features of TRACHEA:

  • epithelia: (…?…)
  • cartilage: (…?…) C shaped cartilaginous rings
  • glands: (…?…)
  • smooth muscle: (localization)
  • elastic fibers: (…?…)
A
  • PSEUDOESTRATIFIED CILIATED COLUMNAR (PCC) cells, GOBLET cells
  • 16 to 20
  • SEROMUCOUS glands
  • BETWEEN OPEN ENDS of C-shapped cartilage
  • PRESENT
67
Q

Histologic features of BRONCHI:

  • epithelia: (…?…)
  • cartilage: (…?…)
  • glands: (…?…)
  • smooth muscle: (…?…)
  • elastic fibers: (…?…)
A
  • PCC to SIMPLE COLUMNAR cells
  • IRREGULAR PLATES
  • fewer SEROMUCOUS glands
  • PROMINENT
  • ABUNDANT
68
Q

Histologic features of BRONCHIOLES:

  • epithelia: (…?…)
  • cartilage: (…?…)
  • glands: (…?…)
  • smooth muscle: (…?…)
  • elastic fibers: (…?…)
A
  • CILIATED, some GLOBET cells, CLARA cells in terminal bronchioles
  • NONE
  • NONE
  • HIGHEST PROPORTION of smooth muscle in the bronchial tree
  • ABUNDANT
69
Q

In (…?…), the secreted mucus is thick or viscous and the cilia have a difficult time moving it toward the pharynx. Patient with this disease have frequent infections of the respiratory system.

A

CYSTIC FIBROSIS

70
Q

Patients lacking DYNEIN having immotile cilia or (…?…) syndrome.
This patients are subject to many infectious respiratory problems. Males also possess immotile sperm.

A

KARTAGENER

71
Q

(Histology of respiratory tract) The columnar and goblet cells are sensitive to irritation. The ciliated cells become taller, and there is an increase in the number of goblet cells and submucosal glands.
Intensive irritation from smoking leads to a (…?…) where the ciliated epithelium becomes a squamous epithelium. This process is reversible.

A

SQUAMOUS METAPLASIA

72
Q

Bronchial metastatic tumors arise from (…?…) cells.

A

KULCHITSKY cells

73
Q

CYSTIC FIBROSIS that results in abnormally thick mucus is in part due to defective (…?…) by (…?…) cells

A

CHLORIDE TRANSPORT and CLARA

74
Q

Chronic obstructive pulmonary disease (COPD) affects the bronchioles and includes (disease 1) and (disease 2)

A

1) EMPHYSEMA

2) ASTHMA

75
Q

EMPHYSEMA is caused by a loss of (…type of fibers…) and results in chronic airflow obstruction. Is it REVERSIBLE? (…?…)

ASTHMA is a chronic process characterized by a reversible (narrowing?/enlargement?) of airways.

A

ELASTIC FIBERS and NO

NARROWING.

76
Q

(…?…) cells, also called BRONCHIOLAR SECRETORY CELLS are nonciliated and secrete a serous solution similar to (…?…)
The number of this cells increases in response to increased levels of polutants like cigarette smoke, and are most abundant in the terminal bronchioles.
They are also involved with (…?…) ion transport into the lumens of the terminal bronchioles.

A

CLARA, and SURFACTANT, and CHLORIDE.

77
Q

Alveolar cell types:

1) (…?…) is involved in gas exchange.
2) (…?…) produce and secrete surfactant.

A

TYPE I PNEUMOCYTE and TYPE II PNEUMOCYTE.

78
Q

(…?…) induces the fetal synthesis of surfactant.
High insulin levels in diabetic mothers antagonize the effects of it.
Infants of diabetic mothers have a (…?…) incidence of RESPIRATORY DISTRESS SYNDROME.

A

CORTICOSTEROIDS and HIGHER.

79
Q

There are openings in the wall of most alveoli that form the pores of (…?…)

A

KOHN

80
Q

Alveoli have ⬆️ tendency to collapse on expiration as ⬇️ is the radius.
This is the law of (…?…)

A

LAPLACE

81
Q

Pulmonary surfactant is a complex mix of (…?…), the most important of wich is (…?…).

Remember Choline, you know french people has weird costumes, so one day CHOLINE was doing a mix salad of LETTUCE, but the main ingredient in this salad was made of DI PALMITO y PHOSPHATIDYL. CHOLINE made LESS salad than she needed, so her ALVEOLI COLLAPSED and she died.

A

LECITHINS and DIPALMITOYLPHOSPHATIDYLCHOLINE (DPPC)

82
Q

(…?…) cells migrate into the developing heart and play an important role in cardiac development.

A

NEURAL CREST

83
Q

The primitive heart tube forms (…?…) dilatations and a cranial outflow tract, the (…?…)

A

FOUR and TRUNCUS ARTERIOSUS

84
Q 
Embryonic dilatation:
Truncus arteriosus (neural crest)

Adult structure:
(…?…)

A

AORTA, PULMONARY TRUNK and SEMILUNAR VALVES

85
Q

Embryonic dilatation:
Bulbus cordis

Adult structure:
(…?…)

A

SMOOTH part of RIGHT VENTRICLE (conus arteriosus)

SMOOTH part of LEFT VENTRICLE (aortic vetibule)

86
Q

Embryonic dilatation:
Primitive ventricle

Adult structure:
(…?…)

A

TRABECULATED part of RIGHT VENTRICLE

TRABECULATED part of LEFT VENTRICLE

87
Q

Embryonic dilatation:
Primitive atrium

Adult structure:
(…?…)

A

TRABECULATED part of RA (pectinate muscles)

TRABECULATED part of LA (pectinate muscles)

88
Q 
Embryonic dilatation:
Sinus venosus (the only dilatation that does not become subdivided by a septum)

Adult structure:
(…?…)

A

Right - SMOOTH part of RA (sinus venarum)

Left - CORONARY SINUS and OBLIQUE VEIN of th LA.

89
Q

List the three major venous systems that flow into the sinus venosus end of the heart tube:

A

1) VITELINE (omphalomesentheric) veins (drain deoxygenated blood from the yolk sac; they will coalesce and form the veins of the liver and part of the IVC)
2) UMBILICAL VEIN (carries oxygenated blood from the placenta)
3) CARDINAL VEINS (carry deoxygenated blood from the body of the embryo, they will coalesce and contribute to some of the major veins of the body (brachiocephalic, SVC, IVC, azygos, renal)

90
Q

During fetal circulation, oxygenated blood flood from the placenta of the fetus throught the umbilical vein. List the vascular shunts that develops in the fetal circulation to bypass blood flow around the liver and lungs.

A

DUCTUS VENOSUS (oxygenated blood bypass the sinusoids of the liver into the IVC and to de RA)

FORAME OVALE (oxygenated blood bypass the pulmonary circulation, into the LA then LV)

DUCTUS ARTERIOSUS (shunts deoxygenated blood from the pulmonary trunk to the aorta to bypass the pulmonaru circulation)

91
Q

Umbilical vein becomes (…?…)

R and L umbilical arteries (…?…)

Ductus venosus becomes (…?…)

Forame ovale becomes (…?…)

Ductus arteriosus (…?…)

A

LIGAMENTUM TERES OF LIVER

MEDIAL UMBILICAL LIGAMENT

LIGAMENTUM VENOSUM

FOSSA OVALIS

LIGAMENTUM ARTERIOSUM

92
Q

List the pressure gradients in the fetal and postnatal circulation:

A

Fetal : R -> L

Postnatal: L-> R

Joe - STEP 1 USMLE (1 decks)

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