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STEP I 2014 > Anatomy 70% > Flashcards

Anatomy 70% Flashcards

1
Q

azygos vein-location, function, excess flow results in, pts with portal HTN are at risk for

A
  • right anterolateral aspect of spine
  • major portal tributary
  • excess flow= congestion of esophageal venous plexus
  • portal HTN= increase risk of variceal rupture ()-high risk of recurrence and mortality
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2
Q

site of anastomoses/portal/caval/clinical sign

umbilicus

A

portal-paraumbiilcal veins
caval-superficial veins of anterior abdominal wall
cs-caput medusa

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3
Q

site of anastomoses/poratl/caval/clinical sign

rectum

A

portal-superior rectal veins (inferior mesenteric veins)
caval- inferior rectal veins (internal iliac vein)
cs-internal hemorrhoids

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4
Q

site of anastomoses/portal/caval/clinical signs

esophagus

A

portal-esophageal veins (l. gastric veins)
caval-veins of the thoracic esophagus which drain into azygos system
cs-esophageal varices

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5
Q

location of spleen vs
kidney vs
lungs and pleural space

A

lungs and pleural space are above spleen

  • spleen-l. upper quadrant along 9th, 10th, and 1th ribs (at posterior axillary line)
  • kidney below rib 11 and medical to posterior axillary line
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6
Q

sagiittal sinus thrombosis-assoiciation (1), clincal symp (4)

A 
hypercoaguable states (pregancy and few wks postpartum) 
-increased intracranial pressure, seizures, parasagittal hemorrhages, and infarcts (decrease cerebral perfusion)
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7
Q

dorsal column vs dorsal horn

A

dorsal column contains axons from the DCML, whose cell body is in the DRG
-dorsal horn contains cell bodies of sencondary afferents of spinothalamic tract- fibers cross in anterior commonsure and ascend in contralateral spinothalamic tract (anterior column sort of)

horns=cell bodies
tracts=axons

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8
Q

layers lumbar puncture needle travels through.
vs
epidural anesthesia vs spinal anesthesia

A

L4-L5.
skin, superficial layer, deep fascia, supraspinous ligamet, interspinous ligamnet, ligamentum flavum, epidural space, dura (hear a small pop), arachnoid, and subarachnoid space.

epidural anesthesia-anesthesia into epidural space- before pop
spinal anesthesia-same place a spinal puncture-after pop

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9
Q

thoracic outlet syndrome- signs, treatment, risk of treatment

A

-affects structures found in scalene triangle (1st rib, anterior and middle scalene m.)
numbness and pain on medial aspect of forearm and hand, weakness of muscles innervated by ulnar nerve (claw hand), decreased blood flow to upper limb (weakened radial pulse-compression of subclavian artery), Horner’s syndrome and hoarseness (compression of sympathetic trunk or recurrent laryngeal nerve)

incision of anterior scalene muscle (compression of lower brachial plexus trunk and subclavian artery between anterior scalene muscle and middle scalene m.)

phrenic nerve lies on anterior surface of anterior scalene m.- paralysis of half of diaphragm

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10
Q

innervation of superior laryngeal vs reccurent laryngeal nerve

A

superior-cricothyroid muscle of larynx

recurrent- all instrinsic muscle of larynx except cricothyroid

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11
Q

which edge is the free edge of lesser omentum?contains (3 important structures)

A

on the right edge. common bile duct, hepatic artery and portal vein

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12
Q

common causes of carpal tunnel syndrome.

anterior border and posterior border of carpal tunnel

A

pregnancy, RA, hypothyroidism (myxedmea of the carpal tunnel), acromegaly (synovial tendon hyperplasia), obesity

  • anterior-flexor retinaculum
  • posterior-carpal bones
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13
Q

most PE arise from what veins? give examples (2)

A

deep veins of lower extremity
deep veins arise from common femoral vein-splits into deep and superficial branches (i.e. superficial vein is part of the deep venous system-even though it’s called superficial)

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14
Q

location of lesion in “drunken sailor gait”

A

vermis of cerebellum- loss of truncal ataxia

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15
Q

which nerve is blocked during labor? near what bony structure?

A

pudendal, near ishial spine

-usually given during 2nd stage of labor just before delivery

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16
Q

kussmal sign vs pulsus paradoxus

A
  • increase in systemic venous pressure on inspiration (constrictive pericarditis)
  • decrease >10-15 mmHg ins systolic pressure with inspiration (cardiac tamponade)
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17
Q

lateral and medial pectoral nerves branch from what parts of the brachial plexus

A

medial and lateral cords respectivitely

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18
Q

pt that’s bed-bound for a long time presents with inability to dorsiflex right foot and loss of sensation on dorsum of foot and foot inversion.

nerve problem and normal function of nerve.
relation of being bed-bound.

A

damage to common peroneal nerve (splits to become superficial peroneal and deep peroneal nerves)

  • common to injury due to superficial location at neck of fibula. (conpression for lying on bed too long)
  • responsible for extroversion of foot, dorsiflexion, and sensation of dorsum of foot
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19
Q

sensation of tibial nerve vs common peroneal nerve

A

both branch from siatic nerve

tibial-sole of foot
common peroneal-dorsum of foot

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20
Q

gag reflex arc (afferent and efferent)

A
  • afferent CN 9

- efferent CN 10

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21
Q

CN responsible for salivation

A

9
other funtions
-taste nd tactile sensation of posterior 1/3 of tongue
-tactile sensation from external ear, pharynx, middle ear and auditory
-input from carotid sinus/body
-motor efferent to stylopharyngeus muscle

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22
Q

direct vs indirect hernia

A
  • all pass through superficial inguinal ring, only indirect passes through deep inguinal ring
  • direct emerges through fascia transversalis (posterior wall of inguinal canal). it’s goes through inguinal triangle (medial to epigastic vessels )
  • indirect are associated with failed closure of “processus vaginalis) (connection b/t abdomen and ingiunal canal)- usually seen in children.

note* patent processus vaginalis is also associated with hydroceles

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23
Q

inguinal triangle (lateral, medial, and inferior border)

A

aka triangle of Hesselbach

  • inferior epigastric artery
  • lateral border of rectus abdominus
  • inguinal ligament
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24
Q

painful direct hernia indicates?

A

direct hernias are usually asymptomatic. if painful then think bowel strangulation- can lead to bowel ischemia and surgery is indicated

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25
Q

location of femoral hernia (femoral artery/inguinal canal)

A
  • medial to femoral artery
  • below inguinal ligament
  • more common in women

note both inguinal hernia pass above inguinal ligmanet

26
Q

which wall of inguinal canal does inguinal ligament form?

A

roof=internal abdominal oblique/transverse abdominus muscles
anterior=aponeurosis of external abdominal oblique
floor=inguinal ligament
posterior=transversalis fascia/conjoined tendon

27
Q

what muscles does median nerve lie between

A

palmaris longus, and flexor carpi radialis

28
Q

which nerve travels through cubital tunnel

A

ulnar- passed behind medial epicondule and crosses elbow through this structure

29
Q

flattening of thenar eminence vs flattening of hypothenar muscles

A
  • loss of median nerve (thenar muscles)

- loss of ulnar nerve (dorsal and palmar interosseous muscles)

30
Q

dislocation of elbow results in deviation of ulnar and humerus bones how- damage to which nerves

A

ulnar bone deviates posteiorly-ulnar nerve

-humerus displaces anteriorly (fill in later)

31
Q

function of deep fibular nerve

A

dorsiflexion

injury causes foot drop

32
Q

function of superior gluteal nerve

A

hip abduction- helps to stabilize pelvis and prevent Trendenburg gait

33
Q

pt bumps into walls and objects on one side with visual acuity 20/20 and no other problems has an occlusion of PCA and not middle cerebral because

A

PCA occlusion leads to homonymous hemianopsia with macular sparing
-middle cerebral infarct- hemiparesis (supplies motor strip), language dysfunction

34
Q

where should intercostal nerve block be performed

A

below the rib and lateral to the angle of the rib, why? b/c the nerve lies in the costal groove of the corresponding rib after passing the angle of the rib

35
Q

name and location of branches of femoral artery name and location of branch of the branches of femoral artery

  • tibial, peroneal, and popliteal, dorsalis pedis
  • where does femoral art branch from?
A

femoral continues into the popliteal artery after exiting the adductor hiatus
popliteal descends behind knee joint and becomes anterior and posterior tibial arteries at lower border of politeus muscle. the peroneal (aka fibular) artery is a branch of the posterior tibial artery in upper leg. dorsalis pedus is a branch of anterior tibial artery

femoral artery branches off of external iliac

36
Q

when eye is abducted which muscles work alone to elevate and depress the eye
when the eye is adducted which muscles work alone to elevate and depress the eye

A
  • elevate: superior rectus, and depress: inferior rectus

- elevate: inferior oblique, and depress superior oblique

37
Q

function of oblique eye muscles

A

superior-depress and abducts the eye (CN 4)
inferior-elevates and abducts the eye (CN 3)

vs superior and inferior rectus which both adduct the eye and elevate and depress respectively

38
Q

pain over the anatomic snuffbox indicates a fracture in what carpal bone?

A

scaphoid (falling on outstreched hands)- must be addressed to restore blood flow and avoid avascular necrosis of proximal portion of bone due to retrograde flow

39
Q

name three main branches of aorta after the inferior phrenica arteries that supply the hemidiaphragm

A

celiac
superior mesenteric
inferior mesenteric

40
Q

name branches of celiac trunk , which branch supplies the head and tail of pancreas

A

left gastric art-
splenic art-body and tail of pancreas,
common hepatic art

41
Q

nerves involved in anterior compartment syndrome

-describe there presentation

A

superior peroneal nerve-weekness of eversion of foot and decreased sensation over most of the dorsum of the foot except first web space

-deep peroneal nerve-loss of dorsiflexion, and extension of toes, and inversion of foot

42
Q

pt with spinal TB and a flocculent, red, tender bulge on one flank, with one in the groin. which muscle is affected?

A

psoas muscle- works to flex thigh at the hip and some external rotation at hip

43
Q

central scotoma

A

another name for macula

  • ethambutol
  • optic neuritis
  • macular degeneration
44
Q

which nerve supplies the 1st and 2nd lumbricles

A

median nerve

45
Q

supply for distal lesser curvature and proximal lesser curvature

A
  • right gastric art

- left gastric art

46
Q

compression of cervical vertebral artery vs cervical spinal nerve.

A

art-decreased blood flow to brain stem with consequent cranial nerve and cerebellar abnormalities
spinal nerve- pain, burning, tingling sensation and weakness or numbness in the shoulder, arm, or hands

47
Q

where does vertebral art enter?

A

C6

48
Q

in upper cervical spine flexion/extension occurs and rotation occurs

A

occipital-C2 joint

C1-C2

49
Q

which organ has a rich anastomotic vascular connection and can resist infarction when occlusion occurs in one of the arteries?

A

stomach. occlusion in gastroduodenal art does not cause infarction

50
Q

what are branches of superior laryngeal nerve?
which nerve follows superior laryngeal artery? what does it innervate?
what branch innervates cricothyroid muscle

A
  • internal and external
  • internal
  • laryngeal mucosa above the vocal folds
  • external
51
Q

laryngeal mucosa innervation vs pharyngeal mucosa innervation

A
  • laryn-superior and reccurrent laryngeal nerves

- pharyn-(CN 9) glossopharyngeal nerve

52
Q

Erb’s palsy vs Klumpke’s paralysis (trunks damaged)

A

Erb’s- upper

Kumpke’s-lower

53
Q

shoulder dsytocia-def, trunk effected, presentation

A

-infant’s anterior shoulder is stuck behind mother’s pubic symphysis
-damages lower trunk
-paralysis of intrinsic hand muscles and clawing of entire hand, numbness along medial aspect of hand
note!!!! b/c T1 is source of sympa innervation to face- can also present with ipsilateral Horner’s syndrome

54
Q 
humerus fractures/nerve involved:
anatomical neck
surgical neck 
lateral epicondyle
medial epicondyle
mid shaft
A 
anatomical- usually doesn't occur, lies within joint capsule and no major nerves are affected
surgical-axillary nerve
lateral- radial nerve 
medial- ulnar nerve
mid shaft- radial
55
Q

describe location of femur insertion of
psoas major
gluteus maximus
gluteus medius, minimus, and piriformis

A
  • lesser trochanter
  • gluteal tuberosity
  • greater trochanter
56
Q

sudden strain to which muscle can produce a reflex contraction severe enough to avulse the what portion of the femur? pt pop?

A

psoas, lesser trochanter (see in athletes with large strong muscles)

57
Q

action and nerve innervation

  • tibialis anterior
  • flexor hallucis longus
  • peroneus brevis
  • peroneus longus
  • tibialis posterior
A
  • dorsiflex of foot/deep peroneal branch
  • plantar flexion of foot/tibial nerve
  • eversion of foot while limiting inversion/superficail peroneal nerve
  • plantar flexion/superficial peroneal nerve
  • inverter and plantar flexor/tibial nerve
58
Q

portosystemic shunt- def, pt pop

A

anastomosis of splenic vein (drains into portal vein) to left renal vein (drains into IVC)
shunt in pts with portal HTN to alleviate pressure

59
Q

varicosities in inferior rectal vein produce what type of hemorrhoids? superior rectal vein?

A
  • external

- internal

60
Q

Trendelenubrg sign-def, and muscles paralyzed

A

pat stands on one leg and hip on lifted leg drops

paralysis of hip abductors (gluteus medius and gluteus minimus)

61
Q

name three flexors of arm at elbow

A

biceps brachii, brachialis, and branchioradialis

62
Q

drainage pathway of the cervix

A

cervical vein, uterine vien, internal iliac vein

STEP I 2014 (14 decks)

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