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*USMLE* > Anatomy > Flashcards

Anatomy Flashcards

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USMLE® Step 1 flashcards
1
Q

spermatic cord

covering layers + their origins
contents (3 arteries + 5 other things)

A

internal spermatic fascia - from transversalis fascia

cremasteric fascia - from internal oblique

external spermatic fascia - from external oblique (outermost layer, deep to dartos muscle + scrotal fascia)

testicular, deferential + cremasteric arteries
genital branch of genitofemoral nerve (ilioinguinal nerve runs outside cord)
vas deferens
pampiniform plexus
tunica vaginalis
lymph vessels

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2
Q

Piriform recess

its mucosa lies just over what structure?
this structure is involved in what function?

A

internal branch of the superior laryngeal nerve

innervates sensory + autonomic function of mucosa of larynx superior to vocal cords

mediates AFFERENT limb of COUGH REFLEX

(things lodged in piriform recess can damage it)

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3
Q

Iliohypogastric nerve

from what? course? innervates what?

injury during what?

A

L1 nerve root, lumbar plexus

from lateral border upper psoas, behind kidney, anterior to quadratus lumborum

motor - ANTEROLATERAL ABD. MUSCLES (int./transv.)
anterior branch - SUPRAPUBIC SKIN
lateral branch - LATERAL GLUTEAL REGION

injury - possible during APPENDECTOMY

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4
Q

most common site of BLUNT AORTIC INJURY

and MCC of this

A 
AORTIC ISTHMUS (just distal to L subclavian a.)
because it is tethered by the ligamentum arteriosum and is thus immobile relative to other parts of aorta

mcc is CAR CRASH with SUDDEN DECELERATION > stretching + torsional forces on aorta + heart

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5
Q

aortic isthmus injury

s/s? imaging? progno?

A

nonspecif - chest + back pain, dyspnea

cxr > wide mediastinum

> 80% die before hospital via aortic rupture

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6
Q

Stab just above clavicle, btwn midclav and sternal border, perpendicular to skin

what is likely injured?

A

pleura

apices extend above clavicle + rib 1 thru “superior thoracic aperature” into neck

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7
Q

accessory nerve

potential injury during what?

A

surgery to posterior triangle of neck

btwn SCM, trapezius, clavicle

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8
Q

ansa cervicalis

is what? innervates what? injured by what?

A

nerve loop from C1-C3 that innervates STERNOHYOID, STERNOTHYROID, and OMOHYOID in anterior neck

penetrating trauma to neck ABOVE CRICOID CARTILAGE can injure

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9
Q

inferior thyroid artery

source + course? injury assoc. w/ what?

A

from thyrocervical trunk > runs posterior to carotid + jugular

injury assoc. with hoarseness (runs next to recurrent laryngeal n. which is often injured with it)

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10
Q

most abundant collagen type

in what tissues?

defective in what disease?

A

type I collagen

in dermis, bone, tendons, ligaments, DENTIN, CORNEA, VESSELS and SCAR TISSUE

defective in OSTEOGENESIS IMPERFECTA

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11
Q

type II collagen

where?

A

cartilage

vitreous humor

nucleus pulposus

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12
Q

type III collagen

where?

defective in what disease?

A

skin, LUNGS, GI, vessels, MARROW, LYMPHATICS and GRANULATION TISSUE

Ehlers-Danlos syndrome (types 3 + 4)

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13
Q

type IV collagen

where?

what disease?

A

basement membranes

Alport syndrome - glomerulonephritis, ESKD, hearing loss (eye changes without vision loss)

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14
Q

Phrenic nerve

origin? irritation/damage causes what? s/s?

A

C3-C5 cervical segments

dyspnea + HICCUPS

REFERRED SHOULDER PAIN - supraclavicular n. is from C3-C4

palsy > respiratory distress with DECREASED BREATH SOUNDS and ELEVATED HEMIDIAPHRAGM

(irritation can be via intrathoracic expansion of a tumor)

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15
Q

brachial plexus

what nerve roots?

A

C5-T1

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16
Q

contents of cavernous sinus?

5 nerves, 1 vessel

A 
CN III
CN IV - trochlear
CN VI - abducens
CN V/1 - ophthalmic
CN V/2 - maxillary

ICA

17
Q

serratus anterior

innervation (spinal segments) ? action + dysfunction?

A

long thoracic n. (C5-7)

scapula protraction

winging of scapula when outstretched hands pressed against wall = sign of dysfunction

18
Q

musculocutaneous nerve

origin (plexus + segments)? innervates what?

A

brachial plexus, lateral cord, C5-C7

innervates biceps, coracobrachialis, and brachialis

gives LATERAL CUTANEOUS NERVE OF FOREARM

(articular branches to elbow joint + humerus)

19
Q

4 muscles of rotator cuff

innervation + attachment

A
  1. Supraspinatus - suprascapular nerve; gr. tuberosity
  2. Infraspinatus - suprascapular nerve; gr. tuberosity
  3. Teres minor - axillary n.; greater tuberosity
  4. Subscapularis - upper/lower subscapular nerves; lesser tuberosity
20
Q

Lateral-to-medial order of 4 important structures emerging from under inguinal ligament

Clinical significance?

A 
Lateral
1. Lateral femoral cutaneous nerve
2. Femoral nerve
3. Femoral artery
4. Femoral vein
Medial

remember “NAV” for the big 3 - femoral lines can be placed in the vein by palpating the arterial pulse + inguinal ligament and cannulation 1 cm below ligament and 0.5-1.0 cm medial to pulse

21
Q

What structures run thru the optic canal? (3)

A

CN II (optic n.)
ophthalmic artery
central retinal vein

22
Q

What structures run thru the superior orbital fissure?

6

A 
CN III
CN IV (trochlear)
CN V1 (ophthalmic)
CN VI (abducens)

sympathetic fibers
ophthalmic vein

23
Q

what structure runs thru the foramen rotundum?

A

CN V2 maxillary

24
Q

What structure runs thru the foramen ovale?

A

CN V3 mandibular

25
Q

what runs thru the foramen spinosum?

A

middle meningeal artery + vein

26
Q

what runs thru the jugular foramen?

A

CN IX, X, XI and jugular vein

27
Q

acronym for retroperitoneal abdominal organs

which are “secondary retroperitoneal”?

A

SADPUCKER

Suprarenal glands
Aorta + IVC
Duodenum* (except 1st part)
Pancreas*
Ureter
Colon* (asc. + desc.)
Kidneys
Esophagus
Rectum (mid-distal)

*secondary retroperitoneal - develop intraperitoneal and migrate retro

28
Q

Blood supply of ureters

Small branches from 5 different arteries supply the ureter; list them proximal to distal

A
  1. Renal
  2. Gonadal
  3. Common iliac
  4. Internal iliac
  5. Vesical
29
Q

How far along the respiratory tract do GOBLET CELLS extend?

A

only to the level of the larger PROXIMAL BRONCHIOLES

beyond that, only serous fluid coats the mucosa

30
Q

How far along the respiratory tract do CILIATED EPITHELIAL CELLS extend?

A

to the level of the RESPIRATORY BRONCHIOLES

but they do become less prevalent distally along the tract

31
Q

How far along the respiratory tract is there CARTILAGE?

What other component of the respiratory mucosa follows a similar pattern?

A

through all the BRONCHI … the the smallest bronchi, but not in the bronchioles

(rings in trachea, plates in bronchi)

SUBMUCOSAL / SEROUS GLANDS also extend to the end of the bronchi

32
Q

Where in the respiratory tract do ALVEOLAR MACROPHAGES begin to appear?

A

in the RESPIRATORY BRONCHIOLES

so they are not just “alveolar”

33
Q

Which femoral condyle does the ACL attach to? and PCL?

A

ACL - LATERAL femoral condyle (to anterior intercondylar tibia)

PCL - MEDIAL femoral condyle (to posterior intercondylar tibia)

34
Q

deep inguinal ring

opening in what? bounded by what?

A

opening in TRANSVERSALIS FASCIA

bounded by TRANSVERSALIS muscle laterally and INFERIOR EPIGASTRIC vessels medially

(testes descend thru here)

35
Q

superficial inguinal ring

is an opening in what?

A

EXTERNAL OBLIQUE MUSCLE APONEUROSIS

36
Q

what is the conjoint tendon?

what space is it a boundary for?

A

common tendon of TRANSVERSUS ABDOMINIS and INTERNAL OBLIQUE mm.

forms part of posterior wall of inguinal canal

37
Q

ophthalmic artery is a branch of what?

A

ICA

first branch after cavernous sinus part

38
Q

proximal attachments of ACL and PCL

A

PCL - on the medial side of the MEDIAL FEMORAL CONDYLE

ACL - on the medial side of the LATERAL FEMORAL CONDYLE

“PM AL” - in the nighttime (PM) Al ruptured his cruciate ligaments

39
Q

Describe the location of the AV node

A

in the RA on the INTERATRIAL SEPTUM

near the insertion of the SEPTAL LEAFLET of tricuspid and the opening of the CORONARY SINUS

*USMLE* (28 decks)

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