Anatomy Flashcards
Parotid gland Travels
Through masseter and pierces bucinnator to end at stenson’s duct at level of 2nd molar
Nerves that lie anterior to parotid
Facial - the zebra buggered my car
(temporal, zygomatic, buccal, mandibular, cervical)
Auriculotemporal nerve (branch of V3)
Vessels that lie anterior to parotid
External Carotid Artery
Retromandibular Vein
Innervation of parotid
Parasympathetic = watery, copious saliva Sympathetic = enzyme rich saliva Sensory = greater auricular nerve
Drains into Deep cervical lymph nodes
Reflex aid
S1-2 = ankle L3-4 = knee C5-6 = biceps C7-8 = triceps
Attachments of triceps
Long head = infraglenoid tubercle
Medial and lateral head = M and L of radial groove
Insert to olecranon process of ulna
NB between M & L lies radial nerve and profundii brachii
Complications from surgery: Posterior Triangle Lymph Node Biopsy
Accessory nerve
Complications from surgery: Lloyd Davies Stirrups
Common peroneal nerve
Complications from surgery: Thyroidectomy
Recurrent laryngeal nerve / superior laryngeal nerve
Complications from surgery: Anterior resection of rectum
Hypogastric nerve
Complications from surgery: Axillary Node Clearance
Thoracodorsal nerve, Long Thoracic nerve, Intercostobrachial nerve
Complications from surgery: Inguinal hernia
Ilioinguinal nerve
Complications from surgery: Varicose vein
Saphenous (medial) and sural (lateral)
Complications from surgery: Posterior approach to hip surgery
Sciatic nerve
Complications from surgery: Carotid Endarterectomy
Hypoglossal nerve
Greater auricular nerve
Superior laryngeal nerve
Likelihood ratio positive test
Sensitivity / (1-specificity)
Not dependent on prevalence
Likelihood ratio negative test
(1-sensitivity) / specificity
Not dependent on prevalence
Trastuzumab (Herceptin)
Breast cancer
HER receptor
Cardiotoxic
Bevacizumab
Colorectal, renal and glioblastoma
anti-VEGF
Imatinib
GIST, CML
Tyrosine Kinase i
Basilisk
Renal transplant
IL2
Cetoximab
EGFR +ve colorectal cancer
Interossei
Innervated by ulnar nerve
3 palmar (3 peat) 4 dorsal (4D)
Lumbricals
1, 2 median
3, 4 ulnar
LOAF muscles (median nerve)
Lateral 2 lumbricals
Opponens pollicis
Abductor pollicis brevis
Flexor pollicis brevis (+longus)
Froment’s sign
Adductor pollicis test (ulnar nerve lesion)
Anterior compartment of thigh
Nerve: femoral
Artery: femoral
Muscles: quadratus femoris, vastus M + I + L, sartorius, iliacus
Adductor compartment of thigh
Nerve: Obturator
Artery: profunda femoris + obturator
Muscles: adductors, gracilis, obturator externa
Posterior compartment of thigh
Nerve: Sciatic
Artery: Profunda femoris
Muscles: semitendonis, semimembranous, biceps femoris
Adductor canal
Lateral = vastus medialis
Posterior = adductor longus + magnus
Roof = sartorius
Contents = saphenous nerve, superficial femoral artery and vein
Anterior compartment of lower leg
Nerve: deep peroneal
Artery: anterior tibial
Muscles: extensors, anterior tibial, peroneus tertius
Lateral compartment of lower leg
Nerve: superficial peroneal
Artery: peroneal
Muscles: peroneus brevis + longus
Posterior compartment of lower leg
Nerve: tibial
Artery: posterior tibial
Muscles (superficial): gastrocnemius, soleus, plantaris
Femoral canal
Lateral = femoral vein
Medial = lacunar ligament
Anterior = inguinal ligament
Posterior = pectineal ligament
Femoral triangle
Superior = inguinal ligament
Medial = adductor longus
Lateral = sartorius
Neurofibromatosis Type 1 (AD)
aka von Recklinghausen's disease: CATCHES Cafe au lait (>6) Axillary freckling Tumours of nervous system Cutaneous neurofibromata HTN Eye features (lisch nodules) Scoliosis
Neurofibromatosis Type 2 (AD)
Bilateral acoustic neuromas (key)
Other tumours of nervous system
Fewer cutaneous features
Borders of Hesselbach’s triangle
Lateral = Inferior epigastric artery Inferior = Inguinal ligament Medial = Linea semilunaris (lateral border of rectus muscle)
Within = direct hernia (so inferior to inferior epigastric artery)
Richter’s hernia
Only part of bowel herniates meaning strangulation can occur without obstruction. More common in femoral hernia
Deep ring
Opens at midpoint of inguinal ligament into transversalis fascia
Inguinal canal - MALT
Start superiorly
Roof = Muscles - internal oblique and transversus abdominis
Anterior = Aponeurosis - external oblique and aponeurosis internal oblique
Floor = Ligaments - inguinal ligament and lacunar ligament
Back wall = T - Transversalis fascia and conjoint Tendon
Cystic hygroma
Anterior triangle
Branchial cyst
Posterior triangle (as follows branchial growth)
Complications from surgery: Ivor Lewis Surgery / Pneumonectomy
Chile leak as lymphatics damaged (thoracic duct)
Complications from surgery: Pelvic cancer surgery
Pelvic autonomic nerves
Complications from surgery: Parotidectomy
Facial nerve
Complications from surgery: Ligating spleen
Tail of pancreas
Complications from surgery: Liver mobilation
Hepatic vein
Complications from surgery: Open hernia repair
Testicular vessels
Complications from surgery: Colonic / gynae resections
Ureters
Complications from surgery: Use of Verres Needle
Bowel perforation
Origin of cystic artery
Right hepatic artery
Salter Harris Fractures
SALTR
I - Straight through II - Above III - Lower IV - Through everything V - rammed (crushed)
SE of drugs: tacrolimus
Impaired glucose tolerance
SE of drugs: azathioprine
Alopecia
Myelosuppression
SE of drugs: MMF
GI and BM suppression
SE of drugs: ciclosporin
Renal failure
Recurrent anterior shoulder dislocations
Bankart’s lesion
Proximal Humerus
Anatomical neck = head and tuberosities - greatest risk of avascular necrosis if fractured
Surgical neck = tuberosities and epiphysis (inferior)
Total oesophagectomy
Also known as Mckeown
For proximal oesophageal cancer
To mobilise oesophagus short gastric vessels ligated
Trigeminal branches exit
Standing Room Only
Superior orbital fissure
Foramen rotundam
Foramen ovale
Trigeminal niche muscular innervation (V3)
Tensor veli palatini
Mylohyoid
Anterior belly of digastric
Tensor tympani
Pancreatitis criteria
PANCREAS
PaO2 < 60 Age > 55 Neutrophils > 15 Calcium < 2 mmol Raised urea > 16 Enzyme (lactate) > 600 Albumin < 32 Sugar > 10mmol
Littres hernia
Hernia with Meckel’s within
Foramen ovale
Otic ganglion V3 Lesser petrosal nerve Accessory meningeal artery Emissary veins
Most in sphenoid
Foramen spinosum
Meningeal spine
Middle meningeal artery
Meningeal branch of the Mandibular nerve
Foramen rotundum
Maxillary nerve (V2)
Foramen lacerum/ carotid canal
Base of the medial pterygoid plate.
Nerve and artery of the pterygoid canal
Internal carotid artery*
Jugular foramen
Temporal bone
Anterior: inferior petrosal sinus
Intermediate: IX, X, XI.
Posterior: sigmoid sinus (becoming the internal jugular vein)
Foramen magnum
Occipital bone
Anterior and posterior spinal arteries
Vertebral arteries
Medulla oblongata
Stylomastoid foramen
Stylomastoid artery
Facial nerve
Superior orbital fissure
Recurrent meningeal artery
Superior ophthalmic vein
Nerves: III, IV, VI, V1
Superior and middle thyroid vein
Internal jugular vein
Inferior thyroid vein
brachiocephalic vein
Inferior thyroid artery
Thyrocervical artery
Decrease gastric secretions
CCK
Secretin
VIP - inhibit gastric acid and pepsin
Somatostatin
CCK
Relaxes sphincter of oddi and contracts GB + reduces gastric motility
Gastrin
Increase HCl + increases gastric motility + trophic effect on gastric mucosa
Also released are histamine and pepsin
Secretin
Increase bicarb rich fluid
Somatostatin
Decreases everything and stimulates gastric mucous production
Absent a waves
Atrial fibrillation
a wave = atrial pressure
Cannon a wave
Complete heart block
a wave = atrial pressure - caused by atrial contractions against a closed tricuspid valve
Large a wave
RVH, tricuspid stenosis
a wave = atrial pressure - caused by atrial contractions against a closed tricuspid valve
Prominent v waves
Tricuspid regurg
v wave = passive filling of blood into the atrium against a closed tricuspid valve
Slow y descent
Tricuspid stenosis, right atrial myxoma
y wave = opening of tricuspid valve
Steep y descent
Right ventricular failure, constrictive pericarditis, tricuspid regurgitation
y wave = opening of tricuspid valve
Bainbridge reflex
Increase HR due to very rapid infusion of blood
Colliquative necrosis
Seen in CNS
Fibrinoid necrosis
Malignant HTN
Caseous necrosis
TB
Lynch Syndrome (HNPCC) (can identify if fulfil Amsterdam criteria)
REGP - MSH1 & 2 (mismatch repair gene mutation)
Right sided colonic (mucinous)
Endometrial
Gastric
Pancreatic
FAP
Left sided colonic
Duodenal adenoma
APC
Gardner’s syndrome
Subtype of FAP - APC gene
FAP + desmoid tumours and mandibular osteomas
Cowden syndrome
PTEN
Hamartoma
Breast
Thyroid
MYH associated polyposis
MYH
Increased risk of kras being knocked out
Peutz Jeugers
LKB1
Malrotation
Ladd’s procedure
Atresia (usually in 24 hrs)
Duodenal - double bubble
Ileal - air fluid levels
Pyloric stenosis
Ramstedt procedure
Biliary atresia
Pathological jaundice
Kasai procedure
Path both sciatic foramina
PIN
Pudendal nerve
Internal pudendal artery
Nerve to obturator internus
Broca’s area
Supplied by middle cerebral artery
Pre/perimenopausal breast cancer
Tamoxifen
Postmenopausal breast cancer
Letrozole
5FU
Antimetabolite - copies uracil in RNA
Anthracyclines (-rubicin)
Intercalation of DNA
Cardiotoxic
Taxanes (have tax in name)
Microtubule disruption
Chemo for breast cancer
FEC
Fluorauracil
Epirubicin
Cyclophosphamide
Tunica vaginalis is derived from
Peritoneum
Testicular artery
Derived from abdominal aorta immediately inferior to renal arteries
Scrotum
Skin
Dartos fascia
Tunica vaginalis
Lymph = inguinal
Multiple lytic and lucent areas (Soap bubble) appearances
Osteoclastoma
Mixed sclerotic and lytic areas
Osteosarcoma
Periosteal reaction (onion skinning)
Ewing’s sarcoma
Osteoid osteoma
Commonest in 10-25 y.o.
Pain responds to NSAIDS
Lucent centre surrounded by reactive sclerosis
Osteochondroma
Pedunculated lesion arising from metaphysis
Chondroma
Usually ribs etc (not long bones)
A - delta fibres
Myelinated pain receptors
C fibres
Unmyelinated pain receptors
B fibres
Autonomic
A - beta fibres
Touch
A - gamma
Proprioception
Transpyloric plane (L1) (12 of them)
Pylorus stomach Left kidney hilum (L1- left one!) Fundus of the gallbladder Neck of pancreas Duodenojejunal flexure Superior mesenteric artery Portal vein Left and right colic flexure Root of the transverse mesocolon 2nd part of the duodenum Upper part of conus medullaris Spleen
T8
Vena Cava and phrenic nerve
T10
Oesophagus and Thoracic duct
T12
Aorta and vagus nerve