Anatomy [All] Flashcards
1
Q
Which dermatome lies on the posterior half of the skull cap.
A
C2
2
Q
Which dermatome is at the high collar area.
A
C3
3
Q
Which dermatome is at the low collar area
A
C4
4
Q
What sensory issues would a L5-S1 herniated disk have.
A
Diminished ankle jerk reflex and diminished sensation to posterior and lateral foot
5
Q
Which directions do most herniations occur in and why.
A
Posterolateral direction because the annulus does not have the support of the posterior longitudinal ligament.
6
Q
Which dermatome would cause diminished sensation to medial foot.
A
L4
7
Q
Which bone is usually injured in the anatomic snuffbo.
A
Scaphoid bone.
8
Q
What might be a complication of the dislocation of the lunate.
A
Carpal Tunnel Syndrome.
9
Q
What are the smiths and colles fracture.
A
Fractures of distal radius.
Smiths- caused by direct blow on forearm of falling on flexed wrist
Colles- falling on extended wrists
10
Q
Where in the basal ganglia are the post-synaptic receptors for dopamine located.
A
Striatum
11
Q
Outline the D1 receptor pathway.
A
Substantia nigra excites striatum which inhibits Gpi so thalamus is uninhibited [excitatory]
12
Q
Outline the D2 receptor pathway.
A
Substantia nigra excites striatum which inhibits GPe which is unable to inhibit STN. STN will excited GPi which will inhibit thalamus [inhibitory]
13
Q
Where does the thoracic duct empty.
A
At the junction of the left internal and left subclavian veins
14
Q
What the muscles involved in arm ABduction.
A
0-15 degrees- supraspinatus
15-90 degrees- deltoid
90-100- trapezius
above 100- serratus anterior
15
Q
What are the layers and contents of the spermatic cord. What nerve runs superficial in the spermatic cord.
A
Layers- External Fascia [derive from external fascia], cremateric muscle and fascia [from internal oblique], internal spermatic fascia [from transversalis]. Contains structures that run to and from testes.
Ilioinguinal nerve [L1] runs superficial in this cord and supplies sensation to medial thigh and scortum or labia in females.
16
Q
Dissection of which nerve might cause the loss of cremasteric reflex.
A
Genitofemoral nerves and also ilioinguinal nerve
17
Q
Damage to what structure might cause testicular edema.
A
Pampiniform plexus [which is in the spermatic cord]
18
Q
Which receptors are responsible for coarse-touch, high frequency vibrations and pressure and tension.
A
Pacinian corpuscles- commonly damaged in diabetic neuropathy.
19
Q
The superficial arch of the palm is the continuation of which arter.
A
Ulnar artery.
20
Q
The deep arch of the palm is a continuation of which artery.
A
Radial artery.
21
Q
Which arteries ensure adequate supply of blood in hand through anastamoses.
A
Superficial and deep palmar arteries.
22
Q
What does the dartos muscle of the scrotum do.
A
Wrinkling of the skin of the scrotum.
23
Q
What nerve will be damaged in the surgical neck fracture of the humerus.
A
Axillary Nerve
24
Q
Which structures are susceptible in midshaft humeral fractures.
A
Radial nerve and deep brachial artery [structures in the radial groove]
25
What is the most likely cause of indirect inguinal hernias.
Failure of processus vaginalis to close.
26
Which ligament is most likely injured in a foot inversion injury. [Ligament torn on lateral side]
Anterior talofibular
27
Lateral ankle sprains usually occur in which positions.
Inversion of plantar flexed foot
28
Which is the only gluteus muscle to extend the hip
Gluteus Maximum
29
What is the symptom of a superior gluteal nerve damage.
Trendelenburg gait [cannot abduct or medially rotate thigh] and difficulty keeping pelvis level
30
Which pharyngeal arch does the right recurrent and inferior laryngeal vagus nerve arise from.
6
31
Which muscle is the only abductor of the laryngeal vocal cords.
Posterior cricoaretynoid.
32
Which pharyngeal arch does the superior laryngeal vagus arise from.
4th
33
What is the unhappy triad.
Combination of MCL injury, ACL injury and medial meniscus injury
34
Weakness in pronating the forearm indicates injury to which nerve.
Median nerve
35
Where are the renin section JXG cell located in a nephron.
Affarrent arteriole tunica media
36
Where is the macula densa located.
Distal tubule
37
What is the anatomical defect in a congenital diaphramatic hernia
Failure of closure of the pleuroperitonial canal causing bowel to be shifted into the thorax
38
Why do congenital diaphramatic hernias usually occur on the left side.
Because the right side has liver and left pleuroperitonial usually fuses with the septum transversum later
39
Why are bag masks contraindicated in babies with pulmonary hypoplasia.
Because they can force air into intestines and further reduce lung capacity
40
In a baby with cyanosis, how do you know if its Tetrology of fallot and not transposition of the great vessels or patent truncus arteriosus.
Tetrology of fallot maybe present weeks later with cyanosis while the others will be immediate blue baby
41
How does squatting help relieve onsets of 'tet spells'
Squatting increases afterload or systemic pressure allowing less shunting of deoxygenated blood from right to left ventricles.
42
What are the four portosystemic anatamosis.
Esophagus, umbilicus and anal anastamoses
43
Which is the only muscle of mastication that lowers the jaw. Which nerve innervates it.
Lateral pterygoid. V3, mandibular branch of trigeminal
44
Which is the only motor component of CNV.
V3
45
What does the greater petrosal branch of CNVII do.
Supply parasympathetics to lacrimal gland
46
What vessels to the infundibulopelvic/suspensory ligamens contain.
Ovarian vessels.
47
Which ligaments of the uterus do not contain any vessels.
Round ligament and ovarian ligaments.
48
Which ligaments of the uterus are derived from the gubernaculum.
Round ligament and ovarian ligaments.
49
What are the typical causes of acute appendix inflammation.
Obstruction through lymphoid hyperplasia or faecalith impaction
50
What are some symptoms of intussussception.
Vomiting, palpable mass, bloody diarrhea, hyperactive bowel sounds.
51
What age group usually has midgut volvulus and sigmoid volvulus.
Midgut- babies and kids
| Sigmoid- elderly
52
What is contained inside the carotid sheath from lateral to medial.
Internal jugular vein, [vagus a little posterior too], common carotid artery
53
What are the most common veins for central line placements.
Internal jugulars, femoral, subclavian
54
What is the virchow triad.
Triad of hypercoagulibility, stasis and endothelial injury
55
What is the strongest ligament of the ankle.
Deltoid ligament
56
Name the ligaments in the lateral ligament complex. Which is the most commonly injured.
Anterior talofibular [most commonly injure], calcenofilbular and posterior talofibular
57
Bilateral Intraocular opthalmoplegia is very indicated of which neural disease.
Multiple Sclerosis
58
What is the Uhthoff phenomenon.
Heat causes slowed conduction through demyelinated nerves so symptoms of MS are worsened.
59
Where do the interneurons of the abducens and oculumotor cross to communicate.
Medial Longitudinal Fasciculus
60
What does the Edinger-Westphal nucleus do.
Supplies parasympathetics to pupil and ciliary muscles
61
What is spinal muscular atrophy Type 1
It is a autosomal recessive inherited disorder in the SMN1 gene causing anterior horn neuron degeneration and LMN defects.
62
Which nerves do the triceps reflex test.
C7, C8
63
Which nerves do the biceps and brachioradialis nerves test.
C5, C6
64
What defect does a C4-C5 slip disc cause.
partial loss of arm flexion and abduction
65
From where are the pudendal nerve fibers derived and what do they supply.
Dervied from S2-S4 and supply the sensation most of perineum and genitals with motor control of external urethral and anal sphincter
66
Where is the common fibular nerve derived from.
L4-S2
67
Where is the tibial nerve derived from
L4-S3
68
Which nerve do the L4-S1 nerves form.
Superior gluteal nerve
69
Erbs-duchenne palse is seen in which root lesion
C5-C6, waiter tip
70
Which structure is tied in a vasectomy.
Ductus deferens
71
What would be the defect in an L5 radiculopathy.
Decreased medial foot sensation and decreased toe extension
72
What is the vitelline duct.
It connects the developing midgut lumen to the yolk sac
73
What does the infraspinatus muscle do.
Lateral rotation
74
What does the teres minor do.
Lateral rotation and adduction
75
What is the most common congenital esophageal atresia in neonates.
Esophageal atresia with distal tracheoesophageal fistula
76
In order of most frequent to least frequent, where do ectopic pregnancies in fallopian tube occur.
Ampulla, isthmus, fimbriae, interstitium
77
A patient with a coarcted aorta is most likely to develop which complication.
Aortic dissection
78
What are the nerves that exit foraman ovale.
CNV3
79
What nerves exit superior orbital fissure.
CN III, CNIV, CNV1, CNVI,
80
What nerves exit foramen rotundum.
CNV2
81
Which foramen does CNVII use to exit the skull.
Stylomastoid foramen
82
What structures go through the jugular foramen.
CNIX, CNX, CNXI, jugular vein
83
How do you distinguish hirschsprung's disease from idiopathic volvulus in neoborns.
Hirschsprung's disease will become obvious in the first 24 hours.
84
Who is most likely to have a femoral hernia.
Women, more concerning because of risk of strangulation
85
What are the borders of the hasselbach's triangle. What is this triangle's significance.
Lateral border- inferior epigastric vessels
Medial border- rectus abdominus
Inferior border- inguinal ligament
Direct hernias pass through this
86
Where is the direct hernia located in relation to the inferior epigastric vessels.
Medially
87
What does pain in inguinal hernias suggest.
Incarceration or strangulation
88
Which veins drains the upper two thirds of the esophagus. Lower one-thirds.
Esophageal vein, left gastric vein
89
What are the most common type of renal stones.
Calcium stones which are radioopaque [envelope, dumbell or prism shaped]
90
Which type of stones are radiolucent.
Uric acid stones, rhomboid or rosettes shaped
91
What are struvite stones and how would they appear on x-ray.
Radioopaque stones with magnesium ammonium phosphate. Coffin-lid shaped
92
Which stones are hexagonal and moderaly radioopaque.
Cysteine stones
93
Damage to the levator ani would result in what symptom.
Urinary incontinence
94
Which foramen does CNIX use to enter the skull. And to exit.
Enter- foramen magnum
| Exit- Jugular foramen
95
What foramen does CNVII use to enter the skull.
Internal acoustic meatus
96
Which structures course through the foramen magnum
CNIX enters, vertebrain arteries and brainstem
97
What is the lateral and medial borders of the anatomic snuffbox.
Medial- extensor pollicis longus
| Lateral- Abductor pollicis longus, extensor policis brevis
98
What structures course through the central tendon of the diaphgram and at which level.
IVC at T8
99
At which level do the common carotid bifurcate.
C4
100
What is one complications that male offsprings of mothers who took diethystilbesterol during pregnancy have.
Spermatocele or epidydymis cyst
101
What is cryptorcidism.
When the testes fail to drop into the scrotum
102
What does cyrtocidism put the testes in risk for.
Testicular germ cell tumors.
103
What happens to the androgens in unilateral crytorchidism. Bilateral.
Unilateral- mostly normal levels.
| Bilateral- decreased inhibin, increased FSH, LH, decreased testosterone
104
If the left superior gluteal nerve was injured, which side hip would drop in the stance phase.
The right side hip and the patient would try to lean to the left to swing his legs forward
105
Which nerve innervates the brachioradialis.
Radial nerve
106
Name all the deformities in turner's syndrome.
HEENT- webbed neck and cystic hygromas as well as lymphedema
Cardiovascular- bicuspid aortic valve, coarctation of aorta
GU- streak ovaries, amenorrhea, horseshoe kidneys
Overall- short stature
107
What heart conditions can cause electrical alternans.
Cardiac tamponade and pericardial effusions.
108
Which type of twinning causes the most complications in utero. What is the most important complication.
Monochorionic monoamniotic monozygotic twins
| Twin/twin transfusion syndrome- because they share a placenta
109
If cleavage of a twin pregnancy occur around 0-4 days, which type of twin pregnancy is likely.
Dichorionic, diamniotic twins
110
What is the time period of cleavage for dichorionic, monoamniotic twins.
4-8 days during the morula to blastocyst phase
111
If it takes greater than 13 days for cleavage to occur, what type of pregnancy results.
Monochorionic, monoamniotic conjoined twins
112
What is the difference in the path to the liver taken by the fat soluble and water soluble vitamins.
Water soluble vitamins get to the liver through the portal system, whereas the fat soluble vitamins [D,E,A,K] are first absorbed in the intestines through lacteals that drain into the lymphatics. The lymphatics of the intestines drain into the thoracic duct which drains into the left jugular angle before reaching the liver.
113
Where is vitamin A stored.
In the ito cells of the liver [perisinusoidal cells]
114
Which lymphatic channel drains the face and neck.
Right lymphatics [which also drains the right arm and back and chest]
115
To which lymph nodes do the prostates drain.
Internal iliac
116
Which abnormality will develop from the incomplete fusion of the paramesonephric ducts in development.
Bicornuate Uterus
117
What behavior characterizes conduction phasia
poor repetition with fluent speech and intact comprehension
118
Which nerve supplies the cricothyroid muscle and what does it do.
Superior laryngeal nerve. It varies the length and tension of the vocal cords
119
What are some defects that will be associated with congenital duodenal atresia.
VACTERL [Vertebral defects, Anal atresia, Cardiac defects, tracheoesophageal fistula, renal defects, limb defects]
120
What is the medical radioisotope technetium-99m test used for.
To detect gastric tissue, especially if its ectopic
121
What are the nerves responsible for erection, emission, and ejaculation.
Erection- parasympathetics from S2-S4 of pelvic splanchnics,
Emission- Sympathetics from T11-L2 of hypogastric plexus
Ejaculation- somatic nerves and visceral nerves from pudendal nerves
Point, squeeze, shoot
122
At what level are the abdominal aortic aneurysms most common.
Just below the level of the kidneys
123
Where does the IMA branch in relation to the common iliac bifurcation and renal arteries.
Below renal arteries and above the common iliac bifurcations
124
Which levels of the lumbar nerves cause the cremateric reflex and anal wink.
Cremasteric- L1, L2 testicle move
| Anal Wink- S3-S4 winks galore
125
Which muscle in the thenar compartment is innervated by the ulnar nerve.
Adductor policis
126
What does a lesion affecting the adductor pollicis cause as symptoms.
Thumbs extension over time so that the patient is unable to grib a piece of paper between thumb and forefinger or between adjacent fingers
127
What is froment's sign
Injury of adductor pollicis will cause exaggerated thumb flexion at the Interphalangeal digit between of inability to flex MCP
128
Which nerve innervates the palatal arches, levator veli palatini and uvula.
Vagus nerve
129
Which nerve innervates the tensor veli palatini and the intrinsic soft palate muscles.
CN V
130
Which branch of the median nerve is spared in carpal tunnel syndrome.
The palmar cutaneous branch so sensation is intact
131
Which dermatome lies at the umbilicus
T10
132
What is the difference between femoral triangle and femoral sheath.
Femoral triangle contains NAVEL from lateral to medial [femoral nerve, artery, vein and lymphatics]
Femoral Sheath contains SHAVE [Femoral artery, vein, and empty space and also deep inguinal nodes]- NO NERVE OR LYMPHATICS.
Femoral sheath is derived from transversalis and iliopsoas fascia
133
What is the nerve, artery, vein and lymphatic system supplying above the pectinate line.
Nerve- visceral
Artery- superior rectal branch of IMA
Vein- drains from superior rectal vein to IMV to splenic vein
Lymphatics- internal iliac lymph nodes
134
What is the nerve, artery, vein and lymphatic system supplying below the pectinate line.
Nerve- somatic
Artery- inferior rectal branch of INTERNAL PUDENDAL ARTERY
Vein- inferior rectal to internal pudendal, to internal iliac to Inferior vena cava
Lymphatics- superficial inguinal lymph nodes
135
What are hemorrhoids.
Prolapse of tissue into anal canal due to straining
136
How are external hemorrhoids different from internal hemorrhoids.
External hemorrhoids are painful due to somatic innervation and will most likely not bleed
137
What is pseudocryptorchidism and what causes it.
Hyperactive contraction of cremasteric muscle drawing the testicles into the abdomen.
138
What does the tensor tympani muscle do and what innervates it.
Moves tympanic membrane medially, innervated by V3 [lies in close proximity to middle meningeal artery]
139
Where are the ito cells [hepatic stellate cells or perisinusoidal cells] located.
In the space of disse in the liver
140
What is the psoas sign and which nerves innervate the muscles involved.
Psoas sign is pain upon passive extension of hip or upon active resistance against hip flexion.
Hip extension causes pain as psoas and illiacus hit the appendix, cecum or sigmoid colon or pancreatic tumor.
Psoas muscle- lumbar plexus
Illiacus- femoral nerve
141
Duodenal ulcers, unlike gastric ulcers, are always associate with hypersecretion of ----
Gastric acid
142
Why does BPH occur.
Excess dihydrotestosterone with advanced age
143
Which dermatome covers the forefinger and middle finger as well as the triceps
C7
144
A duodenal ulcer is at risk of perforation of which artery
Gastroduodenal artery
145
What is the largest branch of the celiac trunk.
Splenic artery
146
What lobe does the PCA supply.
Occipital lobe
147
What are the defects in Di-George's syndrome.
CATCH-22
| Cardiac anomolies, Abnormal facies, Thymus aplasia, Cleft palate, Hypocalcemia
148
Which T-cell markers will be decreased in DiGeorge's syndrome
CD3, CD4, CD8
149
What is subacute combined deficiency and which tracts in the spinal cord does it effect.
SCD is due to Vit B12 deficiency causing neural symptoms, It affects the dorsal columns, lateral corticospinal tracts and spinocerebellar tracts
150
Which parts of spinal cord are degenerated in ALS.
Ventral horn, precentral gyrus, Lateral corticospinal tract
151
What structures make up a bronchopulmonary segment. What is there relationship to the airways
A tertiary bronchus, two pulmonary arteries, veins and lymphatics. Arteries run centrally with the airways while veins and lymphatics run peripherally
152
Symmetric palate elevation confirms that CN-- is intact.
CNX
153
What is neurophysin I. What happens if its lost.
Carrier protein responsible for oxytocin transport from PVN
| Absent let down reflex
154
What is neurophysin II.
Carrier protein for ADH from hypothalamus
155
Which tract is used to transport Oxytocin and ADH to posterior pituitary.
Supraoptic hypophyseal tract.
156
Which tract is used to transport releasing hormones from hypothalamus to anterior pituitary.
Hypothalamic-hypophyseal portal system
157
Which muscle of the pharynx does CNIX innervate.
Stylopharyngeus
158
Which muscle of the tongue does the vagus innervate.
Palatoglossus- only tongue muscle under vagus control
159
Which rotator cuff muscle laterally rotate the arm. Which is more likely to be injured.
Infraspinatus and teres minor. Infraspinatus is more likely to be injured
160
What is the function of the teres major.
Medial rotation and adduction
161
The MCA supplies sensory feeling to which parts of the body
The upper parts
162
What are the symptoms of the medial medullary syndrome. Occlusion of which artery causes it.
Tongue protrusion to ipsilateral side
Medial leminiscus lesion- contralateral proprioception loss
Corticospinal tract lesion- contralateral weakness and paralysis
Due to loss of blood supply to anterior spinal artery
163
What are two most common locations for ulnar nerve lesions.
Hook of hamate or medial epicondyle of humerus
164
What are the two types of sweat glands. What is the difference between them.
Eccrine and apocrine.
Eccrine is found all over the body, most common in palm and soles and secretes watery sweat with exercise- thermoregulatory
Apocrine is found in genitals etc and secretes oily sweat- stimulated by catecholamines
165
What is kernig's sign and what does it indicate.
Pain on flexion of the hip with knee extended- meningisit
166
What is murphy's sign and what does it indicate.
Shortened inspiration with palpation of RUQ- acute cholecystitis
167
What does the subscapularis muscle do.
Medial rotation and adduction
168
What is the difference between neurofibramatousis I and neurofibramatoses II.
Type 1- ch 17 mutation with optic gliomas, pigmentationa nd freckling.
Type 2- ch 22 mutation with juvenile cataracts, schwanomas, acoustic neuromas due to mutation in NF2 gene [tumor suppressor] and merlin protein
169
What mutation does von hipple lindau have and what does it present with.
Ch 3, renal cell carcinomas, impaired balance and hemangiomas
170
Which dermatome provides sensation around the inguinal crease.
L1
171
What syndrome does infarction of PICA present. And AICA
Aica- lateral pontine syndrome
| PICA- lateral medullary [wallenburg syndrome]
172
Which dermatome is at the level of the nipples.
T4
173
What are the main watershed areas of the body
```
Splenic flexure of the colon
ACA, MCA, PCA junctions,
heart subendocardium
straight segment of proximal tubule
TAL of nephron
central vein [zone III] of liver
```
174
What causes diverticulitis
Inflammation of diverticula due to obstruction and retention of material.
This is due to attenuation of muscularis propria creating a false diverticulum through herniation of mucosa and submucosa
175
What causes the following fractures.
| Bowing, spiral, buckle, greenstick, stress
Bowing- bending, cortex deformed without injury to periosteum
Spiral- twisting force, child abuse
Buckle- Compression, buckling of periosteum
Greenstick- periosteal tearing at the convex side
Stress- use over time, hairline fractures
