Anatomy and Histology

Question 1

What type of tissues are made of Type I collagen?

Answer 1

Dermis, bone, tendons, ligaments, dentin, cornea, blood vessels, and scar tissue

Question 2

What type of tissues are made of Type II collagen?

Answer 2

Cartilage, vitreous humor, nucleus pulposus

Question 3

What type of tissues are made of Type III collagen?

Answer 3

Skin, lungs, intestines, blood vessels, bone marrow, lymphatics, and granulation tissue

Question 4

What type of tissues are made of Type IV collagen?

Answer 4

Basement membranes

Question 5

What hypothalamic nucleus controls circadian rhythm and regulation/pineal gland function?

Answer 5

Suprachiasmatic nucleus

Question 6

What hypothalamic nucleus controls secretion of ADH (in part), CRH, TRH, and oxytocin (in part)?

Answer 6

Paraventricular

Question 7

What are the opposing roles of the ventromedial and lateral hypothalamic nuclei?

Answer 7

Ventromedial = Satiety
Lateral = Hunger

(think early vs late alphabet)

Question 8

What are the opposing roles of the anterior and posterior hypothalamic nuclei?

Answer 8

Anterior = heat dissipation
Posterior = conservation

Think “junk in the posterior trunk keeps you warm”

Question 9

What does the hypothalamic Arcuate nucleus do?

Answer 9

Secretes dopamine (inhibits prolactin), GH, GnRH

Question 10

What cell-types does IL-2 stimulate?

Answer 10

Helper T cells (proliferation and differentiation), Monocyte activation, NK cells, T cells, B cell division

Question 11

The cerebellum is primarily responsible for motor planning and coordination of _______ side.

How does a lesion present?

Answer 11

Ipsilateral

Dysdiadochokinesia
Limb dysmetria
Intention tremor

Question 12

Patients who kneel a lot/work on their knees are at risk for what?

Answer 12

Prepatellar bursitis. “Aka housemaids knee”

Pain and decreased range of motion with active movement and no pain with passive movement.

Question 13

Where is the anserine bursa?

Answer 13

Medial side of knee

Question 14

What is thoracic outlet syndrome?

Answer 14

Compression of the LOWER trunk of the brachial plexus in the SCALENE triangle bordered by the anterior and middle scalene muscles and the first rib.

Sx include upper extremity numbness, tingling, and weakness.

Question 15

What is Treacher-Collins syndrome? How does it present?

Answer 15

Genetic disorder resulting in the abnormal development in the first and second pharyngeal arches:

Craniofacial abnormalities (mandibular, maxillary, zygomatic bon hypoplasia) results in airway abnormalities and feeding difficulties. Absent or abnormal ossicles (incus, malleus, stapes) leading to profound conductive hearing loss.

Question 16

PAH is ________ and is thus used to calculate _______.

Answer 16

Filtered AND secreted. RPF

Filtration is free and at a constant fraction. Secretion is a carrier-mediated process and thus can be saturated.

Question 17

What is cut in an episiotomy?

Answer 17

Perineal body

Question 18

What is a benign/inconsequential form of fructose intolerance?

Answer 18

Fructokinase deficiency aka Essential fructosuria

fructose -> F1P

Question 19

Chylomicrons eventually bump into HDLs when they reach the bloodstream. What receptors do they express then?

Answer 19

Apo B48 still
Apo C
Apo E

Question 20

As chylomicrons drop their TAGs off at adipocytes using lipoprotein lipase, what receptor drops off?

Answer 20

Apo C

Apo B48 and Apo E persist on the chylomicron remnant

Question 21

When VLDL leaves the liver cells, what does it contain? What receptor is on its surface?

Answer 21

TAGs and CHOLESTEROL (NOT cholesterol esters)

Apo B100 on cell surface

Question 22

What does LCAT do and how?

Answer 22

Converts cholesterol to cholesterol ESTER inside HDL
(cholesterol esters are then trapped inside lipoprotein and isn’t free to move through membranes)

This interaction is activated via pickup of LCAT by HDL via docking of the Apo A receptor

Question 23

What is LDL composed of? What receptors are on its surface?

Answer 23

Cholesterol esters ONLY
with a SINGLE copy of Apo B100

Comes from an IDL that has lost the TAGs and Apo E

Question 24

What are Ladd’s fibrous bands? What pathology are they seen in?

Answer 24

In midgut malrotation, teh cecum ends up in the RLQ instead of LLQ.
Fibrous bands that connect the retroperitoneum in the RLQ to the right colon/cecum.

They can pass over the second part of the duodenum causing obstruction and thus biliary emesis within the first few days of life.

It may also present as a midgut volvulus on the SMA which will compromise intestinal perfusion and may lead to life-threatening necrosis.

Question 25

Where does cutaneous lymph from the umbilicus down drain? What are the exceptions and the surprising inclusions?

Answer 25

Superficial inguinal nodes **exceptions: NOT glans penis nor posterior calf **inclusions: external genitalia and anus below the dentate line

Question 26

What is a common lesion/sequelae to the arterial system from a high speed MVA?

Answer 26

Blunt aortic injuries due to sudden deceleration causes extreme stretching and torsional forces often at the aortic isthmus which is tethered by the ligamentum arteriosum -> this can cause aortic rupture and widened mediastinum on CXR.

Question 27

What is the allantois/urachus and what are associated pathologies?

Answer 27

At 3 weeks gestation the yolk sac forms a protrusion that extends into the urogenital sinus which gives rise to the bladder. The allantois becomes the urachus, a duct between the bladder and the yolk sac. If the urachus to close leaves a connection between the umbilicus and the bladder causing skin irritation and possible urine discharge. If just the distal part of the urachus fails to close, a urachal sinus results with periumbilical tenderness and purulent umbilical discharge. If just the central portion fails to obliterate, you get a urachal cyst.

Question 28

What is the mnemonic for the 3 places where the trigeminal nerve (CN V) exit the skull? Identify what regions they innervate.

Answer 28

Standing Room Only Foramen Spinosum - V1 - ophthalmic region Formanen Rotundum - V2 - Maxillary Foramen Spinosum - V3 - Mandibular

Question 29

What structures exit through the Superior Orbital Fissure?

Answer 29

CN III, CN IV, V1, VI, ophthalmic vein, sympathetic fibers

Question 30

What structures pass through the jugular foramen?

Answer 30

CN IX, X, XI, jugular vein

Question 31

What are histologic findings of granulomas?

Answer 31

Epitheloid macrophages and multinucleated giant cells

Question 32

What are the immune cell types of granuloma formation?

Answer 32

IL-12 secretion induces TH1 differentiation -> TH1 produce IFN-gamma and TNF-alpha helping to kill ingested bacteria and recruit additional monocytes and macrophages.

Question 33

The _____ ventricle composes the majority of the anterior portion of the heart.

Answer 33

Right

Question 34

Fish bones and other food can get stuck in the piriform recess lateral to the larynx. This can damage the internal laryngeal nerve, a branch of the superior laryngeal nerve, CN X, ultimately damaging the afferent limb of the ______ reflex.

Answer 34

Internal laryngeal Superior laryngeal CN X Cough reflex

Question 35

Taste from the base of the tongue (posterior 1/3) comes from the ______ nerve.

Answer 35

Glossopharyngeal (IX) nerve

Question 36

Taste from the anterior 2/3 of the tongue comes from the ______ nerve.

Answer 36

Facial (VII) nerve.

Question 37

Gag reflex: Afferent = CN __ Efferent = CN __

Answer 37

``` Afferent = IX Efferent = X ```

Question 38

The recurrent laryngeal nerve is a branch of cranial nerve ______.

Answer 38

X

Question 39

Cells with decreased green fluorescence on DHR flow cytometry indicate what deficiency/disease?

Answer 39

NADPH oxidase deficiency; Chronic granulomatous disease

Question 40

Saddle anesthesia and loss of anocutaneous reflex are indicative of ________ syndrome and are associate with damage to nerve roots ___ - ___.

Answer 40

Cauda equina syndrome | S2-S4 (i.e. pudendal nerve)

Question 41

What artery is damaged from a mid shaft humerus break?

Answer 41

Deep radial artery

Question 42

The pancreas is predominantly retroperitoneal except for the ____ which is why the pain radiates to the back in pancreatitis

Answer 42

TAIL

Question 43

Tennis elbow = lateral epicondylitis = problems with wrist ________

Answer 43

extension

Question 44

What is the only abdominal organ derived from mesoderm?

Answer 44

Spleen | note kidney is also a mesoderm organ but it is retroperitoneal!

Question 45

Which CNS cells are curiously derived from mesoderm?

Answer 45

Oligodendrocytes

Question 46

The umbilical arteries regress into the ?

Answer 46

medial umbilical ligaments

Question 47

The allantois/urachus regress into the ?

Answer 47

Median umbilical ligament

Question 48

Which rotator cuff externally rotates the shoulder (i.e. pitching injury)?

Answer 48

Infraspinatus

Question 49

What is NF-kb?

Answer 49

Transcription factor that induces transcription of TNF-alpha and other inflammatory agents. Inhaled fluticasone (corticosteroid) in asthmatics inhibits it.