Anatomy High Yield Flashcards by Alex Miller

Surgical neck fracture of humerus: risk?

Axillary nerve and posterior humeral circumflex artery

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Midshaft humerus fracture: risk?

Radial nerve and deep brachial artery

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Supracondylar fracture: risk?

Brachial artery and median nerve

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Medial epicondyle fracture: risk?

Ulnar nerve

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In a colles fracture, which way is the distal fragment displaced? What can often happen to the ulnar styloid process?

Colles fracture results from forced extension, FOOSH. Distal fragment is displaced dorsally resulting in a dinner fork deformity. Often the ulnar stylid process is avulced.

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Cubital fossa structures lateral to medial?

BAN: Biceps brachii tendon, brachial Artery, median Nerve

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What are the findings of an Upper Brachial Palsy (aka Erb-Duchenne, aka waiter tip)?

Combination lesion of axillary, suprascapular, and musculocutaneous nerve injury.
Will see adducted shoulder, medially rotated arm, extended elbow, and loss of sensation in the lateral aspect of the upper limb

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How would breast cancer spread to the spine?

Posterior intercostal, to azygous system to superior vena cava or vertebral venous plexus.

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Blockage of the subclavian or axillary artery can be bypassed by anastomoses between the thyrocervical trunk and subscapular artery.

What are the anastomotic branches off the Thyrocervical trunk?
What are the anastomotic branches off the subscapular artery?

Thyrocervical trunk comes off the subclavian artery proximal to scapula. Gives off *transverse cervical and *Suprascapular artery

The subscapular artery comes off the axillary artery and gives off the *thoracodorsal artery and the *circumflex scapular artery

** arteries contribute to anastomosis

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What is more lateral, the cephalic vein or the basilic vein?

Cephalic vein—>median cubital vein (joins cephalic/basilic)—> basilic vein
In order of lateral to medial
So Cephalic vein is more lateral

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Although the thenar eminence atrophies in CTS, what is spared and why?

Sensation is spared in carpal tunnel syndrome because palmar cutaneous branch enters hand external to carpal tunnel

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Dislocation of the lunate bone can cause

Acute carpal tunnel syndrome

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What branch of the median nerve innervates the opponens pollicis?

Recurrent branch of the median nerve

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What joints are affected in Rheumatoid arthritis?

MCPS, PIPs

DIPS ARE NOT AFFECTED IN RA

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Traction or tear injury of the upper trunk causes?

Erbs palsy (C5-C6 roots)

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The deltoid, supraspinatus, infraspinatus, and biceps brachii are affected by the Upper trunk injury (C5-C6) known as Erb’s palsy. What are the functional deficits as a result of these muscles being affected?

Deltoid, supraspinatus: deficit in abduction so arm will be adducted by side

Infraspinatus: deficit in external rotation, so arm will be medially rotated

Biceps brachii: deficit in flexion and supination, so arm will be extended and pronated

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Erb’s palsy is a combination lesion of which three nerves?

Axillary, suprascapular, and musculocutaneous

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Klumpke palsy occurs during tree grabbing/ delivering newborns and is a nerve root injury in which roots

C8-T1

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Klumpke palsy is a lesion of which trunk of the brachial plexus

Lower

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Which nerves are lesioned in Klumpke palsy?

Combination of ulnar nerve (claw hand) and median nerve (ape hand) so you get total claw hand

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C8 dermatome vs ulnar neuropathy

Dermatome will be dorsal and ventral

Ulnar will be just ventral

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What nerve innervates the deep head of the Flexor Pollicis Brevis

Deep branch of the ulnar nerve

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Which muscles adduct the fingers at the MCP joint?

Palmar interossei, innervated by ulnar nerve

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Which muscles abduct the fingers at the MCP joint

Dorsal interossei PAD DAB

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Thumb dermatome

Loss of forearm flexion and supination. Loss of sensation over lateral forearm What cord and nerve is damaged?

Lateral cord, musculocutaneous (C5-C7)

``` Patellar reflex levels Achilles reflex levels Biceps reflex levels Triceps levels Cremasteric Anal wink ```

``` L3,L4 S1,S2 C5,C6 C7, C8 L1, L2 S3, S4 ```

Difficulty rising from a seated position (weakened hip extension) is injury to what nerve

Inferior gluteal nerve injury, which supplies Gluteus Maximus

The hamstings (biceps femoris, semitendinosis, semimembranosus) are all hip extenders and knee flexors. They are supplied by the tibial head except for?

The short head of the biceps femoris is supplied by the common fibular nerve

What three muscles are part of the triceps surae and will be affected by an achilles tendon injury?

Gastros, soleus, plantaris

Sciatic nerve levels

L4-S3

Tibal nerve levels

L4-S3

Where does the lateral breast drain

Axillary nodes (pectoral)

What is the lymph drainage of the medial breast?

Parasternal lymph nodes OR opposite breast

What is the venous drainage of the breast? (3)

Internal thoracic, axillary, and intercostal veins

Paralysis of diaphragm, which side is elevated?

The paralyzed side is elevated

Four locations where the esophagus can be constricted

1. Origin at the pharynx 2. Posterior to arch of aorta 3. Compression by left main bronchus 4. Esophageal hiatus

What are the openings of the diaphragm

I (IVC) ate (8) ten (10) eggs (esophagus) at (aorta) twelve (12) IVC=T8 Esophagus=T10 Aorta=T12

What anastomosis is responsible for esophageal varices?

Left gastric v (portal) <> Azygos v (caval)

How would you surgically treat portal htn?

Shunt between portal and hepatic vein | Transjugular intrahepatic portosystemic shunt (TIPS)

What part of thyroid overlies the 2-3rd rings of the trachea

Isthmus of thyroid

Cricothyrotomy is cut between the thyroid and cricoid cartilage at the?

Cricothyroid membrane

Lateral and posterior walls of the left ventricle

Left Circumflex Coronary Artery

Area between the horizontal fissure and oblique fissure, which lobe would this be in?

Middle lobe of right lung

The intercostal nerves supply costal parietal pleural and peripheral diaphragmatic pleura. The phrenic nerve supplies central diaphragmatic and mediastinal pleura. What is the supply of the visceral pleura?

Autonomic supply

Pleura that can be damaged during a subclavian vein cath?

Cervical pleura

Below the arcuate line, which aponeuroses pass in front of the rectus sheath? What is behind?

All three muscles (EO, IO, TA) | Behind is the peritoneum (thin membranous layer)

Above the arcuate line, what structures are anterior to the rectus sheath? Which structures are posterior?

Anterior is external oblique and anterior layer of internal oblique aponeurosis Posterior is the transversus abdominis and the posterior layer of internal oblique aponeurosis

What two structures join to make the ejaculatory duct?

Seminal vesicle and the vas deferens

What is the first structure crossed by any abdominal hernina?

Transversalis fascia

The short gastric arteries and left gastroepiploic vessels are contained within the?

Gastrosplenic ligament

Which ligament connects greater curvature of stomach to the spleen?

Gastrosplenic ligament

The splenic artery/vein and the tail of the pancreas are within which ligament

The splenorenal ligament

Which two ligaments make up the lesser omentum?

Hepatogastric and Hepatoduodenal

Sympathetic innervation of the foregut preganglionic: Postganglionic:

Preganglionic: greater splanchnic (T5-T9) Postganglionic: celiac ganglion

Sympathetic innervation of the midgut Preganglionic Postganglionic

Preganglionic: lesser splanchnic T10-T11 Postganglionic: superior mesenteric ganglion

Hindgut innervation Preganglionic: Postganglionic:

Preganglionic: lumbar splanchnic nerves L1-L2 Postganglionic: inferior mesenteric ganglion

Ruptured gastric ulcer on lesser curvature | Ruptured gastric ulcer on posterior wall of duodenum

Lesser: left gastric | Posterior wall duodenum: gastroduodenal artery

What is the level of the SMA?

Lower border L1

What is the spinal level of the renal artery?

What is the spinal level of the IMA?

Where do the common iliacs branch off the aorta

What are the three branches of the celiac trunk?

Common hepatic Left gastric Splenic

Two branches of the common hepatic artery, which was a branch of the celiac trunk

Proper hepatic | Gastroduodenal

Which artery does the right gastric come off of?

Proper hepatic gives off right gastric, then it ascends within the hepatoduodenal ligament of the lesser omentum to reach porta hepatis; it then divides into right and left hepatic arteries

What artery does the cystic artery come off of?

Right hepatic

What part of stomach is at risk if splenic artery is disrupted?

Fundus and upper portion of the greater curvature because they are supplied by the short gastric arteries of the splenic

Where does the middle colic a. come from?

SMA

What does the ascending (marginal) branch of the left colic artery supply?

Splenic flexure; anastomoses with middle colic.

What is the typical location of a AAA? How does this relate to the duodenum?

Typically just above bifurcation at L4 and crossed by the 3rd part of the duodenum**

A stone in the cystic duct causes biliary colic, but doesnt cause?

Jaundice

Obstruction at ileocecal valve, can see air in biliary tree (pneumobilia)

Gallstone ileus - this would be a gallstone from the body of the gallbladder. Those go through posterior gb wall into the duodenum and then obstruct the ileocecal junction. - a gallstone from the fundus of the gallbladder would enter the transverse colon and pass through the rectum

Caput medusae is caused by shunting between what portal and what systemic veins?

``` Paraumbilical veins (portal) Small epigastric veins (systemic) ```

What are the systemic and portal veins that cause anorectal varices

Superior rectal (portal)<>middle and inferior rectal (systemic)

What is the drainage of the superior rectal vein (portal)

Superior rectal vein—>inferior mesenteric vein—>splenic vein—>portal vein

What is the drainage of the inferior rectal vein?

Inferior rectal vein—>internal pudendal vein—>internal iliac vein—>common iliac vein—> svc

Above pectinate line lymph drainage

Internal iliac node

Below pecitnate line lymph drainage

Superficial inguinal node

Carcinoma of the pancreas commonly occurs in the head of the pancreas and may constrict the?

Main pancreatic duct and the common bile duct leading to jaundice

What two vessels join behind the neck of the pancreas to form the portal vein?

Splenic vein and superior mesenteric vein

Where is the body of the pancreas in regards to the aorta and left kidney?

Anterior to both

What is the only part of the pancreas that is intraperitoneal?

The tail. Which enters the splenorenal ligament.

Abnormal rotation of VENTRAL pancreatic bud

Annular pancreas

What is the embryonic origin of the spleen and kidneys?

Mesoderm | However, the spleen has blood supply from foregut derivative.

Border between inferior spleen and the upper pole of the left kidney is which rib?

11th rib

Kidneys go from which thoracic vertebral level to which lumbar vertebral level

T12-L3

N.B. Renal fascia must be incised in any surgical approach to kidney

Nothing

What two veins join the left renal vein?

Left suprarenal and left gonadal

Nutcracker effect is a cause of varicocele due to compression of the left renal vein between which two arteries?

Aorta and SMA

Perforation in spongy (anterior/bulbar)urethra will lead to blood accumulation in scrotum. what if busck fascia is torn?

Urine escapes into perineal space

Posterior urethral injury of the membranous urethra. Where does the urine leak?

Retropubic space

What lobe is BPH in?

Median/medial lobe. Basically periurethral. Whereas cancer is usually in posterior lobe

Anatomy High Yield Flashcards

(92 cards)