Anatomy High Yield Flashcards

1
Q

Surgical neck fracture of humerus: risk?

A

Axillary nerve and posterior humeral circumflex artery

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2
Q

Midshaft humerus fracture: risk?

A

Radial nerve and deep brachial artery

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3
Q

Supracondylar fracture: risk?

A

Brachial artery and median nerve

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4
Q

Medial epicondyle fracture: risk?

A

Ulnar nerve

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5
Q

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

A

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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6
Q

Cubital fossa structures lateral to medial?

A

BAN: Biceps brachii tendon, brachial Artery, median Nerve

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7
Q

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

A

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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8
Q

How would breast cancer spread to the spine?

A

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

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9
Q

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?
A

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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10
Q

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

A

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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11
Q

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

A

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

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12
Q

Dislocation of the lunate bone can cause

A

Acute carpal tunnel syndrome

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13
Q

What branch of the median nerve innervates the opponens pollicis?

A

Recurrent branch of the median nerve

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14
Q

What joints are affected in Rheumatoid arthritis?

A

MCPS, PIPs

DIPS ARE NOT AFFECTED IN RA

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15
Q

Traction or tear injury of the upper trunk causes?

A

Erbs palsy (C5-C6 roots)

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16
Q

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?

A

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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17
Q

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

A

Axillary, suprascapular, and musculocutaneous

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18
Q

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

A

C8-T1

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19
Q

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

A

Lower

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20
Q

Which nerves are lesioned in Klumpke palsy?

A

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

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21
Q

C8 dermatome vs ulnar neuropathy

A

Dermatome will be dorsal and ventral

Ulnar will be just ventral

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22
Q

What nerve innervates the deep head of the Flexor Pollicis Brevis

A

Deep branch of the ulnar nerve

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23
Q

Which muscles adduct the fingers at the MCP joint?

A

Palmar interossei, innervated by ulnar nerve

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24
Q

Which muscles abduct the fingers at the MCP joint

A

Dorsal interossei PAD DAB

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25
Q

Thumb dermatome

A

C6

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26
Q

Loss of forearm flexion and supination.
Loss of sensation over lateral forearm

What cord and nerve is damaged?

A

Lateral cord, musculocutaneous (C5-C7)

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27
Q
Patellar reflex levels
Achilles reflex levels
Biceps reflex levels
Triceps levels
Cremasteric
Anal wink
A
L3,L4
S1,S2
C5,C6
C7, C8
L1, L2
S3, S4
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28
Q

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

A

Inferior gluteal nerve injury, which supplies Gluteus Maximus

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29
Q

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

A

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

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30
Q

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

A

Gastros, soleus, plantaris

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31
Q

Sciatic nerve levels

A

L4-S3

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32
Q

Tibal nerve levels

A

L4-S3

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33
Q

Where does the lateral breast drain

A

Axillary nodes (pectoral)

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34
Q

What is the lymph drainage of the medial breast?

A

Parasternal lymph nodes OR opposite breast

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35
Q

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

A

Internal thoracic, axillary, and intercostal veins

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36
Q

Paralysis of diaphragm, which side is elevated?

A

The paralyzed side is elevated

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37
Q

Four locations where the esophagus can be constricted

A
  1. Origin at the pharynx
  2. Posterior to arch of aorta
  3. Compression by left main bronchus
  4. Esophageal hiatus
38
Q

What are the openings of the diaphragm

A

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

39
Q

What anastomosis is responsible for esophageal varices?

A

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

40
Q

How would you surgically treat portal htn?

A

Shunt between portal and hepatic vein

Transjugular intrahepatic portosystemic shunt (TIPS)

41
Q

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

A

Isthmus of thyroid

42
Q

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

A

Cricothyroid membrane

43
Q

Lateral and posterior walls of the left ventricle

A

Left Circumflex Coronary Artery

44
Q

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

A

Middle lobe of right lung

45
Q

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?

A

Autonomic supply

46
Q

Pleura that can be damaged during a subclavian vein cath?

A

Cervical pleura

47
Q

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

A

All three muscles (EO, IO, TA)

Behind is the peritoneum (thin membranous layer)

48
Q

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

A

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

49
Q

What two structures join to make the ejaculatory duct?

A

Seminal vesicle and the vas deferens

50
Q

What is the first structure crossed by any abdominal hernina?

A

Transversalis fascia

51
Q

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

A

Gastrosplenic ligament

52
Q

Which ligament connects greater curvature of stomach to the spleen?

A

Gastrosplenic ligament

53
Q

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

A

The splenorenal ligament

54
Q

Which two ligaments make up the lesser omentum?

A

Hepatogastric and Hepatoduodenal

55
Q

Sympathetic innervation of the foregut
preganglionic:
Postganglionic:

A

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

56
Q

Sympathetic innervation of the midgut
Preganglionic
Postganglionic

A

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

57
Q

Hindgut innervation
Preganglionic:
Postganglionic:

A

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

58
Q

Ruptured gastric ulcer on lesser curvature

Ruptured gastric ulcer on posterior wall of duodenum

A

Lesser: left gastric

Posterior wall duodenum: gastroduodenal artery

59
Q

What is the level of the SMA?

A

Lower border L1

60
Q

What is the spinal level of the renal artery?

A

L2

61
Q

What is the spinal level of the IMA?

A

L3

62
Q

Where do the common iliacs branch off the aorta

A

L4

63
Q

What are the three branches of the celiac trunk?

A

Common hepatic
Left gastric
Splenic

64
Q

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

A

Proper hepatic

Gastroduodenal

65
Q

Which artery does the right gastric come off of?

A

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

66
Q

What artery does the cystic artery come off of?

A

Right hepatic

67
Q

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

A

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

68
Q

Where does the middle colic a. come from?

A

SMA

69
Q

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

A

Splenic flexure; anastomoses with middle colic.

70
Q

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

A

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

71
Q

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

A

Jaundice

72
Q

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

A

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
73
Q

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

A
Paraumbilical veins (portal)
Small epigastric veins (systemic)
74
Q

What are the systemic and portal veins that cause anorectal varices

A

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

75
Q

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

A

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

76
Q

What is the drainage of the inferior rectal vein?

A

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

77
Q

Above pectinate line lymph drainage

A

Internal iliac node

78
Q

Below pecitnate line lymph drainage

A

Superficial inguinal node

79
Q

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

A

Main pancreatic duct and the common bile duct leading to jaundice

80
Q

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

A

Splenic vein and superior mesenteric vein

81
Q

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

A

Anterior to both

82
Q

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

A

The tail. Which enters the splenorenal ligament.

83
Q

Abnormal rotation of VENTRAL pancreatic bud

A

Annular pancreas

84
Q

What is the embryonic origin of the spleen and kidneys?

A

Mesoderm

However, the spleen has blood supply from foregut derivative.

85
Q

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

A

11th rib

86
Q

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

A

T12-L3

87
Q

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

A

Nothing

88
Q

What two veins join the left renal vein?

A

Left suprarenal and left gonadal

89
Q

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

A

Aorta and SMA

90
Q

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

A

Urine escapes into perineal space

91
Q

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

A

Retropubic space

92
Q

What lobe is BPH in?

A

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