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anatomy HY Flashcards

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USMLE® Step 1 flashcards
1
Q

loss of aoncutaneous reflex

A

S2-S4

S2-S4 shut the door (Anal reflex)

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2
Q

Achilles reflex

A

S1-S2 buckle my shoe

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3
Q

Patellar reflex

A

L-3 L4 Kick the door

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4
Q

Cremasteric reflex

A

L1-L2 Testicular move

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5
Q

Which ligament will be injured?
Sudden change in direction or Awkward landing?

A

Anterior Cruciate ligament

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6
Q

Impact on the lateral knee?
Which ligament will be injured?

A

The tibial (medial ) collateral ligament

אם נותנים מכה בצד החיצוני הצד הפנימי נקרע לכן ה-medial

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7
Q

The portal triad contains 3 vessels:
1.
2.
3
and this triad runs through the ————
if after occlusion of the area, bleeding does not stop, then think about —————-

A

The portal triad contains three vessels:
1. common bile duct
2. Hepatic artery
3. Portal vein
and this triad runs through the Hepatoduodenal ligament
if after occlusion of the area, bleeding does not stop, then think about IVC bleeding

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8
Q

Lumbar puncture location

A

L-3 L5

The dural sac (subarachnoid space) ends in S2

anatomical landmarks:
Suprsspinous ligament&raquo_space; interspinous ligament&raquo_space; ligamentum flavum&raquo_space; meningeal layers (epidural space)&raquo_space; dura matter&raquo_space; Arachnoid = CSF fluid)

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9
Q

Back pain down the lower limb

Which region may be diminished?
Which reflex diminishes?

A

L1-L5 - lumbar region

Pattelar reflex

S1-S2&raquo_space; buckle my shoe = Achilles reflex
L3-L4&raquo_space; kick the door = Patellar reflex
C5-C6&raquo_space; pick up sticks = Biceps + brachioradialis reflex
C7-C8&raquo_space; lay them straight = Tricepest
L1 L2&raquo_space; testicles are move = Cremester fflex
S3 - S4&raquo_space; close the hole = Anal wink reflex

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10
Q

80 yr Acute onset of Backpain, compression fracture

The reason? Abnormal curvature?

A

osteoperosis (Ca + Po normal )

Kypohsis&raquo_space; mainly in the thoracic spine

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11
Q

9-month pregnant female / obese man.
type of abnormal curvature?

A

Lordosis > the Lumbar region

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12
Q

Unable to move his arm up to the side with a flattened deltoid?

Which nerve is most probable damage?
What is its location?

A

Axillary nerve (Abdduction)

Surgical neck of the humerus

(ARM menmonic- Axillary, Radial- midshaft , Medial- metaphysa)

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13
Q

Which mechanism will cause Axillary nerve damage?

A

Anterior humerus dislocation&raquo_space; A kid throwing a ball ( abduction, extension, external rotation)

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14
Q

PT unable to extend the hand with resistance, unable to grip properly?
which nerve will be damaged? and what its location

A

Radial nerve = midshaft of humerus

  • Also Crutches = laying to a chair with hands behind the chair&raquo_space; Drunk arm over chair
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15
Q

After trauma, loss of sensation in the medial portion of the hand

A

Ulnar nerve

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16
Q

Fracture to the medial epicondyle of the humerus will lead to

A

Ulnar nerve damage

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17
Q

What is the proximal and distal anatomy location of the lesion of Median nerve injury?

A

Supracondylar humerus

distal- carpal tunnel

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18
Q

What is the proximal and distal anatomy location of the lesion of Ulnar nerve injury?

A

Proximal- medial epicondyle
distal- Hook of hamate

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19
Q

extension of flextion?
What will be the problem in Proximal regions vs distal regions of the Ulnar and median nerve

A

Ulnar nerve:
Proximal- unable to flex&raquo_space; ok gesture
Distal- unable to extend&raquo_space; ulnar claw

median nerve
proximal- unable to flex = Pop blessing
Distal - unable to extend = median claw

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20
Q

The distal median nerve will cause which muscle to atrophy?

A

Thenar eminence

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21
Q

Which muscle will cause the distal ulnar nerve to atrophy?

A

Hypothenar Eminence

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22
Q

Breast LN

Where is the majority of the LN will be drawn?

A

Majority: Axillary region

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23
Q

What are a Colles fracture and a Smith fracture

A

Get it ventrally at the wrist when extended

Remember- Colles = Outward (O)
Smith- Inward (I)

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24
Q

Buzzword: Dinner fork

A

Colles fracture

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25
Q

Which anatomy landmarks will be fractured during a “fall on the outstretched hand”

A

*Colles

*Carpal bone: Scaphoid&raquo_space; Tenderness in anatomic snuff box
*hamate (Ulnar nerve damage)
*forearm - Radial head fracture

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26
Q

Buzzword:

Tenderness on anatomic snuff box

A

Scaphoid fracture

Risk for A-vascular necrosis

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27
Q

A child falls and holding his arm in inferolateral placement
what the Dx?

A

clavicle fracture

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28
Q

Which muscles are the Rotator cuff

A

SITS:
Supraspinatus
Infraspinatus
Teres minor
Subscapularis

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29
Q

A pt with decreased resistance when arms are outstretched, adduct, thumbs down

Which muscle is injured? Which nerve innervated him?

A

Supraspinatus muscle = Empty can test
abduction of 0-15 degrees
innervated by supra scapular

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30
Q

Abduction of arm
0-15
15-90
90-180

A

0-15- supraspinatus
15-90- deltoid (axillary)
90-180- trapzezius (CN XI) + serratus ant. (long thoracic nerve)

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31
Q

Pain under Acromnion, pain while lifting the arm above the head

A

Subacrominal bursitis

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32
Q

Pharmacological agent for bursitis?

A

NSIADS ( inhibting COX = less prostacyclin)

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33
Q

elbow swelling past few month + redness
no fever

A

olecranon bursitis

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34
Q

Pt who plays tennis it hurts when opens the door

A

lateral epicondylitis

extensor tendon

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35
Q

golf player

A

medial epicondylitis
common flexor tendon

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36
Q

Which are the 4 muscle flexors of the arm?
(AKa- golf player &raquo_space; Medial-epicondylitis)

A

PFPF:
from radial to ulnar:
Pronator teres
flexor carpi radialis
Palmaris longus
Flexor carpi ulnaris

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37
Q

kid with upward traction

Dx?

how to fix?

A

Tear of the annular ligament at radial neck > hed of radial neck dislocation

hypoproneation maneuver
or
flex and supinate manuver

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38
Q

Cubital fossa structres:

A

Medial to lateral:
Medial nerve
Brachial artery
Biceps tendon
Superficial Radial nerve
MBTbRs
covered by bicipital aponeurosis

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39
Q

Numb in fingers mostly in night

A

Carpal tunnel = median nerve
3.5 lateral digits

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40
Q

Which wrist bone dislocation can cause Median nerve issues?

A

Lunate dislocation

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41
Q

What are the bones of the wrist? and order

A

top: Some Loves Try Positions
bottom: That They Can’t Handle

Scaphoid, Lunate, Triquetrum, pisiform
Trapezium , Trapezoid, Capitate, Hamate

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42
Q

Hypothyroidism, pregnancy, hyper typing (like secretary)

All of them can cause

A

Carpal tunnel syndrome

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43
Q

Hook of hamate nerve relations?

A

Ulnar nerve

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44
Q

Where Erb palsy happens

A

C5-C6

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45
Q

Which muscles are involved in Erb’s palsy?

how the hand will lokk

A

Deltoid
Infraspinatus
Biceps brachii

DIB

Hand look:
Writer tip: adduction, medially rotation, extended and pronated

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46
Q

Klumpke’w paralysis

nerves and muscles
position of the hand

A

C8-T1
lumbricals
interosseus
thenar

LIT

Ape hand = Claw hand

47
Q

A young patient with arm pain; after cooking, her arm mobility decreases. The extremity is pale and cold to the touch.

**she have also extra rib

Dx?

A

Thoracic outlet syndrome&raquo_space;
subclavian compress under clavicle/rib

48
Q

Winged scapula muscle?

(Stab wounds, axillary LN dissection mastectomy)

A

Serratus ant. (long thoracic nerve)

49
Q

What is the path of PCI (Cardiac catheterization)

A

Femoral arternal&raquo_space; External iiliac&raquo_space; common iliac&raquo_space; aorta&raquo_space; common artery

50
Q

left femur shorter than right with lateral rotation

A

Femoral neck fracture + groin pain&raquo_space; medical cirmcuflex femoral artery&raquo_space; a-vascular necrosis

51
Q

Back pain + lifting a box and shooting pain ,
What is the embryological structure most likely to derive from?

A

Notochord&raquo_space; nuecluos pulposis (in disc hernia for exmaple)

52
Q

Weakend hip extension and knee flection: Which nerve and muscle are affected?

A

Sciatic nerve.
Hamstrings muscles

53
Q

Pt after a car accident, she hit her knees on the dashboard. Now, the legs are shortened and medially rotated. What is the underline deformity?

A

Posterior hip dislocation.

The femoral head taken out of the acetabular head

sciofemoral ligament torn

54
Q

Legs shortened and medially rotated with foot drop

A

Posterior hip dislocation

The sciatic nerve&raquo_space; branch is also common peroneal and anterior tibial

(foot drop common peroneal nerve )

55
Q

Stepping gait with large contusion with point of tenderness to the proximal right leg.

Which nerve is affected?

A

Common peroneal nerve

56
Q

What is the common peroneal nerve do

A

evert + dorsiflex (פלקס באצבעות ברגליים)

57
Q

Fibular neck fractures can lead to ———– nerve injury

A

common peroneal

58
Q

Pt is leaning forward when walking. when stand on his right leg his left hip is drop

What is the likely injured nerve?

A

Superior gluteal nerve&raquo_space;
innervate Gluteus medium + minimus

inability to puul the hip up + abduction of thigh lost

when standing&raquo_space; hip rise on the affected side

59
Q

PT after abdominal surgery with burning pain , radiate to the inguinal and suprapubic region.

what is the likely affected nerve?

A

Iliohypogatric nerve

motor innervation : abdominous transversus

60
Q

Laparoscopic surgery for cryptorchid testes. Absent cremasteric reflex. What is the nerve?

A

Genitofemral nerve - motor cremasteric muscle
L1-L2

sensory to the scrotum

61
Q

Ant. + lateral leg tingling with tight jeans, obesity, pregnancy

A

Lateral femoral cutaneous nerve

62
Q

Pelvic teratoma resection + medial thigh sensation with decreased adduction

Which nerve is most likely damaged?

A

Obturator nerve

sensory for the medial thigh
Motor: Adductor, Gracilis , pectineus

63
Q

Anterior hip dislocation,

which nerve could be injured?

A

Obturator nerve

64
Q

obese female with Medial knee pain over the anteromedial proximal tibia. no fracture

What is the likely diagnosis?

A

Pes anserine bursitis

65
Q

After the femoral vein catheter. Diminish patellar reflex with decreased leg extension

Which nerve is injured? what he innervated?

A

Femoral nerve (L2-L4)
motor: Quadricept , sartorius)
Sensory: anterior thigh

66
Q

What contains the Femoral Triangle?

A

from lateral (Sartorius) to medial (adductor longus):
NAVEL or venous to the penis )Vein is more close to the penis)
Femoral Nerve
Femoral Artery
Femoral Vein
Empty space (Femoral canal)
Lymphatic

67
Q

The pt with a cystic fluid collection of the post. Portion of the knee. Unable to plantar flex or curl his toes inward.

would the pt will have problem with inversion or eversion?

A

inversion.

TIP
Tibial nerve- can’t plantarflex
Inversion
Plantaris

*also sensory to the sole of the foot

68
Q

popliteal fossa what is the structrue from superficial to deep:

A

Tibial nerve
popliteal vein
Popliteal artery

69
Q

Which nerve runs through the tarsal tunnel?

A

Tibial nerve

can be compressed by the flexor retinaculum&raquo_space; paraesthesia

70
Q

Which nerve baker cyst can press?

A

Tibial nerve

71
Q

difficult climbing stair, unable to get up from the chier

Hx: post. Hip dislocation?

A

Inferior gluteal nerve
Motor: gluteus maximus (extend of the hip- to get up of the chair and get up of te steps )

72
Q

Post-partum. During labor, epidural Injection of the spine near the sacrospinous ligament. now with urinary incontenence

Which nerve may be implied?

A

Pudendal nerve (s2-S4)

motor: external urethral + anal sphincter

73
Q

Female with hernia.
what is the anatomical region which superior to the pathology?

A

Femorl hernia&raquo_space; Femoral rign&raquo_space; inferior to the inguinal ligament

so the inguinal ligament is superior to that.

74
Q

Which artery can be damaged while fixing a femoral hernia?

A

Obturator artery

75
Q

What are direct and indirect hernias?

A

Direct- directly into the abdomen (medial to vessel) of the old man. Not in scrotum

indirect- pass through deep inguinal ring (lateral to vessels) young males. In scrotum

vessels: inf. epigastric vessels

76
Q

6-year-old, intra-abdominal mass above the pubic symphysis. cystic attached to the umbilicus and the apex of the bladder.
what the the Dx?

A

Urachal cyst

77
Q

Urine leaking from the umbilicus.
which fetal structure abnormality?

A

Urachus

78
Q

Limping after rising in the morning.
no fracture.
Dx?

A

Plantar fasciitis - infl. of the plantar aponeurosis (bottom of the foot)

Attach to the medial tubercle of the calcaneus

79
Q

Feeling “pop” in the knee, in flexed 90 degrees (ant. drawer test) and feel a shift of the tibia

A

ant. cruciate tendon

80
Q

Soccer player complain knee giving out after she fell on her knee flexed

Dx?

A

Post. Cruciate tendon tear

81
Q

Football player get tackled in the lateral side of the knee

What do we fear of?

A

Terrible triad
MAL - knee is very MAL
MCL- prevent hyper abduction.
ACL
Lateral meniscus

82
Q

Pt noted excess varus laxity at the knee

A

LCL tear

LCL- prevernt hyper adduction

83
Q

Locking sensation especially Twisting and squatting

Dx?

A

Meniscus tear

McMurray test for Meniscus&raquo_space; twisting the
External rotation- Medial meniscus
Internal rotation - Lateral meniscus

84
Q

The basketball player rolled his ankle. He has an ankle sprain

Which ligament is most likely affected?

A

The anterior -inferior talofibular ligament

overinversoin and supination of the foot

85
Q

anterior placenta accerta can invade which stracture?

A

Most likely- Bladder

86
Q

Prostatic plexus is originate from?

A

Inf. hypogastric plexus ( continuation of hypgastric nerve)

87
Q

post. Prostectomy erectile dysfunction

which nerve is damage?

A

Inf. hypogastric nerve + pelvic and sacral splenchin nerves = prostatic plexus

leis in the fascia of prostate

proctectomy = damage to the fascia

88
Q

Hemiballism is caused by

A

Damage to the sub-thalamic nuclues&raquo_space; decrease excitation of globus palldus internus&raquo_space; reducing inhibiton of thalamus&raquo_space; movment disorder by wild involuntary of proximal limbs

89
Q

What the cause of Osgood-schaltter disease

A

knee pain (in adolecsent ) due to overuse of the quadriceps muscle group

90
Q

What is the fuction of quadriceps and where its insert

A

knee extension (when hiking, running)

insertion at - tibial tubercle&raquo_space; cuase demege to tha area to a point of fregmentation of the tibial tubercle

91
Q

When a focal seziure have preceded distinctive aura
where in the brain is found this abnormality that explain this aura ?

A

Mesial temporal lobe (eg. hippocampus, amygdala, parahippocampal gyrus)

most common by Hippocampal sclerosis -a/w childhoode febrile seizures

92
Q

Pancoast syndrome
Clnical presenation:

A
  1. shoulder pain- radiating to axilla / scapula
  2. horner syndrome- cercial symp. ganglia
  3. spinal cord compression- if tumor expend to intravertebral lamina
93
Q

Which nerve injury would lead to low extremity:

weakness in dorsiflexion, numbness of dorsal fott and posterior-lateral calf

A

Common Fibular (peroneal nerve)

94
Q

Which nerve injury will cause weakness of knee flextion

A

Sciatic nerve

95
Q

Which nerve injury wil cause a weakness in plantar flextion in inversion, abscent ankle reflex?

A

Tibial nerve

96
Q

Landmark of Lumbar pancture?

A

Iliac crest

97
Q

Hand bone mnemonic

A

Some Lovers Try Position That They Cant Handle:

Scaphoid, Lunate, Triquetrum, pisiform, Trapezium, Trapaziud, capitatem hamate

98
Q

The vulva is drainage to which LN?

A

Inguinofemoral

99
Q

Which female reproductive structures drain to the internal iliac LN

A

Cervix + proxinal vagina

100
Q

Which female reproductive structures drain to the inguinofemoral LN

A

Vulva + Distal Vagina

101
Q

A Stoke in the Thalamus can lead to—-?

A

Contralaterl complete sensory loss (Face and body ) = touch, pain, temperturem vibration, proprioception

102
Q

Which muscle pass to the greater sciatic foramen and when injured can compress the sciatic nerve and cauase sciatic like symptoms

A

piriformis muscle

103
Q

Which artery suppluy to proximal ureter and which the distal ureter?

A

proximal- Renal artery
distal- Sup. vesical artey

104
Q

Neurovascular pairing

Axilla / lateral thorax

answer the nerve and artery related to this location

A

Long thoracic nerve
lateral thoracic artery

105
Q

Neurovascular pairing

Surgical neck of humerus

answer the nerve and artery related to this location

A

Axilla nerve
Posterior circumflex artery

106
Q

Neurovascular pairing

Midshaft of humerus?

answer the nerve and artery related to this location

A

Radial nerve
Deep brachial artery

107
Q

Neurovascular pairing

popliteal fossa

answer the nerve and artery related to this location

A

Tibial nerve
Popliteal artery

108
Q

Neurovascular pairing

Distal humrus/ cubital fossa

answer the nerve and artery related to this location

A

Median nerve
Brachial artery

109
Q

Neurovascular pairing

posterior to medial malleolus

answer the nerve and artery related to this location

A

tibial nerve
posterior tibial arery

110
Q

Which nerve root

loss of Achilles reflex?

A

S1 nerve

Difficult toe walking

heel walking is L5

111
Q

Difficulty heel walking?

A

L5

also in dorsiflection

112
Q

foot drop

A

Common fibular peroneal nerve (L4-S2)
PED- Peroneal evert and dorsiflex

If injuref your foot is dropped

113
Q
A

USMLE HY notes (34 decks)

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