anatomy HY Flashcards
loss of aoncutaneous reflex
S2-S4
S2-S4 shut the door (Anal reflex)
Achilles reflex
S1-S2 buckle my shoe
Patellar reflex
L-3 L4 Kick the door
Cremasteric reflex
L1-L2 Testicular move
Which ligament will be injured?
Sudden change in direction or Awkward landing?
Anterior Cruciate ligament
Impact on the lateral knee?
Which ligament will be injured?
The tibial (medial ) collateral ligament
אם נותנים מכה בצד החיצוני הצד הפנימי נקרע לכן ה-medial
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 —————-
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
Lumbar puncture location
L-3 L5
The dural sac (subarachnoid space) ends in S2
anatomical landmarks:
Suprsspinous ligament»_space; interspinous ligament»_space; ligamentum flavum»_space; meningeal layers (epidural space)»_space; dura matter»_space; Arachnoid = CSF fluid)
Back pain down the lower limb
Which region may be diminished?
Which reflex diminishes?
L1-L5 - lumbar region
Pattelar reflex
S1-S2»_space; buckle my shoe = Achilles reflex
L3-L4»_space; kick the door = Patellar reflex
C5-C6»_space; pick up sticks = Biceps + brachioradialis reflex
C7-C8»_space; lay them straight = Tricepest
L1 L2»_space; testicles are move = Cremester fflex
S3 - S4»_space; close the hole = Anal wink reflex
80 yr Acute onset of Backpain, compression fracture
The reason? Abnormal curvature?
osteoperosis (Ca + Po normal )
Kypohsis»_space; mainly in the thoracic spine
9-month pregnant female / obese man.
type of abnormal curvature?
Lordosis > the Lumbar region
Unable to move his arm up to the side with a flattened deltoid?
Which nerve is most probable damage?
What is its location?
Axillary nerve (Abdduction)
Surgical neck of the humerus
(ARM menmonic- Axillary, Radial- midshaft , Medial- metaphysa)
Which mechanism will cause Axillary nerve damage?
Anterior humerus dislocation»_space; A kid throwing a ball ( abduction, extension, external rotation)
PT unable to extend the hand with resistance, unable to grip properly?
which nerve will be damaged? and what its location
Radial nerve = midshaft of humerus
- Also Crutches = laying to a chair with hands behind the chair»_space; Drunk arm over chair
After trauma, loss of sensation in the medial portion of the hand
Ulnar nerve
Fracture to the medial epicondyle of the humerus will lead to
Ulnar nerve damage
What is the proximal and distal anatomy location of the lesion of Median nerve injury?
Supracondylar humerus
distal- carpal tunnel
What is the proximal and distal anatomy location of the lesion of Ulnar nerve injury?
Proximal- medial epicondyle
distal- Hook of hamate
extension of flextion?
What will be the problem in Proximal regions vs distal regions of the Ulnar and median nerve
Ulnar nerve:
Proximal- unable to flex»_space; ok gesture
Distal- unable to extend»_space; ulnar claw
median nerve
proximal- unable to flex = Pop blessing
Distal - unable to extend = median claw
The distal median nerve will cause which muscle to atrophy?
Thenar eminence
Which muscle will cause the distal ulnar nerve to atrophy?
Hypothenar Eminence
Breast LN
Where is the majority of the LN will be drawn?
Majority: Axillary region
What are a Colles fracture and a Smith fracture
Get it ventrally at the wrist when extended
Remember- Colles = Outward (O)
Smith- Inward (I)
Buzzword: Dinner fork
Colles fracture
Which anatomy landmarks will be fractured during a “fall on the outstretched hand”
*Colles
*Carpal bone: Scaphoid»_space; Tenderness in anatomic snuff box
*hamate (Ulnar nerve damage)
*forearm - Radial head fracture
Buzzword:
Tenderness on anatomic snuff box
Scaphoid fracture
Risk for A-vascular necrosis
A child falls and holding his arm in inferolateral placement
what the Dx?
clavicle fracture
Which muscles are the Rotator cuff
SITS:
Supraspinatus
Infraspinatus
Teres minor
Subscapularis
A pt with decreased resistance when arms are outstretched, adduct, thumbs down
Which muscle is injured? Which nerve innervated him?
Supraspinatus muscle = Empty can test
abduction of 0-15 degrees
innervated by supra scapular
Abduction of arm
0-15
15-90
90-180
0-15- supraspinatus
15-90- deltoid (axillary)
90-180- trapzezius (CN XI) + serratus ant. (long thoracic nerve)
Pain under Acromnion, pain while lifting the arm above the head
Subacrominal bursitis
Pharmacological agent for bursitis?
NSIADS ( inhibting COX = less prostacyclin)
elbow swelling past few month + redness
no fever
olecranon bursitis
Pt who plays tennis it hurts when opens the door
lateral epicondylitis
extensor tendon
golf player
medial epicondylitis
common flexor tendon
Which are the 4 muscle flexors of the arm?
(AKa- golf player »_space; Medial-epicondylitis)
PFPF:
from radial to ulnar:
Pronator teres
flexor carpi radialis
Palmaris longus
Flexor carpi ulnaris
kid with upward traction
Dx?
how to fix?
Tear of the annular ligament at radial neck > hed of radial neck dislocation
hypoproneation maneuver
or
flex and supinate manuver
Cubital fossa structres:
Medial to lateral:
Medial nerve
Brachial artery
Biceps tendon
Superficial Radial nerve
MBTbRs
covered by bicipital aponeurosis
Numb in fingers mostly in night
Carpal tunnel = median nerve
3.5 lateral digits
Which wrist bone dislocation can cause Median nerve issues?
Lunate dislocation
What are the bones of the wrist? and order
top: Some Loves Try Positions
bottom: That They Can’t Handle
Scaphoid, Lunate, Triquetrum, pisiform
Trapezium , Trapezoid, Capitate, Hamate
Hypothyroidism, pregnancy, hyper typing (like secretary)
All of them can cause
Carpal tunnel syndrome
Hook of hamate nerve relations?
Ulnar nerve
Where Erb palsy happens
C5-C6
Which muscles are involved in Erb’s palsy?
how the hand will lokk
Deltoid
Infraspinatus
Biceps brachii
DIB
Hand look:
Writer tip: adduction, medially rotation, extended and pronated
Klumpke’w paralysis
nerves and muscles
position of the hand
C8-T1
lumbricals
interosseus
thenar
LIT
Ape hand = Claw hand
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?
Thoracic outlet syndrome»_space;
subclavian compress under clavicle/rib
Winged scapula muscle?
(Stab wounds, axillary LN dissection mastectomy)
Serratus ant. (long thoracic nerve)
What is the path of PCI (Cardiac catheterization)
Femoral arternal»_space; External iiliac»_space; common iliac»_space; aorta»_space; common artery
left femur shorter than right with lateral rotation
Femoral neck fracture + groin pain»_space; medical cirmcuflex femoral artery»_space; a-vascular necrosis
Back pain + lifting a box and shooting pain ,
What is the embryological structure most likely to derive from?
Notochord»_space; nuecluos pulposis (in disc hernia for exmaple)
Weakend hip extension and knee flection: Which nerve and muscle are affected?
Sciatic nerve.
Hamstrings muscles
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?
Posterior hip dislocation.
The femoral head taken out of the acetabular head
sciofemoral ligament torn
Legs shortened and medially rotated with foot drop
Posterior hip dislocation
The sciatic nerve»_space; branch is also common peroneal and anterior tibial
(foot drop common peroneal nerve )
Stepping gait with large contusion with point of tenderness to the proximal right leg.
Which nerve is affected?
Common peroneal nerve
What is the common peroneal nerve do
evert + dorsiflex (פלקס באצבעות ברגליים)
Fibular neck fractures can lead to ———– nerve injury
common peroneal
Pt is leaning forward when walking. when stand on his right leg his left hip is drop
What is the likely injured nerve?
Superior gluteal nerve»_space;
innervate Gluteus medium + minimus
inability to puul the hip up + abduction of thigh lost
when standing»_space; hip rise on the affected side
PT after abdominal surgery with burning pain , radiate to the inguinal and suprapubic region.
what is the likely affected nerve?
Iliohypogatric nerve
motor innervation : abdominous transversus
Laparoscopic surgery for cryptorchid testes. Absent cremasteric reflex. What is the nerve?
Genitofemral nerve - motor cremasteric muscle
L1-L2
sensory to the scrotum
Ant. + lateral leg tingling with tight jeans, obesity, pregnancy
Lateral femoral cutaneous nerve
Pelvic teratoma resection + medial thigh sensation with decreased adduction
Which nerve is most likely damaged?
Obturator nerve
sensory for the medial thigh
Motor: Adductor, Gracilis , pectineus
Anterior hip dislocation,
which nerve could be injured?
Obturator nerve
obese female with Medial knee pain over the anteromedial proximal tibia. no fracture
What is the likely diagnosis?
Pes anserine bursitis
After the femoral vein catheter. Diminish patellar reflex with decreased leg extension
Which nerve is injured? what he innervated?
Femoral nerve (L2-L4)
motor: Quadricept , sartorius)
Sensory: anterior thigh
What contains the Femoral Triangle?
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
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?
inversion.
TIP
Tibial nerve- can’t plantarflex
Inversion
Plantaris
*also sensory to the sole of the foot
popliteal fossa what is the structrue from superficial to deep:
Tibial nerve
popliteal vein
Popliteal artery
Which nerve runs through the tarsal tunnel?
Tibial nerve
can be compressed by the flexor retinaculum»_space; paraesthesia
Which nerve baker cyst can press?
Tibial nerve
difficult climbing stair, unable to get up from the chier
Hx: post. Hip dislocation?
Inferior gluteal nerve
Motor: gluteus maximus (extend of the hip- to get up of the chair and get up of te steps )
Post-partum. During labor, epidural Injection of the spine near the sacrospinous ligament. now with urinary incontenence
Which nerve may be implied?
Pudendal nerve (s2-S4)
motor: external urethral + anal sphincter
Female with hernia.
what is the anatomical region which superior to the pathology?
Femorl hernia»_space; Femoral rign»_space; inferior to the inguinal ligament
so the inguinal ligament is superior to that.
Which artery can be damaged while fixing a femoral hernia?
Obturator artery
What are direct and indirect hernias?
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
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?
Urachal cyst
Urine leaking from the umbilicus.
which fetal structure abnormality?
Urachus
Limping after rising in the morning.
no fracture.
Dx?
Plantar fasciitis - infl. of the plantar aponeurosis (bottom of the foot)
Attach to the medial tubercle of the calcaneus
Feeling “pop” in the knee, in flexed 90 degrees (ant. drawer test) and feel a shift of the tibia
ant. cruciate tendon
Soccer player complain knee giving out after she fell on her knee flexed
Dx?
Post. Cruciate tendon tear
Football player get tackled in the lateral side of the knee
What do we fear of?
Terrible triad
MAL - knee is very MAL
MCL- prevent hyper abduction.
ACL
Lateral meniscus
Pt noted excess varus laxity at the knee
LCL tear
LCL- prevernt hyper adduction
Locking sensation especially Twisting and squatting
Dx?
Meniscus tear
McMurray test for Meniscus»_space; twisting the
External rotation- Medial meniscus
Internal rotation - Lateral meniscus
The basketball player rolled his ankle. He has an ankle sprain
Which ligament is most likely affected?
The anterior -inferior talofibular ligament
overinversoin and supination of the foot
anterior placenta accerta can invade which stracture?
Most likely- Bladder
Prostatic plexus is originate from?
Inf. hypogastric plexus ( continuation of hypgastric nerve)
post. Prostectomy erectile dysfunction
which nerve is damage?
Inf. hypogastric nerve + pelvic and sacral splenchin nerves = prostatic plexus
leis in the fascia of prostate
proctectomy = damage to the fascia
Hemiballism is caused by
Damage to the sub-thalamic nuclues»_space; decrease excitation of globus palldus internus»_space; reducing inhibiton of thalamus»_space; movment disorder by wild involuntary of proximal limbs
What the cause of Osgood-schaltter disease
knee pain (in adolecsent ) due to overuse of the quadriceps muscle group
What is the fuction of quadriceps and where its insert
knee extension (when hiking, running)
insertion at - tibial tubercle»_space; cuase demege to tha area to a point of fregmentation of the tibial tubercle
When a focal seziure have preceded distinctive aura
where in the brain is found this abnormality that explain this aura ?
Mesial temporal lobe (eg. hippocampus, amygdala, parahippocampal gyrus)
most common by Hippocampal sclerosis -a/w childhoode febrile seizures
Pancoast syndrome
Clnical presenation:
- shoulder pain- radiating to axilla / scapula
- horner syndrome- cercial symp. ganglia
- spinal cord compression- if tumor expend to intravertebral lamina
Which nerve injury would lead to low extremity:
weakness in dorsiflexion, numbness of dorsal fott and posterior-lateral calf
Common Fibular (peroneal nerve)
Which nerve injury will cause weakness of knee flextion
Sciatic nerve
Which nerve injury wil cause a weakness in plantar flextion in inversion, abscent ankle reflex?
Tibial nerve
Landmark of Lumbar pancture?
Iliac crest
Hand bone mnemonic
Some Lovers Try Position That They Cant Handle:
Scaphoid, Lunate, Triquetrum, pisiform, Trapezium, Trapaziud, capitatem hamate
The vulva is drainage to which LN?
Inguinofemoral
Which female reproductive structures drain to the internal iliac LN
Cervix + proxinal vagina
Which female reproductive structures drain to the inguinofemoral LN
Vulva + Distal Vagina
A Stoke in the Thalamus can lead to—-?
Contralaterl complete sensory loss (Face and body ) = touch, pain, temperturem vibration, proprioception
Which muscle pass to the greater sciatic foramen and when injured can compress the sciatic nerve and cauase sciatic like symptoms
piriformis muscle
Which artery suppluy to proximal ureter and which the distal ureter?
proximal- Renal artery
distal- Sup. vesical artey
Neurovascular pairing
Axilla / lateral thorax
answer the nerve and artery related to this location
Long thoracic nerve
lateral thoracic artery
Neurovascular pairing
Surgical neck of humerus
answer the nerve and artery related to this location
Axilla nerve
Posterior circumflex artery
Neurovascular pairing
Midshaft of humerus?
answer the nerve and artery related to this location
Radial nerve
Deep brachial artery
Neurovascular pairing
popliteal fossa
answer the nerve and artery related to this location
Tibial nerve
Popliteal artery
Neurovascular pairing
Distal humrus/ cubital fossa
answer the nerve and artery related to this location
Median nerve
Brachial artery
Neurovascular pairing
posterior to medial malleolus
answer the nerve and artery related to this location
tibial nerve
posterior tibial arery
Which nerve root
loss of Achilles reflex?
S1 nerve
Difficult toe walking
heel walking is L5
Difficulty heel walking?
L5
also in dorsiflection
foot drop
Common fibular peroneal nerve (L4-S2)
PED- Peroneal evert and dorsiflex
If injuref your foot is dropped
