Anatomy x Surgery Flashcards by Nicz Alinsog

Common bruising sign of a skull injury

Raccoon eyes

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Failure of Dorsal induction

Neural tube defect

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Lesion in Broca’s Area

Left Parietal Lobe

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Foster Kennedy Syndrome Triad

Anosmia
Papilledema
Optic atrophy

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Horner’s Syndrome

Ptosis
Miosis
Anhydrosis

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An opacification in the upper maxillary sinus, which represents periorbital fat and possibly an entrapped extraocular muscle in the maxillary sinus.

Teardrop sign

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Elevator of the mandible

Medial pterygoid
Temporalis
Masseter

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Protractor of the jaw and depressor of mandible

Lateral pterygoid

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Branch of Glossopharyngeal nerve that supplies the Carotid sinus

Herring’s nerve

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All muscles of the tongue are supplied by CN XII except

Palatoglossus (pharyngeal plexus CN IX, X)

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All muscles of the soft palate are supplied by the pharyngeal plexus (CN X) except

Tensor Villi Palatini (Trigeminal)

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All muscles of pharynx innervated by CN X except

Stylopharyngeus CN IX

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All muscles of larynx innervated by CN X except

Cricothyroid- external branch of superior LN

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Kiesselbach’s plexus (Little’s area)

G- great palatine artery
A- anterior ethmoidal artery
S- sphenopalatine artery
S- superior labial artery

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What paranasal sinuses are present at the time of birth?

Maxillary and Ethmoid

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Carotid sheath contents

IC= Internal Carotid Artery
10= Vagus nerve
CC= Common Carotid Artery
IV= Internal jugular Vein

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First part of scalene anterior

Vertebral artery
Thyrocervical trunk
Internal thoracic artery

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What are the muscles innervate by Dorsal Scapular Nerve?

Rhomboid Minor
Rhomboid Major
Levator Scapulae

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Nerve innervation of suprascapular foramen, supraspinatus and infraspinatus.

Suprascapular nerve

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Lower scapular nerve innervates what muscle?

Teres major

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Middle scapular nerve innervates

Latissimus dorsi

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Long thoracic nerve innervates what muscle?

Serratus anterior

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What heart condition is Turner’s syndrome associated with?

Coarctation of aorta

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Indications for emergency thoracotomy

-Initial chest tube drainage >1500mL
->200 mL/hr x 4hrs

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Nerve Supply of Diaphragm

Phrenic nerve (C3 C4 C5)

Pain referred to the left shoulder on gentle palpation of the abdomen and classically associated with splenic rupture

Kehr sign

Beck’s triad

Distended neck veins Distant heart sounds Decreased blood pressure

‘Club cells’

Clara cells

What does club cells secrete

secretes GAG

Synthesized surfactants

Type 2 pneumocyte

Failure to pass NGT

Atresia

Most common type of atresia

Type C EA + distal TEF

Most common source of Pulmonary Embolism

Deep venous thrombosis

Classic Hx of pulmonary embolism

Sudden dyspnea and tachypnea

Wedge-shaped density

Hampton hump

Focal oligemia

Westermark sign

Enlarged right pulmonary artery

Palla sign

Gold standard for pulmonary embolism

Angiography

Tumor at the apex of the lung

Pancoast tumor

AKA Superior Sulcus Tumor

Pancoast tummor

Most common cardiac cause of cyanosis in the neonatal period

Transposition of great arteries

Egg-on-string sign

Transposition of great arteries

Machinery like murmur

Patent ductus arteriosus

Auscultation area of Mitral valve

L 5th ICS

Auscultation area of Tricuspid valve

4th ICS to the Left

Auscultation area of Pulmonary valve

2nd ICS to the Left of the sternum

Auscultation area of Aortic valve

2nd ICS to the right

Closure of AV valves

Closure of semilunar valves

Continues machinery like

PDA

Opening snap

Mitral stenosis

Midsystolic click

MVP

Pistol shot murmur, Austin Flint murmur

Aortic regurgitation

Occlusion due to thrombosis

Myocardial infarction

MC manifestation of MI

Chest pain

Tachycardia and HPN in anterior wall MI

James Reflex

HPN and bradycardia seen in inferior wall and posterior wall MI

Jarisch Bezold Reflex

MC used graft

Long/great saphenous vein

Supplies the anterior wall of the heart

Left anterior descending

Supplies the inferior, posterior, right ventricle and SA node

Right coronary artery

MC type of ASD seen in Down syndrome

Ostium Primum

Second most common congenital heart disease

Ventricular septal defect

MC valvular disease in children

VSD

MC type of VSD

Membranous type

Slowest velocity

AV node

Fastest conduction

Purkinje fibers

Pacemaker of the heart

SA node

Strongest layer of abdominal wall

Transversalis fascia

Most common cause of rectus sheath hematoma

Trauma

Palpable abdominal mass that remains unchanged with contraction

Fothergill sign

Bag of worms

Varicocele

Processus vaginalis in females

Canal of Nuck

Hesselbach/inguinal triangle boundaries

S = Inferior epigastric vessel M = Rectus abdominis muscle L = Inguinal ligament

Compartments of femoral sheath

M = femoral canal/lymphatic vessel Intermediate = femoral vein Lateral = femoral artery

Most common type of hernia

Indirect hernia

Most common type of hernia in females

Indirect hernia

Coexisting direct and indirect hernia

Pantaloon Hernia

Positive sign means pain relief and assoc with epidymitis

Prehn sign

Connection between the greater and lesser sac

Epiploic foramen (of Winslow)

Portal triad

Hepatic artery, common bile duct and portal vein

Compression of the hepatoduodenal ligament

Pringle maneuver

Most dependent portion of the abdominal cavity in the supine position

Morrison pouch

Most dependent area in the upright position

Cul-de-sac of Douglas

MC esophageal diverticulum

Zenker diverticulum

Triangle in Zenker diverticulum

Killian’s Triangle

Blood supply of cervical esophagus

Inferior thyroid artery

Blood supply of thoracic esophagus

Bronchial arteries

Blood supply of Abdominal esophagus

Left gastric and inferior phrenic artery

Failure of LES to relax

Achalasia

Type of CA assoc with Barrett esophagus

Adenocarcinoma

Intrinsic factor and HCl secreted by

Parietal cells

Pepsin secreted by

Chief cells

Gastrin secreted by

G cells

Projectile, non billous vomiting and palpable olive in the epigastrium

Pyloric stenosis

Rule of 2’s in Meckel Diverticulum

2% of the population Present in the first 2 years of life 2 inches long 2 feet from ileocecal valve 2 types of heterotropic tissue

Content of Meckel’s Diverticulum and strangulation and necrosis can occur in the absence of intestinal obstruction

Littre hernia

Hernia which Content: antimesenteric border of bowels

Richter hernia

Superior lumbar triangle

Grynfeltt-Lesshaft hernia

Inferior lumbar triangle

Petit hernia

Coffee bean sign

Sigmoid volvulus

Currant jelly stool

Intussusception

Most common type of intussuscpetion

Ileocolic

Colorectal cancer screening

Begin at age 50 Fecal occult blood testing Flexible sigmoidoscopy Colonoscopy

Blood supply of appendix

Appendicular artery

Most common susceptible to blunt trauma

Liver

Ampulla of Vater drains into

Posteromedial wall of the 2nd part of the duodenum

Major duodenal papilla

Main pancreatic duct (Wirsung)

Minor duodenal papilla

Accessory pancreatic duct (Santorini)

2nd MC congenital pancreatic anomaly

Annular pancreas

MC congenital pancreatic anomaly

Pancreatic divisum

Failure of fusion of the ventral and dorsal ducts

Pancreatic divisum

Discoloration of the flanks

Grey-turner sign

Ecchymoses or bruising around the umbilicus

Cullen’s sign

Gastrin secreting tumor

Zollinger-Ellison syndrome

Pancreaticoduodenectomy

Whipple procedure

Whipple disease is caused by what bacteria

Tropheryma whippeli

Whipple triad

Low blood glucose Symptoms of hypoglycemia Relief of symptoms after glucose intake

Most common inherited hemolytic anemia

Hereditary spherocytosis

Mutation in spectrin

Hereditary spherocytosis

Diagnostic test for hereditary spherocytosis

Osmotic fragility test

Most common fusion anomaly of the kidney

Horseshoe kidney

Chromaffin cells is secreted by

Adrenal medulla

5H of Pheochromocytoma

Hypertension Hypermetabolism Hyperglycemia Headache Hyperhidrosis

Diagnostic test for Pheochromocytoma

Vanillymandelic Acid (VMA)

Drug given preoperatively in Pheochromocytoma patient

Phenoxybenzamine

Derived from neural crest cells and most common extra-adrenal site of Pheochromocytoma

Organ of Zuckerkandl

Renal vein entrapment syndrome

Nutcracker syndrome

Compression of the third part of the duodenum

Superior mesenteric artery syndrome

Most common site of aneurysm

Abdominal aortic aneurysm

Most important risk factor for abdominal aortic aneurysm

Atherosclerosis

SMV + splenic vein

Portal vein

What are the primary curvatures of the Vertebral Column?

Thoracic Sacral

What are the secondary curvatures of the Vertebral column?

Cervical Lumbar

Exaggerated posterior curvature

Kyphosis

Exaggerated anterior curvature

Lordosis

High cervical spine injuries can cause arrest of respiration

C2 C3

Ligaments that contribute to the stability of vertebral column

Anterior longitudinal ligament Posterior longitudinal ligament Ligamentum flavum Interspinous ligaments

End of spinal cord in adults

End of spinal cord in newborn

Start of sigmoid colon

End of sigmoid colon

Level of IVC hiatus

Level of esophageal hiatus

T10

Level of aortic hiatus

T12

Breast, lung, prostate CA metastasize to the brain via internal vertebral plexus, basivertebral veins and external vertebral venous plexus that communicate with cranial dural sinuses and veins of thorax, abdomen and pelvis

Batson’s plexus

Congenital defect of the spine in which part of the spinal cord and it’s meninges are exposed through a gap in the backbone

Spina bifida occulta

Portion of vertebral body fails to develop leading to scoliosis

Hemivertebrae

Chronic stress fracture of pars interarticularis

Spondylolysis

Degenerative or traumatic defect of posterior neural arch

Spondylolysis

Body of lumbar moves anteriorly

Spondylolisthesis

Inflammatory condition of facets and periarticular structure

Spondylitis

Inflammatory osteoarthritis (+) HLA-B27 MC seronegative spondyloarthopathy Associated with Bamboo Spine

Ankylosing spondylitis

Central depression in vertebral body seen as fish mouth vertebra on Xray

Sickle cell anemia

Bacterial infection within vertebral bodies

Osteomyelitis

MCC of Osteomyelitis

S. Aureus and P. Aeruginosa

MCC in sickle cell anemia patients

Salmonella typhi

Found between the vertebra and dura mater

Epidural space

Tough, outermost layer

Dura mater

Between the dura and arachnoid

Subdural space

Adherent to spinal cord

Pia mater

Main blood supply to lower part of spinal cord

Great Radicular artery of Adamkiewicz

Dermatome of nipple

Dermatome of umbilicus

T10

Associated with ACL tear

Lateral menisci

Maneuver for ACL tear

Lachman test

Unhappy triad of O’Donoghue

Medial collateral ligament tear ACL tear Medial Meniscus tear

Continuation of semimembranosus

Baker’s cyst

MC fractured tarsal bone

Calcaneal fracture

MC ligament involved in ankle sprain

Anterior talofibular ligament

Supplies the gluteus medius and minimus

Superior gluteal nerve

MC cause of sciatic nerve injury

Intragluteal injection

Strongest ligament

Iliofemoral ligament of Bigelow

Landmark for introducing catheter into ureter

Interureteric fold

MCC type of bladder CA. Presentation are painless hematuria, smoking and aniline dyes

Transitional cell cancer

Pirifomis exits through

Greater sciatic foramen

PE for piriformis syndrome

FAIR test

Supplies the gluteus Maximus

Inferior gluteal nerve

Hamstring muscles

Bicep femoris Semitendinosus Semimebranosus

MC site of fertilization

Ampulla

Dark bluish or purplish-red vagina and cervix

Chadwick/Jacquimier sign

Softening of the isthmus

Hear sign

Softening of the cervix

Goodell sign

Partial failure of fusion of the Müllerian ducts

Bicornuate ducts

Complete failure of fusion of Müllerian ducts

Uterine didephys

MC cause is congenital adrenal hyperplasia Genotype: 46XX Phenotype: Masculinization of female external genitalia

Female pseudohermaphrodism

MC cause is a 5-a reductase deficiency which decrease of DHT Genotype 46 XY Phenotype: stunted development of male external genitalia

Male Pseudohermaphrodism

MC cause is mutation in the androgen receptor

Complete androgen insensitivity syndrome

Most significant passage to brachial plexus - Anterior to C6 transverse process

Erb's Point

UPPER Brachial Plexus Injury

Waiter’s tip C5-C6

LOWER Brachial Plexus Injury

KLUMPKE'S Palsy C8-T1

WRIST DROP and SATURDAY NIGHT Palsy

RADIAL Nerve Injury

APE HAND and POPE'S BLESSING Sign

MEDIAN Nerve Injury - Atrophy of Thenar Eminence

- MEDIAN Nerve Entrapment - TINEL'S sign - PHALEN'S sign

CARPAL TUNNEL SYNDROME

WINGING OF SCAPULA

LONG THORACIC Nerve Injury - Innervates SERRATUS ANTERIOR muscle

Fracture of Surgical Neck of Humerus

Axillary Nerve Injury

Fracture of the Shaft or Mid-portion of Humerus

Radial Nerve Injury

QUADRANGULAR Space

Superior: Subscapularis Inferior: Teres MAJOR Lateral: Humerus Medial: Triceps Contains: Axillary Nerve, Posterior Humeral Circumflex

CUBITAL FOSSA

Base: Line bet lateral & medial epicondyle Lateral: Brachioradialis Medial: Pronator Teres Where axillary artery enters to become radial & ulnar nerves

GOLFER'S Elbow

MEDIAL Epicondylitis

TENNIS Elbow

LATERAL Epicondylitis

Palmar aponeurosis thickening - usually seen in UREMIC px

DUPUYTREN'S Contracture

CLAW-LIKE Deformity - Supracondylar Fracture

VOLKMANN'S Contracture

Nerve responsible to referred chest pain (Ex. MI) to armpit & medial side of arm?

INTERCOSTOBRACHIAL Nerve Dermatome of Heart: T1-4 Dermatome of ICB nerve: T2

Nerve involved in ILL-FITTED CRUTCHES?

RADIAL Nerve Injury

CLAW HAND Deformity

ULNAR Nerve Injury

THORACODORSAL nerve is for?

LATISSIMUS DORSI muscle

ULNAR Nerve Palsy -Adductor policis muscle

FROMENT'S SIGN

-De Quervain Tendosynovitis

FINKELSTEIN SIGN

Rotator Cuff Muscles

SUPRAspinatus ☑️ INFRAspinatus ☑️ Subscapularis ☑️ Teres MINOR

Blood supply of Mid Rectum:

Mid Rectal A (from Internal Iliac A)

Blood supply of Upper Rectum:

Sup Rectal A (from Inf Mesenteric A)

Blood supply of Inferior Rectum:

Inf Rectal A (from Internal Pudendal A from IIA)