Blue Boxes Exam 1 Flashcards
1
Q
Where is cyanosis most noticeable?
A
The lips, eyelids, and deep to the transparent nails.
2
Q
What is it called when the skin looks abnormally red and what causes it?
A
It is called erythema and it is caused by engorged superficial capillary beds after skin injury, exposure to excess heat, infection, inflammation, or allergic reactions.
3
Q
What causes the yellow appearance of the whites of the eyes and skin and what is it called?
A
Bilirubin builds up in the blood in certain liver disorders. It is called jaundice.
4
Q
Surgeons attempt to minimize scarring for cosmetic reasons using surgical incisions that parallel the ___.
A
Langer lines, cleavage lines or tension lines is acceptable
5
Q
A bluish tint to the skin is called ___ and is caused by ____.
A
Cyanosis, defective circulation that is sending an inadequate amount of blood through the lungs.
6
Q
What are stretch marks caused by?
I think this got combined with Cushing’s Syndrome
A
Marked and relatively fast size increases cause distention and loosening of the deep fascia due to protein breakdown leading to reduced cohesion between the collagen fibers.
7
Q
What is a first degree burn?
A
Damage is limited to the epidermis and symptoms are erythema, pain, and edema. Desquamification of the superficial later (peeling) occurs several days later. No scarring
8
Q
What is a second degree burn?
A
The epidermis and superficial dermis are damaged with blistering (superficial) or loss (deep). It is the most painful burn because nerve endings are lost. Sweat glands and hair follicles are mostly unharmed and complete healing will occur (with some scarring)
9
Q
What is a third degree burn?
A
The entire thickness of the skin is damaged and perhaps underlying muscle. There is marked edema and sensory endings are destroyed.
10
Q
What is a major burn defined by the American burn association?
A
3rd degree burns over 10% of body surface area, 2nd degree burns over 25% body surface area, or any third degree burns on the face, hands, feet, or perineum
11
Q
Mortality exceeds 50% when the burn area exceeds ___% of the body surface area
A
70
12
Q
In the rule of nines for burns, what are the parts that make up the nines? What is the 1%?
A
The anterior and posterior head and neck Half of the anterior trunk (The other half of the anterior trunk) Half of the posterior trunk (The other half of the posterior trunk) (If you say the anterior and posterior trunk is 36% that's fine) Left arm Right arm (If you say some combination where the anterior and posterior arms, forearms, and hands equals 18% you're fine) The anterior thighs The anterior legs and feet The posterior thighs The posterior legs and feet (Any combination where the anterior and posterior thighs, legs and feet is 36% is fine) The perineum is the remaining 1%
13
Q
What are supernumerary bones?
A
Also known as accessory bones, these develop when additional ossification centers appear and form extra bones. It is important to know that accessory bones are common in the foot, to avoid mistaking them for bone fragments in radiographs and other medical images.
14
Q
What are sutural bones?
A
Small, irregular, worm-like bones seen along the sutures of the cranium where the flat bones abut, particularly those related to the parietal bone.
15
Q
What are heterotrophic bones?
A
Bones that sometimes form in soft tissues where they are not normally present. (Horse riders develop heterotrophic bones in their thighs often because of chronic muscle strain resulting in small hemorrhagic areas that undergo calcification and ossification.)
16
Q
What is osteoporosis?
A
A reduction in the quantity of bone or atrophy of skeletal tissue
17
Q
What is a sternal puncture?
A
A wide-bore needle is inserted through the thin cortical bone into the spongy bone of the sternum and a sample of red bone marrow is aspirated with a syringe for laboratory examination.
18
Q
What are lines of arrested growth (on X-rays)?
A
The degeneration of cartilage cells in the columns (of bone) continues during starvation and illness, but the proliferation of cartilage slows down, producing a dense line of provisional calcification. These lines later become bone with thickened trabeculae or lines of arrested growth.
19
Q
What can be mistaken for a fracture (on X-rays) (especially in children)? How do you tell the difference?
A
A displaced epiphysial plate or separation of an epiphysis.
The edges of the diaphysis and epiphysis are smoothly curved in the region of the epiphysial plate and bone fractures always leave a sharp, often uneven edge
20
Q
What are osteochondroses?
A
They are clinical disorders of epiphyses in children that result from avascular necrosis of unknown etiology.
21
Q
What are fontanelles?
A
They are fibrous tissue where the bones of the calvaria (skullcap) of a newborn infant’s cranium do not make full contact with each other
22
Q
What is the “soft spot”? (In babies)
A
The anterior fontanelle
23
Q
What does a bulging anterior fontanelle indicate?
A
Increased intercranial pressure. (It also bulges during crying)
24
Q
What does a depressed fontanelle indicate?
A
Dehydration of the baby
25
What is arthritis?
Degenerative joint disease
26
What is septicemia?
Blood poisoning
27
What is arthritis?
Inflammation of the joints
28
What is arthroscopy?
A surgical procedure where the cavity of a synovial joint is examined by inserting a cannula and an arthroscope into it.
29
What causes "buck teeth"?
A short lip that is unable to keep the teeth aligned by the to us of the muscle. Sorry this was a crappy card.
30
What is a muscle that is pulled or that sustains tears more than other muscles? Why?
The hamstrings. When the knee is extended, the hamstrings typically reach their maximum length before the hip is fully flexed
31
What replaces muscle fibers?
Satellite cells of skeletal muscle
32
When muscle size in a person grows, do the muscle cells divide?
No, muscle size can increase through the hypertrophy of existing fibers, not the addition of new fibers. Hypertrophy lengthens and increases myofibrils within the muscle fibers.
33
What is electromyography?
The electrical stimulation of muscles to test muscle action.
It records differences in electron action potentials of muscles during movement.
34
When does muscle tone disappear (the context is emg's)?
Sleep, paralysis, and under anesthesia.
35
What is compensatory hypertrophy? (In the heart)
It is when the myocardium responds to increased demands by increasing the size of its fibers. (If you think the parantheses gives it away, you can also have compensatory hypertrophy of smooth muscle)
36
What is a myocardial infarct?
A heart attack. An area of myocardial necrosis or fibrous scar tissue.
37
Are there satellite cells in cardiac muscle?
No
38
True or false: Smooth muscle cells in the uterine wall during pregnancy increase not only in size but also in number.
True
39
What is arteriosclerosis?
Hardening of the arteries
40
What is atherosclerosis?
The buildup of fat (mainly cholesterol) in the arterial walls.
41
What is an atheromatous plaque?
Also known as atheroma, it is a well-demarcated, hardened yellow area or swelling on the intimal surface of an arteries that is formed by calcium deposits.
42
What is thrombosis?
Formation of a local intravasular clot, or thrombus
43
What is an embolus?
A plug occlusing a vessel (a clot that has travelled distally)
44
What is ischemia?
Reduction of blood supply to an organ or region
45
What is an infarction?
Local death or necrosis of an area of tissue or an organ resulting from reduced blood supply
46
What is a varicose vein?
An abnormally swollen, twisted vein (most often seen in the legs) that is caused when the walls of veins loose their elasticity and incompetent valves.
47
What is incompetent fascia?
Fascia that is incapable of containing the expansion of contracting muscles.
48
What are the ways metastasis can occur?
Direct seeding of serous membranes of body cavities, lymphogenous spread (via lymphatic vessels) and hematogenous spread (via blood vessels)
49
What is contiguity (in relation to cancer)?
It is when cancer invades the body by growing into adjacent tissue.
50
What is the most common route for the dissemination of carcinomas?
Lymphogenous spread of cancer
51
What is a carcinoma?
An epithelial tumor
52
What is the most common route of metastasis of sarcomas?
Hematogenous spread of cancer (typically veins over arteries)
53
What is sarcoma?
Connective tissue cancer
54
What are the most common sites of secondary sarcomas?
The liver and lungs
55
What is lympangitis?
Secondary inflammation of lymphatic vessels
56
What is lymphadenitis?
It is secondary inflammation of lymph nodes.
57
What is lymphedema?
It is a localized type of edema that occurs when lymph does not drain from an area of the body
58
Solid cell growths may permeat lymphatic vessels and form minute ______ _____ which may break free and pass to regional lymph nodes.
cellular emboli
59
Why do the axons of the brain or spinal cord usually not recover?
The growth (of the proximal stumps that begin to regenerate) is blocked by astrocyte proliferation.
60
What is a rhizotomy?
It is a neurosurgical procedure in which either the posterior or anterior root of a spinal nerve is cut for the relief of intractable pain or spastic paralysis.
61
Do any neurons in adults regenerate?
Yes, but only those related to the sense of smell in the olfactory system
62
A "crushing" sub-sternal pain that does not disappear with rest is an indicator of ____.
Myocardial infarction
63
The first rib is located ____ to the clavicle.
Posteroinferior
64
What structures pass superior to the first rib?
The subclavian artery and the subclavian vein and the brachial plexus of nerves
65
Which area of ribs is most commonly fractured?
The middle
66
Where is the weakest part of the rib?
Just anterior to its angle
67
Fractures of the lower ribs may tear the ____ and result in a _____.
Diaphragm, diaphragmatic hernia
68
What is flail chest?
Multiple rib fractures may allow a sizable segment of the anterior and/or lateral thoracic wall to move freely (esp. during inspiration and expiration).
69
What is a thoracotomy?
It is the surgical creation of an opening through the thoracic wall to enter a pleural cavity. (H-shaped incisions seem to be popular for this procedure.)
70
Where does an anterior thoracotomy take place?
Through the perichondrium of one or more costal cartilages
71
Where does a posterior thoracotomy take place?
The posterolateral aspects of the 5th-7th intercostal spaces
72
What is a pneumonectomy?
Removal of a lung
73
What is a supernumary rib?
An extra rib, such as a cervical rib (.5-2% have one) or a lumbar rib
74
Can a child have an injury within the thorax caused by chest compression without a rib fracture?
Yes
75
What happens when costal cartilages undergo calcification?
They become radiopaque. Note, it is indicated that this does not always happen.
76
"Many people in their early 40s suddenly become aware of their ____ ____ ____ and consult their phycisian about the hard lump in the 'pit of their stomach'", fearing the development of a tumor.
ossified xiphoid process
77
The most common site of sternal fracture in eledrly people is at the ___ ___ and results in dislocation of the _____ ____.
sternal angle, manubriosternal joint
78
The concern in sternal injuries is not primarily for the fracture itself, but for the likelihood of ____ injury or ___ injury.
heart, lung. (The mortality rate associated with sternal fractures is 25-45%.)
79
Patients with sternal contusion should be evaluated for _____.
underlying visceral injury
80
The sternal body is often used for ___ ___ ___ ___
bone marrow needle biopsy
81
____ is an uncommon anomaly through which the heart may protrude.
Complete sternal cleft
| protruding heart seems to be called ectopia cordis
82
A perforation remaining in the sternal body because of incomplete fusion
sternal foramen. (It is not clinically significant)
83
receding sternum
pectus excavatum or funnel chest
84
projecting sternum
pectus cavinatum or pigeon breast
85
When clinicians refer to the superior thoracic aperture as the ____ ____ they are emphasizing the ____ and __ _____ ____ that emerge from the thorax through this aperture to enter the lower neck and upper limbs.
thoracic outlet
arteries
T1 Spinal nerves
86
Where does the obtruction causing thoracic outlet syndrome occur?
Outside the aperture in the root of the neck, and the manifestations of the syndrome involve the upper limb
87
Rib dislocation is _______.
The displacement of a costal cartilage from the sternum (dislocation of a sternocostal joint) or the displacement of the interchondral joints.
88
Displacement of interchondral joints usually occurs _____ and involves ribs ____.
unilaterally
| 8, 9, and 10
89
What is associated with displacement of interchondral joints?
Trauma sufficient to displace these joints often injures underlying structures, such as the diaphragm and/or liver (causing severe pain) and produces a lump-like deformity at the displacement site.
90
Rib separation is _____.
Dislocation of the costochondral junction.
91
In separations of the 3rd-10th ribs, tearing of the ________ and _____ usually occurs. As a result, the rib may move _____.
perichondrium
periosteum
superiorly
92
One can detect paralysis of the diaphragm radiographically by noting its ___________. Instead of ____ as it normally does during inspiration owing to diaphragmatic contraction, the paralyzed dome _____ because of pressure from _____.
paradoxical movement
descending
ascends
abdominal viscera (that are being compressed by the active contralateral dome)
93
Dypsnia
Difficulty breathing
94
When people with respiratory problems or difficulty breathing they use their _______ to assist the expansion of their thoracic cavity. They lean on their knees or on the arms of a chair to fix their _______ so these muscles are able to act on their rib attachments and expand the thorax.
accessory respiratory muscles
| pectoral girdle
95
Shingles
A herpes zoster infection that causes a classic, dermatomally distributed skin lesion. Primarily a viral disease of spinal ganglia, usually a reactivation of the varicella-zoster virus or chickenpox virus. Primarily a sensory neuropathy, but weakness from motor involvement occurs in 0.5-5% of people
96
Intercostal nerve block (low yield)
local anesthesia of an intercostal space produced by injecting an anesthetic agent around the intercostal nerves between the paravertebral line and the area of required anesthesia. (That's the obvious part)
It involves infiltration of the anesthetic around the intercostal nerve trunk and its collateral branches.
Complete loss of sensation usually does not occur unless two or more intercostal nerves are anesthetized.
97
Changes in breast tissue, such as _______, occur during ____ and _____.
branching of the lactiferous ducts
menstrual periods
pregnancy
98
Colostrum
a creamy white to yellowish premilk fluid. Believed to be especially rich in protein, immune agents, and a growth factor affecting the infant's intestines.
99
What are the four quadrants of the breast?
The superolateral, superiomedial, inferomedial, and inferolateral (not too hard). May be referred to as positions on a clock.
100
Adrenocarcinoma
glandular cancer
101
_____ may cause retraction of the nipple by a similar mechanism involving the lactiferous ducts
Subareolar breast cancer
102
The most common site of metastasis from a breast cancer
Axillary lymph nodes (The absence of enlarged axillary lymph nodes is no guarantee that metastasis from a breast cancer has not occurred. The malignant cells may have passed to other nodes, such as the infraclavicular and supraclavicular lymph nodes.)
103
The posterior intercostal veins drain into the ____ and communicate with the ____.
azygos/hemi-azygous system of veins
| internal vertebral venous plexus (surrounding the spinal cord)
104
When breast cancer cells invade the _______, attach to or invade the _____ overlying the pectoralis major, or metastasize to the interpectoral nodes, the breast ____ when the muscle contracts. This movement is a clinical sign of advanced cancer of the breast. To observe this ____ movement, the physician has the patient place her hands on her hips and press while pulling her _____ forward to tense her pectoral muscles.
```
retromammary space
pectoral fascia
elevates
upward
elbows
```
105
Mammography
radiographic examination of the breasts
106
Surgical incisions are made in the __________ when possible because these quadrants are less vascular.
inferior breast quadrants
107
deep skin fold beneath breast
inferior cutaneous crease
108
Incisions that must be made near the areola, of on the breast itself, are usually directed _____.
Radially (to either side of the nipple) or circumferentially
109
Mastectomy
breast excision (I almost typed beast excision)
110
Simple mastectomy
The breast is removed down to the retromammary space.
111
Radical mastectomy
Removal of the breast, pectoral muscles, fat, fascia, and as many lymph nodes as possible in the axilla and pectoral region.
112
In current practice, often only the ____ and ____ are removed, a ______ or _____ (known as breast-conserving surgery, a wide local exicision) - followed by ____.
tumor and surrounding tissue are removed
lumpectomy or quadrantectomy
radiation therapy
113
Supernumary breasts
Polymastia
114
Accessory nipples
Polythelia
115
Polymastia and polythelia usually occur along the location of the ______.
embryonic mammary crest
116
Amastia
No breast development
117
Approximately ___% of breast cancers occur in men.
1.5
118
Breast hypertrophy in males after puberty
gynecomastia
119
Gynecomastia may result from ________ and an evaluation must be initiated to rule out important potential causes, such as ____.
an imbalance between estrogenic and androgenic hormones or from a change in the metabolism of sex hormones by the liver
suprarenal or testicular cancer
120
Approximately 40% of postpubertal males with ______ have gynecomastia.
Klinefelter syndrome (XXY trisomy)
121
Wounds to the ______ may result in a ____, the presence of air in the pleural cavity.
base of the neck
| pneumothorax
122
The ____ is especially vulnerable to injury during infancy and early childhood because they have shorter necks. (Hint: layer that covers pleural cavity)
cervical pleura
123
Where might an abdominal incision inadvertently enter a pleural sac?
The right part of the infrasternal angle, the right and left costovertebral angles. (The small areas of pleura exposed in the costovertebral angles inferomedial to the 12th ribs are posterior to the superior poles of the kidneys.)
124
Atelectasis
collapse of lung
125
Primary atelectasis
The failure of the lung to inflate at birth
126
Secondary atelectasis
The collapse of a previously inflated lung
127
The pressure in the pleural cavities during inspiration
-8 mm Hg
128
The pressure in the pleural cavities normally
-2 mm Hg
129
The outer surfaces of the lungs adhere to the _____ as a result of the surface tension provided by the _____.
inner surface of the thoracic walls
| pleural fluid
130
In open-chest surgery, respiration and lung inflation must be maintained by intubating the trachea with a cuffed tube and using a ____.
positive-pressure pump
131
Entry of air into the pleural cavity
pneumothorax
132
rupture of a pulmonary lesion into the pleural cavity
bronchopulmonary fistula
133
bronchopulmonary fistula
rupture of a pulmonary lesion into the pleural cavity
134
The escape of fluid into the pleural cavity
pleural effusion
135
blood in the pleural cavity
hemothorax
136
Hemothorax results more commonly from injury to a ______ or ____ than from laceration of a ______.
major intercostal or internal thoracic vessel
| lung
137
both air and blood in the pleural cavity
hemopneumothorax
138
Thoracentesis
A hypodermic needle is inserted through an intercostal space into the pleural cavity to obtain a sample of fluid or to remove blood or pus
139
Where is the needle inserted in a thoracentesis?
In the costodiaphragmatic recess between the 9th and 10th rib in the midaxillary line during expiration. (The needle should be angled upward to avoid penetrating the deep side of the recess)
140
Where is a chest tube inserted?
In the fifth or sixth intercostal space in the midaxillary line
141
A resistant fibrous covering that inhibits expansion of the lung
lung decortication
142
What procedure is performed to prevent recurring spontaneous secondary atelectasis?
A Pleurectomy and pleurodesis that fuses the viesceral and parietal layers together (in one place)
143
Thoracoscopy
A diagnostic and sometimes therapeutic procedure in which the pleural cavity is examined with a thoracoscope
144
Inflammation of the pleura
Pleuritis/Pleurisy
145
How can pleurisy be detected?
The pleural rub/friction between the two pleurae makes a sound "like a clump of hairs being rolled between the fingers"
146
____ from the lungs carries ____ that remove carbon from the gas-exchanging surfaces and deposit it in the inactive connective tissue or in _______ .
Lymph,
Phagocytes,
lymph nodes
147
Auscultation of the lungs and percussion of the thorax should always include ______ where the apices of the lungs are located.
the root of the neck
148
The inferoposterior part of the inferior lobe is at the level of the _____ .
10th thoracic vertebra
149
Aspirated foreign bodies or food is more likely to enter the _____ .
The right main bronchus (because it is wider and shorter and runs more vertically than the left main bronchus)
150
A cartilaginous projection of the last tracheal ring
Carina
151
The cough reflex is associated with the ____ .
Mucous membrane covering the carina
152
Removal of a whole lung
pneumonectomy
153
removal of a lobe of a lung
lobectomy
154
Removal of a bronchopulmonary segment
segmentectomy
155
Does a segmental collapse (of lung) require compensating space in the pleural cavity to be realized?
No, adjacent segments will expand to compensate for the reduced volume of the collapsed segment.
156
embolus
Obstruction of a pulmonary artery by a blood clot
157
An area of necrotic lung tissue
pulmonary infarct
158
The presence of carbon particles in the axillary lymph nodes is presumptive evidence of ______.
pleural adhesion
159
The most common causes of hemoptysis
bronchitis, lung cancer, pneumonia, bronchiectasis, pulmonary embolism, and tuberculosis
160
Lung cancer (AKA)
bronchogenic carcinoma
161
Common sites of hematogenous metastases of cancer cells from a bronchogenic carcinoma
brain, bones, lungs, and suprarenal glands
162
Often the _______ are enlarged when bronchogenic carcinoma develops owing to metastases of cancer cells from lung tumors.
supraclavicular lymph nodes
163
Sentinel lymph nodes
the node or nodes that first recieve lymph draining from a cancer-containing area
164
Hoarseness could possibly indicate
apical lung cancer (because that's gonna be such an obvious symptom in a lifetime smoker...)
165
True or false: The visceral pleura is sensitive to pain.
False
166
True or false: The parietal pleura is sensitive to pain.
True
167
Irritation of the mediastinal and central diaphragmatic areas of parietal pleura results in referred pain to _____ .
The root of the neck and over the shoulder (C3-C5 dermatome).
168
The ______ is used to examine the thoracic respiratory and cardiovascular structures, as well as the thoracic wall.
posteroanterior projection or PA radiograph.
169
True or false: The right dome of the diaphragm, formed by the underlying liver, is usually approximately half an intercostal space higher than the left dome.
True
170
True or false: Lateral radiographs allow better viewing of a lesion or anomaly confined to one side of the thorax.
True
171
When standing or sitting upright, the central tendon of the diaphragm may fall to the level of the middle of the ____ and ____.
xiphoid process,
| T9-T10 IV discs
172
Mediastinoscopy
An endoscope is inserted through a small incision at the root of the neck, just superior to the jugular notch of the manubrium, into the potential space anterior to the trachea. This may be to view or biopsy mediastinal lymph nodes. (This could also be done through a thoracotomy.)
173
Common cause of widening of the inferior mediastinum
Hypertrophy of the heart due to congestive failure. Widening of the mediastinum is also often obvserved after trauma resulting from a head-on collision.
174
The SVC and IVC are ____ of the pericardium.
Inside
175
Inflammation of the pericardium
Pericarditis
176
By passing a surgical clamp or a ligature around the large vessels anterior to the ______, inserting the tubes of a coronary bypass machine, and then tightening the ligature, surgeons can stop or divert the circulation of blood in these arteries while performing cardiac surgery, such as ______.
transverse pericardial sinus,
| coronary artery bypass grafting
177
How do you detect pericarditis?
Usually the smooth opposing layers of serous pericardium make no detectable sound during auscultation. If there is pericarditis, friction of the roughened surfaces may sound like the rustle of silk when listening with a stethoscope over the left sternal border and upper ribs.
178
A chronically inflamed and thickened pericardium may ____.
calcify
179
Pericardial effusion
Passage of fluid from pericardial capillaries into the pericardial cavity, or an accumulation of pus
180
Non-inflammatory pericardial effusions occur with _____.
congestive heart failure
181
Congestive heart failure
Venous blood returns to the heart at a rate that exceeds cardiac output, producing right cardiac hypertension (elevated pressure in the right side of the heart).
182
Heart compression
Cardiac tamponade
183
Blood in the pericardial cavity
hemopericardium
184
Cardia tamponade
heart compression
185
Pericardiocentesis
drainage of fluid from the pericardial cavity
186
Where is a pericardiocentesis performed?
Through the left 5th or 6th intercostal space near the sternum. (May also be reached via the infrasternal angle by passing the needle superoposteriorly)
187
Apex of the heart is on right side (condition)
dextrocardia
188
Isolated dextrocardia
Only the heart is on the opposite side/right side
189
The thoracic and abdominal viscera (along with the heart) are transposed
situs inversus
190
Cardiac catheterization
A radiopaque catheter is inserted into a peripheral vein and passed under fluoroscopic control into the right atrium, right ventricle, pulmonary trunk, and pulmonary arteries, respectively.
191
Cineradiography
```
Cardiac ultrasonography (not positive these are actually the same thing)
(It can be performed to observe the flow of dye in real time (the dye is a radipaque contrast medium)
```
192
The line of fusion of the primordial atrium (the adult ___) and the sinus venarum (the derivative of the ______) is indicated internally by the ______ and externally by the ______.
auricle,
venous sinus,
crista terminalis,
sulcus terminalis
193
When does the oval foramen close?
When the baby takes its first breath
194
A congenital anomaly of the interatrial septum
atrial septal defect
195
_____ rank first on all lists of cardiac defects.
Ventricular septal defects
196
CVA
Cerebrovascular accident (occlusion of an artery supplying the brain).
197
Stenosis
Failure of a valve to open fully
198
Failure of a valve to open fully (heart)
stenosis
199
Insufficiency or regurgitation (heart)
failure of a valve to close completely
200
Failure of the valve (heart) to open fully
insufficiency or regurgitation
201
Heart murmur
Restriction of high-pressure blood flow (stenosis) or passage of blood through a narrow opening into a larger vessel or chamber that produces turbulence that sets up eddies that produce vibrations that are audible
202
Valvuloplasty
Replacement of defective or damaged cardiac valves
203
An insufficient or incompetent valve with one or both leaflets enlarged, redundant, or "floppy," and extending back into the left atrium during systole
Mitral valve prolapse or mitral valve insufficiency
204
Pulmonary valve stenosis
The valve cusps are fused, forming a dome with a narrow central opening
205
Infundibular pulmonary stenosis
The conus arteriosis is underdeveloped
206
Aortic valve stenosis
Most frequent valve abnormality, degenerative calcification is the cause, Results in left ventricular hypertrophy
207
Echoradiography
method of graphically recording the position and motion of the heart by the echo obtained from beams of ultrasonic waves directed through the thoracic wall. Can detect 20mL of fluid in the pericardial cavity.
208
Doppler echocardiography
Demonstrates and records flow of blood through the heart and great vessels (septal defects, stenosis vs regurgitation)
209
coronary angiography
Long, narrow catheter is passed into the ascending aorta via the femoral artery and a small injection of radiopague contrast material is made and cineradiographs are taken to show the lumen of the artery and its branches and any stenotic areas present.
210
The three most common sites of coronary artery occlusion
Anterior IV (LAD) branch of the LCA (40-50%)
RCA (30-40%)
Circumflex branch of the LCA (15-20%)
211
An area of myocardium that has undergone necrosis
myocardial infarction
212
CAD causes
(Coronary artery disease)
| MI, Coronary atherosclerosis, Slowly progressive CAD
213
Lipid deposits in the intima of the coronary arteries
atherosclerotic process
214
Cause of angina
Narrowed coronary arteries
215
How can angina be treated
sublingual nitroglycerin
216
How can you tell the difference between angina and MI
The pain from an MI does not disappear after 1-2 minutes of rest
217
Coronary bypass graft operation
A segment of an artery or vein is connected to the ascending aorta or to the proximal part of a coronary artery and then to the coronary artery distal to the stenosis.
218
What vein is often used for coronary bypass surgery?
The great saphenous vein
219
A procedure in which a small inflatable balloon attached to its tip is passed into the obstructed coronary artery.
percutaneous transluminal coronary angioplasty. (The balloon is inflated, flattening the atherosclerotic plaque against the vessel's wall.
220
Thrombokinase
An enzyme that dissolves blood clots.
221
Intravascular stent
maintains dilation of a vessel and maintain luminal patency
222
blood from the heart chambers
luminal blood
223
Stress test readings
Heart rate, EKG and blood pressure readings
224
The independent rate ventricles will contract at
25-30 times per minute
225
bundle branch block
Only one ventricle has a normally timed systole with a myogenic conduction of the other ventricle ( a late asynchronous contraction)
226
Fibrillation
Mutliple, rapid, circuitous contractions or twitchings of muscular fibers, including cardiac muscle
227
Atrial fibrillation
The normal regular rhythmical contractions of the atria are replaced by rapid irregular and uncoordinated twitchings of different parts of the atrial walls.
Usually circulation remains satisfactory
228
Ventricular fibrillation
The normal ventricular contractions are replaced by rapid, irregular intervals twitching movements that do not pump. No efective cardiac output, fatal if allowed to persist.
229
Defribillating electric shock
shock given to the heart through the thoracic wall via large electrodes
230
The heart is insensitive to
touch, cutting, cold, and heat
| IT IS SENSITIVE TO ischemia and the accumulation of metabolic products
231
Where do the axons of the heart's sensory neurons enter the spinal cord?
T1-T4 or T5 (especially on the left side)
232
Anginal pain is commonly felt as radiating from the ____.
substernal and left pectoral regions to the left shoulder and the medial aspect of the left upper limb.
233
The most superior part of the arch of the aorta is usually ___ to the superior border of the manubrium
(2.5 cm) inferior
234
Laceration of the thoracic duct during an accident or lung surgery results in ____ escaping into the thoracic cavity at rates ranging from ____.
lymph, 75-200 mL per hour
235
Lymph or chyle from the lacteals of the intestine entering the pleural cavity results in ____. (or is called, like the condition of it)
chylothorax
236
The superior part of the thoracic duct represents the original ___ member of a pair of lymphatic vessels in the embryo.
Left
237
If the inferior vena cava is blocked or the superior vena cava is blocked, the ____ system or ___ system can become the means of venous drainage. (Some people do not have one of these.)
azygous, hemiazygous.
The azygos, hemi-azygos, and accessory hemi-azygos veins offer alternated means of venous drainage from the thoracic, abdominal, and back regions when obstruction of the IVC occurs. If obstruction of the SVC occurs superior to the entrance of the azygos vein, blood can drain inferiorly into the veins of the abdominal wall and return to the right atrium through the azygos venous system and the IVC.
238
A _____ sometimes arises as the last (most-left-sided) branch of the arch of the aorta and crosses posterior to the esophagus to reach the right upper limb.
retro-esophageal right subclavian artery
239
Aneurysm
Localized dilation
240
Symptoms of an aortic aneurysm
Chest pain radiating to the back; difficulty breathing and swallowing due to pressure on the trachea, esophagus, and recurrent laryngeal nerve
241
The most common site for an aortic coarctation
Near the ligamentum arteriosum
242
The arch of the aorta or thoracic aorta has an abnormal narrowing
coarctation of the aorta
243
When the coarctation is inferior to the ligamentum arteriosum, a good collateral circulation usually develops between the proximal and distal parts of the aorta through the ______. This is called a ____.
intercostal and internal thoracic arteries,
| postductal coarctation
244
The thymus produces ___.
T-lymphocytes
245
The borders of the cardiovascular shadow in a PA radiograph
Right border: right brachiocephalic vein, SVC, right atrium, and IVC
Left border: terminal part of the arch of the aorta, pulmonary trunk, left auricle, and left ventricle
246
Types of cardiovascular shadows and their cause
Transverse type: observed in obese persons, pregnant women, and infants
Oblique type: characteristic of most people
Vertical Type: present in people with narrow chests
247
Vertebral body osteoporosis
net demineralization of the bones caused by a disruption of the normal balance of calcium deposition and resorption.
248
The most affected areas of osteoporosis
The neck of the femur, the bodies of vertebrae (especially Thoracic), the metacarpals, and the radius
249
Evidence of osteoporosis
Diminished radiodensity of the trabecular (spongy) bone of the vertebral bodies. Cortical bones appears relatively prominent. Vertical striping (loss of the horizontal supporting trabeculae and thickening of the vertical struts)
250
The surgical excision of one or more spinous processes and the adjacent supporting vertebral laminae in a particular region of the vertebral column
laminectomy (can also be transecting the pedicles)
251
Reasons for a laminectomy
relieve pressure on the spinal cord or nerve roots caused by a tumor, herniated IV disc, or bony hypertrophy
252
Jefferson or burst fracture
fracture of anterior arch and or posterior arch of atlas
253
Wide spreading of the lateral masses indicates a ___.
rupture of the transverse ligament of atlas
254
Fractures of the _____ of the ___ are one of the most common injuries of the cervical vertebrae (up to 40%).
vertebral arch,
| axis
255
A fracture of the pars interarticularis of atlas; cause
traumatic spondylolysis of C2 AKA hangman's fracture; hyperextension of head on neck
256
whiplash injury
hyperextension of the head and neck together
257
subluxation
incomplete dislocation
258
Quadriplegia
paralysis of all four limbs
259
Lumbar spinal stenosis
Narrow vertebral foramen in one or more lumbar vertebrae
260
Lumbar spinal nerves ____ in size as the vertebral column descends. The IV foramen ____ in size as the vertebral column descends.
increase,
| decrease
261
Treatment of lumbar stenosis
Decompressive laminectomy
262
A cervical rib may place pressure on what structures?
The subclavian artery or inferior trunk of the brachial plexus
263
Thoracic outlet syndrome
Compression of the subclavian artery or inferior trunk of the brachial plexus
264
In ____ a local anesthetic agent is injected into the fat of the _____ that surrounds the proximal portions of the sacral nerves.
caudal epidural anesthesia or caudal analgesia,
| sacral canal
265
Locations that epidural anesthesia can be administered through
The sacral hiatus (between the sacral coruna and the 4th sacral spinous process), the posterior sacral foramina into the sacral canal around the spinal nerve roots
266
Syndrome that can follow coccygeal trauma
coccydynia or coccygodynia
267
The L5 is partly or completely incorporated into the sacrum
hemisacralization / sacralization of the L5 vertebra
268
S1 is separated from the sacrum and is partly or completely fused with L5 vertebra
lumbarization of the S1 vertebra
269
Longitudinal growth is completed between ages ____.
18 and 25
270
With aging, the superior and inferior surfaces of the vertebrae become increasingly ____ and the IV discs become increasingly ____.
concave, convex
271
Bony spurs that commonly develop around the margins of the vertebral body
osteophytes
272
True or False: Sometimes the epiphysis of a transverse process fails to fuse
True
273
Spina Bifida occulta
The neural arches of L5 and/or S1 fail to develop normally and fuse posterior to the vertebral canal.
274
What is associated with spina bifida?
A tuft of hair
275
One or more vertebral arches fail to develop completely
spina bifida cystica
276
Spina Bifida Cystica
One or more vertebral arches fail to develop completely
277
herniation of the meninges
meningocele
278
memingomyocele
herniation of the spinal cord and meninges
279
Spina bifida is a result of ____.
Neural arch defects
280
Nuclei pulposi ____ and loose ______ and ____ while gaining ____ with aging.
dehydrate, elastin and proteoglycans
| while gaining collagen
281
True or False: Intevertebral discs decrease in size with age.
False
282
Posterolateral herniated discs often produce ___ and ___ back pain
localized and acute
283
Approximately 95% of lumbar disc protrusions occur at the _____ levels.
L4-L5 or L5-S1
284
Sciatica
Pain in the lower back and hip radiating down the back of the thigh into the leg
285
Cause of sciatica
often herniated lumbar IV disc that compresses and compromises the L5 or S1 component of the sciatic nerve.
286
zygapophysial joint
facet joints between the two articular facets of vertebra
287
The cervical IV discs most commonly ruptured
C5-C6 and C6-C7
288
The most common dens fracture occurs at its ____.
base
289
Fractures of the dens usually result in _____ (of the dens).
avascular necrosis
290
atlantoaxial subluxation
incomplete dislocation of the median atlanto-axial joint
291
What ligament is especially endangered in a whiplash injury?
The anterior longitudinal ligament
292
The most fractured noncervical vertebrae
T11 and T12
293
Fracture of the column of bones connecting the pars interarticularis
Spondylolysis
294
Spondylolithesis
Dislocation between adjacent vertebrae
295
Nerves involved in back pain
Fibroskeletal structures: periosteum, ligaments, and anuli fibrosi of IV discs
Meninges: coverings of the spinal cord
Synovial joints: Capsules of the zygapophysical joints
Muscles: Intrinsic muscles of the back
Nervous tissue: spinal nerves or nerve roots exiting the IV foramina
296
The meninges and fibroskeletal structures are innervated by ___.
Reccurrent meningeal branches of the spinal nerves
297
Humpback
Excessive thoracic kyphosis
298
Hollow back or sway back
Excessive lumbar lordosis
299
Lordosis is associated with ___.
Weakened trunk musculature
300
Scolisosis
Abnormal lateral curvature
301
Failure of half of a vertebra to develop
hemivertebra
302
When a person is standing, an obvious inclination or listing to one side may be a sign of ____ that is secondary to a _____.
Scoliosis,
| herniated IV disc
303
Myelography
Radiopaque contrast procedure that allows visualization of the spinal cord and spinal nerve roots
304
Leptomeninges
The arachnoid and pia mater together (form this)
305
The leptomeninges develop as ___ from the ___ surrounding the _____.
a single layer,
mesenchyme,
embryonic spinal cord
306
The withdrawal of CSF from the lumbar cistern
Lumbar puncture
307
Lumbar punctures occur between ____.
The spinous processes of the L3 and L4 (or L4 and L5) vertebrae.
308
supracristal plane
a plane transecting the highest points of the iliac crests
309
Lumbar puncture is not performed in the presence of ___.
Increased intracranial pressure
310
If blood supply from the spinal and medullary arteries is not present, what else can supply blood to the anterior and posterior spinal arteries?
The segmental medullary arteries
311
Transection of the spinal cord between C1-C3 will result in:
No function below head level; a ventilator is required to maintain respiration
312
Transection of the spinal cord between C4-C5 will result in:
Quadriplegia; respiration occurs
313
Transection of the spinal cord between C6-C8 will result in:
Loss of lower limb function combines with a loss of hand and a variable amount of upper limb function; the individual may be able to self-feed or propel a wheelchair.
314
Transection of the spinal cord between T1-T9 will result in:
Paraplegia; the amount of trunk control varies with the height of the lesion
315
Transection of the spinal cord between T10-L1 will result in:
Some thigh muscle function, which may allow walking with long leg braces
316
Transection of the spinal cord between L2-L3 will result in:
Retention of most leg muscle function; short leg braces may be required for walking.
317
One of the most frequently fractured bones
clavicle
318
Greenstick fracture
One side of a bone is broken and the other is bent
319
First bone to ossify
clavicle
320
The last of the epiphyses of long bones to fuse
A secondary ossification center appears at the sternal end and forms a scale-like epiphysis that begins to fuse with the shaft (daiphysis) (of the clavicle)
So sternal end of the clavicle
321
True or false: Sometimes fusion of the two ossification centers of the clavicle fails to occur.
true
322
Most injuries of the proximal end of the humerus are _____.
fractures of the surgical neck
323
What are some fractures of the humerus?
Spiral fracture (fall on arm), transverse fracture of the shaft of the humerus (direct blow), fracture of the surgical neck (most common, fall), avulsion fracture of the greater tubercle (fall on shoulder, fall when arm is abducted), intercondylar fracture of the humerus (fall on flexed elbow)
324
```
Match the parts of the humerus to the nerve it corresponds to:
Surgical neck
Radial groove
Distal end of humerus
Medial epicondyle
```
S-Axillary nerve
R-Radial nerve
D-Median nerve
M-Ulnar nerve
325
Colles fracture
A complete transverse fracture of the radius (usually the result of forced extension of the hand, usually the result of a fall after outstretching the upper limb) (the most common fracture of the forearm) (The distal fragment is displaced dorsally)
326
bone broken into pieces
comminuted fracture
327
Dinner fork deformity
posterior angulation that occurs in the forearm just proximal to the wrist and the normal anterior curvature of the relaxed hand (after a colles fracture)
328
avulsed
broken off
329
True or false: Normally the ulnar styloid proccss projects father distally than the radial styloid.
False
330
Most frequently fractured carpal bone
scaphoid
331
arthrodesis
fusion of bone (fusion of carpals) surgically
332
A fracture of the scaphoid may not be visible for ___.
10-14 days when bone resoption begins to occur
333
Which nerve should be considered if there is a fracture of the hamate?
The ulnar nerve
334
Boxer's fracture
fracture of the 5th metacarpal (occurs when an unskilled person punched someone with a close and abducted fist)
335
hematoma
local collection of blood
336
Poland syndrome
both the pectoralis major and minor are absent
337
Winged scapula
The medial border and inferior angle of the scapula pull markedly away from the posterior thoracic wall when a person leans on a hand or presses the upper limb against a wall. It occurs when the serratus anterior is paralyzed.
338
Borders of the triangle of ascultation;
| Floor of the triangle
The superior horizontal border of the latissimus dorsia, the medial border of the scapula, and the inferolateral border of the trapezius.
The floor is the 6th intercostal space and the 6th and 7th ribs
339
Manifestation of spinal accessory nerve palsy
marked ipsilateral weakness when the shoulders are elevated against resistance
340
Manifestation of paralysis of the latissimus dorsi
inability to raise the trunk with the upper limbs, inability to use axillary crutch
341
Manifestation of injury to dorsal scapular nerve
scapula on the affected side is located farther from the midline than that on the normal side
342
The axillary nerve in relation to other structures in the upper arm
innervates the deltoid and a patch of skin in the area, winds around the surgical neck of the humerus with the posterior circumflex humeral artery
343
True or false: In adolescents, the joint capsule of the glenohumeral joint is stronger than the epiphysial plate (of the humerus)
True
344
What arteries are involved in the anastomoses of the scapula?
Dorsal scapular artery, suprascapular artery, and circumflex scapular artery
345
Where can the axillary artery be compressed?
Against the humerus in the lateral wall of the axilla and at its origin (as the subclavian artery crosses the 1st rib)
346
_______ may occur in baseball pitchers and football quarterbacks because of their rapid and forceful arm movements.
Aneurysm of the axillary artery
347
A wound to the axillary artery can cause profuse bleeding and ____.
Air emboli
348
The axillary vein lies ____ to the axillary artery.
Anterior and inferior
349
What nerves are at risk during axillary node dissection?
Thoracodorsal and long thoracic nerves
350
Prefixed brachial plexus
The anterior root of C4 contributes to the plexus and the inferiormost root is C8.
351
Postfixed brachial plexus
The superior root of the brachial plexus is C6 and the inferior root is T2. This type can have a plexus compressed by the first rib
352
Manifestation of injury to the superior trunk of the plexus
"waiter's tip position" in which the limb hangs by the side in medial rotation
353
Erb-Duchenne palsy
injuries to the superior parts of the brachial plexus
354
What is one area where cords of the brachial plexus be compressed?
Between the coracoid procss of the scapula and the pectoralis minor tendon
355
Manifestation of injuries to the inferior parts of the brachial plexus
Claw hand (short muscles of the hand (ulnar nerve))
356
Approaches for brachial plexus block
interscalene, supraclavicular, and axillary approach or block
357
How is the biceps reflex tested?
The relaxed limb is passively pronated and partially extended at the elbow. The examiner's thumb is firmly placed on the biceps tendon and the reflex hammer is briskly tapped at the base of the nail bed of the examiner's thumb.
358
Which nerves does the biceps reflex test check?
The musculocutaneous nerve and the C5 and C6 spinal cord segments
359
crepitus
a crackling sound (related to bone, joint, possibly ligament)
360
Where is the biceps tendon located?
The long head is located in the intertubercular groove and its origin is the supraglenoid tubercle of the scapula. (The short head attaches to the coracobrachialis)
361
What happens when the biceps tendon ruptures?
The detached muscle belly forms a ball near the center of the distal part of the anterior aspect of the arm
362
Stopping bleeding through manual or surgical control of blood flow
hemostasis
363
The brachial artery may be clamped distal to the origin of the _____ without producing tissue damage.
Deep artery of the arm or profunda brachii artery.
364
Muscles and nerves can tolerate up to ___ of ischemia.
6 hours
365
Ischemic compartment syndrome
Fibrous scar tissue replaces necrotic tissue and causes the involved muscles to shorten permanently, producing a flexion deformity
366
A midhumeral fracture can damage the ___ nerve.
Radial
367
Injury to the musculocutaneous nerve results in ___.
Paralysis of the brachialis, coracobrachialis, and biceps, which results in weak flexion of the elbow joint and supination of the forearm.
368
Injury to the radial nerve results in ___.
Paralysis of the triceps brachii, brachioradialis, supinator, and extensor muscles of the wrist and fingers.
369
What is the manifestation of radial nerve injury?
Wrist drop (inability to extend the wrist and fingers at the metacarophalangeal joints).
370
The ____ is the common site for sampling and transfusion of blood and intravenous injections because of the prominence and accessibility of veins.
Cubital fossa
371
The median cubital vein is ___ to the brachial artery.
Superficial
372
Lateral epicondylitis is also known as __.
elbow tendinitis or tennis elbow
373
Mallet finger is a result of injury or avulsion of ___.
a long extensor tendon (extensor digitorum)
374
True or false: Fracture of the olecranon does not require a cast.
False
375
Common site of synovial cyst of wrist
the distal attachment of the extensor carpi radialis brevis tendon to the base of the 3rd metacarpal
376
A cystic swelling of the common flexor synovial sheath on the anterior aspect of the wrist can enlarge enough to produce compression of the ____ by narrowing the ____..
median nerve, carpal tunnel
377
True or false: Sometimes the ulnar artery descends superficial to the flexor muscles but normally it does not.
True (this is important because it can be mistaken for a vein)
378
The inability to flex digits two and three into a compact fist (but ability to flex the other digits) indicates:
injury to median nerve (this is also known as the "hand of benediction")(Thenar muscle function is also lost)
379
The inability to flex the distal interphalangeal joint of the index finger indicates?
Injury to the anterior interosseus nerve
380
When a person cannot make the "okay" sign and makes a pinching gesture instead, which nerve is injured?
The anterior interosseus nerve
381
Pronator syndrome
A nerve entrapment syndrome caused by compression of the median nerve near the elbow. (between the heads of the pronator teres)
382
Symptoms of pronator syndrome
pain and tenderness in the proximal aspect of the anterior forearm and hypesthesia (decreased sensation) of palmar aspects of the radial three and ahlf digist and adjacent palm
383
hypesthesia
decreased sensation
384
True or false: Communications occur between the median and ulnar nerves in the forearm.
True (they can happen)
385
Where do ulnar nerve injuries usually occur?
Posterior to the medial epicondyle of the humerus; in the cubital tunnel formed by the tendinous arch connecting the humeral and ulnar heads of the flexor carpi ulnaris; at the wrist; and in the hand
386
Most common ulnar nerve injury location
where the nerve passes posterior to the medial epicondyle of the humerus
387
Inability to flex the fourth and fifth digits indicates injury of the ___ nerve.
ulnar
388
The radial nerve is usually injured in the arm by ____ .
fracture of the humeral shaft
389
Wrist-drop is an indication of ___.
radial nerve injury
390
How can injury to the deep branch of the radial nerve be tested?
The patient is asked to extend the MP joints while the examiner provides resistance. If the nerve is intact, the long extensor tendons should appear prominently on the dorsum of the hand.
391
What is dupuytren contracture?
It is a disease of the palmar fascia resulting in progressive shortening, thickening, and fibrosis of the palmar fascia and aponeurosis. The fibrous degeneration of the longitudinal bands of the palmar aponeurosis on the medial side of the hand pulls the fourth and fifth fingers into partial flexion at the metacarpophalengeal and proximal interphalangeal joints. (Do not confuse with median nerve injury)
392
Where are hand infections most likely to appear?
On the dorsum of the hand
393
Tenosynovitis
inflammation of the tendon and synovial sheath
394
True or false: The tendons of the second, third, and fourth fingers nearly always have separate synovial sheaths
True
395
Tenosynovitis in the ____ may spread to the common flexor sheath.
(synovial sheath of the) fifth digit
396
Parona space
The space between the pronator quadratus and the overlying flexor tendons
397
Quervain tenovaginitis stenosans
Fibrous thickening of the sheath and stenosis of the osseofibrous tunnel (that encloses the APL and EPB)
398
Trigger finger
Thickening of a fibrous digital sheath on the palmar aspect of the digit produces stenosis of the osseofibrous tunnel, and if the tendons of the FDS and FDP enlarge proximal to the tunnel, the person is unable to extend the finger.When the finger is extended passively, there is an audible snap.
399
Raynaud syndrome
Intermittent bilateral attacks of ischemia of the digits marked by cyanosis and often accompanied by paresthesia and pain
400
A presynaptic sympathectomy may be required to treat Raynaud syndrome because the procedure results in ____.
dilation of the digital arteries
401
Where are lesions of the median nerve likely to occur?
The forearm and the wrist, most commonly where the nerve passes through the carpal tunnel
402
What is affected by carpal tunnel syndrome?
Paresthesia, hpoesthesia, or anesthesia of the lateral three and a half digits, weakness of the three thenar muscles (abductor pollicis brevis, opponens pollicis, flexor pollicis brevis)
403
Simian hand
A deformity in which thumb movements are limited to flexion and extension of the thumb in the plane of the palm. Caused by injury to the recurrent branch of the median nerve.
404
Ulnar Canal Syndrome
Compression of the ulnar nerve where it passes between the pisiform and the hook of hamate (covered by the pisohamate ligament). Hypothesia in the medial one and a half fingers occurs and weakness of the intrinsic muscles of tha hand. Clawing of the 4th and 5th fingers may occur, but their ability to flex is unaffected.
405
Handlebar neuropathy
Compression of the ulnar nerve caused by long bicycle journeys
406
The science of studying ridge patterns of the palm
dematoglyphics (Patients with trisomy 21 have dematoglyphics that are highly characteristic)
407
Most dislocations of the sternoclavicular joint in persons less than 25 years of age result from fractures through the ____.
epiphysial plate (because the epiphysis at the sternal end of the clavicle does not close until 23-25 years of age)
408
stiffening or fixation of the joint
ankylosis
409
"Shoulder separation"
Acromioclavicular and coracoclavicular ligament torn
410
Inflammation and calcification of the subacromial bursa
calcific scapulohumeral bursitis
411
Where does pain related to subacromial bursitis occur?
Abduction of the arm during 50-130 degrees of abduction
412
Coracoacromial arch
Coracoid process, coracoacromial ligament, and acromion
413
Test for degenerative tendonitis of the rotator cuff
Patient asked to lower the fully abducted limb slowly and smoothly. If from ~90 degrees abduction the limb suddenly drops to the side , this is an indication of disease or torn supraspinatus tendon.
414
Inability to abduct the arm the first fifteen degrees is a sign of ___, but inability to abduct the arm to or above the horizontal level indicates ___. (The ____ is responsible for abduction above horizontal.)
a torn supraspinatus tendon,
damage to the axillary nerve (caused by fracture to the surgical neck of the humerus or anterior dislocation of the glenohumeral joint),
trapezius
415
Adhesive capsulitis
adhesive fibrosis and scarring between the inflamed joint capsule of the glenohumeral joint, rotator cuff, subacromial bursa, and deltoid. Difficulty abducting the arm
416
Names for busitis of the subcutaneous olecranon bursa
student's elbow, dart thrower's elbow, miner's elbow
417
Types of bursitis of the elbow (knowing which bursa are there)
Subtendinous olecranon bursitis (not common), bicipitoradial bursitis, subcutaneous olecranon bursa
418
Tommy John procedure
Reconstruction of the Ulnar collateral ligament; autologous transplant of a long tendon from the contralateral forearm or leg (palmaris longus)
419
Bull rider's thumb
sprain of the radial collateral ligament and an avulsion fracture of the lateral part of the proximal phalanx of the thumb.
420
Skier's thumb (or game-keeper's thumb)
rupture or chronic laxity of the collateral ligament of the first metacarpalphalangeal joint of the thumb resulting from hyperabduction of the MP joint
421
When a child is suddenly lifted by the upper limb while the forearm is pronated, this can happen
Subluxation of the head of the radius. The distal attachment of the anular ligament can be torn from the neck of the radius. The proximal part of the torn ligament may become trapped between the head of the radius and the capitulum of the humerus.
422
Common sites of ectopic pregnancy
Uterine tubes: ampulla and isthmus
423
Lithopedion
Stone fetus, calcified fetus (undetected abdominal fetus dies)
424
Most spontaneous abortions occur during the ____ .
first 3 weeks
425
Miscarriage occurs within the first 12 weeks ____% of the time.
10-20
426
How do morning after pills work?
They prevent implantation of the embryo
427
What is the active ingredient in plan B?
Progesins and/or estrogens or diethylstilbestrol
428
What is one reason an error could occur in determining the expected delivery date of a baby?
Implantation bleeding can be mistaken for menstruation
429
A tumor resulting from persistent remnants of the primitive streak
sacrococcygeal teratoma
430
Sacrococcygeal teratoma
tumor resulting from remnants of the primitive streak
431
chordoma
Tumor that forms from vestigial remnants of notochordal tissue.
432
Allantoic cyst
remnants of the extraembryonic portion of the allantois
433
Meroencephaly
Partial absence of the brain (sometimes called anencephaly, neural tube defect)
434
Hydatiform moles
degenerating villi form cystic swellings
435
choriocarcinoma
3-5% of hydatiform moles develop into malignant trophoblastic lesions
436
Complete hydatiform
fertilization of an empty oocyte, fertilization of an oocyte with two sperm (I'm kinda confused about what these are)
437
Treponema pallidum
organism that causes syphilis (it can coss the placental membrane)
438
Method that Toxoplasmic gondii enters placenta
creates lesions and crosses the placental membrane through defects created
439
hemolytic disease of the newborn or fetal erythroblatosis
If the fetus is Rh positive and the mother is Rh negative may stimulate the formation of anit-Rh antibodies in the mother which can pass to the fetus and cause jaundice and anemia
440
Preeclampsia
Maternal hypertensions, proteinurea, and edema are essential features of this condition
441
Placenta acreta
abnormal adherence of chorionic villi to the myometrium
442
placenta percreta
When chorionic villi penetrate the full thickness of the myometriumto or through the perimetrium (peritoneal covering)
443
placenta previa
when the blastocyst implants close to or overlying the internal os of the uterus. C-section most likely required (if os is obstructed)
444
oligohydramnios
low volumes of amniotic fluid
445
Polyhydramnios
high volumes of amniotic fluid; associated with meroencephaly
446
Amniotic band syndrome
symptoms: digital constriction, major scalp, craniofacial, and visceral defects
447
Superfecundation
fertilization of two or more oocytes at different times
448
Ichthyosis
excessive keratinization
449
harlequin fetus
Autosomal recessive, mutation of ABCA12 gene, skin markedly thickened, ridged, cracked. Most neonates die in first week.
450
Collodion infant
covered by a thick, taut membrane that resembles colloidon (a protective film) or parchment, deficiency of transglutaminase-1
451
Lamellar ichthyosis
Autosomal recessive, inability to sweat, similar to collodion infant but scaling persists
452
Ectrodactyl-ectodermal dysplasia-clefting syndome
congenital skin condition that is inherited as an autosomal dominant trait. It involves both ectodermal and mesodermal tissue, consisting of ectodermal dysplasia associated with hypopigmentation of skin and hair, scanty hair and eyebrows, absence of eyelashes, nail dystrophy, hypodontia and microdontia, etrodactyly, and cleft lip and palate.
Defect in the P63 gene coding for a transcription factor
453
generalized albinism
skin, hairs, and retina lack pigment
454
piebaldism
lack of melanin in patches of skin and/or hair
455
angioma
persistent transitory and/or surplus primitive blood or lymphatic vessels
456
cystic lymphangiomas
aka cystic hygromas are angiomas composed of lymphatics
457
Nevus flammeus
flat, pink or red, flame-like blotch that often appears on the posterior surface of the neck
458
port-wine stain hemangioma
larger and darker angioma than a nevus flammeus and is nearly always anterior or lateral on the face and/or neck
459
common angioma
pinkish-red blotch
460
Sturge-Weber syndrome
A port-wine stain in the area of distribution of the trigeminal nerve is sometimes associated with a similar type of angioma of the meninges of the brain and seizures at birth
461
athelia
absence of nipples
462
amastia
absence of the breast
463
hypoplasia of the breast
underdevelopment of the breast
464
apalasia (of the breast)
breasts of unequal size
465
extra nipples
polythelia
466
alopecia
absence or loss of scalp hairs
467
excessive hairiness
hypertrichosis
468
pili torti
The hairs are twisted and bent
469
congenital absence of nails
aplastic anonychia
470
What congenital anomaly is associated with maternal rubella?
Patent ductus arteriosis
471
Klippel-feil syndrome
Shortness of the neck, low hairline, and restricted neck movements, fusion of cervical vertebral bodies and abnormalities of the brainstem and cerebellum
472
hemivertebra
failure of one of the two osification centers in a vertebra to form
473
Rachischisis
cleft vertebral column (spinal dysraphism)
474
pectus excavatum
concave depression of the lower sternum
475
acrania
complete or partial absence of the neurocranium
476
meroencephaly
partial absence of the brain
477
prenatal fusion of the cranial sutures
craniosynostosis
478
scaphocephaly
saggital suture closes early, the cranium becomes long, narrow, and wedge-shaped
479
Premature closure of the coronal suture
results in high, tower-like cranium, brachycephaly
480
If the coronal suture closes prematurely on one side only
plagiocephaly
481
Trigonocephaly
premature closure of the frontal suture (deformity of the frontal bone)
482
dwarfism
achondroplasia
483
Thanatophoric dysplasia
lethal skeletal dysplasia; mutations in fibroblast growth factor receptor 3
484
Amelia
Missing limb (4th week)
485
meromelia
absence of part of limb (fifth week)
486
hemimelia
absence of fibula in the leg
487
phocomelia
hands and feet are attached close to the body
488
What causes bifurcate hand and cleft foot?
split hand/foot malformations are caused by the failure of a digital ray to develop
489
shortness of the digits
brachycadtyly
490
supernumary digits
polydactyly
491
simple webbing between digits
cutaneous syndactyly
492
osseus syndactyly
fusion of bones (when the notches between digital rays fail to develop)
493
congenital clubfoot
talipes equinovarus, multifactorial inheritance, abnormal position of foot so that it is not weight-bearing
494
Developmental dysplasia of the hip
Joint capsule is loose
| abnormal development of acetabulum or generalized joint laxity
495
absence of abdominal muscles
prune belly syndrome, results from abdominal laxity secondary to abdominal distenstion from ascites (accumulation of serous fluid in the abdominal cavity)
496
failure of the testes to descend
cryptorchidism
497
dilation of ureters
megaureters
498
Congenital torticollis
wryneck, may result from tearing of fibers of sternocleidmastoid
499
Arthrogryposis
multiple congenital joint contraction
500
Hyperpituitarism can result in?
gigantism, agromegaly, (excessive secretion of growth hormone)
501
Hypothyroidism can result in?
cretinism (growth retardation, mental deficiency, skeletal abnormalities, and auditory and neurological disorders)(delayed epiphysial development) (deficiency in thyroid hormone) (lack of iodine)
502
basilar invagination
superior displacement of bone around the formen magnum
503
assimilation of the atlas
nonsegmentation at the junction of the atlas and the occipital bone
504
Arnold-Chiari malformation
brain tissue extends into spinal canal
505
microcephaly
abnormal development of the CNS
506
Vitamin D deficiency
Rickets (shortened and deformed limbs, bowing of limb bones, ossification of the epiphysical cartilage plates)
507
Retroesophageal right subclavian artery forms when
the right fourth pharyngeal arch artery and the right dorsal aorta dissapear cranial to the seventh intersegmental artery
508
esophageal atresia
the esophagus ends superiorly but there is a tracheoesophageal fistula, so milk, etc. enters the lungs and bile from the stomach can come up through an inferior tracheoesophageal fistual
509
tracheoesophageal fistula
your trachea and esophagus failed to divide properly and there's a hole that links the two tubes
