BRS anatomy review

Question 1

locate apex of heart? blood supply?

Answer 1

left fifth intercostal

anterior intraventricular arter

Question 2

expiration achieved by what muscle?

Answer 2

elastic tissue in lungs and thoracic wall

Question 3

what kind of fibers do greater splanchnic nerves have

Answer 3

GVA and preganglionic sympathetic GVE

General visceral afferent and pre-gangl - sympthatic efferent

Question 4

white rami communicantes severed at 6th thoracic - degen of what nerve bodies?

Answer 4

preganglionic sympathetic (which I undestand) from lateral grey horn -

and - don’t understand - dorsal root ganglion

Question 5

Posterior anterior chest x ray - what part of heart do you see mostly?

right ventricle (sternocostal surface main structure)

Because looking at xray as if at front of patient

Answer 5

Posterior-Anterior (PA) projection
The standard chest radiograph is acquired with the patient standing up, and with the X-ray beam passing through the patient from Posterior to Anterior (PA). The chest X-ray image produced is viewed as if looking at the patient from the front, face-to-face.

Question 6

atrial septum defect?

Answer 6

failure of foramen ovale to close

Question 7

pacemaker of heart?

Answer 7

SA node

Question 8

circumflex branch of left coronary artery supplies?

Answer 8

posterior left ventricle

Question 9

laceration of phrenic (right)

Answer 9

loss of sensation of pericardium and mediastinal pleura - important for INHALATION - not for exhalation

Question 10

drainage of cardiac veins into heart?

Answer 10

anterior cardiac drains to right atrium,

middle small oblique into coronary sinus,

right and left pulmonary into left atrium

Question 11

lack of blood to left ventricle? - thrombosis in circumflex branch of left coronary artery

Answer 11

mitral valve insufficiency

Question 12

cardiac notch?

Answer 12

near superior lobe of left lung

Question 13

thoracentesis?

Answer 13

7 - 9 ribs - to aspirate pleural effusion

Question 14

occlusion of descending thoracic aorta?

Answer 14

lower six intercostal arteries affected

Question 15

which lung has a middle lobe?

Answer 15

right- it has a groove for the horizontal fissure, SVC, and larger capacity than left

Question 16

which lung has a lingula?

Answer 16

LEFT - tongue shaped, left lung upper lobe

Question 17

major muscles of expiration?

Answer 17

abdominal

Question 18

posterior mediastium - what’s there?

descending aorta

Answer 18

hemiazyogos vein -

Posterior Mediastinum:
Organs: esophagus.
Arteries: descending thoracic aorta.
Veins and lymphatics: azygos hemiazygos veins, thoracic duct.
Nerves: vagus, splanchnic, sympathetic chain

Question 19

what’s in superior mediastum?

Answer 19

bracheocephalic veins, trachea, arch of aorta,

Superior Mediastinum:
Organs: thymus, trachea, esophagus.
Arteries: aortic arch, brachiocephalic trunk, left common carotid artery, left subclavian artery.
Veins and lymphatics: superior vena cava, brachiocephalic veins, the arch of the azygos, thoracic duct.

Question 20

middle mediastium

Answer 20

arch of azygos

heart, pericardium, great vessels, trachea, bronchi, esophagus, and lymph nodes. Esophageal tumors, tracheal tumors, and lymph nodes are typically located in this compartment. The posterior mediastinum contains autonomic nerves, vessels, and lymph nodes.

Question 21

tumor superior to root of right lung?

Answer 21

arch of azygus vein

Question 22

lacerate right vagus nerve near recurrent laryngeal?

Answer 22

parasymp nerve fibers will affect bronchial lumen, bronchial smooth muscles decrease heart rate etc - also affect pain, cough reflex and stretch of lung during inspiration

Question 23

cystic fibrosis in child blocks which lung structures?

Answer 23

terminal brochioles (and alveolar ducts) viscose mucus - larger ducts not so affected

Question 24

left primary bronchus is?

Answer 24

longer than right - right receives more foreign bodies, shorter, larger diameter

Question 25

venous drainage of right third intercostal spaces ?

Answer 25

superior intercostal vein - to azygos on right, and brachiocephalic on left

Question 26

Cardiac silhouette right border is SVC ascending aorta would be seen in middle of heart

Answer 26

refers to the outline of the heart as seen on frontal and lateral chest radiographs and forms part of the cardiomediastinal contour. The size and shape of the cardiac silhouette provide useful clues for underlying disease.

Question 27

systole, dystole? systole: contraction of the ventricles of the heart aortic and pulmonic valves open

Answer 27

dystole? mitral and tricuspid valves are OPEN to fill

Question 28

sternal angle?

Answer 28

Bifurcation of the Trachea. Boundary between the superior and inferior portion of the mediastinum. Passage of the thoracic duct from right to left behind esophagus Aortic Arch.

Question 29

third rib articulates w?

Answer 29

body of sternum, body of second thoracic vertebra, transverse process of third thoracic vertebra

Question 30

to aspirate pericardial fluid - insert needle?

Answer 30

left fifth intercostal space

Question 31

first heart sound? The “ lub” is the first heart sound, commonly termed S1, and is caused by turbulence caused by the closure of mitral and tricuspid valves at the start of systole. The second sound,” dub” or S2, is caused by the closure of aortic and pulmonic valves, marking the end of systole.

Answer 31

tricuspid and mitral valves close

Question 32

Valves of the Heart Toilet Paper My Ass tricuspid pulmonary mitral atrial

Answer 32

The right atrioventricular valve is the tricuspid valve. The left atrioventricular valve is the bicuspid, or mitral, valve. The valve between the right ventricle and pulmonary trunk is the pulmonary semilunar valve. The valve between the left ventricle and the aorta is the aortic semilunar valve.

Question 33

chordae tendinae?

Answer 33

colloquially known as the heart strings, are tendon-resembling fibrous cords of connective tissue that connect the papillary muscles to the tricuspid valve and the mitral valve in the heart.

Question 34

Patent ductus arteriosus

Answer 34

(PDA) is a persistent opening between the two major blood vessels leading from the heart. The opening, called the ductus arteriosus, is a normal part of a baby's circulatory system before birth that usually closes shortly after birth.

Question 35

Tracheoesophageal fistula what structure in fetus closes these two structure correctly Tracheoesophageal septum formed by fusion of Tracheoesophageal folds in midline

Answer 35

is an abnormal connection in one or more places between the esophagus (the tube that leads from the throat to the stomach) and the trachea (the tube that leads from the throat to the windpipe and lungs).

Question 36

what structures branches into the bronchial arteries?

Answer 36

descending thoracic aorta

Question 37

hirschsprung disease - megacolon - what nerve?

Answer 37

parasympathetic postganglionic - absense of enteric ganglia - NC

Question 38

round ligament of liver?

Answer 38

left umbilical vein

Question 39

excruciating peritonial pain from lesser sac - what nerve carries?

Answer 39

lower intercostal nerves

Question 40

intercostal nerves?

Answer 40

run from spine - ventral rami become the intercostal nerve - running between innermost and intercostal muscles - under rib in groove w/ artery branch two Lateral cutaneous branch and Anterior cutaneous branch

Question 41

intercostal arteries? internal thoracic arteries also called internal mammmary arteries (supply breasts of men and women) posterior intercostal also supply some branches to back

Answer 41

2 sets - one from aorta - posterior intercostal - - branching to lateral cutaneous posterior anastamoses with anterior intercostal artery that comes from internal thoracic artery decending down -from subclavian in intercostal muscles - betwe transversus thoracis mus and?

Question 42

cremasterie muscle?

Answer 42

genitofemoral nerve

Question 43

shunt around portal system?

Answer 43

splenic vein to left renal to IVC

Question 44

supra renal gland arteries?

Answer 44

aorta, inferior phrenic, renal

Question 45

gastrosplenic ligament (ligamentum gastrosplenicum or gastrolienal ligament)

Answer 45

is part of the greater omentum. Embryonically the gastrosplenic ligament is derived from the dorsal mesogastrium. The gastrosplenic ligament is made of peritoneum that connects the greater curvature of stomach with the hilum of the spleen.

Question 46

inferior pancreaticoduodenal artery?

Answer 46

SMA - anastamose with celiac artery branches

Question 47

during apendectomy at mcburney's point - what structure is most likely to be injured?

Answer 47

iliohypogastric nerve

Question 48

jejuenum vs ilium?

Answer 48

jejeunum - fewer mesenteric arterial arcade - more and taller plicae circulares - less fat (more digestion occurs here)

Question 49

right colic vein?

Answer 49

part of portal system - SMA

Question 50

retriperitoneal infection?

Answer 50

could be the dorsal pancreatic artery - (it is retroperitoneal

Question 51

remnant of fetal ARTERY?

Answer 51

medial umbilical fold - mediAN umbilical fold - urachus remnant lateral umbilical fold (ligament) inferioror epigastic artery and vein which are adult vessels ligamentum venosum - fibrous remnant of umbilical VEIN

Question 52

scrotal lymph? "S" scrotum, skin penis, shit (anal cavity lower) - all go to SUPERFICIAL

Answer 52

superficial inguinal - from scrotum, penis, buttocks and lower part of anal canal

Question 53

deep inguinal lymph?

Answer 53

upper part of vagina, anal canal to external iliac nodes

Question 54

The lymphatic drainage of the prostate primarily

Answer 54

drains to the obturator and the internal iliac lymphatic channels. There is also lymphatic communication with the external iliac, presacral, and the para-aortic lymph nodes.

Question 55

ovarian lymph?

Answer 55

The para-aortic nodes, also known as the lumbar aortic nodes, drain lymph from the kidneys, suprarenal glands, testes, ovaries, uterus, and uterine tubes.

Question 56

appendectomy - ligate what artery?

Answer 56

iliocolic artery - be careful of...iliohypogastric nerve!!

Question 57

severe pain from stomach - what nerve carries this terrible message?

Answer 57

greater splanchnic - vagus only reflex = no pain lower intercostal carries pain but not from stomach but from diaphragm, abdom wall and peritneum

Question 58

processes vaginalis persists?

Answer 58

hydrocele

Question 59

porta hepatis? doorway into liver

Answer 59

doorway- contains hepatic ducts, arteries, and branches of portal vein The porta hepatis is a deep fissure in the inferior surface of the liver through which all the neurovascular structures (except hepatic veins) and hepatic ducts enter or leave the liver

Question 60

The epiploic foramen (also called the foramen of Winslow)

Answer 60

is a passage between the greater sac (peritoneal cavity proper) and the lesser sac (omental bursa), allowing communication between these two spaces.

Question 61

What is contained in the Hepatoduodenal ligament?

Answer 61

The hepatoduodenal ligament is the distal portion of the lesser omentum, that connects the liver to the cranial part of duodenum. It forms the free right border of the lesser omentum and the ventral boundary of the epiploic foramen. It contains the portal vein, hepatic artery and bile duct.

Question 62

meckle's diverticulum is remnant of ? vitalline

Answer 62

yolk stalk - rule of 2s 2 feet proximal to iliocecal junction

Question 63

growing tumor of uncinate process compresses?

Answer 63

SMA

Question 64

direct hernia?

Answer 64

develops after birth

Question 65

pituitary?

Answer 65

near cavernous sinus - behind and above it sphenoid sinus

Question 66

number of sinuses? four pairs

Answer 66

There are four paired sinuses – named according to the bone in which they are located – maxillary, frontal, sphenoid and ethmoid. The mucus from the sinuses drains into your nasal passages and then down the back of your throat to be swallowed.

Question 67

number of dural venous sinuses?

Answer 67

11 - Anterior Sphenoparietal sinuses Cavernous sinuses Superior and inferior petrosal sinuses Midline Superior sagittal sinus Typically becomes right transverse sinus or confluence of sinuses Inferior sagittal sinus Straight sinus Typically becomes left transverse sinus or confluence of sinuses Posterior Occipital sinus Confluence of Sinus Right and Left transverse sinuses ``` Lateral Superior petrosal sinus Transverse sinuses Sigmoid sinus Inferior petrosal sinus Internal jugular vein Sigmoid sinuses ```

Question 68

lesion of optic nerve?

Answer 68

blindness

Question 69

if pituitary tumor large enough? bitemporal hemianopia

Answer 69

partial blindness where vision is missing in the outer half of both the right and left visual field. It is usually associated with lesions of the optic chiasm, the area where the optic nerves from the right and left eyes CROSS near the pituitary gland.

Question 70

binasal hemianopia - vision is missing in the inner half of both the right and left visual field.

Answer 70

bilateral atherosclerosis or aneurysms of the internal carotid arteries simultaneously compressing the adjacent NON‐CROSS fibres of both optic nerves.

Question 71

abduct vocal cords

Answer 71

posterior cricoarytenoid - only muscle that does this - all other ADDUCT The posterior cricoarytenoid muscles are the only muscles to open the vocal cords. By rotating the arytenoid cartilages laterally, these muscles abduct the vocal cords and thereby open the rima glottidis. Their action opposes the lateral cricoarytenoid muscles.

Question 72

Intrinsic and extrinsic muscle of larynx? Cricothyroid muscle lengthen and tense the vocal folds.

Answer 72

The intrinsic laryngeal muscles are responsible for controlling sound production. Cricothyroid muscle lengthen and tense the vocal folds. Posterior cricoarytenoid muscles abduct and externally rotate the arytenoid cartilages, resulting in abducted vocal folds. Extrinsic The extrinsic muscles act to move the larynx superiorly and inferiorly. They are comprised of the suprahyoid and infrahyoid groups, and the stylopharyngeus (a muscle of the pharynx). The supra- and infrahyoid muscle groups attach to the hyoid bone.

Question 73

What is the main function of the pharynx?

Answer 73

It is commonly referred to as the throat. The pharynx is part of both the digestive and respiratory systems. For the digestive system, its muscular walls function in the process of swallowing, and it serves as a pathway for the movement of food from the mouth to the esophagus.

Question 74

cricopharygeaus act as a sphincter - preventing air from entering esophogus

Answer 74

is a semi-circular muscle located in the neck about three inches below the Adam's apple. To prevent the reflux of foods from the esophagus into the throat, the cricopharyngeus remains contracted and tight at most times.

Question 75

The oblique arytenoid muscle and aryepiglottic muscle?

Answer 75

prevent food from entering larynx

Question 76

Great cerebral vein of galen is direct tributary of?

Answer 76

dural venous sinus

Question 77

parasymptethic to eye?

Answer 77

pupil constricts, ciliary m contracts = accommodation THICKER LENS -- enhanced vision for near objects

Question 78

tympanic nerve branch of? continues to lesser petrosal - with symphatheitc = to OTIC ganglion for synapse

Answer 78

glosspharyngeal - Jacobson's nerve is a tympanic branch of the glossopharyngeal nerve, arising from its inferior ganglion. It enters the middle ear cavity through the inferior tympanic canaliculus, runs in a canal on the cochlear promontory and provides the main sensory innervation to the mucosa of the mesotympanum and Eustachian tube.

Question 79

otic ganglion? glossopharyngeal nerve and innervates the parotid gland for salivation. Parotid POTIC/D

Answer 79

The otic ganglion below the foramen ovale in the infratemporal fossa and on the medial surface of the mandibular nerve. It is functionally associated with the glossopharyngeal nerve and innervates the parotid gland for salivation.

Question 80

Four parasympathetic ganglia located within the head –

Answer 80

the ciliary, otic, pterygopalatine and submandibular. They receive fibres from the oculomotor, facial and glossopharyngeal nerves (the vagus nerve only innervates structures in the thorax and abdomen).

Question 81

Which cranial nerve carries parasympathetic fibers?

Answer 81

oculomotor, facial, glossopharyngeal, and vagus nerves. 5 Special somatic afferent (SSA).

Question 82

Special somatic afferent fibers (SSA) 2,8 SSA

Answer 82

are the afferent nerve fibers that carry information from the special senses of vision, hearing and balance. The cranial nerves containing SSA fibers are the optic nerve (II) and the vestibulocochlear nerve (VIII).

Question 83

special visceral efferents.

Answer 83

Acronym: SVE. The term special visceral efferents (SVE) refers to nerve fibers that innervate the voluntary striated muscles of the larynx and pharynx and the muscles of facial expression and mastication.

Question 84

dura in cranium - which CN innervate?

Answer 84

V (mid brain) - v2 and v3 v1 - anterior X and XII (via C1) - posterior

Question 85

carotid sinus? S = Stretch

Answer 85

stretch - at internal carotid IX

Question 86

fracture optic canal ? enter orbit thru SOF can

Answer 86

opthalamic artery and optic nerve ENTER orbit thru SOF The superior orbital fissure is the largest opening that connects the orbit with the middle cranial fossa. [1] The optic canal connects the orbit to the middle cranial fossa and transmits the optic nerve, ophthalmic artery, meningeal sheaths, and sympathetic nerve fibers

Question 87

digastric posterior belly? VII elevates hyoid bone

Answer 87

anterior? V these can affect speech

Question 88

The stylopharyngeus muscle - innervation - (CN IX)

Answer 88

act as a significant dilating muscle of the nasopharynx. During breathing, the contraction of this muscle pulls the nasopharyngeal wall dorsally. This action prevents the dynamic collapse of the dorsal wall of the nasopharynx by supporting the wall during inspiration

Question 89

What do the pharyngeal muscles do? V Vagus - except sylophyngeus

Answer 89

Pharyngeal muscles. The pharyngeal muscles are a group of muscles that form the pharynx, which is posterior to the oral cavity, determining the shape of its lumen, and affecting its sound properties as the primary resonating cavity. The pharyngeal muscles (involuntary skeletal) pushing the food into the esophagus.

Question 90

tensor tympani muscle V connects to the malleus bone. Its role is to dampen loud sounds, such as those produced from chewing, shouting, or thunder.

Answer 90

stapideus? VII The stapedius is the smallest skeletal muscle in the human body. At just over one millimeter in length, its purpose is to stabilize the smallest bone in the body, the stapes.

Question 91

pupil doesn't get larger even when light dims?

Answer 91

superior cervical ganglion damage SYMPATHETIC problem

Question 92

The pupillary light reflex

Answer 92

neural pathway on each side has an afferent limb and two efferent limbs. The afferent limb has nerve fibers running within the optic nerve (CN II). Each efferent limb has nerve fibers running along the oculomotor nerve (CN III). The afferent limb carries sensory input.

Question 93

common tendinous ring? The tendinous ring, also known as the annulus of Zinn, is the common origin of the four rectus muscles (extraocular muscles). The tendinous ring straddles the superior orbital fissure and through it (from superior to inferior) pass: superior division of the oculomotor nerve (CN III)

Answer 93

The annulus of Zinn, also known as the annular tendon or common tendinous ring, is a ring of fibrous tissue surrounding the optic nerve at its entrance at the apex of the orbit. It is the common origin of the four rectus muscles (extraocular muscles). ... Superior division of the oculomotor nerve (CNIII)

Question 94

Which structure passes through the tendinous ring of the orbit?

Answer 94

The optic canal and adjacent part of the fissure are surrounded by the common tendinous ring, from which the four recti arise. The lacrimal, frontal, and trochlear nerves enter the orbit above the ring. The superior and inferior ophthalmic veins leave the orbit usually above and below the ring, respectively.

Question 95

part of v1? lacrimal, frontal and nasociliary

Answer 95

lacrimal, frontal and nasociliary branches of ophthalmic (V1). After leaving the cavernous sinus, the ophthalmic nerve goes through the superior orbital fissure, where it is usually already divided into its three terminal branches: Lacrimal nerve. Frontal nerve. Nasociliary nerve.

Question 96

cranial nerves near styloid process VII, IX, XII

Answer 96

Significant vessels and nerves surround the styloid process. The internal jugular vein, internal carotid artery, and glossopharyngeal nerve (CN IX), vagus nerve (CN X), and accessory nerve (CN XI) lie medial to the styloid process. The occipital artery and hypoglossal nerve (CN XII) run along its lateral side

Question 97

lesion of vagus causes deviation to uvula? hoarseness?

Answer 97

on opposite side damage to recurrent laryngeal of vagus

Question 98

front and isthmus of thyroid gland associated with

Answer 98

inferior thyroid vein

Question 99

numbness in anterior cervical triangle?

Answer 99

transverse cervical nerve The transverse cervical nerve is also formed by fibres from C2 and C3. It curves around the posterior aspect of the sternocleidomastoid, and supplies sensation to the anterior neck. phrenic nerve may be there too - but doesn't have cutaneous fibers

Question 100

The cervical plexus

Answer 100

is a plexus of the anterior rami of the first four cervical spinal nerves which arise from C1 to C4 cervical segment in the neck. They are located laterally to the transverse processes between prevertebral muscles from the medial side and vertebra

Question 101

What are the branches of cervical plexus?

Answer 101

Its branches consist of a superficial and deep set. The superficial branches are the great auricular nerve, lesser occipital nerve, transverse cervical, suprasternal, and supraclavicular nerves. The deep branches are the phrenic, communicantes cervicales, communicating, and muscular.

Question 102

Nerves formed from the cervical plexus innervate

Answer 102

the back of the head, as well as some neck muscles. The branches of the cervical plexus emerge from the posterior triangle at the nerve point, a point that lies midway on the posterior border of the sternocleidomastoid .

Question 103

What muscles does the cervical plexus innervate? Located in the posterior triangle of the neck, halfway up the sternocleidomastoid muscle, and within the prevertebral layer of cervical fascia.

Answer 103

C1-C2: Rectus capitis anterior and lateralis. C1-C3: Longus capitis. C2-C3: Prevertebral muscles and sternocleidomastoid. C3-C4: Levator scapulae, trapezius and scalenus medius. The cervical plexus is a network of nerve fibres that supplies innervation to some of the structures in the neck and trunk. It is located in the posterior triangle of the neck, halfway up the sternocleidomastoid muscle, and within the prevertebral layer of cervical fascia.

Question 104

cervical fascia I PT2 PV cervical plexus in PV

Answer 104

By this classification system, the deep cervical fascia of the neck can subdivide into the investing layer, pretracheal and prevertebral layers, also known as the external, middle and deep layers respectively. The pretracheal, or middle layer, can be further subdivided into the muscular and visceral divisions

Question 105

superior nasal meatus drains?

Answer 105

posterior ethmoidal sinus

Question 106

what drains into middle nasal meatus - a lot

Answer 106

The middle meatus is an air passage of the lateral nasal cavity located between the middle nasal concha and lateral nasal wall. The anterior ethmoid air cells, maxillary and frontal sinuses all drain into the middle meatus.

Question 107

VI run thru what?

Answer 107

cavernous sinus

Question 108

crichoid ligament at same level as?

Answer 108

inferior laryngeal nerves

Question 109

severed III nerve?

Answer 109

paralysis of ciliary muscle - and sphincter pupillae

Question 110

what carries sympathetic fibers to eye ? NOT on III

Answer 110

Many of the fibers destined for the eye form the sympathetic root of the ciliary ganglion, which runs along with the ophthalmic artery to enter the orbit. These fibers then traverse the ciliary ganglion to enter the eye via the short ciliary nerves

Question 111

The pharyngeal arches (branchial arch,

Answer 111

are a series of externally visible anterior tissue bands lying under the early brain that give rise to the structures of the head and neck.

Question 112

what innervates the stylopharngeus?

Answer 112

GLOSSOpharangeus XII

Question 113

nose punch, nasal septum broken, what is damaged?

Answer 113

vomer and perpendicular plate of ethmoid

Question 114

what goes thru internal auditory meatus?

Answer 114

VII and VIII

Question 115

what goes thru foramen lacerum? triangular hole in the base of skull located between the sphenoid, apex of petrous temporal and basilar part of occipital. It is the juncture of the petroclival, sphenopetrosal, and pterygosphenoidal sutures.

Answer 115

nothing = the greater petrosal nerve passes medially to enter the foramen lacerum and fuses there with the deep petrosal nerve, forming the Vidian nerve or pterygoid nerve, which passes from the pterygoid canal to the pterygopalatine fossa

Question 116

carotid sheath?

Answer 116

internal jug, vagus, internal and common carotid NOT sympathetic (w/ superior and middle cervical ganglia)

Question 117

costocervical trunk gives rise to

Answer 117

deep cervical and superior intercosta

Question 118

eye reflex blink carried by? v and VII

Answer 118

nasociliary V1- afferent, efferent VII

Question 119

what lies in wall of cavernous sinus?

Answer 119

The cavernous sinus is a blood space containing endothelium, trabeculae, and ligaments. Each cavernous sinus contains the internal carotid artery (and sympathetic plexus), oculomotor nerve, trochlear nerve, abducens nerve, and the V1 and V2 branches of the trigeminal nerve. NOT the MANDIBULAR

Question 120

adenoid? aka pharangeal tonsil

Answer 120

a mass of enlarged lymphatic tissue between the back of the nose and the throat, often hindering speaking and breathing in young children.

Question 121

Greater petrosal nerve Lacrimal gland. Oral mucosa

Answer 121

The deep petrosal nerve innervates the blood vessels and secretomotor aspects of the. Lacrimal gland. Oral mucosa

Question 122

lesser petrosal?

Answer 122

paratoid

Question 123

needle cricothyrotomy - open into

Answer 123

infraglottic cavity

Question 124

what nerves are involved in swallowing?

Answer 124

many - 5, 7, IX, X

Question 125

what opens the eye? orbicularis oculi or leavator palpebrae superiororis

Answer 125

levator - oculi closes

Question 126

dry mouth?

Answer 126

chordae tympani - secretions of submandibular glands

Question 127

What is the function of the FALX cerebri? cerebellar tentorium

Answer 127

The falx cerebri is a double-fold of dura mater that descends through the interhemispheric fissure in the midline of the brain to separate the two cerebral hemispheres. The cerebellar tentorium or tentorium cerebelli (Latin for "tent of the cerebellum") is an extension of the dura mater that separates the cerebellum from the inferior portion of the occipital lobes.

Question 128

pupillary light reflex?

Answer 128

afferant - II optic nerve The pupillary light reflex compensates for changes in illumination level, whereas the accommodation responses compensate for changes in eye-to-object-viewed distance. ... Consequently, a light directed in one eye elicits responses, pupillary constriction, in both eyes.

Question 129

The frenulum of tongue

Answer 129

or tongue web (also lingual frenulum or frenulum linguæ; also fraenulum) is a small fold of mucous membrane extending from the floor of the mouth to the midline of the underside of the tongue.

Question 130

nosebleed?

Answer 130

sphenopalantine artery a terminal branch of the internal maxillary artery originating from the external carotid artery system. [4] The SPA is the major blood vessel to the nasal cavity mucosa: supplying the superior, middle, and inferior turbinate; lateral nasal wall; and nasal septum.

Question 131

ptosis

Answer 131

drooping or falling of the upper eyelid.

Question 132

miosis

Answer 132

pupil constriction

Question 133

ptosis and miosis?

Answer 133

loss of sympathetic fiber to head HORNERS T1 - T3 - Thoracic Anterior Roots these fibers must follow blood vessels to get to their location

Question 134

arytenoid cartilage

Answer 134

either of a pair of cartilages at the back of the larynx, used in the production of different kinds of voice quality

Question 135

wide skull?

Answer 135

premature coronal suture closure

Question 136

XIi innervates all tongue muscles except?

Answer 136

palatoglossol (in the back - ) XXXXXXXX

Question 137

infection spreading from parotid, neck to mediastrium?

Answer 137

retrophayngeal space

Question 138

The most commonly entrapped material following a blowout fracture

Answer 138

inferior rectus muscle.

Question 139

keyhole pupil?

Answer 139

failure of fusion of retinal fissure

Question 140

hair cells damages in hearing?

Answer 140

longer they have to travel - lower the sound - so if can't hear high sounds, hair cells at base of cochlea travels the least to reach apex

Question 141

CSF not flowing - blocked in brain?

Answer 141

"non-communicating" hydrocephalus aka obstructive

Question 142

branchial cyst vs thyroid nodule?

Answer 142

branchial (2nd arch) needs to be on sternocleidomastoid- anterior border

Question 143

dentist - blocking nerves on maxillary area - near canine - and lots of things put to sleep

Answer 143

infraorbital nerve - eyelid, cheek, nose etc - lesser block would be anterior superior alvelolar

Question 144

sore throat - palantine tonsils swollen - what nerve

Answer 144

IX

Question 145

What Innervates the angle of the mandible?

Answer 145

The angle of the jaw is innervated by the auricular branch of the superficial cervical plexus (SCP). Cervical cutaneous nerves of the CP carry the sensation from the antero-lateral cervical skin

Question 146

what runs thru the parotid gland

Answer 146

The external carotid artery (ECA) ascends through the parotid gland. Within the gland, the ECA gives rise to the posterior auricular artery. The ECA then divides into its two terminal branches - the maxillary artery and superficial temporal artery.

Question 147

bifurcation of common carotid?

Answer 147

C4

Question 148

The chorda tympani

Answer 148

is a branch of the facial nerve that originates from the taste buds in the front of the tongue, runs through the middle ear, and carries taste messages to the brain.

Question 149

SSA? 28, ssa

Answer 149

II (optic) VIII (hearing/balance)

Question 150

SVA? (4) - 1,7,9, 10

Answer 150

smell, taste - 1,7,9, 10

Question 151

SVE (5) 5, 7, 9, 10 , 11

Answer 151

5, 7, 9, 10 , 11

Question 152

facial nerve - how many holes

Answer 152

2 - internal meatus styloid mastoid (digastric and..?)

Question 153

facial - lacrimal and

Answer 153

nasal

Question 154

tensor veli palantini elevate the soft palate There are five muscles which give the actions of the soft palate. They are all innervated by the pharyngeal branch of the vagus nerve (CN X) – apart from Tensor veli palatini – which is innervated by the medial pterygoid nerve (a branch of CN V3).

Answer 154

Like other structures derived from the first pharyngeal arch, tensor veli palatini is innervated by the mandibular division of trigeminal nerve (CN V), that gives off the nerve to medial pterygoid.

Question 155

outside common tendinous ring of SOF? symmetry

Answer 155

IV, v1 (IV VI) see the symmetry?

Question 156

The Stylopharyngeus

Answer 156

is the only muscle in the pharynx innervated by the glossopharyngeal nerve (CN IX) through branchial motor fibers that originate in the rostral part of the nucleus ambiguus.

Question 157

styloglossus function?

Answer 157

brings tongue back into mouth

Question 158

maxillary air sinus?

Answer 158

open into middle meatus, innervated by superior alveolar nerves, rudimentary at birth, infra-orbital nerve on its roof

Question 159

ganglia containing NO post ganglionic parasympathetic?

Answer 159

Trigeminal Geniculate These are just regular ganglia

Question 160

ganglia w/ post ganglionic parasympathetic?

Answer 160

ciliary submandibular pterygopalatine otic

Question 161

constrictor muscles?

Answer 161

anterior to cervical vertebrae, stacked drinking cups, have a cricopharyngeus part which opens at rest The pharyngeal plexus is the main nervous plexus that supplies the pharynx. The sensory branches originate from the glossopharyngeal nerve (CN IX) which runs into the plexus. ... The inferior constrictor muscles are supplied by the external and recurrent branches of the vagus nerve (CN X).

Question 162

nerves that act on the palate include?

Answer 162

pharyngeal plexus, mand v2, | max v3,

Question 163

external carotid artery?

Answer 163

branch supplies upper thyroid gland, hypoglossal nerve passes lateral to it

Question 164

. Sphenomandibular ligament

Answer 164

plays a part in opening of the mouth

Question 165

Thyrohyoid membrane

Answer 165

is perforated by the superior laryngeal artery

Question 166

Stylomandibular ligament

Answer 166

is the fused lower edge of the parotid fascia

Question 167

auditory tube opening of the auditory tube in the middle ear is located in its anterior wall, and from here the

Answer 167

extends forward, medially, and downward to enter the nasopharynx, opening in the lateral wall of the nasopharynx just posterior to the inferior meatus of the nasal cavity.

Question 168

What is nervus intermedius? same fibres as in chorda tympani The chorda tympani is a branch of the facial nerve that originates from the taste buds in the front of the tongue, runs through the middle ear, and carries taste messages to the brain.

Answer 168

The nervus intermedius, also known as intermediate nerve of Wrisberg, is a part of the facial nerve (CN VII) which contains somatic sensory, special sensory, and visceral motor (secretomotor) fibers

Question 169

Pseudounipolar nerve cells Pseudounipolar neurons are sensory neurons that have no dendrites, the branched axon serving both functions.

Answer 169

sensory ganglia in V, VII, IX and X

Question 170

A bipolar neuron, RARE: olfactory epithelium, the retina of the eye, and ganglia of the vestibulocochlear nerve.

Answer 170

or bipolar cell, is a type of neuron that has two extensions (one axon and one dendrite). Many bipolar cells are specialized sensory neurons for the transmission of sense. As such, they are part of the sensory pathways for smell, sight, taste, hearing, touch, balance and proprioception.

Question 171

TOSS

Answer 171

all infrahyoid except T are supplied by Ansa cervicalis - (ansa lies in carotid triangle C1 - C3) omo/sterno/sternothyroid THYROhyoid - C1 thru XII

Question 172

recurrent laryngeal nerve - laryns except?

Answer 172

all intrinsic muscles of the larynx except cricothyroid

Question 173

nerve supply of geniohyoid and thyrohyoid

Answer 173

. C1 fibres via hypoglossal nerve

Question 174

external laryngeal nerve

Answer 174

. cricothyroid

Question 175

superior thyroid artery? SUPER SUPEX EXTRACLOSE

Answer 175

near external laryngeal nerve

Question 176

inferior thyroid artery?

Answer 176

near recurrent laryngeal nerve - which course up near common carotid

Question 177

venous drainage of thyroid TRUE capsule is REMOVED venous plexus lies DEEP

Answer 177

Venous drainage is carried out by the superior, middle and inferior thyroid veins, which form a venous plexus. The superior and middle veins drain into the internal jugular veins, whereas the inferior drains into the brachiocephalic vein

Question 178

safe place to ligate inferior thyroid artery to avoid injury to the recurrent laryngeal nerve Inferior is Away

Answer 178

away from the thyroid gland vice versa with ligation of SUPERIOR thyroid artery

Question 179

The pretracheal fascia,

Answer 179

The pretracheal fascia, which covers the trachea and few other structures in the neck, also encapsulates the thyroid gland. It is labeled as the false capsule or the visceral layer of the pretracheal fascia.

Question 180

What are the branches of mandibular nerve? | The Mandibular Nerve (V3)

Answer 180

On its extracranial course, it divides into three main branches: the buccal, mental, and auriculotemporal nerves. The buccal nerve pierces the skin on the face behind the ramus of the mandible, passes in front of the masseter, and innervates the skin anteriorly of the buccinator muscle.

Question 181

buccal nerve vs buccal branch The buccal nerve is the only purely sensory branch of the anterior division of the mandibular division of the trigeminal nerve. It is not to be confused with the buccal branch of the facial nerve. The buccal branch of the facial nerve innervates the buccinator, levator labii, anguli oris, and orbicularis oris. Resection margins can also affect drainage of saliva from Stensen's duct, accessory ducts, and the parotid gland, which may create salivary leaks, fistulae, and sialoceles.

Answer 181

The buccal nerve is the only purely sensory branch of the anterior division of the mandibular division of the trigeminal nerve. It is not to be confused with the buccal branch of the facial nerve.

Question 182

mumps?

Answer 182

swells parotid - may affect

Question 183

what runs thru parotid gland?

Answer 183

The facial nerve (cranial nerve VII), gives rise to five terminal branches within the parotid gland. These branches innervate the muscles of facial expression.

Question 184

What runs through the parotid gland?

Answer 184

The facial nerve and its branches pass through the parotid gland, as does the external carotid artery and retromandibular vein. The external carotid artery forms its two terminal branches within the parotid gland: maxillary and superficial temporal artery. The gland usually contains several intraparotid lymph nodes.

Question 185

vertebral arteries arise from?

Answer 185

Typically, the vertebral arteries originate from the subclavian arteries. Each vessel courses superiorly along each side of the neck, merging within the skull to form the single, midline basilar artery.

Question 186

forceps injury during childbirth- hurts styloidmastoid foramen?

Answer 186

can't close eyes - Will have taste because VII exits thru middle ear - The chorda tympani is a branch of the facial nerve that originates from the taste buds in the front of the tongue, runs through the middle ear, and carries taste messages to the brain.

Question 187

inferior nasal meatus receives?

Answer 187

tear duct

Question 188

tears are caused by which cranial nerves

Answer 188

The trigeminal V1 (fifth cranial) nerve bears the sensory pathway of the tear reflexes. When the trigeminal nerve is cut, tears from reflexes will stop, while emotional tears will not. The great (superficial) petrosal nerve from cranial nerve VII provides autonomic innervation to the lacrimal gland.

Question 189

taking pulse near tragus of external ear?

Answer 189

superficial temporal - branch of external carotid

Question 190

vocal cords controlled by? exc - cricothyroid (external superior laryngeal

Answer 190

inferior laryngeal nerves, branch of recurrent, branch of X

Question 191

contralateral two things in neck, head - plus eyes

Answer 191

Uvula deviates to the opposite side, SCM pulls head in opposite direction of paralysis

Question 192

The usual branches of the subclavian

Answer 192

on both sides of the body are the vertebral artery, the internal thoracic artery, the thyrocervical trunk, the costocervical trunk and the dorsal scapular artery, which may branch off the transverse cervical artery, which is a branch of the thyrocervical trunk. The subclavian becomes the axillary artery at the lateral border of the first rib.

Question 193

subclavian three parts?

Answer 193

The first portion extends from the origin of the vessel to the medial border of the Scalenus anterior. The second lies behind this muscle. The third extends from the lateral margin of the muscle to the outer border of the first rib, where it becomes the axillary artery.

Question 194

contetns of carotid triangle? crowded

Answer 194

``` common carotid internal jugular vein vagus hypoglossal nerve ansa cervicalis deep cervical lymph ```

Question 195

muscular triangle houses?

Answer 195

infrahyoid strap, larnyx, thyroid, parathyroid

Question 196

what forms the roof of the inguinal canal

Answer 196

?

Question 197

eye test - look toward nose and then upward = what ?

Answer 197

inferior oblique - first have patient look inward (testing medius) but then from there is in pathway to test others adducting eye tests medius rectus

Question 198

wisdom tooth - lower - extracting - may damage?

Answer 198

paresthesia of lower lip - inferior alveolar nerve may be damaged

Question 199

crescent hematoma?

Answer 199

superior cerebral veins - bridging veins - may be torn

Question 200

stone in parotid? what muscle causing problem?

Answer 200

buccinator - may block the drainnage by squeezing the ducts

Question 201

cushings disease - pituitary problem ( behind eye on scan

Answer 201

leads to rapid weight gain in trunk sparing limbs, double vision, sweating, thinning of skin, and hirsutism (facial male pattern harir growth

Question 202

tympanic - middle ear cavity -

Answer 202

relationship with many structures - posterior - facial nerve,

Question 203

hammer to head at pterion?

Answer 203

greater wing of sphenoid

Question 204

TMY stuck open - what muscle returns it to normal after clearing articular eminence?

Answer 204

temporalis

Question 205

fracture of hyoid bone?

Answer 205

middle constrictor - big for swallowing this muscle 10 muscles attach to hyoid

Question 206

middle ear, tympanic cavity sensation

Answer 206

IX hypopharangeal

Question 207

confluence of dural venous sinuses - what area?

Answer 207

faxl cerebri, falx cerebelli, tentorium cerebelli

Question 208

middle ear infection - pain, tender, inflammation posterior to right auricle?

Answer 208

mastoiditis

Question 209

22q11.2 Degeorge

Answer 209

3rd pouch

Question 210

parafollicular C cells of thyroid?

Answer 210

fourth pouch

Question 211

soft palate - and uvula - what arch?

Answer 211

4 6 is larynx

Question 212

Surface ectoderm

Answer 212

Epidermis; adenohypophysis (from Rathke pouch); lens of eye; epithelial linings of oral cavity, sensory organs of ear, and olfactory epithelium; anal canal below the pectinate line; parotid, sweat, mammary gland

Question 213

Endoderm - liver, etc

Answer 213

Gut tube epithelium (including anal canal above the pectinate line), most of urethra and lower vagina (derived from urogenital sinus), luminal epithelial derivatives (eg, lungs, liver, gallbladder, pancreas, eustachian tube, thymus, parathyroid, thyroid follicular and parafollicular [C] cells

Question 214

Ventral wall defects

Answer 214

Developmental defects due to failure of rostral fold closure (eg, sternal defects [ectopia cordis]), lateral fold closure (eg, omphalocele, gastroschisis), or caudal fold closure (eg, bladder exstrophy).

Question 215

constrictor mus - what arch?

Answer 215

4

Question 216

male internal genitalis - but on outside unclear 5α-reductasedeficiency

Answer 216

5α-reductasedeficiency—inability to convert testosterone intoDHT male internal genitalia, ambiguous external genitaliauntil puberty (when testosterone levels cause masculinization) In the testes: Leydig Leads to male (internal and external) sexual differentiation. Sertoli Shuts down female (internal) sexual differentiatio

Question 217

Cytotrophoblast Syncytiotrophoblast SYNthesizes hormones

Answer 217

makes Cell

Question 218

What part of tongue formed by 1st and 2nd phar arches?

Answer 218

1st and 2nd Anterior 2/3 (arches associated with CNs V3 and VII)

Question 219

Genie comes out in STYle 3rd and 4th pharyngeal arches form posterior 1/3(thus sensation and taste mainly via CN IX, extreme posterior via CN X)

Answer 219

genioglossus (protrudestongue), and styloglossus (draws sides of tongue upward to create a trough for swallowing). Motor innervation is via CN X to palatoglossus (elevates posterior tongue during swallowing)

Question 220

pancreas and spleen embryology In a patient who has a malformed accessory pancreatic duct, what pancreatic bud will not have formed correctly? dorsal pancreatic bud

Answer 220

Pancreas—derived from foregut. Ventral pancreatic bud contributes to uncinatep rocess and main pancreatic duct. The dorsal pancreatic budalone becomes the body, tail, isthmus, and accessory pancreatic duct. Both the ventral and dorsal buds contribute to pancreatic head. Annular pancreas—abnormal rotation of ventral pancreatic budforms a ring of pancreatic tissue encircles 2nd part of duodenum; may cause duodenal narrowing (arrows in ) andvomiting. A Pancreas divisum—ventral and dorsal parts fail to fuse at 8 weeks. Common anomaly; mostly asymptomatic, but may cause chronic abdominal pain and/or pancreatitis. Spleen—arises in mesentery of stomach (hence is mesodermal) but has foregut supply (celiac trunk splenic artery)

Question 221

AB / O Blood

Answer 221

Anyone can receive O - The universal blood type is O negative (O-). Donors with type O- blood have the unique power to help anyone in need of a blood transfusion. Red blood cells from O- donors can be transfused to anyone, regardless of the person's blood type. AB - universal donor

Question 222

intestinal atresia

Answer 222

Presents with biliousvomiting and abdominal distension within first 1–2 days of life. Duodenal atresia—failure to recanalize. Abdominal x-ray shows “double bubble” (dilated stomach, proximal duodenum). Associated with Down syndrome. Jejunal and ileal atresia—disruption of mesenteric vessels (typically SMA) ischemic necrosis of fetal intestine segmental resorption: bowel becomes discontinuous. X-ray shows dilated loops of small bowel with air-fluid levels

Question 223

universal recipient?

Answer 223

People with type AB+ blood are universal recipients because they have no antibodies to A, B or Rh in their blood and can receive red blood cells from a donor of any blood type.

Question 224

twinning 4, 8, 12, 13+ unlucky number SCAB chorion = placenta

Answer 224

SCAB): Cleavage 0–4 days: Separate chorion and amnion - Cleavage 4–8 days: shared Chorion Cleavage 8–12 days: shared Amnion Cleavage 13+ days: shared Body (conjoined)

Question 225

Gubernaculum vs Processus vaginalis

Answer 225

Gubernaculum Band of fibrous tissue Anchors testes within scrotum Ovarian ligament + round ligament of uterus Processus vaginalis Evagination of peritoneum Forms tunica vaginalis Persistent patent processus vaginalis hydrocele

Question 226

Describe the pathway by which deoxygenated blood travels from the SVC to the placenta. Don't forget the shunt(s).

Answer 226

SVC → right atrium → right ventricle → pulmonary artery → ductus arteriosus (shunt) → descending aorta → internal iliac arteries → umbilical arteries → placenta

Question 227

What germ layer gives rise to the spleen?

Answer 227

What germ layer gives rise to the spleen?

Question 228

What internal and external genitalia will be seen in an XY male who lacks müllerian inhibitory factor (MIF)?

Answer 228

Both male and female internal genitalia with male external genitalia (streak gonads)

Question 229

blood donors?

Answer 229

AB is universal DONOR of PLASMA O is universal DONOR of RBCs - and a person w O blood is a universal recipient of plasma

Question 230

right or left heart dominance

Answer 230

Heart dominance is described by which coronary artery branch gives off the posterior descending artery and supplies the inferior wall, and is characterized as left, right, or codominant. ... It is at the apex where it meets the left anterior descending artery that is traveling along the anterior surface of the heart.

Question 231

vagina more acidic when?

Answer 231

first two weeks of menstral cycle - when sperm come in - alkaline

Question 232

babinski reflex

Answer 232

a reflex action in which the big toe remains extended or extends itself when the sole of the foot is stimulated, abnormal except in young infants. means nerve problems

Question 233

The myenteric plexus (or Auerbach's plexus)

Answer 233

provides motor innervation to both layers of the muscular layer of the gut, having both parasympathetic and sympathetic input (although present ganglion cell bodies belong to parasympathetic innervation, fibers from sympathetic innervation also reach the plexus), whereas the submucous plexus has only parasympathetic fibers and provides secretomotor innervation to the mucosa nearest the lumen of the gut.

Question 234

meissner

Answer 234

Myenteric and Submucosal Plexuses 1). The myenteric plexus, also known as Auerbach's plexus, is located between the longitudinal and circular muscle layers of most of the digestive tract. The submucosal plexus, also known as Meissner's plexus, is situated in the submucosal region between the circular muscle and mucosa.

Question 235

Cystitis

Answer 235

is an inflammation of the bladder. Inflammation is where part of your body becomes irritated, red, or swollen. In most cases, the cause of cystitis is a urinary tract infection (UTI). A UTI happens when bacteria enter the bladder or urethra and begin to multiply.

Question 236

foot muscles?

Answer 236

Lateral plantar has more investment of the intrinisc foot muscles

Question 237

P wave

Answer 237

atrial contraction

Question 238

QRS

Answer 238

ventricle contraction

Question 239

PR (other PR)

Answer 239

this is a pause - right before Ventrical contraction to finish the filling

Question 240

T

Answer 240

ventricles repolarizing

Question 241

The superior ulnar collateral artery forms a collateral circuit with which of the following arteries?

Answer 241

The superior ulnar collateral artery anastomoses with the posterior ulnar recurrent artery from the ulnar artery that is posterior to the medial epicondyle.

Question 242

The parietal peritoneum covering the inferior surface of the diaphragm transmits its sensory information via the phrenic nerve. In the case of peritonitis in the parietal peritoneum on the inferior surface of the diaphragm, pain may be referred through which of the following nerves? A Greater occipital B Lesser occipital C Superior division of the ansa cervicalis D Supraclavicular

Answer 242

The phrenic nerve consists of contributions from spinal nerve levels C3 to C5. Therefore, when sensory information comes from the parietal peritoneum on the inferior diaphragmatic surface, it may refer through spinal nerves at the same levels. Therefore, the supraclavicular nerve shares levels with the C3 and C4 levels. The greater and lesser occipital nerves both originate at the C2 level, and the superior division of the ansa cervicalis originates from the C1 level.

Question 243

6-year-old boy is stung by a wasp between his shoulder blades. Identify the pain sensation pathway the axons would travel to course from the skin of his back to the spinal cord.

Answer 243

Dorsal ramus, dorsal root, dorsal horn

Question 244

Which of the following structures serves as a common attachment for the external rotator muscles of the hip?

Answer 244

Five of the six external hip rotator muscles attach to some aspect of the greater trochanter of the femur. The quadratus femoris attaches near the greater trochanter on the intertrochanteric crest.

Question 245

A surgeon dissects through subcutaneous fat in the neck and identifies lobulated, slightly paler glandular tissue that will be surgically removed. A vein coursing superficial to the gland and an artery coursing deep to the gland are isolated. The hypoglossal nerve is retracted to avoid risk of damage during the procedure. This surgery is most likely occurring in which of the following cervical triangles?

Answer 245

hypoglossal nerve (CN XII) courses within the submandibular triangle The question outlines the course of the facial vessels in relation to the submandibular salivary gland (the vein is superficial and the artery is deep). The hypoglossal nerve (CN XII) courses within the submandibular triangle. Therefore, the relation of the facial vessels to the submandibular gland and identification of CN XII indicate the location of the surgery within the submandibular triangle.

Question 246

A newborn infant is diagnosed with hydrocephalus, a condition where cerebrospinal fluid (CSF) builds up within the ventricular system of the brain. The skull bones have not yet fused because of the fontanelles; therefore, when the brain swells, the cranium swells as well. One cause of hydrocephalus would be a blockage of the flow of CSF within the ventricular system. Identify the most likely location of blockage that would result in this infant's hydrocephalus. A Choroid plexus B Cerebral aqueduct

Answer 246

The cerebral aqueduct serves as the only drainage of CSF from the lateral and third ventricles. The choroid plexus continually filters plasma to create CSF, and therefore, a block in the aqueduct would result in CSF buildup in the lateral and third ventricles and result in hydrocephalus. A blockage in choroid plexus would result in a decrease in CSF production. A blockage in one of the apertures would not result in hydrocephalus because CSF could exit through another aperture. The central canal of the spinal cord would not result in hydrocephalus.

Question 247

A surgeon is performing an endarterectomy on a 64-year-old man who has stenosis of the carotid artery. In approaching the internal carotid artery, the surgeon severs a nerve embedded within the fascia of the carotid sheath. As a result of this complication, which muscle would most likely be paralyzed? ``` A Digastric muscle (anterior belly) ``` ``` B Digastric muscle (posterior belly) ``` C Masseter muscle D Mylohyoid muscle E Sternohyoid muscle F Stylohyoid muscle

Answer 247

ansa cervicalis of the cervical plexus is embedded within the fascia of the carotid sheath and, as such, infrahyoid muscles would be affected if a nerve is severed within this fascia. The only infrahyoid muscle in the list of choices is the sternohyoid muscle. The anterior belly of the digastric muscle and mylohyoid muscle is innervated by the mandibular nerve (CN V-3); the stylohyoid and posterior belly of the digastric muscles are innervated by the facial nerve (CN VII). The masseter is a muscle of mastication and is innervated by CN V-3.

Question 248

blue dye is placed into the right eye of a patient to assess the patency of the tear duct system. Assuming the lacrimal system is patent, at which structure would the physician see the eventual flow of the dye? A Inferior nasal meatus B Oral cavity C Pharynx D Sphenoethmoidal recess E Superior nasal meatus

Answer 248

he nasolacrimal duct drains into the nasal cavity, into the space inferior to the inferior nasal concha called the inferior nasal meatus.

Question 249

Which of the following arteries supplies blood to the deep extensor muscles of the forearm? A Anterior interosseous artery B Posterior interosseous artery C Radial collateral artery D Radial recurrent artery

Answer 249

The posterior interosseous artery branches from the common interosseous artery, courses along the anterior surface of the interosseous membrane, and pierces the membrane to supply the deep extensor muscles.

Question 250

38-year-old man is admitted to the emergency department after being involved in an automobile accident. He is unable to abduct or adduct his toes. If this patient has a deficit from a spinal cord lesion, which of the following spinal cord levels is most likely affected by this injury?

Answer 250

The intrinsic muscles of the feet are innervated by the lateral plantar nerves. The lateral plantar nerve primarily carries motor innervation from the S2–S3 spinal cord levels. L1–L2 would result in weak hip flexion. L3–L4 would result in weak knee extension. L5–S2 would result in weak hip extension and knee flexion, and S1–S2 would result in weak dorsiflexion and plantar flexion.

Question 251

During thoracocentesis, the needle is pushed in the intercostal space superior to the rib to prevent damage to the intercostal nerve, artery, and vein. Beginning with the external intercostal muscles and ending with the pleural space, which thoracic wall layers, from superficial to deep, does the needle penetrate?

Answer 251

The layers of the lateral thoracic wall in the intercostal spaces that the needle would pass through during thoracocentesis are skin, superficial fascia, external intercostal muscle, internal intercostal muscle, innermost intercostal muscle, endothoracic fascia, parietal pleura, and pleural cavity.

Question 252

Branches of the maxillary artery gain entrance to the pterygopalatine fossa via

Answer 252

Pterygomaxillary fissure The maxillary artery branches off the external carotid artery and courses through the infratemporal fossa. The infratemporal fossa communicates with the pterygopalatine fossa via the pterygomaxillary fissure.

Question 253

A 19-year-old man is admitted to the emergency department after being stabbed in the chest with a pocketknife with a 5-cm-long blade. The stab wound was in the left intercostal space just lateral to the sternal body. Which part of the heart is most likely injured?

Answer 253

The anterior surface of the heart is formed primarily by the right ventricle. Therefore, a stab wound such as the one that occurred in this patient would injure the right ventricle of the heart.

Question 254

An indirect hernia

Answer 254

results from bowel protruding through the deep inguinal ring, and through the inguinal canal and into the scrotum via the superficial inguinal ring. Therefore, during the physical examination, the physician will attempt to feel for herniation by digitally palpating the superficial inguinal ring through the scrotal sac.

Question 255

Radiographic imaging of the brain of an 84-year-old woman reveals a berry aneurysm in the anterior communicating cerebral artery. Rupture of this aneurysm would most likely result in what type of hemorrhage?

Answer 255

subarchnoid

Question 256

When the corneal reflex in a patient is examined, sensory information is conducted from the cornea to the brain via the long ciliary nerve, a branch of CN V-1. The sensory input causes a motor response resulting in the closure of the patient's eyelids. Which motor nerve is being tested when the corneal reflex is being examined?

Answer 256

The orbicularis oculi muscle, the muscle that closes and blinks the eye, is innervated by CN VII, the facial nerve.

Question 257

Ebstein's anomaly is a congenital heart defect where one or two of the tricuspid valve leaflets forms abnormally low because of misalignment. The heart becomes less efficient. What type of murmur would most likely be associated with this type of anomaly?

Answer 257

Systolic murmur with regurgitation The function of the tricuspid valve is to ensure unidirectional flow of blood from the right atrium to the right ventricle. Therefore, when the right ventricle contracts (systole), blood flows into the pulmonary trunk and not back into the right atrium. If the tricuspid valve is malformed and does not function correctly (as in Ebstein's anomaly), blood will regurgitate back into the right atrium during systolic contraction of the right ventricle.

Question 258

spasms of the coracobrachialis muscle, which impinges the nerve that courses through it. Which movement is most likely affected by this muscle spasm?

Answer 258

elbow flexion

Question 259

A 56-year-old man who is diagnosed with rectal cancer is undergoing biopsy of several lymph nodes. The nodes most likely to be sampled from this patient will be from the inferior mesenteric nodes, inguinal nodes, and the:

Answer 259

ymphatics in the abdomen generally follow their associated arteries. Clusters of lymph nodes, which are important in monitoring the immune system, are found along the course of the regional arteries. The rectum is supplied by the following: Superior rectal artery—branch off the inferior mesenteric artery. Middle rectal artery—branch off the internal iliac artery. Inferior rectal artery—branch off the internal pudendal artery. Therefore, if the rectal cancer spreads, it can potentially do so parallel to all three arterial origins. The lymph nodes for the superior and inferior rectal arteries are provided in the stem of the question. The only nodes not mentioned are the internal iliac nodes for the origin of the middle rectal artery.

Question 260

A 46-year-old woman undergoes surgery to fuse (stabilize) the C4–C5 vertebrae due to a herniated disc that is compressing spinal nerves in the neck. The surgeon approaches the cervical vertebrae laterally between the sternocleidomastoid and trapezius muscles. After dissection through the skin and superficial fascia, which of the fascial layers of the neck, from superficial to deep, is the surgeon most likely to dissect through to reach the cervical vertebrae?

Answer 260

Investing to prevertebral

Question 261

After surgery, a 62-year-old patient began experiencing complications. After examination, the physician determined that an important structure located immediately behind the ligamentum arteriosum was damaged during surgery. Which of the following symptoms was the patient most likely experiencing?

Answer 261

Hoarseness of voice The left vagus nerve gives rise to the recurrent laryngeal nerve, located immediately behind the ligamentum arteriosum. The recurrent laryngeal nerve innervates laryngeal muscles that are associated with speaking. Therefore, if the recurrent laryngeal nerve is damaged, the patient will experience a raspy voice or hoarseness. The ligamentum arteriosum (or arteriosus) is the small fibrous remnant of the fetal ductus arteriosum, located between and connecting the proximal left pulmonary artery and the undersurface of the junction of the aortic arch and descending aorta, at the aortic isthmus.

Question 262

Compression of the median nerve in the carpal tunnel leads to weakness in the thenar muscles and the first and second lumbricals as well as cutaneous deficits in which of the following regions?

Answer 262

Palmer surface of digits 2 and 3

Question 263

paralabral cyst arising from a detached inferior glenoid labrum tear compresses neurovascular structures coursing through the quadrangular space. If this condition were to become chronic, which of the following findings would most likely be revealed on an MRI? A Atrophy in the deltoid muscle

Answer 263

Atrophy in the deltoid muscle The axillary nerve courses through the quadrangular space with the posterior humeral circumflex artery. Therefore, compression of the axillary nerve would weaken the deltoid muscle and thus weaken shoulder abduction.

Question 264

Inflammation in Guyon's canal will most likely result in weakness in which of the following movements?

Answer 264

Adduction of digits 2 to 5

Question 265

The suprascapular and dorsal scapular arteries form a collateral circuit on the posterior side of the scapula with which of the following branches of the axillary artery?

Answer 265

The circumflex scapular artery courses through the triangular space to form a collateral circuit with the suprascapular and dorsal scapular arteries.

Question 266

femoral triangle NAVeL

Answer 266

The contents of the femoral triangle are, from lateral to medial, the femoral nerve, femoral artery, femoral vein, and femoral lymph nodes. The acronym NAVL may be helpful in remembering the order where the first letter of each word represents the femoral nerve, artery, vein, and lymphatics.

Question 267

Sweat glands within the S2 dermatome along the posterior region of the thigh most likely receive innervation via preganglionic sympathetic neurons originating from which of the following central nervous system levels?

Answer 267

L2 spinal cord level Preganglionic sympathetic neurons originate between the T1 and L2 spinal cord levels. Dermatomes within the sacral region, such as the S2 dermatome described in this question, are supplied by sympathetics from the L2 spinal cord level, the lowest of all sympathetic innervation origin.

Question 268

The biceps femoris muscle receives its name because it has two origins. One attachment is to the linea aspera of the femur. The other attachment is to the

Answer 268

The biceps femoris muscle is a part of the hamstring group. Each hamstring muscle originates on the ischial tuberosity, which includes the long head of the biceps femoris muscle.

Question 269

Which of the following arteries courses through the proximal part of the interosseous membrane?

Answer 269

The anterior tibial artery branches from the popliteal artery, then courses through the proximal part of the interosseous membrane to enter the anterior compartment of the leg. The interosseous membrane of the leg (middle tibiofibular ligament) extends between the interosseous crests of the tibia and fibula, helps stabilize the Tib-Fib relationship and separates the muscles on the front from those on the back of the leg.

Question 270

A 44-year-old woman is suspected of having meningitis. To confirm the diagnosis, a lumbar puncture is ordered to collect a sample of the cerebrospinal fluid (CSF). Identify the last layer of tissue the needle will traverse in this procedure before reaching CSF.

Answer 270

Arachnoid mater A lumbar puncture collects cerebrospinal fluid and, therefore, the needle has to enter the subarachnoid space, which is located between the arachnoid and pia mater. Therefore, the last layer of tissue the needle would traverse to enter the subarachnoid space is the arachnoid mater.

Question 271

Which of the following muscles can flex, extend, and abduct the glenohumeral joint?

Answer 271

deltoid

Question 272

The greater, lesser, and least splanchnic nerves are examples of which of the following nerves?

Answer 272

Thoracic splanchnic nerves The greater, lesser, and least splanchnic nerves all arise from thoracic spinal nerves (T5–T9 form the greater splanchnic nerves; T10–T11 form the lesser splanchnic nerves; and T12 forms the least splanchnic nerves). The cervical sympathetic nerves course from the superior, middle, and inferior cervical ganglia and course to the pulmonary and aortic plexuses. The lumber and sacral splanchnics are located in the abdominal cavity and serve the abdominal viscera. The pelvic splanchnics originate from the S2–S4 ventral rami and transport preganglionic parasympathetic neurons.

Question 273

During a subclavian venipuncture procedure, the cannula is inserted into the patient's neck just superior to the clavicle. Which of the following is the relative position of the subclavian vein in the root of the neck?

Answer 273

Anterior to the anterior scalene muscle

Question 274

The opening of the coronary sinus is located in which of the following structures? A Left atrium B Left ventricle C Right atrium

Answer 274

The coronary sinus collects venous blood from the coronary circulation and returns the blood to the right atrium. Therefore, the coronary sinus opens into the right atrium.

Question 275

Which of the following structures most likely converts the greater sciatic notch to the greater sciatic foramen? A Obturator membrane B Obturator internus muscle C Piriformis muscle D Sacrospinous ligament

Answer 275

Sacrospinous ligament

Question 276

Which of the following nerves courses between the brachialis and brachioradialis muscles?

Answer 276

radial

Question 277

radiologist is conducting a contrast study of the pulmonary circulation on a 41-year-old man. What is the most likely number of veins observed entering the left atrium? A Two B Three C Four

Answer 277

There are two pairs of pulmonary veins (four veins) that enter the left atrium of the heart.

Question 278

A 50-year-old man is diagnosed with flaccid paralysis limited to the right arm, without pain or paresthesias. No sensory deficits are noted. Laboratory studies reveal that the patient is infected with West Nile virus. The target that the virus has infected resulting in this patient's symptoms is most likely the A Ventral horn of spinal cord gray matter

Answer 278

The patient has no sensory deficits and presents with only motor deficits. Therefore, the virus affects the ventral horn of the gray matter because that is the location of the motor neuron cell bodies.

Question 279

Which of the following structures typically arises from the musculophrenic arteries?

Answer 279

The musculophrenic artery supplies the anterior intercostal arteries for intercostal spaces 7 to 9.

Question 280

The phrenic nerve in the cervical region courses along the anterior surface of which of the following muscles? A

Answer 280

Anterior scalene muscle

Question 281

A 49-year-old woman presents with loss of sweet sensation on the right side of the anterior part of the tongue. Which additional findings may also be seen on the right side of this patient?

Answer 281

Loss of corneal reflex

Question 282

The maxillary artery gains entrance to the pterygopalatine fossa and eventually the nasal cavity and infraorbital canal via which of the following structures?

Answer 282

Pterygomaxillary fissure

Question 283

20-year-old woman stepped on a nail and it penetrated the plantar surface of her bare foot, injuring the lateral plantar nerve. Which of the following muscles would most likely be rendered nonfunctional?

Answer 283

Dorsal interossei muscles The dorsal interossei are muscles innervated by the lateral plantar nerve. The other muscles listed as choices (i.e., first lumbrical, abductor hallucis, flexor digitorum brevis, and flexor hallucis brevis muscles) are all innervated by the medial plantar nerve.

Question 284

55-year-old man who has been diagnosed with colon cancer is noted to have a probable metastatic mass in the neck at the thoracic duct. In which region is the metastasis most likely to be located? Left supraclavicular region

Answer 284

The thoracic duct collects lymph from all regions of the body (including the colon), except for the right side of the head, neck, and right upper limb. Therefore, if a mass is present, it could manifest in the root of the neck where the thoracic duct enters the junction of the left internal jugular and subclavian veins in the supraclavicular region.

Question 285

Which of the following muscles flexes the glenohumeral and elbow joints and supinates the radioulnar joints?

Answer 285

Biceps brachii muscle

Question 286

A 42-year-old man is admitted to the emergency department in shock and requires a saphenous cut down to receive an infusion. To isolate the great saphenous vein in the ankle region, you would most likely determine its location in which of the following areas?

Answer 286

Anterior to the medial malleolus The great saphenous vein is formed from the dorsal venous arch on the dorsum of the foot. The great saphenous vein then courses anterior to the medial malleolus of the tibia, up the medial aspect of the leg.

Question 287

he azygos vein is located in which division of the mediastinum? posterior mediastinum.

Answer 287

he azygos system of veins, along with the thoracic duct, thoracic aorta, esophagus, vagus nerves, sympathetic trunk, and the greater and least splanchnic nerves are located within the posterior mediastinum.

Question 288

In a healthy person, blood from the pulmonary trunk will flow next into which of the following structures?

Answer 288

Pulmonary arteries Deoxygenated blood from the right ventricle is pumped into the pulmonary trunk, which bifurcates into the right and left pulmonary arteries before coursing to the lungs.

Question 289

The suprascapular and dorsal scapular arteries form a collateral circuit on the posterior side of the scapula with which of the following branches of the axillary artery?

Answer 289

Circumflex scapular artery

Question 290

The upper subscapular, lower subscapular, and thoracodorsal nerves branch from which cord of the brachial plexus?

Answer 290

Posterior cord The upper subscapular, lower subscapular, and thoracodorsal nerves branch off of the posterior cord in the axilla, just anterior to the subscapularis muscle.

Question 291

Which of the following nerves perceived pain in the area around the umbilicus and most likely carried the pain sensations to the central nervous system?

Answer 291

lesser splanchnic The T10 dermatome is associated with the umbilical region. Sensory neurons course from the umbilical skin to the T10 spinal cord level. Visceral sensory neurons course from the appendix to the T10 spinal cord level as well as via the lesser splanchnic nerves. Therefore, the referred pain comes from the lesser splanchnic nerve

Question 292

The ischiopubic or conjoint ramus is formed when the ischial ramus joins which of the following structures?

Answer 292

Inferior pubic ramus

Question 293

During surgery of a 60-year-old man, the anterior rectus muscle sheath between the xiphoid process and the umbilicus is incised. In this region, the rectus sheath is derived from which of the following muscles?

Answer 293

he rectus sheath superior to the arcuate line is composed of the aponeuroses from both the external and internal oblique muscles.

Question 294

For general surgical procedures, anesthetics and muscle relaxants are used routinely. However, anesthetics and muscle relaxants may decrease nerve stimulation to skeletal muscles, including the intrinsic muscles of the larynx, which results in closure of the vocal folds. Therefore, tracheal intubation is necessary. Which of the following intrinsic muscles of the larynx may be unable to maintain an open glottis because of the anesthetics?

Answer 294

Posterior cricoarytenoid muscles The posterior cricoarytenoid is the only muscle in the list of choices, which, when stimulated to contract, will open the vocal folds and therefore open the glottis. The other muscles (i.e., cricothyroid, lateral cricoarytenoid, thyroarytenoid, and the transverse arytenoids) will either tense or close the vocal folds.

Question 295

A 5-year-old boy is brought to the pediatrician with a complaint of severe pain, swelling, and redness around his right eye. He is diagnosed with periorbital cellulitis. The pediatrician tells the boy's parents that there is a possibility that the infection could spread to the boy's brain. The most probable route of spread to the brain would be through which of the following structures?

Answer 295

he facial vein drains blood from the orbital region down to the internal jugular vein. However, blood from the orbit also spreads from the orbit via the superior ophthalmic vein through the superior orbital fissure to the cavernous sinus within the skull.

Question 296

The posterior compartment of the thigh primarily receives its blood supply from branches of which of the following arteries?

Answer 296

Deep femoral artery The deep femoral artery gives rise to perforating arteries, which pierce through openings in the adductor magnus muscle insertion and provide the primary vascular supply to the posterior thigh compartment. The inferior gluteal artery provides some vascular supply but not as much as the deep femoral artery.

Question 297

A 34-year-old man is diagnosed with a left internal iliac artery aneurism. As a result, he presents with a left superior gluteal nerve lesion and an accompanying gait disorder. While walking, this patient would most likely compensate by flexing his trunk to the

Answer 297

Left, to lift his right lower limb so that his right foot can be lifted off the ground

Question 298

A 52-year-old man undergoes surgery to biopsy iliac lymph nodes. The physician tells the patient that it is important to identify the peripheral spinal nerves to protect them from being damaged during the surgery. The most likely location to find the genitofemoral nerve is coursing along which of the following surfaces? A

Answer 298

Anterior surface of the psoas major muscle

Question 299

When performing gastric bypass surgery on a 36-year-old woman, the surgeon identifies the hepatogastric and hepatoduodenal ligaments. Together, both ligaments create which of the following structures?

Answer 299

lesser omentum The hepatogastric and hepatoduodenal ligaments are the two components of the lesser omentum. They are named for their attachments to the liver, stomach, and duodenum.

Question 300

trochlear nerve injury During the examination, the patient was most likely unable to accomplish which of the following movements?

Answer 300

Adduction and depression This patient is complaining of double vision, or diplopia. The superior oblique muscle is innervated by the trochlear nerve (CN IV). To clinically test the superior oblique muscle, the patient adducts his eye and then looks inferiorly. Therefore, Choice E (adduction and depression) is the correct answer. Choice B (abduction and depression) is the position for the anatomic action of the superior oblique muscle; however, outward and downward is the location for clinically testing the inferior rectus muscle.

Question 301

During a physical examination, a 24-year-old woman is instructed to lie supine on the examination table. During the procedure, she is instructed to resist allowing the health care provider to pull her feet downward into plantarflexion. The patient presents with right-sided weakness in this task. Which of the following nerves is most likely responsible for this muscle weakness in this patient?

Answer 301

Deep fibular (peroneal) nerve When the feet are pulled downward, the dorsiflexion muscles in the anterior compartment of the leg are being tested. If the patient exhibits weakness in this task, the most likely explanation then is lack of innervation from the deep fibular (peroneal) nerve.

Question 302

While eating popcorn, a child inhaled a kernel into her laryngeal cavity. The popcorn kernel touched the top of her vocal folds, initiating her cough reflex. Which sensory nerve is responsible for relaying the message to the brain that a popcorn kernel has touched the top of the vocal folds?

Answer 302

Internal laryngeal nerve The internal laryngeal nerve is the branch of the vagus nerve (CN X) that provides general sensory innervation to the laryngopharynx and mucosal lining superior to the vocal folds. As such, when a stimulus touches the superior element of the vocal folds, the sensory stimulation is conducted along the internal laryngeal nerve to the brainstem, initiating the cough reflex. The external laryngeal nerve innervates the cricothyroideus muscle. The facial nerve (CN VII) innervates muscles of facial expression. The glossopharyngeal nerve (CN IX) provides sensory innervation for the oropharynx and the posterior third of the tongue. The recurrent laryngeal nerve provides visceral sensory innervation for the mucosal lining inferior to the vocal folds.

Question 303

To Zanzibar by Motor Car

Answer 303

facial nerve branches ``` temporal zygomatic bucal marginal mandibular cervica ```

Question 304

in cranium - there are two types of ganglia - sensory (afferant) and autonomic - the sensory are - sensory are most often affected by shingles no sypapses psuedunipolar

Answer 304

``` trigeminal geniculate VII vestibular and spiral VIII superior and inferior glossophyngeal IX superior and inferior vaga X ```

Question 305

autonomic ganglia in cranium herpes zoster doesn't like autonomic

Answer 305

otic - postganglionic para to parotid - near v3 from IX lesser petrosal nerve ciliary - orbit III submandibular - VII - for submandibular and sublingual glands

Question 306

lack of emotional tearing VII -vs tear reflex (v)

Answer 306

greater petrossal nerve of VII The trigeminal V1 (fifth cranial) nerve bears the sensory pathway of the tear reflexes. When the trigeminal nerve is cut, tears from reflexes will stop, while emotional tears will not. The great (superficial) petrosal nerve from cranial nerve VII provides autonomic innervation to the lacrimal gland.

Question 307

horner's syndrome?

Answer 307

superior cervical ganglion- eyelid droop, eye constricted, flushing of face, slit in eye

Question 308

can't swallow?

Answer 308

v3 - mylohyoid and anterior belly of digastric

Question 309

dilation in one eye

Answer 309

III if shine light in one eye - and it doesn't constrict but the other does? shows which eye isn't working - because both should constrict at the same time - even though light is only going to one - reflex - afferant - II, efferent III

Question 310

cutaneous facial nerve distribution re herpes - where find it?

Answer 310

auricle of external ear

Question 311

superior cervical ganglion

Answer 311

the fight or flight sympathetic ganglion in head - located at based of skull around c2 control vasomotion, pilomotin and sudomotion

Question 312

VI travels with internal carotid in cavernous sinus -

Answer 312

so if carotid has plaque, etc, may affect VI even though a variety of structures in the cavernous sinus

Question 313

loud sounds?

Answer 313

could be VII - stapedius loud low sounds - vs VIII