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Anatomy Block 3 > Clinical Anatomy > Flashcards

Clinical Anatomy Flashcards

1
Q

What is used as a reference point for accurately identifying rib number or intercostal space and where is it located

A

Sternal angle (2nd costal cartilage)

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2
Q

Where do crushing injuries tend to break ribs

A

At the angle

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3
Q

Where will Direct injuries to the rib fracture them

A

can be anywhere

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4
Q

Which ribs are most commonly fractured and why?

A

Middle ribs because of exposed position

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5
Q

When might you experience pain with a fractured rib

A

during respiration coughing or sneezing especially

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6
Q

Where is the needle placed in a thoracentesis or local anesthesia to intercostal space and why?

A

over superior border of the rib (to avoid damage to vein artery and nerve in costal groove on inferior border)

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7
Q

What will provide collateral circulation in the event of coarctation (narrowing) of the descending aorta

A

anastomoses between anterior and posterior intercostal arteries

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8
Q

Why are penetrating/nonpenetrating wounds of the superior mediastinum dangerous and when are they common

A

Because of the number of large vessels there (high speed decelerating injuries)

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9
Q 
If a massive knife wound penetrated the back and posterior mediastinum what might be injured?
Thoracic duct
Arch of aorta
Inferior  vena cava
Left atrium of heart
Trachea
A

Thoracic duct

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10
Q

What aspect of the lung is at risk with wounds to the neck and what does it lie behind?

A

apical extremity behind sternocleidomastoid

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11
Q

What is a pneumothorax and what does it disrupt or change

A

Air into the pleural cavity

neutralizes the normally negative intrapleural pressure to atmospheric pressure

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12
Q

What is Pericardiocentesis

A

Drainage of fluid from the pericardial sac to relieve pressure from around the heart

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13
Q

If you had an accumulation of fluid in the pericardial sac exerting pressure on the heart what might it do?

A

restrict venous returen (cardiac tamponade

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14
Q

Where would you insert the needle for a pericardiocentesis and why?

A

5th or 6th intercostal space close to sternum

it is the location of the cardiac notch so you wont hit lung

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15
Q

What initiates the electrical impulse that drives the cardiac cycle

A

SA node

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16
Q

What can modulate the SA node

A

parasympathetic and sympathetic input from cardiac plexus

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17
Q

What was the embryonic structure and role of the fossa ovalis

A

foramen ovalis that shunted blood from right to left

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18
Q

IF the foramen ovalis does not close what is it called

A

atrial septal defect

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19
Q

If an atrial septal defect is large enough what can occur in the heart

A

movement of blood from left to right atrium and onto right ventricle, causing increased load and RIGHT SIDE ENLARGEMENT

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20
Q

What is Right dominant heart and what is a left dominant heart

A

Right coronary artery has the posterior descending and supplies left ventricle and interventricular septum along with right

left coronary artery has the posterior descending and supplies right ventricle and interventricular septum along with left

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21
Q

Which is more common Right or left dominant heart

A

Right dominant 50%

Left dominant 20%

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22
Q

What section of the right ventricle is smooth

A

Conus arterious region

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23
Q

Where do parietal and visceral plerua meet

A

root of lung

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24
Q

How do you get visceral pain in thoracic and abdominal cavity

A

signal travels back reverse of the pathway that brought sympathetic supply to the organ (returns to same segment supplying preganglionic sympathetic for the organ)

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25
Q

Where is heart pain referred to

A

1st to 5th intercostal spaces and medial aspect of upper limb

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26
Q

Where is gall bladder pain referred to

A

7th to 9th intercostal spaces

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27
Q

Where is appendix pain referred to

A

Umbilical region (T10-T11 level)

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28
Q

What controls peristalsis of the gastrointestinal tract

A

parasympathetic fibers

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29
Q

What stimulates acid secretion by parietal cells in the stomach

A

vagal parasympathetic fibers

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30
Q

What may be done to reduce excess acid formation with peptic ulcers

A

transection of vagal trunks

31
Q 
What is the major fiber component of the greater splanchnic nerve
Pregang sym
postgang sym
pregang para
postgang para
brachiomotor
A

Pregang sym (sensory fibers also travel in the greater splanchnic nerve)

32
Q 
Transection of the vagus in the upper thoraax would least affect which of the following organs
esophagus
heart
stomach
gall bladder 
kidney
A

Heart
Parasympathetic cardiac fibers from vagus arise in the cervical region and travel toward the cardiac plexus independent of vagus proper

33
Q 
What is the most likely location of referred pain from the appendix
Right shoulder
Umbilical region
inferior border of scapula
anterior neck
inguinal region
A

Umbilical region

34
Q

What would rupture of the male urethra lead to and why is this so

A

accumulation of urine between layers in the abdominal wall

due to continuity of superficial membranous fascia with superficial fascia of the perineum

35
Q

What would the cremaster reflex test the integrity of

A

genitofemoral and ilioinguinal nerves

36
Q

Is the cremaster reflex more active in younger or older males

A

Younger

37
Q

What is a hydrocele

A

Accumulation of fluid in the tunica vaginalis or patent processus vaginalis

38
Q

What is a varicocele

A

pampinifiorm plexus of veins is dilated and tortuous

39
Q

What is cut/ligated in a vasectomy

A

ductus deferens bilaterally

40
Q

where is the incision made in a vassectomy

A

superior wall of the scrotum

41
Q

What is the name for protrusion of the abdominal visceral through either inguinal ring

A

inguinal hernia

42
Q

A hernia that follows the normal rout of the testis before birth is what

A

indirect inguinal hernia

43
Q

A hernia that protuedes directly through the abdominal wall in the ingunal triangle and through the superficial ring is what

A

Direct inginal hernia

44
Q

Where would an indirect hernia occur relative to the inferior epigastric vessels

A

Lateral

45
Q

Where would an direct hernia occur relative to the inferior epigastric vessels

A

Medial

46
Q

Which type of inguinal hernia is more common in adult males

A

direct

47
Q

Which type of inguinal hernia is more common in young males

A

indirect

48
Q

Why are inguinal hernias more common in males than females and which ones are rarest in females

A

Because they have fewer and smaller structures passing through abdominal wall

Direct inguinal hernias are more rare

49
Q

What forms the anterior wall of the rectus sheath at the umbilicus

  • superficial membranous fascia and external oblique aponeurosis
  • External oblique and internal oblique aponeurosis
  • Internal oblique and transversus abdominus aponeuroses
  • transversus abdominis aponeurosis and transversalis fascia
  • transversalis fascia and peritoneum
A

External oblique and internal oblique aponeurosis

50
Q 
The cremaster muscle is derived from which of these
exeternal oblique
internal oblique
superficial membranous fascia
tranversus abdominis
transversalis fascia
A

internal oblique

external oblique: external spermatic fascia
Transversalis fascia: internal spermatic fascia
Superfical membranous fascia: dartos and fascia of scrotum

51
Q

What is a hiatal hernia

A

protrusion of part of the stomach through the esophageal haitus of the diaphragm

52
Q

What can cause a hiatal hernia

A

Weakening of musculature around haitus in midle aged individuals

53
Q

In a common hiatal hernia what specifically slides through the hiatus and when

A

cardia and parts of fundus of stomach

especially when idividual lies down or bends over

54
Q

What is appendicitis and what causes it

A

acute inflammation of appendix

from obstruction of the lumen of the organ

55
Q

What is the is the pain progression of appendicitis

A

dull pain in paraumbilical region to serious pain in posterior abdominal wall due to irritation of the sensitive parietal peritoneum

56
Q

What may result from a ruptured appendix

A

Peritonitis (infection of the peritoneum)

57
Q

What are the two common locations for gallstones to lodge

A

distal end of hepatopancreatic ampula (ampula of Vater)

junction of gallbladder neck and cystic duct

58
Q

What could result from blockage of the hepatopancreatic ampulla (from a gallstone)

A

Pancreatitis

59
Q

What are 2 things that could cause pancreatitis

A

blockage of the hepatopancreatic ampulla (from a gallstone)

blockage of pancreatic duct (from swelling of pancreatic head)

60
Q

If you obstruct the ampulla of vater (hepatopancreatic) what can happen

A

Reflux of bile into pancreatic duct

61
Q

If you fracture the lower ribs on the left side what may result

A

rupture of the spleen

62
Q

What are 2 ways to rupture the spleen

A

fracture of lower ribs on left

blunt trauma causing sudden increase in intraabdominal pressure

63
Q

What is the benefit of the greater omentum when one organ is inflamed

A

it is higly mobile and can wrap itself around and inflamed organ thereby protecting other viscera from infection

64
Q 
what specific part of the intestine would receive a gallstone that passed through the common bile duct
1st part of the jejunum
ascending (4th) part of duodenum
horizontal (3rd) part of duodenum
descending (2nd) part of duodenum
superior (1st) part of duodenum
A

Descending (2nd) part of duodenum

65
Q 
The posterior boundary of the omental (epiploic) foramen is formed by what
duodenum
inferior vena cava
lesser omentum
stomach
transverse colon
A

Inferior vena cava

Anteriorly: hepatoduodenal ligament
Superiorly: caudate lobe of liver
Inferiorly: 1st part of duodenum

66
Q

In resection of parts of the gastrointestinal tract why must the vessels in peritoneal structrures be identified?

A

to retain blood supply to the portions not removed

67
Q

if the superior mesenteric artery is occluded slowly over many months what happens to the involved bowl

A

it is nourished by blood of the inferior mesenteric artery by way of marginal artery

68
Q

What is the major pathway for a venous emoli from the lower extremity, pelvis and perineum and where would it go

A

Inferior vena cava

to right heart and the lungs

69
Q

What is Nutcraker syndrome also called and what is it commonly caused by

A

renal vein entrapment syndromee

compression of left renal vein between superior mesenteric artery and the abdominal aorta

70
Q

What are symptoms of nutcracker syndrome

A

Blood in urie and abdominal left flank pain

71
Q

What would the clinical manifestations of portal hypertesion include

A

Varicosities of rectal veins (hemorrhoids)
Esophageal varices
varicosities of cutaneous veins around the umbilicus (caput medusae)

72
Q

What clinical manifestation of portal hypertension is often most severe and possibly fatal

A

bleeding from esophageal varices

73
Q 
Occlusion of the ileocolic artery could result in ischemia of which of the following organs
descending colon
pacnreas
transverse colon
rectum
appendix
A

appendix

ileocolic supplies appendix ileum and seum

pancreas: grecieves from branches of celiac and proximal superior mesenteric

transverse colon: middle colic from SMA

Colon/rectom: branches from IMA

74
Q 
Which of the following is a tributary of the hepatic portal venous system
common iliac vein
suprarenal vein
superior rectal vein
renal vein
inferior phrenic vein
A

superior rectal vein

crosses over the common iliac vessels to become the inferior mesenteric vein

all others drain into inferior vena cava

Anatomy Block 3 (16 decks)

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