Embryology and anatomy Flashcards

1
Q

Sonic hedgehog gene mutations

A

Holoprosencephaly (A-P axis)

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2
Q

Wnt-7 gene mutation

A

Limb development (dorsal-ventral axis)

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3
Q

FGF gene mutation

A

Lengthening of limbs

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4
Q

Homeobox (Hox) genes

A

Appendages in the wrong locations

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5
Q

Implantation of the blastocyst occurs?

A

Stick at 6 (days)

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6
Q

Formation of the bilaminar disc timing?

A

2 weeks (=2 layers)

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7
Q

Formation of the trilaminar disc timing?

A
3 weeks (=3 layers)
Primitive streak, notochord, mesoderm and its organization, and neural plate begin to form
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8
Q

Neural tube formed by what cell layer?

A

Neuroectoderm (neural tube closes at 4 weeks)

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9
Q

When is the fetus most susceptible to teratogens?

A

3-8 weeks

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10
Q

What occurs at week 4 or embryogenesis?

A

Limb development (4 limbs)

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11
Q

What occurs at week 6 of embryogenesis?

A

Fetal cardiac activity visible by transvaginal US

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12
Q

What occurs at week 10 of embryogenesis?

A

Genitalia have female/male characteristics

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13
Q

What is the process called that forms the trilaminar disc?

A

Gastrulation (Ectoderm, mesoderm, and endoderm germ layers form)

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14
Q

What comes from surface ectoderm?

A

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

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15
Q

What comes from neuroectoderm?

A

Brain (Neurohypophysis, CNS neurons, oligodendrocytes, astrocytes, ependymal cells, pineal gland), retina and optic nerve, spinal cord
*Think CNS

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16
Q

What comes from neural crest?

A
CA MOTEL PASS *Think PNS and nearby)
Craniofacial bones
Arachnoid/pia mater
Melanocytes
Odontoblasts (teeth)
Trachael cartilage
Enterochomaffin-like cells
Layrngeal cartilage
Parafollicular cells (thyroid)
All ganglia (including adrenal medulla)
Schwann cells
Spiral septum (heart development)
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17
Q

Mesoderm

A

M=middle=meat layer
Muscle, bone, CT, serious linings of body cavities, spleen, CV structures, lymphatics, blood, wall of gut tube, vagina, kidneys, adrenal cortex, dermis, testes, ovaries

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18
Q

Mesoderm defects?

A
VACTREL
Vertebral defects
Anal atresia
Cardiac defects
Tracheo-esophageal fistula
Renal defects
Limb defects (bone and muscle)
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19
Q

Endoderm

A

Gut tube epithelium
Urethra
Luminal epithelial derivatives (lungs, liver, gallbladder, pancreas, eustachian tube, thymus, parathyroid, thyroid follicular cells)

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20
Q

DEformation

A

Extrinsic disruption, occurs after embryonic period

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21
Q

Malformation

A

Intrinsic disruption, occurs during embryonic period

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22
Q

Aplasia

A

Absent organ development despite present primordial tissue

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23
Q

Disruption

A

Secondary break down of previously normal tissue (amniotic band syndrome)

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24
Q

Teratogen: ACE inhibitors

A

Renal damage

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25
Q

Teratogen: alkylating agents

A

Absence of digits

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26
Q

Teratogen: aminoglycosides

A

CN VIII (“a min gly hit the baby in the ear”)

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27
Q

Teratogen: Carbamazepine

A

Facial dysmorphism, dev. delay, neural tube defects phalanx/fingernail hypoplasia

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28
Q

Teratogen: Diesthylstilbestrol (DES)

A

Vaginal clear cell adenocarcinoma, congenital Mullerian anomalies
(Old oral contraceptive)

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29
Q

Teratogen: folate antagonist

A

Neural tube defects

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30
Q

Teratogen: Isotretinoin

A

Severe/multiple birth defects

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31
Q

Teratogen: lithium

A

Ebstein anamoly (atrialized right ventricle–>tricuspid vavle in the ventricle)

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32
Q

Teratogen: methimazole

A

Aplasia cutis congenita

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33
Q

Teratogen: Phenytoin

A

Fetal hydantoin syndrome: cleft palate, cardiac defects, phalanx/finger hypoplasia

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34
Q

Teratogen: Tetracyclines

A

Discolored teeth

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35
Q

Teratogen: Thalidomide

A

Limb defects

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36
Q

Teratogen: valproate

A

Inhibition of maternal folate absorption–>neural tube defects
folATE~valproATE

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37
Q

Teratogen: Warfarin

A

Bone deformities, fetal hemorrhage, abortion, opthalmologic abnormalities

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38
Q

Teratogen: Alcohol

A

FAS- birth defects and ID

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39
Q

Teratogen: cocaine

A

Abnormal fetal growth and fetal addiction, placental abruption

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40
Q

Teratogen: Smoking

A

Low birth weight, preterm labor, placental problems, IUGR, ADHD
nicotine=vasoconstriction
CO–>impaired O2 delivery

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41
Q

Teratogen: Iodine (lack or excess)

A

Congential goiter or hypothyroidism (cretinism-severely stunted physical and mental growth)

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42
Q

Teratogen: Maternal diabetes

A

Caudal regression syndrome (anal atresia to sirenomelia), congenital heart defects, neural tube defects

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43
Q

Teratogen: Vit A excess

A

Extremely high risk for spontaneous abortions and birth defects (cleft palate/cardiac)

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44
Q

Teratogen: X rays

A

Microcephaly, ID (minimize with lead shielding)

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45
Q

Most common type of monozygotic twins? When does separation occur?

A

Monochorionic, diamniotic (75% of monozygotic twins)

4-8 days after formation of morula

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46
Q

Separation of monozygotic twins at 0-4 days?

A

Dichorianic, diamniotic between 2 cell stages and morula

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47
Q

Cytotrophoblast is part of what?

A

Fetal component of placenta

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48
Q

What is the cytotrophoblast made out of?

A

Inner layer of chorionic villi

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49
Q

Syncytiotrophoblast is part of what?

A

Fetal component of placenta

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50
Q

Syncytiotrophoblast is made out of?

A

Outer layer of chorionic villi, secrets hCG (structually similar to LH, stimulates corpus luteum to secrete progesterone during first trimester)

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51
Q

Decidua basalis if part of what?

A

Maternal component of the placenta

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52
Q

Decidua basalis is made out of what?

A

Derived from endometrium. Maternal blood in the lacunae.

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53
Q

How many umbilical arteries are there?

A

2

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54
Q

How many umbilical veins are there?

A

1

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55
Q

What vessel deliveries deoxygenated blood from the fetal internal iliac arteries to the placenta?

A

Umbilical arteries

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56
Q

What vessel delivers oxygenated blood from the placenta to the IVC via the ductus venosus

A

Umbilical vein

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57
Q

Where are the umbilical arteries and vein derived from?

A

Allantois

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58
Q

What does the allantois become?

A

Urachus, a duct between fetal bladder and yolk sac

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59
Q

Patent urachus

A

Total failure of urachus to obliterate–>urine discharge from umbilicus

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60
Q

What forms from the yolk sac in week 3 of embryogenesis?

A

Allantois, which extends into urogenital sinus

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61
Q

Urachal cyst

A

Partial failure of urachus to obliterate; fluid-filled cavity lined with uroepithelium, between umbilicus and bladder

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62
Q

Presence of urachal cyst leads to risk of?

A

Infection and adenocarcinoma

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63
Q

Vesicourachal diverticulum

A

Slight failure of urachus to obliterate–>outpouching of the bladder

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64
Q

Vitelline duct

A

Connection between the yolk sac and the midgut lumen

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65
Q

What week does the vitelline duct close?

A

week 7

66
Q

Vitelline fistula

A

Vitelline duct fails to close–>meconium and discharge from umbilius

67
Q

Meckel diverticulum

A

Partial closure of vitelline duct, with patent portion attach to ileum, may have heterotopic gastric/pancreatic tissue–> melena, hematochezia, abdominal pain

68
Q

Treacher Collins syndrome

A

1st arch neural crest fails to migrate–>mandibular hypoplasia, facial abnormalities

69
Q

Congenital pharyngocutaneous fistula

A

Persistence of cleft and pouch–>fistula between tonsillar area and lateral neck

70
Q

Branchial pouch- 1st

A

Middle ear cavity, eustachian tube, mastoid air cells

71
Q

Branchial pouch- 2nd

A

Epithelial lining of palatine tonsil

72
Q

Branchial pouch- 3rd

A

Doral wings-develop into inferior parathyroids

Ventral wings-develop into thymus

73
Q

Branchial pouch- 4th

A

Dorsal wings-develop into superior parathyroids

74
Q

DiGeorge syndrome branchial pouch defect

A

Abberant 3rd and 4th pouch development–>Thymic aplasia and failure of parathyroid development (hypocalcemia)

75
Q

MEN2A

A

Mutation of germline RET (neural crest cells):
Adrenal medulla (pheochromocytoma)
Parathyroid (tumor): 3/4 branchial pouches
Parafollicular cells (medullary thyroid cancer)

76
Q

Cleft lip pathology

A

Failure of fusion of the maxillary and medial nasal processes (Formation of the primary palate)

77
Q

Cleft palate pathology

A

Failure of fusion of the two lateral palatine processes or failure of fusion of lateral palatine processes with the nasal septum/median palatine process (formation of secondary palate)

78
Q

Female genital embryology-first step

A

Default dev: Mesonephric duct degerenates and paramesonephric duct develops

79
Q

Male genital embryology first step

A

SRY gene on Y chromosome produce testis determining factor–> testis development

80
Q

What do the sertoli cells secrete in male genital dev?

A

Mullerian inhibitory factor that suppresses dev. of the paramesonephric ducts

81
Q

What do leydig cells secrete in male genital dev?

A

Androgens that stimulate development of the mesonephric ducts

82
Q

Paramesonephric ducts aka?

A

Mullerian ducts

83
Q

Paramesonephric ducts develop into?

A

Female internal structures

84
Q

What are the female internal genital structures and what are they derived from?

A

Fallopian tubes, uterus, upper portion of the vagina

Derived from the paramesonephric ducts

85
Q

Mullerian agenesis presents as?

A
Primary amenorrhea (lack of uterine development)
Fully developed secondary sex characteristics (functional ovaries)
86
Q

Mesonephric duct aka?

A

Wolffian duct (me-so-horny=male)

87
Q

Mesonephric duct

A

Develops into male internal structures EXCEPT prostate

88
Q

What are the male internal genital structures and what are they derived from?

A

SEED

Seminal vesicles, ejaculatory duct, Epididymis, ductus deferens)

89
Q

In females, the remnant of the mesonephric duct becomes?

A

Gartner duct

90
Q

Septate uterus

A

Y shaped uterus on contrast
Incomplete resorption of septum
Decreased fertility
Treat with septoplasty

91
Q

Bicornuate uterus

A

Incomplete fusion of Mullerian ducts–> Increased risk of complicated pregnancy

92
Q

Uterus didelphys

A

Complete failure of fusion–>double uterus, vagina, and cervix.
Pregnancy possible

93
Q

Male/female genital tubercle becomes

A

Male: Glans penis and Corpus cavernosum/spongiosum
Female: Glans clitoris and Vestibular bulbs

94
Q

Male/female urogenital sinus becomes

A

Male: Bulbourerthral glands (Cowper) and Prostate gland
Female: Greater vestibular glands (Bartholin) and
Urethral and paraurethral glands (Skene)

95
Q

Male/female urogenital folds becomes

A

Male: Ventral shaft of penis
Female: Labia majora

96
Q

Male/female labioscrotal swelling becomes

A

Male: Scrotum
Female: Labia majora

97
Q

Hypospadias

A

Abnormal opening of the urethra onto the ventral side-failure of urethral folds to fuse
More common than epispadias

98
Q

Epispadias

A

Abnormal opening of penile urethra on dorsal surface of penis due to faulty positioning of genital tubercle (makes glans penis/corpus cavernosum&spongiosum)

99
Q

Hypospadias is associated with?

A

Inguinal hernia and cryptochidism

100
Q

Extrophy of the bladder associated with?

A

Epispadias

101
Q

Gubernaculum (band of fibrous tissue) in males becomes

A

Anchors testes within scrotum

102
Q

Gubernaculum (band of fibrous tissue) in female becomes

A

Ovarian ligament + round ligament of uterus

103
Q

Processus vaginalis (evagination of peritoneum) in males becomes

A

Tunica vaginalis

104
Q

Processus vaginalis in females becomes

A

Obliterated

105
Q

Gubernaculum function

A

Aids in the descent of the testes and ovaries

106
Q

Where does the proximal vagina/uterus lymphatics drain?

A

Obturator, external iliac, hypogastric nodes

107
Q

Infundibulopelvic ligament (suspensory ligament of the ovary) connects?

A

Ovaries to the pelvic wall

108
Q

Infundibulopelvic ligament (suspensory ligament of the ovary) structures that are contained?

A
Ovarian vessels (ligate these vessels during oophorectomy to avoid bleeding)
Ureter courses retroperitoneally, close to gonadal vessels-->at risk of injury during ligation of ovarian vessels
109
Q

Cardinal ligament connects?

A

Cervix to side wall of pelvis

110
Q

Cardinal ligament contains?

A

Uterine vessels

Ureter at risk of injury during ligation of uterine vessels in hysterectomy (water under the bridge)

111
Q

Round ligament of the uterus connects?

A

Uterine fundus to labia majora

Derived from gubernaclum

112
Q

Broad ligament connects?

A

Uterus, fallopian tubes and ovaries to pelvic side wall

113
Q

Ovarian ligament connects?

A

Medial pole of ovary to lateral uterus

Derived from gubernaculum

114
Q

Broad ligament contains?

A

Ovaries, fallopian tube, road ligaments of uterus

115
Q

What comprises the broad ligament?

A

Mesosalpinx, mesometrium, and mesovarium

116
Q

Histology of the ovaries

A

Simple cubodial epithelium

117
Q

Pathway of sperm during ejaculation

A
SEVEN UP
Seminiferous tubules
Epididymis
Vas deferens
Ejaculatory ducts
nothing
Urethra
Penis
118
Q

Pelvic fracture puts what male genital area at risk?

A

Posterior membranous urethra

119
Q

Blunt trauma puts what male genital area at risk?

A

Posterior bulbar urethra

Injury to the posterior urethra–>urine leakage into the retropubic space

120
Q

Perineal straddle injury puts what male genital area at risk?

A

Anterior urethra, urine can lead into the deep fascia of Buck. If fascia is torn, urine escapes into superficial perineal space

121
Q

Ejaculation uses what nerves

A

Visceral and somatic nerves (pudendal)

122
Q

Emission uses what nerves

A

Sympathetic nervous system (hypograstric nerve)

123
Q

PDE-5-inhibitors mechanism

A

Erectile dysfunction

Decreases the breakdown of cGMP

124
Q

Spermatagonia functions and location

A

Germ cells-maintain germ pool and produce primary spermatocytes
Line the seminiferous tubules

125
Q

Sertoli cells function and location

A

Secrete inhibin –> inhibit FSH

Line seminiferous tubules

126
Q

Sertoli cells are a homolog of what female cell?

A

Granulosa cells

127
Q

What secretes androgen-binding- protein and what is it’s function?

A

Sertoli cells secrete ABP and it stimulates local testosterone levels

128
Q

What secrets inhibin and what is its function?

A

Sertoli cells secret inhibin, and it negatively inhibits FSH

FiSH

129
Q

What was testosterone negatively feedback on after being produced by the leydig cells

A

Hypothalamus (-GnRH) and -LH

130
Q

What forms the blood-testis barrier?

A

Tight junctions of the sertoli cells (isolates gametes from autoimmune attack)

131
Q

What is MIF produced by?

A

Sertoli cells

132
Q

If temperature is decreased how is sperm production affected?

A

Decreased sperm production (and inhibin)

133
Q

If temperature is decreased how is testosterone production affected?

A

Unaffected.

134
Q

Leydig cells are homologs of what female cells?

A

Theca interna cells

135
Q

What is the most potent form of estrogen?

A

Estradiol (>estrone>estriol)

136
Q

Where is estrogen produced?

A

Ovary (17B-estradiol), placenta (estriol), adipose tissue (estrone via aromatization)

137
Q

What is the function of estrogen?

A

Develops genitals and breast tissue, and fat distribution
Growth of follicle, endometrial proliferation, ^ myometrial excitability
Up-regulates estrogen, LH, and progesterone receptors
Inhibition of FSH and LH, then LH surge
Stimulation of prolactin secretion

138
Q

What is progesterone produced?

A

Corpus luteum, placenta, adrenal cortex, testes

139
Q

What is the function of progesterone?

A

Stimulation of endometrial glandular secretions and spiral artery development
Maintenance of pregnancy
Decrease myometrial excitability
Production of thick cervical mucus, which inhibits sperm entry into uterus
Increases body temperature
Inhibitions LH and FSH
Uterine smooth muscle relaxation (prevents contractions
Decreases estrogen receptor expression
Prevents endometrial hyperplasia

140
Q

How many days in the luteal phase?

A

14 days always (ovulation+14 days=menstruation)

141
Q

How many days is the follicular phase?

A

varies-Ovulation+ 14 days= menstruation

142
Q

Conducting zone of the respiratory tree

A

Nose–>terminal bronchioles

Warms air but does not participate in gas exchange

143
Q

What is the part of the respiratory tree that doesn’t exchange oxygen called?

A

Anatomic dead space

144
Q

What is the cell type from the beginning to terminal bronchioles?

A

Pseudostratified ciliated columnar cells

145
Q

What kind of cells line after the terminal bronchioles after the respiratory tree?

A

Cuboidal cells

146
Q

Where do the goblet cells and cartilage end?

A

Bronchi

147
Q

What is considered the respiratory zone of the tree?

A

Lung parenchyma: respiratory bronchioles, alveolar ducts, alveoli
Participates in gas exchange

148
Q

What type of cells line the respiratory bronchioles?

A

Cubodial cells

149
Q

What type of cells line the alveoli?

A

Simple squamous

150
Q

Where does the cilia terminate?

A

At the end of the respiratory bronchioles

151
Q

Where does airway smooth muscle end?

A

Terminal bronchioles

152
Q

Type 1 pneumocytes

A

97% of alveolar surfaces, gas exchange

153
Q

Type 2 pneumocytes

A
Secrete pulmonary surfactant
Stem cells (proliferate during lung damage)
154
Q

Club cell pneumocytes

A

Nonciliated; low-columnar/cubodial with secretory granules

Secrete component of surfactant, degrade toxins, act as reserve cells

155
Q

Lecithin to spingomyelin should be what to signify fetal lung maturity?

A

> 2 in amniotic fluid

156
Q

What gestational week is surfactant synthesis fully functional?

A

35 weeks (begins to produce ~26)

157
Q

What is the “scientific” name for surfactant?

A

Lecithins (dipalmitoylphosphatidylcholine is the most important)

158
Q

Collapsing pressure=

A

2 (surface tension)/radius

159
Q

Relation of pulmonary artery to each lung hilum?

A

RALS
Right lung=anterior
Left lung=superior

160
Q

What structures perforate the diaphragm? name what level

A

IVC-T8 Esophagus-T10 Aorta-12

“I 8, 10 eggs, at 12”

161
Q

Where should you do a thoracentesis?

A

Midclavicularly: above 7th rib (I broke my clavicle when I was 7)
Midaxillary: 9th rib (It took nine AXes to chop down the tree)
Post scapular line: 11th rib

162
Q

How far is the lung away from the pleura?

A

2 ribs above