Final! Flashcards
Which of the following types of medical imagining is/are useful for visualizing moving structures? A) doppler ultrasound B) Ultrasound C) Radiography D) Positron emission tomography E) magnetic resonance imaging F) computerized tomography
- A, B and E
Which of the types of imaging listed above is/are used to create cross-sections of internal structures? A) doppler ultrasound B) Ultrasound C) Radiography D) Positron emission tomography E) magnetic resonance imaging F) computerized tomography
- A, B, D, E, F
Which anatomical plane is at a right angle to the frontal plane and divides the body into unequal right and left sides?
*Sagittal
In anatomical position, which surface of the hand faces posterior?
*dorsal
Moving digits 2 through 4 away from the midline of the hand or foot is called?
*abduction
What is the anatomical term to describe the movement of the foot inferiorly?
*plantarflexion
Name the anatomical plane that divides the body in superior and inferior parts?
*transverse
Which is/are false?
A) regarding skin, tension lines and stretch marks refer to the same thing
B) heterotropic bones form in soft tissues where they are not normally present
C) osteoporosis in the pathological reduction in the quantity of bone
D) avascular necrosis is the loss of bone mass that can result from the immobilization of a limb
E) a bone of the axial skeleton is the sternum
*A, D
What is a facet?
*smooth flat area covered with cartilage
What is a foramen?
*passage through a bone
Which is/are false?
A) a separated cartilaginous epiphysis can be the result of injury in an adult
B) an effect of age is the degeneration of the cartilage of synovial joints
C) a myocardial infarct is the result of compensatory hypertrophy
D) the difference in the wall thickness of arteries versus veins is mostly due to difference in the thickness of the tunica intima
E) ischemia is the reduction in blood supply to an organ or tissue
*A, C, D
Which is/are false?
A) skin ligaments connect deep fascia with the skin
B) the lymphoid circulatory system collects extracellular fluid and transports it to the blood circulatory system
C) lymphadenema is the inflammation of lymph nodes
D) two components of the musculovenous pump are the muscles and venous valves
E) arteriosclerosis is commonly called hardening of the arteries
F) arteries form plexuses around veins
*F
Why do axons of the CNS fail to successfully regenerate after injury, in contrast to those of the PNS?
A) CNS injuries are fatal
B) CNS axons lack any ability to regrow after injury
C) regenerating CNS are misled by chemical signals that prevent proper regrowth
D) CNS axons lack a connective tissue sheath to guide the regenerating axons
E) CNS astrocytes form scar tissue that blocks successful regeneration
*D, E
Distinguish between a dermotome and a myotome:
- a dermotomem is a patch of skin in which cutaneous innervation is provided by a single spinal nerve. Myotome is part of a muscle in which motor innervation is provided by a single spinal nerve
For the following effects, write P if the effect is due to parasympathetic inputs, and S if the effect is due to sympathetic inputs:
- relaxation of smooth muscle in the walls of peripheral blood vessels
- reduction in heart rate
- increase in output of sweat glands
- increase in motility
- erection of penis/clitoris
- dilation of the pupil
- salivary secretion becomes thicker, more viscous (dry mouth)
- increased blood pressure
- S, P, S, P, P, S, S, S,
Several structures are condensations of fascia, such as skin ligaments. Name two others?
*tendons, deep fascia
Name a palpable bone of the back other than a part of the vertebral column:
*spine of scapulae
Which is/are false?
A) the somatic sensory division of the peripheral nervous system carries propriceptive information and visceral information about which we are not typically aware
B) the autonomic sensory division of the peripheral nervous system carries efferent impulses
C) the CNS processes or integrates sensory information and creates a motor ouput
D) the PNS carries information to and from the CNS
E) the supracristal line is an imaginary line connecting the posterior superior iliac spines, and indicates the inferior limit of the lumbar cistern
*A, B, E
Which is/are false?
A) gray rami are found at spinal level C2
B) the sympathetic chain of ganglia is found at vertebral levels T1 through L2
C) synapses between preganglionic and postganglionic somatic fibers are found in sympathetic chain ganglia
D) inputs from the parasympathetic motor division help to prepare the body for rest and digestion
E) arrector pili muscles, sweat glands, and the smooth muscles in the walls of peripheral blood vessels are innervated by the somatic motor system
*B, C, E
Target organs of the parasympathetic motor system are located in:
*pelvis and head
What are the CNS origins of the parasympathetic motor nerves?
*spinal segments S2-S4, and cranial nerve nuclei 3,7,9,10
What is the name of the pathway of the sympathetic motor nerves?
*spinal nerve pathway
What are the CNS origins of the sympathetic motor nerves?
*spinal segments T1-L2`
According to our discussion what is the anatomical differences between motor circuits of the somatic versus the autonomic motor divisions?
- somatic from CNS to effector, one motor neuron
* autonomic: 2 motor neurons, synapse in a prevertebral ganglion
Distinguish between the effector of the autonomic motor system versus the somatic motor system?
*effectors of autonomic are cardiac and smooth muscle and glands. effectors of somatic are skeletal muscles
Which is/are false?
A) preganglionic parasympathetic axons are shorter than postganglionic parasympathetic axons
B) white ramus contains preganglionic parasympathetic axons
C) acetylcholine is the neurotransmitter in the synapses of the paravertebral ganglia
D) the ratio of sympathetic preganglionic motor neurons to postganglionic motor neurons is approximately 1:15
*A, B
Which is/are false?
A) a dermatome in which a patient has lost sensation can indicate the location of a damaged motor nerve
B) a nucleus is located in the CNS, while a ganglion is located in the PNS
C) spinal nerves contain autonomic motor and autonomic sensory fibers as well as somatic motor and somatic sensory fibers
D) motor neurons project to effectors
E) afferent fibers belong to the sensory division of the somatic or the autonomic system
*A
Distinguish between the contents of ventral and lateral horns of the spinal cord. In your answer, be sure to discuss their roles in the nervous system.
*v: neuron cell bodies of somatic motor neurons whose axons transmit motor output to skeletal muscles
L: neuron cell bodies of autonomic motor neurons whose axons transmit afferent impulses from sensory organs to CNS
Distinguish between the posterior versus anterior rami of a typical spinal nerve in terms of the sensory and motor projections of each.
*A: sensory innervation to cutaneous areas of trunk, and motor innervation to all other skeletal muscles
P: sensory innervation to skin overlying the deep back muscles and to zygopophysical joints, and motor innervation to deep back muscles
Which is/are false?
A) arterial anastomoses may be congenital or acquired
B) all veins have valves
C) an arterial anastomosis is a communication between multiple branches of an artery
D) surgical anastomosis can connect blood vessels or two parts of the gastrointestinal tract
*B, D
Which is/are false?
A) rectus abdominus flexes and extends intervertebral joints
B) psoas major flexes intervertebral joints
C) erector spinae extends intervertebral joints
D) external oblique flexes, extends, and laterally flexes, and rotates intervertebral joints
*B, C
What is the general function of the superficial layer of back muscles?
- move and stabilize upper limb
What is the general function of the intermediate layer of back muscles?
*proprioception
Name the boundaries of the triangle of auscultation?
*medial: trapezius L: rhomboid major I: latissimus dorsi F: thoracolumbar fascis R: superficial fascia
What is the clinical significance of the triangle of auscultation?
*no muscle between stethoscope and ribs, so easier to hear breathing (lungs)
In order, name the arteries a drop of blood passes through as it travels from the descending thoracic aorta to an anterior spinal artery?
- posterior intercostal artery, spinal branch, anterior segmental medullary artery, anterior spinal artery
Circle the answers that is/are false?
A) the cauda equina contains nerve roots of lumbar and sacral spinal nerves
B) the body of a lumbar vertebra supports the weight of the trunk, upper limbs, and head
C) in most people, the dura mater between vertebral levels L2 and S2 contains a space called the lumbar cistern, which is filled with cerebrospinal fluid
D) the annulus fibrosis is the yearly celebration of those afflicted with fibrotic breasts
*D
Circle the answers that is/are false?
A) the shingles vaccine reduces the probability of contracting shingles by approximately 20%
B) post-herpetic neuralgia is a complication of the chicken pox (varicella) vaccine
C) shingles virus causes referred pain in the dermatomes
D) the shingles vaccine is recommended for children who have had chicken pox
E) the shingles virus lives in the dermatome after a child has recovered from chickenpox and prior to an outbreak of shingles
*A, B, C, D, E
A needle properly inserted in the median plane of the lumbar region for the purpose of injecting an epidural anesthetic would enter and/or pass through?
*ligamentum flavum, superficial fascia, supraspinour ligament, skin, interspinous ligament, extradural space
Name the ligament that stabilizes or tethers the spinal cord laterally?
*denticulate ligaments
Name the structure that stabilizes or tethers the spinal cord inferiorly?
*external filum terminale
Defend or refute the following statement: an epidural hematoma of the spinal cord results from leakage of a vessel of the external vertebral venous plexus.
- refute
- external vertebral venous plexus is found external to vertebral formamen. The spinal cord is within. If an epidural hematoma were to occur, it would need to be the internal vertebral venous plexus for this leakage to be at the spinal cord.
In the event of rupture of a lumbar intervertebral disk, where in relation to the vertebral bodies does the bulge typically occur? Describe the location referring to the vertebral bodies and nearby structures (We already know that the disks involved are most likely L4-L5 and L5-S1, and that is not what I’m asking)
B) according to our discussion in class, why does the bulge occur where it does and not in some other place in relation to the vertebral body? In your answer, you must take into account the anatomy of structures associated with the vertebral column.
- posterior laterally
- the anterior and posterior longitudinal ligament limit the hernia to lateral areas, though the posterior is smaller and allows more room for herniation posteriorly.
Circle the answers that is/are false?
A) all veins have valves
B) in health, the cerebrospinal fluid is in contact with the arachnoid matter
C) arachnoid trabeculae are bathed in cerebrospinal fluid
D) the dura mater of the brain and spinal cord are continuous
*A
We discussed several ways in which vertebral column structures might impinge on spinal nerve and/or spinal nerve roots. Which vertebral structures, in pathology, might compress the spinal nerves and/or nerve roots? name two
- herniated disk
* osteophytes of intervertebral foramen
In one common example of referred pain, a problem in the stomach results in pain felt in the skin in the center of the back, at the level of the T4-5 dermatomes. The stomach is found deep inside the abdomen, yet the pain is felt in the skin in a remote location from the stomach. What is the relationship between the visceral sensory nerves of the stomach and the somatic sensory nerves in this part of the back that accounts for referred pain?
*the visceral and somatic sensory nerves project on the same spinal segment
Circle the answers that is/are false:
A) herniated intervertebral discs are most often found in the thoracic region
B) nucleus pulposus may escape by rupture of the annulus fibrosis
C) sciatica is referred pain
D) gluteus medius paralysis often occurs as a result of improper lifting of heavy objects
*A, C, D
Describe gluteal gait
*compensate for gluteus medius paralysis, swing one leg out when walking to help with hip drop
In a patient with gluteal gait, which nerve is mostly likely damaged? And Which muscle is affected?
- superior gluteal nerve
* gluteus medius
What is the most common reason for traumatic damage to the sciatic nerve? And what is the preferred treatment for this injury?
- improper gluteal injection
* surgical correction, go in and flood drug out
*name the innervation and blood supply of these compartments of the thigh: anterior and posterior
- A: inn- femoral nerve, BS- deep femoral artery
* P: inn- sciatic nerve, BS- penetrating branches of deep artery of thigh
A knife blade enters the left medial superior quadrant of the gluteal region. The injury was superior to the piriformis, damaging a nerve present in this area. Name that nerve:
After the emergency is attended to, and the patient is feeling better, you attempt to diagnose the extent of the injury. You ask the patient to stand and to lift the right foot off the ground name of describe the result.
You now ask the patient to lift the left foot off the ground. name or describe the results
- superior gluteal nerve
- pelvis drop on opp side of injury
- pelvis stays level
Name the innervation and BS of these compartments of the arm: anterior and posterior
*A: inn- musculocutaneous nerve, BS: brachial artery
P: inn-radial nerve, BS- deep artery of arm
Name the general action of the posterior compartment of the arm?
*extensor of forearm
Name one general action of the anterior compartment of the thigh?
*extend knee, flex hip
Describe sciatica in terms of its:
- presentation in a patient
- Diagnosis
- 2 treatments
- pain felt down L4-S4, pain in butt down to foot, foot drop
- straight leg test
- do nothing goes away in 6-8 weeks, anti-inflammatory medication
Which of the following are risks associated with insufficient sleep?
A) the metabolic syndrome
B) increased daytime sleepiness
C) decreased performance of simple and complex tasks
D) depressed immune function
E) increased accident rate
*A, B, C, D, E
Circle the answers that is/are false:
A) the nervous plelxuses are made up of complicated networks of posterior rami
B) a herniated L4-5 disk is likely to compress the L4 spinal nerve root
C) the nucleus pulposis is derived from the notochord
D) in a laminectomy, the laminae and spinous processes are removed to expose the posterior spinal cord
*A, B
Circle the answers that is/are false?
A)d osteoporosis is more common in elderly men than in elderly women
B) primary kyphosis is a pathological anterior convex curve of the thoracic vertebral column
C) the temporary lordosis of pregnancy is a lateral curvature of the vertebral column
D) lordosis is concave anteriorly
E) secondary lordosis is due to the change in shape of vertebral bodies in the cervical and lumbar vertebral column
F) cervical and lumbar kyphoses appear around the time a baby holds her head up, and begins walking, respectively
*A, B, C, D, E, F
Circle the answers that is/are false:
A) fibers that innervate the intervertebral disks accompany the gray ramus
B) the meninges are innervated by the recurrent meningeal branch
C) equatorial branches supply the vertebral bodies with blood
D) basivertebral veins drain the vertebrae
*none
Circle the answers that is/are false?
A) it is impossible to make up sleep
B) a person is easily roused from stage three/four sleep
C) in 1960, American on average slept 9 hours per night
D) wakefulness is greatest in late morning and early afternoon
E) under normal circumstances, a person completes one cycle of sleep per night
*A, B, E
Circle the answers that is/are false:
A) the triradiate cartilage separates the three hip bones until around the time of puberty
B) the sacrotuberous ligament connects the sacrum and the ischial tuberosity, enclosing the lesser sciatic foramen
C) the tensor of the fascia lata is innervated by the fibular division f the sciatic nerve
D) the gluteus minimus is an adductor of the hip
E) the superior gemellus, inferior gemellus, and obturator internus are medial rotators of the hip
- B, C, D, E
Circle the answers that is/are false:
A) both the breast and the upper limb lymphatic drainage is to the axillary lymph nodes
B) the basilic vein is a superficial vein that enters the deltpectoral triangle
C) the median cubital vein is often used in venipuncture
*B
Circle the answers that is/are false:
A) the infrascapular nerve passes deep to the superior transverse scapular ligament
B) teres major is a lateral rotator of the humerus
C) supraspinatus and infraspinatus are medial rotators of the humerus
D) the anterior compartment of the forearm is innervated by the musculocutaneous nerve
E) the blood supply of the forearm is provided by the ulnar and median arteries
*A,B,C,D
Nearly all c ells in a normally developing human have the same gentic sequence. We discussed a few ways that account for different tissues arising from identical embryonic cells. name one
*differential gene expression
Distinguish between induction and transduction:
*induction is when cells give off signals that effect the fate of nearby cells. Transduction is when an external signal is changed into an internal signal
Circle the answers that is/are false:
A) epithelium is a sheet of cells that can remain a sheet, or take the form of a tube or sphere
B) mesenchyme is the layer of cells between the epiblast and the hypoblast
C) ligand is a molecule that binds to DNA
D) weeks three through eight of development are called fetogenesis or embryogenesis
E) the trophoblast gives rise to the tissues that will eventually develop into the fetus
*D, E
Circle the answers that is/are false:
A) the bilaminar germ disk is composed of epiblast and mesoblast
B) under normal circumstances, an embryo implants during week two
C) the morula stage consists of an epiblast, hypoblast, and blastocoel
D) the blastocyst forms during week two of development
*A, B, C, D
Which is/are present at the end of week two of normal development? A) notochord B) primitive streak C) bilaminar germ disk D) lateral plate mesoderm E) hypoblast
*B, C, E
Compare week 3 through 8 of development with weeks 9-36 in terms of 1) risk of malformations, and 2) the reason that the risk differs in the two periods
1) week 3-8 have a higher risk for malformations than weeks 9-36
2) week 3-8 is when critical systems CNS, PNS developing and the mother doesn’t usually know she pregnant at week 3 so she is vulnerable to environmental things that can harm these systems
A sacrococcygeal teratoma is the result of:
A) failure of somite formation
B) failure of the closure of the posterior neuropore
C) insufficient mesoderm in the prechordal plate
D) failure of the primitive streak to close at the proper time
E) incomplete formation of the blastocyst
*D
Distinguish between myelomeningocoele versus raschisis. In your answer, make sure you characterize the anatomy of each condition completely.
*m: Neural tube defect, meninges and neural tissue herniate
R: NTD, expose neural tissue to amniotic fluid which erodes tissue
Name 3 cells or tissues that are derived from neural crest cells?
*PNS, facial skeleton, melanoblast
During week 2 of development, which 2 layers does the embryoblast (inner cell mass) give rise to?
And what 2 cavities are formed?
- epiblast, hypoblast
* amniotic, and yolk sack
During week 3 of development: which three layers are formed?
*mesoderm, endoderm, ectoderm
We discussed two definitive structures that arise from the prechordal plate. name one:
*heart
According to our discussion in class, what is the cause of caudal dysgenesis?
*not enough cells migrated through the primitive streak
Circle the answers that is/are false:
A) the lateral plate mesoderm gives rise to the urogenital structures
B) the paraxial mesoderm gives rise to the membranes that line the body cavity
C) the sclerotome arises from the paraxial mesoderm
D) planar cell polarity genes are thought to play important roles in convergent extension
E) sonic hedgehog from the notochord affects somite differentiation
*A, B
Circle the answers that is/are false:
A) neurulation is the formation of the neural tube
B) a proper diet and/or 400 micrograms of folic acid prevents 70% of NTD
C) hyper and hypoglycemia are risk factors for NTD
D) having a close relative with a NTD is a risk factor for NTD
*none
Circle the answers that is/are false:
A) babies who were exposed to alcohol in utero can develop characteristic facial features including an indistinct philtrum and narrow palpebral fissures
B) fetal alcohol exposure interferes with prechordal plate mesoderm development
C) holoprosencephaly involves the failure of normal development of the lower limb
D) the prechordal plate is an inducer of the forebrain
*C
According to our discussion in class, alcohol interferes with which chemical signal? A) BMP (bone morphogentic protein) B) TGF (transforming growth factor) C) WNT (wingless, integrated) D) SHH (sonic hedgehog)
*D
Circle the answers that is/are false:
A) somites respond to sonic hedgehog by forming the sclerotome
B) tissues derived from the sclerotome include the dermis and deep back muscles
C) deep back muscles develop from cells of the somites
D) somites differentiate into bone and muscle
*B
Name the imaginary vertical line passing through the middle of the scapula and inferiorly down the thorax and abdomen:
*scapular line
Which rib is later to the sternal angle?
What is the number of the intercostal space superior to that rib you named above?
- rib 2
* 1st
Circle the letter to indicate which answers is/are false:
A) the superior thoracic aperture is bounded by the anterior body of T1, the first rib, the clavicle, and the manubrium of the sternum
B) the inferior thoracic aperture is bounded by the anterior body of T12, the 8th and 7th ribs, and the xiphoid
C) the roof of the intercostal space is superficial fascia, and the floor of the space is the endothoracic fascia
D) the internal thoracic and musculophrenic arteries deliver blood directly to the anterior intercostal arteries
E) anterior and posterior intercostal arteries anastomose
*A, B
Circle the letter to indicate which answers is/are false:
A) anterior rami of spinal nerves 1 through 12 innervate the thoracic wall
B) the anterior ramus of spinal nerve 11 is the subcostal nerve
C) at intercostal space 4, intercostal muscles present on the scapular line are transversus thoracis, innermost intercostal, and external intercostal
D)visceral pleura is attached to endothoracic fascia
*B, C, D
Name the vessels that a drop of blood passes through in order, starting at the thoracic aorta then the posterior intercostal artery, and ending in the internal thoracic vein.
*thoracic aorta, posterior intercostal artery, anterior intercostal artery, anterior intercostal vein
In intercostal space 5, at the midclavicular line, which muscle is/are found in the intercostal space?
*internal intercostal muscle
Circle the letter to indicate which answer is/are false:
A) the pleural cavity is a real space only in pathology
B) during quiet breathing, exhalation requires muscle contraction
C) the central tendon and immediately surrounding muscle have both somatic and visceral innervation, while the periphery of the diaphragm has only somatic innervation
D) the diaphragm moves superiorly with exhalation, and inferiorly with inhalation
*B
Name two vessels that supply the diaphragm with blood:
*musculophrenic artery, phrenic artery
Circle the letter to indicate which answers is/are false;
A) the yolk sac encircles the embryo as a result of lateral and longitudinal folding occurring in weeks 3 and 4
B) the rapid growth of the neural tube is one of the forces that causes longitudinal folding
C) longitudinal folding brings the developing prechordal mesoderm that will become the central tendon of the diaphragm into its definitive position
D) the septum transversum divides the thorax into two separate pulmonary cavities
*D
Which layers give rise to the serous membranes that line the body cavity? A) amnion B) visceral lateral plate mesoderm C) somatic lateral plate mesoderm D) chorion E) extraembryonic mesoderm
*B, C
A smoker with advanced emphysema at the apex of the right lung contracts a pulmonary infection. the infection is initially found at the apex of the left lung. Given what you know about the innervation in this vicinity, characterize the pain the patient feels at this stage of the infection.
- the patient has high deductible health insurance, and so doesn’t seek medical treatment, allowing the infection to spread to the pleural cavity. upon auscultation, what do you expect to hear?
- where does pus resulting from the infection eventually drain when the patient is sitting or standing?
- after the patients immune system fails to resolve the infection, and the fluid continues to collect, what do we call the condition?
- Characterize the pain the patient feels at this stage of the infection?
- given this condition what is the name of the procedure used to drain the fluid from the patient’s body?
- no pain
- pleural rub
- costodiaphragmatic recess
- pleural effusion
- dull unlocalizable pain due to visceral innervation of central part of diaphragm, referred pain over shoulder and side of neck due to visceral innervation of central part of diaphragm, sharp localizable pain due to somatic innervation of peripheral part of diaphragm
- thoracentesis
Describe where on the thorax to perform a thoracentesis.
*8th or 9th intercostal space
Name the layers/structures pierced by the need when performing a thoracentesis.
*skin, superficial fascia, external oblique, external intercostal, internal intercostal, innermost intercostal, endothoracic fascia, parietal pleurae
Name three flat muscles that are found in the anterolateral abdominal wall.
*external/internal oblique, transversus abdominus
Circle the letter to indicate which answers is/are false:
A) abdominal cutaneous innervation is by cutaneous branches of the anterior rami of spinal nerve T5 through L1
B) lymph drainage of the anterolateral abdominal wall superior to the transumbilical plane is primarily to the axillary lymph nodes
C) the inferior epigastric artery delivers blood to the rectus abdominus
D) the linea alba is lateral to the semilunar line
E) the inguinal ligament is the boundary between the abdomen and the thigh
*A, D
Circle the letter to indicate which ansers is/are false:
A) the fetal umbilical arteries are obliterated to become the definitive round ligament of the liver
B) the ductus deferens is found in the medial umbilical fold
C) the inferior epigastric vessels are found in the lateral umbilical fold
D) the urachus is found in the median umbilical fold
E) the umbilical folds are formed by an underlying structure and covered with parietal peritoneum
*A, B
Under pathological circumstances, blood that would normally flow from the superficial lower abdomen and into the femoral vein on its way to the heart reverses direction and flows instead superiorly through the thoracoepigastric vein into the axillary vein, where it returns to the heart through the superior vena cave. which large abdominal vessel must be blocked to cause blood to flow through this route?
*inferior vena cava
Circle the letter to indicate which answer is/are false:
A) the gastrocolic ligament connects the greater curvature of the stomach with the lesser curvature of the stomach
B) the hepatogastric ligament contains the portal triad
C) the hepatophrenic ligament connects the greater curvature of the stomach with the diaphragm
D) the lesser omentum connects the lesser curvature of the stomach with the liver
*A, B, C
Mark all the structures that are found in the anterior rectus shealth superior to the arcuate line.
- rectus abdominus muscle, external oblique muscle, superficial fascia, internal oblique muscle, posterior leaflet of internal oblique deep fascia
Circle the letter to indicate which answers is/are false?
A) parietal peritoneum is a serous layer, derived from mesoderm, and is in contact with the endoabdominal fascia
B) an organ is considered peritoneal if it is mostly covered by parietal peritoneum
C) the mesentery, the transverse mesocolon, and the sigmoid mesocolon are examples of peritoneal ligaments
D) peritoneal ligaments provide pathways for vessels, nerves, and lymphatics
*none
Circle the letter to indicate which answer is/are false:
A) the hindgut is the GI tract from the splenic flexure to the rectum and anal canal
B) the blood supply of the foregut is the celiac trunk and its branches
C) the smooth muscle of the stomach wall is made up of two layers: inner circular and outer longitudinal
D) water absorption occurs primarily in the large intestine
E) the GI tract is viscerally innervated from the stomach to the pectinate line of the anal canal
*C
Circle the letter to indicate which answers is/are false:
A) in the duodenum, bile is added to increase the pH of the duodenum contents
B) the gastric juice is acidic
C) the pancreas secretes digestive enzymes
D) the GI tract is dually innervated
E) parasympathetic inpurs to the GI tract are by the abdominopelvic splanchnic nerves
*A, E
A 46 year old male patient presents with black, tarry stool and his stool specimen is also streaked with bright red blood. He is employed as a household pesticide sprayer, and he self-reports that he has a drinking problem. Upon examination, you find caput medusae, and palpation reveals an enlarged, overly firm liver. According to our discussion in class, and given these symptoms, precisely which condition does the patient have?
- describe how the patient’s damaged liver and his circulatory anatomy contributes to this symptom: black, tarry stool
- cirrhosis of liver
- death of hepatocytes and replace with connective tissue and fat, leading to increase resistance to flow of hepatic portal blood through liver, so blood must find another route back to heart. The distal esophagus veins become distended and rupture in esophagus and blood goes through the GI track and becomes black and tarry
Name two treatment options for cirrhosis of the liver:
- liver transplant
* portosystemic shunt
Circle the letter to indicate which answers is/are false:
A) the omental foramen is the opening between the greater and lesser sacs of the peritoneal cavity
B) the plane of the sternal angle divides the mediastinum into superior versus inferior portions
C) the plane of the sternal angle passes through the C7-T1 intervertebral disk
D) the middle mediastinum contain the heart, pericardium, and roots of the great vessels
*C
Name the boundaries of the mediastinum:
*F: diaphragm R: superior thoracic appature A: sternum and costal cartilage P: vertebral bodies T1-T12 L: mediastinal pleurae
Circle the letter to indicate which answer is/are false:
A) the oblique pericardial sinus is a convenient spot in which to clamp the pumonary trunk and aorta during heart surgery
B) the right coronary artery is responsible for 50% of all atherosclerotic occlusions
C) a complication of atherosclerotic occlusion is that part of the atherosclerotic plaque can rupture and cause clotting within the vessel
D) blood in the coronary veins returns to the heart through the coronary sinus
E) the visceral pericardium and the parietal pericardium are continuous at pericardial reflections
*A, B
Circle the letter to indicate which answer is/are false:
A) the circumflex branch is found in the anterior interventricular sulcus
B) the right coronary artery is found in the coronary sulcus
C) pulmonary circuit is pressurized by the right ventricle
D) the ligamentum arteriosum connects the pulmonary trunk to the aorta
E) the left ventricle is thinner walled than the right ventricle because the systemic circuit has less resistance to blood flow than does the pulmonary circuit
*A, E
Name two treatments for coronary atherosclerotic plaques:
- coronary bypass
* stent
Circle the letter to indicate which answers is/are false:
A) the embryonic gut tube is composed of endoderm and surrounded by mesoderm
B) organs that are secondarily retroperitoneal include the ileum and the jejunum
C) remnants of the embryonic dorsal mesentery are the falcirorm ligament and the greater omentum
D) the vitelline duct is a feature of the midgut, and the allantois is a feature of the hindgut
*B, C
How do rotational abnormalities lead to congenital atresia and stenosis in the GI tract?
*they twist and can cut off blood supply to areas causing atresia or stenosis
Circle the letter to indicate which answers is/are false:
A) in week 4 of embryonic development, the midgut loop forms
B) the cranial loop of the midgut loop gives rise to the future small intestine
C) in week 5 of embryonic development, the cranial and caudal loops rotate 90 degrees counterclockwise around the axis of the superior mesenteric artery
D) in week 6, the physiological herniation retracts into the abdomen and turns 270 degrees counterclockwise
*A, C, D
Circle the letter to indicate which answers is/are false:
A) congenital aganglionic megacolon is caused by failure of neural crest cell migration
B) an ileal diverticulum is an ectopic appendix, located in the distal ileum instead of the cecum
C) under normal circumstances, the vitelline duct disappears during weeks 10-11 of embryonic development
D) volvulus is the pathological twisting of the GI tract
*B
Distinguish between gastroschisis and omphalocoele in terms of embryologic origins and prognosis.
*G: reherniation of midgut loop through umbilicus due to weakness, high survival rate
O: midgut loop doesn’t return back to normal position, associated with cardiac problems, high mortality
Circle the letter to indicate which answers is/are false:
A) esophageal atresia sometimes occurs due to a failure of re-canalization of the esophagus
B) a fistula is an abnormal connection between two organs, or between an organ and the outside
C) a tracheoesophageal fistula is usually accompanied by esophageal atresia
D) cyanosis is a clinical sign of tracheoesophageal fistula
*C
Circle the letter to indicate which answer is/are false:
A) ulcer is the erosion of the gastric lining, and most cases are caused by the bacterium Helicobactor pylori
B) referred pain of gastric ulcer is centered around the xiphoid
C) smoking and alcohol use are risk factors for ulcer
D) a duodenal ulcer can erode the gastroduodenal artery
E) referred pain of duodenal ulcer is felt in the skin over the liver
*none
Name one diagnostic tests for ulcers:
*endoscope
Circle the letter to indicate which answers is/are false:
A) the epicardium lines all the chambers and covers the valves of the heart
B) the myocardium consists of cardiac myocytes, which are attached to each other via gap junctions
C) the smooth parts of the atria are derived from the walls of blood vessels
D) the papillary muscles contract just prior to ventricular systole to ensure that the atrioventricular valve cusps do not prolapse
E) the origins of the right and left coronary arteries are in the sinuses of the pulmonary valve
*A, E
WE discussed 5 functions of the fibrous skeleton of the heart. name two.
- make sure valves open/close the right way
* electrically insulates atria and ventricles
Circle the letter to indicate which answers is/are false:
A) the fossa ovalis is located in the interventricular septum
B) the sinuatrial node is located near the opening of the coronary sinus
C) the closure of the semilunar valves is the source of the first heart sound
D) the purkinje fibers are cardiac cells specialized for the conduction of impulses in the walls of the ventricles
E) the oval foramen allows fetal blood to bypass the lungs by moving directly from the right atrium to the left atrium
*A, B, C
Through which fetal circulatory vessel does blood pass from the pulmonary trunk directly to the aorta, bypassing the lungs?
*ductus arteriosus
Through which fetal circulatory vessel does blood pass from the umbilical vein directly to the inferior vena cave, bypassing the liver?
- ductus venosus
You perform a proper needle pericardiocentesis using a parasternal approach. In order from outside to inside, name the layers/structures/spaces that the tip of the needle will pass through or enter.
*skin, superficial fascia, external intercostal membrane, internal intercostal muscle, fibrous pericardium, parietal pericardium, pericardial cavity
