GEM 1st Flashcards
Name the three most common anatomical planes and their divisions
Sagittal = left and right
Transverse or axial = superior and inferior
Coronal = posterior and anterior
Name the four basic types of tissue and give examples?
Connective tissue (bone, blood, adipose, cartilage, reticular)
Epithelial tissue (squamous, columnar, cuboidal)
Muscle tissue (skeletal, smooth, cardiac)
Nervous tissue (neurons, glial)
Name the 8 cranial bones
Name the systolic followed by diastolic reference ranges (mmHg) for: hypotension, normal, hypertension
<90/60 (hypotensive)
<120/80 (normal range)
>140/90 (hypertensive)
Name two functions of the blood in relation to thermoregulation
Distributing heat from active organs
Vasodilation or vasoconstriction to regulate blood flow towards the skin (convection)
Name five transport functions of the circulatory system
(Hormones) from endocrine glands to target tissues
Molecules and cells for the (immune system)
(Nutrients) from the digestive tract to the liver
(Oxygen) from the respiratory system to the cells
(Waste products) from our cells to the respiratory and excretory systems
What are the two hormones secreted by alpha and beta cells in the pancreas and what do they do?
Alpha cells secrete glucagon which stimulates the liver to release glucose into the blood and stops the liver from taking up more glucose.
Beta cells secrete insulin which stimulates the liver, skeletal muscle, and adipose tissue to take up glucose.
How much glucose (g) circulates in the blood of an average (70kg) adult at a given time?
4g
What are the three dietary monosaccharides?
Glucose, fructose, galactose
What are the three different types of capillaries and give some examples of where they can they be found?
Continuous - allow small molecules through (found in muscle, skin, fat, and nerve tissue)
Fenestrated - found where extensive molecular exchange occurs (small intestine, kidneys, endocrine glands)
Sinusoidal - contains larger gaps and an incomplete basement membrane for exchange of larger molecules and even cells (liver, spleen, lymph nodes)
Describe the ultrastructure of the arteries
Lumen - typically narrower in arteries compared to veins and without valves
Tunica intima - endothelium made up of simple squamous epithelial cells, followed by a basement membrane and internal elastic lamina
Tunica media - typically the thickest layer, made up of smooth muscle cells that can vasoconstrict or dilate, followed by the external elastic lamina
Tunica adventitia - consists of elastic and connective tissue as well as vasa and nervi vasorum
Describe the path of blood through the systemic circulation, starting from the pulmonary veins and ending with the capillaries
- Left atrium
- Mitral valve
- Left ventricle
- Aortic (Semilunar) valve
- Aorta
- Arteries
- Arterioles
- Metarterioles
- Capillary bed
What is pulse pressure and what is the normal range?
Difference between systolic and diastolic blood pressure
40-60mmHg
What is peripheral (vascular) resistance and where is it highest?
The resistance that must be overcome to circulate blood
Highest in arterioles (narrow lumen)
What are the four main components of blood?
55% plasma (water, proteins, ions, dissolved gases)
45% Erythrocytes
Leucocytes
Thrombocytes
What are the 3 main plasma proteins?
Albumin - Maintains oncotic pressure, carries molecules and drugs, scavenges free radicals
Fibrinogen - clotting factor
Globulins - Alpha (such as HDL), beta (such as LDL), gamma (Antibodies)
If fibrinogen and other clotting factors are removed from plasma, what is left?
Serum
What are 4 main steps of haemostasis?
Vasospasm - smooth muscle tissue contracts to reduce bloodflow
Platelet plug - collagen and von Willebrand factor in the vessel wall are exposed to thrombocytes, which activate and become dendritic. Thrombocytes also release Ca2+ which signals thrombocyte aggregation
Coagulation - fibrinogen is then converted to fibrin, which forms a mesh that traps more platelets and erythrocytes to form a thrombus
Fibrinolysis - plasmin breaks down the clot and anticoagulants and vasodilators are released
What are the four pillars of medical ethics?
Autonomy (of patient’s)
Beneficence
Non-maleficence
Justice
What is a solvent and give an example?
The liquid in which a solute is dissolved in to make a solution.
E.g. water is a solvent for salt (solute) which makes brine (solution)
How many particles does one mole (mol) contain?
6.02 x 10^23
Known as Avogadro’s constant
What is the relative charge and relative mass of the three subatomic particles?
Electrons: 1/2000 mass, -1 charge
Protons: 1 mass, +1 charge
Neutrons: 1 mass, 0 charge
What are the 3 dietary disaccharides?
Sucrose, Lactose, Maltose
Define cations and anions?
Positively (cation) or negatively (anion) charged atoms
What is an isotope?
A different form of an element that contains the same number of protons and electrons but a different number of neutrons
Which three factors affect Ionisation energy?
- Nuclear charge (number of protons)
- Distance from the nucleus (reduces with distance)
- Shielding (number of electrons between an outer electron and the nucleus)
Why does it take more energy to remove each successive electron from an atom?
Electrons are being removed from an increasingly positive ion so the force of attraction due to be broken is greater.
Why is it easier to remove an electron from an orbital containing two electrons?
Electron repulsion (as electrons are both negatively charged)
What happens to ionisation energy when moving down groups in the periodic table?
Ionisation energy reduces.
Each element down a group has an extra electron shell, (increased distance and electron shielding from inner shells)
What happens to ionisation energy when moving across periods in the periodic table?
Ionisation energy increases.
Increased number of protons (nuclear attraction) but at roughly the same level (no electron shielding)
What are valence electrons?
An electron in the outer shell of an atom which can participate in the formation of chemical bonds (e.g. covalent bonds)
Describe the structure of a neuron
Are epithelial tissues vascularised?
No. Epithelial tissues are avascular
What are the two main types of nerve cells?
Neurons and glial cells
Where is the pyloric sphincter and what does it do?
At the inferior end of the stomach. Allows chyme to pass into the duodenum.
What are the three phases of digestion?
Cephalic
Gastric
Intestinal
What are the 3 main roles of the liver?
Detoxification - the liver filters all blood from the stomach and intestines and metabolises drugs and toxins into less harmful/more usable components
Synthesis - of bile which is used for fat digestion, neutralising chyme, and for moving waste along the intestine
Storage - of fat soluble vitamins (A,D,E,K) and glycogen
What is the function of the gallbladder?
To concentrate and store bile which is synthesised in the liver
What is the role of the pancreas?
Produces digestive enzymes which are secreted into the duodenum (lipase, protease, amylase)
Produces pancreatic hormones (glucagon, insulin)
Where are leptin and ghrelin produced?
Leptin is produced in adipose tissue and inhibits hunger. Leptin production is directly proportional to the amount of adipose tissue one has.
Ghrelin is produced in the stomach. Ghrelin levels are highest before a meal
What are the two forms of endocytosis?
Phagocytosis - ingestion of particles
Pinocytosis - ingestion of liquid droplets
What is erythropoietin?
A hormone made in the kidneys that stimulates erythropoiesis (erythrocyte production).
What are the roles of the kidneys?
- Removal of wastes
- Control of blood pressure
- Control of blood pH
- Erythropoietin production
What could high levels of erythropoietin indicate?
Anaemia
How long is the average lifespan of an erythrocyte?
100-120 days
What is HbA1c and why is it unreliable in patients with sickle cell disease?
HbA1c measures glycated haemoglobin in the bloodstream and indicates average levels over the past 3 months (limited by erythrocyte lifespan of 100-120 days).
HbA1c is underestimated in sickle cell disease as erythrocyte lifespan is only 10-20 days.
Describe the structure of haemoglobin
2 alpha and 2 beta globins surround 4 heme groups. Heme group contains a porphyrin ring and one iron atom per group.
What is the mesentary and what is it’s function?
A fold of membrane that attaches the intestine to the abdominal wall.
Prevents intestines from collapsing or twisting.
What is the role of the smooth endoplasmic reticulum?
Synthesises and stores lipids (such as cholesterol and phospholipids).
Has various other functions.
What is the defining feature and what is the role of the rough endoplasmic reticulum?
Is studded with ribosomes.
Synthesises proteins
What is the function of the Golgi apparatus?
Responsible for modifying and packaging proteins and lipids into vesicles for exocytosis or transport around the cell
What is a lysosome?
Membrane bound organelles that contain digestive enzymes for invading pathogens or worn out cell parts
Give an overview of haematopoiesis and the two main lineages
Where are mast cells found and what is their role?
Located in connective tissue close to the external environment (mucosal surfaces, skin, intestines etc.)
Contains granules with histamine, heparin, cytokines and other inflammatory mediators. Involved with allergic reactions and parasitic defence
What is saltatory conduction?
Occurs in myelinated axons where an action potential in a node of ranvier triggers the flow of current to the next node, speeding up the transfer of nerve signals
What is the difference between the autonomic and somatic nervous system?
Autonomic - mediates unconscious activities. Only has motor pathways
Somatic - mediates conscious activities. Has motor and sensory pathways
What does a natural killer cell do?
Innate immune cells that destroy damaged cells which no longer produce major histocompatability complex 1 (mhc1) on their cell surface
What is haematocrit and what are the normal ranges in men and women?
% of erythrocytes in the blood.
Men: 41-50%
Women: 36-48%
What is the glycocalyx?
The sugar coat on the outer surface of the plasma membrane.
It aids in the binding of some cells and facilitates cell recognition.
What would happen if an erythrocyte was placed in a Hypertonic solution?
The fluid bathing the erythrocyte contains a high level of solute relative to the cytoplasm, therefore water would diffuse out of the cell, causing the cell to shrivel (Crenation).
Name two carrier-mediated transport systems and provide examples?
Facilitated Diffusion - Ion channels transported down an electrochemical gradient.
Active transport - Uses ATP to transport solutes against their concentration gradiets e.g. Na+, K+ pump
What is a gene?
A sequence of DNA that codes for a protein or polypeptide
How many homologous pairs of chromosomes do humans inherit?
23 pairs
What is the genotype?
The set of genes possessed by a particular organism
What is the phenotype?
The expression of the genotype - may also have environmental influences!
What are Newtons 3 laws of motion?
- A body will remain in a uniform state of motion unless acted upon by an external force
- F = ma
- For every action, there is an equal and opposite reaction
What is the starling principle?
Fluid movements between blood and tissues are determined by differences in hydrostatic and oncotic pressures between plasma inside microvessels and fluid outside them
What is the difference between laminar and turbulent flow and when do they occur?
Laminar flow is constant and often occurs at low velocities. Turbulent flow involves irregular fluctuations and mixing, often at higher velocities.
E.g. A waterfall exhibits both from start (laminar) to finish (turbulent) as water accelerates due to gravity.
In chemistry compounds ending in ‘ide’ are types of what?
Anions (negatively charged ions)
(e.g. chloride, oxide, sulphide)
What is a covalent bond?
A chemical bond that involves the sharing of electron pairs between atoms.
What is an ionic bond?
A type of chemical bond that involves the electrostatic attraction between oppositely charged ions, or between two atoms with sharply different electronegativities.
Ionic bones tend to be stronger than covalent bonds
Is a water molecule polar or nonpolar, and what is the net charge of a water molecule?
Water is a polar molecule as the oxygen atom hogs electrons, giving it a partial negative charge, whereas the hydrogen atoms have a partial positive charge.
The net charge of water is zero
Why is water both cohesive (sticks together) and adhesive (sticks to other things)?
Due to its polarity
Outline the main divisions of the human nervous system and their roles
What are the two human gametes?
Sperm cell - male
Egg cell - female
Are gametes diploid or haploid?
Haploid (23 chromosomes)
All other human cells are diploid, containing 23 chromosome pairs
What are the four main types of macromolecules?
Carbohydrates
Lipids
Proteins
Nucleic Acids
What are the four bases of DNA?
A - adenine
T - thymine
G - guanine
C - cytosine
What are the four RNA bases?
A - adenine
U - uracil
C - cytosine
G - guanine
What are the four protein structure types?
Describe the basic structure of an amino acid
Central Carbon atom
- Hydrogen
- Carboxyl group
- Amino group
- R side chain
List the four main types of carbohydrates and give examples for each
What are the three main types of lipids?
Phospholipids - used to make the polar bilayer of human cells
Sterols - Cholesterol is the primary sterol in humans. Formed in the liver and used to make hormones and bile salts. Phytosterols are found in plants.
Triglycerides - Found in food, the blood, and adipocytes. Either unsaturated or saturated
Describe the chemical structure of a phospholipid
Describe the chemical structure of a triglyceride
Glycerol backbone bound to 3 fatty acid chains
What are the three types of polysaccharides and their functions?
Starch - (amylose and amylopectin) plant energy storage
Glycogen - animal medium-term energy storage
Cellulose - plant structure (indigestible)
What is an enzyme?
Proteins that help to speed up chemical reactions in animals.
Enzymes convert ‘substrates’ into ‘products’ at the active site
Human enzymes normally work best at 37c and at a specific pH related to their area of operation.
Where are the adrenal glands located?
On top of the kidneys
‘Add’ - ‘Renal’
Describe how DNA is stored
As tangled chromatin fibres during interphase. Chromatin forms into chromosomes during Prophase.
Chromosomes are made from tight strands of chromatin. Chromatin is made of tight bundles of histones. DNA is wound around histones to form nucleosomes
Describe tonicity
A measure of the effective osmotic pressure gradient between two solutions separated by a semipermeable membrane. It determines whether water will move into or out of a cell.
Isotonic = No net movement
Hypotonic = Water in (lyse)
Hypertonic = Water out (crenate)
What section of the nervous system does a reflex arc fall under?
Somatic nervous system
Why is iodine important for the thyroid?
Iodine is used to create thyroid hormones, namely triiodothyronine (t3) and thyroxine (t4).
Iodine deficiency slows the metabolism and eventually caused an enlarged thyroid (goiter)
Which part of the body regulates homeostasis?
Hypothalamus (via autonomic nervous and endocrine systems)
Which three pathways do the hypothalamus and pituitary gland use to direct neuroendocrine function?
HPT axis (homeostasis)
HPA axis (flight or fight)
HPG axis (reproduction)
What is cardiac output?
The amount of blood the heart pumps in 1 minute
= stroke volume (ml/beat) x BPM
What is a normal cardiac output for an average sized human at rest?
5-6 litres (per minute)
What is stroke volume and what is a normal range?
Volume of blood ejected out of the left ventricle at each heart beat.
50-100ml
Explain a reduction-oxidation (Redox) reaction
‘OIL RIG’
Oxidation is loss of electrons (becomes positively charged)
Reduction is gain of electrons (becomes negatively charged)
What is an electronegative element? Give an example
An element which attracts electrons (to fill a shell).
Fluorine is the most electronegative element (1 electron away from filling its shell)
What is the ratio of the sodium-potassium pump found in a neuron?
3:2
3 Na+ pumped out for every 2 K+ brought in
Outline the process of an action potential
What is the usual charge of an animal cell?
Cells are normally negatively charged (at rest)
Does a human have more neurons or glial cells?
Glial cells.
Outnumber neurons 10 to 1
How often do neurons divide?
Most never divide and are amitotic in adults
If a 16 atom radioisotope has a half life of 10 seconds, how long will it take for the isotope to be eliminated?
Due to exponential decay, an isotope is never truly eliminated.
However, there are a discreet number of atoms in this question (16) and it will decay to <1 atom after around 40 seconds.
Why are alpha particles dangerous in the body but less so when emitted outside the body?
Alpha particles are heavy and energetic, so can cause great damage in cells, but cannot travel far.
Describe alpha, beta, and gamma radiation
Alpha particles - large, positive, emitted from the nucleus, made of 2 protons and 2 neutrons
Beta particles - small, negative, emitted from the nucleus.
Gamma rays - weightless, high energy. Emitted from nucleus
A hydrogen bond is a bond between a hydrogen and an…
Electronegative element.
Example: water. Oxygen hoggs electrons from its covalent bonds with hydrogen, making oxygen electronegative, which can in turn form a hydrogen bond with other H2O molecules.
Rank the following alcohols in order of chain length: Hexane, Heptane, Ethanol, Propane, Butane, Octanol, Methanol, Pentanol
C - Methanol
C2 - Ethanol
C3 - Propane
C4 - Butane
C5 - Pentanol
C6 - Hexane
C7 - Heptane
C8 - Octanol
Which of the following has the highest boiling point?
Octanol, Ethanol, Methanol, Hexanol
Octanol
Has the longest chain (C8)
How many carbon atoms do the following molecules contain?
methanol,
butan-1-ol,
propan-2-ol,
ethanol
Methanol: 1
Ethanol: 2
Propan-2-ol: 3
Butan-1-ol: 4
How many carbon atoms are found in Butane?
4
What is an unsaturated compound?
Contains double or triple bonds.
Liquid (oil) at room temperature.
What is a saturated compound?
Contains single bonds
Solid at room temperature
What are halogens?
Occupy second to last group on the right of the periodic table.
7 valence electrons, so very reactive
Which of the following carboxylic acids will have the highest boiling point?
Decanoic acid
Hexanoic acid
Nonanoic acid
Decanoic acid
(Longest chain)
What is Pascal’s law?
What is epistaxis?
A nosebleed.
90% occur at the vulnerable kisselbach plexus
What is an occlusion?
A complete or partial blockage of a blood vessel
What is the difference between a haematoma and a thrombus?
When an injury causes bleeding outside the blood vessel into the tissue around it, and that blood then clots, it’s called a hematoma. When blood clots inside a blood vessel, it’s called a thrombus.
What is the treatment for cachexia?
There is no approved treatment for cachexia and quality of life care is the focus.
Stimulating appetite or intubation cannot reverse the condition, although research is ongoing into drugs that modulate Ghrelin production
What are catecholamine hormones?
Hormones produced by the adrenal glands.
The main types are dopamine, norepinephrine, and epinephrine
What is the vagus nerve?
Cranial nerve X
Responsible for internal organ functions such as digestion, heart rate, breathing, cardiovascular activity, reflexes (coughing, sneezing, vomiting). Important role in the gut-brain axis
Explain the seven portions of the electromagnetic spectrum
What is the difference between X-Rays and Gamma Rays?
They have the same basic properties.
X-rays are emitted from processes outside the nucleus, but gamma rays originate inside the nucleus.
In general, nuclear transitions are more energetic than electronic transitions, so gamma rays are usually more energetic and penetrating.
What is the difference between effusion, perfusion, and diffusion?
Effusion - gases or fluids being emitted
Perfusion - bathing an organ or tissue in fluid (e.g. bloodflow to capillaries)
Diffusion - movement of molecules from a high concentration to a low concentration
Define the ‘Octet Rule’
The octet rule states that atoms
desire eight electrons in their valence shells, as this gives them the electron configuration of a noble gas.
Most atoms have to bond with other atoms to acquire this electron configuration.
Name the three major types of intramolecular bonds
Ionic bonds: electrons are transferred from a metal to
nonmetal
Covalent bonds: electrons are shared between nonmetals
Metallic bonds: electrons “float” between a lattice of metallic nuclei
Define ‘Molality’
Molality represents the number of moles of solute dissolved into one kilogram of solvent
Define ‘Osmotic Pressure’
What is the molecular formula of this molecule?
Define ‘Capillary Action’
The movement of water within the spaces of a porous material due to the forces of adhesion (surface of container), cohesion (between water molecules), and surface tension.
Name the 14 facial bones
Name the ossicles of the skull
Malleus
Incus
Stapes
Name the postcranial bones of the axial skeleton
Hyoid
Sternum
Ribs x24
Cervical vertebrae x7
Thoracic vertebrae x12
Lumbar vertebrae x5
Sacrum
Coccyx
What is peripheral oedema?
Swelling under the skin in the appendages (multiple causes)
What is Lymphoedema?
Chronic swelling in the tissues (failure of the lymphatic system)
Name the appendicular bones of the hand and wrist
Scaphoid (she)
Lunate (looks)
Triquetrum (too)
Pisiform (pretty)
Trapezium (try)
Trapezoid (to)
Capitate (catch)
Hamate (her)
Metacarpals
Proximal phalanges
Intermediate phalanges
Distal phalanges
Name the inferior appendicular bones of the legs and hip (not including the distal region)
Ilium x2
Ischium x2
Pubis x2
Femur x2
Patella x2
Tibia x2
Fibula x2
Name the appendicular bones of the feet and ankles
Talus (tiger)
Calcaneus (cubs)
Navicular (need)
Medial cuneiform (m)
Intermediate cuneiform (i)
Lateral cuneiform (L)
Cuboid (c)
Metatarsals
Proximal phalanges
Intermediate phalanges
Distal phalanges
Define ‘Tenesmus’
Tenesmus is the frequent urge to go to the toilet but not being able to go / the incomplete evacuation of the bowels.
Severe inflammation that irritates the nerves involved in defecation is often the cause.
In what part of the cell does DNA transcription mainly happen?
A) Cytoplasm
B) Endoplasmic Reticulum
C) Golgi Apparatus
D) Mitochondrion
E) Nucleus
Transcription (production of mRNA) occurs in the nucleus as it requires a DNA template.
Once mRNA is produced, it leaves the nucleus for translation (protein synthesis). Translation occurs in the cytoplasm, on ribosomes which are both free and on the rough endoplasmic reticulum
What is the major lipid component of the plasmalemma?
A) Cholesterol
B) Linoleic acid
C) Myelin
D) Phospholipid
E) Triglyceride
Plasmalemma is a less common term for the cell membrane. The membrane consists of lipids and proteins. The major lipid component is the Phospholipid bilayer
A patient undergoes rapid weight loss in preparation for bariatric surgery. Their total adipocyte count reduces markedly. True or false?
False. In adults, adipocyte numbers remain stable over time despite a large turnover in these cells. A decrease or increase in weight will change cell volume.
Which of the following is not a common analyte? What does it tell you?
A) Blood gases test
B) CRP test
C) Full blood count
D) Troponin
E) Heel prick test
F) HbA1c
E. The heel prick test (newborn blood spot test) is carried out on all newborns aged 5 days. The test screens for genetic conditions such as Cystic Fibrosis, Phenylketonuria, and Congenital Hypothyroidism. The heel prick test is not as common as the other tests, which may be administered more routinely and frequently throughout a patient’s life.
Define the abbreviation ‘AAA’
Abdominal aortic aneurysm
A swelling in the aorta (which feeds the abdomen). There is no early warning symptom of AAA so screening is important. Screening is offered to all men aged over 65. AAA’s are dangerous if they are at a high risk of rupture.
Define the abbreviation ‘ABG’
Arterial blood gas
Measures the levels of oxygen and carbon dioxide in the radial or femoral artery (less common). Blood pH can also be determined. A common test in the IC unit. Pulse oximetry is a less invasive option in other environments.
Define the abbreviation ‘ACE’
Angiotensin-converting enzyme
*ACE converts the hormone Angiotensin I to the active Vasoconstrictor Angiotensin II. Therefore, ACE indirectly increases blood pressure by causing vasoconstriction. ACE inhibitors are commonly used drugs for cardiovascular disease treatment.
When does a mother’s milk typically ‘come in’?
2-4 days postpartum
Describe the 2 fontanelle’s in a standard case and the times at which they fuse.
The soft gaps where two sutures of a newborn’s cranium are yet to fuse. Posterior fontanelle and anterior fontanelle (larger).
Posterior fuses at roughly 3 months. Anterior at 9-18 months.
Describe Phenylketonuria (pathophysiology, diagnosis, treatment)
Pathophysiology: Autosomal recessive mutation of Phenylalanine hydroxylase gene. Phenylalanine accumulates from high protein foods or aspartame. Severe intellectual disability and psychiatric disorders follow.
Diagnosis: Heel prick test (routine newborn screening). Symptoms can include fairer skin, hair, eyes (low melanin) and a musty smell.
Treatment: Specialist dietetic support (low protein diet and amino acid supplements). Regular blood tests.
Which of the following is correct in eukaryotes?
A) There are 20 essential amino acids
B) There are around 500 amino acids throughout biology, with 20 proteinogenic amino acids in humans
C) There are 21 proteinogenic amino acids, which includes 9 essential amino acids
D) There are 9 essential amino acids, which make up some of the 22 amino acids in eukaryotes
C. There are 20 amino acids in the standard genetic code plus selenocysteine in humans. These are proteinogenic (incorporated into proteins during translation). 9 of these are essential.
Histidine, isoleucine, leucine, lysine, methionine, phenylalanine, threonine, tryptophan, and valine
Define Hypertrophy, Hyperplasia, Metaplasia, and Neoplasia
Hypertrophy: Increase in cell size
Hyperplasia: Increase in cell number
Metaplasia: Transformation of a cell
Neoplasia: Uncontrolled cell formation
What is the difference between involution and atrophy?
Involution is a normal decrease in cellular / organ size (e.g., postpartum)
Atrophy is an induced reduction (e.g. , stress, toxicity, nutrition)
Outline the difference between necrosis and apoptosis? After which stimulus do they occur?
Both occur after irreversible cell injury (a stressor which is too significant to adapt to). Apoptosis is programmed (controlled) whereas necrosis is passive.
*Autophagy (intracellular recycling) is another process which occurs in response to a stimulus. Notably autophagy occurs during extended fasting.
Which of the following is the most common start codon for translation, coding for methionine
A) Cytosine, Guanine, Cytosine
B) Arginine, Uracil, Guanine
C) Arginine, Arginine, Arginine
D) Arginine, Thymine, Guanine
E) Guanine, Uracil, Guanine
B
AUG codes for methionine, which is the most common start codon in mRNA translation at the ribosome.
What is the difference between lymphoid and myeloid cell lineages?
Lymphoid cells form the basis of the adaptive immune response
Myeloid cells form the basis of the innate immune response
What are the primary lymphoid organs and what is their purpose?
Thymus and bone marrow.
These tissues are responsible for the development of lymphocytes, a type of immune system cell.
What are the secondary lymphoid organs and what is their purpose?
Lymph nodes, spleen, tonsils, certain tissues in the mucous membrane layers of the body.
They support the maturation, survival, and activation of lymphocytes. They are located throughout the body.
(The lymphatic system also includes lymphatic vessels, which drain lymph, or interstitial fluid, from tissues and return it to the bloodstream)
What are the five cardinal signs of inflammation?
Rubor (redness)
Tumour (swelling)
Calor (heat)
Dolor (pain)
Functio laesa (function)
Cirrhosis is the proximate cause of liver disease. Which of the following is a likely root cause?
A) Excess Alcohol Consumption
B) Viral Hepatitis
C) Environmental Toxin Exposure
D) All of the Above
D
All of these can be the root cause of liver scarring, which will lead to liver disease. The proximate cause is an intermediary on the disease pathway
What are the two main lymphoid cell types which mature in the Thymus?
Cytotoxic T cells (CD8+)
Helper T cells (CD4+)
Why are ‘productive’ viruses often cytolytic?
Productive viruses rapidly produce progeny using cell machinery. This creates endoplasmic reticulum stress (ER stress), where there is a build up of unfolded or misfolded proteins.
ER stress can lead to cell death (apoptosis) or immune cell clearance (cytotoxic) as these cells are recognised as faulty. ER stress can also lead to tumour progression.
Viruses often induce cell lysis, allowing for attachment and infection of further cells
What causes lymphadenopathy?
Lymph nodes swell during infection (both localised and generalised).
This is often due to an increase in number and size of lymphoid follicles and proliferation of lymphocytes to respond to an antigen.
Explain the pathophysiology of lymphadenopathy
Lymphadenopathy refers to the swelling of lymph nodes. These glands swell due to multiplication of cells (lymphocytes, plasma cells, monocytes, or histiocytes).
Swelling is usually localised. Widespread swelling indicative of systemic infection
What are the main functions of the spleen?
Filtration - removes old and damaged erythrocytes, and microorganisms, from the bloodstream.
Defence - contains lymphocytes and macrophages
Storage - of blood and iron
Define the terms ‘GALT’ and ‘MALT’
Gut-associated lymphoid tissue
Mucosa-associated lymphoid tissue
Define Peyer’s patches and their function
Found in the small intestine (predominantly distal)
Antigens entering the intestinal tract encounter macrophages, dendritic cells, B-lymphocytes, and T-lymphocytes found in Peyer’s patches and other GALT sites. Peyer’s patches (gastrointestinal) are analogous to the tonsils (respiratory). They trap foreign particles, survey, and destroy them
Which is not an example of an antigen?
A) Aflatoxin
B) PSA
C) CD8+ cell
D) Salmonella typhi
E) Herpes Zoster
‘C’ is not an antigen as it is a cytotoxic T cell (adaptive immunity).
Antigens are exogenous or endogenous substances that trigger an immune response in the body.
Define ‘PSA’
prostate-specific antigen
What are the three professional antigen presenting cells
Dendritic Cells
Macrophages
B Lymphocytes
Professional antigen presenting cells (APCs) are cells that process antigens and present them to T cells, initiating immune responses
What are the most common immune cells
Neutrophils (40-60% of all Leukocytes)
What are the main differences between Neutrophils and Macrophages?
Both are leukocytes which engage in phagocytosis and are part of the innate immune system.
Neutrophils are short-lived and found in the blood, macrophages are longer-lived and tissue bound.
Macrophages are primarily responsible for clearing away cellular debris, dead cells, and microbes. Neutrophils kill bacteria, fungi, and foreign debris
What is an antigen?
Antigens are exogenous or endogenous substances that trigger an immune response in the body.
How do antigens trigger an initial adaptive immune response?
Antigens trigger adaptive immunity by binding to antigen receptors on B and T lymphocytes
Antigen-presenting cells present antigens on their surface using MHC molecules. When an antigen binds to a lymphocyte’s antigen receptor, the lymphocyte becomes activated.
Define Humoral Immunity
Process of adaptive immunity manifested by immunoglobulin production, by B lymphocytes, and complement protein support
Why do lymphocytes congregate at certain lymphatic regions?
Lymphocytes congregate in secondary lymphoid organs (lymph nodes, spleen, and tonsils) to mount immune responses. These organs trap antigens for exposure to T and B lymphocytes, and are where mature lymphocytes continue to develop.
Does innate immunity improve upon repeated pathogenic exposure?
No. The innate immune response to a particular pathogen is the same upon first exposure as it is following all subsequent exposures (i.e. no memory)
Define PAMPS and DAMPS
Pathogen-associated molecular patterns (PAMPs) - derived from microorganisms. Alert the immune system to the presence of pathogens.
Damage-associated molecular patterns (DAMPs) - derived from host cells. Released in response to trauma, ischaemia, and tissue damage.
Both PAMPs and DAMPs bind to specific receptors on pattern recognition receptor (PRR)-bearing cells of the innate immune system
Which is the best description of Chemotaxis?
A) An end-stage complication of oncologic treatment
B) Categorisation of chemical structures by type and function
C) Movement of an organism in response to a chemical stimulus
D) Chemical load on the host brought about by viral infection
C
Outline the APGAR score methodology
Appearance (skin colour)
Pulse
Grimace
Activity (muscle tone)
Respiration
0–2 points per characteristic. A score >7 at 5 minutes post-birth is considered normal
What is histamine? What is it’s function?
A signalling chemical which sends messages between cells. Histamine has numerous functions, but is primarily known for upregulating immune response. Activation of H1 receptors cause allergy symptoms (vasodilation, pruritis, tachycardia…)
Predominantly released by Mast Cells in the connective tissues.
Define ‘Pruritus’
Itchy skin.
Often caused by allergic reactions to food, insect bites, pollen, and medicines
Which 3 arteries branch off the aortic arch?
Brachiocephalic (right subclavian and right carotid)
Left carotid
Left subclavian
Which blood vessels branch off the ascending aorta?
Left and right coronary arteries
What are the main functions of the lymphatic vessels?
Fluid balance (draining excess interstitial fluid)
Transport (of immunological molecules, cells, and waste products)
What is the correct compression rate (CPR) per minute?
A) 60-80
B) 130-150
C) 70
D) 100-120
E) 72
D. 100-120 compressions per minute
How deep do chest compressions have to be for maximum effectiveness, according to 2021 resuscitation guidelines?
5-6cm
Outline the SOCRATES acronym?
Site (arm)
Onset (2 days ago)
Character (intermittent)
Radiation (yes, from chest)
Associated Symptoms (tight chest)
Timing (worse upon exertion)
Exacerbation and relief (rest)
Severity (4-8)
Likely diagnosis = myocardial infarction
Define type I and type II error and what impacts them
Type I = False Positive.
Determined against a preset significance level (termed alpha). Not affected by sample size. Increases if the number of end-points increases (due to chance findings).
Type II = False Negative. Determined by both sample size and alpha
Define power
The power of a study is the probability of (correctly) rejecting the null hypothesis when it is false, i.e. the probability of detecting a statistically significant difference
Which period does embryology cover?
Weeks 1-8 post conception
*Fetus = week 9 onwards
When is a fetus viable? What is the viability cut-off?
24 weeks gestation
What is the Carina and where is it situated?
The cartilage situated at the point where the trachea (windpipe) divides into the two bronchi.
When are the zygote, embryo, and morula stages in fetal development?
Zygote = days 1-2. Pronuclei form and zygote undergoes mitosis
Embryo = Days 2-3. Zygote divides into smaller cells. Forms and embryo
Morula = Day 3. Embryo divides sequentially. Once it has 16 cells, it is a morula
What is a blastocyst?
A fertilised egg, ready to attach to the uterus (endometrium)
What is the Trophoblast and what does this form during pregnancy?
The trophoblast is the outer layer of cells of the blastocyst. It plays a crucial role in early pregnancy, forming two main structures:
Placenta
Chorion
Drugs which carry a positive or negative charge are unable to cross membranes. Why?
Lipid solubility - Charged drugs have low lipid solubility and high water solubility, making them hydrophilic. They cannot easily penetrate cell membranes.
Electrical resistance - Charged drugs have high electrical resistance which prevents them from penetrating cell membranes.
*by contrast, un-ionised drugs are usually lipid soluble and can diffuse readily across membranes
Define the term ‘absorption’ from a pharmacokinetics perspective
Absorption refers to the intake of a drug into the systemic circulation.
Absorption rate can be modified by site of administration and drug formulation.
Define the therapeutic window
The dose of a drug that provides safe and effective therapy with minimal adverse effects.
Too low a concentration will be ineffective. Too high a concentration will increase the risk of adverse effects
Outline bioavailability (F) as a mathematical formula
F = quantity of drug reaching systemic circulation / quantity of drug administered
F = 100mg in circulation / 1g taken orally
Define a drug analogue
A drug whose physical structure is related to that of another drug.
Although physical properties are comparable, biochemical properties may differ
Patient A takes a large, orally administered drug in a fasted state. Patient B takes the same drug after a small breakfast of eggs. Which absorbs quicker?
There are numerous factors to drug absorption.
Based on this information, patient A will express a quicker absorption of the drug due to increased gastric emptying rate into the duodenum
What is the fundus and where is it located?
Fundus is a non-specific term referring to the part of a hollow organ that is across from, or farthest away from, the organ’s opening.
A classic example is the upper part of the stomach, which forms a bulge above the level of the opening of the oesophagus (furthest from the pylorus)
Define the ‘first pass effect’
Medication undergoes metabolism at a specific location in the body. This decreases the active drug’s concentration upon reaching systemic circulation of site of action.
This commonly refers to the liver, where drugs are often metabolised. Drugs can be administered via other methods to avoid first pass metabolism (sub-lingual, intravenous, rectal)
What is glyceril trinitrate used for? Why is it delivered sub-lingually?
Used to treat angina.
Sub-lingual administration bypasses first pass metabolism and allows for rapid response
Define ‘drug clearance’
The volume of plasma cleared of a drug over a specified time period
Outline the stages of the Analgesic Stepladder, including examples
- Non-opioids (paracetamol, NSAIDs)
- Weak opioids (codeine, tramadol)
- Strong opioids (morphine, oxycodone, fentanyl)
What is cranial nerve V?
Trigeminal nerve
Has motor (chewing, swallowing) and sensory functions (face)
What is cranial nerve X?
Vagus nerve
Has motor and sensory functions. Main nerve of the parasympathetic nervous system (autonomic, ‘rest and digest’)
What is the significance of the posterior cricoarytenoid (PCA)?
The only muscle that abducts the vocal folds, opening the rima glottidis.
Works with the adductor muscles to control phonation, swallowing, and coughing
What is Choanal Atresia and what are the symptoms?
When a neonate has excess tissue that blocks the choanae, making it harder for them to breathe. If one passage is blocked, your baby may have mild symptoms. Babies born with both passages blocked need emergency treatment to support ventilation
What are the 4 main functions of the Larynx?
Phonation - contains vocal cords, which vibrate as air passes through them, producing sound.
Respiratory Control - adductor and abductor muscles control airflow (notably, the posterior cricoarytenoid)
Protecting the Airway (Swallowing) - epiglottis covers the opening to the trachea during, directing food and liquids down the oesophagus
Cough Reflex - if something accidentally enters the larynx, it triggers a cough reflex
Outline the key anatomical structures that air passes in the URT during normal respiration
- Nares
- Nasal Cavity
- Turbinates (past the conchae and through the meatus
- Choanae
- Nasopharynx
- Oropharynx
- Laryngopharynx
Outline the tributaries of the aortic arch
Outline the difference between anosmia, hyposmia, and hyperosmia
Anosmia - Loss of olfaction
Hyposmia - Reduced olfaction
Hyperosmia - Increased olfactory sensitivity
Briefly outline transsphenoidal surgery
Name the 3 branches of the trigeminal nerve (CN V)
Ophthalmic (V1): Carries sensory information from the scalp, forehead, upper eyelid, and nose.
Maxillary (V2): Carries sensory information from the cheeks, upper lip, upper teeth, and lower eyelid.
Mandibular (V3): Handles sensory input from the jaw, lower lip, lower teeth, and also controls muscles involved in chewing
Where are the inferior, middle, and upper meatus situated?
Inferior Meatus - Located under the inferior nasal concha (the lowest turbinate). It’s the longest and lowest of the three meatuses.
Middle Meatus - Situated below the middle nasal concha. It’s in this region that the maxillary sinus and frontal sinus drain, making it an important passage for airflow and drainage.
Superior Meatus - Found beneath the superior nasal concha (the highest turbinate). This meatus is smaller and allows drainage from the posterior ethmoid air cells.
Outline how DVT can cause PE and how it is less likely to cause cerebral embolism
Deep Vein Thrombosis is more likely to cause Pulmonary Embolism as a dislodged thrombus in the lower limbs will then travel via the inferior vena cava into the right side of the heart, then the lungs. At this point, the vessels decrease in size and an embolus can lodge. Prior to this, the vessels still have a wide lumen and less occlusion risk.
Cerebral Embolism would occur after an embolus leaves the left ventricle and travels up the carotid arteries. After this, the vessels narrow and an embolus can lodge.
Define Aortic Hiatus
The aortic hiatus is an opening in the diaphragm that allows the descending aorta, thoracic duct, and sometimes the azygos and hemiazygos veins to pass through.
Located at T12 vertebral level
What does a D-Dimer test show?
D-dimer is a protein fragment (small piece) that’s made when a blood clot dissolves. D-dimer isn’t usually found in the blood unless blood clots are being broken up.
High D-Dimer concentrations indicate a blood clotting disorder
What are the gold standard biomarkers for detecting myocardial infarction?
Cardiac Troponins (cTnI & cTnT) have high sensitivity (low false negatives) and specificity (low false positives).
cTnI and cTnT rise 3-6 hours post infarction.
Outline the role of Beta-1 and Beta-2 receptors and their locations
β1 primarily in heart and kidneys. β2 in lungs, blood vessels, and other smooth muscles.
β1 increases heart activity (activated by adrenaline and noradrenaline)
β2 mediates smooth muscle relaxation.
What is the clinical significance of finger clubbing?
It is often a sign of a significant underlying disease, prompting further diagnostic evaluation to identify the primary cause.
Strongly correlated with lung cancer
At which vertebral level does the trachea bifurcate?
A) T1
B) C7
C) C3, C4, C5
D) T4, T5
E) T7, T8
D.
The trachea bifurcates at around Thoracic Vertebrae 4 or 5
Define ‘Cerumen’
Earwax
Produced in the outer part of the ear canal. It is secreted by specialized glands called ceruminous glands and sebaceous glands, which are located in the skin of the outer ear canal. These glands produce a mix of secretions that combine with dead skin cells to form earwax, which helps protect and lubricate the ear canal, trapping dust, dirt, and microorganisms to prevent them from reaching the eardrum.
What are the four main roles of prostaglandins in relation to inflammation?
Vasodilation:
Increased blood flow to affected tissues delivers immune cells and nutrients for healing. Also causes calor and rubor.
Vascular Permeability:
Allows immune cells and proteins to move more easily into damaged tissues. Causes tumor
Nociception:
Sensitises nerve endings. Pain acts as a protective mechanism, discouraging further use. Causes dolor and functio laesa
Pyrexia:
Some prostaglandins act on the hypothalamus. Inhibits pathogen growth and enhances immune response. Causes calor
How do NSAIDs affect the gastric lining?
NSAIDs inhibit COX-1 and COX-2 enzymes.
COX-2 inhibition reduces pain and inflammation, but COX-1 inhibition reduces protection of the gastric wall.
Gastric ulcers are therefore a risk of NSAIDs, which should be administered with food to reduce side effects
What is another name for the eustachian tube?
Pharyngotympanic tube
This provides anatomical clues as to where this structure is situated
What is the main function of the cricoid cartilage?
Provides structural support to the airway in the larynx. It is the only complete ring of cartilage in the trachea
Which anatomical landmark indicates the C5 vertebral level?
Thyroid cartilage (Adams apple)
At which level does the oesophagus begin?
C6 vertebra
Level with the cricoid cartilage
Is the adenoid visible through the oral cavity?
No
Adenoid tissue (pharyngeal tonsil) is located behind the nasal cavity and superior to the roof of the mouth. This area (nasopharynx) cannot be seen through the oral cavity
What are the 5 main functions of the sinuses?
- Reducing skull weight
- Humidifying inhaled air
- Enhancing vocal resonance
- Trauma protection
- Mucus production (for pathogens)
Outline how to conduct a mallampati assessment
Ask the patient to open their mouth and protrude their tongue as far as possible.
I: complete visualisation
II: whole uvula visible
III: partial uvula visible
IV: no visibility
What is the location and significance of the Cribriform plate?
Located in the ethmoid bone at the roof of the nasal cavity.
Olfaction: Olfactory foramina allow olfactory nerve fibers to pass, transmitting sensory information.
Protection: Shields olfactory bulbs, which are located above the cribriform plate. These bulbs process smell information.
Structure: Contributes to the stability and separation of the nasal and cranial cavities.
Name the four sinuses in superior to inferior order
Frontal sinus - superior to eyes
Ethmoid sinus - medial to eyes
Sphenoid sinus - posterior to nose
Maxillary sinus - inferior to eyes
What is the clinical relevance of the C7 vertebra?
Prominent anatomical landmark (vertebra prominens)
Is vulnerable to trauma due to prominence and weight of the head
Innervates specific regions of the arm, forearm, and hand. Symptoms of nerve/vertebral injury can therefore be felt in the forearm and middle finger
What are the functions of the uvula?
- Closes nasopharynx when swallowing
- Produces saliva
- Supports vocal resonance
- Triggers immune defence
- Triggers gag reflex
Name the four tonsils and their locations
Palatine - back of oral cavity
Adenoids (pharyngeal) - in the nasopharynx
Lingual - at the base of the tongue
Tubal - entrance to the eustachian tubes
What is the main difference between gram-negative and gram-positive bacteria?
Gram-positive bacteria have a thick peptidoglycan layer outside the cell membrane. Stains purple. Often more susceptible to antibiotics which target the peptidoglycan
Negative bacteria have a thin peptidoglycan layer between two membranes (inner and outer). Stains pink. Often more resistant to antibiotics and associated with more aggressive immune response
Which branch of the complement system is activated by gram-negative bacteria?
Alternative complement pathway (activated by polysaccharides - peptidoglycan)
What are the two types of respiratory failure and what defines them?
Type 1: Hypoxemic. Low O2. Caused by chronic conditions that damage lungs
Type 2: Hypercapnic. High CO2. Often due to reduced ventilation
How does carbon dioxide level affect acidosis / alkalosis?
CO2 reacts with water to form carbonic acid. CO2 is therefore acidic
Hypocapnia = respiratory alkalosis
Hypercapnia = respiratory acidosis
Define atopic
Atopic refers to a genetic predisposition to develop allergic reactions such as asthma, eczema, hay fever, and other allergic reactions.
Atopic individuals often produce more immunoglobulin E (IgE)
What do high CRP levels indicate in the context of infection?
A) Viral infection
B) Parasitic Infection
C) Any / general infection
D) Bacterial infection
E) Fungal infection
D.
CRP levels are more specific to bacterial infections, but they can be elevated for every other type of infection in certain circumstances
What does a high Eosinophil count likely indicate?
High eosinophils are a hallmark of Parasitic infection
What does leukocytosis indicate?
Leukocytosis = high WBC
High WBC is often indicative of a bacterial infection, particularly when accompanied by a neutrophil predominance
What is the gold standard test for cystic fibrosis?
Ionic sweat test (sweat chloride test)
Sweat is stimulated using pilocarpine. If collected sweat has a high chloride concentration, CF may be present
What is polyuria?
Excessive production and passage of urine.
Typically defined as urine output greater than 3 litres per day in adults
What does a low V/Q ratio indicate?
Poor ventilation (V) relative to perfusion (Q).
Examples: asthma, COPD, pneumonia
What does a high V/Q ratio indicate?
Poor perfusion (Q) relative to ventilation (V)
Example: Pulmonary Embolism
Outline the two functional divisions of the respiratory system?
(Conducting): nasal cavities, larynx, pharynx, trachea, bronchi, bronchioles, terminal bronchioles
(Respiratory): respiratory bronchioles, alveolar ducts, alveolar sacs, alveoli
What will a CTFR gene mutation cause?
The CTFR protein regulates the movement of sodium ions across epithelial cell membranes, maintaining fluid balance.
CTFR mutations may cause Cystic Fibrosis
Define dyspnea
Shortness of breath
What does a fibroscan measure?
Liver stiffness (scarring)
Define TATT
Tired all the time
When is a foetus most vulnerable to a teratogen
Embryonic period (weeks 3-8)
This period is marked by organogenesis
Antigens and antibodies work in unison within the human body. True or false?
False. Antibodies respond to antigens, which are harmful to the body
Antibody response is a type of humoral immunity. True or false?
True.
Humoral immunity is a component of the adaptive immune system that primarily involves B lymphocytes producing antibodies
Which cells produce immunoglobulins?
A) Plasma cells
B) Neutrophils
C) Mast cells
D) All of these
A. Plasma cells.
Plasma cells develop from B Lymphocytes
Which immunoglobulins are more common in the human body?
A) IgM (primary response)
B) IgA (mucous membranes)
C) IgE (parasitic protection)
D) IgG (secondary response)
D
IgG is the most common immunoglobulin. Found predominantly in extracellular fluid. Has the longest half life of all immunoglobulins (21 days). Four subclasses (IgG1, IgG2, IgG3, IgG4)
The heart has C5-C6 nerve roots. Which of these sites would be more common for referred MI pain?
A) Lattissimus dorsi
B) Gastrocnemius
C) Sternocleidomastoid
D) Teres minor
D. Teres minor
The main function of a virion is to
A) Aid viruses in host evasion
B) Deliver DNA / RNA to a host cell
C) Protect viruses from threats
D) Support viral reproduction
B
Viruses are made up of
A) Genetic material and enzymes
B) Lipids and glycoproteins
C) Lipids and proteins
D) All of these
D
What is the Baltimore Classification?
A system of organising viruses into groups based on their genome type and replication strategy
Enveloped viruses can fuse with a host cell membrane. True or false?
True
PKU carrier status is determined by the paternal gamete. True or false?
False. PKU is an autosomal recessive disorder and is not sex linked
A child with an autosomal dominant trait cannot be a carrier. True or false?
True. Dominant traits can only be expressed. They can still be passed on, but they cannot be true ‘carriers’
An autosomal recessive carrier will only pass on a trait if they procreate with another carrier. True or false?
False.
The trait could be passed on if procreation is with a partner with the disorder (2 copies). This would leave a 50% chance of the child having the trait (requires 2 copies).
If procreation between 2 carriers, there is a 50% chance of the child being a carrier, 25% of the child having the trait, and 25% chance of being unaffected
In UK hospitals, is bacterial or viral pneumonia more common?
Bacterial pneumonia is more common in hospital settings due to AMR
A cough that produces green, yellow, or bloody mucus is the most common symptom of pneumonia. True or false?
True
What is the leading cause of respiratory-related mortality in the UK?
Pneumonia (1 case per 100)
Why are glucocorticoids administered through different routes?
Glucocorticoid receptors are ubiquitous. Local administration limits side effects
Which administration route offers the least systemic effects
A) Inhalation
B) Intranasal
C) Oral
D) Injectable
E) Topical
B.
Typically Intranasal administration offers the least systemic effects. Topical delivery can also be specific, whereas inhaled, oral, or Injectable delivery are often more systemic.
Which condition is likely to be treated with a synthetic glucocorticoid like dexamethasone?
A) T1DM
B) Iron-deficiency anaemia
C) Osteoporosis
D) Acute asthma
D
What are the two types of corticosteroids?
Glucocorticoids and Mineralocorticoids
Which process is occurring here?
Steroidogenesis
What does a tracheal deviation commonly indicate?
Tension pneumothorax
Define hemoptysis
Coughing up blood
What is the function of the Trachealis?
Trachealis is a band of smooth muscle located along the posterior aspect of the trachea.
Contraction = tracheal narrowing and increased airflow velocity / pressure
Relaxation = tracheal widening and reduced airway resistance
Define pleuritis (pleurisy)
Inflammation of the respiratory pleurae. This often causes sharp pain which originates in the parietal pleura (innervated by phrenic nerve)
What is the pleural cavity and where is it located?
The space between the visceral and parietal pleura. The space contains a small amount of serous fluid for lubrication and surface tension
Where are the horizontal and oblique fissures located?
Oblique: Separates the upper and lower lobes (left) and the middle and lower lobes (right) of the lungs
Horizontal: Found only in the right lung. Separates upper and middle lobes
What are the main energy stores of the body and where are these energy stores located?
Lipids (triglycerides) - Adipose tissue. Around 85% of body energy storage is lipids
Proteins - Half of all protein is found in skeletal muscle. Around 15% of body energy storage is protein
Carbohydrates - Liver glycogen, muscle glycogen, glucose (body fluids). Less than 1% of body energy storage
What is the main difference between marasmus and kwashiorkor and what are the key symptoms?
Marasmus - Severe wasting. Loss of adipose and muscle tissue. Caused by insufficient calories
Kwashiorkor - Severe wasting. Presence of ascites and/or bilateral pitting oedema. Caused by protein energy malnutrition
What are the main differences between cachexia and sarcopenia?
Cause: Chronic disease-driven inflammation vs aging and inactivity
Onset: Rapid Vs gradual
Tissues: adipose and muscle tissue loss Vs muscle loss only
Prognosis: difficult to reverse vs reversible (via exercise)
Define steatosis
A condition where fat builds up in an organ, usually the liver.
Steatosis is a common condition in developed societies, affecting about 30% of adults
What are the three key structures of the heart that change once a neonate is born?
Ductus Venosus - shunts blood mostly to the inferior Vena cava (some blood to the liver) in neonates
Ductus Arteriosus - shunts blood from the aorta to the pulmonary artery
Foramen Ovale - shunts deoxygenated blood from left to right atrium
What is a patent Foramen Ovale?
A common heart defect (25-30%). Does not regularly cause clinical concern.
Occurs when the Foramen Ovale fails to close after birth
Where is the Cubital Fossa located?
Anterior to the elbow. The depression of the inner arm joint
When are Korotkoff sounds heard?
Upon auscultation of the brachial or radial arteries, whilst they are partially occluded by a sphygmomanometer.
Sounds occur between diastolic and systolic values
Arrange these units in order:
ng, mg, ug, g, kg, pg
kg , g , mg , ug , ng , pg
Write 8ug in standard form
8g x 10^ -6
8ug = 0.008mg
8ug = 0.000008g
Count the 0’s and times to the power of minus that figure
Write out the following units in descending order?
kg, ug, mg, pg, Gg, cg, Tg, g, Mg, ng, fg, dg
Teragram Tg
Gigagram Gg
Megagram Mg
Kilogram kg
Gram g
Decigrams d
Centigrams cg
Milligrams mg
Micrograms ug
Nanograms ng
Picograms pg
Femtograms fg
Which unit of measurement is smallest?
A) Gigagram
B) Femtogram
C) Microgram
D) Picogram
E) Nanogram
Femtogram 10^-15
Picogram 10^-12
Nanogram 10^-9
Microgram 10^-6
Gigagram 10^9
What is the difference between Peak Flow and Spirometry testing. What do they measure, what is the purpose, and what are the pros and cons
Peak Flow: Measures peak expiratory flow rate (PEFR) to assess airway obstruction (maximum speed of exhalation). Mainly used for monitoring asthma over time. Quick, easy, low cost, but less sensitive to detecting asthma
Spirometry: Measures forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC). Generates FEV1/FVC Ratio. Used for diagnosing lung conditions. More complex and sensitive to detecting early lung disease
Outline the indicators of normal, obstructive, and restrictive pathologies using an FEV1/FVC Ratio
> 70% ratio: normal or restrictive
<70% ratio: obstructive
Restrictive lung disease would see a normal or increased ratio, but reduced FVC (indicates reduced lung capacity)
What is the significance of the Left Anterior Descending Coronary Artery?
The LAD coronary artery is also referred to as ‘The Widowmaker’. Perfuses most of the left ventricle, so occlusion can be severe.
Has high atherosclerotic potential due to turbulent flow, high workload, and pressure
What is the difference between Orthopnoea, Tachypnoea and Dyspnoea?
Orthopnoea = breathing difficulty when lying down
Tachypnoea = rapid breathing (>20bpm)
Dyspnoea= breathing difficulty in general
What could finger clubbing indicate from a cardiovascular perspective?
- Congenital heart defects (patent ductus Arteriosus, patent ductus Venosus, patent foramen Ovale, central septal defect).
- Infective endocarditis
Finger clubbing is most commonly associated with lung cancer
Which bacteria is most commonly associated with infective endocarditis via a dental mechanism?
A) Staphylococcus aureus
B) Aspergillus
C) Staphylococcus epidermis
D) Streptococci viridans
D: Streptococci viridans
What is Hallux valgus?
Commonly referred to as a bunion. The big toe (Hallux) deviates laterally and a bony prominence forms.
Caused by improper mechanics of the metatarsophalangeal joint
What is the main binding target for Cytotoxic T Cells and Helper T Cells?
Cytotoxic (CD8+) = MHC I
Found on the surface of all nucleated cells in the body. Allows CD8+ cells to monitor intracellular infections.
Helper (CD4+) = MHC II
Found on the surface of all antigen presenting cells. MHC II can then activate immune cells and cytokines
Outline the 5 key symptoms of the cardiovascular system
Pain
Breathlessness
Palpitations
Swelling
Syncope
Outline the 5 key symptoms of the respiratory system
Pain
Breathlessness
Wheeze
Cough
Sputum / Haemoptysis
What does ESR measure during a blood test?
Erythrocyte Sedimentation Rate (ESR) measures how quickly erythrocytes settle at the bottom of a test tube over a specific period. The result is reported in millimeters per hour (mm/hr).
ESR is a nonspecific marker of inflammation. When there is inflammation, the blood contains higher levels of fibrinogen and other proteins, causing red blood cells to clump together and settle faster.
What are the key differences between polymyalgia rheumatica and rheumatoid arthritis?
- PMR affects large muscle groups. RA affects joints
- PMR almost exclusively affects older adults. RA common onset is 30-50 years.
- RA has positive antibodies (rheumatoid factor and anti-CCP). PMR will test negative
Outline the main differences between temporal arteritis and polymyalgia rheumatica
TA is a vasculitis of large and medium arteries (especially temporal). PMR affects muscles and periarticular tissues.
There is an overlap between the two conditions, with 40-50% of TA patients experiencing PMR symptoms. TA is more severe and can lead to stroke or blindness.
Outline the key differences between CRP and ESR in a blood test
- Erythrocyte Sedimentation Rate
Rises slowly with inflammation (weeks) and dissipates slowly. Less specific, is affected by confounders. Useful for measuring chronic conditions - C-Reactive Protein
Rises rapidly (hours) with inflammation and falls quickly. Specific measure of acute inflammation
Outline the main differences between gamma radiation and x rays.
Gamma Radiation: Emitted from nucleus of a radioactive atom during nuclear decay. Typically higher energy and shorter wavelengths. Very high penetration. Used in cancer therapy and equipment sterilisation. Used for imaging.
X-rays: Produced when high-energy electrons strike a metal target or they transition between energy levels in atoms. Have a slightly lower energy and wavelength. High penetration, less than gamma rays.
Outline the 6 keys steps of catecholamine synthesis
Phenylalanine
L-Tyrosine
L-Dopa
Dopamine
Norepinephrine
Epinephrine
What are the three key catecholamines and their functions?
- Epinephrine (Adrenaline)
Increases heart rate, blood pressure, and glucose levels for a “fight or flight” response. Targets heart, lungs, and blood vessels. - Norepinephrine (Noradrenaline)
Vasoconstriction, increased blood pressure, and enhanced alertness. Targets blood vessels and brain. - Dopamine
Regulates movement, mood, reward, and blood flow to the kidneys. Targets brain (CNS) and kidneys.
What are the two types of solid joints in the human body?
Fibrous
- Very little movement
Cartilaginous
- Voderate, but limited movement
Where is articular cartilage located?
Within the joint capsule, at the ends of bones (where bones articulate).
Articular cartilage is separated by synovial fluid
What two major changes occur to synovial fluid during osteoarthritis?
- Altered synovial fluid composition
- Becomes less viscous
- Reduced lubrication
- Due to reduced hyaluronic acid concentration - Increased synovial effusion
- Low grade inflammation
- Due to cartilage degradation
- Causes effusion and joint swelling
What are the 3 types of cartilage and their functions?
- Hyaline
Most common type. Smooth, translucent, low friction. Articular surfaces, larynx, costal cartilage are examples. - Elastic
More flexible. Contains elastic fibres. Examples include external ear, epiglottis, eustachian tube. - Fibrocartilage
Most durable form. Resists compression and tensile forces. Found in intervertebral discs, pubic symphysis, menisci.
What is bursitis?
Inflammation of bursae due to repetitive friction, direct trauma, infection, or inflammation (RA or Gout)
Leads to increased synovial fluid production, swelling, inflammation, and possibly fibrosis
What is the function of Tenosynovia?
Synovial sheaths surrounding tendons. Secretes synovial fluid for lubrication
Reduces friction and allows efficient movement of tendons.
The primary pathophysiological process in tenosynovitis involves inflammation of which structure?
A) synovial fluid
B) tendon
C) synovial sheath
D) muscle
C. Tenosynovitis is inflammation of the synovial sheath which surrounds tendons.
*Seen in rheumatoid arthritis when ‘silk’ coat is replaced with ‘duffle’ coat due to inflammation
In tenosynovitis, what is the main consequence of synovial membrane inflammation?
A) Increased bone density
B) Decreased blood flow to joint
C) Excessive synovial fluid
D) Tendon rupture
C. Excessive synovial fluid production
Which of the following is the most common cause of tenosynovitis:
A) trauma
B) infection
C) rheumatoid arthritis
D) gout
B. Infection is most common cause.
*Tenosynovitis is also a complication of rheumatoid arthritis
What is scar tissue primarily made from?
Made primarily of collagen fibres, produced by fibroblasts post trauma.
Scar tissue (fibrosis) is typically less vascular, flexible, and innervated than normal tissue, reducing function.
Outline the 6 different types of synovial joints and give an example for each
Hinge: Humeroulnar
Pivot: Atlantoaxial
Saddle: Carpometacarpal
Condyloid: Atlantooccipital
Ball and socket: Glenohumeral
Gliding (plane): Intercarpal
Which of the following best describes the composition of tendons and ligaments?
A) primarily made of elastic fibres
B) mostly made of type III collagen
C) mainly made of type I collagen
D) mostly made of adipose tissue
C. Tendons and ligaments are composed mainly of type I collagen for tensile strength
Which of the following structures stabilises the knee joint and prevents anterior displacement of the tibia?
A) medial collateral ligament
B) posterior cruciate ligament
C) anterior cruciate ligament
D) lateral collateral ligament
C. Anterior Cruciate Ligament (ACL)
What is the primary function of the menisci in the knee joint?
A) provide blood supply to the articular cartilage
B) reduce friction between the femur and tibia
C) absorb shock and improve joint congruence
D) prevent hyperextension of the knee
C. There are 2 menisci in the knee. They are crescent-shaped fibrocartilaginous structures which absorb shock and increase joint congruence within the joint capsule
Why is the medial meniscus more prone to injury compared to the lateral meniscus, in the knee?
It is firmly attached to the medial collateral ligament (MCL). This makes the medial meniscus less mobile. It also plays a higher weight bearing role.
What is the ‘unhappy triad’ or ‘terrible triad’ of the knee?
Combination of 3 injuries which occur due to high impact sports trauma. They can occur simultaneously due to shared pattern of stress:
- Anterior Cruciate Ligament
- Medial Collateral Ligament
- Medial Meniscus
Which disease is most commonly associated with osteophyte formation?
Osteoarthritis.
Osteophytes (bone spurs) are examples of bone remodelling due to chronic cartilage degeneration
What are the key symptoms of osteoarthritis?
Dolor, tumor, functio laesa, crepitus.
*Rubor and calor are not associated with osteoarthritis due to the inflammation being low grade. Rubor and calor may indicate septic or autoimmune arthritis.
What are the 3 main pathological features of osteoarthritis?
- Articular cartilage (Hyaline) degeneration
- Subchondral bone changes (sclerosis and cyst formation)
- Osteophyte formation
What is the clinical significance of hyperuricemia?
Hyperuricemia = elevated uric acid
Uric acid crystals (tophi) deposit in synovial joints. Initiates an inflammatory response. Caused by either overproduction (purine consumption) or underexcretion (renal damage) of uric acid.
Dolor, rubor, calor, tumor, and functio laesa of the first metatarsophalangeal joint (MTPJ) is a typical presentation of which disease?
Gout
*Uric acid typically accumulates in the MTPJ due to lower temperature, reduced blood flow, and higher pressure compared to other regions. A history of high purine consumption (meat, shellfish, beer) or renal dysfunction will commonly accompany this.
What is the common name for calcium pyrophosphate deposition disease (CPPD)?
Pseudogout
*Characterised by calcium pyrophosphate dihydrate as opposed to uric acid crystals
How does the crystalline shape differ in gout compared to pseudogout?
Gout = needle shaped monosodium urate monohydrate crystals
Pseudogout = rhomboid calcium pyrophosphate dihydrate crystals
What causes pseudogout?
Pseudogout is often idiopathic. It is the most common cause of mono arthritis in the elderly population
A patient presents with a hot, swollen, acutely painful, stiff joint. It is monoarthritic and occurring in a well-vascularised joint. What is your primary diagnosis until proven otherwise?
Septic arthritis, until proven otherwise.
*These symptoms indicate acute inflammation. Septic arthritis is serious as it can result in joint destruction, sepsis, and long-term disability. This is septic arthritis until proven otherwise.
Outline the fasciotomy procedure
- Surgical laceration of muscle fascia
- Often conducted to relieve compartment syndrome
- Wound us often left open temporarily to ease pressure
- Goal is to prevent muscle necrosis and nerve injury
What is the clinical significance of the odontoid process (or ‘dens’)
The dens is a bony projection found on C2 vertebra. It articulates with C1 and forms the atlanto-axial joint.
Odontoid fractures are common cervical spine injuries, particularly in elderly
How many vertebra are there in each region of the vertebral column?
Cervical: 7
Thoracic: 12
Lumbar: 5
Sacral: 5 (fused)
Coccygeal: 4 (fused)
How many ribs are in the standard human body and which types exist?
24 ribs
True ribs: 7 pairs
False ribs: 3 pairs
Floating ribs: 2 pairs
What is the significance of the tubercle of a rib?
A small process that articulates with the corresponding vertebra
At what level does the spinal cord end and taper to become the conus medullaris?
L1 to L2 level
*Below this is the lumbar cistern and the filum terminals. These make up the cauda equina
Which of the following symptoms is most characteristic of cauda equina syndrome?
A) unilateral leg pain
B) saddle anaesthesia
C) intermittent back pain
D) appendicular muscle twitching
B. Saddle anaesthesia
What is the pathophysiology of Ankylosing Spondylitis and associated symptoms?
A chronic inflammatory disease affecting spine and sacroiliac joints. Chronic inflammation causes enthesitis (inflammation of tendon/ligament attachment points). Progressive ossificaton causes fusion of the spine (ankylosis).
Symptoms: chronic lower back pain and stiffness. Pulmonary fibrosis, aortic regurgitation, and eye inflammation can also occur
Define ‘Ankylosis’
Stiffness or fixation of a joint by a disease process
Define ‘Spondylitis’ and provide some examples of spondyloarthropathies
Spondylitis = inflammation of the vertebrae
Examples include:
- Ankylosing Spondylitis (fusion of vertebrae)
- Psoriatic Spondylitis
- Reactive Spondylitis
- Enteropathic Spondylitis
What are the three regions of the sternum?
Manubrium
Sternal body
Xiphoid process
What is the primary joint of the shoulder?
Glenohumeral joint
What are the 4 rotator cuff muscles (SITS)?
Supraspinatus: Initiates abduction
Infraspinatus: External rotation
Teres Minor: External rotation
Subscapularis: Internal rotation
What is the clinical significance of the coracohumeral ligament?
It is one of the large stabilising ligaments of the shoulder.
The coracohumeral ligament compensates for rotator cuff weakness.
The coracohumeral ligament often thickens and contracts in ‘frozen shoulder’, restricting movement
What range is considered a full term pregnancy?
37-42 weeks
Is Patent Foramen Ovale an ASD?
No. Patent Foramen Ovale is not a true Atrial Septal Defect.
It is an incomplete fusion of the septum primum and septum secundum rather than a structural deficiency.
Which cardiac abnormality is this procedure correcting?
Persistent Truncus Arteriosus
*Ventricular outflow has not separated into 2 separate vessels. This is a Septal Defect
A newborn is on a ventilator and has visible cyanosis. She is diagnosed with Patent Ductus Arteriosus. Which structures are connected by this persistent shunt?
Aorta and pulmonary trunk
*Ductus Arteriosus, in isolation, is rarely symptomatic. This presentation suggests a combination of other abnormalities, which commonly occur with Patent Ductus Arteriosus
Pronounced cyanosis in a newborn is likely indicative of what?
Severe congenital heart defects such as Tetralogy of Fallout or Transposition of Great Arteries.
*Smaller defects may be asymptomatic or only yield minor symptoms
What are the four key features of Tetralogy of Fallot?
- Ventricular Septal Defect
(Mixing of blood between ventricles) - Pulmonary Stenosis
(Compressed pulmonary artery) - Right Ventricular Hypertrophy
(Due to pulmonary stenosis) - Overriding Aorta
(Compresses pulmonary artery)
Name the four heart valves, in order of Vena Cava through to systemic circulation
Tricuspid valve (3 cusps)
Pulmonary valve (3 semilunar cusps)
Mitral valve (2 cusps)
Aortic valve (3 semilunar cusps)
A sonographer identifies transposition of the great arteries. Which part of the heart is the fetus’ Ascending Aorta connected to in this case?
Right ventricle.
The Ascending Aorta is normally connected to the left ventricle, pulmonary artery to the right ventricle. Transposition involves the switching of these vessels.
A diagnosis of Patent Foramen Ovale involves the failed fusion of which structures during cardiac development.
Septum primum and Septum secundum
What causes the disappearance of Korotkoff sounds in Phase V?
A) Turbulent blood flow
B) Vascular spasm
C) Restoration of laminar blood flow
D) Increased arterial resistance
C. Complete restoration of laminar blood flow (as Korotkoff sounds are associated with turbulent flow, caused by partial occlusion of an artery)
Why should Korotkoff sounds be auscultated using the bell of a stethoscope?
A) It amplifies high-frequencies
B) Diaphragm is less comfortable
C) It captures low-frequencies
D) Diaphragm is prone to background noise
C. The bell captures low frequency sounds better, such as Korotkoff sounds
What are the two longitudinal ligaments of the vertebral column?
Anterior Longitudinal Ligament (ALL)
- Runs along the anterior surface of the vertebral bodies from the occiput to the sacrum.
Posterior Longitudinal Ligament (PLL)
- Runs along the posterior surface of the vertebral bodies inside the vertebral canal.
What is the most elastic ligament of the vertebral column?
Ligamentum Flavum is more elastic than other ligaments and has yellow colouring.
The Ligamentum Flavum is a segmental ligament that aids in elastic recoil of the spine and supports appropriate curvature
What is the clinical significance of the Ligamentum Flavum?
With age or chronic stress, the ligamentum flavum may thicken and lose elasticity. This can encroach upon the spinal canal, contributing to lumbar spinal stenosis and/or exacerbate a herniated disk (compression)
The ligamentum flavum is also a surgical landmark which provides tactile feedback when inserting a needle (due to elasticity)
What is the function of the Nuchal Ligament and where is it located?
Located from the occiput to C7 vertebra.
Helps to maintain the head in an upright position. Restricts excessive flexion of the neck to protect spinal structures. Serves as an attachment point for several muscles (Trapezius, Splenius capitis, Rhomboid minor)
What is the difference between a disability and a long-term illness?
Disability = physical, mental, sensory, or intellectual impairment that ‘substantially limits’ everyday activities.
Long-Term Illness = chronic condition that requires ongoing management. May or may not limit daily activities.
Define reflex tachycardia
Temporary increase in heart rate to accommodate pressure changes (often upon standing).
Becomes less sensitive with age with poor baroreceptor sensitivity
Mneumonic: How to take a history (5 stages)
Move along the fingers
Thumb = ID & Consent
Digit 2 = OCART
Digit 3 = Lifestyle, Genes, Drugs
Digit 4 = Psychosocial
Digit 5 = ICE
Define SOCRATES
Site
Onset
Character
Radiation
Associations
Timing
Exacerbation / Relief
Severity
Outline the 5 vital signs and their healthy ranges?
Temperature (37c)
Pulse Rate (60-100 , regular)
Blood Pressure (120/80)
Respiratory Rate (12-20)
Oxygen Saturation (>95%)
Outline this mneumonic for heart sounds
All = Atrial
Prostitutes = Pulmonary
Take = Tricuspid
Money = Mitral
Define ‘OCART’
Onset (when exactly?)
Character (what exactly?)
Associations (anything else?)
Radiation
Timing (constant or intermittent?)
What is the formula for left ventricular ejection fraction?
EF = (stroke volume / end diastolic LV volume) x 100
What is the normal range (%) for left ventricular ejection fraction?
50-70%
With each heartbeat, 50-70% of blood in your left ventricle gets pumped to your body
A patient presents with a persistent cough, weight loss, and a smoking history. The patient is also complaining of a hoarse voice. What is the likely diagnosis?
These are red flag symptoms for lung cancer.
Specifically, the hoarse voice indicates recurrent laryngeal nerve compression, which is likely caused by a Pancoast tumour in the apex of the lung
What is the main cause of Horner’s Syndrome? (Oculosympathetic paresis)
Horner’s syndrome presents with a drooping eyelid (ptosis) and pupil constriction (miosis). This is often unilateral.
Chest and neck tumours, as well as stroke, are likely causes.
Outline the mnemonic for antibody types in the human body and their key functions
GAMED
IgG - God mode. This antibody increases in intensity every time the same disease is reintroduced. We play god by administering vaccines and boosters which manipulate this antibody.
IgA - Asshole. This is the primary antibody found in mucus membranes.
IgM - Me first. First line of antibodies that are produced to attack antigens. Unlike IgG, these do not increase in intensity.
IgE - Ewwww. Allergies and parasites (lots of gunk)
IgD - Don’t know. The least known antibody type. We do know that B cells use IgD as their receptors.
Describe the structure of the five antibodies and how they differ
IgG - Monomer (Y-shaped)
IgA - Dimer
IgM - Pentamer
IgE - Monomer (Y-shaped)
IgD - Monomer (Y-shaped)
Which antibody has a pentamer shape?
IgM (‘me first’. The first antibody to attack antigens)
Which antibody has a dimer shape?
IgA (A for ‘asshole’. This is the primary antibody found in mucus membranes)
List the 5 antibodies in order of prevalence
IgG (75-80%)
IgA (10-15%)
IgM (5-10%)
IgE (<1%)
IgD (<1%)
*Remember GAMED mnemonic
Where is the spinal cord situated?
A) Spinal body
B) Spinous process
C) Spinal canal
D) Pedicles
C. The spinal cord passes through the spinal canal. This is a narrow space posterior to the spinal body
What is spinal stenosis?
The narrowing of the spinal canal (posterior to the spinal body).
Spinal stenosis can compress the spinal cord, leading to complications.
Outline the key anatomical features of a typical vertebra.
The spinal body gives way to pedicles, which in turn form the transverse and spinal processes. The lamina is found close to the vertebral canal and this gives way to superior and inferior articular processes.
What are the three deviations of the spine?
Lordosis: bent back
Kyphosis: bent over
Scoliosis: bent sideways
What are the 4 natural curvatures of the spine?
Sacral kyphosis
Lumbar lordosis
Thoracic kyphosis
Cervical lordosis
Which spinal curvature occurs when a person hunches over a computer device?
Kyphosis. Specifically, excessive kyphosis of the thoracic vertebrae (which are normally kyphotic to a lesser degree)
Where is the zygapophyseal joint located?
Between the superior and inferior articulating processes of two corresponding vertebrae
Which joint fuses the sacrum to the pelvis?
Sacroiliac joint (notably the sacro-iliac ligament)
Where is the pubic symphysis located?
At the base of the pelvis. This ligament joins the left and right pelvic bones and helps to absorb shock from locomotion.
What is the common term for a lumbar vertebral disc herniation?
Slipped disk.
This is where the cartilaginous disk between two vertebrae herniates (or prolapses) from its standard position. This can cause nerve compression.
Which vertebral level is the Hyoid bone?
C3
At which vertebral level is the sternal angle located?
T4/T5
The hyoid bone is an anatomical landmark which sits superior which other two surface landmarks?
Thyroid cartilage and cricoid cartilage.
The hyoid is the most superior surface landmarks of the neck, found at the region where the neck meets the underside of the chin. Moderate Palpation is required.
What is the mediastinum and it’s function?
A space within the chest that contains the heart, pericardium, great vessels, trachea, and essential nerves
What is the plane of motion that the atlantooccipital joint allows?
Flexion-extension.
This allows the ‘yes’ movement of nodding
What is the clinical significance of the Atlantoaxial joint?
C1-C2 location and mobility allow for around 50% of cervical rotation to occur at this site. This allows the ‘no’ movement.
This pivot joint can be susceptible to trauma and/or degeneration, due to its mobility
