Gen Anatomy Flashcards
Landmark: lumbar puncture
Iliac crest
Innervation of positive PSOAS sign in AP physical exam
Innervation
Psoas ms - lumbar plexus
Iliacus ms - femoral n
Right leg hyperextended, the iliopsoas muscle group pushes against the appendix.
Also positive in pancreatic cancer, inflammation of cecum and sigmoid colon.
McBurney’s point
2/3 of the way FROM umbilicus to asis.
Pudendal nerve block
Ischial spine
Retro peritoneal structures 9
SAD PUCKER
Suprarenal/adrenal gland Aorta and IVC Duodenum 2 & 3 Pancreas Ureters Colon desc and ascending Kidneys Esophagus lower 2/3 Rectum lower 2/3
Site of mets ovarian ca via direct extension
Since its intraperitoneal, it will affect those within peritoneum too ie transverse colon etc excluding SAD PUCKER
Control of vomiting aka chemoreceptor trigger zone
Area postrema - medulla at floor of 4th ventricle
Pituitary functions
TAN HATS
Thirst
Adenohypophysis
Neurohypophysis and median eminence Hunger Autonomic regulation Temperature Sexual urges
Lesion in superior colliculi
Paralysis of conjugate VERTICAL gaze - parinaud syndrome
CN III IV VI - superior orbital fissure along with V1
Most common initial sensory impairment in DM
Loss of vibrational sensation - Pacinian corpuscle
Histo pacinian: onion like appearance
Meissner corpuscle vs Merkel nerve
mEISSner corpuscle: hairlEISS: light touch
Merkel nerve: hair follicles: deep static touch
Found in feet, transducer pressure
Ruffini corpuscle
Produces Major Basic Protein
Eosinophil
Abnormal opening of penile urethra on the superior/dorsal side of penis due to faulty positioning of genital tubercle
Epispadia
- You hit your Eye when you pEE
- associated with bladder Extrophy
Note: failure of urethral folds to close:HYPOspadia:hypo is below
Injury to male urogenitalia
Anterior bladder wall rupture Superior bladder wall rupture Urethral rupture above the urogenital diaphragm Penile urethral rupture Urethral below the urogenital diaphragm
Anterior bladder wall rupture: fractured pelvis:urine into retro public space.
Superior bladder wall rupture:DOME RUPTURE:compression of full bladder:urine into peritoneal cavity
Urethral rupture above the urogenital diaphragms: fractured: IMPROPER CATHERIZATION: urine into retro public space
Urethral below the urogenital diaphragm:STRADDLE INJURY :urine flow into scrotum and perineal area
Penile urethral rupture: crush injury: urine into buck’s fascia within penis
Cells of the adrenal medulla and SNS ganglia
Chromaffin cells
- visualized by staining with chromium salts.
- neural crest derivative
- innervated by splanchnic nerve
- secrete Epi, NorE, and Enkephalins
Staining: adrenal cortex vs medulla
Cortex : eosinophilic
Medulla: basophilic (chromaffin cells)
Injury to Artery of Adamkiewicz occurs during
Cardiac surgery
Artery of Adamkiewicz
- BS lower 2/3 spinal cord
- from aorta, enters at level of T8-L4
Watershed area in spinal cord
T4-T8
Anterior spinal artery supplies: spinothalamic, lateral CST, autonomic
So infarct during surgey ANTERIOR CORD SYNDROME causes loss of
- pain and temp
- loss of motor control at these levels
- bowel and bladder control
Epithelial cell junctions
Loss of _____promotes metastasis
E Cadherin
- found in zonula adherins
Permit communication and electrical exchange between cells
Gap junction
Duration of MI based on histology and sequelae/risk
Early coagulative necrosis, edema, hemorrhage, wavy fibers
4 - 12 hrs
Risk of arrhythmia
MI sequelae 0 -4 hrs post attack
Arrhythmia
CHF exacerbation
Cardiogenic shock
Duration of MI based on histology and sequelae/risk
Contraction bands from REPERFUSION injury. Release of necrotic cell content into blood. Beginning of NEUTROPHIL migration.
1-3 days
Fibrinous perocarditis
Duration of MI based on histology and sequelae/risk
MACROPHAGE infiltration followed by granulation tissue at margins
3-14 days
Free wall rupture causing tamponade
Papillary muscle rupture
Ventricular aneurysm
Interventricular septal rupture
Duration of MI based on histology and sequelae/risk
Contracted scar complete
2 weeks to several months
Dressler’s syndrome - prinzmetal like treated with Ca blockers
Responsible for central vision
Macula in occipital pole
- PCA supplies occipital lobe, responsible for perceiving LATERAL visual field in both eyes
- Meyer’s loop is the INFERIOR division of optic radiations as they pass through the temporal lobe. Supplied by MCA.
Identify presentation of a CN 7 lesion (5)
1 dec taste sensation anterior 2/3 IPSI tongue - chorda tympani
2 retroauricular pain - sensory to small area of IPSI ear
3 IPSI facial paralysis - motor to muscles of facial expression
4 inc sensitivity to noise IPSI ear - NS to STAPEDIUS ms which normally prevents excessive movement of stapes
5 dryness IPSI eye and mouth - PNS to IPSI lacrimal gland, submandibular and sublingual gland
Basal ganglia direct vs indirect pathway
Which is inhibitory?
INdirect pathway : INhibits movement
D1 receptor : D1rect pathway
- D1rect pathway : D1 receptor : facilitates movement
- INdirect pathway : INhibits movement : D2 receptor
- Lentiform nucleus = put amen + globus pallidus
- Striatum = putamen (motor) + caudate (cognitive)
- recall nigroStriatal pathway
Count up innervation of reflexes ankle, knee, biceps and triceps
ankle S1 2
knee L3 4
biceps L5 6
triceps L7 8
AEGIS
Alpha fibers : extrafusal fibers
Gamma fibers : intrafusal fibers
Skeletal
Pathway of muscle reflex
Muscle stretch -> intrafusal stretch -> stimulates Ia afferent -> stimulates alpha motor neuron -> reflex extrafusal contraction
Site where arachnoid granulations transport CSF from subarachnoid space into the bloodstream
Superior Sagittarius sinus
- site of defect in normal pressure hydrocephalus - “wet, wacky, wobbly”
Innervated by radial nerve
Radial nerve innervates the BEST
Brachioradialis
Extensors of the wrist and fingers
Supinator
Triceps
Raleased by Eosinophils
Major Basic Protein
Eosinophilia detected in NAACP
Neoplasia Asthma Allergies Collagen disorder Parasitic infections
Level of horizontal fissure or right lung
Level of 4th rib anteriorly
- separates right upper lobe from middle lobe
Relation of pulmonary artery to the bronchus at each lung hills
“RALS”
Right anterior, Left superior
Pulmonary artery is anterior to bronchus at right
Pulmonary artery is superior to bronchus at left
Why more aspiration in right lung
Right main stem bronchus is WIDER and more VERTICAL than left
Cremaster reflex NS
L1-L2
- most injured in hernia repair
- defect: numbness of scrotum and inner thigh
Note most injured vaginal delivery: S2-S4 pudendal nerve. Innervates external genitalia. Presents with bowel and bladder incontinence, perineal anesthesia.
Responsible for central vision
Macula in occipital pole
- PCA supplies occipital lobe, responsible for perceiving LATERAL visual field in both eyes
- Meyer’s loop is the INFERIOR division of optic radiations as they pass through the temporal lobe. Supplied by MCA.
Identify presentation of a CN 7 lesion (5)
1 dec taste sensation anterior 2/3 IPSI tongue - chorda tympani
2 retroauricular pain - sensory to small area of IPSI ear
3 IPSI facial paralysis - motor to muscles of facial expression
4 inc sensitivity to noise IPSI ear - NS to STAPEDIUS ms which normally prevents excessive movement of stapes
5 dryness IPSI eye and mouth - PNS to IPSI lacrimal gland, submandibular and sublingual gland
Basal ganglia direct vs indirect pathway
Which is inhibitory?
INdirect pathway : INhibits movement
D1 receptor : D1rect pathway
- D1rect pathway : D1 receptor : facilitates movement
- INdirect pathway : INhibits movement : D2 receptor
- Lentiform nucleus = put amen + globus pallidus
- Striatum = putamen (motor) + caudate (cognitive)
- recall nigroStriatal pathway
Count up innervation of reflexes ankle, knee, biceps and triceps
ankle S1 2
knee L3 4
biceps L5 6
triceps L7 8
AEGIS
Alpha fibers : extrafusal fibers
Gamma fibers : intrafusal fibers
Skeletal
Pathway of muscle reflex
Muscle stretch -> intrafusal stretch -> stimulates Ia afferent -> stimulates alpha motor neuron -> reflex extrafusal contraction
Site where arachnoid granulations transport CSF from subarachnoid space into the bloodstream
Superior Sagittarius sinus
- site of defect in normal pressure hydrocephalus - “wet, wacky, wobbly”
Innervated by radial nerve
Radial nerve innervates the BEST
Brachioradialis
Extensors of the wrist and fingers
Supinator
Triceps
Raleased by Eosinophils
Major Basic Protein
Eosinophilia detected in NAACP
Neoplasia Asthma Allergies Collagen disorder Parasitic infections
Level of horizontal fissure or right lung
Level of 4th rib anteriorly
- separates right upper lobe from middle lobe
Relation of pulmonary artery to the bronchus at each lung hills
“RALS”
Right anterior, Left superior
Pulmonary artery is anterior to bronchus at right
Pulmonary artery is superior to bronchus at left
Why more aspiration in right lung
Right main stem bronchus is WIDER and more VERTICAL than left
Cremaster reflex NS
L1-L2
- most injured in hernia repair
- defect: numbness of scrotum and inner thigh
Note most injured vaginal delivery: S2-S4 pudendal nerve. Innervates external genitalia. Presents with bowel and bladder incontinence, perineal anesthesia.
Responsible for central vision
Macula in occipital pole
- PCA supplies occipital lobe, responsible for perceiving LATERAL visual field in both eyes
- Meyer’s loop is the INFERIOR division of optic radiations as they pass through the temporal lobe. Supplied by MCA.
Identify presentation of a CN 7 lesion (5)
1 dec taste sensation anterior 2/3 IPSI tongue - chorda tympani
2 retroauricular pain - sensory to small area of IPSI ear
3 IPSI facial paralysis - motor to muscles of facial expression
4 inc sensitivity to noise IPSI ear - NS to STAPEDIUS ms which normally prevents excessive movement of stapes
5 dryness IPSI eye and mouth - PNS to IPSI lacrimal gland, submandibular and sublingual gland
Basal ganglia direct vs indirect pathway
Which is inhibitory?
INdirect pathway : INhibits movement
D1 receptor : D1rect pathway
- D1rect pathway : D1 receptor : facilitates movement
- INdirect pathway : INhibits movement : D2 receptor
- Lentiform nucleus = put amen + globus pallidus
- Striatum = putamen (motor) + caudate (cognitive)
- recall nigroStriatal pathway
Count up innervation of reflexes ankle, knee, biceps and triceps
ankle S1 2
knee L3 4
biceps L5 6
triceps L7 8
AEGIS
Alpha fibers : extrafusal fibers
Gamma fibers : intrafusal fibers
Skeletal
Pathway of muscle reflex
Muscle stretch -> intrafusal stretch -> stimulates Ia afferent -> stimulates alpha motor neuron -> reflex extrafusal contraction
Site where arachnoid granulations transport CSF from subarachnoid space into the bloodstream
Superior Sagittarius sinus
- site of defect in normal pressure hydrocephalus - “wet, wacky, wobbly”
Innervated by radial nerve
Radial nerve innervates the BEST
Brachioradialis
Extensors of the wrist and fingers
Supinator
Triceps
Raleased by Eosinophils
Major Basic Protein
Eosinophilia detected in NAACP
Neoplasia Asthma Allergies Collagen disorder Parasitic infections
Level of horizontal fissure or right lung
Level of 4th rib anteriorly
- separates right upper lobe from middle lobe
Relation of pulmonary artery to the bronchus at each lung hills
“RALS”
Right anterior, Left superior
Pulmonary artery is anterior to bronchus at right
Pulmonary artery is superior to bronchus at left
Why more aspiration in right lung
Right main stem bronchus is WIDER and more VERTICAL than left
Cremaster reflex NS
L1-L2
- most injured in hernia repair
- defect: numbness of scrotum and inner thigh
Note most injured vaginal delivery: S2-S4 pudendal nerve. Innervates external genitalia. Presents with bowel and bladder incontinence, perineal anesthesia.