Shelf: 100 Must Know Concepts

Question 1

Lumbar Puncture

needle penetrates what levels
b/w vertebrae

spinal cored termination in adults and children

Answer 1

LP: needle enters subarachnoid space to extract CSF or to inject anesthetic to the epidural space

levels: L3/L4 or L4/L5; level or hoizontal line through upper points of iliac crest
adult: L2; children: L3

Question 2

Herniated disc
region
nerve compression
result of lumbar herniation

Answer 2

region: cervical or lumbar
nerve compression: the root one number below
(ex: L4/L5 herniation affects L5 nerve)

result: lower limb reflexes decreased on the affected side

Question 3

Patellar tendon reflex decrease means herniation of

Answer 3

L2/L3 or L3/L4

Question 4

Achilles tendon reflex decrease means hernation of

Answer 4

L5/S1

Question 5

Kyphosis

Answer 5

exaggeration of thoracic curvature that may result from osteoporosis or disk degenration

Question 6

Lordosis

Answer 6

exaggeration of lumbar curvagure

Question 7

Scoliosis

Answer 7

lateral deviation or torsion

Question 8

Humerus Surgical Neck Fractures

Answer 8

affect anterior and posterior circumflex humeral arteries and the axillary nerve

Question 9

Humerus Midshaft Fracture

Answer 9

affects radial nerve and profunda brcachii

Question 10

Supracondylar region humerus fracture

Answer 10

brachial artery and median nerve

Question 11

Medial epicondylar humerus fracture

Answer 11

ulnar nerve

Question 12

Scaphoid Fracture

issue

Answer 12

proximal fragment may undergo avascular necrosis

Question 13

Abduction of Upper Limb

Answer 13

0-15: supraspinatus muscle (suprascapular N)
15-110: deltoid muscle (axillary N)
110-180: trapezius (spinal accessory nerve)

Question 14

scapular anastamoses

Answer 14

suprascapular
subscapular
circumflex scapular
transverse cervical

Question 15

Injury to musculocutaneous nerve

Answer 15

weakens flexion of the elbow and supination of the arm

accompanied by anesthesia over lateral aspect of forearm

Question 16

Describe trendelenburg sign

Answer 16

superior gluteal nerve injury leads to contralateral dropped hip

Question 17

What are the structures under the inguinal ligament/

Answer 17

(from lateral to medial):

femoral nerve
femoral artery
femoral vein
femoral canal

Question 18

Describe a femoral hernia

more frequently in
dangerous because

Answer 18

femoral hernia passes below the inguinal ligament into the inguinal canal

occurs more frequently in women
dangerous b/c hernial sac may become strangulated

Question 19

Unhappy triad of knee joint injuries includes

Answer 19

tibial collateral ligament
medial meniscus
ACL

Question 20

ACL rupture leads to

Answer 20

tibia can be pulled excessively forward on the femur, exhibiting anterior drawer sign

Question 21

PCL rupture

Answer 21

tibia can be pushed backward excessively on the femur, exhibiting posterior drawer sign

Question 22

Ankle sprain
usually always
what ligament

Answer 22

usually always an inversion injury
lateral ligament (anterior talofibular ligament)

Question 23

Fibular neck fracture

Answer 23

causes injury to the common fibular nerve, which winds around the neck of the fibula

leads to foot drop

Question 24

Peau d Orange

Answer 24

lymphatic drainage causes shortening of the suspensory ligaments of cooper, causing dimpling of the skin

Question 25

Diaphragm paralysis results in

Answer 25

phrenic nerve issues

Question 26

Phrenic nerve course

Answer 26

anterior to the root of the lung

Question 27

Vagus nerve course

Answer 27

posterior to the root of the lung

Question 28

Cardiac Hypertropy

Answer 28

left atrial enlargement secondary to mitral valve failure can compress on the esophagus and manifest as dysphagia

Question 29

SA node

Answer 29

site where contraction of heart muscle is initiated; situated near the opening of the SVC

Question 30

AV Node

Answer 30

receives impulses from the SA node; situated in lower part of atrial septum near coronary sinus

Question 31

AV bundle fo HIS

Answer 31

descends from AV node to ventricular septum where it divides into L and R bundle branches

Question 32

RCA Supplies

Answer 32

right atrium & ventricle SA node AV node

Question 33

Most common place of MI

Answer 33

LAD

Question 34

AV Bundle supplied by

Answer 34

LCA

Question 35

ASD caused by

Answer 35

failure of the foramen ovale to close after birth

Question 36

Postnatally, ASD's result in

Answer 36

left to right shunting (b/w right and left atrium) and are non cyanotic

Question 37

Most common septal defect

Answer 37

VSD

Question 38

VSD's result in

Answer 38

left to right shunting (not cyanotic)

Question 39

VSD's are found in the

Answer 39

membranous portion of the interventricular septum

Question 40

``` Patent Ductus Arteriosus results from sustained by common in results in ```

Answer 40

failure of ductus arteriosus to constrict (connection b/w pulmonary trunk & aorta) sustained by prostaglandin E2 common in cases of maternal rubella results in left to right shunt

Question 41

Aneurysm of the aortic arch leads to

Answer 41

compression of left recurrent laryngeal nerve, coughing, hoarseness, dysphagia

Question 42

Coarctation of the Aorta result from clinical sign

Answer 42

result: congenital narrowing of aorta sign: higher blood pressure in upper limbs than lower; rib notching

Question 43

First structure crossed by any abdominal hernia

Answer 43

transversalis fascia

Question 44

Indirect Inguinal Hernia characteristics

Answer 44

passes through the deep inguinal ring, lateral to the inferior epigastric vessels, passes through the superficial inguinal ring to reach the scrotum

Question 45

Ligaments of lesser omentum

Answer 45

hepatogastric | hepatoduodenal

Question 46

Epiploic Foramen Posterior Superior Inferior

Answer 46

posterior: IVC superior: caudate lobe of liver inferior: 1st part of duodenum

Question 47

Posterior Gastric Ulcer Goes to Affects what Artery

Answer 47

goes to lesser omentum; results in referred pain to the back | affects splenic artery

Question 48

Sliding Hiatal Hernia

Answer 48

hernia of the cardia of the stomach into the thorax through the esophageal hiatus

Question 49

Branches of celiac trunk

Answer 49

left gastric common hepatic splenic

Question 50

Likely artery to rupture during 1st part of duodenal erosion

Answer 50

gastroduodenal artery

Question 51

Common sites for impaction of gallstones

Answer 51

1. common hepatic duct 2. bile duct 3. hepatopancreatic ampulla, which will lead to jaundice

Question 52

Gallstones in the fundus of the gallbladder

Answer 52

fundus is in contact with the transverse colon and gallstones erode through the posterior wall and enter the transverse colon, eventually get held up at the ileocecal junction

Question 53

Extrahepatic portocaval shunt

Answer 53

b/w splenic vein and left renal vein

Question 54

Intrahepatic portocaval shunt

Answer 54

b/w portal vein and hepatic veins

Question 55

Sites of portocaval anastamoses

Answer 55

esophageal veins paraumbilical veins rectal veins

Question 56

Rectal Anastamoses

Answer 56

b/w superior rectal (from IMV) and inferior rectal vein (from portal vein)

Question 57

Head of pancreas is traversed by

Answer 57

superior mesenteric vessels

Question 58

What are the ureteric constriction points?

Answer 58

ureteopelvic junction pelvic brim wall of urinary bladder

Question 59

Benign prostate hypertrophy usually involves which lobe

Answer 59

median lobe of the prostate

Question 60

Erection controlled by

Answer 60

parasympathetic fibres from the pelvic splanchnic nerves

Question 61

Ejaculation controlled by

Answer 61

sympathetic fibers from the inferior hypogastric plexus

Question 62

Ampulla of uterus

Answer 62

site of fertilization

Question 63

Hysterosalpingography what is it visualize

Answer 63

what: inject viscous iodine through the external os visualize: uterine cervix, uterine cavity, and uterine tubes on x ray

Question 64

Anterior cranial fossa fracture

Answer 64

anosmia (fracture of cribiform plate)

Question 65

scaphocephaly

Answer 65

premature closure of the sagittal suture

Question 66

epidural hematoma caused by

Answer 66

skull fracture near pterion causing hematoma from middle meningeal artery