stuffs 1 Flashcards
Flow through kidneys starting at glomerulus?
Glomerulus, proximal convoluted tubule, nephron loop-ascending and descending limb, distal convoluted tubule and back into collecting system
Glomerular filtration
The movement of substance from the blood within the glomerulus into the capsular space
Tubular reabsorption
The movement of substances from the tubular fluid back into the blood
Tubular seretion
The movement of substances from the blood into the tubular fluid
Main function of the loop of henle?
Create a very salty environment to help concentrate the urine by causing the water to be reabsorbed (*osmotic balance)
Difference between cortical nephron and juxtamedullary nephron?
Cortical’s bulk is in the cortex (more of them) and juxtamedullary is extended primarily into the medulla (less of them)
What is found in the cortex of a kidney?
Renal columns, renal corpuscles, PCT/DCT, *brown
What is found in the medulla of a kidney?
Pyramids, medullary rays, loops of henle and collecting tubules, *red
what is the median umbilical fold in fetal development?
urachus
in adult, bladder to navel
incontinance
lose of voluntary control of external sphincter typically in older women due to weak pelvic floor
renal calculi
kidney stones; calcium salt stones in renal system (meds to break up)
What is the difference the sympathetic ganglion chain and the IML? Importance?
The IML only goes down to L2/3 BUT the sympathetic chain goes down to the coccyx. This is important because it means there is ONLY descending fibers after L2/3 for sympathetic ganglion chain
**why does T12-L2 have white and grey rami?
Because IML reaches to L2/3. Therefore you still have presynaptic white and postsynaptic gray
Why does L3- L5 only have gray rami?
Because the IML only reached L2/3 and everything inferior has to be descending (so it cannot have white rami coming in, ONLY gray postsynaptic leaving)
what two vertebrae overlap in lumbar and saccral plexus?
lumbar 4 and lumbar 5
How is the cutaneous innervation for the gluts odd?
Nerve for the muscles come from lumbosacral plexus BUT innervation cutaneously is emerging from dorsal rami
Explain the relationship between the piriformis muscle and sciatic nerve?
88% have sciatic nerve emerging BELOW piriformis, BUT ½ can pierce through the muscle or it can fully pierce through the muscle or it can emerge above
Why not give a shot in the glut maximus? Where are most injections?
Because the presence of the sciatic nerve (and superior/inferior gluteal nerves)! Most injections in the superior lateral gluteal region in the gluteus medius or TFL (because it is safer and has less nerves)
Positive Trendelenburg sign?
Means there is a superior gluteal nerve lesion. Example: injury on the right= dipping down motion on CONTRALATERAL SIDE (aka left) bc the muscles aren’t contracting. Contracting muscles= good/stable
What is cruciate anastomosis? What arteries form cruciating anatomoses?
Network of blood around the head of humerus; provides anatomical insurance incase anything happens with femoral artery. Medial circumflex artery, inferior gluteal artery, lateral circumflex artery, 1st perforating artery (and femoral artery)
What is the clinical relevance of the femoral triangle?
Location of femoral hernias, heart work=inserting cathode or balloon stint, great pulse point, arteriole grams
Is the inguinal hernia or femoral hernia more common? Why? How do you check for a femoral hernia?
Inguinal, mainly because it is an already open space. It is lateral to the pubic tubercle (and the inguinal hernia would be found medial). So palpate for the superficial ring to determine if the buldge is from the medial or lateral side
Describe how LE reflexes work?
1) Stimulus is tapping on tendon
2) Send afferent info back to spinal nerves
3) Efferent response affects
a. Direct effect= kicking of leg (afferent to efferent)
b. Inhibits antagonistic muscle (afferent to interneum)
What does a knee jerk (patellar reflex) test?
L3-4, femoral nerve (quadricep muscle)
