Upper limb Flashcards
1
Q
Week one and two of development
A
2
Q
What does hematoxylin stain and what color/
A
3
Q
Signs of a dislocated humerus at Glenohumeral joint
A
Visibly deformed shoulder
swelling/bruising
pain
tx:
closed reduction, sling, rehab
4
Q
What are acidic dyes?
A
Negative charge net
proteins
eosin-pink
aniline-blue
Orange g-orange
5
Q
Minimum distance 2 objects can be apart and still viewed as two separate images
A
Resolution
6
Q
Growth and Development of Spine ages and areas of ossification
A
4 weeks to 25 years
3 primary centers- Centrum and Neural Arch
5 secondary centers- 1 spinous process
2 transverse process
2- epiphyseal ring
7
Q
Advantages/disadvantages of x-ray machines?
A
Cheap, wide available
ionizing radiation and images are limited to what they actually show 2D-images, imposed
8
Q
Can CT imaging be in 2D and 3D?
A
Yes
9
Q
Name enzymes that contribute to different fertilization events
A
Hyaluronidase- help sperm get through corona radiata
acrosin, esterase, neurominidase help penetrate the zona pellucida
lysosomal enzymes get released into perivitelline space by plasma membrane of oocyte
10
Q
What is ultrasound particular useful for?
A
Soft tissues
blood flow
real time images
any angle
less expensive
11
Q
What ADDucts the arm?
Scapulohumeral muscles
A
Teres Major
12
Q
T1 or T2
A
T1 then T2
13
Q
What enzyme is secreted from acrosome that helps the passage of sperm through the corona radiata?
A
Hyluronidase
14
Q
Where is a normal area for implantation?
A
15
Q
What happens day 8 during implantation?
A
Syncytiotrophoblast erodes endometrium
16
Q
What is the blood supply of the breast?
A
Internal thoracic artery
lateral thoracic artery
thoracoacromial artery
Posterior intercostal arteries
17
Q
how does air between the objective lens and the coverslip affect image quality?
A
Decreases resolution
18
Q
How does the amniotic cavity arise and from which blastocytic tissue it comes from?
A
Embryoblast forms the flat bilaminar plate called the embryonic disc that then divides into two layers, epiblast and amnion, the amniotic cavity forms between the two layers.
19
Q
Venous Drainage of the Breasts
A
Axillary vein
Internal thoracic vein
20
Q
What do T2 weighted images show?
A
Bright signal from fluid
intermediate signal from fat
21
Q
In electron microscopy what are heavy metals and osmium tetroxide used for?
A
22
Q
What is the point fertilization begins and ends?
A
Begins when the egg and sperm cells first contact each other and ends when parental chromosomes come together and intermingle at metaphase of the first mitosis division of the zygote.
23
Q
What does CT used to generate an image?
A
Gantry emits rays, computer reads information
give a 3D slice
24
Q
What histochemical technique would be used in a liver biopsy to assess extent of scar tissue?
A
Mason’s trichrome- connective tissue
25
What happens day 6 during implantation?
Blastocyst attaches
26
A biopsied material is covered in cryoprotectant and immersed in liquid nitrogen. What step in processing is described?
Fixation
27
Name the most commonly used light microscope?
Compound bright field
28
Indications and Limitations of CT
Evaluation of lung -parenchyma, soft tissues of the neck, chest and abdomen
data can be 'windowed' post processing
quick, inexpensive imaging for brain
very large and expensive
uses ionizing radiation
29
What's the blood supply to the Deltoid?
Posterior Circumflex Huméral Artery
30
Dorsal horn vs Ventral horn?
Dorsal- sensory input
Ventral- motor output
31
Flexor retinaculum
Anterior of carpal tunnel
shelters median nerve in carpal tunnel
32
Name results of fertilization
1. Completes meiosis of oocyte
2. Restores normal diploid number of chromosomes
3. Creates genetic variation
4. determines sex
5. Initiates cleavage of zygote
33
What does Nuclear Medicine imaging use?
Radiopharmaceuticals/tracers
rates of metabolism/hot spots
diagnose severity or treat a disease
less expensive/more precise than exploratory surgery
34
Hypoechoic
Structures that reflect some sound waves
35
Clinical test for Teres Major/lower subscapular nerve
Arm is ABducted
resistance to adduction
*palpate in posterior axillary*
36
What are some Acromion variations?
Flat-12%
Curved-56%
Hooked-29%
Convex-3%
37
Explain which tissues give rise to the primary and secondary umbilical vesicles
Yolk sac-
hypoblast is continuous with the exocoelomic membrane, forms roof of exocoelomic cavity. They form the viseral lining of the yolk sac. Primary umbilical vesicles.
It gets bigger and cavities appear deep to cytotrophoblast and superficial to exocoelomic membrane. Then called secondary umbilical vesicle
38
What contains mixed nerves and splits?
39
Most radiolucent to most radiodense
Air- Alex
Fat-Feels
Soft tissue, fluid- Sorry
Fluid- For
Calcium/bone-Condemning
Metal-mammography
40
What is in the Antebrachial Fascia?
Bicipital aponeuosis
Interosseous membrane
Palmar carpal ligament
Flexor and Extensor Retinaculum
41
CT scanners are now the foundation of what type of imaging?
Axial or cross sectional
42
What is seen we’ll with MRI?
Soft tissue contrast
air appears as black
bowel is limited due to gas
43
What is the spinal cord?
Continuation of the medulla oblongata
conduction pathway
major reflex center
44
Indications and limitations of Ultrasound
Any plane
used for fetus, abdominal organs
heart
not good with gas or stuff behind bone
very safe
45
Bigger is better with microscope?
False
46
What does Eosin stain and what color?
47
Which step of tissue preparation preserves topographical relations of cellular/tissue contents?
Fixation
48
ID 2 layers of embryonic disc and ID where prechordial plate will form.
2 layer: epiblast and hypoblast
prechordial plate is a thickening in the endodermal layer formed by mesododermal cells from the primitive node that migrate rostrally along the midline between ectoderm and endoderm layers
49
What's sectioning artifact and staining artifact?
Sectioning- scores and tearing nicks/blemishes
staining-precipitates, contamination
50
Clinical test for Deltoid
Arm ABducted more than 15 degrees
apply resistance
middle Deltoid palpated
51
During an EGD for GERD a biopsy is taken. What histochemical method is the pathologist likely to use?
Immunocytochemistry or in situ hybridization
52
What happens day 9 during implantation?
Blood filled lacunae appear
53
What does white matter in the spinal cord have?
Tracts and fasciculi
54
What do T1-weighted images show?
Dark fluid and bright fat
55
What two clinical tests to access Suprascapular nerve?
Supraspinatus and Infraspinatus
56
What happens on implantation day 5?
Zona pellucida degenerates
57
What is most common stain fixture?
58
Which specialized histochemical technique permits the localization of proteins? Nucleic acids?
Proteins-antibodies/ immunohistochemistry or immunocytochemistry
Nucleic acids-in situ hybridization
59
1. Ultrasound
2. x-ray
3. Nuclear medicine
4. MRI- magnetic resonance imaging
5. CT-computerized tomography
60
Dermatome map
61
How is a MRI obtained?
H+ protons aligned in random directions
super magnet aligns protons
radiowaves jostle them
then they are turned off
time to realign is measured by scanner
computer makes images
62
What does Periodic acid Schaff stain?
Complex carbs
glycoproteins
glycolipids
stain red/purple
63
Steps in electron or light microscope
1. Collection
2. fixation
3. Dehydration
4. clearing agent
5. Infiltration @ 52-60C- paraffin- light, epoxy resins-electron microscope
6. embedding
7. section tissue-microtome
64
Which intercellular structures do hematoxylin and eosin stain?
Nucleic acids and proteins
65
Attachments/actions/innervation for Levator Scapulae
TP C1-C4
superior angle of scapula
Dorsal scapular
66
MRI vs CT
Like CT but better tissue differentiation
67
Most common fracture of the forearm
Colles Fracture-falling on outstretched hand
Dinner fork deformity
complete transverse fx of the distal radius- displaced dorsally and in pieces
ulnar styloid process is often broken off
68
1. T12- count, see ribs
2. L3- count-sometime extra- check with ribs
3. see rib
4. inferior articular facet
5. spinous process
69
What stain is used to ID glycogen?
Periodic acid-Schiff PAS
70
What is the ratio between the speed of light in a vacuum and the speed of light in any other media called?
Refractive index
71
Attachments/actions/innervation for Latissimus Dorsi
SP T7-L5
Thoracolumbar fascia, sacrum, iliac crest ribs 10-12
floor of intertubercular sulcus of humerus
Thoracodorsal
72
CT scanners are moderately expensive, what is another disadvantage?
Ionizing radiation
73
Which type of electron microscope permits visualization of surface ultra structure?
Scanning electron microscope
74
What is Gray matter?
Location of nerve cell bodies
75
76
CT of spine good for?
Catching small fox, more than x-ray
disc herniation
canal stenosis
bone size and quality for screw insertion
77
What happens day 10 and 11 during implantation?
Lacunar networks form
78
Anechoic
Structure that transmit sound waves without reflection
79
Intermediate back
Attachments/actions/innervation for Serratus Posterior Inferior
SP T11-L2
inferior border of ribs9-12, lateral side
anterior rami T9-T12
80
What does the Circumflex Scapular Artery supply?
Teres Major and Teres Minor
81
What is used to produce conventional radiography?
Ionizing radiation
82
What does ultrasound use to produce It’s images?
Sound waves- crystals
83
One CT is how many X-rays?
200
84
Basic principles of image formation X-ray
Ionizing radiation
85
Name two meta chromatic dyes that are basic
Methylene blue- blue color
toluidine blue-blue color
stain
Sulfates, phosphates and carboxylated rich polysaccharide stain red/purple
86
\_\_\_\_\_\_\_\_ is widely used to diagnose cancers?
Immunohistochemistry
87
What are basic dyes?
Positive charge
stain nucleic acids
hematoxylin-blue
pyronin g-red
88
Intermediate back muscle
Attachments/actions/innervation for Serratus Posterior Superior
SP C7-T3
superior border of ribs 2-5
anterior rami T2-T5
89
What is Myelography used for?
Evaluation of nerve roots, spinal cord and dura
Good alternate to MRI for Claustrophobia and metal implants
visualize to subarachnoid space
contrast injected into spinal canal
90
Attachments/actions/blood supply for Trapezius
Superior nuchal line
external occipital protuberance
SP C7-T12
lateral 1/3 of clavicle/acromion/spine of scapula
spinal accessory, cranial nerve 11
91
Attachments/actions/innervation for Rhomboid minor
Ligamentum nuchae + SP C7-T1
medial border of scapula at spine
dorsal scapular
92
Spine joints are what type of joint?
Synovial
93
What is Masson's Trichrome?
Nuclei stain blue/black
cytoplasm and bone stain red
collagen blue-green
"Connective tissue stain"
94
95
Identify characteristics of a blastocyst compared to a morula
Morula-mass of 16 totipotent cells in a sphere, 3-4 days after fertilization
blastocyst- has a cavity inside the zona pellucida along with an inner mass, 4-5 days after fertilization
96
What happens day 10 during implantation?
Blastocyst fully embedded
97
What stain is used in electron microscope?
Heavy metals as contrasting agents
osmium tetroxide-fixative and contrast agent
98
When is EPF released?
Early blastocyst
99
Immunohistochemistry looks at
Cell and tissue protein and labeled antibodies
used to dx cancer
100
Most common image modality in a hospital or local practice?
Conventional radiography-xray
101
Most frequently fractured carpal bone
Scaphoid.
fall on abducted hand
often missed on X-ray
102
Describe cleavage of the zygote and formation of the blastocyst
Repeated mitotic divisions that start about 30 hours after fertilization, little to no growth-cell sized reduced. Cells called blastomeres.
9 cells-ball shape
12-32 blastmeres called morula
103
T1 weighed?
**Bright Fat**
good for vertebral bodies, intervertebral discs, nerve root and spinal cord
contrast helps with infectious/inflammatory conditions of spine and seeing spinal tumors
104
In situ hybridation is used to detect?
Cancer cells, chromosomsal alterations and response to therapy
105
What happens day 7 during implantation?
Trophoblast differentiates
106
MRI are the foundation of what imaging?
Nuclear imaging
107
What does the Axillary Nerve innervate?
Teres Minor
Deltoid
108
What is weighting?
Altering the radio frequency, strength and timing
T1/T2
109
Resolution is ______ related to wavelength illumination
110
What is 0.61xlambda/ N.A.?
111
What is the total objective of 4x scanning objective 10x eyepiece,
10x objective 10x eyepiece
40x objective 10x eyepiece
40x, 100x, 400x
112
A-isoechoic
b. hyperechoic
c. anechoic
d. Hypoechoic
113
What happens day 13 and 14 during implantation?
Primary chorionic villi develop
114
Attachments/actions/innervation for rhomboid major
SP T2-T5
Medial border of scapula below spine
Dorsal scapular
115
What does In situ hybridization look at?
Detection of cancer cells, chromosomal alterations, responses to therapy
116
\_\_\_\_\_\_ is widely used to diagnose cancers
117
3 interpretations of histologic sections
Hollow tube with swelling
highly coiled tube
sphere and solid cylinder
118
T2 weighted?
**Weighed toward water- bright on T2, dark on T1**
signal intensity related to tissue hydration
high water content better- ex CSF, cysts, intervertebral discs, infection and tumors
good at differentiating normal vs abnormal
119
What happens day 11 and 12 during implantation?
Uteroplacental circulation established
120
Basic principles of Computed Tomography
Table moves through gantry
generator and detector slice
displayed from an inferior view
121
What does the Suprascapular Artery supply?
Supraspinatus
Infraspinatus
122
Where do para sympathie nerves arise from?
CN 3, 7,9,10
S2-4
123
What are some populations that ultrasound is recommended?
Pregnant women, fetuses, children
124
Where/when early pregnancy factor and human chorionic growth hormone are being produced and when/how to test them
EPF- secreted by trophoblastic cells. Appear in mother serum 24-48 hours after fertilization. Blood test in first 10 days.
hCG produced by syncytiotrophoblastic cells of placenta. 10 days after missed period-12-15 days post ovulation.
test in urine
125
How does a single fertilized cell divide to form blastula?
Start 30 hrs after fertilization, no growth,just cell size reduced. Zygote moves toward uterus. Still have zone pellucida.
cells are compact for greater interaction, form embryoblast
126
What is the basis by which magnetic resonance produces images?
Hydrogen atoms, water and fat/soft tissues
strong magnetic field with pulsing energy analyzed by computers
expensive and large
127
Name the property in which certain basic dyes react with certain macromolecules resulting in a color different than the dye?
Metachromasia
128
129
Examples CT uses with contrast
Upper GI
barium enema
IV pyelography
angiography
cardiac cath
130
What Scapulohumeral muscles ABduct the arm?
Anterior Deltoid
Supraspinatus the 1st 15 degrees
131
Clinical test for Subscapularis
Same as infraspinatus
flex elbow/adduct arm
resistance to medial rotation
palpate
132
What are the Rotator cuff muscles
SITS
Supraspinatus
Infraspinatus
Subscapularis
Teres Minor
133
What does ultrasound use?
High frequency sound waves
piezoelectric crystals
reflection some waves- hypoechoic-soft tissues
reflect waves similar to surrounding areas-isoechoic
hyperechoic- reflect most waves
134
5 types of Vertebrae
Cervical 7 includes axis, atlas- have transverse foramen
Thoracic- 12, articulate with ribs
Lumbar-5
Sacral- usually , fuse to form sacrum
coccygeal- 3-5
135
Clinical ways to overcome issues with fertilization
IVF
cyropreservation of embryos
intracytoplasmic sperm injection
IU assisted in vivo fertilization
surrogacy
