Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MD3002 > Week 1 > Flashcards

Week 1 Flashcards

1
Q

Where is the cavity “proper”?

A

Between the teeth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Where is the vestibule?

A

Outside the teeth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What 2 bones make up the hard palate?

A
  • Maxilla

- Horizontal plate of Palatine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What does the ramus of the Mandible divide into?

A
  • Condylar

- Coronoid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What does the mandibular foramen allow the passage of?

A

The inferior alveolar/dental nerve to the lower teeth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What lies in the submandibular fossa?

A

Submandibular gland

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What attaches at the Mylohyoid line?

A

Mylohyoid muscle, forming the floor of the mouth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What lies in the sublingual fossa?

A

Sublingual gland

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What attaches at the retromolar fossa?

A

Lower end of the pterygomandibular raphe, between buccinator and superior constrictor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What movements at the Temporomandibular joint close the mouth?

A

Retraction and Elevation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What movements at the Temporomandibular joint open the mouth?

A

Protrusion and Depression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the only muscle of mastication that opens the mouth?

A

Lateral Pterygoid muscle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What 3 muscles elevates the mandible to close the mouth?

A
  • Medial Pterygoid
  • Masseter
  • Temporalis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the name of the cheekbone?

A

Zygoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What epithelium lines the mucous membrane internally?

A

Non-keratinised, stratified squamous

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Describe the Buccinator?

A
  • Cheek muscle
  • Compresses the vestibule
  • Contributes to orbicularis oris
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Describe the fibres of the upper buccinator in relation to the lips?

A

Upper fibres contribute to the upper lip, but also cross over into the lower lip

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Name the point of cross over of the buccinator upper and lower fibres?

A

Modiolus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the fusion at the pterygo-mandibular raphe?

A

Buccinator and superior pharyngeal constrictor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the superior attachment of the pterygomandibular raphe?

A

Pterygoid hammulus (medial pterygoid plate)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What nerves cause the sensation to skin of cheeks and lips and internal mucous membrane?

A

Branches of Maxillary and Mandibular divisions of Trigeminal nerve (V2 & V3)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What’s the main muscle of the muscular “diaphragm” of the floor of the mouth?

A

Mylohyoid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What nerve supplies the Myohyoid muscle?

A

Mandibular division of the Trigeminal nerve (V3)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What main muscle does the tongue comprise of?

A

Genioglossus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What do extrinsic tongue muscles alter?

A

Position

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What do intrinsic tongue muscles alter?

A

Shape

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What muscles draw the tongue upwards and backwards?

A
  • Palatoglossus

- Styloglossus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What muscle draws the sides of the tongue downwards?

A

Hyoglossus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What is the surface of the tongue covered by?

A

Different papillae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What nerve provides the motor supply to all tongue muscles except palatoglossus?

A

Hypoglossal (Cranial XII)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What nerve provides the motor supply to the palatoglossus muscle?

A

Vagus (X) via the pharyngeal plexus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What are the 3 extrinsic muscles of the tongue?

A
  • Palatoglossus
  • Hyoglossus
  • Styloglossus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What are the 2 systems of veins draining the tongue and where do they drain to?

A
  • Deep & dorsal

- Converge on internal jugular

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What are the 3 Salivary Glands?

A
  • Parotid (serous)
  • Submandibular (mucous & serous)
  • Sublingual (mucous)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What nerve supplies the salivary glands (PNS & secretomotor)?

A

Glossopharyngeal nerve IX (and facial nerve VII)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What makes up a large proportion of the soft palate?

A

Aponeurosis of tensor palati (covered by mucous membrane)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What muscle forms the palatoglossal arches?

A

Palatoglossus muscle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Describe the attachment of Tensor palati?

A

Attaches above medial pterygoid plate and cartilage of the auditory tube, and lies outside the med. pterygoid plate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What is the important thing to remember about lymph drainage of the tongue?

A

Crosses midine, drains to deep cervical nodes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Describe the nerve supply of sensation of the tongue?

A
  • Anterior 2/3 is lingual branch of trigeminal,

- Posterior 1/3 glossopharyngeal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Which nerves supply the hard an soft palate?

A

Greater and lesser palatine branches of maxillary nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What occurs to close the oropharyngeal isthmus during chewing?

A

Palatoglossus and palatopharyngeus contract to draw palate down and draw together medially, tensor palati tenses so levator palati can close nasopharyngeal isthmus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

What lies between the Palatoglossal and Palatopharyngeal arches in the oral cavity?

A

Palatine Tonsils

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

What are the 3 longitudinal muscles that elevate the larynx?

A
  1. Palatoglossus
  2. Palatopharyngeus
  3. Salpingopharyngeus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Where is a common place in the pharynx for fish bones to become stuck?

A

Piriform fossa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Where is the Piriform fossa located?

A

Between the quadrangular membrane of the larynx and side wall of the pharynx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

What holds the nasopharynx open?

A

Stiff Pharyngobasilar fascia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

What are the 4 Pharyngeal Attachments?

A
  1. Medial pterygoid plate of sphenoid
  2. Pharyngobasilar fascia attaches to cartilage of auditory tube
  3. Levator Palati from apex of petrous temporal bone
  4. Fascia, and posterior, Midline pharyngeal raphe attaches to pharyngeal tuberacle
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

How is the midline pharyngeal raphe formed?

A

By the 3 constrictors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

What part of the hyoid bone does the stylohyoid ligament attach?

A

Lesser Horn

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Where does the superior constrictor attach?

A

To the Pterygmandibular raphe with buccinator

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Where does the middle constrictor attach?

A

Hyoid bone and stylohyoid ligament

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Where does the inferior constrictor attach?

A

Oblique line of thyroid cartilage, cricoid cartilage & fascia on cricothyroid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

What does the internal laryngeal nerve & vessels pierce?

A

Thyro-hyoid membrane

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

What vessels pass through the “gaps” with the internal laryngeal nerve?

A

Superior laryngeal vessels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

What vessels pass through the “gaps” with the recurrent laryngeal nerve?

A

Inferior Laryngeal vessels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

What does the internal laryngeal nerve provide?

A

Sensation to larynx above the vocal folds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

What does the external laryngeal nerve supply?

A

Cricothyroid muscle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

Where does the recurrent laryngeal nerve travel?

A

Passes deep to inferior constrictor to reach the larynx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

Which nerve supplies the 3 pharyngeal contrictors?

A

Pharyngeal branch of the Vagus (X)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

What can uncoordinated contraction of cricopharyngeus cause?

A

Excessively raise pressure in the pharynx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

What fascia lies outside the muscular pharynx and blends with pre tracheal fascia?

A

Buccopharyngeal fascia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

What forms the upper oesophageal sphincter?

A

Inferior constrictor has a lower circular part- cricopharyngeus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

What is the palatopharyngeal sphincter/ Passavant’s muscle and what is it’s function?

A
  • Derived from superior constrictor/ palatopharyngeus

- Provides socket into which soft palate can be moved up into during swallowing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

Describe where a pharyngeal diverticulum is likely to occur and why?

A
  • Just above the cricopharyngeal sphincter
  • Superior constrictor ends & only 2 layers remain
  • This allows a potential weakness
  • Cricopharyngeal uncoordination may be issue
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

List what the Palatopharyngeus does?

A
  • Elevates the pharynx & Larynx
  • Draws soft palate downwards
  • Brings palatopharyngeal arch towards midline to help palatoglossus separate the oral cavity and pharynx
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

How does the Stylopharyngeus descend?

A

From styloid process to between the superior & middle constrictors & fans into internal pharyngeal surface

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

How does the Salpingopharyngeus descend?

A

Into the pharynx from the cartilage of the auditory tube

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

What is the 2 main functions of the Salpingopharyngeus?

A
  • Elevator of pharynx & Larynx

- Open auditory tube during swallowing for pressure equalisation in the middle ear

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

What nerve supplies the Salpingopharyngeus?

A

Vagus Nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

What is the nerve supply of the Palatine tonsil?

Where is the referred pain?

A
  • Glossopharyngeal IX

- To middle ear

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

What is Waldeyer’s ring?

A

Ring of tonsillar tissue found in posterior 1/3 of tongue, roof of nasopharynx (adenoid) and opening of auditory tube

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

Swelling of which 2 tonsils may lead to mouth breathing and middle ear infections?

A
  • Pharyngeal tonsil/ adenoid

- Tubal tonsil

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

What is the Vallecula?

A

Pit/fossa between the tongue and epiglottis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

What happens is the pharynx is pierced when putting a catheter in the auditory tube?

A

Catheter could enter internal carotid artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

What is the blood supply of the upper pharynx?

A

Branches of External Carotid Artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

What is the blood supply of the lower pharynx?

A

Branches of Subclavian

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

Which lymph node drains the palatine tonsil?

A

Jugulodigastric

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

What is the venous drainage of the pharynx?

A

Pterygoid plexus, converges on facial and internal jugular veins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

Which nerve supplies sensory the oropharynx, inferior aspect of the soft palate and posterior 1/3 of tongue?

A

Glossopharyngeal (IX)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

What nerve gives sensory supply to the nasopharynx?

A

Maxillary (V2)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

What nerve gives sensory supply to the laryngopharynx, vallecula and epiglottis?

A

Vagus (X)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

Which 2 nerves supply parasympathetic secretomotor impulses to the pharynx?

A
  • Vagus (X)

- Facial (VII)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

What nerve give motor to supply to all but stylopharyngeus?

A

Vagus (X)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

What is the only muscle supplied by the Glossopharygeal nerve (IX)?

A

Stylopharyngeus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

What are the 6 steps to swallowing?

A
  1. Bolus pushed backwards by mylohyoid & intrinsic tongue muscles
  2. Styloglossus pulls tongue up & back to tip bolus through oropharyngeal isthmus
  3. Soft palate tensed (tensor palati) & elevated (levator palati) to sit within Passavant’s ridge, separating nasa from oropharynx
  4. Palatoglossal & Palatopharyngeal arches relax & move laterally
  5. Stylopharyngeus, Salpingopharyngeus, Palatopharyngeus, Stylohoid & Digastric elevate pharynx & larynx
  6. Relaxation of elevators, contraction of constrictors
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

What are the Gastrointestinal (abdomen) questions you ask when taking a patients history?

A
  • Abdominal pain
  • Anorexia & weight change
  • Dyspepsia/Indigestion
  • Dysphagia
  • Nausea & Vomiting
  • GI tract bleeding
  • Jaudice
  • Change in bowel habit (constipation/diarrhoea)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

What are the Genitourinary questions you ask when taking a patients history?

A
  • Urinary frequency
  • Dysuria
  • Nocturia
  • Incontinence
  • Hesitancy
  • Urinary urgency
  • Urinary flow
  • Haematuria
  • Loin pain
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

What are the other questions to consider during a Genitourinary history?

A
  • Vaginal bleeding
  • Vaginal discharge
  • Menstrual history
  • Obstetric history
  • Sexually active?
  • Contraception
  • Last menstrual period (LMP)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
90
Q

What does “SOCRATES” for pain stand for?

A
  1. Site
  2. Onset
  3. Character
  4. Radiation
  5. Associated symptoms
  6. Timing
  7. Exacerbators/relievers
  8. Severity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
91
Q

What are the 9 regions of the Abdomen?

A
  1. Right Hypochondrium
  2. Epigastric
  3. Left Hypochondrium
  4. Right Lumbar (R. Flank)
  5. Umbilical
  6. Left Lumbar (L. Flank)
  7. Right Iliac fossa
  8. Hypogastric (suprapubic)
  9. Left Iliac fossa
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
92
Q

What are the 4 quadrants of the Abdomen?

A
  1. Right upper
  2. Left upper
  3. Right lower
  4. Left lower
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
93
Q

What could pain radiation to the back indicate?

A

Pancreatitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
94
Q

What could pain radiation to the shoulder tip indicate?

A

Diaphragmatic irritation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
95
Q

What could pain radiation from loin to groin indicate?

A

Renal Colic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
96
Q

What are the associated symptoms with GU and Abdomen problems?

A
  • Sweating/Fevers
  • Vomiting/nausea
  • Diarrhoea
  • Urinary symptoms
  • Vaginal bleeding/discharge
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
97
Q

What are common aggravating/exacerbating factors?

A
  • Eating/not eating
  • Movement/lack of movement
  • Position
  • Exercise (cardiac disease)
  • Urination/ menstruation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
98
Q

What are the common relieving factors?

A
  • Eating/not eating
  • Vomiting/opening bowels
  • Movement/ lack of movement
  • Position
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
99
Q

What can be the causes of gaining weight?

A
  • Fluid gain ie. cardiac failure, liver disease, nephrotic syndrome
  • Hypothyroidism
  • Depression
  • Increased energy input/output ratio
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
100
Q

What can be the causes of weight loss?

A
  • Malignancy
  • Malabsorption ie. chronic pancreatitis/ coeliac disease/Crohn’s disease
  • Metabolic diseases ie. diabetes/hyperthyroidism/renal disease/chronic infection (TB/HIV)
  • Psychiatric causes ie. depression/dementia/anorexia nervosa
  • Malnutrition
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
101
Q

What usually makes Dyspepsia/Indigestion worse/better?

A
  • Triggered by food

- Relieved by antacid/”Gaviscon”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
102
Q

What is Dysphagia?

A

Difficulty swallowing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
103
Q

What could the oral causes of dysphagia be?

A
  • Painful mouth ulcers
  • Tonsillitis
  • Pharyngitis
  • Glandular fever
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
104
Q

What could the neurological causes of dysphagia be?

A
  • CVA

- Bulbar or pseudobulbar palsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
105
Q

What could the neuromuscular causes of dysphagia be?

A
  • Achalasia
  • Pharyngeal pouch
  • Myasthenia Gravis
  • Diffuse oesophageal spasm
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
106
Q

What could the mechanical causes of dysphagia be?

A
  • Oesophageal carcinoma
  • Peptic oesophagitis
  • Benign stricture
  • Extrinsic compression (lung tumour, lymph nodes)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
107
Q

What is Odynophagia?

A

Painful swallowing in mouth or oesophagus. Can occur with/without dysphagia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
108
Q

What are the 3 different types of vomit?

A
  1. Food
  2. Bile
  3. Blood (“coffee ground” or fresh red)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
109
Q

What does Haematemesis mean?

A

Vomiting blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
110
Q

What are the different causes of Haematemesis?

A
  • Gastric or duodenal ulcer
  • Gastric erosions
  • Varices
  • Mallory-Weiss syndrome
  • Reflux oesophagitis
  • Gastric carcinoma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
111
Q

What is the commonest cause of life-threatening GI bleeding?

A

Peptic ulceration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
112
Q

What does Melaena mean?

A

Passage of black tarry stools usually secondary to bleed in oesophagus, stomach or duodenum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
113
Q

What does lower GI tract bleeding commonly look like?

A

Fresh blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
114
Q

What are the different causes of Lower GI tract bleeding?

A
  • Haemorrhoids
  • Anal fissure
  • Diverticular disease
  • Large bowel polyps/carcinoma
  • Inflammatory bowel disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
115
Q

What does painless Jaundice suggest?

A

Carcinoma of head of pancreas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
116
Q

What does Tenesmus mean?

A

Feeling of not fully emptying bowels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
117
Q

What are the common causes of Constipation?

A
  • Diet/Dehydration
  • Painful anal conditions
  • Immobility
  • Medication ie. opiates
  • Hypothyroidism
  • Colonic/rectal carcinoma
  • Neuromuscular ie. spinal cord disease/Parkinson’s disease
  • Hypercalcaemia
  • Irritable bowel syndrome
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
118
Q

What are the common causes of Diarrhoea?

A
  • Diet
  • Stress
  • Infection ie. viral gastroenteritis/food poisoning
  • Inflammation ie. UC/Crohn’s
  • Endocrine ie. hyperthyroidism
  • Malabsorption ie. coeliac
  • Irritable bowel syndrome
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
119
Q

What are the Upper GI tract red flags?

A
  • Dysphagia
  • Blood loss
  • Weight loss
  • Upper Abdominal/epigastric mass
  • Back pain
  • Painless jaundice
  • Persistent vomiting
  • Iron deficiency anaemia
  • Worsening dyspepsia if >55 yrs old
  • New onset if >55 yrs old
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
120
Q

What are the Lower GI tract red flags?

A
  • Bleeding
  • Bowel habit
  • Mass
  • Iron deficiency anaemia
  • History of lower GI cancer with any other symptoms
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
121
Q

What are symptoms of GU problems?

A
  • Dysuria
  • Increased Urinary frequency
  • Urgency
  • Hesitancy
  • Nocturia
  • Urinary flow
  • Incontinence
  • Haematuria
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
122
Q

What are the symptoms of a Lower UTI (cystitis)?

A
  • Dysuria
  • Increased Frequency
  • Urgency
  • Suprapubic discomfort
  • Possibly haematuria
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
123
Q

What are the symptoms of an Upper UTI (pyelonephritis)?

A
  • Loin pain
  • Fevers
  • Rigors
  • Flank tenderness
  • Increased Urinary frequency
  • Dysuria
  • Possibly haematuria
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
124
Q

What are the symptoms of Prostatism (enlarged prostate)?

A
  • Irritative (urgency, dysuria, frequency, nocturia)
  • Obstructive (reduced force, hesitancy, interruption of stream during)
  • Perineal pain
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
125
Q

Describe Loin pain?

What are the different causes?

A
  • Side of back, below ribs

- Pyelonephritis/renal calculo/hydronephrosis/renal tumour/renal abscess/referred pain from back

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
126
Q

Describe Haematuria?

What are the different causes?

A
  • Frank red blood/dipstick testing
  • UTI/Urinary tract calculi/bladder carcinoma/glomerulonephritis/renal carcinoma/benign prostatic hypertrophy/prostatic carcinoma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
127
Q

What are the GU red flags?

A
  • Any age with painless macroscopic haematuria
  • Haematuria & symptoms of UTI but sterile urine
  • Testicular swelling
  • Abdominal mass thought to be from urinary/genital tract
  • Hard irregular prostate
  • Normal prostate, but rising/raised age specific PSA with/without lower urinary tract symptoms
  • High PSA
  • Postmenopausal bleeding
  • Persistent intermenstrual bleeding
  • Palpable pelvic mass/cervical lesion/vulval mass
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
128
Q

What are the exocrine secretions of the salivary glands?

A
  • Salt
  • Water
  • Mucus
  • Amylase
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
129
Q

What is the function of Amylase?

A

Polysaccharide-digesting enzyme

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
130
Q

What is the exocrine secretion of the oesophagus?

A

Mucus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
131
Q

What is the exocrine secretions of the stomach?

A
  • HCl
  • Pepsin
  • Mucus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
132
Q

What is the function of HCl secretion in the stomach?

A

Solubilisation of food particles, kills microbes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
133
Q

What is the function of Pepsin secretion in the stomach?

A

Protein-digesting enzyme

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
134
Q

What is the function of Mucus secretion in the stomach?

A

Lubricate and protect epithelial surface

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
135
Q

What are the exocrine secretions of the small intestine?

A
  • Enzymes
  • Salt
  • Water
  • Mucus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
136
Q

What is the exocrine secretions of the large intestine?

A

Mucus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
137
Q

What are the exocrine secretions of the pancreas?

A
  • Enzymes

- Bicarbonate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
138
Q

What is the function of enzyme secretion in the pancreas?

A

Digest carbohydrates, fats, proteins & nucleic acids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
139
Q

What is the function of bicarbonate secretion in the pancreas?

A

Neutralize HCl entering small intestine from stomach

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
140
Q

What are the exocrine secretions in the liver?

A
  • Bile salts
  • Bicarbonate
  • Organic waste products trace metals
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
141
Q

What is the function of bile salt secretion in the liver?

A

Solubilise water-insoluble fats

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
142
Q

What is the function of organic waste secretion in the liver?

A

Elimination in feces

143
Q

What is the function of the gallbladder?

A

Store & concentrate bile between meals

144
Q

Describe the purpose of motility?

A

Propulsion of ingested food from mouth to rectum mixing and reduction in particle size to optimise time for digestion and absorption

145
Q

Describe the purpose of digestion?

A

Ingested food is digested into absorbable molecules

146
Q

Describe the purpose of absorption?

A

Nutrients, electrolytes and water are absorbed from intestinal lumen into bloodstream

147
Q

What are the 5 Major Physiological processes of the GI tract?

A
  1. Motility
  2. Secretion
  3. Digestion
  4. Absorption
  5. Excretion
148
Q

What is the Mucosal immune system (GALT) in the GI tract?

A
  • Organised aggregates of lymphoid tissue (Peyer’s patches)

- Diffuse populations of immune cells (lymphocytes & mast cells)

149
Q

What does “GALT” stand for?

A

Gut-associated lymphoid tissue

150
Q

What are the non-immunologic protective mechanisms for the GI tract?

A
  • Gastric acid
  • Mucin
  • Peristalsis
  • Epithelial cell layer barrier
151
Q

What is the lamina propria?

A

Underlying loose connective tissue with capillaries, enteric neurones and immune cells

152
Q

What is the muscularis mucosae (lamina muscularis)?

A

Thin smooth muscle layer of the mucosa

153
Q

What is the submucosa layer?

A
  • Loose connective tissue
  • Larger blood vessels
  • Lymphatics
  • Secretory glands
  • Enteric neurones in submucosa
154
Q

What is the muscularis externa (muscle layer)?

A
  • Inner layer of circular muscle
  • Outer layer of longitudinal muscle
  • Enteric neurones between the muscle layers (myenteric plexus)
155
Q

What is the serosa layer?

A
  • Outer layer of connective tissue covered with squamous epithelial cells
156
Q

List the 9 layers of the GI tract most superficial to deep?

A
  1. Epithelium
  2. Lamino propria
  3. Muscularis mucosae
  4. Submucosa
  5. Submucosal plexus
  6. Circular muscle
  7. Myenteric plexus
  8. Longitudinal muscle
  9. Serosa
157
Q

What is the ANS extrinsic component of GI tract innervation?

A
  • Sympathetic

- Parasympathetic

158
Q

What is the Intrinsic component of GI tract innervation?

Enteric Nervous System

A
  • Submucosal plexus (Meissner’s plexus): small & large intestine
  • Myenteric plexus (Auerbach’s plexus): between circular & longitudinal muscle layers throughout GI tract
159
Q

What nerves does the parasympathetic innervation of GI tract originate?

A

Vagus nerve/ Pelvic splanchnic nerves

160
Q

Where does the sympathetic innervation of GI tract originate?

A

Sympathetic ganglia

161
Q

What 4 things control the intrinsic (enteric) nervous system of the GI tract?

A
  1. Secretory cells
  2. Endocrine cells
  3. Mechanoreceptors
  4. Chemoreceptors
162
Q

How many ml of water are lost in feces per day?

How many g of solids are lost in feces per day?

A
  • 100ml

- 50g

163
Q

What are the stimuli for secretion of gastrin hormone?

A
  • Protein
  • Nerve supply
  • Distention of stomach
164
Q

Where is the gastrin hormone secreted?

A
  • G cells of the antrum
  • Duodenum
  • Jejunum
165
Q

What are the actions of gastrin hormone?

A

Stimulates gastric acid secretion and mucosal growth

166
Q

What are the stimuli for secretion of cholecystokinin hormone?

A
  • Protein
  • Fat
  • Acid
167
Q

Where is Cholecystokinin hormone secreted?

A
  • I cells of duodenum
  • Jejunum
  • Ileum
168
Q

What are the actions of Cholecystokinin hormone?

A
  • Stimulates pancreatic enzyme secretion, bicarbonate secretion, gallbladder contraction, growth of exocrine pancreas.
  • Inhibits gastric emptying
169
Q

What are the stimulus for the secretion of secretin hormone?

A
  • Acid

- Fat

170
Q

Where is secretin hormone secreted?

A
  • S cells of duodenum
  • Jejunum
  • Ileum
171
Q

What are the actions of secretin hormone?

A
  • Stimulates pepsin secretion, pancreatic bicarbonate secretion, billary bicarbonate secretion, growth of exocrine pancreas
  • Inhibits gastric acid secretion
172
Q

What is the stimulus for the secretion of gastric inhibitory peptide hormone?

A
  • Protein
  • Fat
  • Carbohydrate
173
Q

What is the site of secretion for gastric inhibitory peptide hormone?

A
  • K cells of duodenum

- Jejunum

174
Q

What is the action of gastric inhibitory peptide hormone?

A
  • Stimulates insulin release

- Inhibits gastric acid secretion

175
Q

What is the stimulus for the secretion of motilin hormone?

A
  • Fat
  • Acid
  • Nerve
176
Q

Where is motilin hormone secreted from?

A
  • M cells of duodenum

- Jejunum

177
Q

What is the action of motilin hormone?

A

Stimulates gastric motility and intestinal motility

178
Q

What does the WHO constitution (2006) say about Health & Human rights?

A

The enjoyment of highest attainable standard of health is a functional right of every human being

179
Q

List 2 historic global declaration & 2 global legalising documents which address Health & Human rights?

A
  1. WHO constitution (2006)
  2. Universal Declaration of Human rights (UN) (1948)
  3. International Covenant on Economic, Social & Cultural Rights (1976)
  4. UN Convention on the Rights of the Child (1990)
180
Q

Why are infectious diseases a global ethical issue?

A
  • “Unrivalled consequences”
  • Violation of important rights
  • Justice
  • Do not respect boundaries
181
Q

What are the 3 rights violated during infectious diseases?

A
  1. Right to freedom of movement
  2. Right to privacy
  3. Right to informed consent
182
Q

What 6 considerations regarding ethics of isolation and quarantine did Micheal Selgelid raise?

A
  1. Must be effective in controlling disease
  2. If less restrictive measures achieve same effect, use them
  3. Consequences of not quarantining must be severe
  4. Must be implemented in an equitable manner
  5. Must be minimally burdensome
  6. Those contained must receive compensation
183
Q

What are the 3 good moral reasons for carrying out research in developing countries?

A
  1. Global health inequalities
  2. Disproportionate burden of disease
  3. Value of research in developing countries
184
Q

What are the 3 other reasons for carrying out research in developing countries?

A
  1. Less stringent ethical standards
  2. Cost
  3. Number of participants, particularly drug-naive
185
Q

What are the important considerations regarding research & clinical trials?

A
  • Ethical review & protection of participants
  • Healthcare infrastructure
  • Valid consent
  • Community engagement
  • Benefits to participants after trial/research is over
  • Importance of collaborating with local scientists
186
Q

What is the key trial regarding the control question in clinical trials of developed and developing countries?

A

076 protocol (1994)- published 1997 NEJM.

Using AZT to prevent maternal-child transmission of HIV

187
Q

What does section 33 of the updated Declaration of Helsinki (2013) say about the use of Placebo?

A

Use of any intervention less effective than the best proven one, placebo, or no intervention is necessary to determine the efficacy/safety of an intervention

188
Q

What are the medical ethics in times of armed conflict (war)?

A

Identical to medical ethics in times of peace, as stated in the International Code of Medical Ethics of the WMA

189
Q

What are the 2 main points stated in WMA Guidelines for Disaster & War?

A
  • Primary obligation is to their patients

- Primary task is to preserve health and save life

190
Q

What are the issues and questions regarding Ebola and Health & Human rights?

A
  • Outbreak centred around poorest countries
  • Originally not regarded as Western problem
  • Should Western healthcare workers working in affected countries be transferred back to Western healthcare facilities?
  • Who should receive the limited experimental treatments?
191
Q

What is the main question regarding Ebola and Quarantine/Isolation?

A

Should healthcare workers returning from Ebola treatment centres be quarantined?

192
Q

What is the issues regarding Ebola and Research & Clinical trials?

A
  • WHO (2014) determining whether it was ethical to administer experimental drugs despite potential for unknown side effects & determine who should receive priority
  • Study design was also controversial (RCT “gold standard” or not)
193
Q

What are the main point in BMA toolkit for “Ethics & Medical electives in resource poor countries”?

A
  • Stay within your competence
  • Maintain ethical standards
  • Develop “cultural competence”
  • Minimise burden on host country
194
Q

What structures are in the right upper quadrant of the abdomen?

A
  • Liver

- Gall bladder

195
Q

What structure is in the left upper quadrant of the abdomen?

A

Jejunum

196
Q

What structures are in the right lower quadrant of the abdomen?

A
  • Ileum
  • Caecum
  • Appendix
197
Q

What structure is in the left lower quadrant of the abdomen?

A

Sigmoid colon

198
Q

Where is the subcostal plane?

A

Below the costal margin at L3

199
Q

Where is the inter (trans) tubercular/Supracristal plane?

A

Between iliac crests at L4/5

200
Q

Describe the skin of the abdomen?

A

Loosely attached to underlying structures except at umbilicus allowing movement and distention

201
Q

What does the “scar” at the umbilicus represent?

A

Site of attachment of the umbilical cord in the foetus

202
Q

Is there a definite deep fascia in abdominal wall?

A

No, as it would be too restrictive

203
Q

What is Camper’s fascia?

A

Superficial, fatty layer

204
Q

What is Scarpa’s fascia?

A

Deeper, membranous layer

205
Q

What abdominal fascia lies deep too muscles, outside the peritoneum?

A

Endo-abdominal/Transversalis fascia & then extraperitoneal fat

206
Q

What is the Camper’s fascia replaced by in the scrotum?

A

Dartos muscle

207
Q

What happens to the Scarpa’s fascia at the penis and scrotum?

A
  • At penis it’s Colles’ fascia
  • At scrotum it’s Perineal fascia
  • Fuses with fascia lata of the thigh below inguinal ligament, and also with the perineal body
208
Q

What does bruising trapped under Scarpa’s fascia look like?

A

Blue swimming trunks but front only

209
Q

Describe the Thoracolumbar fascia?

A

Passes from iliac crest to 12th rib & is 3 layers that surround the back muscles & fuse together

210
Q

What 2 muscles does the thoracolumbar fascia give origin to?

A

Transversus abdominis & internal oblique

211
Q

Describe the Transversalis fascia?

A

Thin layer that lines transversus abdominis muscle & is continuous with a similar layer lining the diaphragm & iliacus muscle

212
Q

Describe the Extraperitoneal fascia?

A

Thin layer that contains variable amount of fat & lies between transversalis fascia & parietal peritoneum

213
Q

Describe Parietal peritoneum?

A

Thin serous membrane that lines walls of abdomen & encloses peritoneal cavity

214
Q

List the 4 muscles of the anterior abdominal wall?

A
  1. External oblique
  2. Internal oblique
  3. Transversus abdominis
  4. Vertical Rectus abdominis muscle (& Pyramidalis)
215
Q

What are the 3 functions of the muscles of anterior abdominal wall?

A
  1. Support contents, raise intra-abdominal pressure, withstand pressure from descent of diaphragm
  2. Support vertebral column, flexing, laterally flexing & rotating trunk against resistance
  3. Respiration
216
Q

What are the attachments of External oblique muscle?

A
  • Lower 8 ribs
  • Lateral lip of iliac crest
  • Aponeurosis to linea alba via rectus sheath
  • Forms Inguinal ligament NOT to thoracolumbar fascia
217
Q

Describe the direction of fibres of the External oblique?

A

Pass downwards & medially

218
Q

What is the nerve supply of the External oblique & Rectus Abdominis?

A

T7-12

219
Q

What are the attachments of the Internal Oblique muscle?

A
  • Thoracolumbar fascia
  • Iliac crest
  • Lateral 2/3rd of inguinal ligament
  • Lower 3/4 ribs & costal cartilages
  • Aponeurosis to linea alba via rectus sheath
  • Pubic crest behind superficial inguinal ring via conjoint tendon
220
Q

Describe the direction of the fibres of Internal oblique muscle?

A

Pass upwards & medially to ribs, but downwards to conjoint tendon

221
Q

What can injury to iliohypogastric nerve cause?

A

Weaken the conjoint tendon & predispose to inguinal hernias

222
Q

What are the attachments of Transversus Abdominis?

A
  • Thoracolumbar fascia
  • Iliac crest
  • Lateral 1/3 or 1/2 of inguinal ligament
  • Lower 6 ribs & costal cartilages
  • Aponeurosis to linea alba via rectus sheath
  • Pubic crest behind superficial inguinal ring via conjoint tendon
223
Q

Describe the direction of the fibres of Transversus Abdominis?

A

Pass transversely to ribs, linea alba & conjoint tendon

224
Q

What is the nerve supply of Transversus Abdominis muscle & Internal Oblique muscle?

A

T7-12 & L1

iliohypogastric nerve

225
Q

How is the Conjoint tendon (Inguinal Falx) formed?

A

From the aponeuroses of internal oblique & transversus abdominis

226
Q

Where does the Conjoint tendon attach?

A

Pubic crest & pectineal line behind the superficial inguinal ring, therefore supports the ring

227
Q

What are the attachments of the Rectus Abdominis (& Pyramidalis) muscle?

A
  • Costal cartilages of ribs 5 to 7
  • Xiphoid
  • Pubic symphysis
  • Pubic crest
  • Pectineal line
228
Q

Describe the direction of the fibres of Rectus Abdominis (& Pyramidalis) muscle?

A

Pass vertically, but interspersed with tendinous intersections

229
Q

What is the linea alba?

A

A midline fusion of external oblique, internal oblique & transverses abdominis muscles

230
Q

What happens at the arcuate line?

A
  • All the aponeuroses pass anteriorly and the posterior sheath ends
  • Inferior epigastric vessels enter the sheath, behind rectus abdominis
231
Q

Describe the inguinal canal/tunnel?

A
  • Created by descent of testis

- 2 openings (deep & superficial rings), each “protected” by 2 of the 3 muscles

232
Q

What does the inguinal canal contain?

A
  • Vas deferens
  • Testicular vessels in male/round ligament in female
  • Ilio-inguinal nerve
233
Q

What is the deep inguinal ring?

A
  • Opening in, or evagination of transversalis fascia

- Transmits vas deferens & gonadal vessels

234
Q

What is the superficial inguinal ring?

A

Triangle opening in external oblique aponeurosis, base on pubic crest

235
Q

Describe the relationship between the internal oblique & transversus abdominis to the inguinal canal?

A

The muscle fibres start anterior to spermatic cord in canal, then arch over it to form the conjoint tendon posteriorly

236
Q

What happens to the internal oblique and transversus abdominis lower fibres during coughing, micturition, defecation and parturition?

A

They contract, flattening out arched roof so its lowered toward the floor (can close canal)

237
Q

What is a hernia?

A

Protrusion of a viscus through the wall of its containing cavity

238
Q

Where is an inguinal hernia usually located?

A

Above & medial to pubic tubercle

239
Q

Where is a femoral hernia usually located?

A

Below & lateral to pubic tubercle

240
Q

Describe a direct inguinal hernia?

A

Through the posterior wall of the inguinal canal MEDIAL to the inferior epigastric vessels

241
Q

Describe an indirect inguinal hernia?

A

Through the deep inguinal ring LATERAL to inferior epigastric vessels

242
Q

When can hernias increase in size?

A

During coughing/straining

243
Q

What happens if the hernia causes obstruction?

A
  • Colicky abdominal pain
  • Distension & vomiting
  • Hernia is Tense, tender & irreducible
244
Q

What happens to the hernia when strangulation occurs?

A

Lump becomes red & tender

245
Q

What are the 3 skeletal muscles of the posterior abdominal wall?

A
  1. Quadratus lumborum
  2. Psoas major & minor
  3. Iliacus
246
Q

What is the function of Quadratus lumborum muscle?

A

Stabilises 12 rib for diaphragmatic movement in respiration & may weakly laterally flex the trunk along with psoas minor

247
Q

What is the function of Psoas major & iliacus?

A

Pass to lesser trochanter together & are powerful hip flexors

248
Q

Describe the attachment of the iliolumbar ligament?

A

Transverse process of L5 to posterior superior iliac spine

249
Q

What is the nerve supply of the quadratus lumborum?

A

T12 & L1-4

250
Q

What is the nerve supply of the Psoas Major?

A

L1-3

251
Q

What is the nerve supply of the Iliacus?

A

Femoral nerve L2,3,4

252
Q

What is the femoral sheath an extension of?

A

Abdominal transversalis fascia

253
Q

What special lymph node does the femoral canal contain?

A

Cloquet’s lymph node

254
Q

What are the 4 different boundaries of the femoral canal?

A
  1. Medial- Lacunar ligament
  2. Lateral- Femoral vein
  3. Posterior- Pectineus/pectineal ligament
  4. Anterior- Inguinal ligament
255
Q

What passes through the intervertebral foramen?

A

Mixed spinal nerve

256
Q

What is the subcostal nerve?

A

T12

257
Q

What is the epigastric dermatome?

Where is the referred pain?

A
  • T7

- Stomach & Oesophagus

258
Q

What is the Umbilical dermatome?

Where is the referred pain?

A
  • T10

- Appendix, gonad, small intestine

259
Q

What is the suprapubic dermatome?

Where is the referred pain?

A
  • T12

- Lower colon, bladder, uterus

260
Q

What must you do if surgically splitting rectus abdominis muscle?

A

Fibres pushed laterally, toward nerves, to avoid denervation

261
Q

How do the nerves pass between the rectus abdominis & internal oblique muscles?

A

Forwards & medially

262
Q

Where does the iliohypogastric nerve pierce?

A

External oblique aponeurosis above superficial inguinal ring

263
Q

Where does the ilio-inguinal nerve emerge?

A

Through the superficial ring

264
Q

Where is the lumbar plexus formed and located?

A

Formed in Psoas, located on posterior abdominal wall

265
Q

Where is appendicectomy incisions performed?

A

1/3 up the line from ASIS to umbilicus at McBurney’s point

266
Q

Describe the superior epigastric artery?

A
  • Branch of internal thoracic (mammary)
  • Enters upper rectus sheath between sternal & costal origins of diaphragm
  • Descends behind rectus
  • Supplies upper central anterior abdominal wall
267
Q

What anatomises may form a collateral circulation for an obstructed aorta?

A

Superior Epigastric Artery & Inferior Epigastric Artery

268
Q

What artery supplies the upper, lateral abdominal wall?

A

Musculophrenic branch of internal thoracic artery

269
Q

Describe the inferior epigastric artery?

A
  • Branch of external iliac
  • Runs upwards & medially along medial side of deep inguinal ring
  • Pierces transversalis fascia to enter rectus sheath
  • Ascends behind rectus muscle
  • Supplies lower central anterior abdominal wall
270
Q

Describe the deep circumflex iliac artery?

A
  • Branch of external iliac above inguinal ligament
  • Runs upward & laterally toward ASIS & along iliac crest
  • Supplies lower, lateral abdominal wall
271
Q

Where do the superficial epigastric & superficial circumflex iliac arteries arise from?

A

Femoral just below inguinal ligament

272
Q

What arteries supply the lateral abdominal wall?

A

Lower 2 posterior intercostal & 4 lumbar arteries

273
Q

What abdominal wall veins drain into the proximal end of the great saphenous?

A
  • Superficial epigastric
  • Superficial circumflex
  • Superficial
  • Deep external pudendal
    (ALL IMPORTANT IN VARICOSE VEIN SURGERY)
274
Q

What forms an important portosystemic venous anastomosis?

A

Para-umbilical veins connect the system through umbilicus to portal veins of liver

275
Q

What would obstruction of the portal vein cause?

A

Venous back pressure into veins of abdominal wall, resulting in a Caput Medusae

276
Q

What is the anterior abdominal wall superficial lymph drainage?

A

ABOVE umbilicus to the axillary nodes, BELOW umbilicus to the superficial inguinal nodes

277
Q

What is the posterior abdominal wall superficial lymph drainage?

A

ABOVE the iliac crests to axillary nodes, BELOW the iliac crests to superficial inguinal nodes

278
Q

What is the inferior abdominal wall deep lymph drainage?

A

External iliac –> para-aortic nodes

279
Q

What is the superior abdominal wall deep lymph drainage?

A

Parasternal nodes –> mediastinal nodes

280
Q

When is a Kocher anterior abdominal wall incision used?

A

Removal of the gall bladder

281
Q

When is a Thoraco-abdominal anterior abdominal wall incision used?

A

Accessing oesophagus

282
Q

When is a midline anterior abdominal wall incision used?

A

Rapid access through almost avascular line alba, POOR HEALING

283
Q

When is the muscle splitting loin anterior abdominal wall incision used?

A

Appendicectomy, STRONG HEALING

284
Q

When is the Pfannenstiel anterior abdominal wall incision used?

A

Gynaecological & pelvic procedures

285
Q

When is the Paramedian anterior wall incision used?

A

Like midline incision but avoiding linea alba for better healing, fibres of rectus abdominis are split/reflected laterally towards nerve supply

286
Q

What do you need to maintain when performing a skin flap?

A

Vascular pedicle, both arterial & venous

287
Q

What is the difference between Isolation & Quarantine?

A

ISOLATION- separate people who are ill from those who are healthy.

QUARANTINE- separating & restricting movement of people who are well as they have been exposed and may develop it.

288
Q

How is the rectus sheath formed?

A

By the aponeuroses of the transverse abdominis, external & internal oblique muscles

289
Q

What is the difference between peritoneum of a male and female?

A

Males is closed cavity but females have communication with exterior via uterine tubes, uterus & vagina

290
Q

What lies between the parietal peritoneum and transversalis fascia?

A

Extraperitoneal fascia/tissue

291
Q

What are the 2 parts of the peritoneal cavity?

A
  1. Greater Sac

2. Lesser Sac

292
Q

Where is the Greater sac of the peritoneal cavity?

A

Diaphragm –> Pelvis

293
Q

Why would the greater sac be used for dialysis?

A

Due to its great surface area

294
Q

Where is the lesser sac of the peritoneal cavity?

A

Behind the stomach & lesser omentum, extends slightly into greater omentum

295
Q

How do the greater and lesser sacs communicate?

A

Via epiploic foramen (of Winslow)

296
Q

Give examples of structures that the peritoneum forms?

A
  • Omenta
  • Mesenteries
  • Ligaments
297
Q

What is the omenta?

A

Two-layered folds of peritoneum that connect the stomach & 1st part of duodenum to other structures

298
Q

Where is the greater omentum derived from?

A

Dorsal mesentery

299
Q

What is the clinical significance of the omenta?

A

It’s drawn to diseased/perforated structures to seal them off

300
Q

What 2 things may the lesser omentum be referred as?

A

Hepatogastric & Hepatoduodenal ligaments

301
Q

What is the mesentery?

A

Fan shaped double-layered fold of peritoneum that connects jejunum & ileum to posterior abdominal wall

302
Q

What does the mesentery contain?

A
  • Superior mesenteric artery as a series of anastomotic arcades
  • Superior mesenteric vein
303
Q

What differences in mesentery aid the surgeon in identifying parts of the intestine?

A

JEJUNUM- mesentery has few arcades with long vasa recta

ILEUM- mesentery has many many arcades with short vasa recta

304
Q

What is the root of the Sigmoid mesocolon & what does it transmit?

A
  • Root is left iliac fossa

- Transmits sigmoid branches of inferior mesenteric vessels & nerves & lymphatics

305
Q

What is the root of the Transverse mesocolon & what does it transmit?

A
  • Root is inferior to pancreas
  • Transmits branches of middle colic vessels
  • Divides peritoneal cavity into supra & infra colic compartments
306
Q

What does the supra colic compartment contain?

A
  • Liver
  • Stomach
  • Spleen
307
Q

What does the infra colic compartment contain?

A
  • Jejunum
  • Ileum
  • Ascending & descending colon
308
Q

What is the Right posterior subphrenic/ Hepatorenal space (Morison’s Pouch)?

A
  • Potential space with the epiploic foramen in it

- Pus may collect here forming abscesses

309
Q

What is the vesico-uterine pouch (in females)?

A

Separating bladder from uterus

310
Q

What does the median umbilical fold contain?

A

Urachus

311
Q

What ligaments connect the liver to the diaphragm?

A

By falciform ligament, coronary ligaments, right & left triangular ligaments

312
Q

What do the splenorectal & gastrosplenic ligaments connect?

A

Spleen to the posterior abdominal wall & stomach

313
Q

What organ is said to be truly intraperitoneal?

A

Ovary as its absorbed its peritoneal covering

314
Q

What are 4 primary retroperitineal urinary organs?

A
  1. Adrenal glands
  2. Kidneys
  3. Ureter
  4. Bladder
315
Q

What are the 2 primary retroperitoneal circulatory vessels?

A
  1. Aorta

2. Inferior vena cava

316
Q

What are the 2 primary retroperitoneal digestive organs?

A
  1. Oesophagus

2. Rectum (middle 1/3, lower 1/3 extraperitoneal)

317
Q

What are the 3 secondarily retroperitoneal organs?

A
  • Head, neck, body of pancreas
  • Duodenum (except proximal 1st)
  • Ascending & descending colon
318
Q

What is the parietal peritoneum sensitive to?

A
  • Pain
  • Temperature
  • Touch
  • Pressure
319
Q

What is the nerve supply of the parietal peritoneum at the pelvis?

A

Obturator nerve (L2,3,4)

320
Q

What is the visceral peritoneum sensitive to?

A
  • Stretch

- Tearing

321
Q

What are the 3 main changes that occur to the trilaminar disk?

A
  1. Neural tube & body wall are dervived from ectoderm (epiblast)
  2. Cardiovascular, musculoskeletal systems and the body cavities (coeloms) are derived from mesoderm
  3. GI, respiratory and reproductive tracts are derived from endoderm
322
Q

Describe the crucial events occuring at day 17?

A
  • Notochord burrows from primitive node, between ecto- and endoderm.
  • It induces overlying ectoderm to become neutral plate
323
Q

How are coeloms formed?

A
  • Mesoderm cavitates

- In abdomen intra-embryonic coelom becomes peritoneal cavity

324
Q

When does cephalocaudal folding begin?

A

End of 3rd week ie. day 18

325
Q

What does cephalocaudal folding create?

A
  • Endodermal tube of pharynx
  • Oesphagus
  • Stomach
  • Intestinal tract
  • GI Glands
326
Q

What is Exomphalos/Omphalocele?

A

Failure of intestine to return to abdomen, lies within peritoneum & amnion in umbilical cord

327
Q

What is Gastroschisis?

A

Failure of abdominal wall, contents not covered by peritoneum or amnion

328
Q

Which structures have a ventral mesentery?

A

Stomach & proximal part of duodenum

329
Q

What does the ventral mesentery become?

A

Lesser omenum & falciform ligament

330
Q

All of the contractile tissue in the GI tract is smooth muscle, apart from where?

A
  • Pharynx
  • Upper 1/3 oesophagus
  • External anal sphincter
331
Q

Describe the function/structure of single unit smooth muscle?

A

Contain gap junctions which allow propagation of electrical signals so that when one muscle cell is depolarised so is it’s neighbour

332
Q

Describe the 4 stages of calcium activation of myosin in smooth muscle?

A
  1. Ca2+ bind to calmodulin creating a complex
  2. This activates myosin light chain kinase
  3. Which then activates myosin by phosphorylation
  4. Phosphorylated myosin binds to actin generating contraction
333
Q

What is Latch state in smooth muscle contraction?

A

Maintaining high tension due to decrease detachment rate of myosin heads

334
Q

What is the advantage of latch state in smooth muscle contraction?

A

High force, low energy consumption (ATP)

335
Q

What is Myosin Phosphatase?

A

Enzyme that dephosphorylates myosin light chain kinase for smooth muscle relaxation

336
Q

What cells are the origin/initiation of slow waves in smooth muscle?

A

Interstitial cells of Cajal (ICC)

337
Q

What are Interstitial cells of Cajal (ICC) and where are they mainly found?

A
  • Pacemaker cells

- Myenteric plexus

338
Q

What is the intrinsic firing rate of the ICC cells in the stomach?

A

3 waves per min

339
Q

What is the intrinsic firing rate of the ICC cells in the duodenum?

A

12 waves per min

340
Q

What effect does neural/hormonal input have on frequency of slow waves & action potentials in smooth muscle?

A
  • Slow wave Frequency UNAFFECTED

- Action potential Frequency AFFECTED (strength of contraction)

341
Q

What are the 6 steps in slow wave generation?

A
  1. Increase in intracellular Ca2+ conc
  2. Opening of Ca2+ dependent K+ channels
  3. Increased K+ permeability leads to slow hyper polarisation
  4. Voltage gated Ca2+ channels close & intracellular Ca2+ conc falls
  5. Ca2+ dependent K+ channels close
  6. Voltage gated Ca2+ channels open
342
Q

What is the smooth muscle membrane potential at rest during slow wave generation?

A

Between -50mV & -40mV

343
Q

What are the 3 things smooth muscle action potentials and depolarisation are stimulated by?

A
  1. Stretch
  2. Acetylcholine
  3. Parasympathetics
344
Q

What are the 2 things smooth muscle hyperpolarisation is stimulated by?

A
  1. Norepinephrine

2. Sympathetics

345
Q

What chemical in saliva acts as a lubricant?

A

Mucin (glycoprotein)

346
Q

Which 2 enzymes are found in saliva which initate digestion?

A
  1. Amylase

2. Lipase

347
Q

Describe involuntary swallowing?

A

Sensory information relayed from mechanoreceptors to brain stem, initiates reflex oscillatory pattern of activity in chewing muscles

348
Q

In the afferent pathway, where is the sensory information from touch receptors near?

A

Pharynx

349
Q

Where is the swallowing centre?

A

Medulla & lower pons

350
Q

What does the efferent motor pathway in swallowing involve?

A

Cranial innervation of pharynx & upper oesophagus & vagal motor innervation of lower oesophagus

351
Q

Describe the 6 stages of swallowing?

A
  1. Upper oesophageal sphincter opens to allow bolus to enter
  2. Upper oesophageal sphincter closes
  3. Primary peristaltic contraction mediated by swallowing reflex creating high pressure behind bolus (accelerated by gravity)
  4. Lower oesophageal sphincter opens mediated by peptidergic nerves in vagus releasing VIP
  5. Receptive relaxation of orad region of stomach
  6. Lower oesophageal sphincter closes
352
Q

What is VIP?

A

Vasoactive intestinal peptide, inducing smooth muscle relaxation

353
Q

What is the definition of Achalasia?

A

Absence of relaxation

354
Q

What could be a possible cause of Achalasia?

A

Selective loss of neurons which regulate the lower oesophageal sphincter by releasing VIP

MD3002 (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions