18.05 anatomy revision Flashcards
Sciatic nerve relations to gluteus medius and long head of biceps femoris?
It does not have any contact to gluteal medius and lies behind the biceps femoris
Posterior compartment of the leg?
Superficial - soleus, gastrocnemius, PLANTARIS
Deep - tibialis posterior, flexor digitorum longus, flexor hallucis longus, POPLITEUS
Lymph drainage of the tongue?
Anterior - ipsilateral Posterior - bilateral deep Tip - submental Lateral - submandibular - deep cervical Mid tongue lateral - ipsilateral deep Mid tongue central - bilateral deep -
Blood supply to lacrimal apparatus?
Ophthalmic artery
Bleeding after hypophyesctomy symptom?
Bitemporal hemianopia. It is contained in the dural sac, so acts like tumour
Whic muscle is innervated by cervical branch of the VII?
Platysma
Which muscle is not innervated by the trigeminal nerve?
Medial pterygoid
Mylohyoid
Stylohyoid
Masseter
Temporalis
Stylohyoid is innervated by the facial nerve.
Which of the structures listed below lies posterior to the carotid sheath at the level of the 6th cervical vertebra?
Hypoglossal nerve
Vagus nerve
Cervical sympathetic chain
Ansa cervicalis
Glossopharyngeal nerve
The carotid sheath is crossed anteriorly by the hypoglossal nerves and the ansa cervicalis. The vagus lies within it. The cervical sympathetic chain lies posteriorly between the sheath and the prevertebral fascia.
Where are accessory spleens not found?
Gonads
Tail of pancreas
Greater omentum
Splenorenal ligament
Ureter
Accessory spleens
- 10% population
- 1 cm size
- locations: hilum of the spleen, tail of the pancreas, along the splenic vessels, in the gastrosplenic ligament, the splenorenal ligament, the walls of the stomach or intestines, the greater omentum, the mesentery, the gonads
During a right hemicolectomy the caecum is mobilised. As the bowel is retracted medially a vessel is injured, posterior to the colon. Which of the following is the most likely vessel?
Right colic artery
Inferior vena cava
Aorta
External iliac artery
Gonadal vessels
The key in this question is that its during the caecal mobilization. The gonadal vessels and ureter are important posterior relations that are at risk during a right hemicolectomy. During latter stages of the procedure, the ileocolic artery and vein are traced along the anterior aspect of the duodenum. At this point it is possible to injure these, the superior mesenteric vein or the middle colic vein, injury to any of these can result in torrential bleeding that is very difficult to control.
Which of the following statements relating to the vertebral column is false?
There are 7 cervical vertebrae
The cervical and lumbar lordosis are secondary curves developing after birth due to change in shape of the intervertebral discs
The lumbar vertebrae do not have a transverse process foramina
The lumbar vertebrae receive blood directly from the aorta
The spinous process is formed by the junction of the pedicles posteriorly
The spinous process is formed by 2 laminae posteriorly.
Which of the following statements relating to the vertebral column is false?
There are 7 cervical vertebrae
The cervical and lumbar lordosis are secondary curves developing after birth due to change in shape of the intervertebral discs
The lumbar vertebrae do not have a transverse process foramina
The lumbar vertebrae receive blood directly from the aorta
The spinous process is formed by the junction of the pedicles posteriorly
The spinous process is formed by 2 laminae posteriorly.
What type of visual field defect is most likely to be noted in a patient with a craniopharyngioma?
Lower bitemporal hemianopia
Upper bitemporal hemianopia
Right superior quadranopia
Right homonymous hemianopia
Left homonymous hemianopia
Lesions at the optic chiasm classically produce a bitemporal hemianopia, however note lesions that spread up from below ie pituitary tumours, the defect is worse in the upper fields and if a lesion spreads down from above ie craniopharyngiomas, the visual defect is worse in the lower quadrants. Therefore this patient is likely to have a lower bitemporal hemianopia.
Damage during mastectomy
Long thoracic nerve (of Bell) Derived from C5-C7 and passes behind the brachial plexus to enter the axilla. It lies on the medial chest wall and supplies serratus anterior. Its location puts it at risk during axillary surgery and damage will lead to winging of the scapula.
Thoracodorsal nerve and thoracodorsal trunk Innervate and vascularise latissimus dorsi.
Axillary vein Lies at the apex of the axilla, it is the continuation of the basilic vein. Becomes the subclavian vein at the outer border of the first rib.
Intercostobrachial nerves Traverse the axillary lymph nodes and are often divided during axillary surgery. They provide cutaneous sensation to the axillary skin.
Lymph nodes The axilla is the main site of lymphatic drainage for the breast.
A 43 year old man suffers a pelvic fracture which is complicated by an injury to the junction of the membranous urethra to the bulbar urethra. In which of the following directions is the extravasated urine most likely to pass?
Posteriorly into extra peritoneal tissues
Laterally into the buttocks
Into the abdomen
Anteriorly into the connective tissues surrounding the scrotum
None of the above
The superficial perineal pouch is a compartment bounded superficially by the superficial perineal fascia, deep by the perineal membrane (inferior fascia of the urogenital diaphragm), and laterally by the ischiopubic ramus. It contains the crura of the penis or clitoris, muscles, viscera, blood vessels, nerves, the proximal part of the spongy urethra in males, and the greater vestibular glands in females.
When urethral rupture occurs as in this case the urine will tend to pass anteriorly because the fascial condensations will prevent lateral and posterior passage of the urine.
A 42 year old woman is admitted to the vascular ward for an endarterectomy. Her CT report confirms a left temporal lobe infarct. What is the most likely visual defect to be encountered?
Right homonymous hemianopia
Right superior quadranopia
Right inferior quadranopia
Left superior quadranopia
Left homonymous hemianopia
Temporal lesions cause a contralateral superior quadranopia. Think temporal area is at the top of the head i.e. superior quadranopia.
Which of the following is not contained within the middle mediastinum?
Main bronchi
Arch of the azygos vein
Thoracic duct
Pericardium
Aortic root
The thoracic duct lies within the posterior and superior mediastinum.
Arch of azygous is within the MIDDLE MED.
Azygous vein is in the POST. MED.
Which of the following structures accompanies the posterior interventricular artery within the posterior interventricular groove?
Great cardiac vein
Middle cardiac vein
Small cardiac vein
Anterior cardiac vein
Coronary sinus
What is the lymphatic drainage of the male spongy urethra?
External iliac nodes
Internal iliac nodes
Para aortic nodes
Deep inguinal nodes
Meso rectal nodes
The lymphatic drainage of the spongy urethra and the glans penis is to the deep inguinal nodes. The prostatic and membranous urethra drains to the internal iliac nodes.
A 63 year old man is due to undergo a splenectomy. Which splenic structure lies most posteriorly?
Gastrosplenic ligament
Splenic vein
Splenic artery
Splenic notch
Lienorenal ligament
The lienorenal ligament lies most posteriorly. The antero-lateral connection is via the phrenicocolic ligament. Anteriorly the gastro splenic ligament. These structures condense around the vessels at the splenic hilum.
An 18 year old man develops a severe spreading sepsis of the hand. The palm is explored surgically and the flexor digiti minimi brevis muscle is mobilised to facilitate drainage of the infection. Which of the following structures is not closely related to this muscle?
The hook of hamate
Median nerve
Superficial palmar arterial arch
Digital nerves arising from the ulnar nerve
None of the above
The flexor digiti minimi brevis originates from the Hamate, on its under- surface lie the ulnar contribution to the superficial palmar arterial arch and digital nerves derived from the ulnar nerve. The median nerve overlies the flexor tendons.
