Satiety center of hypothalamus
- Ventromedial area.
- “If you zap your ventromedial area, you will grow both ventrally and medially”.
- stimulated by leptin.
- damage may be caused by craniopharyngioma.
Hunger center of hypothalamus
- Lateral area.
- “If you zap your lateral nucleus, you will shrink laterally.”
- inhibited by leptin.
- Lat makes you Fat.
Stroke to PCA
- occipital cortex, visual cortex.
- contralat. hemianopia w/macular sparing.
Where can the great saphenous vein be harvested from?
-just inferolateral to the pubic tubercle.
Whats a common way to get Klumpke palsy and what are symptoms?
- grabbing tree branch while falling.
- Lower trunk (C8-T1) of brachial plexues.
- total claw hand. clumsiness of hand.
What is the only muscle innervated by the ext. branch of the sup. laryngeal nerve?
What nerve is at risk during a thyroidectomy?
External branch of superior laryngeal nerve. Due to its proximity to the superior thyroid a/v.
-this nerve inn. the cricothyroid muscle. Which is the only muscle of the larynx not inn. by the reccurent laryngeal.
Where does thoracic duct enter thorax?
- aortic hiatus
- so does azygos vein.
Where does vagus n. enter abdominal cavity?
-T10, esophageal hiatus.
Portocaval anastomoses (PCAs): esophageal varices
- portal circ: left gastric vein
- systemic circ: esophageal vein
- portal circ: superior rectal vein
- systemic circ: middle & inferior rectal veins
PCAs: caput medusae
- portal circ: paraumbilical veins
- systemic circ: superficial & inferior epigastric veins
- nerve roots
- L2-L4. “Kobe is a smooth obturator”.
Common peroneal (fibular) n.
- nerve roots
- how to injure?
-tibialis anterior = only need to know muscle.
-Trauma or compression of lateral aspect of leg,
fibular neck fracture
-you get foot drop.
- how to injure
- problems s/p injury
-Knee trauma, Baker cyst (proximal lesion); tarsal tunnel syndrome (distal lesion).
-Inability to curl toes and loss of sensation on sole
of foot. In proximal lesions, foot everted at rest
with loss of inversion and plantarflexion.
Diseaes that can damage superior gluteal nerve?
Peroneal Everts and Dorsiflexes; if injured, foot drop PED
Tibial Inverts and Plantarflexes; if injured, can’t stand on TIPtoes.
Which responds to aspirin (pain-wise):
Osteoid osteoma or osteoblastoma?
Whats the only tumor we need to know about that arises in the epiphysis of bone?
Giant cell tumor.
- locally aggressive yet benign tumor often around the knee.
- “Soap bubble” appearance on x-ray.
- Multinucleated giant cells.
Where to find osteosarcoma?
-Metaphysis of long bones, often around knee. -malignant prolif. of osteoblasts. -region of growth plate = metaphysis. -codman triangle (elevation of periosteum) -sunburst pattern on x ray
What are the 2 most common bone malignancies in children?
Osteosarcoma & ewings sarcoma.
- who gets it?
- where does it appear?
- what do cells look like?
- is it responsive to chemo?
- boys <15 yo
- Anaplastic small blue cell malignant tumor
- it IS responsive to chemo
-“Onion skin” appearance in bone.
-Associated with t(11;22) translocation.
(11 + 22 = 33 (Patrick Ewing’s jersey number).
juvenile rheumatoid (idiopathic) arthritis
- is rheumatoid factor always present?
- ANA still positive?
rheumatoid factor is often absent. ANA still positive.
RA can get bakers cyst in popliteal fossa
-what are other possible Sxs?
subQ rheumatoid nodules = fibrinoid necrosis.
- fever, fatigue, pleuritis, pericarditis.
- spiking/remitting fevers = possible.
Whats the most specific test for RA?
anti–cyclic citrullinated peptide antibody test.
HLA association w/RA?
Physical finding in Sjogrens
- dry eyes
- dry mouth
- bilateral parotid gland enlargement.
- dental caries