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Anatomy Topnotch > 2. Anatomy > Flashcards

2. Anatomy Flashcards

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1
Q

chest pain the results from transient ischemia brought on by exertion

A

Angina pectoris

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2
Q

angina pectoris is due to

A

reduced blood flow because of narrowing of artery

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3
Q

angina pectoris
is substernal pain that may be referred over the ___
dermatomes

A

T1 -T5

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4
Q

T1 dermatome int he medial aspect of the left arm and forearm may be felt over the

A

cervical dermatomes in the neck up to level of the angle of the mandible

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5
Q

results from localized avascular necrosis of cardiac cells caused by prolonged ischemia

A

myocardial infarction

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6
Q

common site of occlusion for MI

A

anterior interventricular artery

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7
Q

difference of angina pectoris and MI

A

angina pectoris - tightness/ squeezing pain precipitated by stress or exertion
MI- more severe pain, not relieved by rest

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8
Q

Nerve supply of the heart

A

ANS via the cardiac plexuses
Sympathetic - cervical and upper thoracic
Parasympathetic - vagus nerve

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9
Q

As a pathologist, you are examining the heart of a victim of fatal trauma and note a tear at the junction of SVC and right atrium. This tear would likely damage the

A

Sinoatrial node

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10
Q

pacemaker of the heart

A

SA node

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11
Q

SA node is located

A

within atrial wall on right side of its junction with Superior vena cava

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12
Q

right/left bundle branches are located at

A

muscular portion of interventricular septum

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13
Q

V1 placement

A

4th ICS just to the right of sternum

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14
Q

V2 placement

A

4th ICS just to the left of the sternum

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15
Q

V3 placement

A

midway between V2 and V4

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16
Q

V4 placement

A

midclavicular line, 5th ICS

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17
Q

V5 placemement

A

anterior axillary line, 5th ICS

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18
Q

V6 placement

A

midaxillary line, 5th ICS

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19
Q

right atrium receives blood from

A

SVC, IVC, coronary sinus, anterior cardiac vein, vena cordis minimae

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20
Q 
The following veins drain into right atrium EXCEPT?
A. coronay sinus
B. Superior vena cava
C. Anterior cardiac
D. Great cardiac
A

D.Great cardiac

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21
Q

internal wall of right atrium is composed of

A 
sinus venarum (posterior) 
musculi pectinati (anterior)
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22
Q

fossa ovalis is remnant of

A

foramen ovale

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23
Q

if foramen ovale persists after birth it leads to

A

ASD

Atrial septal defect

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24
Q

internal surface of right ventricle has irregular muscular ridges called

A

trabeculae carnae

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25
trabeculae carne is where this muscle originates
papillar muscle
26
apices of right ventrice are connected by fibrous strands called
choradae tendinae
27
modified trabeculae carnae that crosses the interventricular septum
moderator band
28
has thicker wall than right atrium
right ventricle left atrium left ventricle
29
this heart chamber receives 4 pulmonary veins on its posterior wall
left atrium
30
most posterior of 4 chambers
left atrium
31
walls twice as thick as right ventricle
left ventricle
32
how many papillary muscles does right and left ventricle have
3 papillary muscles (anterior, posterior, septal) - RV | 2 papillary muscles (anterior, posterior) LV
33
presence of moderator band RV LV
RV- present | LV - absent
34
crescenteric cavity | chamber of heart
RV
35
circular cavity | heart chamber
left ventricle
36
The heart tube continues to elongate and bend on day
23
37
This bending, which may be due to cell shape changes, creates cardiac loop completed at day
28
38
primitive atrium forms the
left atrium
39
sinus venosis forms the
right horn -> right atrium | left horn -> coronary sinus
40
primitive ventricle forms
all of the left ventricle
41
bulbus cordis forms
all of the right ventricle
42
truncus arteriosus becomes partitioned to form the
root of aorta and pulmonary trunk
43
most common formof congenital heart diseases
Atrial septal defect
44
ASD is due to
most common form is due to patent foramen ovale | shunts blood from left atrium to right atrium
45
Atrial septal defect results in this adaptation
hypertrophy of right atrium, right ventricle, and pulmonary trunk
46
most common type of CHD 25%
Ventricular septal defect
47
ventricular septal defect is more common in this gender
males
48
membranous VSD is due to
incomplete closure of the IV foramen results from failure of the membranou part of IV septum to develop left to right shunting of blood, increase blood flow to lungs and cause pulmonary hypertension
49
The anatomic description of this CHD consists of an outlet ventricular septal defect (VSD), a single semilunar valve, and a common great artery that overrides the VSD.
Persistent Truncus Arteriosus
50
most common cause of cyanotic heart disease
Transposition of the Great Arteries
51
The anatomic description of this CHD is aorta lies anterior to the right of he pulmonary trunk and arises anteriorly from the morphological RV and pulmonary trunk arises from the morphological LV
TGA | Transposition of Great Arteries
52
TGA is associated with
ASD and VSD
53
right to left shunting of blood and cyanosis
Tetralogy of Fallot
54
components of tetralogy of fallot
pulmonary stenosis VSD dextropositio of aorta/ overriding aorta right ventricular hypertrophy
55
before birth, the respiratory function of the lungs are performed by
placenta
56
these vasculature carry oxygenated blood back to the heart
umbilical veins
57
pathway for oxygenated blood in fetus
umbilical vein -> ductus venosus -> Inferior vena cava -> right atrium -> foramen ovale -> left atrium -> left ventricle -> aorta
58
pathyway for unoxygenated blood in fetus
superior vena cava -> right atrium -> right ventricle -> pulmonary trunk -> ductus arteriosus -> aorta
59
these shunts close when the baby is born
foramen ovale ductus arteriosus ductus venosus
60
anatomical closure of foramen ovale occurs by
3rd month ] foramen ovale -> fossa ovalis
61
remnant of umbilical vein
ligamentum teres
62
remnant of umbilical arteries
medial umbilical ligaments
63
remnant of ductus venosus
ligamentum venosum
64
remnant of foramen ovale
fossa ovalis
65
remnant of ductus arteriosus
ligamentum arteriosum
66
when does ductus arteriosus close
close immediately after burth | complete obliteration and fibrosis by 3-4 weeks
67
remains patent and may be used for exchange transfusions of blood during early infancy
umbilical vein and ligamentum teres
68
Patent ductus arteriosus is more common in this gender
females
69
most common congenital anomaly associated with maternal rubella infection during early pregnancy
patent ductus arteriosus
70
failure of the ductus arteriosus to involute after birth and form the ligamentum arteriosum
Patent ductus arteriosus
71
This congenital defect will result in aortic blood shunted
Patent ductus arteriosus
72
the pharyngeal arches develop during
4th week
73
returning blood from the placenta; involutes after birth
umbilical/allantoic or placental veins
74
returning blood from the splanchopleura (yolk sac and gut derivatives ) become the portal system
vitelline or omphalomesenteric veins
75
returning blood from the somatopleura of embryo; be come the caval system
cardinal veins
76
carry well oxygenated blood from the placenta to the sinus venosus
umbilical veins
77
2 parts of pleura
visceral | parietal
78
4 subdivisions of the lungs
costal pleura mediastinal pleura diaphragmatic pleura cervical pleura/ cupula
79
What is the inferior limit of the parietal pleura in the Midaxillary line
rib 10
80
A thoracentesis is performed to aspirate an abnormal accumulation of fluid with pleural effusion. A needle should be inserted at the midaxillary line between whihc of the following two ribs as to avoid puncturing the lung
ribs 8 and 10
81
Costal line of pleural reflection passes OBLIQUELY across the
MCL- 8th rib MAL- 10th ib Rib sides of vertebral column -12th rib
82
Lower margin of lungs
MCL- 6th rib MAL - 8th rib rib sides of verterbal column - 10th rib
83
Parietal pleura is sensitive to
pain, touch temperature presure
84
visceral pleura is sensitive to
stretch
85
nerve supply of parietal pleura
costal - intercostal nerve mediastinal - phrenic nerve diaphragmatic - phrenic and intercostal
86
nerve supply of visceral pleura
pulmonary plexus
87
The following are characteristics of left lung except a. deep cardiac notch b. provided with middle lobe c. with oblique fissure d. provided with lingula
b. provided with middle lobe
88
vital organ of respiration
lungs
89
this lung is larger, heavier, shorter and wider
right lung
90
each lung has
apex hilum of the lung root of the lung
91
3 surfaces of the lung
costal mediastinal diaphragmatic
92
3 borders of the lung
anterior inferior posterior
93
where parietal and visceral pleura meet
root of the lung
94
contains bronchi, pulmonary artery pulmonary veins lymph vessels and bronchial vessels
root of the lung
95
type/s of bronchi present in right lung
eparterial and hyparterial
96
type of bronchi present in left lung
hyparterial
97
which of the following forms the lower division of the upper lobe of the left lung
superior and inferior lingular
98
largest subdivision of a lobe
bronchopulmonary segment
99
bronchopulmonary segment are named according to
the segmental bronchus supplying it
100
what separates bronchopulmonary segments
connective tissue
101
anatomical and surgical unit of the lung
bronchopulmonary segments
102
bronchopulmonary segments of right lung
SUPERIOR LOBE Apical Posterior Anterior MIDDLE LOBE Lateral Medial ``` INFERIOR LOBE Superior Anterior basal Medial basal Lateral basal Posterior basal ```
103
bronchopulmonary segments of left lung
``` SUPERIOR LOBE Apico-posterior Anterior Superior/Inferior Lingular INFERIOR LOBE Superior Anterior basal lateral basal Posterior basal ```
104
eparterial bronchus
right superior bronchus
105
main bronchi that is wider, shorter, more vertical
right main bronchi
106
types of bronchi
main/primary secondary/lobar tertiary/segmental
107
type of secondary bronchus
right lung a. eparterial - superior b. hyparterial - middle and inferior left lung both hyparterial
108
a thoracic surgeon removed a right middle lobar bronchus along with lung tissue from a 57 year old heavy smoker with lung cancer. Which of the following bronchopulmonary segments must contain cancerous tissues?
lateral and medial bronchopulmonary segment
109
Lung cancer located near the cardiac notch, a deep indentation of the lung. Which of the following lobes is most likely to be excised
superior lobe of the left lung
110
A child suspected of aspirating a small metal button is seen in the emergency room. Although the child does not complain of pain, there is frequent coughing. DIminished breath sounds should be heard
right inferior lobe
111
examination of the bronchi using a bronchoscope
bronchoscopy
112
which bronchus will foreign body likely enter
right bronchus - shorter, wider, more vertical
113
in a patient who is standing or sitting, the foreign body tends to lodge in thus segmement
posterobasal segment of the inferior lobe of the lung
114
foreign body aspiration supine position which BPS
superior BPS of the right lower lobe
115
foreign body aspiration lying on the right side which BPS
posterior BPS of the right upper lobe
116
foreign body aspiration lying on the left side which BPS
inferior lingular BPS of the left upper lobe
117
blood supply of the lung
bronchial arteries - from descending thoracic aorta | pulmonary arteries - from pulmonary trunk
118
venous drainage of lungs
bronchial veins -> drain into azygous and hemiazygous vein pulmonary veins - empty into left atrium
119
superior pulmonary sulcus tumor
Pancoast tumor
120
A 56 year old man diagnosed with pancoast tumor. The patient has symptoms of shoulder pain associated with ptosis, miosis, enophthalmos, and anhidrosis
cervical sympathetic trunk
121
pancoast syndrome
lower trunk brachial injury - pain radiating to shoulder and medial aspect of the arm; atrophy of muscles of forearm and hand lesions of cervical sympathetic ganglia - - horner syndrome (pstosis, enophthalmos, miosis, anhidrosis, and vasodilation)
122
lymph drainage of the lungs
superficial/subpleural plexus | deep plexus
123
lies deep in the visceral pleura and drains lymph from the surface to the hilum of the lung
superficial/subpleural plexus
124
drain into bronchopulmonary / hilar LN to tracheobronchial LN
deep plexus
125
posterior intercostal artery is branch of
thoracic aorta
126
anterior intercostal artery is branch of
internal thoracic artery and musculophrenic artery
127
posterior intercostal vein drain into
azygous / hemiazygous veins
128
anterior intercostal vein drain into
internal thoracic vein
129
posterior intercostal arteries are supplied by
first two- superior intercostal of the costocervical trunk | remaining branches- supplied by descending aorta
130
anterior intercostal arteries are supplied by
Upper six- Internal thoracic artery | remainign - musculophrenic
131
THORACENTESIS - the needle is inserted ____ to avoid damage to intercostal vessels and nerves
ABOVE the rib
132
order of structures of intercostal space
VAN Vein Artery Nerve
133
site of thoracentesis
midaxillary lien MAL 8th intercostal space layers: skin, superficial fascia,, 3 layers of intercostal muscles and parietal pleura
134
the highest level thoracentesis is done without induring the lung in MAL is
8th intercostal space
135
lowest level to perform thoracentesis lie at level of which rib
10th rib
136
the subclavian artery is divided into three parts by this muscle
scalenus anterior
137
first part of subclavian artery
vertebral thyrocervical (inferior thyroid, superficial cervical, suprascapular) internal thoracic
138
portion of aorta
Ascending aorta Arch of aorta Descending aorta Abdominal aorta
139
Ascending aorta branches
right and left coronaries
140
arch of aorta branches
brachiocephalic left common carotid left subclavian
141
descending aorta branches
``` bronchial mediastinal esophageal posterior intercostal pericardial subcostal ```
142
aneurysm of the aortic arch - sign
pulsatile swelling in the suprastenal notch
143
aneurysm of the aortic arch- can lead to
compress the trachea, esophagus, left recurrehnt laryngeal nerve DOB difficulty swallowing hoarseness
144
types of coarctation of aorta
postductal coartation | preductal coartation
145
infantile form of coarctation of aorta
postductal coartation
146
constriction of varying length of aorta
coarctation of aorta
147
coarctation of aorta | gender twice more at risk
males
148
coarctation of aorta constriction is just DISTAL to the ligamentum arteriosum
postductal coarctation
149
coarctation of aorta constriction is just PROXIMAL to the ligamentum arteriosum
preductal coarctation
150
adult form of coarctation
postductal coarctation
151
coarctation of the aorta | blood pressure sign
BP reduced in lower limbs and | elevated in the head, neck and upper limbs
152
continuation of sigmoid sinus
internal jugular vein
153
Internal jugular vein leaves the skull through
jugular foramen
154
Internal jugular vein is closely related to these nodes
deep cervical nodes
155
Internal jugular vein position in carotid sheath
lateral to vagus nerve | and internal and common carotid arteries
156
Internal jugular vein | tributaries
``` inferior petrosal facial lingual pharyngeal superior thyroid middle thyroid ```
157
indications for central venous catheter
1. administration of drugs and parenteral nutrition 2. hemodynamic monitoring 3. rapid fluid administration 4. long term venous access
158
common sites of central venous catheters
internal jugular subclavian (infraclavicular approach) femoral
159
infraclavicular approach will have the needle pierce the following structures
``` skin superficial fascia pectoralis major (clavicular head) clavipectoral fascia suclavius muscle wall of subclavian vein ```
160
aantomical problems of subclavian catheterization infraclavicular approach
hitting the clavicle hitting the first rub hitting the subclavian artery hitting the phrenic nerve
161
complications of subclavian catheterization infraclavicular approach
``` pneumothorax hemothorax subclavian artery puncture internal thoracic artery puncture diaphragmatic paralysis ```
162
advantages of using right IJV in catheterization
larger than the left | its course to the SVC is straight
163
disadvantages and risks of using left IJV in catheterization
1. chylothorax- thoracic duct joins the left IJV; misplaced catheter may result in chylothorax 2. pneumothorax- cervical pleura extends further into the neck on the LEFT 3. longer - it turns and joins the subclavian to form the brachiocephalic vein and again to enter the SVC
164
important landmark of right IJV catheterization
supraclavicular fossa
165
union of the internal thoracic and subclavian vein
brachiocephalic vein
166
brachiocephalic vein is formed at the level of
inferior border of first right costal cartilage
167
tributaries of brachiocephalic vein
internal thoracic vertebral inferior thyroid superior intercostal
168
union of the right and left brachiocephalic veins
superior vena cava
169
at this level, superior vena cava ends to enter the right atrium
3rd RIGHT costal cartilage
170
connects SVC from IVC
azygos vein
171
azygos vein is formed by the union of
right ascending lumbar and right subcostal veins
172
this vasculature ascends through the aortic opening in the diaphragm on the RIGHT side of the aorta to the level of 5th thoracic vertebra
azygos vein
173
tributaries of azygos vein
``` intercostal vein mediastinal vein esophageal bronchial hemiazygos ( left subcostal and ascending lumbar) accessory hemiazygos ```
174
etiology of superior vena cava syndrome
compressed by LN enlargement because of metastasis from a bronchogenic carcinoma
175
signs and symptoms of | Superior vena cava syndrome
headache edema of the head and neck prominent superficial veins and cyanosis
176
in complete occlusion of SVC, venous return from the head, neck and upper limbs is shunted into
tributaries of IVC
177
what causes changes of breast morphology in breast cancer
interference with the lymphatic drainage of the breast by cancer -> deviation of the nipple and produce a thickened with prominent pores of the skin (Peau d’ orange sign)
178
retraction of the nipple is caused by
pulling on the lactiferous ducts
179
skin dimpling is caused by
shortenng of the suspensory/ cooper ligament
180
the breast lies in this layer
superficial fascia
181
the breast overlies these muscles
pectoralis major serratus anterior mucles external oblique muscles rectus abdominis
182
cooper ligament connects
dermis - pectoral fascia
183
nipple is usually at this level
4th ICS
184
breast adenocarcinomas most commonly begin as painless masses in the
upper lateral quadrant
185
late stage signs of breast adenocarcinoma
retraction fixation of the nipple dimpling of the skin
186
breast adenocarcinomas metastasize mainly to
axillary lymph node
187
radical mastectomy | what structures are removed
breast pectoralis major/minor muscles axillary lymphnodes and vessels
188
nerve injuries related ater radical mastectomy | winging of the scapula
long thoracic nerve
189
nerve injuries related ater radical mastectomy | difficulty in horizontal extension of the upper extremities
thoracodorsal nerve
190
nerve injuries related ater radical mastectomy | loss of sensation on the upper inner aspect of the arm
intercostal nerve
191
nerve injuries related ater radical mastectomy difficulty in lifting her child, flapping ehr arms, doing arm wrestling
medial pectoral nerve
192
nerves that can be injured | radical mastectomy
long thoracic nerve thoracodorsal nerve intercostal nerve medial pectoral nerve
193
blood supply of the breast
a. internal thoracic from subclavian artery b. lateral thoracic and thoracoacromial from axillary c. post intercostal from thoracic aorta
194
venous drainage ofthe breast
internal thoracic vein | lateral thoracic and thoracoacromial to axillary vein
195
lateral quadrants of the breast drain to ___ LN
axillary LN
196
medial quadrants of the breast drain to ___ LN
parastenal
197
nerve supply of the breast
4-6th intercostal nerve
198
A 45 year old woman is noted to have a 1.5 cm breast cancer located in the UPPER INNER QUADRANT of the RIGHT breast. Which of the following LN is most liekly affected
parastenal node
199
Level 1 axillary node
anterior/pectoral LN posterior/ scapular LN lateral/ humeral LN
200
level 2 axillary LN
central LN
201
level 3 axillary LN
apical LN
202
clinical stage of breas cancer | carcinoma in situ; confined to the ductal system
0
203
clinical stage of breas cancer | less than or equal to 2 cm; LNs are uninvolved
1
204
clinical stage of breas cancer | less than or equal to 5 cm; oneto three axillary nodes involved
2
205
less than or equal to 5 cm; 4 or more axillary nodes are involved
3
206
clinical stage of breas cancer | distant metastases are present
4
207
motor nerve supply of the diaphragm
phrenic nerve
208
sensory nerve supply of diaphragm
central - phrenic nerve | peripheral - intercostal nerves
209
right crus of the diaphragm | is at this level
L1-L3
210
left crus of the diaphragm | is at this level
L1-L2
211
phrenic nerve arises from
C3,C4, C5
212
the right lymphatic duct drains the
right side of the body above the diaphragm
213
three openings of diaphragm
aortic hiatus esophageal hiatus caval foramen
214
caval foramen lies in this level
T8
215
esophageal foramen lies in this level
T10
216
aortic hiatus lies in this level
T12
217
caval foramen contains
inferior vena cava | right phrenic nerve
218
aortic hiatus contains
aorta thoracic duct azygous vein
219
esophageal hiatus contains
esophagus | vagus nerve
220
umbilicus is normally at what level
L3-L4
221
subcostal plane is at this level
10th rib ; L3
222
transtubercular plane lies at this level
L5; transtubercular
223
nine regions of abdomen
epigastric umbilical hypogastric/ Pubic R/L hypochondriac R/L lumbar R/L inguinal
224
how many muscles in the abdomen
4 paired muscles (3 flat, 1 strap-like)
225
strengthens the abdominal wall
muscles
226
most superficial abdominal muscle
external oblique
227
free inferior margin of external oblique muscle
inguinal ligament
228
form aponeurosis which splits to form rectus sheath
internal oblique
229
innmermost abdominal muscle
transversus abdominis
230
aponeurosis of these abdominal muscles contribute to a conjoint tendon
Internal oblique | Transversus abdominis
231
abdominal muscle on either side of linea alba
rectus abdominis
232
lateral borders convex of rectus abdominis
linea semilunaris
233
cresenreric border on the posterior wall, midway between the umbilicus and pubic crest
arcuate line
234
contents of the rectus sheath
``` rectus abdominis pyramidalis superior epigastric vessels inferior epigastric vessels lower 5 infercostal and subcostal vessels and nerves ```
235
blood supply of the abdomen
A. Superior epigastric artery - from internal thoracic artery B. Inferior epigastric artery - from external iliac artery C. Deep circumflex iliac artery - from external iliac
236
venous drainage of the abdomen
A.Superior epigastric vein - to internal thoracic vein B. Inferior epigastric vei - to external iliac vein C. Deep circumflex iliac - to external iliac vein
237
nerve supply of the abdomen
ventral rami of lower 6 thoracic nerves ( T7-T12) | First lumbar nerve
238
inguinal region extends between
ASIS and pubic tubercle
239
floor/ inferior border of inguinal canal
inguinal ligament
240
what fascia does deep inguinal ring lie
fascia transversalis
241
what fascia does superficial inguinal ring lie
external oblique aponeurosis
242
spermatic cord | structures within
``` vas deferens testicular artery testicular veins (pampiniform plexus) testicular lyph vessels autonomic nerves autonomic nerves processus vaginalis cremasteric artery artery of vas deferens genital branch of genitofemoral nerve ```
243
Abnormal cysts in the spermatic cord includes
hydrocele hematocele spermatocele varicocele
244
accumulation of serous fluid in the scrotum
hydrocele
245
accumulation of blood; results form the rupture of testicular blood vessels after trauma
hematocele
246
cyst containing sperm that develops in the epididymis
spermatocele
247
results from the dilations of tributaries of testicular vein
varicocele
248
also known as Poupart ligament
Inguinal ligament
249
boundaries of Hesselbach triangle
rectus abdominis - medial inferior epigastric artery - superior, lateral inferior and lateral - inguinal ligament

Anatomy Topnotch (26 decks)

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