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31

What border of rib for thoracentesis?

Upper border. Above 7th for midclavicular, 9th for midaxilary, and 11th for posterior scapular line.

32

Obstruction of Foramena of Magendie or Luschka would cause?

Enlargement of ALL ventricles

33

What's so special about Left Renal vein?

Well it's longer. Second, the left gonadal vein drains it directly (Right drains into IVC). Any obstruction -> left-sided variocele in males.

34

Superficial vs deep inguinal LN drainage in males

Scrotum vs. glans penis and superficial nodes. Para-aortic does testis.

35

Wrist drop?

Radial nerve injury - arises near lateral epidcondyle of humerus where it articulates with head of radius. Deep branch often gets caught.

36

First pharyngeal arch

Trigeminal nerve and 1st aortic arch (regress except maxillary a.)

37

Second pharyngeal arch

Facial nerve, muscles of facial expression. Second aortic arch - not much.

38

Third pharyngeal arch

Glossopharyngeal nerve. Stylopharyngeas. Third aortic arch -> common and proximal IC arteries.

39

Fourth pharyngeal arch

Superior laryngeal branch of vagus. Muscles of pharynx, soft palate, some laryngeal. Fourth aortic rage -. TRUE aortic arch and subclavian arteries.

40

Fifth pharyngeal arch

Obliterated

41

Sixth pharyngeal arch

Recurrent laryngeal branches of vagus. Most muscles of larynx. 6th aortic arch -> pulmonary arteries an ductus arterioles.

42

Winged scapula

Long thoracic nerve. Serratus anterior.

43

Ventral pancreatic bud vs. dorsal pancreatic bud

Dorsal pancreatic bud stays in place and makes the pancreatic tail, body, most of the head, and the small accessory pancreatic duct. Ventral bud rotates (connected to bile duct) and becomes the uncinate process, portion of pancreatic head, and proximal portion of main pancreatic duct. Fuse at Wk 8

44

Pancreas divisum

Accessory duct becomes dominant dorsal duct (of Santorini) and open to duodenum via minor papilla. Small ventral duct (of Wirsung) from ventral side opens into major papilla. 5% of pop and usu. clinically silent.

45

Blood supply to ureters

Proximal 1/3 receives blood from renal artery, and are therefore preserved during transplantation. Distal 2/3 from iliac, gonadal, and vesicle arteries.

46

Watershed areas of the colon?

Splenic flexure (SMA vs. IMA) and distal sigmoid colon (IMA and hypogastric)

47

Obturator foramen

Obturator nerve is only nerve that exits pelvis via this foramen. Adductor opponent of this after dividing into branches. Anterior - gracilis, pectinous, adductors longus and brevus. Posterior - obturator externs and adductor magnus. Injury -> weakness of adduction

48

Abduction of thigh by what muscles?

Tensor fascia lata (superior gluteal), sartorius (femoral)

49

Hip flexors

Iliopsoas (psoas major, iliacus, psoas minor), rectus femoris, tensor fascia lata

50

Hip extensors

Gluteus maximus, semitendinosus, semimembranosus, biceps femoris - long head

51

Hip abductors

Gluteus medius and minimus

52

Hip adduction

Adductor brevis, adductor longus, adductor magnus

53

Somatic sensory innervation of tongue?

Ant 2/3 = CN V3. Post. 1/3 = CN IX.

54

Dislocated knee -> what injury?

Popliteal artery injury

55

Thin person with small bowel obstruction?

SMA syndrome. Decreased mesenteric fat leads to dec. angle between SMA and aorta. Compression Left renal vein and duodenum.

56

AV fistula presentation?

Often high-output cardiac failure. Distal to fistula, limb is cold to touch. Tachycardia diminishes when PRESSURE is applied to site of fistula = BRANHAM sign.

57

Sialolithiasis

Salivary gland stones. 80% of them are founding submandibular gland. Lithotomy. Inc. salivation.