Anatomy Flashcards
(167 cards)
1
Q
pericardium: innervated by?
A
phrenic N
2
Q
pericarditis: EKG
A
diffuse ST elevation
3
Q
pericarditis: clinical presentation
A
sharp pain:
- worse when inspire, supine
- better when lean forward
4
Q
pericarditis: comp
A
effusion, tamponade
5
Q
coronary arteries: arise from?
A
ostia in sinus of valsalva (just distal to aortic valve)
6
Q
when do the coronary arteries fill?
A
diastole
7
Q
LAD: supplies?
A
- 2/3 IVS
- ant RV, LV
8
Q
LCX: supplies?
A
LV –> lat & post
9
Q
RCA: supplies?
A
- inf wall of RA, RV
- SA, AV nodes
10
Q
post descending artery: br of?
A
usu RCA
11
Q
SA nodal, AV nodal A: br of?
A
RCA
12
Q
what determines heart dominance?
A
where post descending artery arises
13
Q
MVP: murmur
A
mid-systolic click
14
Q
AR: murmur
A
diastolic:
- high pitch blowing
- head bob w wide pulse pressure
15
Q
PR: murmur
A
diastolic:
- low pitch
- increase w inspiration
16
Q
MS: murmur
A
diastolic:
- opening snap
- late rumble
17
Q
aortic dissection: pathophys
A
intimal layer –> tear –> false lumen bw intima & media
18
Q
aortic dissection: assoc dz?
A
- HTN
- bicuspid aortic valve
- CT disorders
19
Q
aortic dissection: clinical findings
A
- sudden tearing chest pain –> radiate to back
- unequal BP in arms
- CXR: mediastinal widening
20
Q
aortic dissection: classification
A
Stanford A: proximal dissection
Stanford B: distal
21
Q
aortic dissection: tx
A
Stanford A: surg
Stanford B: BB, vasodilator, observe
22
Q
thoracic aortic aneurysm: comp
A
- aortic root dilate –> AR
- compress struct: recurrent laryngeal, esophagus
23
Q
syphilis: vasc comp
A
thoracic aortic aneurysm
24
Q
who do you screen for an aortic aneurysm?
A
65-70yo who have ever smoked
25
how do you manage an aortic aneurysm?
M:
observe
> --> repair
F: 5.0cm
26
inf epigastric A: br of?
external iliac A
27
post pit: hormones
- ADH
| - oxytocin
28
post pit: derived from?
neuroectoderm
29
ant pit: derived from?
oral ectoderm
30
islet of Langerhans: location of B cells?
center
31
islet of Langerhans: location of alpha cells?
periphery
32
islet of Langerhans: location of delta cells?
interspersed
33
midgut: what happens wk6?
herniate thru umbilical ring
34
midgut: what happens wk10?
- return to abd cavity
| - rot around SMA
35
GI dev: fail to close --> rostral fold --> leads to?
sternal defect
36
GI dev: fail to close --> lat fold --> leads to?
- omphalocele
| - gastroschisis
37
GI dev: fail to close --> caudal fold --> leads to?
bladder extrophy
38
Down synd: GI comp
- Hirschsprung's
- duodenal atresia
- annular pancreas
- celiac dz
39
differentiate: omphalocele vs gastroschisis
- omphalocele: abd contents --> herniate into umbilical cord --> covered by peritoneum
- gastroschisis: abd contents --> extrude lat to umbilicus --> not covered by peritoneum
40
diaphragm: hiatus? where?
I Ate(8) 10 Eggs At 12:
- T8: IVC, R phrenic N
- T10: esophagus, R/L vagus
- T12: aorta, thoracic duct
41
what are the branches of the celiac artery?
- L gastric
- common hepatic
- splenic
42
hepatic A: branches?
- R gastric
| - R gastroepiploic
43
splenic A: branches?
- L gastroepiploic
| - short gastric
44
venous blood from stomach --> drains to?
portal V
45
what is: falciform lig
lig that divide liver into R & L lobes
46
what comprises the portal triad?
1) bile ductule
2) portal V
3) hepatic A
47
how do blood & bile flow in relation to each other?
opp directions
48
what are the zones of the liver?
zone 1, 2, 3
49
where is zone 1 of the liver?
periportal
50
where is zone 3 of the liver?
pericentral V
51
zones of liver: viral hep
zone 1
52
zones of liver: ischemia
zone 3
53
zones of liver: toxin
zone 3
54
hepatocyte --> bile --> secrete into?
bile canaliculus
55
what is: bile canaliculus
dilated intercell space bw adj hepatocytes (not a duct)
56
central V of liver: fx
blood flow out of liver
57
what forms the common bile duct?
- cystic duct
| - common hepatic duct
58
spleen rupture --> leads to?
massive intraperitoneal hemorrhage
59
spleen: location in relation to ribs?
ribs 9, 10, 11
60
appendicitis --> pain at umbilicus: d/t?
GVA fibers to T10 dermatome
61
appendicitis --> pain at McBurney's pt: d/t?
appendicitis --> irritate parietal peritoneum --> GSA fibers to RLQ
62
what is: "hourglass stomach"
sliding hiatus hernia
63
what is most common diaphragmatic hernia?
sliding hiatus hernia
64
what is: paraesophageal hiatus hernia?
fundus of stomach --> into chest cavity
65
sliding hiatus hernia: assoc dz
GERD
66
differentiate: direct vs indirect inguinal hernia --> location in relation to pertinent vessel?
MD's LI:
- direct: medial to inf epigastric A
- indirect: lat
67
differentiate: direct vs indirect inguinal hernia --> location --> protrude thru?
- direct: inguinal triangle
| - indirect: internal inguinal ring --> into scrotum
68
femoral hernia: location
below inguinal lig --> thru femoral canal
69
what hernia is more common in infant?
indirect
70
what is the most commonly fractured bone?
clavicle
71
clavicle fracture: #1 cause?
sports --> fall onto:
- outstretched hand
- shoulder
72
clavicle fracture: #1 location
mid 1/3
73
clavicle fracture at mid 1/3: what happens to medial end? lat?
- medial: pull sup (SCM)
| - lat: pull inf/med (wt of arm, pec major)
74
what are the nerves of the brachial plexus?
- musculocutaneous
- median
- radial
- ulnar
- axillary
75
axillary N: nerve root
C5-6
76
axillary N: br of?
post cord
77
axillary N: fx
innervate deltoid & teres minor
78
axillary N: becomes?
lat brachial cutaneous
79
radial N: nerve root?
C5-T1
80
radial N: br of?
post cord
81
radial N: fx
all muscles of post side of arm, forearm
82
musculocutaneous N: nerve root
C5-7
83
musculocutaneous N: br of?
lat cord
84
musculocutaneous N: fx
innervate all muscles of ant side of arm
85
musculocutaneous N: becomes?
antebrachial cutaneous N
86
ulnar N: nerve root
C8-T1
87
ulnar N: br of?
medial cord
88
ulnar N: fx
- forearm: flexor carpi ulnaris, flexor digitorum profundus
| - hand: most muscles
89
median N: nerve root
C5-T1
90
median N: br of?
med & lat cord
91
median N: fx
- forearm: most ant muscles
| - hand: 3 muscles of thenar eminence, 2 lumbricals
92
what are the UE reflexes?
C5: biceps
C6: brachioradialis
C7: triceps
93
UE sensory test
```
C5: lat elbow
C6: lat forearm, thumb
C7: middle finger
C8: pinky
T1: medial forearm, elbow
```
94
UE motor test
```
C5: elbow flex
C6: wrist extend
C7: elbow extend
C8: wrist flex
T1: finger abduct
```
95
Erb palsy: aka?
waiter's tip
96
Erb palsy: injury to
upper trunk or C5-6 roots
97
Erb palsy: cause
- infant: delivery --> pull head away from shoulder
| - adult: fall on head & shoulders simultaneously
98
Erb palsy: presentation
arm at side --> extend, med rot --> pronate
99
Klumpke palsy: injury to
lower trunk --> C8-T1
100
Klumpke palsy: cause
- upward force on infant arm
| - adult: fall from tree --> grab branch
101
Klumpke palsy: deficit in
intrinsic hand muscles
102
Klumpke palsy: presentation
complete claw hand
103
thoracic outlet synd: injury to
- lower trunk
| - subclavian vessels
104
thoracic outlet synd: cause
- displaced rib
- neoplasm
- scalene issue
105
thoracic outlet synd: deficit in
similar to Klumpke (intrinsic hand muscles)
106
thoracic outlet synd: presentation
Adson's sign: loss of the radial pulse in the arm by rotating head to the ipsilateral side with extended neck following deep inspiration
107
winged scapula: injury to
long thoracic N (C5-7)
108
winged scapula: cause
- axillary N dissection
| - stab wound
109
winged scapula: deficit in
serratus ant
110
winged scapula: presentation
- scapula protrude when press against wall
| - can't raise arms past horizontal
111
rotator cuff: muscles
SItS:
- supraspinatus
- infraspinatus
- teres minor
- subscapularis
112
rotator cuff: innervation
C5-6
113
supraspinatus:
- N
- axn
- buzzword
- N: suprascapular
- axn: abduct arm
- test: empty can test
114
infraspinatus:
- N
- axn
- buzzword
- N: suprascapular
- axn: ext rot arm
- cause: pitching injury
115
teres minor:
- N
- axn
- N: axillary
| - axn: ext rot arm
116
subscapularis:
- N
- axn
- buzzword
- N: subscapular
- axn: int rot arm
- buzzword: lift off test
117
humerus fracture --> surg neck --> leads to?
injure:
- axillary N (C5-6): lose deltoid, arm abduct
- post circumflex A
118
humerus fracture --> midshaft --> leads to?
injure:
- radial N (C5-T1): "Sat night palsy/crutches" --> wrist drop, decreased extension
- deep brachial A
119
humerus fracture --> distal end --> leads to?
injure:
- ulnar N: ulnar claw hand
- brachial A
120
radius fracture: 2 types? which is more common?
```
#1) colle's fx
#2) smith's fx
```
121
colle's fracture: type of injury?
FOOSH --> fracture distal radius --> distal part --> displace post
122
smith's fracture: type of injury?
fall on back of hand --> distal part --> displace ant
123
medial epicondylitis: cause? pain where?
- cause: elbow --> repetitive flexion
| - pain: medial aspect
124
lat epicondylitis: cause? pain where?
- cause: elbow --> repetitive extend
| - pain: lat aspect
125
what is the most commonly fractured carpal bone?
scaphoid
126
what is the most commonly dislocated bone?
lunate
127
lunate dislocation --> leads to?
acute carpal tunnel synd
128
scaphoid fracture: comp
avascular necrosis: primarily served by retrograde blood flow from radial A branches
129
scaphoid: palpated where?
anatomic snuff box
130
how do you test for carpal tunnel synd?
- Phalen's test
- Prayer test
- Tinel's test
131
carpal tunnel synd: cause
median N compressed --> numb, pain
132
carpal tunnel synd: affects what muscle?
thenar muscles
133
hand: motor innervation
C8-T1: all muscles
134
hand: sensory innervation
by dermatome:
- C6: thumb, index
- C7: middle
- C8: ring, pinky
by cutaneous N:
- median
- ulnar
- radial
135
median N: innervates what part of hand
- lat thumb
| - dorsal hand: thumb to mid-ring
136
ulnar N: innervates what part of hand
mid-ring to pinky
137
radial N: innervates what part of hand
thumb to mid-ring: palmar, fingertips
138
median N --> distal to wrist --> injure --> #1 loss?
thumb opposition
139
what N can be injured with hernia repair?
ilioinguinal N (L1) --> courses thru superficial inguinal ring
140
lumbar plexus: N roots? N?
T12-L5:
- iliohypogastric (L1)
- ilioinguinal (L1)
- genitofemoral (L1-2)
- lat femoral cutaneous (L2-3)
- femoral (L2-4)
- obturator (L2-4)
- lumbosacral trunk (L4-5)
141
iliohypogastric N: nerve root? fx?
L1
- rectus abdominis
- cutaneous: small area of thigh
142
genitofemoral N: N roots? fx?
L1-2
- cremaster
- cutaneous: small area of thigh
143
femoral N: N roots? fx?
L2-4
ant thigh
144
obturator N: N roots? fx?
L2-4
medial thigh
145
lumbrosacral trunk: N roots? fx?
L4-5
join sacral plexus in pelvis
146
L1: fx
- sensory: proximal 1/3 ant thigh
| - motor: hip flexors
147
L2: fx
- sensory: medial, ant thigh
| - motor: hip flexor, adductor
148
L3: fx
- sensory: ant thigh just above knee
| - motor: knee extensor
149
L4: fx
- sensory: medial leg
- motor: ankle dorsiflexion
- patellar reflex
150
L5: fx
- sensory: lat leg, dorsal foot, big toe
| - motor: toe extensor
151
S1: fx
- sensory: lat malleolus
- motor: ankle flexor
- achilles reflex
152
obturator N injury: presentation
decreased:
- sensory to medial thigh
- adduction
153
femoral N injury: presentation
decreased:
- thigh flex
- leg extend
154
common peroneal (fibular) N injury: presentation
foot drop
155
tibial N injury: presentation
- can't curl toes
| - decrease sensation to sole
156
sup gluteal N injury: presentation
impair gluteus medius, minimus --> Trendelenburg sign --> pelvis drop to opp side
157
inf gluteal N injury: presentation
impair gluteus maximus --> difficulty:
- rise from chair, climb stairs
- hip extend
158
ACL injury: cause
- hyperextend
| - twist knee jt
159
ACL injury: test
- ant drawer
| - Lachmans
160
PCL injury: cause
car accident, severe fall --> blow to flexed knee
161
MCL injury: test
valgus force
162
LCL injury: test
varus force
163
knee meniscus injury: test? good for?
- McMurray: posterior meniscal tears
| - Bounce home: more general tears
164
unhappy triad: what is? cause?
lat force to planted leg:
- ACL
- MCL
- med meniscus
165
ankle --> lat --> ligaments?
1) ant talofibular
2) calcaneofibular
3) post talofibular
166
ankle --> medial --> ligaments?
deltoid
167
how do you grade an ankle sprain?
of lig involved
