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Anatomy > Block 8 Clinicals > Flashcards

Block 8 Clinicals Flashcards

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1
Q

diaphragm referred pain

A

subclavicular nerves (C3/C4) –> neck and shoulder

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2
Q

morgani hernia

A

hernia through foramen of morgani (R sternocostal triangle: just R and post to sternum)
fills the cardiophrenic space (btwn ant thoracic wall, pericardium and mediastinal pleura)
pushes heart to left

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3
Q

paralysis of R crus of diaphragm –> ?

A

GERD

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4
Q

rupture of celiac trunk –>

A

bleed into rectocrural space and superiorly into posterior mediastinum

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5
Q

retrocrural space

A

btwn crura, abdominal aorta, lumbar spine

contains azygous and hemiazygous v, thoracic duct, lymph nodes

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6
Q

Pott’s disease

A

osteomyelitis of vertebral column due to TB

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7
Q

psoas abcess

A

infection of T12 vert can spread down psoas major and present on medial thigh @ attachment to lesser trochanter

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8
Q

Bochdalek hernia

A

hernia through foramen of Bochdalek (L lumbocostal triangle: post, L of lumbar)
fills L thoracic cavity
pushes mediastinum to R, compresses R lung

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9
Q

scaphoid abdomen

A

seen in infants born w/ Bochdalek hernia

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10
Q

eventration

A

opening through diaphram muscles but w/ fascia still covering it

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11
Q

aortic aneurysm

A

may indent lumbar vert or push ureter away
can lead to retroperitoneal hernia
crescent sign: impending rupture of aneurysm; hyperdense, attenuating

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12
Q

aortic dissection

A

separation of the wall of the aorta
possibly due to focal ischemia
crescent shaped false lumen: luminal wall is peeled away from outer layer and fills with blood

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13
Q

superior mesenteric artery syndrome

A

normal angle = 50 - 60 (maintained by fat)
snydrome < 25
rapid weight loss –>. compress L renal vein, uncinate process of pancreas, part III of duodenum

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14
Q

if SMA compresses L renal vein…

A

blood backs up into L gonadal vein

may cause L sided varicoceles of scrotum

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15
Q

if SMA compresses part III duodenum

A

cause colic like symptoms

relief when lean forward

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16
Q

May-Thurner syndrome

A

thrombus formation in L common iliac vein due to R common ilaic artery compressing it

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17
Q

testis irritation/trauma referred pain

A

T10

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18
Q

ovarian irritation/torsion/ovulatory pain referred pain

A

T10, T11 or lower

due to irritation of mesosalpinx

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19
Q

mittelschmerz

A

ovulatory pain

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20
Q

severed pelvic splanchnic –>

A

incontinence

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21
Q

hydrouretonephrosis

A

urine backs up into the minor calyces from vesicoureteral reflux
can lead to kidney failure

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22
Q

kidney infection signs

A

psoas sign: flexion and passive extension of thigh

dude to infection extending beyond renal capsule to irritate posterior structures

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23
Q

regional failure of segmental, lobar, interlobar and arcuate arteries –>

A

segmental necorsis of respective cortical/medullary regions

–> pitting of normally smooth kidney surface or necrotic cysts

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24
Q

things that shift ureters

A

masses

aortic aneurysms

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25
flattening of renal papillae indicates...
hydroureteronephrosis or hydronephrosis | due to stenosis/obstruction of ureter
26
widening of calyx formices indicates ...
hydroureteronephrosis or hydronephrosis | due to stenosis/obstruction of ureter
27
rough, eroded contours of renal papillae indicates...
papillary necrosis from long standing pyelonephritis
28
renal infarct
segmental necrosis of kidney due to segmental nature of arteries
29
polycystic kidney disease
cysts compress parenchyma leading to glomerulosclerosis and gradual destruction of nephrons
30
bifid (Y-shaped) ureter
separate pelvises for the upper and lower pole | generally not a problem
31
duplication of ureter
extra ureteric bud both ureters compete @ trigone and have difficult bladder entrance --> lots of vesicoureteral reflux
32
spina bifida and urinary system
--> atonic bladder --> vesicoureteral reflux --> repeated pylonephritis --> kidney damage/failure
33
horseshoe kidney
during development: caudal part of kidneys fuse into U shape get caught on IMA trying to ascend in dev --> stay low - prone to trauma w/o rib protection ureters cross bridge --> obstructs urine flow, may --> ureteric colic
34
staghorn calculus
calcified cast of pelvis and calyceal system
35
ureteric stones
can block urine flow can get stuck (see sites) can cause referred pain
36
ureteric stones can get stuck where
``` uretopelvic jxn where ureter crosses external iliac ureterovesical jxn (intramural portion @ trigone of bladder) ```
37
ureteric stones referred pain
above pelvic pain line: (symp) back -> flank -> loin -> groin -> thigh below (after hits trigone): (para) perineum
38
phleboliths
calcified thrombi in ruptured pelvic veins | caused by valsalva maneuvers
39
non-stone ureteric blockage
filling defect called goblet sign | usually caused by tumor occluding lumen
40
ptotic kidney location
``` perineal space (gerota's space) medial to kidney where renal fascia fuses w/ fascia of great vessels ```
41
Cullen's sign
retroperitoneal bleed extravasates to surface around umbilicus
42
Grey-Turner's sign
retroperitoneal blees extravasates to surface on flank
43
catecholine excess leads to
pheochromacytoma
44
kidney agenesis
failed induction and formation of kidneys
45
oligohydramnios
low amniotic fluid
46
pulmonary hypolplasia
underdeveloped lungs | fetus must breathe amniotic fluid for lung development
47
Potter sequence
anuria --> oligohydramnios --> pulmonary hypoplasia --> death soon after birth other sx: stumpy digits, hip dislocation, flattened facial features
48
pelvic kidney
kidney ascension: | stuck at arterial fork, remains in pelvis
49
kidney ascent issues (beyond kidney location)
kidneys fail to medially rotate --> kinking and obstruction of ureters
50
supernumerary renal vessels
when the lower renal vessels dont degenerate during ascent | arteries more likely to cause obstruction due to higher pressure
51
changes in shape of trigone indicate
underlying disease (metastatic carcinoma)
52
common chamber/conduit of anorectum and urogenital
fecal and urinary products in urethra (male) and vaginal vestibule (female) due to failure of cloaca to divide properly
53
epispadias
urethra tract open dorsally caused by exstrophy of urinary bladder (glandular urethra closes dorsally, penile urethra closes ventrally)
54
torsion of appendix epididymis or appendix testis
"blue dot" sign of Dresner | can lead to necrosis of the appendicies
55
parametritis
fissures in parametrium | common post partum infection
56
hematocolpos
blood fills vagina during menstruation due to intact hymen
57
uterus didelphys
double cervix w/ double vagina | septa in between
58
bicornate uterus
two separate uterine horns and crevices | common vagina
59
SMA rupture bleeding -->
anterior retroperitoneal space | spreads to both sides
60
kidney trauma/ruptured renal vessel bleeding -->
gerota's space (unilat) | can do down into retroperitoneum
61
benign prostatic hyperplasia location
periurethral zone | can compress urethra
62
prostatc metastatic adenocarcinoma location
usually in peripheral zone | post wall
63
male ascites likely location
rectrovesical pouch | space btwn bladder and rectum
64
female ascites likely location
rectouterine pouch (of Douglas)
65
most common site of fertilization
ampulla of uterine tube
66
most common site of ectopic pregnancy
ampulla of uterine tube | inadequate SM contraction to move to uterus
67
females more prone to peritonitis....why?
holes for ovum in peritoneal cavity
68
careful in hysterectomy...
don't clamp ureter
69
tearing of male urethra -->
can extavasate into Colle's fascia and end up in abdomen or down into scrotum
70
Buck's fascia
deep fascia of penis bucks clamps down on veins to maintain erection separate spongiosum from cavernosa
71
risks of episiotomy
too posterior - cut perineal body or external anal sphincter
72
to get to greater vestibular gland
cut through bulbospongiosus muscle and bulb
73
loss of symp innervation of sphincter vesicae -->
retrograde ejaculation | sperm in bladder

Anatomy (9 decks)

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