CC Regional/ Anatomy Flashcards by Tori Trimble

In the adult patient, the superior border of the thyroid cartilage is:
A. C2
B. C4
C. C6
D. C8

Answer: B (C4)

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The patient presents for a stellate ganglion block for the treatment of CRPS Type I of the RUE. After completion of the block, sympathetic blockade of the RUE can be assessed by observing:

A. Ptosis of the Right eye
B. Miosis of the Right Pupil
C. Enopthalamus of the Right globe
D. Temperature change of the right arm

Answer D

Temp change in right arm
Stellate ganglion block is
most commonly performed
for patients with upper
extremity pain (CRPS I or II).
Horner’s syndrome, a side
effect of stellate ganglion
block, is heralded by
symptoms of SNS
denervation such as miosis,
ptosis, and enophthalmos of
the globe on the ipsilateral
side of the block. Although
practitioners look for the
development of Horner’s
syndrome as a metric for
efficacy of the block, its
presence does not necessarily
equate to sympathetic
denervation of the upper
extremity.

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A superior laryngeal nerve block:

A. provides sensory block to the epiglottis and airway mucosa to the level of the VC
B. Is achieved via an injection through the cricothyroid membrane while the patient is instructed to cough
C. Provides blockade of the external branch of the SLN
D. Requires that air be aspirated initially to ensure proper placement of needle

Answer: A

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The cricoid cartilage:

A. is the most narrow portion of the adult airway
B. Brodens into a flat plate anteriorly
C. Is the first cartilaginous structure encountered during laryngoscopy
D. Is the only cartilage of the larynx that forms a complete ring

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In the adrenal gland, glucocorticoids are only secreted in the:
A. Zone Fasciculata
B. Zona Reticularis
C. Zona Glomerulus
D. Medulla

Answer: A

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Fibers found in the spinothalamic tract of the SC are involved in transmission of:

A. Proprioception
B. Simple TOuch
C. Pain
D. Fine Motor control
E. Temp
F. Coordinated motor control
G. SNS functions

Answer: B, C, E

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Match the term with the associated muscle:

Thyroarytenoid
Lateral Cricoarytenoid
Post. Cricoarytenoid
Cricothyroid

A. Opens (Abducts) VC
B. Closes (Adducts) VC
C. Tenses and elongates the VC
D. Shortens and relaxes VC

Thyroarytenoid – shortens and relaxes VC
Lat Cricoarytenoid - Closes (adducts) VC
Post Cricoarytenoid - Opens (abducts) VC
Cricothyroid - Tenses and elongates VC

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Cranial nerves processing only motor function include:

A. Hypoglossal
B. Optic
C. Trigeminal
D. Facial
E. Trochlear
F. Abducens

Answer : E, F, A

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Primary complication associated with the sitting position:
A. Venous air embolism
B. Cerebral hypoperfusion
C. Venous pooling in LE
D. A significant decrease in FRC

Answer: A

Although hypoperfusion of
the cerebral vasculature,
pooling of blood in the lower
extremities and a decrease in
FRC may all occur in the
sitting position, VAE is the
principal hazard. Air may be
entrained into the vasculature
as a result of a negative
pressure gradient created
when the operative site is
above the level of the heart.
The incidence of venous air
embolism in the sitting
position ranges from 1-76%.

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The component of the nephron that is involved in the concentration of urine via the countercurrent mechanism is the:

A. Distal tubule
B. Loop of Henle
C. PCT
D. JGA

Answer: B

The loop of henle is the establishment of a hyperosmotic state within the
medullary area of the kidney,
a mechanism that is vital to
the conservation of salt and
water. Water conservation and
the production of a
concentrated urine involve a
countercurrent exchange
system or “multiplier” in
which a concentration
gradient causes fluid to be
exchanged across parallel
sides of the hairpin-shaped
loop. The gradient increases
as the loop moves from the
renal cortex into the medulla.

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The protective mechanism which prevents the over dissension of the alveoli at high lung volumes is known as:
A. Driving reflex
B. Pharyngeal dilator reflex
C. Paradoxic reflex of head
D. Herring-Breuer Reflex

Answer: D

Stimulation of stretch
receptors in the lungs can
elicit the Hering-Breuer
inflation reflex. This reflex
may help prevent over
distention of the alveoli at
high lung volumes by
inhibiting large tidal volumes
and may decrease the
frequency of the inspiratory
efforts by causing a transient apnea

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Upon removal of the drapes after an extended surgery in the supine position, it is noted that the patient’s legs are crosse.d After awakening, the patient complains of numbness on the lateral and posterior portion of the of the sole of his foot. The nerve root most likely injured is the:

A. Obturator nerve
B. Saphenous Nerve
C. Sural Nerve
D. Deep peroneal nerve

Answer: C

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The posterior cord of the tracheal plexus gives rise to the: (choose 2)
A. Median N
B. Ulnar N.
C. Axillary N
D. Musculocutaneous N
E. Radial N
F. Intercosto-brachial N

Answer C, E

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A potential problem associated with cannulation of the dorsals pedis artery for monitoring BP:
A. th vessel is deep and torturous, resulting in difficult cannulation
B. The waveform may be distordted resulting in overestimation of BP
C. Risk of Sural Nerve damage
D. Risk of saphenous Nerve damage

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Attributes associated with the development of post-op ulnar neuropathy include: (choose 4)

A. Male Sex
B. Extreme obesity
C. Female Sex
D. Prolonged bedrest
E. Preexisting contralateral ulnar neuropathy
F. The use of DMR
G. use of regional anesthetic techniques

Answer: A, B, E, D

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Cerebrospinal fluid:

A. is produced at a rate of 200 mL/day in the adult
B. Is reabsorbed by the choroid plexus
C. Is produced by the arachnoid granulations
D. Occupies a volume of approximately 150 mL in the SA space

Answer: D

Cerebrospinal fluid supports
and cushions the spinal cord
and brain. It occupies a
volume of approximately 150
mL in the subarachnoid space.
It is produced by choroid
plexuses in the brain’s
ventricles at a rate of
approximately 500 mL/day. It
is largely reabsorbed by
arachnoid granulations and by
small CNS capillaries.

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A view of the larynx is shown. Label each with the corresponding structure.

Arytenoid Muscles
Thyroid Cartilage
Cricoid cartilage
Arytenoid catilage

A. Thyroid Cartilage
B. Cricoid Cartilage
C. Arytenoid Cartilage
D. Arytenoid Muscles

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Arterial blood supply to the larynx arises form the:

A. Right and left Pulmonary arteries
B. Superior and inferior thyroid arteries
C. Superior and inferior bronchial arteries
D. Right and left common carotid arteries

Answer: B

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The cricoparyngeous muscle receives sensory innervation primarily from the:

A. Glossopharyngeal Nerve
B. Vagus Nerve
C. Hypoglossal Nerve
D. Spinal accessory Nerve

Answer: A

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The lower border of the scapula corresponds to the spinal level:

A. T5
B. T7
C. T9
D. T11

Answer: T7

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Anatomic dead space ends at the:

A. Terminal Bronchiole
B. Respiratory bronchiole
C. Alveolar Duct
D. Respiratory Lobule

Answer: A Terminal Bronchiole

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The most serious complication of a supraclavicular block is:
A. Phrenic Nerve Block
B. Subclavian artery puncture
C. Pneumothorax
D. Paresthesias

Answer: C Pneumothorax

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Chassaignac’s Tubercle may be palpated at:

A. The level of the hyoid bone at C3
B. The superior level of the thyroid cartilage at C4
C. The cricoid cartilage at C6
D. The suprasternal notch at C7

Answer: C

Chassaignac’s tubercle is an
anatomic landmark for the
placement of interscalene and
cervical plexus blocks. It is
the transverse process of the
verterbal body at C6 and may
be palpated lateral to the
cricoid cartilage.

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The Ansa Cervicalis innervates the:

A. Glossogenious muscle
B. Thyrohyoid muscle
C. Geniohyoid muscle.
D. Sternohyoid muscle

Answer: Sternohyoid muscle

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Potential complications associated with an inter scale block include: (choose 4) A. Phrenic nerve block B. Injection of LA into vertebral artery C.Total spinal D. Enopthalamus E. Ptosis of the contralateral eye F. Pneumothorax G. Perforation of the Posterior communicating artery

Answer A, B, C, F

CSF flows form the third to fourth ventricle through the: A. Foramen of Monroe B. Cerebral Aqueduct of Sylvius C. Foramen of Luschka D. Foramen of Magendie

Answer B Cerebral aqueduct of Sylvius CSF is secreted by the choroid plexus in lateral ventricles 1 and 2, flows through the foramen of Munro to the 3rd ventricle, through aqueduct of Sylvius (A.K.A. cerebral aqueduct) to 4th ventricle and through the foramina of Magendie and Luschka (A.K.A. lateral and medial apertures of 4th ventricle) to the subarachnoid space.

Organ designed as preportal organs include: (select 4) A. Stomach B. Adrenals C. Pancreas D. Small intestines E. Kidneys F. Spleen G. Lungs

Answer: A, C, D, F

Accessory muscles involved in forceful expiration include: A. SCM B. Intercostals C. Scalenes D. Rectus Abdominis

Answer D

Drag and drop to the corresponding Structures 1. Ductus Venosus 2. Ductus Arteriosus 3. Foramen Ovale 4. Umbilical Vein Fossa Ovalis Lig Arteriosum Lig Teres Hepatis Ligament Venoisum

1. Ductus Venosus -- Ligament Venosium 2. Ductus Arteriosis - Ligament Arterosum 3. Foramen Ovale - Fossa Ovale 4. Umbilical Vein - Ligament Teres Hepatis

The dominant motor nerve innervating the bicep brachii is the: A. Radial B. Ulnar C. Median D. Musculocutaneous

Answer: D - musculocutaneous

In the adult during placement of the PAC through the Right IJ, the RV should be entered at approximately ____ cm

Answer: 25 - 35 cm

Motor innervation to the Superior oblique muscle of the eye is supplied by: A. Abducens B. Occulomotor C. Trochlear D. Ophthalmic

Answer: A Although the majority of extraocular muscles receive motor innervation from the oculomotor nerve (CN III), the trochlear nerve (CN IV) provides motor innervation to the superior oblique muscle of the eye. The abducens (CN VI) provides motor innervation to the lateral rectus muscle of the eye.

A plantar view of the foot is shown Match the locations with the name. A B C D

A. Saphenous B. Medial Plantar C. Tibial Nerve D. Sural

Of the following, the therapeutic intervention that causes the least ventilatory compromise in the prone patient is the: A. Use of Wilson Frame B. Use of a Jackson Table C. Proper placement of the chest rolls D. Use of an abdominal binder

Answer; Use of a Jackson Table

The body mass index classification for adults with obesity is: A. 20 B. 25 C. 30 D. 40

Answer: C

The Sural Nerve: A. travels superficially with the saphenous nerve behind the lateral malleolus into the ankle B. Provides sensory information to the anterior portion of the sole of the foot C. May be injured form sustained pressure on the lateral tibial epicondyle D. Arise form the roots of the fourth and fifth lumbar nerve

Answer: A The Sural nerve is formed from the union of a branch of the tibial and the common peroneal nerves. It travels superficially with the short saphenous nerve behind the lateral malleolus into the ankle, where it provides sensory innervation to the posterior portion of the sole of the foot, as well as to the posterior portion of the heel and the portion of the Achilles tendon immediately above the ankle.

Components that complete the thin filament of the contractile apparatus include: A. Myosin, Troponin and Tropomycin B. Tropnin, myosin and Actin C. Actin, Troponin and Tropmyosin D. Myosin, Actin and Tropomyosin

Answer: C Actin, Troponin and Tropomyosin

Place the blocks in descending order of peak plasma concentrations following block placement: Intercostal Epidural Trans-tracheal Caudal

1. Tracheal (Highest) 2. Intercostal (second) 3. Caudal (Third) 4. Epidural (Fourth)

The pudendal block: A. Blocks visceral efferent as they join the lumbar sympathetic chain B. Blocks the distribution of sacral nerves 2, 3, 4 C. Blocks Frankenhauser plexus D. Is useful for visceral pain associated with the first stage of labor

Answer: B The pudendal block provides analgesia for the second stage of labor by blocking distribution of sacral nerves 2, 3 and 4, which innervate the lower vagina and perineum. It is useful for forceps or vacuum deliveries or episiotomy.

The sins which is in close proximity to the optic chasm and the hypophysis is the: A. Frontal B. Ethmoid C. Sphenoid D. Maxillary

Answer: C

The innermost layer of the wall of a blood vessel is known as: A. Tunica Intima B. Tunica Media C. Tunica Muscularis D. Tunica Vascular

Answer: Tunica Intima

Which of the following nerves is located in the groove between the tendons of the anterior tibial and extensor hallicus longs muscle. A. Posterior Tibial B. Deep peroneal N C. Sural Nerve D. Saphenous Nerve

Answer: B Deep Peroneal The deep peroneal nerve is located behind the anterior tibial artery, between the tendons of the anterior tibial and extensor hallucis longus muscles.

Venous drainage from the orbit of the eye is achieved primarily through A. Ciliary veins B. Lacrimal Veins C. Superior Vortex Veins D. Superior ophthalmic vein

Answer: D - SUperior Opthalamic Vein

Complications resulting rom trendelenburg position include (select 3): A. Decreased pulmonary capillary wedge pressure B. Edema of the Upper Airway C. Inadvertent right maintem intubation D. Decreased CVP E. Decreased MAP F. Increased myocardial oxygen consumption

B, C, F

The fissure forming the boundary between the frontal and temporal lobes of the brain is called the: A. Central sulcus B. Lateral Sulcus C. Corpus Callosum D. Inula

The secretion of ADH causes the reabsorption of free water. The sites of action include (choose 2): A. PCT B. Depending loop C. Ascending loop D. DCT E. Collecting Ducts F. Renal Caleculi

Answer: D, E The late distal tubule reabsorbs 10% of filtered water. This area is permeable to water only in the presence of ADH. The collecting duct is also permeable to water in the presence of ADH and causes the reabsorption of water into the medullary interstitium, thereby reducing the volume of and concentrating the urine.

A 78M is scheduled for fulguration of bladder tumors. In order to achieve complete anesthesia of the bladder dome, it is necessary to obtain a level of spinal anesthesia at least: A. T8 B. T10 C. L2 D. L4

Answer: B T10

The width of the synaptic gap at the motor terminal is approximately: ______ nm

20 - 50 nm The motor axon terminal is separated from the muscle cell it innervates by a synaptic gap or cleft of only 20 - 50 nm.

Functions of the spleen include (Choose 3): A. Reservoir for platelets B. Reservoir for RBCs C. Removal of foreign antigens D. Erythropoiesis in fetus and adults E. Production of IgG F. Removal of aged and damaged erythrocytes

A, C, F Functions of the spleen include: hematopoiesis in the fetus, blood filtering by splenic sinusoids, removal of foreign antigens by macrophages, IgM production, and removal of aged RBCs and abnormal blood cells. The spleen has a minor role as a reservoir of platelets but has no specific reservoir function for RBCs.

The portal triad includes (choose 3) A. Hepatic Artery B. Portal Vein C. Hepatic Vein D. Bile Duct E. Cystic Duct F. Vagus Nerve

A, B, D Hepatic Artery, Portal Vein, Bile Duct

In the cardiac myocyte, the area that delineates the border between two separate sarcomeres is known as the: A. "A" Band B. "I" Band C. "M" Band D. "Z" Band

Answer: Z The Z band bisects each "I" band of sarcomere

Nerve fibers inolved in the mediation of sharp pain include: A. A-Beta fibers B .A-gamma fibers C. A - delta fibers D. C fibers

Answer; C Larger myelinated A delta fibers are believed to mediate the transmission of sharp pain. Small, unmyelinated C fibers mediate the transmission of dull pain.

Effects of aging on the CV system include (select 3) A. increased PNS activity B. decreased response to beta receptor stimulation C. Enhanced ischemic conditioning by VA D. Stiffening of the myocardium E. Decreased sympathetic activity F. Cardiac conduction system changes

Answer: B, D, F Effects of aging on the cardiovascular system include: 1) decreased response to β-receptor stimulation, 2) stiffening of the myocardium, arteries and veins, 3) changes in the ANS with increased sympathetic and decreased parasympathetic activity, 4) conduction system changes, and 5) defective ischemic preconditioning by volatile anesthetics.

Periop vision loss occurs most frequently in anesthetized patients: A. undergoing cardiac surgical procedures B. In the prone position C. In the steep trendelenburg position D. Receiving glycine bladder irritant

Answer: A Perioperative vision loss occurs most frequently in patients undergoing cardiac surgical procedures.

Primary venous drainage of the lower 2/3 of the esophagus occurs via the: A. Inferior thyroid vein B. Accessory hemizygous vein C. Azygous vein D. Hemizygous vein

Answer: C The primary venous drainage of the lower two-thirds of the esophagus occurs via the azygous vein which enters the superior vena cava at approximately the 5th intercostal space on the right.

Direct anastomosis with the ICA at the circle of willis occurs with the: A. PCA B. ACA C. MCA D. Basilar Artery

Answer: C

The pneumotaxic center (select 3): A. Limits the depth of inspiration B. is located in the rostral pons C. Sends impulses to the inspiratory DRG neurons D. When maximally activated, increases ventilatory frequency E. Has intrinsic rhythmaticity F. is the major pacemaker for RR

Answer: A, B, D

Primary branches of the trigeminal nerve include: (select 3): A. Mandibular N B. Zygomatic N. C. Ophthalmic N. D. Buccal N. E. Maxillary N. F. Lingual N

Answer: A, C, E The trigeminal nerve, CN V, divides into three primary branches: the uppermost ophthalmic branch (sensory only), the maxillary nerve (sensory only) and the mandibular nerve (mixed motor and sensory), the largest branch of the three.

The NT secreted by the motor end-plate which results in stimulation of nicotinic receptors is: A. GABA B. ACh C. NE D. Dopamine

Answer: B - ACH

During the division of the tracheobronchial tree, the loss of cartilage occurs at approximately the: A. 5th generation B. 11th generation C. 16th generation D. 22nd generation

Answer: C - 16th generation

Structures contained within the carotid sheath include (Choose 3) : A. Common carotid artery B. Internal carotid Artery C. Internal jugular vein D. External Jugular Vein E. Vagus Nerve F. Phrenic Nerve

A, C, E

When utilizing the axillary approach to block the brachial plexus, the Neve that frequently needs supplemental blockade is the: A. Musculocutaneous nerve B. Ulnar Nerve C. Median Nerve D. Radial Nerve

A: Musculocutaneous nerve

Nerves originating from the Edinger-Westphall nucleus include the: A. Trochlear B. Abducens C. Ophthalmic D. Accessory Oculomotor Nerve

Answer: D accessory oculomotor nerve The accesory oculomotor nerve originates from the Edinger-Westphal nucleus which is located adjacent to the oculomotor nucleus.

Nerves arising from the sacral plexus include: A. Femoral B. Ileoinguinal Nerve C. Sciatic D. Obturator

Answer C

A 39 week gestation primipara is brought to the OR for C/S. Upon laying flat, she becomes diaphoretic and nauseated. The most effective maneuver to rectify these symptoms is: A. Volume load the patient with 1L 0.9% NS B. Place the patient in light left lateral tilt with wedge under R hip C. Place the patient in trendelenburg position D. Place the patient in a slight R tilt with wedge under left hip

Answer: B

Compartment syndrome has been associated with: A. Intraop HTN B. Elevation of extremities C. Use of patient warming devices D. Use of regional techniques

Answer: B

Sensory innervation of the larynx below the level of VC is provided by the: A. SLN, external branch B. SLN, internal branch C. Glossopharyngeal D. RLN

Answer: D The recurrent laryngeal nerve provides sensory innervation to the larynx below the vocal cords and motor innervation to all of the muscles of the larynx with the exception of the cricothyroid muscle.

CC Regional/ Anatomy Flashcards

(68 cards)