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CHI280 - Human Anatomy 1 > Clinical > Flashcards

Clinical Flashcards

0
Q

What will oculusion of anterior cerebral artery do

A

Sensorimotor function loss in lower limb and bladder weakness

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1
Q

What causes a headache- innervation

A 
Dura mater is stretch sensitive
Trigeminal nerve:
   V1: anterior and posterior cerebral falx and            cerebellar tentorium
   V2: anterolateral reflections
   V3: lateral reflections
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2
Q

What will occlusion of middle cerebral artery do

A

Sensorimotor function loss primarily in face and hands

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3
Q

What will occlusion of posterior cerebral artery do

A

Visual disturbances

Possible sensory loss on one side of thalamus deprived of blood

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4
Q

What does frontal cortex do

A

Supplementary motor area

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5
Q

What does pre-central gyrus do/ what lobe

A

Primary motor area

Frontal lobe

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6
Q

What does the post central gyrus do and what lobe

A

Primary somatosensory cortex/ gustatory cortex

Parietal lobe

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7
Q

What does parietal lobe do

A

Somatosensory association area

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8
Q

What does temporal lobe do

A

Auditory and auditory association area

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9
Q

What does occipital lobe do

A

Visual cortex and visual association area

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10
Q

What does medial geniculate body do

A

Relays auditory impulses from inferior colliculus to primary auditory cortex

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11
Q

What does lateral geniculate body do

A

Relay visual impulses from optic tract to primary visual cortex

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12
Q

Lesion of olfactory nerve, how does it happen

A

Loss of smell

Fracture of cribiform plate

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13
Q

Lesion of optic nerve, and how

A

Loss of pupillary constriction
Visual field defects
Direct trauma to orbit, pressure on optic pathway

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14
Q

Lesion of oculomotor nerve and how

A 
Dilated pupil
Pstosis
Eye turns down and out
Pupillary reflex of side of lesion will be lost
Fracture from cavernous sinus
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15
Q

Lesion of trochlear nerve and how

A

Inability to look down when eye is addicted

Nerve starches on brainstem, fracture of orbit

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16
Q

Lesion to trigeminal nerve and how

A

Loss of pain and touch sensations
Masseter and temporal is don’t collapse
Deviation of mandible to side of lesion with mouth open
Roof maxillary sinus, tri ganglion

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17
Q

Lesion of abducent nerve and how

A

Eye falls to move laterally
Dip optima on lateral gaze
Base of brain, fracture of cavernous sinus/orbit

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18
Q

Lesion to facial nerve and how

A

Paralysis of facial muscles, eyes remain open
Angle of mouth droops, forehead does not wrinkle
Laceration/confusion in parotid region, fracture of temporal bone

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19
Q

Lesion to vestibulocochlear and how

A

Progressive unilateral hearing loss
Tinnitus
Tumor of nerve

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20
Q

Lesion of Glossopharyngeal and how

A

Loss of taste posterior 1/3 of tongue
Loss of sensation on afferent side of soft palate
Brainstem lesion, deep laceration of neck

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21
Q

Lesion to vagus nerve and how

A

Sagging of soft palate
Deviation of uvula
Hoarseness owing to paralysis of vocal fold
Brainstem lesion, deep laceration of neck

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22
Q

Lesion to spinal accessory and how

A

Paralysis of scm, trapezius
Drooping of shoulders
Laceration of neck

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23
Q

Lesion to hypoglossal and how

A

Protruded tongue deviates towards affected side
Moderate dysarthria
Neck laceration, basal skull fracture

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24
Q

Where does sympathetic autonomic nervous system come from

A

Thoracolumbar region

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25
Q

Where does parasympathetic ans come from

A

Cranial sacral region

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26
Q

Post ganglionic fibres of sympathetic/parasympathetic

A

Sympathetic- long

Parasympathetic - short

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27
Q

Where are the pre-synaptic cell bodies of sympathetic nervous system

A

Lateral horn of grey matter t1-l2

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28
Q

Where are the prevertebral ganglia of sympathetic nervous system

A

Plexuses on abdominal aorta

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29
Q

Where does the visceral efferent motor (sympathetic) fibres exit

A

Grey rami communicante

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30
Q

Where does visceral efferent motor (sympathetic) fibres enter

A

White rami communicante into sympathetic trunk

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31
Q

What splanchic nerve carrys parasympathetic fibres

A

Pelvic splanchic

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32
Q

Where are the para vertebral ganglia

A

Adjacent to vertebral column

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33
Q

What cranial nerves do parasympathetic go through

A

III - oculomotor
VII - vestibucochlear
IX- Glossopharyngeal
X - vagus

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34
Q

What is horners syndrome

A

Increased parasympathetic
Lesion in pathway of sympathetic fibres to head
Clinical signs
Pstosis: drooping of upper eyelid
Miosis: pupillary constriction
Anhidosis: loss of sweating
Flushed, warm dry skin: vasodilation of subcutaneous arteries

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35
Q

What is innervation of nasal canal

A

Anterosuperior: ophthalmic
Posterior superior: maxillary
Special sense: olfactory

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36
Q

Where do the para nasal sinuses drain

A

Most into middle nasal meatus

Sphenoid sinus into sphenoethmoid recess

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37
Q

Where is frontal sinus pain referred to

A 
Skin of forehead
Meninges in anterior cranial fossa
Falx cerebri
Tentorium cerebelli
Supra orbital nerve
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38
Q

Where does the maxillary sinus pain refer to

A

Maxillary dental arch

Infra orbital nerve

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39
Q

What is rhino sinusitis

A

Inflammation of paranasal sinuses (ethmoid and maxillary)
Caused by obstruction of nasal discharge
Nasal congestion, facial pain/pressure, fever, headache, painful maxillary teeth

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40
Q

What is ptosis caused by

A

Loss of sympathetic innervation to superior tarsus muscle- oculomotor nerve

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41
Q

What is a pudendal nerve block

A

S2-s4 dermatomes
Does not block superior park of vagina
Can feel uterine contractions

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42
Q

What is caudal epidural block

A

S2-s4 spinal nerve roots
Pain fibres from uterine body (superior to pelvic pain line)
Ascends to inferior thoracic-superior lumbar levels
Mother is aware of contractions
No headache

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43
Q

What is a spinal block

A

Needle into spinal subarachnoid space at l3/4 vertebral level
Severe headache is common
Vertebral epidural space is continuous with cranial epidural space

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44
Q

How does pain travel from sub peritoneal uterus and vagina (inferior to pain line)

A

Travels retrograde lye along parasympathetic pathway s2-4 spinal sensory ganglia

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45
Q

How does the pain from intro peritoneal uterus (superior to pain line) travel?

A

Travel retrogradely along sympathetic pathway

To inferior most thoracic and superior lumbar spinal ganglia

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46
Q

Explain cardiac referred pain

A

Afferent pain fibres run centrally in the middle and inferior cervical branches
Axons of these primary sensory neurons enter spinal cord at segments t1-4/5 especially on left

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47
Q

Injury to recurrent laryngeal nerves and what is the course of left nerve

A

Supply all intrinsic muscles of larynx

Left recurrent laryngeal winds around arch of aorta and ascends

48
Q

Describe renal entrapment syndrome

A

Left renal vein transverses acute angle between superior mesenteric artery anteriorly and abdominal aorta posteriorly
Downward tract to superior mesenteric artery can compress renal vein

49
Q

What vertebral level do the celiac, superior mesenteric and inferior mesenteric artery originates

A

Celiac - t12
Superior mesenteric - l1
Inferior mesenteric - l3

50
Q

What vertebral level does supra renal, renal and gonadal originate

A

Supra renal - l1
Renal - l1
Gonadal - l2

51
Q

How do hiccups occur

A

Involuntary spasmodic contraction of diaphragm
Sudden inhalation that are rapidly interrupted by spasmodic closure of glottis
Result from irrational of afferent/efferent nerve endings or medullary nerves in brainstorms that control diaphragm

52
Q

What happens when the phrenic nerve gets sectioned

A

Complete paralysis and eventual atrophy of muscular part of corresponding half of diaphragm

53
Q

Why is female urethra more susceptible to infection

A

Shorter
More distensible
Open to exterior through vestibule of vagina

54
Q

What’s important to avoid during a tracheostomy

A

Inferior thyroid veins
Left brachiocephalic vein
Thyrus

55
Q

Lesion of cervical sympathetic trunk

A

Horners syndrome
Miosis: contraction of pupil
Ptosis: levatornpalpebrae apple brae superiosis
Vasodilation and absense of sweating

56
Q

Injury to supra scapular nerve

A

Vulnerable to injury middle third of clavicle
Results on loss of lateral rotation humerous at glenohumeral joint
Ability to initiate abduction also affected

57
Q

What are he two most commonly fractured facial bones and why

A

Nasal- prominence

Mandible - vulnerability

58
Q

What type of joint it tmj

A

Synovial

59
Q

During life threatening haemorrhage where is best place to apply pressure

A

Like crown to occlude superficial temporal artery, supra trochlear artery, occipital artery

60
Q

What are the two paired arteries entering calvaria to supply brain

A

Vertebral artery

Internal carotid

61
Q

How does sinusitis cause a headache localised to anterior and middle cranial fossa

A

Refered pain

Sensory innervation of sinuses is same as dura in anterior and middle cranial fossa

62
Q

What muscle opens eyelid

A

Levator palpebrae superiosis

63
Q

What eye open the eye in fright

A

Superior tarsal muscle

64
Q

What muscle closes the eye

A

Orbicularis oculi

65
Q

Corneal reflex innervation

A

Afferent: ophthalmic
Efferent: facial

66
Q

Pupillary light reflex innervation

A

Afferent: optic nerve
Efferent: oculomotor

67
Q

Why are maxillary sinuses most commonly infected

A

Because Ostia has to drain into middle nasal meatus
Is at the superior end of sinus and point medially
Sinus has to be very full to drain or when lying down most superior sinus will drain

68
Q

Internal and external surface of tympanic membrane innervation

A

Internal: Glossopharyngeal
External: branch of cnv3 (auriculotemporal)

69
Q

Cleaning ear wax- what nerve

A

Cnv3 and vagus

70
Q

Which muscles contract to open pharyngotympanic tube

A

Tensor veil palatine

Elevator veil palatine

71
Q

A deviated uvula would indicate lesion of what cranial nerve

A

Vagus

72
Q

What innervates the general sense of the toungue

A

Anterior 2/3 - trigeminal
Posterior 1/3- Glossopharyngeal
Pharynx - vagus

73
Q

What innervates taste of the toungue

A

Anterior 2/3- facial (chorea tympanii)
Posterior 1/3- Glossopharyngeal
Pharynx: vagus

74
Q

What autonomic fibres innervate salivary glands

A

Parasympathetic

75
Q

Submandibular and sublingual innervation by what nerve

A

Facial

76
Q

Parotid gland innervation by what nerve

A

Glossopharyngeal

77
Q

What is in the common sheath

A

Internal jugular vein
Vagus nerve
Common carotid artery

78
Q

Internal jugular vein lies anterior and adjacent to what muscle

A

Scm

79
Q

The cervical plexus emerges from middle of posterior border of which muscle

A

Scm

80
Q

What does the phrenic nerve lie on top of

A

Anterior scalene

81
Q

Describe the pathway of sympathetic nerves

A

Adjacent to thoracic urethra in posterior mediastinum

Fibres contribute to cardiac and oesophageal plexus on anterior surface of oseophagus

82
Q

Describe the path of the vagus nerve

A

Pass through neck in carotid sheath
Enter through anterior to subclavian artery
Passes posterior to primary bronchi contribute to autonomic plexus

83
Q

Describe path of phrenic nerves

A

Pass through neck anterior to anterior scalene muscle
Pass anterior to primary branch on lateral aspect of pericardium
Heads inferiorly to diaphragm

84
Q

The intercostal neurovascular bundles are located between which two muscle layers

A

Innermost and inner intercostal

85
Q

Posterior and subcostal arteries derived from what major blood vessel

A

Thoracic aorta

86
Q

Internal thoracic and superior intercostal arteries derived from what major blood vessel

A

Subclavian aretry

87
Q

Superior and lateral thoracic arteries derived from what major blood vessel

A

Axillary artery

88
Q

Posterior intercostal veins drain to what vein

A

Hemiazygos/ Azygos

89
Q

The medial arcuate ligament is thickening over the fascia of what muscle

A

Psoas muscle

90
Q

Lateral arcuate ligament is thickening of fascia over anterior surface of what muscle

A

Quadratic lomborum

91
Q

What’s in caval opening/what level

A

T8

Ivc, right phrenic nerve

92
Q

What’s in oesophageal hiatus/ what level

A

T10

Oesophagus, vagus trunk

93
Q

What’s in aortic hiatus/ what level

A

T12

Aorta,thoracic duct, Azygos vein

94
Q

Innervation do the pleura of thorax
Costal
Mediastinal
Central and peripheral

A

Costal: intercostal nerve
Mediastinal: phrenic nerve
Central: phrenic
Peripheral: intercostal

95
Q

Motor/sensory innervation of diaphragm and where does it refer

A 
Motor: phrenic c3-c5
Sensory: 
    Central: phrenic.
       Refers to supraclavicular region
    Periphery: intercostal
       Refers to costal margin of anterolateral abdominal wall
96
Q

Level of splanchic nerves

A 
Greater t5-9
Lesser t10-11
Least t12
Lumbar l1-2
Pelvic s2-4
97
Q

Why do gondola arteries branch from aorta immediately inferior to renal arteries

A

Reflects their embryoial origin

Gonads and kidneys develop adjacent to each other on posterior abdominal wall

98
Q

What nerve provides parasympathetic to abdomen/pelvis

A

Vagus/pelvic splanchic

99
Q

What nerve pierces Psoas and describe pathway/what it innervates

A

Gentitofemoral
L1-2
Passes anterior because it entered the inguinal canal to innervate cremaster muscle, anterior scrotum and labia major

100
Q

What nerve is major nerve of perineum and pathway

A

Pudenal s2-4
Exit pelvis via greater sciatic notch
Pass posterior to sacrospinous ligament and enters lesser sciatic notch into ischioanal fossa

101
Q

What is the sympathetic and parasympathetic innervation of kidneys and abdominal part of ureter

A

Sympathetic: least and lumbar splanchic
Parasympathetic: vagus

102
Q

Sympathetic and parasympathetic innervation of pelvic part of ureter and bladder

A

Sympathetic: lumbar and sacral splanchic
Parasympathetic: pelvic splanchic

103
Q

How do visceral afferent fibres conduct pain from viscera superior to pain line

A

Sympathetic fibres travel retrogradely to inferior thoracic and superior lumbar dorsal root ganglia

104
Q

How do Visceral afferent fibres conduct pain inferior to pain lime

A

Parasympathetic fibres to dorsal root ganglia s2-4

105
Q

Which blood vessel does left ovarian vein drain to

A

Left renal vein

106
Q

What blood vessel does right ovarian vein drain

A

Inferior vena cave

107
Q

What blood vessel do ovarian arteries branch from

A

Abdominal aorta

108
Q

What blood vessels do uterine and vaginal arteries branch fro,

A

Internal iliac arteries

109
Q

What are the four nerves of lumbrosacral plexus and spinal cord segments that provide sensory innervation of scrotum of males and labia majora for females

A

1 ilio inguinal l1
2. Genital branch of genitofemoral l1-2
3. Posterior cutaneous nerve of thigh s1-33
4 pudendal nerve s2-4

110
Q

Cremaster muscle reflex afferent and efferent

A

Afferent: ilio inguinal
Efferent: genital branch of genitofemoral

111
Q

The obturator internis is what to levator ani muscle

A

Lateral

112
Q

Pubococcygeus is what to puborectalis

A

Lateral

113
Q

Bulospongiusus muscle is what to ischicavernous

A

Medial

114
Q

The ilio Psoas passes what is inguinal ligament

A

Deep

115
Q

Sacrospinous ligament runs what to sacrotuberous ligament

A

Deep

116
Q

The sciatic nerve exits pelvis between what two muscles

A

Pisiformis and coccygeal

117
Q

What are the fetal adaptions in the body

A
  1. Foramen ovale closes to form fossa oval is
  2. Ductus arteriesus degenerates to form ligamentum arteriosum
  3. Ductus venosus degenrstes to form ligamentum venosum
  4. Umbilical artery degenerates to form umbilical fold
  5. Umbilical vein degenerates to form round ligament of liver
118
Q

What nerve is damaged during vaginal delivery that can lead to denier action of external urethral and anal sphincter and why

A

Pudendal
Sits medial to ischial spine as it re-enters pelvis
Sits in perineum which is superficial hence likely to be injured

CHI280 - Human Anatomy 1 (22 decks)

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