Exam 3 Flashcards
(199 cards)
1
Q
What does lateral and longitudinal folding cause blood islands to do?
A
- merge into one solid tube
* long: puts it at definitive position in Thorax
2
Q
What does the Outflow tract become?
A
*pulmonary trunk and aorta
3
Q
What do the conotruncal cushion grow out from?
A
*wall of primordial heart
4
Q
What does the endocardial cushion grow out from?
A
*endocardial part of the heart
5
Q
Where do the conotruncal cushion originate from?
A
*Neural Crest cells
6
Q
What is the pathway for blood that will close?
A
*ostium primum
7
Q
what forms from the atrioventricular canal?
A
*interatrium septum (fibrous skeleton of the heart)
8
Q
What forms 2nd and closes off to cause misalignment of holes?
A
*septum seundum
9
Q
What is the misaligned hole on the L side called?
A
*oval foramen and valve of oval foramen
10
Q
What closes in fetal circulation after birth?
A
*ductus arteriosus, oval foramen, umbilical vein and ductus venosus, and umbilical artery
11
Q
What becomes the aortic and pulmonary trunk?
A
- P: pulmonary channel
* A: aortic channel
12
Q
What percent of babies have septal defects?
A
- 1% of babies (10% if include still born babies)
13
Q
What percent of babies with heart problems have other developmental defects?
A
*30%
14
Q
What are the signs and treatment of a septal defect in the membranous part of the ventricles?
A
- doesn’t seal up, surgery required
- baby cyanosis and sweat while suckling
- flow from L to R
15
Q
How is a septal defect in the muscular part of the ventricles treated?
A
*seals up on its own
16
Q
What are the signs of an atrial septal defect and how is it detected and treated?
A
- if doesn’t seal up, surgery required
- Doppler ultrasound to find hole
- shunt from R to L
- big defect causes blood to bypass pulmonary circuit (cyanotic, sweat while suckling)
- pulmonary side under more pressure (enlarged R side) if have this in adult
17
Q
What are the alterations a tetralogy of fallot can cause?
A
- pulmonary stenosis
- overriding aorta
- interventricular septal defect
- hypertrophy
18
Q
What accompanies tetralogy of fallot and how do you fix it?
A
- patent ductus arteriosus
* surgical fix
19
Q
What is stenosis of valves?
A
*calcium of vales, hardening, narrow opening
20
Q
What is insufficient of valves?
A
*doesn’t close right, blood comes back through
21
Q
What is ductus arteriosus, signs and treatments?
A
- ductus art doesn’t close
- cyanosis sweat during suckling
- prostaglandins, surgical (can hit recurrent laryngeal nerve)
22
Q
Where would hypertrophy in tetralogy of fallot occur?
A
- walls of RV
23
Q
What part would be effected in the interventricular septal defect in tetralogy of fallot?
A
*membranous part
24
Q
What are the muscles of the posterior abdominal wall?
A
*psoas, quadratus, iliacus, trans abdominis, internal and external oblique
25
What can a peritoneal infection do?
*travel to psoas major and go into thigh
26
Where is the pain felt in a psoas abscess?
*fever, pain in flank, pain walking
27
What is a psoas abscess caused by and how is it treated?
* staph aur
| * antibiotics, surgically drained
28
What produces blood in the fetus?
*spleen
29
What stores and releases RBC?
*spleen
30
What is a lymphatic organ and what does that mean?
* spleen
| * makes macrophages
31
What is the spleen derived from?
*mesoderm
32
What does the spleen do?
* splenic circulation (polysach. antigens recognize)
33
What are some reason why people don't have a spleen?
* splenic agenesis, rupture in trauma, disease cured by removal of spleen (Hep c)
34
What is an overwhelming post splenectomy (OPSI) and how is it treated, and what are the signs?
* bacterial septic (blood infection)
* rec in 24-48 hours, 50-70% die
* intravenous antibiotics
* flu like symp, fever, headache, nausea
* vaccine, renew every 5 years
35
What gets 20% of the body's blood supply?
*kidney
36
What does the kidney do and where is it located?
* removes waste
| * T12-L3 vert
37
What is surrounded by a capsule (stretchy)?
*spleen
38
What is surrounded by para fat and a strong capsule of CT?
*kidney
39
What does the renal pyramid have in it?
*millions of nephrons
40
Where can you get constrictions of the ureters?
*superior part, kink over common iliac arteries, and by bladder
41
What is a kidney stone (renal calculi) composed of?
*oxalate, calcium, and cholesterol
42
Where is the pain in a kidney stone felt?
* pain when stretched
| * pain in flank, groin, and lower back pain
43
How do you treat a kidney stone?
*lithotripsy (aim sound waves and tear them apart, epidural)
44
What is a stag horn calculi?
*kidney stone that remains in renal pelvis
45
Where do the kidneys develop?
*begin in pelvis ind evelopment
46
What has little anastomosis?
* segmental artery
47
Where is the bloodless zone?
*along lateral edge of the kidney
48
What is a simple renal cyst and how is it treated and detected?
* 1 or a few swollen nephrons
* needle aspirated (if pushing on something)
* ultrasound
49
What does the suprarenal gland not have?
*hilum
50
What does the suprarenal gland do?
*produce hormones
51
What do the hormones for the suprarenal gland do?
*regulate salt balance, glucose, androgens (esp during development)
52
What is the cortex and medulla derived from?
* C: mesoderm
| * M: neural crest cells
53
Where does the medulla get sympathetic input from?
*T5-L1
54
What does the Medulla secrete?
*epinephrine and norepinephrine
55
What is a pheochromocytoma tumor and what are the signs and treatment and ways to detect it?
* adrenal constantly release EPI and norepinephrine
* rapid heart rate, forceful heart beat, high BP, shaking, tremor, sweating
* urine/blood test, imaging
* remove suprarenal gland
56
What can a high BP put you at risk for?
*heart attack, stroke, kidney failure
57
Where does the adrenal medulla pathway synapse?
* in adrenal medulla (with Chromaffin)
| * has no post ganglionic fibers
58
What is chromaffin derived from and dump out?
* neural crest cell
| * dump EPI and NPE in blood stream
59
Where is the superior and posterior mediastinum found?
* S: vertebrae T4 and T5
| * P: T5-T12
60
What is in the venous angle?
*internal jugular and subclavian vein
61
Where are the greater/lesser/least splanchnic nerves found?
*G: T5-T10
Less: T10-T11
L: T10-T12
62
What do the greater/lesser/least splanchnic nerves supply input to?
*symp input to foregut and midgut
63
What dumps into azygous on the R side?
*posterior intercostal art
64
What delivers O2 arterial blood to lung tissues?
*bronchial artery
65
What do you have in embryo?
*2 aortas and 2 vena cavas
66
What predominates on the R and L side during embryo?
* vena cave predominates on R
| * aorta predominates on L
67
What does the azygous vein supply blood to?
*superior Vena Cava
68
What happens in persistent L Vena Cava?
*connect common iliac to Renal on L side
69
What does the thoracic duct do?
*conveys most lymph of the body to the venous system
70
What kind of input is the Vagus nerve and what does it innervate?
* parasymp input
| * abdominal structures
71
What is in the aortic arch?
*brachiocephalic trunk, L common carotid art, and L subclavian art
72
What is coarctation of aorta with collateral circulation and where does it typically occur?
* narrowing that causes obstruction to blood flow to inf part of body
* distal to ductus art and L subclavian art
73
What are the signs and treatment of coarctation of aorta with collateral circulation?
* babies: sweating during suckling, cyanosis
* adults: bruit, enlarged L side of heart
* balloon catherization, resection and anastomosis
74
What is Bruit and what can it lead to?
* swishing sound
| * congestive heart failure
75
What are the causes of treatment of coarctation of aorta with collateral circulation?
* duct art tissue eptoptic
| * not enough blood delivered during development
76
What is the origins of the Recurrent laryngeal nerve and what does it do?
* O: vagus nerve
| * intrinsic muscle of larynx
77
What is the pharyngeal arch derived from and how many are there?
* 6
| * derived from arch of eardrum, mandible
78
What happens to the 5th aortic arch?
*never develops
79
What is the Subclavian art derv from?
*4th arch
80
What happens to the 6th on the L side become part of?
*pulm artery and ductus arter
81
What happens to the 6th arch on the R side become?
* disappears
| * causes R recurrent larynx. to hook around subclavian art
82
What closes off the obturator foramen?
*muscle and deep fascia
83
What separates the greater foramen from the lesser foramen?
*sacrospinous ligament
84
What structures pass through the greater sciatic foramen?
* superior/ inferior gluteal artery
* piriformis
* sciatic nerve
85
What does piriformis do?
*lateral rotator of femur
86
What does the pudendal nerve do?
* inn soft tissue
| * leaves pelvis and goes in perineum
87
What structures pass through the lesser sciatic foramen?
* internal pudendal artery
* pudendal nerve
* obturator internus muscle
88
What is the pelvic inlet also called?
*pelvic brim
89
What is the conflict of the pelvic outlet?
*baby head has to fit through here
90
What do bipedal humans have to have?
*narrow pelvis
91
What is altricial?
*born immature
92
What are the boundaries of the pelvic outlet?
*inferior part of pubic symp, ischioppubic ramus, ischiotuberosity, sacrotuberous lig, inf tip of coccyx
93
What is the pelvic diaphragm?
* musculofascia sling (support for pelvic viscera)
| * boundary between pelvis and perineum
94
What are the functions of the pelvic diaphragm?
*support pelvic viscera, maintain voluntary fecal content, guide baby head out
95
What is all the soft stuff beneath pelvis and between the thigh called?
*perineum
96
What are the muscles of the pelvic diaphragm?
```
*coccygeus
Levator ani (iliococcygeus, pubococcygeus, puborectalis)
```
97
What is the obturator artery a branch of?
*internal iliac artery
98
What is the external anal sphincter?
*voluntary
99
What is the internal anal sphincter made of?
* inner circular layer
| * involuntary sphincter
100
What does the internal sphincter respond to?
*pressure by opening
101
What is the pectinate lilne?
*anal columns with anal sinus
102
What is inferior and superior to the pectinate line?
* I: somatic innervation
| * S: visceral innervation
103
What is the spot of the clocal membrane in embryo?
*pectinate line
104
Which hemorrhoids are painful?
*external
105
What is internal hemorrhoid associated with?
*age, lining of GI track weaken (can't hold veins in place)
106
What wraps around the anal canal and you kink it to control the anal sphincter?
*puborectalis
107
What is the urinary bladder covered with?
*perineum
108
What is the wall of the bladder made up of?
*detrusor muscle
109
Where does the trigone develop from?
*distal part of ureter in embryo
110
What prevents urine from going back up?
*ureteric orifices
111
What does the neck of the detrusor muscle function as?
*an internal urethral sphincter
112
What is the function of the internal urethra sphincter in men and women?
* F: argue if still there
| * M: contracts during orgasm, prevents semen from going into bladder
113
What holds the ovarian artery and vain in place?
*suspensory ligament of ovary
114
What do the ovaries do?
*produce hormones that regulate uterine cycle and early pregnancy
115
Where does fertilization happen?
*distal part of uterine tube
116
What is an eptopic pregnancy and what is it due to?
*can occur in uterine tube, due to scar from STI (chlamydia, gonorrhea)
117
What are the signs of chlamydia and detection and treatment?
* 20% no symptoms
* pain in lower abdomen, heavy mens bleeding, foul smelling vaginal discharge, fever, painful urination/sexual intercourse
* sample of fluid near cervix
* antibiotics
118
What is in the lumen of the uterine tube?
*ciliated epithelium, secretory cells
119
What do the ciliated epithelium and secretory cells do?
* C: propel egg toward uterus
| * S: provide nutrition to egg and sperm
120
What is the function of the uterus?
* smooth involuntary
| * development of fetus, expel fetus
121
How long is the urethra in women?
*2.5-4 cm long
122
Where does the embryo implant?
*myometrium
123
What is the endometrium?
*lining of lumen, shed every month
124
What is scraped during a pap smear and prone to cervical cancer?
*external os
125
Why does more menstrual cycles make you more likely to get cervical cancer?
*inverts ever month into acidic environment, causes inflammation
126
What is the Prostate?
*fibromuscular gland (has CT and smooth muscle)
| increase in size over age (makes more tissue)
127
What is BPH (benign prostate hyperplasis), signs/treatment?
* close off urethra, cant drain bladder
* frequent urination, sudden urge to urinate
* drugs to relax muscle, transurethral resection of prostate
128
What adds the nutrient part to sperm during ejaculation?
*seminal and prostate gland
129
What is the ductus deferens?
*muscular tube (smooth muscle, moves ejaculate)
130
Where is sperm produced and stored?
* S: epididymis
| * P: testis
131
What adds the lubricating part of ejaculate?
*bulbourethral gland
132
What turns 90 degrees and you can puncture while inserting the catheter?
*spongy urethra
133
What does the spongy urethra contain?
*urethral glands in wall (omit lubricating fluid)
134
What kind of fibers are in the superior hypogastric plexus?
*symp fibers, has both pre and postganglion fibers
135
What does the erectile tissue have?
*symp and parasymp innervation
136
What do the pelvic splanchnic nerves innervate, and what kind of innervation?
*erectile tissue (parasymp)
137
what kind of fibers does the inferior hypogastric plexus have?
*symp and parasymp
138
What inn the pudendal nerve?
*anti rami S2-S4, motor and sen functions
139
Where do the motor and sensory functions of the pudendal nerve go?
* M: inn pelvic diaphragm
| * S: perineum and external genital
140
What does the phallus become?
*penis or clit
141
What can an undescended testis lead to?
*infertilization and cancer
142
What is the remnant of vaginal process?
*tunica vaginalis
143
What is the remnant of the gubernaculum?
*ligament of ovary, round ligament of uterus , scrotal ligament
144
Where is an indirect (congenital) inguinal hernia found and where is the pulse felt?
* lateral to inferior epigastric vessels
| * pulse felt deep over inguinal ring
145
Where is a direct (acquired) inguinal hernia found and where is the pulse felt?
* medial to inferior epigastric vessels
| * more superficial
146
Who gets more femoral hernias?
*females
147
What muscles help with erection?
* ischiocavernosus
| * bulbospongiosus
148
What is in the bulb?
*corpus spongiosum
149
What is the perineal body and what can happen there?
* fibromuscular
* can tear during child birth
* lead to prolapsed uterus, bladder
150
What is an episiotomy and what can it lead to?
* enlargement of birth canal by cutting muscle
| * weakness
151
What passes obliquely through the tunica albuginea?
*veins that when squeezed become erect
152
What is a tumescence?
*erection
153
What happens during the parasympathetic input of an erection?
* arousal/tumescence phase
| * causes smooth muscle of helicine arteries to relax and blood flows in
154
What happens during the sympathetic inputs of an erection?
* ejaculation/ orgasm phase
| * vasocontrict, detumescence (blood flows out)
155
What does the anterior compartment of the arm do?
*arm extension and forearm flexion
156
What does the biceps brachii do?
*supination
157
What does the brachialis do?
* main forearm flexor
| * inn by musculocutaneous nerve
158
What does the coracobrachialis do?
* arm adductor
| * weak arm extensor
159
What does the forearm do?
*flexion, extension, abduction, adduction of wrist
160
How many muscles are in your forearm?
*19
161
What does the flexor carpi radialis do?
*flex wrist/wrist abduction
162
What does the palmaris longus do?
*tenses palmar aponeurosis
163
What do 2-60% or people not have?
*palmaris longus
164
What does the flexor carpi ulnaris do?
*adduct wrist
165
What does the first layer of the forearm do and what does it attach to?
* pronators and flexor
| * attach to medial epicondyle (common flexor tendon)
166
What is the distal attachment for the flexor digitorum superficialis and what does it do?
* middle phalanges
| * flexes metacarpophalangeal and proximal interphalanges
167
What is the distal attachment for the flexor digitorum profundus and what does it do?
* distal phalanges
| * flexes metacarpophalangeal and proximal/distal interphalanges
168
What does the flexor pollicis longus do?
*flexes thumb
169
What does the pronator quadratus do?
* primary pronator
| * fibers going 90 degrees
170
What innervates the anterior forearm?
*median nerve
171
What does the ulnar nerve innervate?
*medial half of flexor digitorum profundus and ulnaris
172
What innervates the Thenar muscle?
*median nerve
173
What can cause an injury at the median nerve?
*cubital fossa, supracondylar fracture
174
What are the symptoms of a median nerve injury?
* thenar wasting (ape hand)
* diminished opposability
* lose of pronation
* numb/tingling in lateral 3.5 digits
175
What causes injury to the ulnar nerve?
*fracture of medial epicondyle
176
What are the signs of ulnar nerve injury?
* wasting of hypothenar (claw hand)
* digits 3,4,5 hyperextension at metacarp joints, flexed at proximal/ distal interph. joint
* middle digit has sensory deficit
* lose function in adduction/abduction of digits
177
What does the posterior compartment of the forearm do, what is it innervated by and what are its origins?
* extend wrist and digits, abduction/extension of thumb, supination
* origins of common extensor tendon (on lateral epicondyle)
* all inn by radial nerve
178
What is the extensor digiti minimi attached to?
*5th digit
179
What is the extensor carpi radialis longus attached to?
*2nd metacarp
180
What is the extensor carpi radialis brevis attached to?
*3rd metacarpal (more deep)
181
What can cause damage to the radial nerve and what are the signs?
* broken humerus
* wrist drop (can't extend wrist)
* if at proximal wrist (diff extending elbow)
182
What is a reflex?
*rapid involuntary response to a stimulus
183
What is clonus?
* most hyperactive a reflex can be
| * reflex keeps working indefinitely
184
What does a hypoactive and hyperactive reflex indicate?
* O: peripheral problem
| * E: Central problem
185
What does a Golgi tendon detect?
*tension of tendon
186
What does a muscle spindle detect?
*movement of muscle fibers
187
How can a legion be determined?
*by reflexes in CNS and PNS (can find location)
188
What kind of reflexes are there?
*deep tendon, cranial nerve, cutaneous stimulation
189
How do you score reflexes?
*0-absent, 1-hypoactive, 2-normal, 3-hyperactive without clonus, 4- hyperactive with clonus
190
What is a doctor looking for when they are checking your reflex?
*symmetry
191
What spinal segments are affected in a quadriceps, triceps, biceps, calcaneal, and plantar reflex?
*Q: L3,4
*C:S1
*P: L5,S1
*T: C6,7
B:C5,6
192
What are the normal response to a plantar reflex check?
* babies: spread toes apart
| * adults: curl toes
193
What is a Babinski sign and what does it indicate?
* CNS legion
| * separate toes during plantar reflex test
194
What is bifurcation of the brachial artery and how common is it?
* divides at middle of arm
| * 3%
195
What can high bifurcation cause?
* ulnar art run superficial (mistaken as vein)
| * chemical drug can accidently be put into it
196
What is a chemical endartitis?
* put drugs in brachial artery
| * damage art, inflammation of capillary distal to site of injection (causes blood clott, circulation shut down)
197
What runs on superficial side of serratus anterior?
*long thoracic nerve
198
How can the long thoracic nerve get injured?
*stabbing injury
199
What does a damage to the long thoracic nerve cause?
* winged scapula
| * can't hold scapula against rib cage, pops out
