Exam review Flashcards

Question

Rotator cuff relations

Answer 1

* A: Tendon of pectoralis major * P: tendon of latissimus dorsi * M: Pectoral muscles * L: deltoid * S: Deltoid * I: unstable free edge

Answer 2

* Absence or hypoplasia of any of the muscles

Answer 3

* The pituitary gland is a major extradural endo- and exo-crine gland located within the pituitary fossa within the calvarium

Answer 4

* Pars distalis * Largest part – anterior wall of the Rathke pouch * Pars tuberalis * Part of the adenohypophysis surrounding the anterior aspect of the infundibular stalk * Pars intermedia * Thin layer of cells between the pars distalis and the neurohypophysis

Answer 5

* Also known as the neurohypophysis * Considered to be an extension of the brain and from an embryologically different source * Secretes hormone stimulating hormones (ACTH etc) * Produces the pituitary bright spot on MRI * Continuous with the infundibulum * Continuous with the hypothalamus

Answer 6

* A: Anterior clinoid process * P: dorsum sellae, posterior intercavernous sinus * M: infundibulum * L: dura mater cavernous sinuses and their contents * S: Optic chiasm, suprasellar cistern, pituitary aneurysm * I: sphenoid sinus

Answer 7

* Rich anastamotic supply from the hypophyseal plexus which has branches from the meningohypophyseal trunk, and the anterior and posterior hyphohyseal arterial. This also allows for diffusion of the hormones * 6 arteries, 3 from above, 3 from below * Circuminfundibular anastomosis * Inferior hypophyseal arterial circle * Branches * Above * Superior hypohyseal artery * Infundibular artery * Prechiasmal artery * Below * Inferior hypophyseal artery * Capsular * Artery of the inferior cavernous sinus * Portal * Blood from hypothalamus

Answer 8

* S: optic chiasm * I: sphenoid sinus * L: cavernous sinus * A: frontal/sphenoid sinus * P:4^th ventricle

Answer 9

o Empty sella o Hypoplasia o Hyperplasia o Duplication

Answer 10

* Large, complex serious membrane, forming a closed sac within the abdominal cavity

Answer 11

* Can be divided into two main compartments, separated by the roots of the transverse mesocolon * Supramesocolic space * Inframesocolic space * Can also be divided into greater and lesser sac * Innervation: * * Parietal: spinal nerves * Diaphragmatic: phrenic * Visceral: no afferent * Mesenteroc: Pacinian corpuscles

Answer 12

* Adrenal glands * Kidneys * Pancreas * Aorta/IVC * Duodenal segments D1/4 * Ascending and descending colon.

Answer 13

* There are multiple peritoneal reflections which provide support for intraabdominal organs including * In the female: * The broad ligament - doubled layer of peritoneum which drapes over the uterus, and contains the ovaries and Fallopian tubes * Mesentery – doubled layer of peritoneum which contain neurovasculature for the abdominal viscera * The appendix may have its own mesentery * This allows for identification of the rectosigmoid junction – the rectum loses the mesentery * Gastroduodenal * Ligament of trietz * Supports the duodenal-jejunal flexure * Hepatorenal * Contains the portal triad (portal vein, hepatic artery and the common bile duct) * Lienorenal * Contains the splenic artery and vein

Answer 14

* The triceps is the muscle of the posterior compartment of the arm bilaterally * Allows for extension of the elbow

Answer 15

* Originates as three heads: * Long head – infraglenoid tubercle of the scapula * Medial – posterior humerus inf to the radial groove * Posterior and lateral intermuscular septum * Insertion: olecranon process of the ulna * Neurovasculature * Innervation: radial nerve * Arterial supply: branches of the brachial artery * Venous drainage: venae commitantes

Answer 16

* A: Radial nerve, humerus * P: muscular fascia, skin, fat * S: shoulder joint * I: elbow joint * M: coracobrachialis * L: deltoid * Radial nerve and profunda brachii vessels run in the groove between origins of lateral and medial heads

Answer 17

* Hypoplasia * Abnormal insertion * Abnormal origin * Duplication of the long head * Patella cubiti * Long head may be supplied by axillary nerve

Answer 18

* The pancreas consists of four parts * Head ( * Uncinate process - * Neck: thinnest part, ant to SMA, SMV * SMV joins splenic vein behind the pancreatic neck to form the portal vein * Body: * Ant surface: covered by peritoneum * Splenic vein * Tail Between layers of splenorenal ligament

Answer 19

* Main pancreatic duct * Portion, proximal to the dorsal ventral fusion point * Drains at ampulla of vater * Connects with accessory pancreatic duct * Pancreatic duct of Wirsung * Distal portion * Segment of the ventral duct between the dorsal ventral fusion point and the major papilla * Accessory pancreatic duct of Santorini * Portion of the duct distal to the dorsal ventral fusion point * Drains anterior and superior portion of head

Answer 20

* Arterial supply * Superior pancreaticoduodenal artery (Coeliac trunk) * Inferior pancreaticoduodenal artery (SMA) * These divide into anterior and posterior branches * Branches of the splenic * Venous drainage * Veins of the same name as the arteries * Superior pancreaticoduodenal – portal vein * Inferior pancreaticoduodenal - SMV * Drains into the portal circulation * Innervation * Sympathetics via the pre-aortic and coeliac plexi * Parasympathetics * Lymphatics * Coeliac, splenic, superior mesenteric, hepatic group of lymph nodes

Answer 21

* P: * L2 vertebral body * Right kidney hilum, portal vein and IVU|C * CBD * Aorta * Left kidney hilum, left suprarenal gland, right crus * Splenic vein, IMV and confluence of splenic and SMV to form portal vein * A: * Lesser sac: separating from stomach * Lesser omentum and liver * Attachment of the transverse mesovolon * D1 * Infracolic compartment * S: * Origin of coeliac trunk * SHA * Splenic artery

Answer 22

* Ansa pancreatica * Pancreatic division * 3 types * Annular * BIfid * Ectopic * Pancreactic clefts

Answer 23

* Synovial condyloid articulation

Answer 24

* Articular surfaces * Distal radius * Triangular articular disc * Scaphoid * Lunate * Triquetrum * Ligaments * Palmar radiocarpal ligament * Dorsal radiocarpal ligaments * Ulnar and radial collateral * Palmar and dorsal radioulnar ligaments * Capsule * Continuous with midcarpal joint * Proximally extends as the palmar radial recess * Movement * Flexion and extension Radial and ulnar deviation

Answer 25

* Arterial supply * Ulnar and radial arteries * Dorsal and palmar carpal arches * Venous drainage * Cephalic and basilic veins * Innervation * Median nerve * Radial nerve * Ulnar nerve

Answer 26

Anterior: radial artery, ulnar artery, median nerve, ulnar nerve, numerous flexor tendons Posterior: numerous extensor tendons

Answer 27

* It is a pyramidal structure with the apex pointing inferiorly, measuring approximately 10cc in volume * There are three surfaces: anterior, inferolateral and posterior * AnteriorL posterior limit of the retropubic space. Connected to the pubic bone by puboprostatic ligaments * Inferolateral: rests on the levator ani fascia * Posterior: triangular and flat surface. Anterior to the rectum and has a vertical median groove. Separated by Denonvillier’s fascia. * Has a pseudocapsule formed by fibromuscular tissue surrounding 3 distinct layers of fascia. Anterior, lateral and posterior . Laterally it fuses with the levator fascia * It can be divided into to peripheral and central zone, which is connected by the transitional zone * Zonal anatomy * Peripheral * Accounts for approximately 70% of the total in a young adult, deficient anteriorly * Central * Contains ejaculatory ducts * Posterior to the prostatic urethra, forms the base * Transition * Remaining 5% * Anterolateral to the prostatic urethra

Answer 28

* Arterial supply: prostatic arteries from the inferior vesical * Venous drainage into the prostatic plexus, which communicates with the internal pudendal plexus which communicates potentially with Baton’s vertebral plexus * Lymphatic drainage is into the iliac and pre-aortic lymph nodes * Innervation: pelvic splanchnic nerves and the hypogastric plexus.

Answer 29

* A: Pubic symphysis * P: rectum, fascia * S: bladder * I: penis, pelvic diaphragm * M: prostatic urethra * L: ischiorectal fossa

Answer 30

Additional lobes Missing lobes

Answer 31

* Inverted triangular space which forms the transition between the arm and the forearm. * Located anterior to the elbow joint

Answer 32

* S: line joining the medial and lateral humeral epicondyles * L: medial border of brachioradialis * M: lateral border of pronator teres * Apex: meeting of the medial and lateral boundaries * Roof: * Deep fascia of the forearm * Medial cutaneous nerve of the forearm, lateral cutaneous nerve of the forearm * Basilic vein, cephalic vein, median cubital * Floor: brachialis, supinator

Answer 33

* Brachial artery * Brachial vein * Median nerve * Biceps tendon * Radial nerve * Posterior interosseous branch of radial nerve

Answer 34

* The vertebral arteries are major arteries of the posterior circulation of the brain.

Answer 35

* Origin * 1^st part of the subclavian vein * Termination * Within the calvarium as the basilar arteries * Course * Can be divided into segments * V1: angles posteriorly between longus colli medially and scalenus anterior laterally through the colliscalene triangle behind the CCA to entre the transverse foramen at C6 * * Ant: CCA, VV, thoracic duct, lymphatic duct * Post: ventral rami of spinal nerves C7 and C8, TP C7, inferior cervical ganglion * AM: inferior thyroid artery, middle cervical ganglion * V2: through the transverse foramina from C6-3. Accompanied by VV and sympathetic nerves. Turns superolateral through inverted L shaped transverse foramen of C2 * V3: emerges from TP of C2 sweeping laterally to pass through the transverse foramen of C1, passes around the posterior border of lateral mass of C1, below the inferior border of the posterior atlanto-occipital membrane. Pierces the dura and arachnoid. * V4: anterior to the roots of the hypoglossal nerve and joints its contralateral counterpart at the lower border of the pons

Answer 36

* V1: segmental cervical muscular and spinal * V2: anterior meningeal artery, muscular and spinal * V3: posterior meningeal * V4: anterior and posterior spinal arteries, medullary perforators, PICA

Answer 37

* Relations * A: clivus * P: cerebellum * M: Transverse foramina * L: Transverse foramina * S: Basilar artery * I: subclavian artery (1^st part)

Answer 38

* Hypoplastic * Aplastic * Duplicated * Fenestrated * Termination as the PICA

Answer 39

* Passage in the anterior abdominal wall that transmits structures from the pelvis to the perineum

Answer 40

* Deep inguinal ring * Laterally by the angle between the transversus abdominis and inguinal ligament * Medially: inferior epigastric vessels

Answer 41

* Inverted V shaped, triangular opening in the medial end of the external oblique aponeurosis * Lateral crus: pubic tubercle * Medial crus: pubic crest near the symphysis * Posterior crus: pass behind the cord to attach to the rectus sheath

Answer 42

* Superior: internal oblique, transversus abdominis * Ant: external oblique aponeurosis and internal oblique aponeurosis * I: inguinal ligament and lacunar ligament * P: transversalis fascia, conjoint tendon

Answer 43

* Spermatic cord in the male * Ductus deferens * Artery to the ductus deferens * Genital branch of the genitofemoral nerve * Iliolumbar * Iliohypogastric * Round ligament in the female * Ilioinguinal nerve * Genital branch of the genitofemoral nerve

Answer 44

* The anal canal is the final part of the alimentary tract and is located within the pelvis. It is a single, midline organ

Answer 45

* Structure * The anus can be separated into by the dentate line into superior and inferior segments * The superior segment is considered visceral and the inferior segment is considered somatic * Continence is partially preserved by the puborectalis sling. * Boundaries * Superior: levator ani * I: external anal sphincter

Answer 46

* Above the dentate line: * A: superior rectal, * N: least splanchnic nerve * V: vein * L: rectal nodes * Below the dentate line: * A: inferior rectal , * N: inferior rectal branches of the pudendal nerve * V: internal iliac * L:

Answer 47

* S: small bowel * I: external anal sphincter * M: anal canal * L: ischio anal fossa * A: female: uterus, pouch of douglas. Male: bladder, rectovesical pouch * P: sacrum, pre-sacral fat

Answer 48

* At the level of the S3 vertebral body,the sigmoid colon loses it mesentery * Taenia coli flatten and fuse * The anal canal extends from the levator ani to the external anal sphincter

Answer 49

* A: superior, middle and inferior rectal arteries, * N: least splanchnic nerves, sympathetic nodes * V: internal iliac plexus, external iliac plexus

Answer 50

* Approximately 10-12cm long and 1-4mm in diameter * The fallopian tubes consist of 5 parts * Fimbriae * Infundibulum * Ampulla * Isthmus * Interstital or intramural * They are open to the peritoneum bilaterally and are not directly connected to the ovaries * They are directly continuous with the cornu of the uterus bilaterally * They are contained within the doubled layer of peritoneum called the broad ligament, and have a separate section within it called the mesosalpinx.

Answer 51

* A: branches of the ovarian and uterine arteries ( * N: pelvic splanchnic nerves * V: uterine plexus which then drains into the internal iliac veins * L: iliac group of lymph nodes

Answer 52

* A: bladder * P: rectum * S: broad ligament * I: pelvic soft tissue * M: cornu of the uterus * L: pelvic side wall, ovaries

Answer 53

* Duplication * Absence * Hypoplastic unilateral * Hypoplastic bilateral * Abnormal entry into the uterine body or fundus

Answer 54

* 7.5cm in length, 5cm wide at its upper part, 2.5cm in thickness * Divisible into two parts, cervix and body * The uterus is a muscular structure which has multiple layer including endometrium and myometrium * It is shaped as an inverted pear, with the broad side usually facing superiorly * There is are cornu bilaterally which communicate with the fallopian tubes * The central cavity is triangular in shape * It is continuous with the cervix inferiorly, through the cervical os and canal * * A: pubocervical * L: transverse cervical ligaments * P: uterosacral * I: puborectalis and pubovaginalis

Answer 55

* Arterial * Uterine branches of the superior vesical branches * Anastamoses with the ovarian arteries * Venous * Uterine venous plexus draining into the internal iliac veins * Lymphatics: inguinal and iliac * Innervation: hypogastric and ovarian plexi, ¾ sacral nerves

Answer 56

* A: bladder * P: rectum * S: broad ligament * I: cervix, vagina * M: uterine cavity, endometrium * L: fallopian tube s

Answer 57

* Didelphys * Bicornuate * Unicornuate * Anteverted/retroverted * Anteflexed/retroflexed

Answer 58

* They are egg shaped structures located along the lateral pelvic wall bilaterally measuring approximately 2cc in volume * Within the shallow fossa in the angle between the internal and external iliac vessels * They are surrounded by a doubled layer of peritoneum known as the broad ligament, within a separate enclosure known as the mesovarium * Suspended within the suspensory ligament of the ovary running from the side wall to the ovary * They communicate with the peritoneum and have the fimbriae of the fallopian tubes medial to them

Answer 59

* A: ovarian arteries from the aorta, immediately below the renal arteries * V: right drains directly into the IVC, left drains into the left renal vein. * L: iliac lymph nodes or para-aortic

Answer 60

* A: broad ligament, mesovarium, obliterated umbilical artery * P: ureter, internal iliac vessels, suspensory ligament with ovarian vessels * S: external iliac vessels * I: levator ani * M: ovarian ligament, rectouterine pouch, bowel * L: obturator vessles and nerves, obturator internus and fascia, parietal peritoneum

Answer 61

* Suprapelvic position on psoas major * Inguinal canal location * Shape: spheroidal, flattene, cresenteric * Supranumerary * Absence or hypoplasia * Ectopic adrenal or thyroid tissue * Polycystic

Answer 62

* They are oval, egg shaped structures which measure approximately cc in volume * They are surrounded by a fascial layer known as the tunica albuginea, * From the mediastimum testis, there are several radiating septa extending into the testis forming 250-400 lobules. Contains 2-3 seminiferous tubules. Drains into the epididymis * Efferent ducts in the head of the epididymis unite to form the globus minor in the body and tail region which continues as the ductus deferens They are connected to the medial spermatic cord bilaterally which allows for ejaculation of sperm.

Answer 63

* Testicular arteries are from the * Venous drainage into the pampiniform plexus which surrounds the testes, then into the right and left testicular veins. The right drains directly into the IVC, the left drains into the left renal vein * Innervation is from the * Lymphatics: into the para-aortic or inguinal

Answer 64

* Superolaterally: epididymis * Otherwise surrounded by the pampiniform plexus and the layers of fascia forming the scrotum

Answer 65

* Unilateral undescended * Bilateral undescended * Unilateral/bilateral agenesis * Polyorchidism * Bilobed testes * Tersticular appendages

Answer 66

* Elongated structure, posterolateral to the testis, can be subdivided into 3 parts. Head, body and tail * Total length is 6-7cm * Head is the largest and most prominent part, at the superior pole of the testis, measures approximately 5-12 mm in length can have an appendix * Tail is found at the inferior pole

Answer 67

* The bladder is a rounded structure * It has a smooth outer surface and a slightly trabeculated inner surface, caused by the undistended detrusor muscle * At the posterior inferior surface there is the with the two urerteric and single urethral orifice.

Answer 68

* A: superior (internal iliac) and inferior (internal ) vesical arteries * V: similarly named veins * Lymphatics: iliac and inguinal lymph nodes * N: pelvic splanchnic, hypogastric plexus, sacral branches

Answer 69

* A: pubic symphysis * P: rectum * S: peritoneum – small bowel * I: levator ani * M: N/A * L: iliac vessels

Answer 70

* Hypospadias * Agenesis * Duplication * Ectopic ureteric insertion

Answer 71

* Attaches to the inner tip of the coccyx * Ischial spine and along the tendinous arch of the obturator fascia * Fuses with the pubococcygeus

Answer 72

* Causes the angle at the recto-anal angle, and assists in faecal continence * Is sling shaped

Answer 73

* From the inner surface of the pubis and the obturator fascia with fibres fusing medially at the perineal body and musculature of the prostate/vagina

Answer 74

* A: Internal pudendal branches of the internal iliac * V:Into the pudendal branches of the internal iliac * N: via the pudendal nerves of the lumbar and sacral plexi * L: inguinal and iliac lymph node chains

Answer 75

* A: pubic symphysis * P: coccyx * S: bladder, rectum, small bowel * I: anus, ischioanal fossa * M: N/A * L: side walls of the pelvis

Answer 76

* Large paired muscle of the posterior abdominal wall and pelvis. * Function: assists flexion of the hip, lateral flexion of the trunk. Stabiliser and flexor of the hip

Answer 77

* The lumbar plexus forms within the psoas muscle bilaterally * A: genitofemoral * L: iliohypogastric, ilioinguinal, lateral femoral cutaneous, femoral nerves * M: obturator, lumbosacral trunk

Answer 78

* Hypoplasia – unilateral/bilateral. * Division of the femoral nerve into multiple slips within the psoas prior to uniting as a common trunk * Origin from the sacrum * Separate tendinous insertion to the iliacus * Agenesis * Psoas minor muscle

Answer 79

* Origin * At the level of the pelvic brim where the internal iliac artery divides into its anterior and posterior divisions * Division at the superior brim of the greater sciatic foramen * Course * Courses down the lateral wall of the pelvis * Down the ischial spine anterior to piriformis giving off visceral and parietal branches

Answer 80

* Umbilical artery * Superior vesical * Obturator * Vaginal * Inferior vesical artery * Uterine artery * Middle rectal * Internal pudendal * Inferior gluteal

Answer 81

* Iliolumbar * Lateral sacral * Superior gluteal

Answer 82

* Superficial epigastric artery * Superficial circumflex iliac artery * Superficial external pudendal artery * Deep external pudendal artery * Terminal * Profunda femoris * Superficial artery

Answer 83

* Emerges from the inguinal ligament medial to the midpoint of the inguinal ligament and medial to the deep inguinal ring, halfway between the ASIS and symphysis pubis * Femoral vein medially * Runs down the anterior and medial thigh with first 4 cm enclosed within the femoral vein * Terminates within the femoral triangle

Answer 84

* A: skin, superficial fascia, superficial iliac circumflex vein, superficial layer of fascia lata, anterior femoral sheath * P: posterior femoral sheath, pectineal fascia, psoas major tendon, hip joint capsule, adductor longus, femoral vein * L: femoral nerve * M: femoral vein

Answer 85

* L: Medial border of sartorius * M: medial border of adductor longus * S: inguinal ligament * F: iliopsoas, pectineus * R: skin, subcut tissue, scarpas fascia, GSV, superficial lymph nodes

Answer 86

* Femoral nerve * Femoral sheath: femoral artery, femoral vein, femoral canal

Answer 87

* O: at the adductor canal * Course * Deepest structure on the floor of the popliteal fossa, superficial muscle * T: lower border of popliteus, divides into the anterior tibial and the tibioperoneal trunk

Answer 88

* Superior and inferior, medial and lateral genicular arteries * Middle genicular * Muscular * Cutaneous

Answer 89

* Starts medial to tibial nerve and ends lateral to it * Deep: popliteal surface of femur, knee joint capsular, popliteus * S: popliteal vein, tibial nerve * L: biceps femoris, lateral condyle of the femur, plantaris and lateral head of gastrocs * M: semimembranosus, medial condyle of femur, medial head of gastrocs

Answer 90

* O: one of the two terminal branches of the sciatic nerve , posterior divisions of the anterior rami of L4-S2 * Course: Diverges from the sciatic by sloping lateral and downwards to lie laterally in the popliteal fossa * Remains subfascial and winds around the fibular neck and enters lateral compartment of the leg * Divides into terminal branches into peroneus longus

Answer 91

* Peroneal communicating nerve * Lateral sural * Superior and inferior genicular * Recurrent genicular * Muscular * Terminal branches * Superficial and deep peroneal

Answer 92

* Ant * Plantaris * Lateral head of gastrocs * Knee joint capsule * Fibular origin of soleus * Post * Peroneus longus

Answer 93

* Level of the division * Sural communicating branch- absent 20%

Answer 94

* Origin: post division of L2-L4 * Course: * From lateral border of psoas to descend between the iliacus and psoas muscles * Motor branch to iliacus prior to passing under the inguinal ligament * Femoral triangle * Above iliacus, outside and lateral to the femoral sheath * Branch to pectineus * Lateral femoral circumflex artery separates nerve into superficial and deep divisions * Terminal branch reaches apex of the femoral triangle to become the saphenous vein

Answer 95

* Superficial division * Nerve to sartorius * Medial cutaneous nerve of the thigh * Intermediate cuteaneous nerve * Sympathetic vasomotor supply to blood vessels * Deep * Rectus femoris, vastus lateralis, intermedius and articularis genu, medialis, * Continues as the saphenous nerve (passing behind sartorius)

Answer 96

* Splits into separate slips within the psoas * Accessory femoral nerve * Femoral branch of the lateral femoral cutaneous nerve * Saphenous nerve

Answer 97

* O: Gluteal surface of ilium, behind posterior gluteal line, lumbar fascia, sacrum, sacrotuberous ligament * I: Gluteal tuberosity, ITB *

Answer 98

* O: gluteal surface of ilium, between the middle and posterior gluteal line * I: GT

Answer 99

* O: gluteal surface of the ilium between middle and inferior gluteal lines * I: GT

Answer 100

* M: natal cleft * L: hip joint * S: muscles of the posterior back * I: hamstrings muscles * A: ilium * I: sciatic nerve

Answer 101

* Max: superior and inferior gluteal arteries, med and min: superior gluteal artery * V: Similar to arterial supply * N: Medial and lateral gluteal nerves via the sacral plexus * L: into the inguinal lymphatic chain

Answer 102

* Extends flexed thigh at that hip * Stabilises hip and knee via attachment to ITB * Gluteus medius and minimus abduct the hip joint * Medial rotation of the thigh.

Answer 103

* Gluteus quartus * Fusion of the gluteus maximus and TFL

Answer 104

* Origin: ASIS * Insertion: most anterior tendon of the pes ansarenus, then to the medial tibia

Answer 105

* Posterior: rectus femoris, pectineus, adductor longus, adductor magnus * Medial: femoral nerve/artery/vein * Ant to the superficial femoral nerve * Deep: fascial roof of the adductor canal (superficial femoral vessels, saphenous, nerve to vastus medialis muscle) * Near origin: pierced by intermediate cutaneous nerve of the thigh * Near insertion: * Posterior: gracilis and semitendinosis * Deep: bursae * Infrapatellar branch of the saphenous nerve

Answer 106

* Arterial supply: * Venous drainage: small tributaries into the femoral vein * N: nerve of the anterior compartment of the thigh, femoral nerve (muscular branch from ant division for the femoral nerve) * L: into the inguinal chain

Answer 107

* Posterior tibial artery * Medial plantar artery * Lateral plantar artery * Dorsalis pedis

Answer 108

* Posterior tibial artery * Runs within the tarsal tunnel posterior to the medial malleolus * Lateral plantar artery * Crosses the sole of the foot obliquely towards the base of the 5^th metatarsal * Plantar arch: lies within the neurovascular plane deep to the plantar anastomoses, superficial to the long tendons

Answer 109

* Small saphenous * Lateral accessory * Superficial epigastric * Superficial circumflex iliac * Superficial external iliac * Superficial external pudendal * Deep external iliac veins * Anterior accessory saphenous

Answer 110

* Communicating branches with great saphenous * Cutaneous venous tributaries

Answer 111

* Originates as the continuation of the medial marginal vein * Anterior to the medial malleolus to ascend medial to and then posterior to the medial aspect of the tibia * Winds around the medial aspect of the knee and continues upwards to pierce the saphenous hiatus of deep fascia, 1-3cm distal to the inguinal ligament to drain into the femoral vein at the saphenofemoral junction * Relations * Branches of the saphenous nerve

Answer 112

* Originates at the lateral aspect of the foot, and continues superiorly along the lateral surface, it passes over the popliteal fossa and drains into the popliteal vein at the popliteal fossa

Answer 113

* Fenestrated great saphenous * Duplicated greater or lesser saphenous * Absence of the superficial system * Variable termination

Answer 114

* Floor: popliteus muscle * Roof: posterior fascia * Superior medial: biceps femoris * Superior lateral: Biceps femoris * Inferior medial and lateral: heads of gastrocnemius

Answer 115

* Popliteal artery and vein * Tibial nerve and fibular nerve * Knee joint * Geniculate arteries * Posterior femoral cutaneous nerve * Small saphenous vein * Popliteal lymph nodes

Answer 116

* O: head of the fibula * I: 1^st metatarsal and medial cuneiform

Answer 117

* Medial to the fibularis longus * Origin: lower 3 of the lateral surface of the fibula * Reaches under the sole of the foot to insert into the base of the 5th metatarsal

Answer 118

* A: branches of the peroneal nerve - * V: into the short saphenous vein * N: muscular branches of the common peroneal nerve - * L: popliteal lymph nodes

Answer 119

* Duplex belly of fibularis longus * Fusion of fibularis brevis and longus * Os peroneum

Answer 120

* Origin: long head - ischial tuberosity as conjoint tendon, short head – lateral linear aspera and lateral supracondylar line of the femur and adjacent intermuscular septum * Insertion: Fibular head, crural fascia, lateral tibial condyle * A: inferior gluteal artery, perforating artery, popliteal artery * V: femoral vein * N: long head: tibial division of the sciatic nerve, short head – common peroneal

Answer 121

* O: Ischial tuberosity * I: infraglenoid tubercle of the posterior medial tibial condyle, posterior joint capsule, popliteal fascia, posterior horn of medial meniscus * A: same as biceps * N: tibial N

Answer 122

* O: ischial tuberosity as conjoint tendon * I: most posterior tendon inserting into the pes anserinus

Answer 123

* Absence of short head * Exclusive tibial insertion * Absent semimembranosis * Accessory semimembanosus

Answer 124

* Superficial palmar arch * Superficial branch of the ulnar artery * Distal to the flexor retinaculum * Superficial to the long flexor tendons of the digits and deep to the palmar aponeurosis * Across the centre of the palm at the level of the distal border * Palmar digital artery * Branches off the superficial palmar arch * Runs on the ulnar side of the little finger * Common palmar digital arteries * 3 * Run in the webs between fingers, * Proper palmar digital arteries * Either side of the palmar aspect of each finger * Occasionally gives off a dorsal branch * Superficial palmar branch * Branch of the radial artery * Superficial to the thenar muscles

Answer 125

* Radial artery * Passes into the hand along the roof of the anatomical snuffbox then dorsally around the scaphoid and trapezium passing between the two heads of the 1^st dorsal interosseus muscle and between the two heads of adductor pollicis to enter the deep plane of the palm * Princeps pollicis * Along first metacarpal * Divides into two palmar digital branches at the metacarpal head * Radialis indicis * Radial aspect of index * Deep palmar arch * Originates between oblique and transverse heads of the adductor pollicis * Palmar metacarpal * 3 palmar metacarpal arteries * At the metacarpal heads * Perforate the interosseous spaces to anastamose with the dorsal metacarpal arteries

Answer 126

* Posterior carpal arch * Anastamosis between the dorsal carpal branches and the dorsal branch of the anterior interossesous artery * Dorsal metacarpal arteries * Split at the webs to supply dorsal sides of the fingers via the dorsal digital arteries Anastamose with the deep palmar arch via the palmar metacarpal arteries

Answer 127

* Origin * At the border of the first rib as the continuation of the subclavian * Termination * At the inferior border of teres major where it continues as the brachial artery * Parts * Divided into three parts by the pectoralis minor muscle * 1^st part: proximal to the pectoralis minor * 2^nd part: behind the pectoralis minor * 3^rd part: distal to the pectoralis minor

Answer 128

* 1^st part: 1 branch * Superior thoracic artery (supplied pec maj and min) * 2^nd part: 2 branches * Thoracoacromial * Lateral thoracic * 3^rd part: 3 branches * Subscapular artery * Anterior humeral circumflex * Posterior humeral circumflex

Answer 129

• Commences at the confluence of the dorsal veins of the hand runs along the medial aspect of the arm • Anterior the medial epicondule of the humterus • Penetrates the brachial fascia at the basilic hiatus • Courses medially to the brachial artery • Tributaries: median cubital vein, median antebrachial vein

Answer 130

• Origin is at the anatomical snuffbox on the radial side of the superficial venous network • Course o Around the radial aspect of the foream, through the anterolateral forearm o Passes upwads over the anterior elbow region and through the anterolateral brachium lateral to the biceps muscle in the deltopectoral gorrve o Through the anterior wall of the axilla perforating the clavipectoral fascia • Tributaries o Accessory venous plexi o Unite medial to the elbow.

Answer 131

origin: union of the ulnar and radial veins in the cubital fossa location: courses superiorly in the upper arm, often in close proximity to the brachial artery1 drainage: deep and superficial palmar venous arches termination: union of the brachial and basilic veins at the inferior border of teres major forms the axillary vein

Answer 132

 Two roots:  Lateral cord – C5,6,7  Medial cord – C8, T1

Answer 133

 Lies medial to the axillary artery  Enters the arm from the axilla at the inferior margin of the teres major and descends medially between biceps and triceps.  In the arm, laterally to the brachial artery and crosses it anteriorly from lateral to medial. Lies on corachobrachialis then brachialis  Cubital fossa: medial to the brachial artery and biceps brachii  Enters the forearm between the two heads of pronator teres  Gives off the anterior interosseus nerve  Deep to FDS and superficial to FDP  Enters the hand through the carpal tunnel

Answer 134

 Muscular branch: pronator teres  Elbow: superficial layer of forearm flexors and intermediate latyer  Anterior interosseus nerve  Palmar cutaneous branch  Recurrent branch in the hand: thenar muscles  Digital cutaneous branch  Articular branches of: elbow, wrist, carpal and phalangeal joints

Answer 135

o Persistent median artery of the forearm o Accessory branches arising proximal or distal to the carpal tunnel o Variant course of the thenar branch o Aberrant origin to the motor branch o Anastamoses between median and ulnar

Answer 136

* A: left anterior descending, left circumflex artery * V: drains into the great cardiac vein, through thebesian veins * N: receives both parasympathetic supply (via the vagus) and parasympathetic supply (via the cardiac plexus) * Lymph: drains to the perihilar and mediastinal lymphnode groups

Answer 137

* A: IV septum, RV * P: descending aorta, L vagus, sympathetic chain * S: L atrium * R: Right pleura * L: L lung pleura and L phrenic * I: diaphragm

Answer 138

* Parachute valve * Double inlet ventricle * Interventricular septal defect * Tetralogy of Fallot * Transposition of the great vessels

Answer 139

* S: SVC * I: IVC * P: interatrial septum, fossa ovalis * A: cardiac wall * L: R AV ostium

Answer 140

* Divided into 2 parts by the crista terminalis * Sinus venarum cavarum * Posterior to the crista terminalis * Drains IVC and SVC * Smooth wall * Atrium * Anterior half * Ridged by pectinate muscles fanning out from crista terminalis

Answer 141

* SVC * IVC * Coronary sinus * AV ostium

Answer 142

* A: right coronary, conus and sinoatrial, acute marginal * V: thebesian veins, * N: cardiac plexus and vagus nerve * Lymph: mediastinal groups

Answer 143

* P: left atrium, * R: right lung, * L: right ventricle, aortic root and valve * S: SVC I: IVC

Answer 144

* Chiari network * Incomplete closure of the foramen ovale * Variable size of the fossa ovalis * Doubled coronary sinus * May drain into left atrium * SVC may be joined into the left atrium

Answer 145

* Initially runs down the midline of the neck, posterior to the trachea * Returns to midline at the level of T4-5 * Returns to left of midline in posterior mediastinum * Passes through the oesophageal hiatus at the level of T10 along with the thoracic duct * Has a very short abdominal course and terminates as the cardiac sphincter

Answer 146

* Cervical: cricoid cartilage at C5-6 * Thoracic: aortic arch at T4-5 * Abdominal: oesophageal hiatus at T10

Answer 147

* Superior 1/3 * A: inferior thyroid * V: inferior thyroid * Middle 1/3 * A: direct branches from the aorta * V: azygos direct branches into the IVC * Inf: * A: branches of the left gastric artery * V: left gastric vein into the portal circulation * Lymphatics: deep cervical, posterior mediastinal, left gastric and coeliac group * Innervation: symp: oesophageal plexus, parasym: vagus

Answer 148

* A: trachea, recurrent laryngeal nerves, Left main bronchus, left atrium * P: vertebral column, descending aorta, thoracic duct, accessory hemiazygous and hemiazygos * L: lung, pleura, L subclavian artery, thoracic duct * R: lung, pleura, azygos vein

Answer 149

* Oesophageal atresia * Tracheo-oesophageal fistula * Oesophageal bronchus * Aberrant right subclavian artery

Answer 150

* Oblique pericardial sinus * Formed by the superior and inferior vena cava and the four pulmonary veins, posterior to the left atrium * Transverse pericardial sinus * Between the aorta and the atria, surrounding the ascending aorta

Answer 151

* Agenesis * Dysgenesis * Partial covering * Variant recesses

Answer 152

* Aortic (from the transverse) * Superior aortic recess: from its mouth located inferiorly, ascends posterior to then to the right of the ascending aorta and ends at the level of the sternal angle * * Diverticulum descending from superiorly located mouth to run between the lower ascending part of the aorta and the right atrium * Pulmonic recesses * Right: posterior to the right pulmonary artery and anterior to the oesophagus * Left: superior relation is the left superior pulmonary vein and medially by the ligament of Marshall * Post caval * Posterior to the superior vena cava, superior to the right superior pulmonary vein, inferior to the right pulmonary artery * Pulmonary venous recesses * Right and left: medially and upward on the back of the left atrium between the superior and inferior pulmonary veins on each side, indenting the side walls

Answer 153

* A: internal thoracic and pericardiophrenic and musculophrenic branches, branches from the descending thoracic aorta * V: pericardiophrenic veins * I: phrenic nerves, vagus n, sympathetic trunks L: tracheobronchial nodes, pre-pericardial nodes

Answer 154

* A: body of the sternum, cartliages of the L 3-7 ribs, pleura and lungs and thymus * P: oesophagus, descending thoracic aorta, pleura, lungs * Laterally: pleura and lungs, phrenic nerves * I: blends with central tendon of the diaphragm

Answer 155

* Parietal: continuous with the chest wall, named according to the site it lines * Cervical * Costal * Diaphragmatic * Mediastinal * Visceral: continuous with the lungs, this has multiple fissures and invaginations

Answer 156

* Lines of reflection * Above clavicle 1 inch above the mid point of the medial third of the clavicle * 2^nd rib: both descend down the midline * 4^th rib: left pleural line deviates laterally to accommodate the heard * 6^thrib: both lines deviate laterally to accommodate the heart * 8^th rib: both pass the MCL * 10^th rib: right and left pleural lines pass the midaxillary line * 12^th rib: both travel posteriorly around the chest wall

Answer 157

* Costodiaphragmatic * Costomediastinal * Phrenicomediastinal * Vertebromediastinal recesses

Answer 158

* Neurovasculature * A: parietal = internal thoracic, intercostal and phrenic arteries, visceral = bronchial * V: parietal = internal thoracic, intercostal and phrenic veins, visceral = pulmonary veins * Lymphatics: within the deep pulmonary plexus Innervation: costal = intercostal nerves, mediastinal and diaphragmatic = phrenic

Answer 159

* Accessory fissures * Left accessory * Right azygos

Answer 160

* Superior: superior border of the cricoid cartilage * Inferior: inferior border of the thyroid cartilage

Answer 161

* Below the level of the vocal cords * To the inferior aspect of the cricoid cartilage

Answer 162

* At the level of the vocal cord * Anterior and posterior commisures

Answer 163

* Contains the aryepiglottic folds * Epiglottis * Pre-epiglottic space * Arytenoid cartilages * False vocal cords * Paraepiglottic space

Answer 164

* Areytenoid * Accessory * Cuneiform * Corniculate

Answer 165

* Thyroid * Cricoid * Epiglottic * Connected by the cricothyroid membrane

Answer 166

* Ant: strap muscles, anterior jugular * Post: oesophagus, laryngopharynx * Sup: hyoid, laryngopharynx * Inf: trachea

Answer 167

* * Above the vocal cords: superior laryngeal artery * Below: inferior laryngeal artery * Venous * Above: superior laryngeal vein * Below: inferior laryngeal vein * Lymphatics * Supraglottic: follows the superior laryngeal artery in to the superior deep cervical nodes and the pre-epiglottic nodes * Subglottic: inferior deep cervical chain nodes, into the right lymphatic duct and thoracic duct on left * Innervation * Recurrent laryngeal nerves provide motor control to the vocal folds * Sensory above the supraglottic region: internal laryngeal nerve * Subglottic region: recurrent laryngeal nerve

Answer 168

* It is formed by two paired lobes which are connected by a central isthmus * Lies from C5-T1 * Butterfly shaped * Two lobes, each with a superior and inferior pole * Isthmus is adherent to 2-4^th tracheal rings

Answer 169

* Supplied by the superior and inferior thyroid arteries * Superior from the external carotid artery * Inferior from the thyrocervical trunk from the subclavian artery * * Superior thyroid * Middle thyroid * Inferior thyroid * * Into perithyroid lymph nodes, prelaryngeal, pretracheal and paratracheal * Neuro * Superior, middle and inferior cervical ganglia

Answer 170

* Posterior: parathyroid glands are embedded within it, one in each of the superior and inferior portions of the lobes, trachea * Anterior: platysma, visceral fascia, * Lateral: carotid sheath containing the common carotid arteries, internal jugular veins, vagus nerve, sternocleidomastoid * Superior: Cricoid cartilage

Answer 171

* Pyramidal lobe * Hemithyroid agenesis * Ectopic thyroid tissue * Base of tongue * Thyroglossal duct cysts * Arterial supply via the thyroid ima artery from the aortic arch

Answer 172

* At the foramen caecum in the midline of the base of the tongue * During the 5^th embryonic week, migrates inferiorly to the body of the hyoid bone, * Forms the thyroglossal duct

Answer 173

* Origin: pterygoid hamulus, pterygomandibular raphe, mandible * Artery: ascending pharyngeal artery N: pharyngeal plexus

Answer 174

* Origin: greater cornu of the hyoid bone, lesser cornu and the stylohyoid ligament * A: pharyngeal branch o the ascending pharyngeal artery, tonsillar branch of the facial artery * N: pharyngeal plexus

Answer 175

* Origin: Cricoid cartilage, * A: ascending pharyngeal, * Thyropharyngeal muscle * Cricipharyngeal muscle

Answer 176

* Common carotid artery * Auditory tube * Levator palati * Ascending palatine artery

Answer 177

* Superior laryngeal artery and nerve * Stylopharyngeus * Glossopharyngeal

Answer 178

* External laryngeal nerve * Internal branch of the superior laryngeal nerve * Superior laryngeal artery

Answer 179

* Inferior laryngeal nerve * Inferior laryngeal artery

Answer 180

* Origin: TP of 3^rd-6^th cervical processes * Insertion at the scalene tubercle on the first rib

Answer 181

* A: phrenic and vagus neves, ascending cervical, transverse cervical and suprascapular arteries, internal jugular and subclavian veins, sternocleidomastoid and omohyoid muscles, clavicle * P: second portion of subclavian, scalenius medius, anterior rami of C3-t1 * M: CCA, 1^st portion of subclavian, thyrocervical trunk, vertebral artery and vein, stellate ganglion, thoracic duct/lymphatic duct * L: trunks of the brachial plexus, 3^rd portion of the subclavian

Answer 182

* Branches of the ansa cervicalis * Arterial supply from the * Venous drainage into the intercostal veins

Answer 183

* There are two head: * Insertions: Mastoid process, lateral half of the superior nuchal line * Medial third of the clavicle * Suprasternal notch of the sternum * * Sternal head passes over the sternoclavicular joint and joins the clavicular head halfway up the neck * Common belly then passes posterolaterally to the insertion

Answer 184

* Spinal accessory nerve * Arterial: superior thyroid and occipital arteries * Venous: jugular veins

Answer 185

* Upper half * P: cervical plexus, * A: platysma, external jugular vein * Lower half : * Post: ant scalene, CCA, IJV, carotid sheath * Ant: platysma

Answer 186

* Separate sternomastoid and cleidomastoid heads * Absent clavicular or sternal head * Fusion with trapezius * Additional clavicular head * Doubled or quadrupled * Absent

Answer 187

* Parts: gland, canaliculi, sac, duct * Drains to the inferior nasal meatus * Lacrimal canaliculi: superior and inferior on each side * Common canaliculis drains to the lacrimal sac posterior to MPL and anterior to the orbicularis occuli * Lacrimal sac * Lies within the lacrimal fossa * Superior fundus which tapers inferiorly * Enclosed by the lacrimal fascia * Nasolacrimal duct * Two parts: membranous and osseus * Inraossueus : lies within the nasolacrimal canal of the maxilla * Membranous part: within the nasal mucosa, terminates below the inferior nasal meatus, valve of HASLER

Answer 188

* Arterial: ophthalmic artery Vein: superior and inferior ophthalmic veins

Answer 189

* Parasympathetics: lacrimal branch of the frontal nerve (ophalthamic division of trigeminal) * Sympathetics * Via the superior ophthalmic plexus Greater and deep petrosal nerves

Answer 190

* Incompetent valve of hasler * Drains into the inferior meatus * Variable number and course of the canaliculi

Answer 191

* Of the lacrimal gland * S: superior wall of the orbit * Inferomedial: globe

Answer 192

* There are 6 muscles: Superior rectus (SR), Inferior rectus (IR), Medial rectus (MR), Lateral rectus (LR), inferior oblique (IO), and superior oblique (SO) * SR, MR, IR and LR have a common origin at the tendinous annulus of Zinn * IO originates from the superior surface of the maxilla * SO originates from the greater wing of the sphenoid and hooks over the tendinous trochlear prior to insertion

Answer 193

* Innervation * IO, SR, IR and MR are supplied by the inferior division of the oculomotor nerve * LR is supplied by abducens nerve * SO is supplied by the trochlear nerve * Arterial supply * Branches of the ophthalmic artery * Venous drainage * Via the superior and inferior ophthalmic veins and the infraorbital vein

Answer 194

* Variable blood supply * Variable origins of the IO and SO

Answer 195

* Sphenopalatine * Anterior ethmoidal * Posterior ethmoidal * Superior labial * Greater palatine

Answer 196

* Division of sphenopalatine * Common trunk ant and post ethmoidal

Answer 197

* M: perpendicular plate * L: pterygomaxillary fissure * A: post wall of maxilla * P: medial and lateral pterygoid plates, inferior aspect of the lesser wing of the sphenoid * R: inferior orbital fissure, sphenoid bone Floor palatine canal

Answer 198

* Sphenpalatine foramen: communicates with the nose, transmits the sphenopalatine artery * Pterygomaxillary fissure: communicates with the masticator face (infratemporal fossa) * Inferior Orbital fissure: * Foramen rotundum: meckel’s cave, cavernous sinus * Vidian canal – vidian N * Greater and lesser palatine canals

Answer 199

* The part of the maxillary artery * Pterygopalatine ganglion * Maxillary artery * Maxillary division trigeminal * N of pterygoid canal

Answer 200

* Frontal * Zygomatic * Maxillary * Ethmoid * Lacrimal * Sphenoid – both greater and lesser wings * Palatine

Answer 201

* The orbit has three main communicating orifices * Superior orbital fissure * Contains the ophthalmic artery, ophthalmic nerve, frontal and lacrimal nerves, CN III,IV and VI and the superior ophthalmic vein * Optic canal * CN II, central retinal artery, sympathetic nerves, meningeal layers * Inferior orbital fissure * Inferior ophthalmic vein * Infraorbital canal * Contains the infraorbital nerve * Anterior and posterior ethmoidal foramina * Anterior and posterior sphenopalatine foramina

Answer 202

* Variable presence of sutures and joints * Ophthalmic artery can originate from the middle meningeal artery * Absent IOF * Accessory SOF

Answer 203

* There are 4 key spaces of the bony orbit * Globe * Optic nerve complex * Intraconal * Conal * Extraconal

Answer 204

* The maxillary sinuses form part of the paranasal sinuses * They are contained within the maxillary bones * Paired structure located at the front of the face, which hare shaped as inverted pyramids, with the apex directed inferomedially * Allow for vocal resonance and lightens the head

Answer 205

* S: floor of orbit * I: hard palate * M: vomer * L: zygoma * A: maxilla, infraorbital nerve * P: Base of skull, middle cranial fossa

Answer 206

* Art: sphenopalatine, branches of the external carotid and maxillary arteries * Facial, maxillary, infraorbital and greater palatine * V: facial vein, - * Neuro: sphenoparietal * Lymph: into the submental or anterior chain lymph nodes

Answer 207

* * Concha bullosa * Haller cells * Infraorbital air cells Silent sinus

Answer 208

* Shaped as a flat cone pointing to the middle and inner ear * The deepest point is the umbo * Attaches to an incomplete ring of bone along the wall of the EAC, tympanic annulis * 3 layers * Cutaeneum * Radiatum circulare * Mucosa

Answer 209

* Pars tensa * Tense, largerportion of the membrane * Extends from the anterior and posterior malleolar folds at the level of the lateral process of the malleus to the inferior edge of the membrane * Pars flaccida * Smaller and is the portion above the anterior and posterior malleolar folds

Answer 210

* Innervation * External surface: auricular temporal, greater auricular nerve, arnold’s nerve * Internal surface: Jacobson’s nerve * Arterial supply * * Deep auricular artery * * Anterior tympanic * Stylomastoid branch of the posterior auricular artery * Venous drainage * Pterygoid plexus * Superior petrosal sinus * * Pre-auricular nodes * Retropharyngeal nodes * Superior deep cervical nodes

Answer 211

* S: tegmen tympani, jugular bulb * I: parotid * A: TMJ * P: Mastoid * M: stapedius * L: external acoustic canal

Answer 212

* Agenesis * Variant nervous supply

Answer 213

* It can be divided into a superficial and deep lobe * Completely enclosed by the parotid fascia * Transmits saliva along Wharton’s duct, which opens behind the second molar * Structures enclosed within it * Retromandibular vein * Division of the extracranial facial nerve * Intraparotid lymph nodes * ECA: branches into its terminal branches: superficial temporal and Maxillary artery * Inferior projection is known as the tail, lower 2cm of the gland

Answer 214

* Innervation: sensory – auriculotemporal, greater auricular, parasympathetic – aurocotemporal, sympathetic – plexus surrounding the ECA * Arterial spply * Transverse facial artery * * Plexus then into the internal jugular vein * Lymphatics * Deep cervical chain

Answer 215

* Superior pole: external acoustic meatus, TMJ * Lower pole: behind angle of mandible, ant to SCM and post belly of digastric * Lateral surface: SC tissue * Ant: ramus of the mandible, masseter on its outer surface and medial pterygoid on its inner surface * Parotid duct and facial nerve branches emerge * Deeper part: ST and maxillary arteries emerge * Deep surface * Indented by the mastoid process * ECA enters * Styloid process separates form the IJV and the ICA

Answer 216

* Agenesis * Accessory parotid glands * Accessory parotid ducts * Facial nerve divides proximal to its entrance to the parotid * Facial nerve divides distal to its entrance to the parotid. * Facial process * Ectopic parotid tissue * Parotid duct duplication * Congenital agenesis

Answer 217

* Temporalis * O: from the temporal fascia * I: coronoid process * A: Deep temporal branches and middle temporal V: retromandibular/facial vein

Answer 218

* O: zygoma * I: inferior aspect of the angle of the mandible * A: masseteric artery of the maxillary artery, facial artery, transverse facial branch of the superficial temporal artery

Answer 219

* O: Two heads * Superficial head: maxillary tuberosity, pyramidal process of the palatine bone * Deep head: from the medial aspect of the lateral pterygoid plate * I: Mandibular angle and ramus * Innervation: mandibular division of the * Arterial supply: maxillary artery

Answer 220

* O: two heads * Upper: lower part of the lateral surface of the greater wing of the sphenoid and infratemporal crest * Lower: lateral surface of the lateral pterygoid * I: * Upper: TMJ capsule * Lower: pterygoid fovea Action: opens the mouth

Answer 221

* All are contained within the masticator space * A: Skin * P: Mandible, pterygopalatine fossa * S: Zygoma, temporal fossa, middle cranial fossa, orbit * I: submandibular glands, digastric, floor of mouth, tongue

Answer 222

* Originates from the ICA from the ophthalmic portion * Course * Passes through the optic canal * Gives off its major branches * Termination * Two terminal branches are

Answer 223

* Orbital * Lacrimal * Supraorbital * Ethmoidal – anterior and posterior * Internal palpebral * Supratrochlear * Dorsal nasal * Ocular * Central retinal * Long and short posterior ciliary * Anterior ciliary * Muscular

Answer 224

* Sympathetics: internal carotid plexus * Parasymp: via the vagus

Answer 225

* Course * Through the stylomastoid foramen * Gives off the posterior auricular * Passes between the posterior belly of digastric muscle and the stylohyoid muscle * Passes anteriorly through the parotid * Where it divides * Terminal branches * Temporal * Zygomatic * Buccal * Marginal mandibular * Cervical

Answer 226

* Muscles of facial expression * Stylo * Posterior belly of digastric Stapedius muscle

Answer 227

* Labyrinthine * Superficial petrosal Stylomastoid

Answer 228

* Defined as the area outside the conal muscles * Base which is anterior and formed by the orbital septum. External sides formed by the bones of the orbit. Internal sides formed by the extraocular muscles

Answer 229

* Lacrimal gland * Lacrimal duct * Lacrimal, and frontal, nasociliary nerves * Zygomatic nerves, infraorbital nerve * Lacrimal, supraorbital, ant and post ethmoidal, internal palpebral, supratrochlear, dorsal nasal, infraorbital * Levator palpabrae superioris muscle * Superior ophthalmic, inferior ophthalmic vein, infraorbital vein Extraocular fat

Answer 230

* Contains the extraocular muscles * Inferior rectus, SR, MR,LR, * Periorbital fascia * Space containing the structures attaching the tendinous annulus of Zinn

Answer 231

* Neves: Optic, oculomotor and nasociliary, abducens, ciliary * Ophthalmic – central retinal Fat

Answer 232

* Ant: posterior nares, posterior margin of nasal septum * Inf: soft palate * Sup: basisphenoid, basiocciput. * Post: C1, 2 * L: pharyngeal opening of the Eustacian tube, fossa of Rosenmuller

Answer 233

* Art: ascending pharyngeal, ascending palatine, ascending cervical, maxillary * Venous: pharyngeal venous plexus, pterygoid plexus * Innervation * Motor: Pharyngeal plexus * Sensory, pharyngeal nerve of the max division of trigeminal, glossopharyngeal * Lymphatics * Anterior cervical chain

Answer 234

* A: nasal cavity * P: clivus/ BOS * I: oropharynx * S: middle cranial fossa * M: none L: pterygopalatine fossa

Answer 235

* Med: body of sphenoid * Sup: lesser wing * Inf: greater wing * Lat: frontal bone

Answer 236

* Lacrimal * Frontal * Superior ophthalmic vein * Trochlear * Superior division of oculomotor * Nasociliary * Inferior division of oculomotor * Abducens * Inferior ophthalmic vein

Answer 237

* Air cells (3-18) separated by bony septa * Separated into anterior and posterior groups by the basal lamella, lateral attachment of the middle turbinate to lamina papyracea * Anterior: drain to the hiatus semilunaris and middle meatus via the ethmoid bulla Posterior: drain to the superior meatus via the sphenoethmoidal recess

Answer 238

* Supplied by the anterior and posterior ethmoidal arteries, * Venous drainage: inferior petrosal sinus * Innervation: Lymphatics: submandibular and retropharyngeal

Answer 239

* Anteriorly: nasal bone * Posteriorly: sphenoid sinus * Medially: nasal septum * Laterally: lamina papyracea * S: orbits/ middle cranial fossa * I: nasal cavity

Answer 240

* Accessory cells * Agger nasi * Haller * Onodi

Answer 241

* Maxillary ostium * Drainage channel of the maxillary sinus * Infundibulum * Common channel draining the ostia of the maxillary antra and anterior ethmoid air cells * Ethmoid bulla * Single air cell projecting over the hiatus semilunaris * Uncinate process * Hook like process arising from the posteromedial aspect of the nasolacrimal duct * Hiatus semilunaris

Answer 242

* The maxillary sinus and ethmoid air cells drain into the anterior portion of the hiatus semilunaris * The frontal and sphenoid sinuses drain into the posterior portion of the hiatus semilunaris * Drains into the middle meatus of the nasal cavity

Answer 243

* Concha bullosa * Intralamellar cell * Haller cells * Deviation of the uncinate process * Deviated nasal septum

Answer 244

* Origin * The biliary ducts originate at the center of the hepatic cell * They then course through the liver and coalesce * Course * Right: anterior and posterior * Segments VI and VII right posterior * Segment V and VIII right anterior * Left: superior and inferior * Combine to form the right and left hepatic ducts * Combine to form the common hepatic duct * This courses anteriorly to the portal vein and laterally to the right and left hepatic arteries at the porta hepatis * This then courses down in the free edge of the omentum, giving off the cystic duct within Calot’s triangle * It continues as the common bile duct at this point * Termination * Forms the Ampulla of vater with the pancreatic duct * In the major duodenal papilla in the inferior aspect of the D2 segment of the duodenum

Answer 245

* Art: hepatic arteries, cystic artery and branches of the pancreaticoduodenal and gastroduodenal artery * Vein: directly into the portal system * Nerve: sympathetics by the greater splanchnic, parasympathetics from the coeliac plexus * Lymphatic: portal lymph nodes

Answer 246

* Posteriorly: portal vein * Laterally: hepatic artery

Answer 247

* Trifurcation at the porta hepatis * Duplication * Combines with the pancreatic duct

Answer 248

* Part of the large bowel * Blind ending sac * Measuring 6cm * Covered by peritoneum * Variable mesentery * Located within the right iliac fossa * Originates with the fatty iliocaecal valve * Continuous superiorly with the ascending colon * Has the expected 3 layers * Mucosa, submuscosa and muscularis propria * The teniae coli continue through the small bowel. * These converge at the base of the appendix which is continuous with the caecum inferiorly

Answer 249

* Art: branches of the SMA * Venous drainage: caecal veins draining into the SMA * Lymphatics: mesenteric then SMA nodes * Innervation: parasymp: sma plexus, symp from the great splanchnic nerves

Answer 250

* A: small bowel, anterior abdominal wall * P: ilium * S: ascending colon * I: lateral pelvic wall and appendix, * M: terminal ileum, ileocaecal valve L: pelvic side wall

Answer 251

* Caecal bascule * Subhepatic caecum * Mobile caecum * Variable position of the appendix

Answer 252

* The first and 3 parts are retroperitoneal structures * It forms a rough C shape: with the head of the pancreas lodged within the curve * Measures 20-30cm * At the level of L1-3

Answer 253

* First part of the duodenum * Horizontally: passes laterally to the right, superiorly and posteriorly for approximately 5cm, makes a sharp curve inferiorly * Relations * A: gallbladder, liver * P: gastroduodenal artery, portal vein, common bile duct * I: head of pancreas * S: epiploic foramen M: pyloric sphincter

Answer 254

* Second part of the duodenum * Vertically: passes inferiorly to the lower border of the vertebral body, makes a sharp turn to the inferior duodenal flexure * A: transverse mesocolon * P: right kidney, right ureter, right adrenal gland * S: liver/gallbladder * I: jejunum * M: head of the pancreas * L: ascending colon, hepatic flexure, right kidney * Ampulla of vater is at the inferior portion

Answer 255

* 3^rd part * Horizontal: passes transversely to the left crossing the vertebral column * A: root of the small bowel mesentery * P: right psoas, right ureter, gonadal vessels, aorta, IVC * M: duodenum * L: duodenum * S: head of pancreas I: jejunum

Answer 256

* 4^th part * Angles superiorly: to the ligament of trietz * Relations * * S: stomach * I: loops of ileum * P: left psoas, aorta

Answer 257

* Arterial: From the coeliac trunk and the SMA via the , inferior and superior pancreaticoduodenal arteries * Venous: similarly named veins draining into the portal venous system * Lymphatics: into the SMA and coeliac plexi * Innervation: greater splanchnic nerve

Answer 258

* Duodenal diverticulum * Duodenal duplication

Answer 259

* Its is an approximately 10cm sac * Has a fundus, neck and body * Communicates with the biliary tree via the cystic duct * Microscopic * Serosa * Muscular * Lamina propria Mucosa

Answer 260

* Arterial: cystic artery from the common hepatic artery * Venous: directly into the portal venous system * Lymphatics: cholecysto-retropancreatic, choleycsto-coeliac, cholecysto-mesenteric Innervation: greater splanchnic, coeliac plexus

Answer 261

* A: visceral surface of the liver, transverse colon, 9^th costal cartilage * P: right kidney, distal first part, proximal second part of the duodenum * M: first part of the duodenum, free margin of the lesser omentum and epiploic foramen * L: right lobe of the liver * S: visceral surface of the liver, anterior abdominal wall * I: transverse colon, second part of the duodenum

Answer 262

* Phrygian cap * Sigmoid * Septation * Single or multiple * Hartmann pouch * Floating gallbladder * Accessory gallbladder * Agenesis * Duplication * Cystic duct * Cystic artery

Answer 263

* 25-30cm long * 3 parts * Abdominal: from the renal pelvis to the pelvic brim * Pelvic: pelvic brim to the bladder * Intramural: within the bladder wall * Origin * They originate at the renal pelvis passing anteriorly to the renal vein and posterior to the renal artery * They are formed by the superior and inferior calyces * Constrictions * PUJ * Pelvic brim * VUJ

Answer 264

* Course within the retroperitoneum * Along the transverse processes of the L2-5, anterior to the medial edge psoas muscles * Enter the pelvis and pass anteromedially to the sacroiliac joint at the bifurcation of the common iliac vessels * Down anterior to the internal iliac artery down the lateral pelvic sidewall * At the level of the ischial spine it turns forward and medially to enter the posterolateral wall of the bladder where it runs an oblique 1-2cm course

Answer 265

* Upper * A: ureteric branches of the renal arteries * V: ureteric veins draining into the renal veins * Middle * Branches of the lumbar arteries and veins * Lower * Branches of the superior vesical arteries and veins * Lymphatic * Aortocaval and common iliac, internal and external iliac * Innervation * Renal, aortic, hypogastric autonomic plexi

Answer 266

* Post: psoas, genitofemoral nerve, common iliac vessels, tips of L2-5 TP * Ant: * Right: descending duodenum, gonadal vessels, right colic vessels, ileocolic vessels * L: gonadal artery, left colic, loops of jejunum, sigmoid mesentery and colon * M: * R: IVC * L: abdominal aorta, IMV

Answer 267

* Post: Sacroiliac joint, internal iliac artery * * Male: seminal vesicle * Female: lateral fornix of the vagina * * Male: ductus deferens * Female: uterine artery * * Female: cervix

Answer 268

* Duplex * Bifid * Agenesis * Partially duplicated * Ectopic insertion * Ureterocele * Cicumcaval

Answer 269

* Enclose within the perirenal fascia * Two portions, outer cortex, inner medulla. * Surrounded by a collagenous cpsule * Cortex is subdivided into 3 zones * Glomerulosa * Fasciculata * Reticulata * Each adrenal gland is formed by a medial and lateral limb with a common body. * They are located above the superior pole of the kidneys bilaterally and are therefore retroperitoneal organs

Answer 270

* A: superior, middle and inferior adrenal glands (from the aorta and renal arteries) * V: superior middle and inferior adrenal glands * Innervation: sympathetics from the paraortic plexus Lymphatics: para-aortic lymph nodes

Answer 271

* A: peritoneum * P:right kidney * S: right hemidiaphragm * I: IVC * M: right crus, right inferior phrenic artery * L: bare area of the liver

Answer 272

* Pancake * Ectopic * Agenesis * Duplication * Accessory * Hypoplasia * Horseshoe

Answer 273

* Segments * 1:caudate lobe * Bounded posteriorly by the fossa for the IVC, ant by the ligamentum venosum, inf by portal hepatic * 2: above the portal vein, to the left of the left hepatic vein * 3: below the portal vein to the left of the hepatic vein * 4a: above the portal vein between the middle and left hepatic veins * 4b: below the portal vein, between the left and middle hepatic veins * 5: below the portal vein, between the middle and right hepatic veins * 6: below the portal vein, to the right of the right hepatic vein * 7: above the portal vein, to the right of the right hepatic vein * 8: above the portal vein, between the middle and right hepatic veins

Answer 274

* It is approximately 3 x5x 7 inches * Lies between ribs 9-11 * The spleen has three borders * Superior * Inferior * Intermediate * Two surfaces * Diaphragmatic and visceral * Enclosed in a thin capsule * There are often multiple spenuncules * Ligaments * Gastrosplenic * Attaches the spleen to the greater curvature of the stomach * Contains the short gastric and left gastroepiploic arteries * Splenorenal * Attaches the spleen to the left kidney * Contains splenic artery and vein and the pancreatic tail

Answer 275

* Art: splenic artery (direct branch of the coeliac * V: splenic vein (drains into the portal) * L: retropancreatic lymph nodes * Innervation: symp: coeliac plexus, parasym: vagal trunk

Answer 276

* A: ribs 9-11 * P: right hemidiaphragm * S: right hemidiaphragm * I: splenic flexure of the colon * M: pancreatic tail L: ribs

Answer 277

* Wandering * Polysplenia * Asplenia * Splenogonadal fusion * Retrorenal * Splenic cleft

Answer 278

* Skin * Campers * Scarpas * External oblique * Internal oblique * Transversus abdominis * Fascia transversalis * Parietal peritoneum

Answer 279

* A: superior and inferior epigastric arteries from the internal thoracic and anterior divisions of the internal iliac arteries, superficial epigastric, superior circumflex iliac, superficial external pudendal arteries * V: similarly named veins * Innervation: anterior rami of the lumbar segmental nerves * Lymph * Above the umbilicus : axillary and sternal * Below umbilicus: superficial inguinal

Answer 280

* Rectus dibarification * Spigellen hernia * Level of the arcuate line * Number of the horizontal septations * Pyrimidalis and sternalis

Answer 281

* Composed of the aponeuroses of the transversus abdominis, external oblique and internal oblique muscle * Fuse laterally at the linea semilunaris * Inferior to the arcuate line, the internal oblique aponeurosis passes anterior to the rectus abdominis, the posterior surface of rectus abdominis is in contact with the transversalis fascia * Contains * Rectus abdominis and pyramidalis muscles * Lower 6 thoracic nerves, branches of the posterior intercostal vessels * Superior and inferior epigastric vessels

Answer 282

* The kidneys are supplied by the renal arteries bilaterally * These arise at the level of * Courses inferiorly and passes posterior to the IVC and the right renal vein to reach the renal hilum. * They are retroperitoneal * Divide into 3 branches * Superior * Gives off the inferior adrenal artery * Middle * Inferior * Further divide into ureteric, capsular and cortical branches * There are also lobar, and interlobar branches

Answer 283

* Drained by similarly named veins * The right renal vein drains directly into the IVC * The left renal vein drains into the IVC after receiving the adrenal veins and the gonadal veins, inferior phrenic

Answer 284

* Duplicated or accessory renal arteries * Aberrant renal arteries * Duplicated renal veins * Pelvic kidney * Horseshoe kidney * Cross fused ectopia * Early branching * Four types of renal vein abnormalities * Non-classified: supernumerary renal veins

Answer 285

* Originates from the abdominal aorta at the level of L1 * Behind the neck of the pancreas and the splenic vein * Crosses anterior to the 3^rd part of the duodenum * Enters upper portion of the small bowel mesentery

Answer 286

* Inferior pancreaticoduodenal * Right colic * Middle colic * Ileocolic * Jejunal * Ileal branches * Marginal artery of Drummond

Answer 287

* Pancreas * Duodenum * Ascending and transverse colon * Ileum and jejunum * Appendix Caecum

Answer 288

* Mesenteric venous arcades unite to form the jejunal and iliac veins * Gastrocolic trunk drains into the right hand side of the SMV anterior to the uncinate process * Lies to the right of the SMA

Answer 289

* Mesenteric venous arcades * Ileocolic veins * Right colic vein * Inferior pancreaticoduodenal vein * Gastrocolic trunk * Right gastroepiploic vein * Middle colic * Anterior superior pancreaticoduodenal vein

Answer 290

* A: right common iliac artery, right gonadal vessels D3, CBD, PV, head of pancreas, D1, epiploic foramen, liver * P: lower lumbar vertebrae, IV discs, ALL, R psoas major, sympathetic trunk, right coeliac ganglion, R 3^rd and 4^th lumbar arteries, right renal artery, right adrenal artery, right inferior phrenic artery * Left lateral: abdominal aorta, caudate lobe, right crus * Right lateral: right kidney, right ureter, D2, liver * S: right atrium * I: confluence of the common iliac veins

Answer 291

* Duplication * Left sided * Drainage of the azygous directly into the RA * IVC webs * Azygous continuation of the IVC * Cicumaortic venous collar

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