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Gen Anatomy Flashcards

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0
Q

Landmark: lumbar puncture

A

Iliac crest

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1
Q

Innervation of positive PSOAS sign in AP physical exam

A

Innervation
Psoas ms - lumbar plexus
Iliacus ms - femoral n

Right leg hyperextended, the iliopsoas muscle group pushes against the appendix.

Also positive in pancreatic cancer, inflammation of cecum and sigmoid colon.

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2
Q

McBurney’s point

A

2/3 of the way FROM umbilicus to asis.

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3
Q

Pudendal nerve block

A

Ischial spine

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4
Q

Retro peritoneal structures 9

SAD PUCKER

A 
Suprarenal/adrenal gland
Aorta and IVC
Duodenum 2 & 3
Pancreas
Ureters
Colon desc and ascending
Kidneys
Esophagus lower 2/3
Rectum lower 2/3
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5
Q

Site of mets ovarian ca via direct extension

A

Since its intraperitoneal, it will affect those within peritoneum too ie transverse colon etc excluding SAD PUCKER

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6
Q

Control of vomiting aka chemoreceptor trigger zone

A

Area postrema - medulla at floor of 4th ventricle

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7
Q

Pituitary functions

TAN HATS

A

Thirst
Adenohypophysis

Neurohypophysis and median eminence
Hunger
Autonomic regulation
Temperature
Sexual urges
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8
Q

Lesion in superior colliculi

A

Paralysis of conjugate VERTICAL gaze - parinaud syndrome

CN III IV VI - superior orbital fissure along with V1

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9
Q

Most common initial sensory impairment in DM

A

Loss of vibrational sensation - Pacinian corpuscle

Histo pacinian: onion like appearance

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10
Q

Meissner corpuscle vs Merkel nerve

A

mEISSner corpuscle: hairlEISS: light touch

Merkel nerve: hair follicles: deep static touch

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11
Q

Found in feet, transducer pressure

A

Ruffini corpuscle

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12
Q

Produces Major Basic Protein

A

Eosinophil

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13
Q

Abnormal opening of penile urethra on the superior/dorsal side of penis due to faulty positioning of genital tubercle

A

Epispadia

  • You hit your Eye when you pEE
  • associated with bladder Extrophy

Note: failure of urethral folds to close:HYPOspadia:hypo is below

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14
Q

Injury to male urogenitalia

Anterior bladder wall rupture
Superior bladder wall rupture
Urethral rupture above the urogenital diaphragm
Penile urethral rupture
Urethral below the urogenital diaphragm
A

Anterior bladder wall rupture: fractured pelvis:urine into retro public space.

Superior bladder wall rupture:DOME RUPTURE:compression of full bladder:urine into peritoneal cavity

Urethral rupture above the urogenital diaphragms: fractured: IMPROPER CATHERIZATION: urine into retro public space

Urethral below the urogenital diaphragm:STRADDLE INJURY :urine flow into scrotum and perineal area

Penile urethral rupture: crush injury: urine into buck’s fascia within penis

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15
Q

Cells of the adrenal medulla and SNS ganglia

A

Chromaffin cells

  • visualized by staining with chromium salts.
  • neural crest derivative
  • innervated by splanchnic nerve
  • secrete Epi, NorE, and Enkephalins
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16
Q

Staining: adrenal cortex vs medulla

A

Cortex : eosinophilic

Medulla: basophilic (chromaffin cells)

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17
Q

Injury to Artery of Adamkiewicz occurs during

A

Cardiac surgery

Artery of Adamkiewicz

  • BS lower 2/3 spinal cord
  • from aorta, enters at level of T8-L4
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18
Q

Watershed area in spinal cord

A

T4-T8

Anterior spinal artery supplies: spinothalamic, lateral CST, autonomic

So infarct during surgey ANTERIOR CORD SYNDROME causes loss of

  • pain and temp
  • loss of motor control at these levels
  • bowel and bladder control
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19
Q

Epithelial cell junctions

Loss of _____promotes metastasis

A

E Cadherin

  • found in zonula adherins
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20
Q

Permit communication and electrical exchange between cells

A

Gap junction

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21
Q

Duration of MI based on histology and sequelae/risk

Early coagulative necrosis, edema, hemorrhage, wavy fibers

A

4 - 12 hrs

Risk of arrhythmia

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22
Q

MI sequelae 0 -4 hrs post attack

A

Arrhythmia
CHF exacerbation
Cardiogenic shock

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23
Q

Duration of MI based on histology and sequelae/risk

Contraction bands from REPERFUSION injury. Release of necrotic cell content into blood. Beginning of NEUTROPHIL migration.

A

1-3 days

Fibrinous perocarditis

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24
Duration of MI based on histology and sequelae/risk MACROPHAGE infiltration followed by granulation tissue at margins
3-14 days Free wall rupture causing tamponade Papillary muscle rupture Ventricular aneurysm Interventricular septal rupture
25
Duration of MI based on histology and sequelae/risk Contracted scar complete
2 weeks to several months Dressler's syndrome - prinzmetal like treated with Ca blockers
26
Responsible for central vision
Macula in occipital pole - PCA supplies occipital lobe, responsible for perceiving LATERAL visual field in both eyes - Meyer's loop is the INFERIOR division of optic radiations as they pass through the temporal lobe. Supplied by MCA.
27
Identify presentation of a CN 7 lesion (5)
1 dec taste sensation anterior 2/3 IPSI tongue - chorda tympani 2 retroauricular pain - sensory to small area of IPSI ear 3 IPSI facial paralysis - motor to muscles of facial expression 4 inc sensitivity to noise IPSI ear - NS to STAPEDIUS ms which normally prevents excessive movement of stapes 5 dryness IPSI eye and mouth - PNS to IPSI lacrimal gland, submandibular and sublingual gland
28
Basal ganglia direct vs indirect pathway Which is inhibitory?
INdirect pathway : INhibits movement D1 receptor : D1rect pathway - D1rect pathway : D1 receptor : facilitates movement - INdirect pathway : INhibits movement : D2 receptor - Lentiform nucleus = put amen + globus pallidus - Striatum = putamen (motor) + caudate (cognitive) - recall nigroStriatal pathway
29
Count up innervation of reflexes ankle, knee, biceps and triceps
ankle S1 2 knee L3 4 biceps L5 6 triceps L7 8
30
AEGIS
Alpha fibers : extrafusal fibers Gamma fibers : intrafusal fibers Skeletal
31
Pathway of muscle reflex
Muscle stretch -> intrafusal stretch -> stimulates Ia afferent -> stimulates alpha motor neuron -> reflex extrafusal contraction
32
Site where arachnoid granulations transport CSF from subarachnoid space into the bloodstream
Superior Sagittarius sinus - site of defect in normal pressure hydrocephalus - "wet, wacky, wobbly"
33
Innervated by radial nerve Radial nerve innervates the BEST
Brachioradialis Extensors of the wrist and fingers Supinator Triceps
34
Raleased by Eosinophils
Major Basic Protein Eosinophilia detected in NAACP ``` Neoplasia Asthma Allergies Collagen disorder Parasitic infections ```
35
Level of horizontal fissure or right lung
Level of 4th rib anteriorly - separates right upper lobe from middle lobe
36
Relation of pulmonary artery to the bronchus at each lung hills "RALS"
Right anterior, Left superior Pulmonary artery is anterior to bronchus at right Pulmonary artery is superior to bronchus at left
37
Why more aspiration in right lung
Right main stem bronchus is WIDER and more VERTICAL than left
38
Cremaster reflex NS
L1-L2 - most injured in hernia repair - defect: numbness of scrotum and inner thigh Note most injured vaginal delivery: S2-S4 pudendal nerve. Innervates external genitalia. Presents with bowel and bladder incontinence, perineal anesthesia.
39
Responsible for central vision
Macula in occipital pole - PCA supplies occipital lobe, responsible for perceiving LATERAL visual field in both eyes - Meyer's loop is the INFERIOR division of optic radiations as they pass through the temporal lobe. Supplied by MCA.
40
Identify presentation of a CN 7 lesion (5)
1 dec taste sensation anterior 2/3 IPSI tongue - chorda tympani 2 retroauricular pain - sensory to small area of IPSI ear 3 IPSI facial paralysis - motor to muscles of facial expression 4 inc sensitivity to noise IPSI ear - NS to STAPEDIUS ms which normally prevents excessive movement of stapes 5 dryness IPSI eye and mouth - PNS to IPSI lacrimal gland, submandibular and sublingual gland
41
Basal ganglia direct vs indirect pathway Which is inhibitory?
INdirect pathway : INhibits movement D1 receptor : D1rect pathway - D1rect pathway : D1 receptor : facilitates movement - INdirect pathway : INhibits movement : D2 receptor - Lentiform nucleus = put amen + globus pallidus - Striatum = putamen (motor) + caudate (cognitive) - recall nigroStriatal pathway
42
Count up innervation of reflexes ankle, knee, biceps and triceps
ankle S1 2 knee L3 4 biceps L5 6 triceps L7 8
43
AEGIS
Alpha fibers : extrafusal fibers Gamma fibers : intrafusal fibers Skeletal
44
Pathway of muscle reflex
Muscle stretch -> intrafusal stretch -> stimulates Ia afferent -> stimulates alpha motor neuron -> reflex extrafusal contraction
45
Site where arachnoid granulations transport CSF from subarachnoid space into the bloodstream
Superior Sagittarius sinus - site of defect in normal pressure hydrocephalus - "wet, wacky, wobbly"
46
Innervated by radial nerve Radial nerve innervates the BEST
Brachioradialis Extensors of the wrist and fingers Supinator Triceps
47
Raleased by Eosinophils
Major Basic Protein Eosinophilia detected in NAACP ``` Neoplasia Asthma Allergies Collagen disorder Parasitic infections ```
48
Level of horizontal fissure or right lung
Level of 4th rib anteriorly - separates right upper lobe from middle lobe
49
Relation of pulmonary artery to the bronchus at each lung hills "RALS"
Right anterior, Left superior Pulmonary artery is anterior to bronchus at right Pulmonary artery is superior to bronchus at left
50
Why more aspiration in right lung
Right main stem bronchus is WIDER and more VERTICAL than left
51
Cremaster reflex NS
L1-L2 - most injured in hernia repair - defect: numbness of scrotum and inner thigh Note most injured vaginal delivery: S2-S4 pudendal nerve. Innervates external genitalia. Presents with bowel and bladder incontinence, perineal anesthesia.
52
Responsible for central vision
Macula in occipital pole - PCA supplies occipital lobe, responsible for perceiving LATERAL visual field in both eyes - Meyer's loop is the INFERIOR division of optic radiations as they pass through the temporal lobe. Supplied by MCA.
53
Identify presentation of a CN 7 lesion (5)
1 dec taste sensation anterior 2/3 IPSI tongue - chorda tympani 2 retroauricular pain - sensory to small area of IPSI ear 3 IPSI facial paralysis - motor to muscles of facial expression 4 inc sensitivity to noise IPSI ear - NS to STAPEDIUS ms which normally prevents excessive movement of stapes 5 dryness IPSI eye and mouth - PNS to IPSI lacrimal gland, submandibular and sublingual gland
54
Basal ganglia direct vs indirect pathway Which is inhibitory?
INdirect pathway : INhibits movement D1 receptor : D1rect pathway - D1rect pathway : D1 receptor : facilitates movement - INdirect pathway : INhibits movement : D2 receptor - Lentiform nucleus = put amen + globus pallidus - Striatum = putamen (motor) + caudate (cognitive) - recall nigroStriatal pathway
55
Count up innervation of reflexes ankle, knee, biceps and triceps
ankle S1 2 knee L3 4 biceps L5 6 triceps L7 8
56
AEGIS
Alpha fibers : extrafusal fibers Gamma fibers : intrafusal fibers Skeletal
57
Pathway of muscle reflex
Muscle stretch -> intrafusal stretch -> stimulates Ia afferent -> stimulates alpha motor neuron -> reflex extrafusal contraction
58
Site where arachnoid granulations transport CSF from subarachnoid space into the bloodstream
Superior Sagittarius sinus - site of defect in normal pressure hydrocephalus - "wet, wacky, wobbly"
59
Innervated by radial nerve Radial nerve innervates the BEST
Brachioradialis Extensors of the wrist and fingers Supinator Triceps
60
Raleased by Eosinophils
Major Basic Protein Eosinophilia detected in NAACP ``` Neoplasia Asthma Allergies Collagen disorder Parasitic infections ```
61
Level of horizontal fissure or right lung
Level of 4th rib anteriorly - separates right upper lobe from middle lobe
62
Relation of pulmonary artery to the bronchus at each lung hills "RALS"
Right anterior, Left superior Pulmonary artery is anterior to bronchus at right Pulmonary artery is superior to bronchus at left
63
Why more aspiration in right lung
Right main stem bronchus is WIDER and more VERTICAL than left
64
Cremaster reflex NS
L1-L2 - most injured in hernia repair - defect: numbness of scrotum and inner thigh Note most injured vaginal delivery: S2-S4 pudendal nerve. Innervates external genitalia. Presents with bowel and bladder incontinence, perineal anesthesia.

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