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Flashcards in Gen Anatomy Deck (65)
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Innervation of positive PSOAS sign in AP physical exam

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.

1

Landmark: lumbar puncture

Iliac crest

2

McBurney's point

2/3 of the way FROM umbilicus to asis.

3

Pudendal nerve block

Ischial spine

4

Retro peritoneal structures 9

SAD PUCKER

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




5

Site of mets ovarian ca via direct extension

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

6

Control of vomiting aka chemoreceptor trigger zone

Area postrema - medulla at floor of 4th ventricle

7

Pituitary functions

TAN HATS

Thirst
Adenohypophysis

Neurohypophysis and median eminence
Hunger
Autonomic regulation
Temperature
Sexual urges

8

Lesion in superior colliculi

Paralysis of conjugate VERTICAL gaze - parinaud syndrome

CN III IV VI - superior orbital fissure along with V1

9

Most common initial sensory impairment in DM

Loss of vibrational sensation - Pacinian corpuscle

Histo pacinian: onion like appearance

10

Meissner corpuscle vs Merkel nerve

mEISSner corpuscle: hairlEISS: light touch

Merkel nerve: hair follicles: deep static touch

11

Found in feet, transducer pressure

Ruffini corpuscle

12

Produces Major Basic Protein

Eosinophil

13

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

Epispadia

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

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

14

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

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

15

Cells of the adrenal medulla and SNS ganglia

Chromaffin cells

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

16

Staining: adrenal cortex vs medulla

Cortex : eosinophilic

Medulla: basophilic (chromaffin cells)

17

Injury to Artery of Adamkiewicz occurs during

Cardiac surgery

Artery of Adamkiewicz
- BS lower 2/3 spinal cord
- from aorta, enters at level of T8-L4

18

Watershed area in spinal cord

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

19

Epithelial cell junctions

Loss of _____promotes metastasis

E Cadherin

- found in zonula adherins

20

Permit communication and electrical exchange between cells

Gap junction

21

Duration of MI based on histology and sequelae/risk

Early coagulative necrosis, edema, hemorrhage, wavy fibers

4 - 12 hrs

Risk of arrhythmia

22

MI sequelae 0 -4 hrs post attack

Arrhythmia
CHF exacerbation
Cardiogenic shock

23

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.

1-3 days

Fibrinous perocarditis

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.