Part 2 Flashcards
1
Q
9 item format of abdominal sectioning
A
Left hypochondriac, epigastric, right hypochondriac, left lateral abdominal, umbilical, right lateral abdominal, left inguinal, hypogastric, right inguinal
2
Q
Mediastinum definition
A
Wall of organs including heart, esophagus, thymus, trachea, and major blood vessels that separates the right from the left pleural cavity
3
Q
Most likely place for a hip fracture of an elderly patient
A
The anatomical neck of the femur
4
Q
Skier’s fracture mechanism of injury
A
Fracture of the fibula due to extensive weight being placed on it from confined mobility of boot while twisting and turning and managing skis, individuals can typically still walk down mountain despite pain because THE FIBULA IS NOT WEIGHT BEARING
5
Q
The part of the talus that interacts with the tibia and fibula
A
The dome of the talus
6
Q
The balls of the feet or the balls of the hand correspond to the…
A
heads of the metatarsals and heads of the metacarpals respectively
7
Q
Large attachment site vs medium vs small on a bone terms
A
trochanter, tuberocity, tubercle
8
Q
Great saphenous vein
A
Long superficial vein returning blood on medial side from foot, leg and thigh and emptying into the femoral vein at the level of the femoral triangle. Often this is harvested for a CABG
9
Q
Important thing to remember when using the great saphenous vein in a CABG
A
Veins have valves, so it has to be oriented properly to allow blood flow
10
Q
NAVL
A
The femoral nerve, artery, vein (hugged together within femoral sheath), and lymphatics (in the order lateral to medial) that travel together in the femoral triangle
11
Q
Borders of the femoral triangle
A
The inguinal ligament, adductor longus, and sartorius
12
Q
Saphenous branch of femoral nerve
A
Goes below knee, must be identified in ACL surgery and avoided cut to protect sensation in pockets on the leg
13
Q
Femoral nerve origin and muscles it innervates
A
L2-4, innervates anterior thigh muscles such as quads, sartorius, and pectineus
14
Q
Why don’t we lose blood flow to the glute area when sitting for prolonged periods?
A
The arteries perforate through the adductor magnus around to the back side at the adductor hiatus
15
Q
Blood supply to vastus lateralis and what is the vastus lateralis often used for
A
Descending limb of lateral circumflex femoral artery, as an injection site IM
16
Q
Trendelenberg gait
A
A result of paralysis or pareisis of the gluteus medius on the contralateral side causes swinging of leg around, remember glute medius helps by raising hip girdle on contralateral side
17
Q
Sciatic nerve origin and components
A
Arises from L4-S3, tibial nerve which wraps around to innervate posterior leg, and common fibular nerve to innervate the anterior leg
18
Q
Innervation of biceps femoris long head vs short head
A
Long head is tibial portion and short head is common fibular portion of sciatic nerve
19
Q
Common finding on knee aspiration with an ACL tear
A
Middle genicular artery runs alongside ACL and tears with it so blood will be found, 1 of 6 genicular arteries
20
Q
Name the 6 deep external rotators of the hip
A
- Gemelli superior and inferior
- Obturator externus/internus
- Quadratus femoris
- Piriformis
21
Q
Adductor hiatus
A
Break in adductor magnus muscle to allow for passage of femoral artery and vein, changing names to popliteal
22
Q
Pes Anserine
A
Attachment site of 3 different muscles, sartorius, semitendinosus, and gracilis on the medial lower face of the knee
23
Q
The gastrocnemius is bi-articulate, meaning…
A
It crosses 2 joints
24
Q
What are the 4 major types of laxatives
A
1) fiber and bulk forming agents
2) surfactants
3) osmotic agents
4) stimulant laxatives
25
Neuroimaging criteria for mild head trauma
GCS <15, suspected open or depressed or basilar skull fracture, >1 episode of vomiting, neurologic deficit, bleeding diathesis or anticoag use, seizure, >60 y/o, retrograde amnesia, intoxication or abnormal behavior
26
kidney stone size charting for passage
<5 mm manage at home, between 5-10 mm alpha blocker and outpatient assuming no other complicating factors for 4 weeks total, >10 mm urologic eval
27
"Natural" skin products will more than 9/10 times contain....
...allergens
28
Recent studies indicate overuse of SABA (albuterol) is associated with increased risk of ...
...asthma exacerbations and increased asthma related mortality.
29
First line treatment for genitourinary syndrome of menopause (formerly vulvovaginal atrophy or atrophic vaginitis) in the absence of contraindications
low dose vaginal estrogen cream or insert or ring
30
4 cardinal features of parkinson disease
-Bradykinesia
-Rigidity (cogwheel), resistance to passive range of motion
-resting tremor
-postural and gait instability
31
Vibratory angioedema definition
Rare manifestation in a patient with untreated OSA and severe snoring that can result in anaphylaxis if untreated
32
1st line treatment for parkinson disease
carbidopa/levodopa
33
To extend the benefit of levodopa between doses in a parkinson disease pt, they can take one of these 3 medication types
-dopamine agonists (pramipexole, ropinorole, rotigitine)
-MAOI's
-Catechol-o-methyltransferase inhibiors (-capone)
34
zonisamide (zonegran) drug class
Misc. Antiseizure agent
35
maxalt (rizatriptan) drug class
Triptan (serotonin 5HT1b1d receptor agonist)
36
psyllium (metamucil) drug class
Bulk forming laxative similar to fiber
37
Methylcellulose (citrucel) drug class
Bulk forming laxative similar to fiber
38
docusate (colace) drug class and MOA
surfactant laxative, lowers surface tension of stool allowing water to enter it and bulk it up
39
polyethylene glycol (PEG, miraLAX) drug class and MOA
osmotic laxative, pulls water into the colon from intestinal wall allowing for bulking of stool
40
What class of laxative is most concerning if abused and what consequences can occur
Osmotic laxatives, electrolyte derangement and overload issues in pt's with cardiac or renal dysfunction
41
Lactulolose drug class
osmotic laxative
42
sorbitol drug class
osmotic laxative
43
List of the saline laxatives (2) and what mechanism do they work by? What is the most serious complication with them?
milk of magnesia, mag citrate, they are osmotic laxatives. Hypermagnesemia in pt's without renal function
44
bisacodyl (dulcolax) drug class and MOA
stimulant laxative, alteration of electrolyte transport in intestinal mucosa and increase motor activity of intestines
45
senna (senoket) drug class
stimulant laxative
46
Triptan (serotonin 5HT1b1d receptor agonist) MOA
Bind vascular seratonin receptors in the cranial arteries that vasoconstrict reducing blood flow as the dilation of those arteries during migraine attacks often worsens pain
47
Pectineus muscle function, insertion, nerve, vasculature
Function: Flexion of femur at hip, adduction of femur at hip
Insertion: Pubis to femur
Nerve: Femoral
Vasculature: Obturator artery (branch off internal illiac
48
Psoas major function, insertion, nerve
Function: Flexion of femur at hip, external rotation of femur at hip
Insertion: T12-L5 to lesser trochanter
Nerve: Femoral
49
Iliacus Function, insertion, nerve, vasculature
Function: Flexion of femur at hip, external rotation of femur at hip
Insertion: Iliac crest to lesser trochanter
Nerve: femoral
Vasculature; Medial femoral circumflex artery
50
Sartorius function, insertion, nerve, vasculature
Function: Flexion of femur at hip, flexion of tibia at knee, external rotation of femur at hip
Insertion: Anterior superior Iliac spine to medial tibia
Nerve: Femoral
Vasculature: femoral
51
Rectus femoris function, insertion, nerve, vasculature
Function: Flexion of the femur at the hip, extension of the tibia at the knee
Insertion: Anterior inferior iliac spine to tibial tuberocity
Nerve: Femoral
Vasculature: femoral artery
52
Vastus lateralis function, insertion, nerve, vasculature
Function: Extension of tibia at the knee
Insertion: Linea aspera of femur to the tibial tuberocity
Nerve: Femoral
Vasculature: Descending limb of the lateral circumflex femoral artery
53
vastus intermedius function, insertion, nerve, vasculature
Function: Extension of tibia at the knee
Insertion: Linea aspera of femur to the tibial tuberocity
Nerve: Femoral
Vasculature: Femoral artery
54
vastus medialis function, insertion, nerve, vasculature
Function: Extension of tibia at the knee
Insertion: Linea aspera of femur to the tibial tuberocity
Nerve: Femoral
Vasculature: femoral arter
55
adductor longus function, insertion, nerve, vasculature
Function: Adduct femur at hip
Insertion: Pubis to linea aspera of femur
Nerve: Obturator
Vasculature: Profunda femoral artery
56
adductor brevis function, insertion, nerve, vasculature
Function: Adduct femur at hip
Insertion: Pubis to linea aspera of femur
Nerve: Obturator
Vasculature: Profunda femoral artery
57
adductor magnus function, insertion, nerve, vasculature
Function: Adduct femur at hip
Insertion: Pubis to linea aspera AND adductor tubercle of femur
Nerve: Obturator and sciatic
Vacsulature: Profunda femoral artery
58
Gracillis function, insertion, nerve, vasculature
Function: Adduct femur at hip, flex tibia at knee
Insertion: Pubis to medial tibia
Nerve: Obturator
Vasculature: Medial circumflex branch of femoral artery
59
Tensor fascia lata function, insertion, nerve, vasculature
Function: Flexion of femur at hip, abduction of femur at hip, internal rotation of femur at hip
Insertion: Iliac crest to lateral tibia
Nerve: Gluteal nerve
Vasculature: Superior gluteal artery
60
gluteus maximus function, insertion, nerve, vasculature
Function: Extension of femur at hip, external rotation of femur at hip
Insertion: Iliosacrum to IT tract
Nerve: inferior gluteal nerve
Vasculature: Gluteal arteries
61
gluteus medius function, insertion, nerve, vasculature
Function: Abduction of femur at hip
Insertion: Ilium to greater trochanter
Nerve: Superior gluteal nerve
Vasculature: superior gluteal artery
62
gluteus minimus function, insertion, nerve, vasculature
Function: Abduction of femur at hip
Insertion: Ilium to greater trochanter
Nerve: Superior gluteal nerve
Vasculature: superior gluteal artery
63
Piriformis function, insertion, nerve, vasculature
Function: Abduction of femur at hip
Insertion: Sacrum to greater trochanter
Nerve: Superior gluteal nerve
Vasculature: superior gluteal artery
64
obturator internus/externus function, insertion, nerve, vasculature
Function: Lateral rotation of femur at hip
Insertion: Obturator foramen to greater trochanter
Nerve: Obturator
Vasculature: Obturator artery
65
superior and inferior gemelli function, insertion, nerve, vasculature
Function: Lateral rotation of femur at hip
Insertion: Ischial spine to greater trochanter
Nerve: Obturator
Vasculature: Inferior gluteal artery
66
quadratus femoris function, insertion, nerve, vasculature
Function: Lateral rotation of femur at hip
Insertion: Ischial spine to greater trochanter
Nerve: Obturator
Vasculature: Inferior gluteal artery
67
semimembranosus function, insertion, nerve, vasculature
Function: Flexion of the tibia at the knee, extension of femur at the hip
Insertion: Ischial tuberosity to medial tibia
Nerve: Tibial nerve (sciatic)
Vasculature: Profunda femoral artery
68
semitendinosus function, insertion, nerve, vasculature
Function: Flexion of the tibia at the knee, extension of femur at the hip
Insertion: Ischial tuberosity to medial tibia
Nerve: Tibial nerve (sciatic)
Vasculature: Perforating arteries
69
Biceps femoris long head function, insertoin, nerve, vasculature
Function: Flexion of tibia at knee, extension of femur at hip
Insertion: Ischial tuberosity and femur to fibula
Nerve: Tibial nerve(sciatic)
Vasculature: Perforating arteries
70
Tibialis anterior function, insertion, nerve, vasculature
Function: Dorsiflextion of the foot at the ankle, Inversion of foot at the ankle
Insertion: Tibia to the medial cuniform
Nerve: Deep fibular nerve
Vasculature: Anterior tibial artery
71
Extensor digitorum longus function, insertion, nerve, vasculature
Function: Dorsiflection of foot at ankle, Extension of toes at MTP joint
Insertion: Tibia to distal phalanx digits 2-5
Nerve: Deep fibular nerve
Vasculature: Anterior tibial artery
72
Extensor hallucus longus function, insertion, nerve, vasculature
Function: Dorsiflexion of the ankle, extension of digit 1 at MTP joint
Insertion: Tibia to distal phalanx digit 1
Nerve: Deep fibular nerve
Vasculature: Anterior tibial artery
73
Fibularis tertius function, insertion, nerve, vasculature
Function: Dorsiflexion of foot at ankle, eversion of the foot at the ankle
Insertion: Fibula to inferior side of 5th metatarsal underside
Nerve: deep fibular nerve
Vasculature: anterior tibial artery
74
Fibularis longus function, insertion, nerve, vasculature
Function: plantarflexion of foot at ankle, eversion of foot at ankle
Insertion: Fibula to inferior side of first metatarsal
Nerve: Superficial fibular nerve
Vasculature: Anterior tibial artery
75
Fibularis brevis function, insertion, nerve, vasculature
Function: Plantarflexion of foot at ankle, eversion of foot at ankle
Insertion: Fibula to superior side of 5th metatarsal
Nerve: Superficial fibular nerve
Vasculature: Anterior tibial artery
76
Gastrocnemius function, insertion, nerve, vasculatur
Function: plantarflexion of foot at ankle, flexion of tibia at knee
Insertion: Condyle of the femur to achilles tendon
Nerve: Tibial nerve
Vasculature: sural arteries
77
Soleus function, insertion, nerve, vasculature
Function: Plantarflexion of foot at ankle
Insertion: Tibia to achilles tendon
Nerve: Tibial nerve
Vasculature: Sural arteries
78
Plantaris function, insertion, nerve, vasculature
Function; Plantarflexion of foot at ankle
Insertion: Femur to achilles tendon
Nerve: Tibial
Vasculature: Popliteal artery
79
Flexor Hallucis longus function, insertion, nerve, vasculature
Function: Dorsiflexion of foot at ankle, flexion of 1st toe at MTP
Insertion: tibia to distal phalanx of toe one
Nerve: Tibial
Vasculature: Posterior tibial artery
80
Flexor digitorum longus function, insertion, nerve, vasculature
Function: Dorsiflexion of foot at ankle, flexion of 2-5 toes at MTP
Insertion: tibi to distal phalanges of toes 2-5
Nerve: tibial
Vasculature: posterior tibial artery
81
Tibialis posterior function, insertion, nerve, vsaculature
Function: Plantarflexion of foot at ankle, Inversion of foot at ankle
Insertion: Tibia to navicular
Nerve: Tibial
Vasculature: Posterior tibial artery
82
Biceps femoris short head function, insertoin, nerve, vasculature
Function: Flexion of tibia at knee
Insertion: Femur to fibula
Nerve: Common fibular nerve
Vasculature: Perforating arteries
83
calcium and albumin relationship
calcium in serum is principally bonded to protein, mainly albumin, therefore serum calcium levels in patients that also have hypo or hyperalbuminemia might not reflect accurate levels, thus ionized calcium remains gold standard for assessing status esp. if diagnosis of hypocalcemia is in doubt
84
HCV virus transmission
Primarily blood such as sharing needles or maternal to child, can be sexually transmitted mostly M2M if there is blood exposure such as through anal
85
Lomotil (diphenoxylate and atropine) drug funciton
antidiarrheal
86
Embryonic 3 germ layers and what they form
Ectoderm - forms epidermis and nervous sytem
Mesoderm - Muscle, bone, blood and other connective tissue
Endoderm - mucus lining of GI and respiratory tracts
87
Examples of simple cuboidal epithelium
Found in Liver, thyroid, mammary, salivary and other glands, bronchioles, and most kidney tubules
88
Examples of simple columnar epithelium
Inner lining of GI tract, uterus, kidney & uterine tubes
89
Pseudostratified epithelium location
Found in respiratory system, not all cells reach surface
90
Keratanized stratified sqamous epithelium location
The skin
91
Nonkeratanized stratified squamous epithleium location
oral mucosa, esophagus, vagina
92
Transitional epithelium location and function
Ureters, bladder, able to contract and expand with distension
93
6 cells of connective tissue
1) Fibroblasts - produce fibers and ground substance
2) Macrophages - WBC phagocytose foreign material
3) Neutrophil - suicide bomber
4) Plasma cells - release antibodies
5) Mast cells - secrete histamine and heparin inhibit clotting and dilate blood vessel
6) Adipocytes - store triglycerides
94
3 types of cartilage, characteristics and where they are found
1) Hyaline - tracheal rings, glass matrix layout
2) Elastic - external ear, elastic fibers to bounce back
3) Fibrocartilage - Meniscus, parallel collagen fibers
95
Tight junction
Completely encircle the cell joining it to surrounding cells, zipper like pattern that prevents any substances between the cells such as in the GI and urinary tract
96
Desomosomes
Patch between 2 cells holding them together against mechanical stress
97
Gap junctions
Communicating junctions to allow for small solutes to pass from cell to cell
98
3 mixed organs with endo and exocrine function
1) Liver
2) Gonads
3) Pancreas
99
Holocrine glands definition
Secretory cells that disintegrate in order to deliver accumulated product and some cell fragments, such as oil producing cells of scalp
100
Metaplasia definition
Changing one type of mature tissue into another
101
Neoplasia definition
Growth of a tumor (benign or malignant)
102
Atrophy vs necrosis vs apoptosis
Atrophy is shrinkage of cells and number of cells
Necrosis is pathological death of tissue
Apoptosis is planned cell death, cells shrink and are phagocytosed WITHOUT inflammation
103
Simple squamous epithelium location
Alveoli, glomeruli, endothelium and serosa
104
Mitosis
Asexual reproduction, forms 2 identical daughter cells with no mechanism for genetic diversity, undergoes Interphase, prophase, etc
105
Meiosis
Sexual reproduction, forms 4 haploid gametes with diverse spread of genes through crossing over and homologous recombination to create egg and sperm
106
Sex hormone release pathway
Hypothalamus -> GnRH -> pituitary gland -> gonadotropins (FSH/LH)
107
Embryonic age definition
Number of days since fertilization
108
Gestational age definition
Number of days since start of ovarian cycle (embryonic age + 2 weeks)
109
Zygote
One cell stage of fertilized ovum before first cleavage occurs
110
Morula
Ball of cells composing the early embryo that produces both the embryo and the placenta and membranes - each cell is totipotential
111
Blastocyst
The stage that follows the morula stage. It consists of a fluid filled cavity surrounded by trophoblasts with embryoblast cells at one pole.
112
Trophoblast
Cells outside the blastocele, becomes the placenta
113
Embryoblast
Inner cell mast inside blastocele, becomes the embryo
114
Fertilization occurs in the...
...distal third of the fallopian tube
115
What occurs 3-4 days after ovulation
Entrance in the uterine cavity
116
What occurs 5-6 days after ovulation
HCG levels rise, tropoblast releases enzymes that erode the uterine lining for implantation
117
What occurs 7-12 days post ovulation
Trophoblast cells engulf and destroy cells of the uterine lining to create blood pools, stimulate capillary growth and develop placenta
118
Where do ectopic pregnancies occur?
Implantation in the distal third of the fallopian tube, sometimes elsewhere as well
119
Sacrococcygeal teratoma
Leftover primary streak containing all 3 cell types, easily removed without issue
120
Why do dermatomes form the way they do?
They are lined up linearly on the neural fold, but projection of the limbs causes distortion of them
121
Exposure to toxins within first ___ weeks causes greastest damage during development, exposure beyond that causes...
9...minor or small changes in the infant
122
Meconium
product of cell loss, digestive secretion and swallowed amniotic fluid in an embryo (essentially feces)
123
By how many weeks can a fetus live outside the body?
24-26
