PBL 1

Question 1

where does the arterial supply to the upper ib begin?

Answer 1

subclavian atyeru

Question 2

when does the subclavian artery become the axillary artery?

Answer 2

at the lateral border of the first rib

Question 3

what are the 6 branches of the axillary artery?

Answer 3

superior thoracic artery
thoracoacromial artery
lateral thoracic artery
subscapular artery (Branches for circumflex scapular ans thoracodorsal)
anterior circumflex humeral
Posterior circumflex humeral

SOMETIMES LIFE SEEMS A PAIN

Question 4

when does the axillary artery become the brachial artery?

Answer 4

at the lower border of the teres major muscle

Question 5

distal to the teres major, what does the brachial artery give rise to?

Answer 5

the produnda brachii (deep brachial artery) - this travels within the the radial groove of the humerus with the radial nerve

Question 6

what does the profunda brachii artery give rise to?

Answer 6

medial collateral and radial collateral arteries

Question 7

what does the medial collateral artery anastamose with?

Answer 7

recurrent interosseous artery

Question 8

what does the radial collateral artery anastamose with?

Answer 8

radial recurrent artery

Question 9

what does the brachial artery give rise to?

Answer 9

Profunda Brachii
Superior Ulnar Collateral Artery
Inferior Ulnar Collateral Artery
Ulnar Artery
Radial Artery

Question 10

what does the infeiror ulnar collateral artery anastamose with?

Answer 10

the anterior ulnar recurrent and medial collateral arteries

Question 11

what does the superior ulnar collateral artery anastamose with?

Answer 11

posterior ulnar recurrent artery

Question 12

what does the thoracoacromial artery supply?

Answer 12

pectoralis major and minor, part of deltoid, skin over clavipectoral fascia

Question 13

what does the lateral thoracic artery supply?

Answer 13

lateral structures of the thorax and breast

Question 14

what do the anterior and posterior circumflex humeral artery supply?

Answer 14

teres major ad inor, deltoid, long head of tricep brachii

Question 15

what does the subscapular artery supply?

Answer 15

muscles and skin of the shoulder, upper extremities and thoracic wall

Question 16

what does the circumflex scapular artery supply?

Answer 16

deltoid, teres minor, tricep brachii, glenoid labrum, skin over lateral scapula

Question 17

what does the medial collateral atery supply?

Answer 17

triceps

Question 18

what does the inferior ulna collteral artery supply?

Answer 18

brachialis, biceps brachii, coracobrachialise

Question 19

what does the radial recurrent artery supply?

Answer 19

elbow joint, brachialis, brachioradialis

Question 20

what does the anterior ulna recurrent artery supply?

Answer 20

elbow joint and pronator teres

Question 21

what does the posterior ulna recurrent artery supply?

Answer 21

elbow joint, flexor carpi ulnaris and palmaris longus

Question 22

what are the 4 stages of general anaesthesia?

Answer 22

induction
excitement
surgical anaesthesia
medullary paralysis

Question 23

whats the induction stage of general anaesthetic?

Answer 23

from consciousness to unconsciousness

Question 24

whats the excitement stage of general anaesthetic?

Answer 24

depression of inhibitory CNS neurones leading to increased excitement, involuntary movement, bp, HR and RR

Question 25

what is the surgical anaestesia of general anaesthetic?

Answer 25

gradual loss of muscle tone and reflexes, patient is fully unconscious and there is regular breathing

Question 26

what is the medullary paralysis stage of general anaesthetic?

Answer 26

respiratory and cardiovascular failure which can lead to death if not reversed

Question 27

what are some intravenous general anaesthetic agent?

Answer 27

propofol, etomidate, ketamine and thiopental sodium

Question 28

what are IV general anaesthetic agents usef for?

Answer 28

unconsciousness so the induction phase

Question 29

what are the 3 key things needed for general anaesthesia?

Answer 29

immobility analgesia unconsciousness

Question 30

whats the moa of general anaesthtic IV agents?

Answer 30

bidning to GABA-A rceptors which causes a conformational change which opens a central pore, allowing Ca2+ in and causing hyperpolarization of rsting potential - this makes it more difficult for excitatory neurotransmitters to depolarise the neuron and generate an action potential

Question 31

what are side effects of etomidate?

Answer 31

adrenal suppression ans transient skeletal muscle movements

Question 32

what are side effects of propofol?

Answer 32

respiratory deoression and hypotension

Question 33

what is an example of barbiturates?

Answer 33

thiopental sodium

Question 34

what are side effects of barbiturates?

Answer 34

apnea, cough, bronchospasms and respiratory depression

Question 35

what are inhalation general anaesthetic agent examples?

Answer 35

nitrous oxide, xenon, cyclopropane

Question 36

what are inhalation general anaesthetic agents good for?

Answer 36

analgesia

Question 37

how do nitrous oxide, xenon and cyclopropane work?

Answer 37

they inhibit NMDA receptors so we get decreased neurotransmission of pain

Question 38

what are side effects of ketamine?

Answer 38

hypertension, tachycardia, hypersalivationn, emergence phenomena

Question 39

what are side effects of nitrous oxide and cyclopropane?

Answer 39

dizziness, nausea and vomiting

Question 40

what are side effects of xenon?

Answer 40

there are no significant side effects

Question 41

what are examples of halogenated volatile anaesthetics?

Answer 41

halothane, enflurone, isoflurone, sevoflurane, desflurane

Question 42

what are the moas of halogenated volatile anaesthetics?

Answer 42

bind to GABA-A receptors, activate 2-pore-domain K+ channels, inhibit NMDA receptors etc... very diverse!

Question 43

what are side effects of halogenated volatile anaesthetics?

Answer 43

hypotension and reduction in cardiac output - dependant on dose

Question 44

whats a side effect of sevoflurane?

Answer 44

renal toxicity

Question 45

whats a side effect of halothane?

Answer 45

cardiac arrythmias and hepatotoxicity

Question 46

what is malignant hyperthermia?

Answer 46

a rare but potentially lethal complication of anaesthesia - rise in temp - increased muscle rigidity - tachycardia - acidosis

Question 47

whats a common trigger of malignant hyperthermia?

Answer 47

voltaile anaesthetics

Question 48

how do we classify fractures?

Answer 48

the position of bone ends (nondisplaced or displaced) completeness of break (incomplete or complete) orientation of break (transverse or linear) and whether it has penetrated the skin (compound or simple)

Question 49

what is osteomyelitis?

Answer 49

inflammation of bone or bone marrow, usually caused by staph aureus infection during a fracture

Question 50

what are the 4 stages of bone healing?

Answer 50

inflammatory stage/hematoma formation fibrocartilaginous callus formation bony callus formation bone remodelling