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Gross > Unit 5 and DMD Conference > Flashcards

Unit 5 and DMD Conference Flashcards

1
Q

phrenic nerves supply the ______ with somatic sensory and motor fibers

A

diaphragm

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2
Q

fibrous layer: (outer/inner) portion of pericardium

A

outer

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3
Q

inner serous layer of pericardium consists of _____ and _____ portions

A

parietal (inseparable from fibrous) and visceral (inseparable from <3)

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4
Q

pericardial cavity is divided into two areas called:

A

sinuses (transverse and oblique)

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5
Q

which sinus explains the value of a transesophageal appraoch used by radiologists to study mitral and tricuspid vales

A

oblique (esophagus is directly behind LA)

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6
Q

pericardiocentesis is performed in the area of:

A

the cardiac notch of the left lung

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7
Q

apex of heart is (LV/LA)

A

LV tip

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8
Q

base of heart is (LV/LA)

A

LA, which faces posteriorly

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9
Q

_____ and _____ sulci contain major branches of coronary arteries

A

atrioventricular and interventricular

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10
Q

three things that open into the RA

A

superior and inferior VC, coronary sinus

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11
Q

musculature of RV distinguished by presence of ____ and ____

A

trabeculae carneae and papillary muscles

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12
Q

function of septomarginal trabeculum

A

conducting system

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13
Q

papillary muscles are attached to the three cusps of the AV valves by the:

A

chordae tendineae

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14
Q

valve between RA and RV

A

tricuspid

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15
Q

valve between LA and LV

A

bicuspid/mitral

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16
Q

LA receives four ______

A

pulmonary veins (which return oxy blood from lungs)

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17
Q

during diastole, blood flows into the (atria/ventricles)

A

ventricles

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18
Q

during systolic contraction, the AV valves are (opened/closed) and the aortic and pulm valves are (opened/closed)

A

AV valves closed

aortic and pulm valves opened

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19
Q

four interconnected rings of fibrous tissue that surround and stabilize openings of cardiac valves

A

cardiac skeleton

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20
Q

R and L fibrous trigones interconnect:

A

four fibrous rings of cardiac skeleton

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21
Q

two diseases that affect bicuspid valve

A

rheumatic fever, bacterial/infective endocarditis

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22
Q

scarring of bicuspid valve results in _______ _______ _____ and a distinctive heart murmur

A

atrioventricular valvular incompetence

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23
Q

a consequence of incomplete emptying of LA

A

pulmonary congestion

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24
Q

stenosis causes the associated ventricle to:

A

hypertrophy

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25
Q

the two coronary arteries originate from the ___ sinus

A

aortic sinus

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26
Q

three major branches of right coronary artery

A

artery of SA node, marginal artery, posterior interventricular

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27
Q

three major branches of left coronary artery

A

anterior interventricular, circumflex, left marginal

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28
Q

three major cardiac veins

A

great, middle, small (empty into coronary sinus which opens into RA)

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29
Q

two arteries used for coronary bypass surgery

A

internal thoracic, radial (forearm)

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30
Q

_____ _____ involves passing a catheter with a balloon into the diseased portion of a coronary artery to reestablish circulation

A

coronary angioplasty

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31
Q

enzyme that disperses blood clot

A

thrombokinase

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32
Q

cardiac plexus contains what three types of fibers

A

symp, parasymp, visceral afferent

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33
Q

preganglionic symp neurons of cardiac plexus originate in IML cell column at spinal levels:

A

T1-T5

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34
Q

long postganglionic symp fibers that join the cardiac plexus

A

cervical cardiac nerves

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35
Q

preganglionic parasymp fibers of cardiac plexus are part of the ____ nerve

A

vagus

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36
Q

visceral afferent fibers that are part of the vagus nerve monitor:

A

cardiac output blood pressure (baroreceptors in major vessels and blood chemistry aoritc bodies)

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37
Q

cell bodies of visceral afferent fibers of cardiac plexus found where?

A

dorsal root ganglia T1-T5

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38
Q

pain from angina pectoris (is lasting/is brief)

A

brief (a few minutes, result of a heavy meal or strenuous exercise)

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39
Q

cardiac myocytes in the ____ node initiate, perpetuate, and maintain the heart beat

A

sinoatrial node

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40
Q

conducting path of heart

A

SA node > atrial musculature > AV node > AV bundle > bundle branches > both ventricles > Purkinje fibers

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41
Q

Progenitor heart cells migrate through the primitive streak and into the
lateral plate mesoderm to form the:

A

primary heart field

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42
Q

Signals from (which germ layer) induce primary heart field in lateral plate mesoderm

A

endoderm

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43
Q

three signals that induce primary heart field

A

BMP, WNT inhibitors, NKX2.5

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44
Q

Left-right asymmetry of heart determined by ____ cascade patterns in lateral plate mesoderm

A

Nodal (Lefty, Pitx2)

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45
Q

_______ tubes fuse to form the primitive heart tube

A

Endocardial

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46
Q

at what day in development does the primitive <3 tube form

A

22 days

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47
Q

Cells from a ____ ____ _____ contribute to the heart tube

and lengthen the outflow tract

A

second heart field

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48
Q

The heart tube undergoes ___ _____ to establish

relative positions of heart chambers and vascular connections

A

looping morphogenesis (23-35 days)

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49
Q

dextrocardia is a defect of what process in <3 development

A

looping morph

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50
Q

Septation of the atrium: the ___ ____ extends towards

endocardial cushions in the atrioventricular canal

A

septum primum

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51
Q

extension of the septum primum creates an opening called the

A

ostium primum

52
Q

the _______ septum divides the AV canal

A

atrioventricular (AV), formed by endocardial cushions

53
Q

Septation of the atrium: the ostium primum closes, what two things now form?

A

ostium secondum and septum secondum

54
Q

formation of the septum secondum

leaves an opening called the

A

foramen ovale

55
Q

large openings in atrial septal defects can result in:

A

intracardiac shunting (right to left most dangerous)

56
Q

four atrial septal defects

A

patent foramen ovale, ostium secondum defect, endocardial cushion defect, common atrium

57
Q

Atrioventricular valve formation: ____ _____

fuse to form left and right AV canals

A

endocardial cushions

58
Q

tissue that can fuse to divide a lumen in the <3

A

endocardial cushions

59
Q

Septation of the outflow tract: endocardial

cushions fuse to form a

A

conotruncal septum

60
Q

Septation of the outflow tract: ___ ___ ___

contribute to the conotruncal septum formation

A

neural crest cells

61
Q

two outflow tract defects

A

persistent truncus arteriosis, transposition of the great arteries

62
Q

Septation of the ventricle: muscular interventricular septum

fuses with conotruncal septum and AV septum to form

A

the

membranous interventricular septum

63
Q

large VSDs cause left-to-right shunts
that increases ______ blood flow
and _____ hypertension

A

pulmonary blood flow

pulmonary hypertension

64
Q

____ in the outflow tract are remodeled to form

semilunar valves

A

cushions (semilunar valves form between the ventricles and the great arteries)

65
Q

fetus: oxygenated blood from the placenta
flows through the ___ ___ to
the inferior vena cava

A

ductus venosus

66
Q

fetus: the inferior vena cava shunts blood
through the ____ ____ into the
left atrium

A

foramen ovale

67
Q

fetus: venous blood in the right ventricle
is pumped into the pulmonary
artery and most flows through the
_____ _____ into the aorta

A

ductus arteriosis

68
Q

fetus: deoxygenated blood returns to

the placenta via _____ ____

A

umbilical arteries

69
Q

four circulation changes at birth

A

ductus venosus, foramen ovale and ductus

arteriosus all close to establish postnatal circulation, pulmonary circuit starts working

70
Q

____ _____ ____results in blood mixture and can
overload pulmonary circulation and lead to left ventricle
hypertrophy.

A

patent ductus arteriosus

71
Q

two major divisions of mediastinum

A

superior and inferior

72
Q

azygos vein in (anterior/posterior) mediastinum

A

posterior

73
Q

three parts of azygos venous system

A

azygos vein, hemi azygos, accessory hemi azygos

74
Q

where is the hyoid bone found

A

neck

75
Q

The ______ divides the superficial anterior neck into two triangles

A

sternocleidomastoid

76
Q 
CN XI Accessory
Cervical plexus
Phrenic nerve
Brachial plexus
found in the (anterior/posterior) triangle of neck
A

posterior

77
Q 
Hyoid Bone
Thyroid & cricoid cartilages
Trachea
Thyroid & submandibular glands
found in the (anterior/posterior) triangle of neck
A

anterior

78
Q

A subdivision of the anterior triangle between the omohyoid, digastric and sternocleidomastoid muscles

A

carotid triangle

79
Q

Common carotid artery
Internal & external carotid arteries with branches
Internal jugular vein
Vagus, spinal accessory, & hypoglossal nerves
found in which triangle of the neck

A

carotid triangle

80
Q

three superficial muscles of neck

A

platysma, trapezius, sternocleidomastoid

81
Q

The (supra/infra) hyoid help with swallowing and movement of the tongue

A

suprahyoid

82
Q

four suprahyoid muscles

A

mylo, genio, stylo, digastric

83
Q

The (supra/infra) hyoid muscles help with movement of the hyoid bone during swallowing

A

infrahyoid

84
Q

four infrahyoid muscles

A

omohyoid, sternohyoid, thyrohyoid, sternothyroid

85
Q

The ____ muscles all attach on the anterior portion of the neck and includes the Longus colli muscle

A

prevertebral

86
Q

The subclavian vein & phrenic nerve pass anterior to this muscle: (anterior/middle/posterior) scalene

A

anterior scalene

87
Q

The subclavian artery passes posteriorly and can be divided into thirds by this muscle: (anterior/middle/posterior) scalene

A

anterior scalene

88
Q

brachiocephalic trunk splits into:

A

right common carotid and right subclavian

89
Q

(internal/external) carotid supplies the face and neck

A

external

90
Q

(internal/external) carotid supplies the brain and eye

A

internal

91
Q

vertebral artery is a branch from the ______ artery

A

subclavian

92
Q

_____ artery supplies the lower neck and upper limb

A

subclavian

93
Q

mnemonic for eight branches of external carotid

A

Seven Angry Ladies Fight Over PMS

94
Q

eight branches of external carotid

A

SALFOPMS: superior thyroid, ascending pharyngeal, lingual, facial, occipital, posterior auricular, maxillary, superficial temporal

95
Q

three parts of subclavian artery

A
  1. vertebral artery, thyrocervical trunk, internal thoracic artery
  2. costocervical trunk
  3. internal thoracic/internal mammary artery
96
Q

Anterior & (internal/external) Jugular veins drain from the neck and face into the Subclavian vein

A

external

97
Q

(external/internal) jugular vein drains blood from brain, superficial face, and neck

A

internal

98
Q

(subclavian/brachiocephalic) vein drains the upper limbs

A

subclavian

99
Q

_____ veins are formed by the junction of the internal jugular and subclavian veins

A

brachiocephalic

100
Q

what do the thoracic splanchnic nerves innervate

A

the embryonic gut

101
Q

the (cervical/brachial) plexus is found between the anterior and middle scalene muscles

A

brachial

102
Q

the (external carotid/subclavian) artery lies between the anterior and middle scalene muscles

A

subclavian

103
Q

which nerves innervate the trachea, esophagus, and laryngeal muscles and branch off from the vagus

A

L and R recurrent laryngeal nerves

104
Q

myasthenia gravis is due to a defect in which structure of the mediastinum

A

thymus

105
Q

which cranial nerve innervates the trapezius and sternocleidomastoid muscles

A

CN XI

106
Q

clinical significance of thoracic duct

A

lymph carries cancer as it metastasizes

107
Q

the (brachial/cervical) plexus is found in the posterior/lateral triangle of the neck

A

cervical

108
Q

two glands in the anterior triangle of the neck

A

submandibular and thyroid

109
Q

the (brachial/cervical) plexus is found in the anterior triangle of the neck

A

brachial (specifically the carotid triangle)

110
Q

clinical problem most related to the anterior triangle of the neck

A

damage to blood supply (common carotid, internal jugular vein, internal and external carotid arteries and branches

111
Q

early signs of DMD

A

abnormal gait, difficulty with stairs/running/rising, lordosis (spine), pseudohypertrophy of calf muscles (actually build up of connective tissue)

112
Q

post wheelchair signs of DMD

A

scoliosis, resp insufficiency, cardiomyopathy, trouble swallowing

113
Q

mode of inheritance of DMD

A

X linked recessive

114
Q

(DMD/BMD): some dystrophin present, less common, less severe, maintains reading frame, protein smaller than normal

A

BMD

115
Q

first diagnostic test for DMD

A

creatine kinase (muscle damage)

116
Q

common treatment given to DMD patients to slow progress of dz

A

glucocorticosteroids

117
Q

two side effects of deflazacort (glucocorticosteroid)

A

asymptomatic cataracts, short stature

118
Q

protein that links muscle cell cytoskeleton to ECM

A

dystrophin

119
Q

least important component of dystrophin gene to function

A

central rod (can be shorter and protein still functions)

120
Q

what is the goal behind exon skipping in the treatment of DMD

A

skip a whole exon to get back on the reading frame, turn DMD into BMD

121
Q

difficulty in creating exon skipping treatment for DMD

A

each patient needs a personally tailored treatment to his own deletion

122
Q

difficulty in administering exon skipping treatment for DMD (Goemans Study)

A

quick turnover > need lots of injections, getting the treatment to heart muscle

123
Q

where is utrophin found

A

only at NMJ and myotendinous junction, everywhere before birth

124
Q

positives of using utrophin therapy for DMD

A

no adverse immune response, doesn’t have to be tailored to each patient

125
Q

problems with using utrophin therapy for DMD

A

poor bioavailability in humans, only tested in mice so far

Gross (2 decks)

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