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4 Anatomy

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q123456's version from 2016-06-27 01:26

 

Question Answer
Exdative effusionsprotein rich fluid from plasma due to increase vascular permeability caused by inflammation
a)pleural fluid protein/serum protein>0.5
b)Pleural fluid LDH/serum LDH>0.6
Transudate effusionsa)Decreased oncotic pressure (cirrhosis and nephrotic syndrome)
b)Increased hydrostatic pressure (CHF)
memorize

 

Question Answer
The primary motor cortexlocated in the precentral gyrus
handles signals coming from the premotor area of the frontal lobes.
The primary sensory cortexlocated in the postcentral gyrus
handles signals coming from the thalamus.
Cerebral Artary1)Anterior cerebral A: the foot and leg on the opposite side
2)Middle cerebral A:
Broca's
Wernicke's
Basal ganglia and internal capsule
Contralateral face and arm
Aphasia of broca's and Wernicke's
3)Posterior cerebral A:
Contralateral loss of pain and temperature sensations
Visual field defects
Ipsilateral oculomotor nerve
Contralateral deficits of facial, vagus, hypoglossal nerve and horner's syndrome
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Question Answer
arterial wallintima: the endothelium, a thin subendothelial layer of loose connective tissue
media:smooth muscle cells
adventitia:type I collagen and elastic fibers
vasa vasorum: arterioles, capillaries and venules in the adventitia and outer part of the media
memorize

GI

Question Answer
lesser omentum1) gastrohepatic ligament KA34-15
inferior surface of the liver and the lessor curvature of the stomach
pancreatectomy
Incised for surgical access
2) hepatoduodenal ligament: common bile duct, hepatic artery and portal vein, not be incised for surgical access
splenorenal ligamentbetween the posterior abdominal wall and the spleen
splenic artery and vein
abdominal wallcamper fascia, scarpa fascia, external oblique, internal oblique, transversus abdominis, parietal peritoneum
memorize

lymphatic drainage

Question Answer
Right lymphatic ductR arm/chest/head
enter R subclavian vein
thoracic ductall the rest except R arm/chest/head
enter left subclavian vein
parasternal nodesmedial breast
paratracheal nodeslungs
celiac nodesstomach,
duodenum,
liver,
gallbladder,
pancreas
spleen
superior mesenteric node (SM)Jejunum ileum
inferior mesenteric node (IM)
KA35-33
Appendix,
cecum,
colon
upper rectum
lateral aortic nodeskidney/upper ureter,
testes
ovary, uterine tube, upper uterus
male reproductive system-----------------------
lateral aortic nodes: testes

external: prostate
internal iliac nodes: ductus deferens, seminal vesicle and ejaculatory duct and bladder

superficial inguinal nodes:
skin of pennis, scrotum
-------------------------
female reproductive systemlateral aortic nodes:
ovary, uterine tubes and upper uterus

External/internal iliac nodes:
lower uterus, cervix, upper vagina

deep inguinal nodes: clitoris and labia minora

superficial inguinal node: lower vigina, vulva
-----------------------------
urinary bladderexternal/internal iliac nodes
prostate glandinternal iliac/sacral nodes
Rectum---------------------------
Inferior mesenteric nodes: Upper rectum
Internal iliac nodes: lower rectum and anal canal
superficial inguinal nodes: anal canal below pectinate line KA36-11
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Question Answer
Crainial nervesI: Olfactory:cribriform plate
II: optic(vision):optic canal
--------------------------------------------
superior orbital fissure
III: oculomoter: levator palpabrae (elevation of eyelid) and eye ball movement
IV: Trochlear: superior bolique
VI: Abducens: lateral rectus
--------------------------------------------
V: Trigeminal KA24-9
superior orbital fissure: V1
foramen rotundum: V2
foramen ovale: V3

motor:
The mandibular division V3 controls:
the muscles of mastication: masseter/temporal/pterygoids.
the tensor tympani (a muscle within the ear)

sensory: anterior 2/3 tongue

mouth drooping
inability to close the eye
inability to wrinkle the forehead
hyperacusis (sensitive to sound)
blink reflex
-----------------------------------------------
internal acoustic meatus
VII: Facial
motor: facial expression, say"mi"
sensory: anterior 2/3 taste. external ear
submandibular, sublingual and lacrimal glands (eye)

VIII: Vestibulocochlear: hearing
-----------------------------------------------
Jugalar foramen
IX: Glossopharyngeal:
motor:
swallowing: stylopharyngeus
parotid salivary gland
sensory:
carotid sinus,
sensation and taste posterior 1/3
KA24-16

X: Vagus
swallowing
phonation, say "kuh",
hoarseness and can barely speak above a whisper>>>damage the recurrent laryngeal nerves
all intrinsic laryngeal muscles except cricothyroid KA-24-17
taste on rear of tongue
visceral function

*****The pharyngeal reflex or gag reflex: is a reflex contraction of the back of the throat evoked by touching the roof of the mouth, the back of the tongue, the area around the tonsils, the uvula, and the back of the throat. the sensory limb is mediated predominantly by CN IX; the motor limb by CN X . absence of gag reflex: CNIX and X are damaged

XI: Accessory
trapezius (inability to shrug ipsilateral shoulder) and sternocleidomastoid (inability to rotate head to contralateral side)

Hypoglossal canal
XII: Hypoglossal
tongue movement: say"La, la, la"

a 27 year old man is involved in a motorcycle accident and sustains a severe closed head injury. A CT scan of the head shows a basilar skull fracture in the region of the foramen ovale. Which of the following is most likely to occur? loss of the ability to chew food.
tongue taste and painTaste nerves:VII, IX, X
Tongue pain nerves:V3, IX, X
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Question Answer
Branchial arch 1 DerivativesCartilage: Meckel’s cartilage, Mandible, Malleus,incus
Muscles: Muscles of Mastications (masseter, temporalis, pterygoids) and tensor tympani
Nerves: CNV2,V3
Arteries: Maxillary artery
Branchial arch 4-6Cartilage: thyroid, cricoid, arytenoids, corniculate, cuneiform
Muscles:
4th arch: most pharyngeal constrictors, cricothyroid, levator veli palatini
6th: all intrinsic muscles of larynx except cricothyroid
Nerves: 4th: CNX(swallowing) 6th: CNX (speaking)
Arteries: none
Branchial arch 3Cartilage: greater horn of hyoid
Muscles: stylopharyngeus
Nerves: CNIX
Arteries: none
Branchial arch 2Cartilage: Reicherts cartilage, stapes, styloid process, lesser horn of hyoid, stylohyoid ligament.
Muscles: facial expression, stapedius, stylohyoid, post belly of digastric
Nerves: CNVII
Arteries: Stapedial artery, hyoid artery
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Question Answer
pudendal nerveperineum
S2-4
greater sciatic foramen
lesser sciatic foramen
palpation of ischial spine>>>locate pudendal N

motor: ejaculation
sensation of clitoris, penile erection and anal canal
Peroneal nervesuperficial peroneal nerve: S1
lower lime artery
37-13
arota-->external iliac artery-->femoral artery-->popliteal artery-->A tibial artery and P tibial artery
popliteal artery:
adductor hiatus and adductor magnus
popliteal fossa (knee)
dislocates knee>>>difficulty finding pulses distal to the injury>>>damage the popliteal artery
The collection of arterial blood samplein the atmosphere, PO2=150mmHg, PCO2=0 mmHg
in the arterial blood, PO2=100 mmHg, PCO2=40 mmHg
avoid exposing the blood to room air
because such exposure tends to cause the blood to partially equilibrate with the room air: elevated PO2, deceased PCO2, elevated PH
the lower limbArtery
Aorta →External iliac A→femoral A→Popliteal A→A tibial A, P tibial A and fibular A
Above knee
Medial circumflex femoral A
Perforating A

Testicular artery originate directly from the aorta KA6/47

R ovarian V→IVC
L ovarian V→Rena l V →IVC KA14/33

femoral triangle: medial to lateral KA10/40
1)femoral vein
2)femoral artery
3)femoral nerve
Nerve
Anterior

Femoral N L2-4
flexion of thigh and extension of leg is lost
sensory loss on anterior thigh and medial leg

Obturator N L2-4
Adductors
adduction of thigh is lost
sensory loss on medial thigh

Posterior
Superior gluteal N:
gluteus medius and minimus
unable to pull pelvis down
abduction of thigh are lost
Inferior gluteal N: gluteus maximus, unable to rise from a seated position, climb stair or jump
Sciatic N
1) Tibial N:inversion of foot, plantar flexion of foot, flexion of toes, sensory loss on sole of foot KA34/34
2) Common fibular N: eversion of foot, dorsiflexion of foot, extension of toes, sensory loss on anterolateral leg
KA4/19
A) Superficial fibular N L4-S1
1) peroneus longus KA2/24
2) peroneus brevis
B) Deep fibular N (L5-S2): dorsiflex and evert the foot (damage: food drop)
1) tibialis anterior KA36/48
2) extensor hallucis longus
3) extensor digitorum longus
4) peroneus tertius



*S1 reflex (Achilles tendon reflex) occurs when the Achilles tendon is tapped while the foot is dorsi- flexed.


Great sciatic foramen
Superior gluteal N KA11/18
Inferior gluteal N
Sciatic N
Pudendal N
 palpation of ischial spine KA2/13, KA11/6,  gestation-labor related questions

Pelvic nerve KA12/39

S1 nerve root innervates KA2/24
The superficial peroneal N: peroneus longus and brevis
Tibial N: Gastrocnemius and soleus→achilles tendon (the S1 reflex or the achilles tendon reflex)
memorize

CNS

Question Answer
Venous drainageKA34-37
The dura separates into two layers
Dural venous sinuses is form between the external layer and the internal layer of the dura mater
Superior Sagittal Sinus (receives the superior cerebral veins *subdural hemorrhage)
Inferior Sagittal Sinus
Straight Sinus
Occipital Sinus.
Transverse Sinus>>>the sigmoid sinus>>> the internal jugular vein.

***venous blood is located between the dura and arachnoid
A subdural hemorrhage, caused by a violent shaking of the head can cause bleed from the superior cerebral veins (“bridging veins”).
blood accumulates slowly (days to weeks after trauma); and
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Question Answer
direct inguinal herniahesselbach's triangle
1 lateral border: inferior epigastric vessels
2 medial border: rectus abdominis
3 inferior border: inguinal ligament
sinoatrial nodeat the sternal border of the right third intercostal space
right atrium close to the point of entry of the superior vena cava
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