This site is 100% ad supported. Please add an exception to adblock for this site.

4. Anatomy III p82-93


undefined, object
copy deck
Amniotic Fluid Abnormalities
p. 82
What is polyhydramnios?
high amount of amniotic fluid (>1.5-2L)
What is polyhydramnios clinically associated with?
esophageal/duodenal atresis and anencephaly both of which impair the ability of the fetus to swallow amniotic fluid
What is the condition leading to low amniotic fluid (<0.5L) called?
What 2 conditions is oligohydramnios associated with?
Bilateral renel agenesis or posterior urethral valves (in males) which results in the failure of the fetus to excrete urine into the amniotic fluid.
What syndrome can oligohydramnios result in?
Potter's Syndrome
What does the term Potter's syndrom describe?
Bilateral renal agenesis leading to oligohydramnios which results in fetal limb and facial deformaties and pulmonary hypoplasis
What causes Potter's syndrome?
Malformation of the ureteric bud
What results when the poles of both kidneys fuse during development?
Horseshoe kidney
What arrests the ascend of the fused kidneys?
The horseshoe kidneys get trapped under the inferior mesenteric artery.
Landmark Dermatomes
p. 82
What dermatome is found at the posterior half of the skull?
Where is the C3 dermatome?
neck (high turtleneck shirt)
Where is the C4 dermatome?
lower neck (low-collar shirt)
Where is the T4 dermatome?
At the nipple
Which dermatome can be found at the level of the xiphoid process?
Which dermatome is important for early appendicitis pain refferl to the umbilicus?
Where is the L1 dermatome?
At the inguinal ligament
What dermatome is found at the knee caps?
Which dermatomes are associated with erection and sensation of penile and anal zones?
S2, S3, S4 (S2, 3, 4 keeps the man begging for more)
Gallbladder pain can be reffered to the right shoulder via which nerve?
Phrenic nerve
Which dermatome is found at the level of the belly butten?
Rotator Cuff Muscles
p. 82
Which muscles form the rotator cuff?
Supraspinatus, Infraspinatus, Teres minor, and Subscapularis (SItS)
Which muscle helps the deltoid abduct the arm?
What function does the Infraspinatus muscle have?
laterally rotates the arm at the shoulder joint
What is the function of the Teres minor muscle?
to adduct and laterally rotate the arm (Possible mistake in First Aid)
Which muscle medically rotates and adducts the arm?
Thenar-hypothenar Muscles
Name the thenar muscles.
Opponens pollicis, Abductor pollicis brevis, Flexor pollicic brevis
Name the hypothenar muscles.
Opponens digiti minimi, Abductor digiti minimi, Flexor digiti minimi
What functions do the thenar and hypothenar muscles preform?
oppose, abduct and flex (OAF)
Unhappy triad/Knee injury
p. 83
What structures can be injured when a football player's cleated shoe is planted firmly in the turf and the knee is struck from the lateral side?
medial collateral ligament (MCL), medial meniscus, and anterior cruciate ligament (ACL) (unhappy triad on the knee joint)
What does a anterior drawer sign indicate?
Tearing of the Anterior cruciate ligament (ACL)
What does abnormal passive abduction indicate?
A torn Medial collateral ligament (MCL)
Recurrent Laryngeal nerve
The recurrent laryngeal nerve is a branch of which cranial nerve?
Which muscles does it supply?
intrinsic muscles of the larynx except the cricothyroid muscle
What structure does the right recurrent laryngeal nerve wrap around?
right subclavian artery
What structure does the left recurrent laryngeal nerve wrap around?
arch of the aorta and the ligamentum arteriosum
In what kind of surgery can this nerve be damaged in?
thyroid surgery
What happens when this nerve gets damaged?
Scalp and meninges: layers
p. 83
Name the layers of the scalp
skin, connective tissue, aponeurosis, loose connective tissue, pericranium (SCALP)
Name the meninges.
Dura, arachnoid, and pia (DAP)
What space is found between the dura and arachnoid?
subdural space
Between what meninges is the subarachnoid space located?
between the arachnoid and the pia
What is found in the subarachnoid space?
In which scalp layer are the emissary veins found?
loose connective tissue
Mastication Muscles
Which 3 muscles are responsible for closing the jaw?
Masseter, temporalis, and medial pterygoid (M's munch)
Which muscles opens the jaw?
Lateral pterygoid
Which nerve innervates the muscles that are responsible for jaw opening and closing?
Trigeminal nerve V3
Name the nerve that supplies the muscles of the tounge except palatoglossus.
Hypoglossal nerve
What nerve innervates the palatoglossus muscle?
Vagus nerve
The muscles with the root "palat" (except tensor veli palatini) are innervated by what nerve?
vagus nereve
What nerve innervates tensor veli palatini?
mandibular branch of CN V
Carotid Sheath
List the structures found in the carotid sheath (in the order from lateral, medial, posterior)
Internal jugular vein, common carotid artery, and vagus nerve (VAN)
Diaphragm Structures
What structure crosses the diaphragm at T8?
IVC (I 8 10 EGG's AT 12)
At what T level does the esophagus and vagus nerve cross the diaphragm?
T10 (I 8 10 EGG's AT 12)
What structure crosses the diaphragm at T12?
aorta, thoracic duct, and azygous vein (I 8 10 EGG's AT 12)
Name the innervation of the diaphragm
C3, 4, and 5 (phrenic nerve)
Where can the pain from the diaphragm be reffered to?
Coronary artery anatomy
What artery supplies the SA and AV nodes?
RCA right coronary artery
The inferior portion of the left ventricle is supplied by what artery 80% of the time?
RCA via the PD posterior descending artery
In which artery does coronary artery occlusion most sommonly occur?
LAD left anterior descending artery
What artery supplies the anterior interventricular septum?
LAD left anterior descending artery
When do coronary arteries fill?
during diastole
What is the most posterior part of the heart?
left atrium
What can the enlargement of the left atrium cause?
Bronchopulmonary segments
p 85
What does each bronchopulmonary segment contain?
3º (segmental) bronchus and 2 arteries (bronchial and pulmonary) in the center
What drains along the borders of the bronchopulmonary segments?
veins and lymphatics
What runs with the airways?
Lung Relations
p. 85
How many lobes does the right lung has?
3 lobes
Which lung lobe has 2 lobes?
What is the homologue of the right middle lobe in the left lobe?
Which lung is the more common site for inhaled foregin body?
right lung?
Why is 1 lung a more common site for inhaled foregin body?
Because of the lessvacute angle of the right main stem bronchus
What is the relation of the pulmonary artery to the bronchus in each lung hilus?
RALS - right lung anterior and left lung superior
Femoral Triangle
What does the femoral sheath contain?
femoral artery, femoral vein, and femoral canal (containing deep inguinal lymph node)
Does the femoral nerve lie within the femoral sheath?
no, it lies outside the sheath
What do you call the entrance of abdominal contents through the femoral canal?
femoral hernia
What does the femoral triangle contain?
femoral vein, aretery and nerve (VAN)
Where does the femoral hernia protrude to?
below and lateral to the pubic tubercle
Abdominal Hernias
What are abdominal hernias?
protrusions of peritoneum through an opening - usually sites of weakness
What is the name of the hernia in which abdominal structures enter the thorax?
diaphragmatic hernia
What is the most common diaphragmatic hernia?
hiatal hernia
What happens in this type of hernia?
the stomach herniates upward through the esophageal hiatus
What can result from a defective development of pleuroperitoneal membrane in infants?
diaphragmatic hernias
From where does a direct hernia protrude?
from the inguinal (Hesselbach's) triangle - bulges directly through the abdominal wall medial to the inferior epigastric artery
Which inguinal ring does it go through?
external inguinal ring only
Who usually gets a direct hernia?
older men
What does the indirect hernia go through?
the internal (deep) inguinal ring and external (superficial) inguinal ring and into the scrotum
On which side of the inferior epigastric artery does the indirect hernia enter the internal inguinal ring?
lateral to the inferior epigastric artery
Who usually get an indirect hernia and why?
infants, because of the failure of processus vaginalis to close
Which structures make up Hesselbach's triangle?
inferior epigastric artery, lateral border of rectus abdominis, and inguinal ligament
Where does the inguinal canal start and end?
begins at the deep inguinal ring and terminates at the superficial ring
What does the inguinal canal transmit?
the spermatic cord or the round ligament of the uterus and the genital branch of the genitofemoral nerve
What structures make up the anterior wall of the inguinal canal?
aponeuroses of the external oblique and internal oblique muscles
What structures make up the posterior wall of the inguinal canal?
aponeurosis of the transverse abdominal muscle and transversalis fascia
What structures make up the superior wall of the inguinal canal?
arching fibers of the internal oblique and transverse muscles
What structures make up the inferior wall (floor) of the inguinal canal?
inguinal and lacunar ligaments
Arterial supply of stomach
p. 87
From where does the stomach receive its main blood supply?
from the branches of the celiac trunk
From where does the celiac trunk arise?
from the front of the abdominal artery immediately below the aortic hiatus of the diaphragm
What arteries does the celiac trunk divide into?
left gastric, splenic, and common hepatic arteries
What does the left gastric artery run along?
lesser curvature of the stomach
What artery does the left gastric artery anastomose with?
the right gastric artery
What does the splenic artery run along?
runs along the superior boarder of the pancrease
What arteries does the splenic artery give rise to?
(dorsal pancreatic artery), short gastric arteries and left gastroepiploic artery
What does the left gastroepiploic artery run along?
the greater curvature of the stomach
What does the common hepatic artery divide into?
hepatic artery proper, right gastric artery, and gastroduodenal artery
portal system anastamoses
p. 88
esophageal varices results at the anastamosis of which veins?
left gastric vein (portal) and azygous (systemic)
manifestation of portal hypertension at the anastamosis of the superior rectal with the middle/inferior rectal veins
caput medusae is at anastamosis of which veins
paraumbilical (portal) and inferior epigastric (systemic)
the two other sites of portal system anastamosis
retroperitoneal vein (portal) with renal vein (systemic) and retroperitoneal vein with paravertebral vein (systemic)
3 manifestations seen in alcoholic cirrhosis
esoph. Varices, hemorrhoids, caput medusae "Gut, butt and caput"
lymph drainage
p. 88
drains right arm and right half of head
right lymphatic duct
what thoracic duct drains
everything that right lymphatic duct does not
pectinate line
location of pectinate line
where hindgut meets ectoderm
innervation, hemorrhoid type, aterial supply and venous drainage above pectinate line
visceral innervation, internal hemorrhoids, superior rectal artery, and rectal vein to inferior mesenteric vein to portal system
innervation, hemorrhoid type, aterial supply and venous drainage below pectinate line
somatic innervation, external hemorrhoids, inferior rectal artery, inferior rectal vein to internal pudendal vein to internal iliac vein to IVC
retroperitoneal structures
p. 88
parts of duodenum that are retroperitoneal
2nd, 3rd and 4th parts
parts of colon that are retroperitoneal
descending and ascending colon
2 big organs that are retroperitoneal
pancreas (except tail) and kidneys
2 major vessels that are retroperitoneal
aorta and IVC
digestive tract anatomy
p. 89
two big nerve plexuses in digestive tract and what they do
Submucosal (Meissners) controls Secretions; Myeneteric (Auerbach's) controls Motility
Layers of digestive tract from inside to out
villi, lamina propria, muscularis mucosae, submucosa, serosa
Gonadal venous drainage
p. 89
drainage of left ovary/testis
left gonadal vein to left renal vein to IVC
drainage of right ovary/testis
right gonadal vein to IVC
Enteric plexuses
p. 89
location of myenteric plexus
b/w inner and outer layers of GI smooth muscle
location of submucosal plexus
b/w mucosa and inner layer of GI smooth muscle
GI blood supply
p. 89
region and structures supplied by celiac artery
foregut: stomach to duodenum, liver, gallbladder, pancreas
hindgut is supplied by which artery
inferior mesenteric artery
superior mesenteric artery supplies ---
midgut: duodenum to proximal 2/3 of transverse colon
Kidney anatomy and glomerular structure
p. 90
grossly, the collecting system is made up of --
papillae, medullary pyramids, renal pelvis and ureter
which structures are in the renal medulla?
proximal and distal straight tubules, loop of Henle, vasa recta
location of macula densa
part of DCT next to afferent arteriole
Juxtaglomerular apparatus (JGA)
p. 90
two components of JGA
JG cells (afferent arteriole) and macula densa (DCT, senses Na)
three factors leading to renin secretion
decreased renal blood pressure, decreased sodium in distal tubule, increased sympathetic tone
what secretes erythropoeitin?
JG cells
Ureters: course
p. 90
two structures under which ureters pass
uterine artery and ductus deferens "water under bridge"
Ligaments of the uterus
p. 91
which ligament contains ovarian vessels?
suspensatory ligament of uterus
what does round ligament of uterus contain?
which ligament contains uterine vessels?
transverse cervical ligament
what does broad ligament contain?
round ligaments of uterus and ovaries and uterine tubules and vessels
Autonomic innervation of male sexual response
p. 91
erection is mediated by ---- while emission is mediated by ----.
Parasympathetics; Sympathetics "Point and Shoot"
which nerves mediate ejaculation?
visceral and somatic
Clinically important landmarks
p. 91
McBurney's point
site of appendix, 2/3 of way from umbilicus to ASIS
significance of ischial spine
site of pudendal nerve block
site of lumbar puncture
iliac crest
Peripheral nerve layers
p. 91
what is covered by endoneurium?
single nerve fiber
what must be rejoined in microsurgery for lim reattachment?
Perineurium: the Permeability barrier
what surrounds the entire nerve?
p. 91
sites of meissner's corpuscles and their function
dermis of palm, soles, and digits; involved in light discriminatory touch of hairless skin
Sites of Pacinian corpuscles and their function
deep skin at ligaments joint capsules, serous membranes and mesenteries; involved in Pressure, coase touch, vibration and tension
Inner ear
p. 92
3 components of bony labyrinth
cochlea, vestibul and semicircular canals
Site and composition of endolymph
membranous labyrinth, high potassium (like ICF)
site and composition of perilymph
bony labyrinth, high sodium
site of cochlear duct, utricle, saccule, and semicircular canals
membranous labyrinth
what frequency does base of cochlea pick up?
site and function of ampullae
in semicircular canals, for angular acceleration
site and function of maculae
in utricle and saccule, for linear acceleration
which frequency is lost first in hearing loss in elderly
site of endolymph production
stria vascularis
Collagen types
p. 92
most abundant protein in human body
collagen primarily found in basement membrane and basal lamina
type IV. "under the floor"
collagen type primarily found in cartilage
type II. "carTWOlage"
collagen type primarily found in bone
type I. "bONE"
Reticulin found in skin, blood vessels, uterus, fetal tissue, and granulation tissue
type III.
Collagen type X is found primarily in -----.
epiphyseal plate
Epidermis layers
p. 92
What are the layers of the epidermis from surface to base?
stratum corneum, stratum lucidum (in thick skin), stratum granulosum, stratum spinosum, stratum basalis. "Californians Like Girls in String Bikinis"
Epithelial cell junctions
p. 93
This type of junction is also called the zona occludens. (occludes diffusion across intracellular space)
tight junction
Forming a perimeter just below the tight junction, the zona adherens (intermediate junction) is composed of ------ and ------ filaments.
e-cadherin & actin filaments
Desmoplakin and ----- filaments are a part of the desmosome, also called the ----- ------.
keratin. Macula adherens
Structures that allow adjacent cells to communicate for electric and metabolic purposes.
gap junction
These structures connect cells to underlying extracellular matrix. Integrins are found in these structures.
Glomerular basement membrane
p. 93
The glomerular basement membrane is formed from fused endothelial and podocyte basement membranes and coated with ---- (pos / neg) charged ------ ------.
heparan sulfate
Responsible for filtering plasma according to ----- and ----.
charge & size.
In Nephrotic syndrome, Negative charge is lost. That's why plasma -----, which are negatively charged, are lost in the urine as a consequence.
Principle antigen presenting cell of epidermis
Langerhans cell
Cilia structure
p. 93
what is the arrangement of microtubules?
what is dynein?
what happens in Kartagener's syndrome?
Nissl bodies
p. 93
What are nissl bodies?
RER in neurons, not found in axon or axon hillock
What do nissl bodies synthesize?
enzymes (i.e. ChAT) and peptide neurotransmitters

Deck Info