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High Yield Anatomy 2


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Autonomic pathwaysconsist of two motor neurons, a __ and a __
Autonomic pathwaysconsist of two motor neurons, a myelinated preganglionic
(presynaptic) neuron and an unmyelinated postganglionic (postsynaptic) neuron.
Because the linea albais relatively avascular, incisions may
not heal well and
Compression of the left testicular veinby a full sigmoid colon produces
varices of the pampiniform plexus on the left side- fertility may diminish.
In the female, palpable per vaginaare the
cervix and ostium of the uterus, the
The cavity of tunica vaginalisis a potential space that represents the detached
portion of the peritoneal cavity that surrounds the testis except at the mesorchium.
and the pelvic inlet more
The female pelvisis less massive, the subpubic angle is greater (almost 90°), and
The midrectum drains along the
middle rectal lymphatics.
from the
sacral promontory to a point a few millimeters below the superior mar-
ported by mesorchium) where?
in the scrotum.
The transverse midplane diameter,measured between the
ischial spines, is the
E. Spleen
The correct answer is E. The spleen follows the long axes of ribs 9 to 11 and lies mostly posterior to the stomach, above the colon, and partly anterior to the kidney. Therefore, it is the most likely organ of the group to be pierced by a sharp object penetrating just above rib 10 at the posterior axillary line. Note that the pleural cavity, and possibly the lower part of the inferior lobe of the lung, would be pierced before the spleen.
The left lobe of the liver (choice D) is positioned just beneath the diaphragm, just over and anterior to the stomach. The anterior positioning of this structure makes it an unlikely candidate for injury in this case. Even with deep penetration at the co
E. Vesicouterine space
The correct answer is C. The posterior fornix is in contact with the floor of the rectouterine space. The rectouterine space is the lowest part of the peritoneal cavity in the female pelvis. The patient has introduced bacteria into the peritoneal cavity by the penetration of the sharp object, producing sepsis.
The vesicouterine space (choice E) is the region within the peritoneal cavity of the female pelvis between the urinary bladder and the uterus. This space is not related to the posterior fornix of the vagina.
E. Nerve cell body loss in the ipsilateral dorsal horn
The correct answer is B. The dorsal root ganglion (DRG) contains nerve cell bodies of primary sensory afferents (the neurons that actually detect the sensory input). The primary afferents that sense conscious proprioception, discriminative touch, and vibration have cell bodies in the DRG, send axons into the spinal cord via the dorsal roots, ascend in the ipsilateral dorsal columns (in this case in the fasciculus cuneatus), and synapse in the medulla (in this case in the nucleus cuneatus). Therefore, if the DRG were destroyed, axonal loss would be predicted in the ipsilateral dorsal columns.
Choice D is not correct because the cell bodies of lower motor neurons (which reside in the ventral horn) send axons out of the spinal cord via the ventral roots to eventually synapse on skeletal muscle and would therefore not be affected by this injury.
E. Between the parietal pleura and the visceral pleura
The correct answer is A. The pericardial space is located between the epicardium (also known as the visceral pericardium) and the parietal pericardium. A tear of a blood vessel immediately outside of the heart will cause bleeding into the pericardial space. This accumulation of blood in the pericardial space causes increased pressure on the heart, which restricts filling of the heart during diastole (cardiac tamponade). This reduced filling results in reduced cardiac output and reduced blood pressure.
E. Superficial perineal space
The correct answer is E. The bulb of the penis contains the urethra, and is found in the superficial perineal space. The superficial perineal space is found between the inferior fascia of the urogenital diaphragm (perineal membrane) and the superficial perineal fascia (Colles' fascia). The attachments of the superficial perineal fascia to the posterior edge of the urogenital membrane and to the ischiopubic rami prevent the urine from escaping posteriorly into the gluteal region or laterally into the thigh. The urine can escape anteriorly onto the anterior abdominal wall, where it will be deep to the superficial abdominal fascia (Scarpa's fascia).
The retroperitoneal space (choice D) is the region between the parietal peritoneum and the endoabdominal fascia. This space contains connective tissue, fat, and several organs, including the kidney and ureter.
E. passes through the deep inguinal ring
The correct answer is B. Direct inguinal hernias enter the inguinal canal by tearing through the posterior wall of that structure. The typical location for this type of hernia is through the inguinal triangle, bounded laterally by the inferior epigastric artery, medially by the lateral border of the rectus abdominis, and inferiorly by the inguinal ligament. Direct inguinal hernias pass medial to the inferior epigastric artery, whereas indirect inguinal hernias pass lateral to the inferior epigastric artery because the deep inguinal ring is lateral to the artery.
Indirect inguinal hernias pass through the deep inguinal ring (choice E), direct inguinal hernias do not. Both types of inguinal hernias pass through the superficial inguinal ring.
E. Wall of the left atrium
The correct answer is B. The atrioventricular (AV) node is in the subendocardium of the interatrial septum. From the AV node, the Purkinje fibers of the atrioventricular bundle enter the interventricular septum to carry impulses to the ventricle. The function of the AV node is to retard the conduction of the cardiac impulses so that ventricular systole occurs after atrial systole.
The wall of the left atrium (choice E) does not contain any nodal cells.
E. Superior pancreaticoduodenal artery and inferior pancreaticoduodenal artery
The correct answer is E. The superior pancreaticoduodenal artery is a branch of the gastroduodenal artery, which is a branch of the common hepatic artery, itself a branch of the celiac trunk. The inferior pancreaticoduodenal artery is a branch of the superior mesenteric artery. Occlusion of the celiac trunk would allow blood from the superior mesenteric artery to reach the branches of the celiac trunk via the connections between the superior and inferior pancreaticoduodenal arteries.
The right colic and middle colic arteries (choice D) are both branches of the superior mesenteric artery.
E. Superior mesenteric vein-splenic vein
The correct answer is C. The splenic vein drains directly into the portal vein. The left renal vein drains directly into the inferior vena cava. Anastomosis of these veins would allow blood from the portal vein to drain retrograde though the splenic vein into the renal vein and then into the inferior vena cava.
The superior mesenteric vein (choice E) drains directly into the portal vein. The splenic vein also drains directly into the portal vein. Thus, neither vein is part of the caval venous system.
E. Superior pancreaticoduodenal-right gastroepiploic
The correct answer is D. The connection that specifically links the midgut (superior mesenteric artery territory) to foregut (celiac artery territory) is through the superior pancreaticoduodenal (from celiac artery) and inferior pancreaticoduodenal (from superior mesenteric artery) arteries.
Both the superior pancreaticoduodenal artery and the right gastroepiploic artery are branches of the gastroduodenal artery arising from the hepatic artery (choice E).
E. Right ventricle
The correct answer is A. The left atrium forms most of the posterior wall of the heart. The esophagus passes immediately posterior to the heart. Enlargement of the left atrium may compress the esophagus and cause dysphagia.
The right ventricle (choice E) forms most of the anterior wall of the heart and a small portion of the diaphragmatic surface of the heart. It is not related to the esophagus.
E. Renal artery
The correct answer is B. The ureter leaves the renal pelvis and lies on the posterior abdominal wall as it descends to the pelvis. It crosses the pelvic brim at the level of the bifurcation of the common iliac artery. At this point it crosses anterior to the origin of the external iliac artery to enter the pelvis.
The origin of the renal artery (choice E) is from the abdominal aorta at about the level of the second lumbar vertebra. The renal arteries pass laterally to enter the renal pelvis. At this site, the ureter is posterior to the artery.
A bronchopulmonary segmentis defined by a?
Segmental bronchus and accom-
E. Short gastric
The correct answer is C. The arterial supply of the stomach is complex and is consequently a target on the USMLE. The right gastric artery supplies the distal lesser curvature.
The right gastroepiploic artery (choice D) is normally supplied by the gastroduodenal artery.
A large VSD is the principal factor in
tetralogy of Fallot.
A long mesorchiummay predispose to
testicular torsion with high potential for testicular ischemia and necrosis.
A patent urachus(rare) allows
reflux of urine through the umbilicus.
E. Superior gluteal nerve
The correct answer is C. The pudendal nerve is a branch of the sacral plexus that exits from the greater sciatic foramen, and then enters the lesser sciatic foramen, to lie in the pudendal canal on the lateral wall of the ischioanal fossa. The inferior rectal nerve is a branch of the pudendal nerve, which crosses the ischioanal fossa to reach the anal canal, where it innervates the external anal sphincter and provides sensory innervation to the area.
The superior gluteal nerve (choice E) is a branch of the sacral plexus that exits through the greater sciatic foramen and innervates the gluteus medius, gluteus minimus, and tensor fascia latae muscles.
E. One half inch below the midpoint of the inguinal ligament
The correct answer is D. The inguinal canal lies entirely above the inguinal ligament. The deep inguinal ring is about one-half inch above the midpoint of the inguinal ligament. The superficial inguinal ring is superolateral to the pubic tubercle. Indirect inguinal hernias enter the inguinal canal through the deep inguinal ring.
The inguinal canal is entirely above the inguinal ligament. The thigh is below the inguinal ligament (choice E).
E. Posterior and superior mediastinum
The correct answer is E. The mediastinum is divided into four regions. The region above the manubriosternal junction (level of fourth thoracic vertebra) is the superior mediastinum. The region below the manubriosternal junction is divided into the anterior mediastinum (anterior to the pericardium), the middle mediastinum (within the pericardium), and the posterior mediastinum (posterior to the pericardium). The thoracic duct enters the thorax through the aortic hiatus of the diaphragm. At this point it lies in the posterior mediastinum, the region posterior to the pericardium. As it ascends through the thorax and passes the level of the fourth thoracic vertebra, it enters the superior mediastinum.
In addition to the thoracic duct, the posterior mediastinum (choices C and E) contains the descending aorta, azygos vein, hemiazygos vein and the esophagus.
A pudendal block can be effected by injecting an anesthetic into the vicinity of
the pudendal nerve in the pudendal canal close to the ischial spine.
E. Splenorenal ligament
The correct answer is D. The hepatoduodenal ligament is the portion of the lesser omentum that connects the liver to the first part of the duodenum. Within the hepatoduodenal ligament are found the proper hepatic artery and its branches, the common bile duct and its branches, and the portal vein. The cystic artery is usually a branch of the right hepatic artery, which is a branch of the proper hepatic artery.
The splenorenal ligament (choice E) is the mesentery that connects the spleen to the posterior abdominal wall. The splenic artery and splenic vein are within the splenorenal ligament.
D. Splenorenal ligament
The correct answer is D. The splenorenal ligament is the portion of the dorsal mesentery between the posterior abdominal wall and the spleen. This mesentery transmits the splenic artery and vein from their retroperitoneal position in the proximal portion of their course to the peritoneal spleen.
The lesser omentum (choice C) is derived from the ventral mesentery. It is the mesentery between the lesser curvature of the stomach and the liver and between the first portion of the duodenum and the liver. It is not related to the spleen.
The left gastric artery, which supplies the proximal lesser curvature (choice D), arises directly from the celiac artery.
A ventricular septal defect produces
a serious right-to-left shunt with
in the right ventricle.
fusion of the
external oblique and internal oblique aponeuroses
Adrenal arteriesarise from the
inferior phrenic arteries, the aorta, and the renal
An apical pulseis palpable at the point of maximal impulse (PMI) in which intercostal space? Just beneath what?
Fifth space, just beneath the nipple
Anterior interventricular sulcus
Between left and right ventricles, marks the interventricular septum
Aortic Auscultation
Right of sternum over second intercostal space
Atrioventricular Function
Stimulated by atrial depolarization. It leads into the atrioventricular (A-V) bundle to synchronize ventricular depolarization
Atrioventricular Location
Atrioventricular near the interatrial septum
Atrioventricular Vasculature
Branch of right coronary artery near the posterior inter-ventricular branch
Autonomic pathwaysconsist of
two motor neurons
nancy or constipation) results in
blood shunting through the anastomotic connections to the systemic venous system.
transverse perineal muscle extravasations of blood or urine will not pass into where?
extravasations of blood or urine will not pass into the anal triangle.
all three aponeuroses and there is no posterior leaf.
Extraperitoneal Organ's ?
Rectum, anal canal, urinary bladder, cervix, prostate
gland, seminal vesicles
Peritoneal Organ's ?
Sigmoid colon, uterus, uterine tubes, ovaries, testes
Deep Perineal Space
Deep transverse perineal external urethral sphincter, bulbourethral glands, membranous urethra
Superficial Perineal Space
Testes, crura of penis, bulb of penis, penile urethra, superficial transverse perineal muscles
Coronary sulcus
Between atria and ventricles. nearly vertical behind sternum. marks the annulus fibrosus that supports the valves
Coronary sulcus (Contents)
Right side contains the right coronary artery, and small cardiac vein. Crossed by anterior cardiac veins
Left side contains circumflex branch of the left coronary artery and coronary sinus
T12 - ?
Direct inguinal
Through the inguinal triangle bounded by inguinal ligament,
inguinal ring adjacentto the spermatic cord. Usually acquired
stone, what may develop?
pancreatitis may develop.
E. Portal vein, hepatic artery, and hepatic vein
The correct answer is D. The free edge of the lesser omentum contains three important structures: the common bile duct, the hepatic artery, and the portal vein.
Neither the cystic duct (choices A, B, and C) nor the hepatic vein (choices B, C, and E) lies in the free edge of the lesser omentum.
The short gastric artery (choice E) supplies the proximal greater curvature above the splenic artery.
E. Right triangular ligament
The correct answer is A. While most of the liver is covered with peritoneum, there are several reflections of the peritoneum (commonly called "ligaments") on the posteroinferior surface of the liver. When the opposing layers of the reflections are separated, a "bare area" on the liver is produced. The largest bare area contains on one end the inferior vena cava and is bounded by a continuous irregular ring of ligament that is somewhat arbitrarily divided into sections called the anterior and posterior layers of the coronary ligaments. It is the anterior layer of the coronary ligament that would be felt in the maneuver described in the question stem.
The right triangular ligament (choice E) is the name given for the area where the anterior and posterior reflections of the coronary ligament merge on the inferior part of the posteroinferior surface of the liver.
E. Seminal vesicle
The correct answer is B. The deep perineal space is the region of the middle layer of the urogenital diaphragm. This layer of the diaphragm contains two skeletal muscles, the sphincter urethrae muscle and the deep transverse perineal muscle. Also found in this space is the bulbourethral gland (Cowper's gland). The membranous portion of the urethra is the portion of the urethra that passes through the urogenital diaphragm.
The seminal vesicle (choice E) is in the pelvis, superior to both the pelvic diaphragm and the urogenital diaphragm. The seminal vesicle's duct joins the ductus deferens to form the ejaculatory duct, which enters the prostatic portion of the urethra.
Each uterine artery crosses immediately superior to a ureter in the
Extraperitoneal Organs?
Thoracic esophagus, rectum, kidneys, ureters,
and adrenal glands
Passes inferior to the inguinal ligament through the femoral ring
Indirect inguinal
Through the deep inguinal ring and along the inguinal canal—
the superficial ring withinthe spermatic cord. Usually congenital
Kidney stones may lodge at these locations with pain referred, respectively, to what regions?
the subcostal, inguinal, and perineal regions.
Metastatic carcinoma of the rectummay be widely disseminated within the
abdomen, pelvis, and inguinal region.
Minor calycesreceive one or two pyramids before fusing into
major calyces.
Mitral Auscultation
Apex of heart in fifth intercostal space in left midclavicular line
Movement of feces into the rectal ampulla generates
the urge to defecate.
E. Sinoatrial node
The correct answer is D. Individual cardiac muscle cells are joined together at the intercalated disks. These disks contain membrane specializations called gap junctions. Gap junctions allow for the electrical transmission of a membrane depolarization from one cell to the next. This electrical transmission accounts for the synchronous depolarization of cardiac muscle cells, which results in the synchronous contraction of these cells.
The sinoatrial node (choice E) is in the wall of the right atrium, near the entrance of the superior vena cava. The sinoatrial node is composed of specialized cardiac muscle cells that spontaneously depolarize at a rate faster than regular cardiac muscle
Normal uterine position is?
anteflexed (uterus bent forward on itself at the level
Thoracic splanchnic nerves
epigastric region
Referral Area
T1-T5: upper and midthorax
Intercostal nerves

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