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T10
Answer: It is the articulation of the manubrium and body of the sternum, and it marks the dividing point of the superior mediastinum from the inferior mediastinum. It also overlies the tracheal bifurcation and aortic arch and is useful for counting intercostal spaces. (Second ribs articulate here.)
1. What underlying bony feature does the point of the hip demarcate?
Answer: Spleen, splenic flexure of the transverse colon, pancreatic tail, stomach (variable), and part of the left kidney.
2. When comparing the female to the male pubic arch, what difference is apparent?
Answer: Ilium, ischium, and pubis. All come together in the acetabulum.
-Skin; -Subcutaneous tissue (fatty Camper's fascia and membranous Scarpa's -Fascia in the lower abdomen); -External oblique; -Internal oblique; and -Transversus abdominis muscles; -Tranversalis fascia; -Extraperitoneal fascia (preperitoneal fat); -and peritoneum.
Answer: The greater and lesser sciatic foramina. They provide an avenue for structures to pass from the pelvis to the gluteal region and posterior thigh, and for the pudendal vessels and nerves to enter the pudendal canal and pass to the perineum.
Answer: The iliofemoral ligament, which forms an inverted "Y" ligament (of Bigelow) that limits hyperextension.
Answer: Primarily the retinacular arteries of the medial and Lateral femoral circumflex, and acetabular branch of the obturator artery, which runs in the ligament of the femoral head (less important In adults).
Answer: Genital branch of the genitofemoral nerve. It innervates the cremaster muscle?
Answer: Superior gluteal nerve. Weakness of abductors (gluteus medius and minimus) on the weightbearing limb can lead to gluteal lurch during walking; this is known as a positive Trendelenburg sign.
Answer: A hernia that occurs lateral to the inferior epigastric vessels, passes through the deep inguinal ring and inguinal canal, and may appear at the superficial inguinal ring.
Answer: The epiploic foramen (Winslow), just posterior to the hepatoduodenal ligament and anterior to the IVC.
6. What is the inferior extent of the lung and parietal pleura in quiet respiration at the midaxillary line?
Lung extends to the eighth rib and the pleura to the tenth rib.
Answer: It is the lowest point in the female pelvis (where peritoneal fluids may collect), and access to drain these fluids is possible via the posterior vaginal fornix. Answer: Mesovarium (surrounds and suspends ovary), Mesopsalpinx (surrounds and suspends the uterine tubes), And mesometrium (surrounds and supports the uterus).
8. What are the three major branches of the celiac artery (trunk), and what do they supply?
Answer: Left gastric, common hepatic, and splenic. They supply the spleen and the foregut derivatives of the GI tract. Esophagus (distal end) Stomach Duodenum (proximal end) Liver, gallbladder, pancreas
8. What powerful flexor of the thigh at the hip attaches to the lesser trochanter?
Answer: Stress incontinence may result from a loss of functional integrity of the pubovesical ligaments, vesicocervical fascia, levator ani, and / or urethral sphincter.
9. Identify several easy ways to differentiate the jejunum from the ileum.
Answer: The jejunum compared to the ileum is larger in diameter; its mesentery contains less fat; its arterial arcades are fewer; and it has a longer vasa recta.
9. Uterine prolapse may occur with the loss of support of which important structures?
Answer: The transverse cervical (cardinal) and uterosacral ligaments, and the levator ani muscle, Answer: Femoral nerve (L2L4). The muscles are largely extensors of the leg at the knee.
Answer: Semitendinosus, semimembranosus, and the long head of the biceps femoris. They extend the thigh at the hip and flex the leg at the knee. They are supplied by the tibial nerve and attach to the ischial tuberosity.
Answer: Midgut derivatives of the GI tract. Distal portion of duodenum to the left colic flexure.
10. Which branches of the internal iliac artery arise from the posterior division?
Answer: One third of the way along a line connecting the anterior superior iliac spine to the umbilicus. It is a good landmark for locating an inflamed appendix (point of tenderness).
11. Why are gluteal intramuscular injections given in the upper outer quadrant?
Answer: To avoid injury to the large sciatic nerve, which runs through the lower half of the gluteal region.
Answer: An attachment arrangement of tendons of the semitendinosus gracilis, and sartorius muscles to the medial tibial condyle (looks like a goose's foot).
Answer: Anterior drawer sign, where the tibia moves anterioly in relation to the femur. The ACL normally prevents hyperextension of the knee and is injured more than the posterior cruciate ligament.
13. Where do sperm and seminal fluids empty into the urethra?
Answer: The portion that is pressed against the diaphragm and is not covered with visceral peritoneum. It will have a dull appearance rather than glistening appearance.
Answer: Inferior anal (rectal) nerves from the pudendal nerve (S2-S4).
Answer: Injury to the ACL, tibial collateral ligament, and medial meniscus.
15. Trace bile from the liver to the gallbladder and then duodenum, naming every duct traversed in correct order. 15. What is the arterial blood supply to the muscles of the anterior compartment of the leg?
Answer: Right and left hepatic ducts to the common hepatic duct to the cystic duct to the gallbladder. From the gallbladder to the cystic duct to the common bile duct to the hepatopancreatic ampulla (of Vater) to the second part of the duodenum.
Answer: The inferior and middle rectal veins (tributaries of the internal iliac vein - caval system) anastomose with the superior rectal vein from the inferior mesenteric vein, a tributary of the portal venous system. Answer: Parasympathetic preganglionic fibers arise from S2-S4 via pelvic splanchnic nerves that course to the inferior hypogastric plexus (pelvic), synapse there, and then innervate pelvic viscera (smooth muscle and glands).
Gastrocnemius - Tibial Fibularis longus - Superficial fibular Tibialis anterior - Deep fibular Plantaris - Tibial Flexor hallucis longus - Tibial Flexor digitorum brevis - Medial plantar (from tibial) Soleus - Tibial Abductor digiti minimi - Lateral plantar (from tibial) Plantar and dorsal interossei - Lateral plantar (from tibial)
Gastrocnemius Fibularis longus Tibialis anterior Plantaris Flexor hallucis longus Flexor digitorum brevis Soleus Abductor digiti minimi Plantar and dorsal interossei
Answer: In the abdomen at the cisterna chyli, which is the dilated beginning of the duct that receives lymph from the lumbar and interstitial lymphatic glands.
Answer: Deep fibular nerve ( if weakened eversion is also present, then it is the common fibular nerve).
1. Ureteropelvic junction 2. Pelvic brim - Crossing the bifurcation of common iliac a or beginning of external iliac a 3. Ureterovesicular junction: Passage through the wall of the urinary bladder
17. Identify three common anatomical sites where a renal calculus (stone) may become lodged and obstruct urine flow. 17. Lymphatic spread of cancer cells from a malignant ovarian tumor may involve the aortic (lumbar) lymph nodes directly. Why?
Answer: The lymphatic vessels of the ovary follow the ovarian artery directly back to the abdominal aorta and infiltrate aortic nodes in this region.
18. How is the joint between the talus and tibia classified?
Answer: The right vein empties into the IVC and the left vein empties into the left renal vein.
Answer: The pubic symphysis anteriorly, the ischial tuberosity laterally, and the coccyx posteriorly.
Answer: They distribute to the foregut and midgut derivatives of the GI tract by synapsing in the celiac and superior mesenteric ganglia and sending postganglionic fibers to the viscera on the vessels of the celiac and SMA.
19. How are thoracic splanchnic nerves distributed to the abdominal GI tract?
Answer: It anchors the perineum because it provides for attachment of many skeletal muscles of the perineum as well as fascial layers.
Answer: Loss of functionality in the nerves that relax the smooth muscle tone of the corpus cavernosum, which impedes blood flow into cavernous erectile tissue. Current medications facilitate smooth muscle relaxation and increase blood flow.
Answer: Plantar calcaneonavicular ligament, which supports the head of the talus and medial longitudinal arch of the foot. It is fairly elastic, hence its name.
Answer: Afferents axons conveying pain pass via thoracicand lumbar splanchnic nerves to the dorsal root ganglia (site of the afferent neurons) and into the spinal cord between the T5 and L2 levels, where they synapse in the dorsal horn (gray matter).
20. Where do the pain afferents from the abdominal viscera terminate in the central nervous system?
21. What is the female homologue of the male corpus spongiosum penis?
21. Which nerves of the lumbar plexus arise from L2L4 ventral rami, and what do they innervate?
Answer: Femoral nerve, which innervates the anterior compartment muscles of the thigh (largely knee extensors), and obturator, which innervates medial compartment muscles of the thigh (largely hip adductors).
1) Iliohypogastric (L1/T12-L1) 2) Ilioinguinal (L1/T12-L1) 3) Genitofemoral (L1-2) 4) Lateral femoral cutaneous (L2-3) 5) Femoral nerve (L2- 4) 6) Obturator nerve (L2- 4)
Answer: Calcaneus. Most are intraarticular fractures in which the talus is driven down on the calcaneus, as in a fall from a great height, with a landing on the heel.
22. In the lower limb, what are the two deep tendon reflexes?
Answer: The patellar tendon reflex (L3-L4) and the calcaneal tendon reflex (S1-S2). Answer: Foregut and midgut derivatives are innervated by the vagus nerve; the hindgut is innervated by the pelvic splanchnic nerves (S2-S4).
Answer: Medial and lateral plantar arteries derived from the posterior tibial artery.
25. What dermatomes are associated with each of the following regions? Inguinal region Knee Second toe Posterior leg and thigh
L1 L4 L5 S1-S2
32. What is the axis around which the gut tube rotates during development?
Esophageal tributaries anastomoses with those tributaries to azygos system > SVC Complication:
Esophageal tributaries anastomoses with those tributaries to azygos system > SVC Complication: ?
Indirect vs Direct Inguinal Hernia Leaves lateral to the inferior epigastric vessels Enters through the deep inguinal ring Mainly congenital Most common (75%) Hernial sac by persistent processus vaginalis and the covering of the spermatic cord Lies within the cord, covered by processus vaginalis Indirect vs Direct Inguinal Hernia Leaves medial to inferior epigastric vessels Protrudes through the inguinal (Hesselbach's) triangle Always acquired, but seems like genetic factors predispose Hernial sac by fascia transversalis & peritoneum Lies outside of the processus vaginalis, parallel to spermatic cord and its coverings.
Esophageal varices
Indirect
Paraumbilical veins anastomoses with subcutaneous veins of anterior abdominal wall > SVC & IVC Complication: ?
CAPUT MEDUSAE
...
Superior rectal vein anastomoses with middle and inferior rectal veins to the IVC Complication: ?
Internal HEMORRHOIDS
SA node to AV node to common AV bundle (of His) to right and left bundle branches and subendocardial Purkinje system.
Veins of Retzius - anastomose of small colic veins with veins in the posterior abdominal wall Complication: ?
SILENT VARICES
The pulmonary and aortic valves. Each has three semilunar cusps or leaflets. (They share a common embryologic origin.)
Pulmonary stenosis or narrowing of the right ventricular outflow, transposed aorta, right ventricular hypertrophy and VSD.
What does the fourth pair of aortic arches become in the adult?
Answer: On the right side, the right subclavian artery; on the left side, the aortic arch.
Answer: VSD (ventricular septal defect), which usually occurs in the membranous portion of the ventricular septum.
Compression of one or more of the structures passing out of the thoracic outlet. The subclavian artery or vein or lower portion of the brachial plexus is often involved.
What structure of the embryonic foregut region gives rise to the lung buds?
Laryngotracheal diverticulum.
Postganglionic sympathetic fibers (to the heart) and visceral afferents from the heart.
The right main bronchus is wider, shorter, and more vertical than the left bronchus, and aspirated infective agents can gain easier access to the right lung.
Visceral afferents from the ischemic heart are conveyed to the upper thoracic spinal cord levels, which also receive somatic afferents from the T1T4 dermatomes. Both groups of afferents converge in the dorsal horn of the spinal cord, and angina may be perceived as localized to the somatic distribution (T1-T4) rather than identified with the heart.
Answer: It has important connections with tributaries of the inferior vena cava and portal system, which normally drains most of the venous blood from below the diaphragm back to the heart. If this drainage is compromised, the connections with the azygos system provide alternative routes of venous return to the heart.