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Anatomy/ Embryology
FA review Round 2 2020
Question | Answer |
---|---|
What are the 4 components of the Urethra? | 1. Prostatic urethra 2. Membranous urethra 3. Bulbous urethra 4. Penile urethra |
What part of the urethra is injured in "straddle injuries"? | Bulbous urethra |
Which type of injuries cause injury to the Bulbous urethra? | Straddle injuries |
How is a damage to the Bulbous urethra clinically presented? | Rupture will cause inability to void, blood in urethral meatus, and scrotal swelling |
What action often result in damage to the Membranous urethra? | Pelvic fracture |
A "high-riding prostate" is often a result of damage to which part of the urethra? | Membranous urethra |
If blood is accumulted in the retrpubic space, it most likely indictates an ijury to the ___________ urethra. | Membranous urethra |
Which ligaments make up the "Unhappy Triad"? | MCL, ACL, and Medial meniscus |
What is a possible cause for development of classic unhappy triad? | Lateral knee impact |
How is "Unhappy triad" clinically presented? | Pain, stiffness, instability of knee, and inability move the knee through its range of motion (ROM). |
What injury is indicated with medial space widening of the Tibia? | MCL injury |
LCL injury is diagnosed by: | Lateral space widening of the Tibia |
What are the 3 arterial sources of the Esophagus? | Inferior Thyroid artery, Bronchial arteries and Thoracic aorta, and most distal third by the left gastric artery |
Which artery supplies the proximal 1/3 of the esophagus? | Inferior Thyroid artery |
Which part of the esophagus is irritated by the Left Gastric artery? | Distal 1/3 of esophagus |
What arterial bodies supply the middle 1/3 esophagus? | Bronchial arteries and Thoracic aorta |
Which TORCHES infection is the main cause of neonatal PDA? | Rubella infection |
Clinical presentation of Rubella infection in pregnant mother | Arthralgias, fever, lymphadenopathy, and facial rash that progressed caudally |
Congenital Rubella or Congenital Rubeola is the main cause of PDA in neonate? | Congenital Rubella |
What is affected or damaged in Tabes dorsalis? | Degeneration of the Dorsal columns of the Spinal Cord and the Dorsal roots |
What are infection is known to cause Tabes dorsalis? | Syphilis (Treponema pallidum) |
Which part of the spinal cord is affected in Tabes dorsalis? | Dorsal columns and dorsal roots |
What are neurological deficits seen with Tabes dorsalis? | Impaired proprioception and ataxia |
What is injured in Erb palsy? | Nerves arising from C5-C6 (upper trunk) |
What nerve roots make up the Upper Trunk? | C5 and C6 |
What muscles are injured in Erb palsy? | Deltoid, Supraspinatus, Infraspinatus, and Biceps brachii |
How is Erb's palsy presented? | Pronated forearm, a flexed wrist ("waiter's tip), and internally rotated should and the inability to adduct arms at the shoulder |
Which condition is due to injury to the Upper trunk of the Brachial plexus? | Erb's palsy |
What is the function of the Subthalamic nucleus? | Directly excites the internal segment of the Globus pallidus, which then inhibits the Thalamus |
What is the result of decreased subthalamic nucleus activity? | Large involuntary motor movements on the contralateral side of the lesion |
Damage to the Subthalamic nucleus causes ipsilateral or contralateral motor deficits? | Contralateral |
The Basal ganglia and other deep brain structures are particularly susceptible to: | Lacunar small-vessel infarcts |
Which wrist bone fracture is difficult to diagnose or visualize immediately after injury? | Scaphoid fracture |
What occurs few weeks after initial injury causing a Scaphoid fracture? | The proximal fragment undergoes osteonecrosis and the bone begins to be reabsorbed, leading to noticeable hyperdensity and sclerosis on the radiography |
Which type of wrist bone fracture is often seen with late osteonecrosis and bone sclerosis? | Scaphoid fracture |
What is another way to refer to a Smith fracture? | Reverse Colle's fracture |
What causes a Smith fracture? | Trauma to the dorsal side of flexed wrist |
What is a Smith fracture? | Fracture of distal end of the radius with a distal fracture fragment displaced ventrally |
Fracture of distal end of the radius with a distal fracture fragment displaced dorsally. | Colle's fracture |
How is a fracture of the Hook of Hamate clinically presented? | Pain over the anatomical snuffbox |
What is Parkinson disease? | Degeneration of Dopaminergic neurons of the Substantia nigra pars compacta |
Where to neurons involved or affected in Parkinson disease project to? | Striatum |
What composes the Striatum? | Putamen and Caudate |
What is the action of neurons of the Striatum in Parkinson disease? | Modulate activity in both direct and indirect pathways |
What is/are the MCC of C7 radiculopathy? | C6-C7 disc herniations |
What are the motor and sensory deficits of C7 radiculopathy? | Motor ---> Triceps Sensory ===> Abnormality of the middle finger |
Which root is most likely affected in C7-radiculopathy? | C7 (60%) and C6 (25%) |
Why are aspirates most likely to be found in the Right or Left lung? | Right lobes of the lung because the Right-main bronchus is more vertical and wider than the left |
Where are aspirates most likely found in a patient sitting or standing while aspirated? | Right-middle or Right-inferior lobe(s) |
If a patient aspirates while supine, where would the aspirate most likely found? | Superior segment of Right-lower lobe |
What causes infertility in Cystic fibrosis patients? | Inadequate Mesonephric duct development |
Which condition is associated Mesonephric duct underdevelopment leading to infertility? | Cystic fibrosis |
What artery is infarcted in Medial Medullary Syndrome? | Anterior Spinal artery (ASA) |
What are the clinical features or Medial Medullary syndrome? | - Weakness of Contralateral body - Ipsilateral tongue deviation - Contralateral loss of proprioception and vibratory sense below the face |
What are the contralateral deficits seen in Medial Medullary syndrome? | Weakness of contralateral body adn loss of proprioception and virbratory sense below the face |
How is the tongue affected in Medial Medullary syndrome? | Ipsilateral tongue deviation upon protrusion |
What are the 3 muscles that close the jaw? | Masseter, Temporalis, and Medial Pterygoids |
Which muscle causes the jaw to open? | Lateral pterygoid |
Which nerve innervates the muscles of mastication? | CN V3 |
What is the arterial supply of the Midgut? | SMA |
What is the Parasympathetic innervation of the Midgut? | Vagus nerve |
What is the vertebral level of Migut? | L1 |
What structures are contained by the Midgut? | Distal duodenum to Proximal 2/3 of the Transverse colon |
The Jejunum and Ileum are part of the Hindgut or Midgut? | Midgut |
Embolisms are more common in acute or chronic events? | Acute |
Thromboembolism ar comre common in chronic or acute events? | Chronic |
What important substance is secreted by Sertoli cells in males? | MIF |
What is the role of MIF? | Prevents the development of female reproductive organs |
A healthy looking male, with fully developed female reproductive organs may indicate failure of which cells? | Sertoli cells |
What is the MCC of S1 radiculopathy? | L5-S1 herniated disc |
What are the clinical deficits seen in S1 radiculopathy? | 1. Decreased sensation in the Posterior leg and the lateral foot 2. Diminished/absent ankle-jerk reflex 3. Weak plantarflexion of the foot |
Which radiculopathy is seen with a weak plantarfleidon of the foot? | S1 radiculopathy |
Which radiculopathy is seen with a weak dorsiflexion of the foot? | L5 radiculopathy |
Herniation of L4-L5 disc. Dx? | L5 radiculopathy |
Which radiculopathy is seen with a diminished ankle-jerk reflex? | S1 radiculopathy |
Which part of the foot has decreased sensation in S1 radiculopathy? | Lateral foot |
Which part of the leg, anterior or posterior, is seen with decreased sensation in S1 radiculopathy? | Posterior leg |
Which part of the foot present decreased sensation in L5 radiculopathy? | Medial foot |
If the patient present a weak dorsiflexion of the foot, what is a probable diagnosis? | L5 radiculopathy |
What nerve provides motor innervation to the Palatal arches and Uvula? | Vagus nerve |
Which areas of the mouth are innervated by the Vagus nerve? | Uvula and Palatal arches |
What is the result of a LMN lesion in CN X? | Contralateral deviation of the uvula |
Which nerve is commonly damaged that causes the Uvula to deviate contralateral to the side of the lesion? | Vagus nerve |
Which is the vein that liver-synthesized proteins first enter to? | Hepatic veins |
Liver proteins leave the liver and enter the systemic circulation via? | Hepatic veins and then IVC |
What is the blood flow of the Portal vein? | Delivers blood from the GI tract to the liver and directly to the systemic circulation |
What is a common cause of Back pain? | Disc herniation |
Which dermatome covers the Inguinal Ligament? | L1 dermatome |
Which part is covered or innervated by the L1 dermatome? | Inguinal ligament |
What is the MC congenital cardiac anomaly? | VSD |
What is the description of the auscultation of a VSD? | Harsh or blowing Holosystolic murmur best heard at the Lower left sternal border |
What is the place to best auscultate and hear a VSD? | Lower Left Sternal Border (LLSB) |
The smaller the VSD = | The louder the VSD |
What part(s) of the hand are innervated by the Ulnar nerve? | Sensation of the Medial 1 1/2 digits and hypothenar eminence |
Which nerve (ulnar, radial, or medial) provides sensation the "pinky" finger? | Ulnar nerve |
Which nerve provides sensation innervation to the Hypothenar eminence? | Ulnar nerve |
The ulnar nerve provides sensation to the hypothenar or thenar eminence? | Hypothenar eminence |
What does the Deep Motor branch of the Ulnar nerve innervate? | Most intrinsic muscles of the hand, including the ADDUCTOR POLLICIS muscle |
Which nerve innervates the ADDUCTOR POLLICIS in the hand? | Deep Motor branch of the Ulnar nerve |
What are clinical signs or features of superficial laceration damaging the ulnar nerve? | Sensory loss, ulnar claw hand, or the Froment sign |
Which rare but severe viral infection may lead to a damaged Superior Gluteal nerve? | Polio |
What muscles are innervated by the Superior Gluteal nerve? | Gluteus medius and Gluteus minimus |
Function of the Gluteus medius and minimus: | 1. Abduct and medially rotate the thigh 2. Keep pelvis at level |
Which muscles are known to keep the pelvis at level? | Gluteus medius and Gluteus minimus |
Which muscles are in charge of abducting and medially rotating the thigh? | Gluteus medius and Gluteus minimus |
Description of the Trendelenburg gait: | As patient leans on the AFFECTED side the CONTRALATERAL hip drops. |
Which side of the hip is "dropped" if the patient suffered from a Left Superior Gluteal nerve injury? | Right |
Contralateral or Ipsilateral. In Trendelenburg gait, the hip drops to the ___________________________ side. | Contralateral |
What is the MCC of Inferior Gluteal nerve injury? | Posterior hip dislocation |
What muscle is innervated by the Inferior Gluteal nerve? | Gluteus maximus |
What is the function of the Gluteus maximus? | Extend and laterally rotate the tight and aids in standing from the sitting position |
Which gluteal muscle, minimus, medius, or maximus, extend and laterally rotate the thigh? | Gluteus maximus |
What nerve is likely to be injured if the patient has difficulty or weakness standing up from the sitting position? | Inferior Gluteal nerve |
Which actions are often described to be difficult in a patient with an damaged/injured Inferior Gluteal nerve? | 1. Standing from sitting position 2. Ascending stairs 3. Jumping |
What are common Neural tube defects (NTD)? | Meningocele and Meningomyelocele |
What deficiency is most often associated with development of NTD in utero? | Folate deficiency |
What type of teratogenic effects are seen with Folate deficiency in pregnancy? | Neural tube defects (NTD) |
What are the most common labs to diagnose NTD? | Elevated AFP levels in the amniotic fluid and maternal serum |
What is the confirmatory test used for NTD? | Elevated AChE (acetylcholinesterase) in amniotic fluid |
Which is the only neural tube defect with normal AFP level? | Spina bifida oculta |
Which nerve is compressed in Carpal Tunnel syndrome? | Median nerve |
Where is the Median nerve compressed in Carpal Tunnel syndrome? | In the Carpal tunnel between the flexor tendons and the Flexor retinaculum |
Which finger or hand digit is seen with decreased strength in Carpal tunnel syndrome? | Thumb |
Which hand muscles are affected in Carpal tunnel syndrome? | Opponens pollicis, Flexor Pollicis brevis, and Abductor pollicis brevis |
What nerve(s) are derivatives of the 6th Pharyngeal arch? | Recurrent and Inferior Laryngeal branch of the CN X |
The Recurrent Laryngeal nerve of CN X, is a derivative of which pharyngeal arch? | 6th pharyngeal arch |
Which muscles are innervated by the Recurrent/inferior laryngeal nerve branch? | All intrinsic muscles of the Larynx, except for the cricothyroid |
Which branch of the CN X is derived from the 4th pharyngeal arch? | Superior Laryngeal branch of CN X |
What muscles are innervated the the Superior Laryngeal branch of the CNX? | Pharyngeal constrictor; cricothyroid, adn levaro veli palatini |
Pharyngeal clefts (grooves) are derived from ==> | Ectoderm |
Pharyngeal arches are derived from : | Mesoderm and Neural crest |
Pharyngeal clefts, arches, or pouches, are derived from Endoderm? | Pharyngeal pouches |
What organs/tissues are originated by Pharyngeal arch mesoderm? | Muscles and arteries |
What is Pollicis? | The genitive or possessive of the latin word for thumb which is pollex |
What is the definition of Opponens? | Any of several muscles of the hand or foot that tend to draw one of the lateral digits across the palm or sole toward the others |
What are the roots of the Musculocutaneous nerve? | C5-C7 |
Injury to the Musculocutaneous nerve results in: | 1. Absent Biceps reflex 2. Loss of Forearm flexion and supination 3. Loss os sensation in lateral forearm |
Which part of the Brachial plexus, if compressed or injured, causes damage to the Musculocutaneous nerve? | Upper trunk |
Which area of body losses sensation if the Musculocutaneous nerve is damaged? | Lateral forearm |
What are MOTOR deficits seen in Musculocutaneous nerve injuries? | Forearm flexion and supination |
What nerve is suspected to be injured if patient is unable to supinate forearm? | Musculocutaneous nerve |
Which reflex is lost by damage to the Musculocutaneous nerve? | Biceps reflex |
(-) or Weak Biceps reflex. Suspected injury to which nerve? | Musculocutaneous nerve |
Which vessel is at risk of compression in pregnant women? | IVC |
At what vertebral point does the IVC cross the diaphragm? | T8 |
Which structure is at risk of compression in people with increased intra-abdominal pressure? | IVC |
How does the IVC traverse the diaphragm at T8? | Directly though the central tendon of the diaphragm |
Which structures traverse the diaphragm at T8? | IVC and right phrenic nerve |
Which 2 structures traverse the diaphragm at T10? | Esophagus and CN X |
At what vertebral level does the CN X traverse the diaphragm? | T10 |
Which structures are known to traverse the diaphragm at T12 level? | Aorta, Thoracic duct, and Azygous vein |
What is the acute cardiac consequence of Rheumatic fever? | Pancarditis |
What type of cardiac defects or anomalies are seen in as a chronic consequence of Rheumatic fever? | Valvular (M>A>T) stenosis or regurgitation |
What does the valvular incompetence of chronic RF produces? | Back up blood flow within the heart, enlarging previous chambers and pressures |
Enlargement of the left atrium may produce: | Left-recurrent laryngeal nerve impingement and compression of esophagus, leading both hoarseness of voice and dysphagia, respectively. |
What is the function of the Subscapularis? | Medially (internally) rotate and adduct the arm |
What is the innervation of the Subscapularis muscle? | Upper and Lower Subscapular nerves |
What is the function of the Teres minor muscle? | Adducted and Externally rotate the arm |
Which rotator cuff muscle medially rotate and adduct the arm? | Subscapularis |
Which rotator cuff muscle adduct and externally rotate the arm? | Teres minor |
What is the nerve that innervates the Teres minor muscle? | Axillary nerve |
Which week of gestation is the one with greatest risk of developing Neural tube defects? | 4th week |
What type of teratogenic defects are seen if the incident occurs in the 4th week of gestation? | Neural tube defect (NTD) |
What NTD is suspected if the Physical exam finds a sacral dimple? | Spina bifida oculta |
Which NTD is associated with improper closedure of the Posterior neuropore? | Spina bifida |
What are the roots of the Ulnar nerve? | C8-T1 |
Which brachial plexus trunk forms or gives rise to the ulnar nerve? | Lower trunk |
What nerve is possible damaged or affected with compression of Brachial plexus lower trunk? | Ulnar nerve |
What muscles are innervated by the Ulnar neve? | Hypothenar muscles, two of the Lumbrical muscles, and all the interosseous muscles of the hand |
What type of injury often results in Lower trunk of brachial plexus damage? | Sudden upward pulling of abducted arm |
Sudden upward pulling of abducted arm, often results in what condition? | Klumpke's palsy |
Which nerve innervates all the interosseous muscles of the hand? | Ulnar nerve |
When does an Uncal herniation occur? | As the Supratentorial mass pushes the medial temporal lobe medially and inferiorly, compressing the ipsilateral Oculomotor nerve and contralateral crus cerebri against Kernohan's notch |
What are the clinical results or deficits of Uncal herniation? | 1. Ipsilateral Oculomotor nerve (CN III) palsy and, 2. Contralateral hemiparesis |
What is the difference between paresis and paralysis? | Paresis means weakness of the muscle and patient can still use affected part, while in paralysis the patient cannot move or use the affected area. |
What term is used to indicate paralysis? | -plegia |
What phase are Oocytes arrested until ovulation? | Prophase I |
What phase are Oocytes arrested from Ovulation until Fertilization? | Metaphase II |
What nerve is commonly injured with a fracture to the Fibular Neck? | Common fibular (peroneal) nerve |
What are the clinical deficits seen with an injured Common Fibular (peroneal) nerve? | Inability to DORSIFLEX and EVERT foot |
What nerve is suspected damaged in patient is unable to dorsiflex and/or evert foot? | Common fibular (peroneal) nerve |
What nerve injury causes Foot drop gait? | Common fibular (peroneal) nerve |
Does the Common Fibular (peroneal) nerve travel medially or laterally in the leg? | Lateral |
What tissue hyperplasia is associated with Duodenal ulcers? | Hyperplasia of Brunner's glands |
Which condition is often associated with hyperplasia of the Brunner glands? | Duodenal ulcers |
What are the causes or mechanisms of pathogenesis for Duodenal ulcers? | 1. Decrease mucosal protection or, 2. Increased gastric acid secretion |
Which ulcer is known to cause abdominal pain between meals? | Duodenal ulcers |
Which is the most commonly injured tendon of the Rotator cuff? | Supraspinatus tendon |
On which actions, does the Supraspinatus tendon provide aid? | Aids the Deltoid in abduction of the arm, especially in the first 15 degrees |
Which tendon is known to help deltoid arm abduction in the initial 15 degrees? | Supraspinatus tendon |
Which arm nerve is known to provide motor innervation to all the interosseous muscles of the hand? | Ulnar nerve |
Example of an important interosseous hand muscle: | Adductor Pollicis muscle |
What nerve is usually damaged by first time suicide attempt to cut their wrists? | Ulnar nerve |
What is the motor innervation of the Adductor pollicis muscle? | Deep Motor branch of the Ulnar nerve |
Which processes fail to fuse that result in Cleft palate? | Lateral/Medial Palatine processes |
Lateral Palatine processes fail to fuse together. Dx? | Cleft Palate |
Medial Palatine processes fail to fuse together. Dx? | Cleft palate |
Which processes failure to fuse result in Cleft lip? | Medial nasal processes and Maxillary processes |
Failed fusion of Maxillary processes. Dx? | Cleft lip |
Failed fusion of Medial Nasal processes. Dx? | Cleft lip |
What is the MCC of death in infants born with congenital diaphragmatic hernia? | Pulmonary hypoplasia |
In which cases, Pulmonary hypoplasia, is the main cause of death? | Infants with congenital diaphragmatic hernia |
Why does Pulmonary hypoplasia develop in infants with congenital diaphragmatic hernia? | Impaired growth and inflation of the newborn's lungs |
What is a common cause of Pulmonary hypoplasia? | Oligohydramnios |
Which is a severe consequence or sequelae of Oligohydramnios? | Pulmonary hypoplasia |
What are the common veins used for placement of Central lines? | Internal jugular, Subclavian, and Femoral veins |
Anatomical location of the Internal Jugular vein. | Lateral to the Common Carotid artery, anterior to the Vagus nerve, and within the Carotid sheath |
Which nervous system controls male erection? | Parasympathetic |
Which nervous system controls the male emission and ejaculation? | Sympathetic |
Which dermatomes provide sensation to the penis and anal region? | S2, S3, and S4 |
Which are the nerve roots associated with the Pelvic Splanchnic nerves, controlling male erection? | S2-S4 |
Which nerve innervation causes Ejaculation ? | Hypogastric nerve, T11-L2 |
Dermatome S3, S3, S4 provide/cover ===> | Penile and anal sensation |