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Anatomy 1
UWORLD + FA anatomy review
| Question | Answer |
|---|---|
| Wernicke's aphasia | Well-articulated, nonsensical speech with a lack of language comprehension |
| Wernicke's area: | Located in the auditory association cortex within the posterior portion of the superior temporal gyrus in the dominant temporal lobe |
| What is the irrigation of the Wernicke area? | Inferior division of the MCA |
| What is the blood supply of the Broca's area? | Superior division of the MCA |
| The ________ irrigates both the Broca and Wernicke area. | MCA |
| What areas of the ocular orbit are most readily damage by a direct blow to the globe? | Medial and inferior wall due to the thin bones bordering the ethmoid and maxillary sinuses |
| The ethmoid cells are located __________ and the maxillary sinuses area located ________________ with respect to the ocular orbital foramen. | Medial; Inferior |
| The biceps reflex is done by tapping the ________________________. | Biceps brachii tendon passing in the Cubital fossa |
| What are the spinal nerves involved in the Biceps reflex? | C5-C6 |
| Deficits to the C7 root of the brachial plexus causes defects in the _____________ and __________ nerves. | Radial and Median |
| What is the most common way to have damage to C7 root in cases of absence trauma? | Cervical radiculopathy |
| Radial nerve deficit include: | - Decreased triceps reflex - Inability to extend wrist and finger (Wrist drop) |
| What are some median nerve deficits upton damage? | Loss sensation in palm in third finger |
| C8 and T1 create the ______________ trunk, _____________ cord, and _____________ and ____________ nerves. | Lateral trunk, medial cord, and ulnar and median nerves |
| What nerves come off the Posterior cord? | Axillary and Radial nerve |
| The joining of the lateral and Medial cords produces the ________________ | Median nerve |
| What terminal branch comes off directly from C5 and C6? | Musculocutaneous nerve |
| What nerve may be damage in Thyroidectomy? | External branch of the Superior Laryngeal nerve |
| What muscle is innervated by the External branch of the Superior Laryngeal nerve? | Cricothyroid muscle |
| What runs along the External branch of the Superior Laryngeal nerve? | Superior Thyroid artery and vein |
| What arterial bodies irrigate the Thyroid and PTH glands? | Superior and Inferior Thyroid arteries. |
| The orbital floor is composed by the _________________ bone and the _________________. | Zygomatic bone and Maxilla |
| What nerve is damage in orbital floor fracture? | Infraorbital nerve, which is a continuation of the Maxillary nerve |
| What are clinical deficits seen with damaged Infraorbital nerve? | Numbness and Paraesthesia of the UPPER CHEEK, UPPER LIP, and UPPER GINGIVA. |
| In orbital floor fractures, why is there an impaired vertical gaze? | Due to entrapment of the inferior rectus muscle |
| What is the only major nerve that exits through the Obturator foramen? | Obturator nerve |
| What are the deficits seen in injury to the Obturator nerve? | 1. Weakness on thigh ADDUCTION 2. Sensory loss over distal medial thigh |
| What muscles are in charge of thigh ABDUCTION? | Gluteus medius, gluteus minimus, and tensor fascia lata |
| What nerve innervates the Gluteus minimus and medius? | Superior Gluteal nerve |
| Through which foramen does the Superior Gluteal Nerve exits the pelvis? | Greater Sciatic foramen ABOVE the Piriformis |
| What muscle(s) is in charge of thigh extension? | Gluteus maximus |
| The Gluteus maximus is innervated by the __________________ nerve, which exits the Pelvis though the ______________ foramen, and ____________ the _________________. | Inferior Gluteal Nerve; Greater Sciatic foramen; Below the piriformis |
| Which group of muscles are in charge of flexing the thigh? | Psoas, Iliacus, and Sartorius muscles |
| What are the nerves innervating the Psoas and Iliacus muscles? | Psoas innervated by the Lumbar plexus, and the Iliacus is innervated by the Femoral nerve. |
| The Quadriceps femoris group of muscles are innervated by the _______________ nerve, and are in charge of _______________ of the ___________. | Femoral nerve; Extension of leg. |
| What is the most common Pineal gland tumor? | Germinomas |
| Germinomas present most commonly with 2 major characteristics? | 1. Obstructive hydrocephalus 2. Dorsal midbrain (Parinaud) syndrome |
| Where are germinomas usually located? | Suprasellar region |
| What are the characteristics seen with an Obstructive Hydrocephalus? | Papilledema, headache, and vomiting (morning MC) |
| Parinaud syndrome usually presents with: | LImitation of UPWARD gaze with a downward preference, bilateral eyelid retraction, and near - light dissociation |
| A patient with Dorsal Midbrain Syndrome (____________________), can _____________ eye but does not react to _________________. | Parinaud Syndrome; ACCOMMODATE; Does not react to LIGHT |
| What is Collier's sign? | Bilateral eyelid retraction. MC associated with Parinaud syndrome. |
| What three structures make up the Brainstem? | Midbrain, Pons, and Medulla |
| Damage to the Lateral Medulla causes? | Wallenberg Syndrome |
| Damage to the Pons, usually results in _____________ syndrome. | "Locked-in" syndrome |
| What is the most common cerebral tumor in children? | Medulloblastoma |
| What are the common physical findings of a patient with a Medulloblastoma? | Gait and limb ataxia, intention tremor, and nystagmus |
| What artery prevents the rise or ascent of a Horseshoe kidney? | Inferior Mesenteric Artery |
| A person with Horseshoe kidney has a higher risk of developing: | Ureteropelvic junction obstruction, recurrent infections, urolithiasis, and Neoplasm (Wilms tumor in children, and RCC in adults) |
| Which vessels form a anastomoses during uterter transplantation? | He DONOR RENAL artery with the RECIPIENTS EXTERNAL ILIAC artery. |
| The proximal ureter (near kidney) is irrigated mostly by the _________ artery. | Renal |
| The distal (near bladder) ureter portion is irrigated the the _________________ artery. | Superior Vesical artery |
| What is the overall clinical presentation of an Aortic dissection? | Severe back pain, hypertension, ECG abnormalities, and transesophageal echocardiogram showing a dissection flap. |
| What are the 2 types of Aortic Dissection? | 1. Stanford Type A: involve any part of the ASCENDING aorta 2. Stanford Type B: involve any part of the DESCENDING aorta |
| Most Stanford Type A aortic dissection originate near the ____________________. | Sinotubular junction |
| Stanford Type B aortic dissections commonly originate near the __________________________. | Left Subclavian Artery |
| During a cricothyrotomy, what tissues are cut? | Superficial Cervical fascia --> Pretracheal fascia --> cricothyroid membrane |
| Where is the most common place for stenosis-causing Subclavian Steal syndrome? | Subclavian artery proximal to the origin of the Vertebral artery |
| Reversal of blood flow of the vertebral artery usually indicates? | Subclavian Steal Syndrome |
| If blood in the Vertebral artery is not going to the brain, and the dx of Subclavian steal syndrome is made, which artery has been "stealing" the blood from the brain? | Left Subclavian artery (MC) |
| What causes the retractions in the skin seen in invasive breast carcinoma? | Malignant infiltration of the SUSPENSORY ligaments of the breasts |
| What is another name for the Suspensory Ligaments of the breast? | Cooper Ligaments |
| Malignant invasion of the Cooper ligaments may cause ____________. | Skin retractions |
| Where is the most common place for Invasive breast carcinoma? | Upper Outer Quadrant of the breast |
| Peau d'orange | seen in malignant breast cancer; due to malignant spread through the axillary lymphatics, they can block cutaneous lymphatic flow |
| Thickened, dimpled skin over the beast | Peau d'orange |
| Hip flexor | Psoas muscle |
| Where does the Psoas muscle originate? | Anterior surface of the Transverse processes and Lateral surface to the vertebral bodies |
| What is the erector spinae? | Muscle running along the spinous processes |
| What is the function of the Erector Spinae muscle? | Bilateral contraction --> Spine extension |
| What area of the nose causes the most bleeding? | Mucosal irritation to the Anterior Nasal Septum |
| Why does severe nose bleeding occurs when the anterior nasal septum is injured? | It is where the Kiesselbach plexus is located |
| What is the medical term used for nose bleed? | Epistaxis |
| What is the Kiesselbach plexus? | Anastomoses site of the Ethmoidal, sphenopalatine and Superior labial arteries |
| What is compresses in order to stop epistaxis? | Nasal alae |
| Postcentral gyrus is also known as the: | Primary somatosensory cortex |
| What is the role of the Postcentral gyrus? | responsible for all somatic sensory input for the contralateral side of the body |
| Focalized seizure to the postcentral gyrus, immediately causes? | Numbness and paraesthesias to the contralateral side of body |
| A seizure reaching the precentral gyrus would cause? | Motor deficits, causing contralateral convulsions |
| As a seizure covers all the brain hemispheres it presents as: | Tonic-clonic convulsions |
| Broca's aphasia | Uncontrolled vocalization and expressive aphasia, but with good comprehension of commands and vocabulary. |
| What is the pathophysiology of a Indirect inguinal hernia? | Patent Processus vaginalis |
| Who is most commonly affected with an Indirect inguinal hernia? | Infant males |
| What are characteristics of an indirect inguinal hernia? | - Originates lateral to the Inferior epigastric vessels - Protrudes through deep inguinal ring into the inguinal canal - follow the spermatic cord |
| What population is most affected by a direct inguinal hernia? | Older men |
| What is the pathophysiology of a Direct inguinal hernia? | Weakness of the Transversalis fascia |
| What are some characteristics of a Direct inguinal hernia? | Protrudes MEDIAL to the Inferior epigastric vessels, and through the Hesselbach triangle |
| Widening of the femoral ring, may cause? | Femoral Hernia |
| Which gender is most likely to develop a Femoral hernia? | Women |
| What are features of the Femoral Hernia? | 1. Emerges inferior to the inguinal ligament 2. Protrudes through femoral ring tinto the femoral canal |
| What is the physiological opening seen in the External abdominal oblique aponeurosis? | Superficial inguinal ring |
| The Transversalis fascia's physiological opening is the _____________________. | Deep inguinal ring |
| Hesselbach triangle is associated with | Direct inguinal hernia |
| What is orchiopexy? | Surgical repair of an undescended testicle |
| During orchiopexy, the testis is "pulled" down through which physiological opening? | Superficial inguinal ring in the External abdominal oblique aponeurosis |
| What injuries cause damage to the anterior urethra? | Straddle injuries |
| The posterior urethra is most commonly damaged by: | Pelvic fractures |
| A patient with full bladder sensation, high-riding boggy prostate, and blood in urethral meatus. Suspected dx? | Damage to the posterior urethra |
| The facial nerve courses along the ___________________ gland. | Parotid |
| Parotid tumors can affect the CN ______, and eventually causing ______________. | VII; Ipsilateral Facial droop |
| CN VII exits the skull through the ______________________ foramen. | Stylomastoid |
| Damage to the Trigeminal nerve causes _________________. | facial numbness. |
| What is the function of the Medial Collateral ligament (MCL)? | Resists force that pushes the knee medially. |
| Meniscal injury | diagnosis by joint tenderness while knee is flexed. Usually accompanied by MCL or LCL tear |
| Papillary muscle rupture | Life-threatening complication 3-5 days after myocardial infarction. |
| Papillary muscle rupture presents with: | Mitral regurgitation and Pulmonary edema |
| The posterior medial papillary muscle is solely irrigated by the ________________________ artery, thus making highly susceptible for ischemic injury. | Posterior Descending artery |
| LAD supplies what areas of the heart: | 1. Anterior 2/3 of the interventricular septum 2. Anterior wall of left ventricle 3. Anterolateral papillary muscle |
| Besides the LAD, what other artery supplies the anterolateral papillary muscle is the _____________________. | Left Circumflex artery |
| What is the location of the Schwannomas? | Cerebellopontine angle (between the cerebellum and the lateral pons) |
| Schwannomas arise from Cranial nerve ______. | 8 |
| What clinical features are presented in Schwannomas? | 1. Ipsilateral sensorineural hearing loss/ tinnitus and vertigo (CN8) 2. Loss of Facial expression ( CN 5) 3. Facial paresis (CN 7) |
| Bilateral acoustic Schwannomas are highly associated with ______________. | NF type 2 |
| What are some defects seen in Facial Nerve (CN 7) damage: | 1. Facial muscle paralysis (upper and lower) 2. Loss of taste in the anterior 2/3 of tongue 3. Decrease salivation and lacrimation 4. Hyperacusis (paralysis of Stapedius) |
| Paralysis of Stapedius | Hyperacusis |
| What blood vessels are the ones that provide the most blood irrigation of the large and small intestine? | SMA and IMA |
| How is ischemic injury protected in the large and small intestine? | Anastomoses of SMA and IMA |
| What are anastomoses created by the SMA and IMA? | 1. Marginal artery of Drummond (most important) 2 Arc of Riolan |
| Acute nausea is caused by stimulation to the ___________. | CTZ (chemoreceptor trigger zone) |
| What structure is found in the area postrema of the dorsal medulla near the 4th ventricle? | CTZ |
| Why is the CTZ affected more by chemicals in the blood? | There is a lack of BBB |
| The cerebellum is responsible for: | Motor planning and coordination of the IPSILATERAL extremities |
| How is the cerebellum divided? | 1. Medial Vermis --> mediates axial/truncal posture via theri descending medial motor systems 2. Lateral hemisphere - |
| What are the deficits of affected lateral cerebellum? | IPSILATERAL: 1. Dysdiadochokinesia 2. Limb dysmetria 3. Intention tremor |
| What is dysdiadochokinesia? | Impaired rapid alternating movements |
| What is limb dysmetria? | Overshoot or undershoot during targeted movement |
| The sense of taste is strongly related and associated with the senses of _______________. | Smell |
| Loss in the loss of smell tends to cause | To loss the sense of taste |
| What is ageusia? | Loss sense of taste |
| External Hemorrhoids are innervated by what nerve? | Inferior Rectal nerve, a branch of the Pudendal nerve. |
| External hemorrhoids: | Originate below dentate line and are painful. Innervated by the Pudendal nerve. |
| What are the muscles of the rotator cuff? | Supraspinatus, Infraspinatus, Teres minor, and Subscapularis |
| What is the function of Supraspinatus? | Abduction |
| What is the function of Infraspinatus? | External rotation |
| What is the function of the Teres minor? | Adduction + External rotation |
| What is the function of the Subscapularis? | Adduction + Internal rotation |
| Way to remember the functions of the rotator cuff muscles: | AB E AD + E AD + I |
| Tennis Elbow is also known as: | Lateral Epicondylitis |
| Overuse of Wrist extensor muscles | Lateral Epicondylitis |
| Overuse of wrist flexors muscles cause: | Golfer's elbow ( medial epicondylitis) |
| Sudden traction on the outstretched and pronated arm of a child | Nursemaid's elbow |
| Radial head subluxation causes _________________. | Nursemaid's elbow |
| What ligament is damaged in Nursemaid's elbow? | Annular ligament |
| What is the Biceps Tendon rupture? | presents with visible or palpable mass in the mid-upper arm ("Popeye's" deformity) |
| Through which skull foramen does the CN V3 exits the skull? | Foramen Ovale |
| CN V3 innervates which muscles? | Muscles of mastication, which include: Masseter, medial and lateral pterygoids, and temporalis |
| Unilateral CN V3 lesion | Jaw deviation to the affected side upon opening the mouth |
| Bilateral CN V3 lesion | Mandibular and lack of jaw movement |
| MCC place to apply a femoral nerve block | Inguinal crease |
| What areas are anesthetized with a femoral nerve block at the inguinal crease? | Anterior thigh, femur, and knee |
| What sight deficits are seen with damaged optic tract? | Contralateral Homonymous Hemianopia and Marcus Gunn pupil (abnormal pupillary reflex) |
| Contralateral homonymous hemianopia with intact pupillary reflex | Lateral geniculate nucleus (LGN) damage |
| What deficits are causes by damage to the Frontal eye field? | Eyes deviate toward the lesion side upon intended gaze |
| Meyer Loop lesion | Contralateral Upper Quandranipsia |
| The macula receives blood flow from the ___________. | MCA |
| Damaged visual cortex causes: | Contralateral homonymous hemianopia with macular sparing and normal pupillary reflex. |
| What nerve roots account for the Sciatic Nerve? | L4- S3 |
| What are some common causes of Sciatic nerve injury? | Hip fracture and arthroplasty |
| Injury to the Sciatic nerve near the pelvis causes damage along the entire extension of the nerve, and presents with: | 1. Weakness in knee flexion due to Sciatic nerve damage 2. Weakness to dorsiflex, and numbness of calf and dorsal foot, due to Common Peroneal nerve damage. 3. Weakness to plantarflexion, and absent ankle reflex due to tibial nerve damage. |
| In case of absent ankle reflex, suspect of: | Tibial nerve damage and/or Sciatic nerve damage near the pelvis. |
| Cause of Gerstmann syndrome? | Damage to the Angular gyrus of the Dominant Parietal lobe |
| What are the key features of Gerstmann syndrome? | 1. Agraphia (can't write) 2. Acalculia (can't do math) 3. Finger agnosia (can't differentiate fingers) 4. Left and Right disorientation |
| What is the cause for Brown Sequard Syndrome? | Hemisection of the Spinal cord |
| It a Brown-Sequard syndrome hemisection lesion in above the ______, it can also be manifested with ____________________________. | T1; Ipsilateral Horner's Syndrome |
| What are the clinical features of Brown Sequard Syndrome? | 1. IPSILATERAL spastic paralysis (due to corticospinal tract injury) 2. IPSILATERAL loss of tactile/vibratory/positional sensation (dorsal column damage) 3. CONTRALATERAL loss of pain and temperature (spinothalamic tract) 1-2 levels below the lesion |
| What is the contralateral manifestation of Brown-Sequard Syndrome? | Loss of pain and temperature 1-2 levels below the original site of the lesion. |
| What part of the CNS is affected in Hemiballism? | Contralateral Subthalamic Nucleus |
| The glossopharyngeal nerve exits via the _______________ _______________. | Jugular foramen |
| Lesions to the CN IX causes: | - loss of gag reflex (afferent limb) - loss sensation of upper pharynx, posterior tongue, tonsils, adn middle ear cavity - loss of taste in posterior 1/3 of tongue |
| What are the SOMATIC functions of CN 9? | Elevates the larynx during swallowing (innervation of the Stylopharyngeus) |
| What is the general sensation of CN 9? | - Tympanic membrane (inner surface) - Eustachian tube - Posterior 1/3 of tongue - Upper pharynx (afferent portion of gag reflex) - Carotid body and carotid sinus |
| Special Sensory of CN 9? | Taste of the posterior 1/3 of the tongue |
| What is the sensation of Chorda Tympani? | It is a branch of CN VII; taste sensation of the ANTERIOR 2/3 of tongue. |
| What is the clinical presentation of damage to the CN XII? | Ipsilateral tongue protrusion deviation |
| Mediates the protrusion of tongue by motor afferent fibers | CN 12 |
| What is the motor innervation of the tongue? | Carrier by CN 12 |
| The general sensory innervation of the tongue? | - ANTERIOR 2/3 is innervated by CN V3 - POSTERIOR 1/3 innervated by CN 9 - Posterior area of tongue root by CN 10 |
| What nerves mediate the sensation in gustatory innervation? | Anterior 2/3 by the Chorda tympani a branch of the CN 7 Posterior 1/3 is innervated by CN 9 Posterior of tongue root, taste buds, and upper esophagus are innervated by CN 10. |
| The anterior sensation of tongue is done by which nerve? | Mandibular branch of the Trigeminal nerve |
| What nerve gives the gustatory sensation to the anterior 2/3 of tongue? | Chorda tympani a branch of the CN 7 |
| CN 9 tongue innervation: | Provides the general and gustatory sensation of the POSTERIOR 1/3 of the tongue. |
| What is the CN most responsible for the motor innervation of the tongue? | CN 12 |
| Lesions to the Terminal sulcus and Foramen cecum of the tongue, refer to the _________________ portion of it. | Anterior 2/3 |
| What the two most common sites for Ulnar nerve injury? | 1. Medial epicondyle of the Humerus ("Funny" bone) 2. Guyon's canal near the Pisiform and Hook of Hamate |
| Injury near the Hook of Hamate, is often associated with what nerve damage? | Ulnar nerve |
| The hypothenar area is innervated by the __________ nerve. | Ulnar nerve |
| Ulnar nerve damage: | 1. Sensory loss over medial 1 1/2 of digits and Hypothenar eminence. 2. Weakness on Wrist flexion/ Adduction 3. Weakness on finger Abduction/ Adduction 4. Weakness of flexion of 4th and 5th digits |
| Hypothenar eminence flattening | MC due to muscle atrophy caused by Ulnar nerve damage |
| What nerve innervates the Coracobrachialis? | Musculocutaneous nerve |
| Injury to the Musculocutaneous nerve produces? | 1. Decreased strength of FOREARM flexion 2. Sensory loss over the LATERAL forearm |
| Numbness or sensory loss over the lateral forearm most likely indicates _______________ nerve injury. | Musculocutaneous |
| Forearm flexion is done by the __________________ nerve. | Musculocutaneous |
| Which ovarian Ligament contains the Ovarian artery, vein, lymphatics, and nerves? | Suspensory Ligament of the Ovary |
| What is another name for the Suspensory Ligament of the Ovary? | Infundibulopelvic Ligament |
| What are the contents of the Suspensory Ligament? | Ovarian artery, vein, lymphatics, and nerves |
| What surgical procedure may cause Suspensory Ligament of the Ovary injury risk? | Oophorectomy |
| The ureters are in close proximity to which Ovarian ligament? | Suspensory Ligament of the Ovary |
| What are the 3 main ovarian ligaments? | 1. Ovarian ligament 2. Broad Ligament 3. Suspensory Ligament of the Ovary |
| Ovarian ligament: | Connects the ovary to the side of the uterus just BELOW the Fallopian Tubes. It does not contain any major vessels to the ovary. |
| What are the subdivisions of the Round ligament of the Ovary? | 1. Mesosalpinx 2. Mesovarium 3. Mesometrium |
| The Broad ligament of the ovary: | Connects the Upper uterine body and upper cervix to the Pelvic sidewall |
| Round ligament | originate at the uterine fundus, runs down the Fallopian Tubes and through the inguinal canal to the labia majora |
| What are the vessel contents of the Round ligament? | Artery of Sampson (rarely a cause of bleeding) |
| A hysterectomy tends to increase risk of damage to which ligament? | Round ligament |
| Surgical procedure 1. Hysterectomy 2 Oophorectomy | Possible ligament injury: 1. Round ligament 2. Suspensory ligament of the Ovary |
| MCC of Thoracic Outlet Syndrome (TOS): | Compression of the BRACHIAL PLEXUS, as it passes through the SCALENE TRIANGLE, the space bordered by the anterior and middle Scalene muscles and the 1st rib |
| S/S of TOS: | - Upper extremity numbness and tingling - Weakness that worsens with repetitive overhead movements |
| A patients with an "extra rib" should raise suspicion of possible _________________ syndrome. | Thoracic Outlet Syndrome |
| What is a risk factor for developing TOS? | Extra (cervical) rib |
| In TOS, the involvement of the the Subclavian vein and artery causes: | Upper extremity swelling and pain |
| The blood supply and irrigation of internal hemorrhoids is: | Superior rectal vein -----> Inferior Mesenteric vein |
| What blood vessel is ligated in the treatment of internal hemorrhoids? | Inferior Mesenteric vein tributaries |
| External hemorrhoids blood drain follows this path: | Inferior rectal vein ---> Internal Pudendal vein ---> Internal Iliac vein |
| What are the muscles innervated by the musculocutaneous nerve? | 1. Forearm flexors - biceps brachii and brachialis 2. Coracobrachialis (flexes and adducts arm) |
| What are the nerve roots assigned to the Musculocutaneous nerve? | C5 - C7 |
| The medial forearm cutaneous sensation is done by the: | Medial cutaneous nerve of the Forearm |
| What nerve branches provide cutaneous sensitivity to the Posterior arm and forearm? | Posterior cutaneous branches of the Radial nerve |
| What nerve provides innervation to the Thenar eminence? | Median nerve |
| What are the most common pineal tumors? | Germinomas |
| What is the clinical presentation of Germinomas? | 1. Obstructive Hydrocephalus from aqueductal stenosis -- papilledema, headache, and vomiting 2. Parinaud Syndrome -- Upward gaze palsy, bilateral eyelid retraction, and near light dissociation |
| Which is the MC location of a Germinoma? | Suprasellar region |
| MCC of Deep intracerebral hemorrhage? | HTN vasculopathy involving the small, penetrating branches of major cerebral arteries |
| What are the most common locations for Deep Intracerebral hemorrhages? | Basal ganglia (Putamen), cerebellar nuclei, Thalamus, and pons |
| What is the irrigating vessels of the Putamen? | Lenticulostriate arteries, which are deep branches of the MCA. |
| Ischemic events to the Putamen and Internal capsule result in? | Dysarthria, contralateral hemiparesis, and contralateral hemisensory loss. |
| Pontine hemorrhages are due to: | ruptures of small branches of the Basilar artery, usually in a setting of poorly controlled hypertension |
| Pontine hemorrhage is clinically presented with: | 1. Coma -- disruption of the reticular activating system 2. "Locked-in" syndrome -- Corticospinal and Corticobulbar tract damage 3. Pinpoint pupils -- descending sympathetic tract injury. |
| Where does the Trigeminal nerve arises from? | Middle cerebellar peduncle of the Lateral aspect tohe the mid-pons. |
| Infarct or damage to the anterior aspect of the pons result in: | Contralateral hemiparesis and positive Babinski sign due to injury to corticospinal tract, and, contralateral lower facial palsy and dysarthria, due to damage to the corticobulbar tract. |
| What is radiculopathy? | Set of conditions in which one or more nerve are affected adn do not work properly (neuropathy), resulting in pain, weakness, numbness, or difficulty controlling specific muscles. |
| What are the two most common types of Radiculopathies? | Cervical and Lumbar (Sciatica) |
| Lumbosacral radiculopathy | Pain radiating along the Sciatic nerve, which runs down or both legs for the lower back |
| Cervical radiculopathy | Pin at the neck radiating to the chest or arm |
| Common term for radiculopathy | Pinched nerve |
| Lumbosacral radiculopathies cover from _____ to ______ dermatomal distributions. | L2 to S1. |
| Suspect _______ lumbosacral radiculopathy in cases of absent or diminished PATELLAR reflex. | L4 radiculopathy |
| S1 radiculopathy is seen with: | - Absent/diminished Achilles reflex - Weak hip extension (Gluteus maximus) - Weak knee flexion (hamstrings) - Weakness in plantar flexion |
| What sensory loss is seen with S1 radiculopathy? | Buttocks, Posterior thigh and calf, lateral foot |
| L4 radiculopathy: | Sensory loss over the anterolateral thigh, knee, and medial calf and foot Weakness in hip adduction and knee extension Absent Patellar reflex |
| No achilles reflex, suspect dx? | S1 Lumbosacral radiculopathy |
| What is damaged causing hearing loss in a setting of prolonged exposure to loud noises? | Stereo Ciliated hair cells of the Organ of Corti |
| Which frequency is always lost first? | High-frequency |
| Vestibular Schwannoma hearing loss: | Due to damage of the Auditory nerve Unilateral High-frequency sensorineural hearing loss |
| Ossicle damage will present | with affection of air conduction across all frequencies |
| How is a perforation of the tympanic membrane hearing loss described? | Unilateral conductive hearing loss |
| Which area of the Auditory system is especially associated with low-frequency noises? | Cochlear cupula |
| Subserosal Leiomyomas are commonly known as ________________. | Fibroids |
| Subserosal Leiomyomas: | Often cause irregular uterine enlargement leading to pelvic pressure. |
| Why does a patient with a fibrinoid often complains of constipation? | Fibroids arise for the posterior subserosal surface of the uterus and cause constipation , due to pressure on the colon. |
| Meningioma | Common brain adult tumor |
| Where is the common location of an Meningioma? | Arise from dural flexion (falx cerebri and tentorium cerebri) |
| Lesions to the Primary Somatosensory cortex result in: | Contralateral sensory loss |
| Lesion to the Parietal association cortex? | -mostly in non-dominant hemisphere - cause contralateral hemineglect due to impaired visuospatial processing. |
| What visceral muscle is the most important while performing the Valsalva maneuver? | Rectus abdominis |
| What is the role of the Rectus abdominis during the Valsalva maneuver? | Increase in intra abdominal and intrathoracic pressures |
| What is produced in the Raphe nuclei? | Serotonin |
| Where is ACh made? | Nucleus basalis of Meynert |
| What are the non-small cell lung tumors? | Squamous cell carcinoma and adenocarcinoma |
| Pancoast tumors are: | Non-small cell lung tumors |
| Where is the MC location of Pancoast tumors? | Near the Superior Sulcus |
| A Pancoast tumor is presented: | - Ipsilateral shoulder pain, upper lim paraesthesias, adn areflexic arm weakness due to involvement of the Brachial plexus. - Horner's syndrome causing ipsilateral partial ptosis, miosis, and anhidrosis, due to involvement of the Cervical sympathetic ganglia |
| Where is the Cavernous sinus located with respect to the Sphenoid sinus? | Inferolateral to the Pituitary and above to the Sphenoid sinuses. |
| What is the MCC of Cavernous Sinus Thrombosis? | Spread infection from nearby sinuses, such as Sphenoid, ethmoid or teeth. |
| What is the clinical presentation of Cavernous Sinus Thrombosis? | Patients present headache, fever, proptosis, and IPSILATERAL deficits of CN 3, 4, V1 and V2. |
| What is the MC causative organism of Cavernous sinus thrombosis? | Staph aureus |
| What test is done to diagnose injury to the Supraspinatus muscle? | "Empty-can" test |
| What is the position of the thumbs during the "empty-can" test of the supraspinatus? | Full internal rotation ( pointing down) |
| CN III palsy affect the _______________________ side. | IPSILATERAL |
| What is the most common artery aneurysm causing CN 3 palsy? | Ipsilateral Posterior Communicating artery |
| Location of the AV node | Endocardial surface of the Right atrium, near the insertion of the Septal leaflet to the Tricuspid valve and the orifice of the Coronary sinus |
| Where is the ablation of aflutter catheter placed? | Directed toward the Isthmus of the heart (near the fossa ovalis) |
| A carpal tunnel lesion of the Median nerve results in: | Pain and numbness in the first 3-digits and 1/2 the 4th digit, as well as, weakness of THUMB FLEXION and OPPOSITION |
| What causes a Benediction hand? | Median nerve injury at the proximal forearm. |
| Thenar eminence decreased sensation is seen with what nerve injury. | Median nerve injury at the proximal forearm. |
| What color does the trachea appear in a CT of the chest? | Dark-black |
| In a Chest CT, the traque serves a landmark for reference of which structures? | Anterior to the Trachea are the Great vessels, and, Posteriorly is the Esophagus |
| Lesser omentum | Double layer of peritoneum that extends from the liver to the lesser curvature of the stomach and the beginning of the Duodenum. |
| What are the divisions of the Lesser Omentum? | 1. Hepatogastric and Hepatoduodenal ligaments |
| What is connected by the Greater omentum? | The Greater curvature of the stomach down the small intestine and back up via the Transverse colon, up to the posterior abdominal wall. |
| Patella fracture exhibits | Inability to extend knee against gravity and palpable gap in the extensor mechanism |
| What is the perineal body? | Fibromuscular tissue between the Urogenital and Anal triangles. |
| How is the Perineal body damaged or excised? | During a vertical midline Episiotomy |
| Improper fixation of a midline Episiotomy can result in: | 1. Pelvic organ prolapse 2. Dyspareunia |
| What substances stimulate Pituitary release of Prolactin? | TRH (high in Hypothyroidism) and VIP |
| Dopamine has an ____________________ effect on ________________ release from the Pituitary gland. | Inhibitory; Prolactin |
| Antipsychotics cause _________________, because _____________. | Hyperprolactinemia; They block the effects of Dopamine |
| Pupillary light reflex is controlled by which two cranial nerve responses? | CN 2 and CN 3 |
| CN 2 response in Light pupillary reflex accounts for: | The afferent limb pupillary reflex. Damage is indicated by a negative Direct response |
| CN 3 response in the Light pupillary reflex accounts for: | Efferent limb; damaged in cases of abnormal consensual response. |
| The liver is less affected by ischemic infarct because: | Dual or collateral blood supply via the Hepatic vein and Hepatic artery |
| What organ is at most risk or vulnerability for infarction? | CNS (brain) |
| Partial lesion to the retina | Focal mononuclear scotoma |
| Optic tract lesion results in: | Contralateral Homonymous hemianopia + Marcus Gunn pupil (abnormal light reflex) in the eye contralateral to the lesion. |
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