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ANATOMY: BBC Test 1
| Question | Answer |
|---|---|
| Where is cyanosis especially evident? | Lips, eyelids, nails |
| What causes stretch marks? | Marked and relatively fast size increase |
| What layers of skin do superficial lacerations affect? | Epidermis and maybe superficial layer of dermis |
| Do superficial lacerations bleed? | If they extend into dermis |
| What layers of skin do deep lacerations affect? | Deep layer of dermis, extending into subcutaneous tissue or beyond |
| What layers of skin are affected in a 1st degree burn? | Epidermis |
| What are symptoms of a 1st degree burn? | Erythema, pain, edema, desquamation (peeling) - no significant scarring |
| What layers of skin are affected in a 2nd degree burn? | Epidermis and either superficial or deep dermis |
| What is another name for a 1st degree burn? | Superficial burn |
| What is another name for a second degree burn? | Partial thickness burn |
| What are symptoms of a 2nd degree burn involving superficial dermis? | Blistering, pain |
| What are symptoms of a 2nd degree burn involving deep dermis? | Loss of skin, pain |
| What degree of burn is considered to be the most painful and why? | 2nd degree because nerve endings are being damaged |
| Are sweat glands and hair follicles damaged in a 2nd degree burn? | Only the most superficial parts |
| What layers of skin are involved in a 3rd degree burn? | Entire thickness of skin and perhaps underlying muscle |
| What is another name for a 3rd degree burn? | Full-thickness burn |
| What are symptoms of a 3rd degree burn? | Marked edema, numbness on the burned areas |
| Why are the burned areas in a 3rd degree burn numb? | Because sensory endings are destroyed |
| T/F: The extent of the burn (% of total body surface affected) is generally more significant than the degree (severity in terms of depth) | True |
| What is the Rule of Nine? | Body is divided into ares that are approximately 9% or multiples of 9% of total body surface |
| What is another name for accessory bones? | Supernumerary |
| When do accessory bones develop? | When additional ossification centers appear and form extra bones. |
| What do studies show that extra bone really is? | Missing part of the main bone |
| Where can accessory bones commonly be found? | In the foot |
| What are small, irregular wormlike bones? | Sutural bones (wormian bones) |
| What is reduction of a fracture? | Broken ends of bone brought together, approximating their normal position |
| How do bones heal? | Surrounding fibroblasts proliferate and secrete collagen which forms a collar of callus to hold bones together. Soon the callus calcifies and is eventually resorbed and replaced by bone |
| How can the age of a young person be determined? | By studying the ossification centers in bones |
| What are the main criteria for studying ossification centers? | 1. Appearance of calcified material in the diaphysis and/or epephyses 2. Disappearance of the radiolucent line representing the epiphysial plate (absence of this line indicates that epiphysial fusion has occured |
| How much earlier does the fusion of the epiphyses with the diaphysis occur in girls compared to boys? | 1-2 years earlier in girls |
| What is the dense line of provisional calcification that occurs when degeneration of cartilage cells in the columns continues, called? | Lines of arrested growth |
| What is avascular necrosis? | Death of bone tissue due to loss of arterial supply to an epiphysis or other parts of a bone |
| What is osteochondroses? | Group of clinical disorders of epiphyses in children that result from avascular necrosis of unknown etiology |
| What is another name for the skullcap? | Calvaria |
| What are fontanelles? | Wide areas of fibrous tissue formed from sutures at sites where an infant's cranium does not make full contact with each other |
| Which fontanelle is most prominent and is known as the soft spot? | Anterior fontanelle |
| What might a depressed fontanelle indicate? | Dehydration |
| What is another name for DJD? | OA |
| What is DJD often accompanied by? | Stiffness, discomfort, and pain |
| What is arthroscopy? | Surgical procedure in which the synovial joint is examined by inserting a cannula and an arthroscope into it |
| What is often the caused of DOMS? | Eccentric muscle contractions |
| How much can muscles lengthen before injury? | Typically about 1/3 of their resting length |
| What are the two methods of muscle testing? | 1. Person performs movements that resist those of examiner: Person keeps forearm flexed while examiner tries extending it 2. Examiner performs movements that resist those of person: Examiner asks person to flex forearm while examiner resists efforts |
| In compensatory hypertrophy, how does the myocardium respond to increased demands? | By increasing the size of its fibers |
| Do cardiac muscle cells divide (do they regenerate)? | No |
| What is the most common acquired disease of arteries? | Ateriosclerosis |
| What is arteriosclerosis characterized by? | Thickening and loss of elasticity of arterial walls |
| What is a common form of arteriosclerosis and what is it associated with? | Atherosclerosis - buildup of fat (mainly cholesterol) |
| What are varicose veins? | Abnormally swollen, twisted veins |
| How do varicose veins form? | When walls of veins lose their elasticity, they become weak. These weakened veins dilate under the pressure of supporting a column of blood against gravity |
| What is the most common type of cancer? | Carcinomas |
| How are carcinomas most commonly spread? | Lymphogenously |
| Are cancerous nodes painful when compressed? | No |
| What type of tissue do carcinomas affect? | Epithelial |
| What is the most common route for sarcomas? | Hematogenous route |
| Which type of cancer is more malignant? | Sarcomas |
| What type of tissue do sarcomas affect? | Connective tissue |
| What type of blood vessels does metastasis usually occur in and why? | Veins because there are more of them and they have thinner walls |
| What are the most common sites of secondary sarcomas? | Liver and lungs |
| What is lymphedema? | Localized type of edema that occurs when lymph does not drain from an area of the body |
| What happens after a back injury as a protective mechanism? | Spasm |
| What is a spasm? | Sudden involuntary contraction |
| What are spasms attended by? | Cramps, pain, and interference with function |
| How is the patient placed when trying to examine posterior segments of the lungs in the triangle of ascultation? | Fold arms across chest and flex trunk |
| When can the axillary nerve be injured? | During a humeral fracture because it wraps around the surgical neck of it |
| What can happen with incorrect use of crutches? | Compression of axillary nerve |
| What is the cutaneous branch of the axillary nerve and what does it innervate? | Superior lateral cutaneous nerve of the arm which innervates lateral side of proximal part of arm |
| What are the most commonly affected areas regarding osteoporosis? | Neck of femur, bodies of vertebrae, metacarpals, and radius |
| What is a laminectomy? | Surgical excision of one or more spinous processes and adjacent supporting vertebral laminae |
| Why is a laminectomy often performed? | To relieve pressure on SC or nerve root |
| What is one of the most common injuries of cervical vertebrae? | Fracture of vertebral arch of axis |
| What part of the vertebral arch of the axis is typically fractured? | Pars interarticularis |
| What is a fracture to the pars interarticularis called? | Traumatic spondylolysis of C2 |
| How does traumatic spondyloysis of C2 usually occur? | Whiplash |
| What is spina bifida occulta? | Neural arches of L5 and/or S1 fail to develop normally and fuse posterior to vertebral canal |
| Since spina bifida occulta is usually concealed by the overlying skin, how is it indicated? | By a tuft of hair |
| What is a more severe form of spina bifida occulta? | Spina bifida cystica |
| What is spina bifida cystica? | One or more vertebral arches may fail to develop completely |
| What is spinal bifida cystica associated with? | Herniation of meninges |
| What do severe forms of spina bifida result from? | Neural tube defects, such as the defective closure of the neural tube during the 4th week of embryonic development |
| What happens to the nuclei pulposi with age? | Dehydration and loss of elastin while gaining collagen |
| Do intervertebral discs increase or decrease in size with age? | Increase |
| Where do herniations of nucleus pulposus usually extend? | Posterolaterally |
| What is the most common level for disc protrusions to occur? | L4-L5 or L5-S1 |
| What is sciatica? | Pain in the lower back and hip that radiates down the back of the thigh and into the leg that is caused by a herniated lumbar IV disc that compresses and compromises the L5 or S1 component of the sciatic nerve |
| What is another name for bone spurs? | Osteophytes |
| What is the general rule regarding which nerve root is compressed due to a herniated disc? | When an IV disc protrudes, it usually compresses the nerve root numbered one inferior to the herniated disc; however in the cervical vertebrae it is usually the same disc and nerve |
| T/F: The transverse ligament of the atlas is stronger than the dens of the C2 vertebrae | True |
| When does atlanto-axial subluxation occur? | When the transverse ligament of the atlas ruptures which sets the dens free |
| Dislocation of the transverse ligament rupture is most likely to cause what? | SC compression |
| What 5 categories of structures receive innervation in the back and can be sources of pain? | 1. Fibroskeletal structures: periosteum, ligaments, anuli fibrosis 2. Meninges 3. Synovial joints 4. Muscles 5. Nervous tissue |
| What part of bone does osteoporosis affect? | Trabeculae of spongy bone |
| What is excessive lumbar lordosis characterized by? | Anterior tilting pelvis |
| What is functional scoliosis caused by? | Difference in leg length with compensatory pelvic tilt |
| What is a rhizotomy? | Procedure done to relieve intractable pain or spastic paralysis. Done in the nerve roots because this is the only site where M and S fibers of spinal nerves are segregated |
| What are the only neurons to proliferate (grow in numbers) in the adult nervous system? | Olfactory epithelium |
| What is paresthesia? | Pressure on a nerve (pins and needles) |
| What is a crushing nerve injury? | Injury that damages or kills the axons distal to the injury site; however nerve cell bodies usually survive and the nerve's connective tissue covering remains intact; no surgical repair |
| What is a cutting nerve injury? | One that requires surgical intervention |
| What is anterograde degeneration? | Degeneration of axons detached from their cell bodies |
| What is the Saturday Night Syndrome? | Intoxicated individual who passes out with a limb dangling across the arm of a chair which causes more serious and often permanent, paresthesia |
| Do the lumbar spinal nerves increase in size from S to I or I to S? | S to I |
| What is a lumbar puncture? | Withdrawal of CSF from the lumbar cistern |
| What is a lumbar puncture done? | Pt is sidelying with back and hips flexed |
| What does a lumbar puncture go through? | Dural sac |
| Where is spinal anesthesia injected? | Subarachnoid space |
| What is a common symptom of receiving a lumbar puncture? | HA |
| Where is an epidural anesthesia given? | Extradural space or through the sacral hiatus (caudal epidural anesthesia) |
| What are important arteries in the SC? | Segmental medullary arteries which supply blood to anterior and posterior spinal arteries |
| What is lumbar spondylosis? | Group of bone and joint abnormalities (DJD) |
| What is colostrum? | Cream white to yellowish premilk fluid that may be secreted from the nipples during the last trimester of pregnancy and during initial episodes of nursing |
| How is the breast divided? | Into 4 quadrants |
| What is lymphedema? | Excess fluid in subcutaneous tissue |
| How does a carcinoma appear on a mammogram? | Large, jagged density |
| Where are surgical incisions usually made in breasts and why? | Inferior breast quadrant because these quadrants are less vascular |
| What is a simple mastectomy? | Breast is removed down to the retromamary space |
| What is a radical mastectomy? | More extensive surgical procedure that involves removal of the breast, pectoral muscles, fat, fascia, and as many lymph nodes as possible in the axilla and pectoral region |
| What is a lumpectomy or quadrantectomy? | Current practice that often only removes the tumor and surrounding tissue |
| What is another name for a lumpectomy or quadrantectomy? | Breast-conserving surgery |
| What is polymastia mean? | Supermumerary breasts |
| What does polythelia mean? | Accessory nipples |
| What is the embryonic mammary crest? | The milk line - line extending from axilla to the groin |
| Why is breast cancer in men typically associated with more serious consequences? | Because it usually isn't detected until extensive metastases have occured |
| What is gynecomastia? | Breast hypertrophy in males |
| What can be a cause of gynecomastia? | Imbalance between estrogenic and androgenic hormones or from change in the metabolism of sex hormones by the liver |
| What is one of the most frequently fracture bones? | Clavical |
| MOA for clavicular fx | FOOSH or falling directly on shoulder |
| What is the weakest part of the clavicle? | Junction of its middle and lateral thirds |
| After a clavicular fx what prevents a dislocation of the ACJ? | Coracoclavicular ligament |
| Why does the shoulder drop after a clavicular fx? | Because the trap is unable to hold the lateral fragment and weight of upper limb |
| Why does the medial fragment of the clavical elevate after a fracture? | Because the SCM elevates it |
| What changes occur when there is an absence of the pectoralis major? | Nipple is more inferior and anterior axillary fold is absent |
| What RTC tendon is most commonly ruptured? | Supraspinatus |