Quick Facts Anatomy 1 Of 2

Front 1

Indifferent stage of gonads (weeks)

Back 1

Weeks 4-7

Front 2

Where do the indifferent gonads develop?

Back 2

In a longitudinal elevation or ridge of intermediate mesoderm - urogenital ridge

Front 3

Where do the primordial germ cells arise from?

Back 3

From the lining cells in the wall of the yolk sac

At week 4, primordial germ cells migrate into the indifferent gonad

Provide a critical inductive influence on gonad development

Front 4

Components of the indifferent gonad

Back 4

1. Primordial germ cells

2. Primary sex cords - finger-like epithelial extensions inside the gonads that are populated by migrating primordial germ cells

3. Mesonephric (Wolffian) duct - male genital truct

Paramesonephric (Mullerian) duct - female genital truct

Front 5

Development of testis and ovary

Back 5

Front 6

Factors for the development of male reproductive system (4)

Back 6

1. Sry gene - short arm of the Y chromosome (encodes testis-determining factor [TDF])

2. Testosterone - Leydig cells

3. Mullerian-inhibiting factor (MIF) - Sertoli cells

4. Dihydrotestosterone (DHT) - external genitalia

Front 7

Events during meiosis I

Back 7

Front 8

Events during meiosis II

Back 8

Front 9

Meiosis chart

Back 9

Front 10

Type B spermatogonia/oogonia genetic status

Back 10

46, 2n (Diploid)

Front 11

Primary spermatocyte/oocyte genetic status

Back 11

46, 4n

Front 12

Secondary spermatocyte/oocyte genetic status

Back 12

23. 2n

Front 13

Gametes genetic status

Back 13

23, 1n (Haploid)

Front 14

Spermatogenesis

Back 14

Front 15

Oogenesis

Back 15

Front 16

Week 1 of development chart

Back 16

Front 17

2 changes of a spermatozoa in the female genital truct

Back 17

1. Capacitation - during 7 hours in the female truct, removal of several proteins from the plasma membrane of the acrosome of the spermatozoa

2. Acrosome reaction - release of hydrolytic enzymes from the acrosome used by sperm to penetrate the zona pellucida -> cortical reaction that prevents other spermatozoa penetrating the zona pellucida

Front 18

Morula

Back 18

32-cell stage of division

Front 19

Blastocyst

Back 19

Forms as fluid develops in the morula

Consists of an inner cell mass known as the embryoblast, and the outer cell mass known as the trophoblast, which becomes the placenta

At the end of the first week, the trophoblast differentiates into the cytotrophoblast and syncytiotrophoblast and then implantation begins

Front 20

Ectopic pregnancy

Back 20

Front 21

Risk factors for the tubal ectopic pregnancy

Back 21

-Endometriosis

-Pelvic inflammatory disease (PID)

-Tubular pelvic surgery

-Exposure to diethylstilbestrol (DES)

Front 22

What risks in diethylstilbestrol (DES) exposure

Back 22

-clear cell carcinoma, a rare vaginal tumor in girls and women who had been exposed to this drug in utero

-tubal ectopic pregnancy

Front 23

Implantation

Back 23

Front 24

Week 2 of the development

Back 24

Formation of the bilaminar embryo

Front 25

Week 2 of development chart

Back 25

Front 26

Into what does the embryoblast differentiates?

Back 26

Epiblast and hypoblast, forming a bilaminar embryonic disk

Epiblast -> amniotic cavity

Hypoblast -> primary yolk sac

Front 27

From what structure does the mouth develops?

Back 27

Prechordal plate (formed by fusion of epiblast and hypoblast)

Front 28

Extraembryonic mesoderm

Back 28

Is derived from the epiblast

Extraembryonic somatic mesoderm lines the cytotrophoblast, forms the connecting stalk, and covers the amnion

Extraembryonic visceral mesoderm covers the yolk sac

Front 29

Connecting stalk

Back 29

Suspends the conceptus within the chorionic cavity

Front 30

Chorion

Back 30

Wall of the chorionic cavity

Consists of extraembryonic somatic mesoderm, cytotrophoblast, and the syncitiotrophoblast

Front 31

Is there mitosis in syncytiotrophoblast or cytotrophoblast?

Back 31

No mitosis in syncytiotrophoblast!

Cytotrophoblast is mitotically active

Front 32

Locations of hematopoiesis

Back 32

1. Mesoderm surrounding the yolk sac (up to 6 weeks)

2. Fetal liver, spleen, thymus (6 weeks - 3rd trimester)

3. Bone marrow

Front 33

Where is the hCG produced?

Back 33

Syncytiotrophoblast

Front 34

Function of the hCG

Back 34

Stimulates progesterone production by the corpus luteum

Front 35

Low hCG

Back 35

-spontaneous abortion

-ectopic pregnancy

Front 36

High hCG

Back 36

-multiple pregnancy

-hydatidiform mole

-gestational trophoblastic disease

Front 37

What replaces the blastocyst cavity?

Back 37

Primary yolk sac

Front 38

When are the extraembryonic mesoderm and chorion formed?

Back 38

2 week (formation of the bilaminar embryo)

Front 39

Embryonic period

Back 39

Weeks 3-8

Front 40

Embryonic week 3

Back 40

Front 41

Gastrulation

Back 41

Front 42

What does the mesoderm form? (3)

Back 42

1. Paraxial mesoderm (35 pairs of somites)

2. Intermediate mesoderm

3. Lateral mesoderm

Front 43

What happens in third week of embryonic development?

Back 43

Gastrulation and early development of nervous and cardiovascular systems; corresponds to first missed period!

Front 44

Sacrococcygeal teratoma

Back 44

Front 45

Chordoma

Back 45

Front 46

Hydatidiform mole. Two types. Their genotype.

Back 46

Front 47

Germ layer derivatives

Back 47

Front 48

Surface ectoderm derivatives (9)

Back 48

Front 49

Neuroectoderm derivatives (7)

Back 49

Front 50

Neural crest ectoderm derivatives (13)

Back 50

Front 51

Mesoderm derivatives (13)

Back 51

Front 52

Endoderm derivatives (11)

Back 52

Front 53

Yolk sac derivatives (2)

Back 53

Front 54

Pathogenesis of cystic fibrosis

Back 54

The apical Cl channels do not open -> NaCl and water cannot move across -> thickening of the mucus layer covering the epithelia

Front 55

Simple cuboidal epithelium

Back 55

-renal tubules

-salivary gland acini

Front 56

Simple columnar epithelium

Back 56

-Small intestine

-Large intestine

Front 57

Simple squamous epithelium

Back 57

-Endothelium

-Mesothelium

-Epithelium lining the inside of the renal glomerular capsule

Front 58

Stratified squamous epithelium

Back 58

-Nonkeratinized: oral cavity, pharynx, and esophagus

-Keratinizing: skin

Front 59

Pseudostratified columnar epithelium

Back 59

-nasal cavity

-trachea

-bronchi

-epididymis

Front 60

Transitional epithelium (urothelium)

Back 60

-ureter

-bladder

Front 61

Stratified cuboidal epithelium

Back 61

Salivary gland ducts

Front 62

Back 62

Front 63

Hematoxylin

Back 63

Front 64

Eosin

Back 64

Front 65

Back 65

Front 66

Back 66

Front 67

Back 67

Front 68

Back 68

Bladder transitional epithelium

Front 69

Back 69

Front 70

Layers of the epidermis

Back 70

Front 71

Back 71

Front 72

Back 72

Front 73

Microfilaments

Back 73

Front 74

Intermediate filaments. 4 groups.

Back 74

Front 75

Microtubules. Function of dynein and kinesin.

Back 75

Front 76

First step in the invasion of malignant cells through an epithelium results from ...

Back 76

... a loss of expression of cadherinsthat weakens the epithelium

Front 77

Changes in ... are evident in neurons in Alzheimer's disease and in cirrhotic liver diseases

Back 77

intermediate filaments

Front 78

Colchicine action

Back 78

Prevents microtubule polymerization and is used to prevent neutrophil migration in gout

Front 79

Vinblastine and vincristine action

Back 79

Inhibit the formation of the mitotic spindle

Used in cancer therapy

Front 80

Cadherin and selectin

Back 80

Front 81

Catenin complex of proteins

Back 81

Links cytoplasmic portions of cadherins to cytoplasmic actin filaments

Front 82

Integrins

Back 82

Front 83

Basement membrane structure

Back 83

1. Basal lamina (type IV collagen, glycoproteins [laminin], and proteoglycans [heparin sulfate])

2. Reticular lamina (reticular fibers) - under the basal lamina

Front 84

Cell junctions chart

Back 84

Front 85

Tight junctions (zona occludens)

Back 85

Front 86

Proteins associated with tight junctions

Back 86

-occludins (ZO-1,2,3)

-claudin proteins

These proteins bind to actin microfilaments

Front 87

Zonula adherens

Back 87

Front 88

Proteins of zonula adherens

Back 88

Cadherins

Bind to actin microfilaments

Front 89

Desmosomes (macula adherens)

Back 89

Front 90

Proteins of desmosomes

Back 90

Cadherins

Bind to intermediate filaments in large bundles (tonofilaments)

Front 91

Hemidesmosomes

Back 91

Front 92

Proteins of hemidesmosomes

Back 92

Integrins on the cell bind to fibronectin and fibronectin and laminin in turn bind to collagen (type IV) in the basal lamina

Internally, like a desmosome, the hemidesmosomes are linked to intermediate filaments

Front 93

Gap junctions (communicating junctions)

Back 93

Front 94

Connexon structure

Back 94

6 connexin molecules - gap junction

Front 95

Pemphigus vulgaris

Back 95

Front 96

Bullous pemphigoid

Back 96

Front 97

Microvilli

Back 97

Front 98

Cilia

Back 98

Front 99

Kartagener syndrome

Back 99

Front 100

Structure of the axoneme of a cilium

Back 100

Front 101

Embryology of vertebrae

Back 101

During week 4, sclerotome cells of the somites (mesoderm) migrate medially to surround the spinal cord and notochord. After proliferation of the caudal portion of the sclerotomes, the vertebrae are formed, each consisting of the caudal part of one sclerotome and the cephalic part of the next

Front 102

Composition of the vertebral column

Back 102

Front 103

Each intervertebral disk is numbered by the vertebral body ... the disk

Back 103

Above

Front 104

Notochord derivative

Back 104

Nucleus pulposus

Front 105

Anulus fibrosus function

Back 105

Connects the adjacent bodies

Front 106

Nucleus pulposus function

Back 106

Shock absorber

Front 107

Anterior longitudinal ligament function

Back 107

Prevents hyperextension of the vertebrae

Often involved in "whiplash" accidents

Front 108

Posterior longitudinal ligament function

Back 108

Limits flexion of the vertebral column

Causes the herniation of a disk to be positioned posterolaterally

Front 109

Most common direction of disk herniation

Back 109

Posterolateral

Front 110

Disk herniation

Back 110

Front 111

Boundaries of the intervertebral foramina

Back 111

Front 112

Termination of spinal cord in adults

Back 112

L1-L2

Front 113

2 specializations of the pia mater

Back 113

1. Denticulate ligaments

2. Filum terminale

Front 114

Termination of the dural mater/dural sac

Back 114

S2

Front 115

Arachnoid termination

Back 115

Like dural mater - S2

Front 116

Epidural and subarachnoid spaces

Back 116

Front 117

Significance of the internal vertebral venous plexus

Back 117

Front 118

How many spinal nerves are there?

Back 118

31 pairs: 8 cervical, 12 thoracic, 5 lumbar, 5 sacral, and 1 coccygeal

Front 119

Cross section of spinal cord and parts of spinal nerve

Back 119

Front 120

Where are sensory ganglions located?

Back 120

Dorsal roots

Front 121

Relationship of exit of spinal nerves and vertebral levels

Back 121

Front 122

On what level is the lumbar puncture performed?

Back 122

L4-L5 interspace

Front 123

A horizontal line drawn at the top of the iliac crest marks the level of the ...

Back 123

L4 vertebra

Front 124

The interlaminar spaces are covered by the ...

Back 124

Ligamentum flava

Front 125

Layers passed during lumbar puncture

Back 125

Front 126

Preganglionic cell bodies of the SNS

Back 126

Lateral horn gray matter of spinal cord segments T1-L2 (14 segments)

Front 127

Postganglionic cell bodies of the SNS

Back 127

2 types of motor ganglia in the PNS:

1. Chain or paravertebral

2. Collateral or prevertebral (found only in abdomen or pelvis)

Front 128

Thoracic splanchnic nerves

Back 128

Front 129

Lumbar splanchic nerves

Back 129

Front 130

Sympathetic (thoracolumbar) outflow

Back 130

Front 131

Sympathetic outflow chart

Back 131

Front 132

Cross section of spinal cord's sympathetic outflow

Back 132

Front 133

Preganglionic cell bodies of the PsNS

Back 133

Front 134

Postganglionic cell bodies of the PsNS

Back 134

Front 135

Parasympathetic (craniosacral) outflow

Back 135

Front 136

PsNS ganglions

Back 136

1. CN III - ciliary ganglion:

-pupillary sphincter

-ciliary m.

2. CN VII - submandibular ganglion:

-submandibular gland

-sublingual gland

CN VII - pterygopalatine ganglion:

-lacrimal gland

-nasal and oral mucosal glands

3. CN IX - otic ganglion:

-parotid gland

4. CN X and S2-S4 - terminal ganglia

Front 137

PsNS outflow chart

Back 137

Front 138

Cooper ligaments

Back 138

Suspensory ligaments that attach the mammary gland to the skin and run from the skin to the deep fascia

Front 139

Arterial supply to the mammary glands

Back 139

1. Internal thoracic artery - a branch of subclavian artery which supplies the medial aspect of the gland

2. Lateral thoracic artery - a branch of the axillary artery, supplies the lateral part of the gland. Courses with the long thoracic nerve, superficial to the serratus anterior muscle

Front 140

Orange-peel appearance of the mammary glands

Back 140

The presence of a tumor within the breast can distort Cooper ligaments. which results in dimpling of the skin

Front 141

What nerves can be lesioned during the radical mastectomy? Symptoms?

Back 141

1. Long thoracic nerve (serratus anterior muscle) during ligation of the lateral thoracic artery. Few weeks after surgery:

-winged scapula

-weakness in abduction of the arm above 90 degrees

2. Thoracodorsal nerve (latissimus dorsi):

-weakness in extension

-weakness in medial rotation of the arm

Front 142

The lymphatic drainage of the breast

Back 142

1. Laterally, most of the lymphatic flow (75%) drains from the nipple, superior, lateral, and inferior quadrants of the breast -> pectoral nodes -> axillary nodes

2. Medial quadrant -> parasternal nodes, which accompany the internal thoracic vessels -> opposite breast

Front 143

Embryology of lower respiratory system

Back 143

Week 4, lower respiatory tract (trachea, bronchi, and lungs) -> single respiratory (laryngotracheal) diverticulum of endoderm from the ventral wall of the foregut

-respiratory epithelium develops from endoderm

-muscles, connective tissues, and cartilages develop from mesoderm

*Respiratory diverticulum -> lung bud

*Diverticulum and lung bud -> bifurcation -> 2 bronchial buds -> series of divisions -> main, secondary, and tertiary bronchi (by the sixth month)

*Tracheoesophageal septum forms to separate the esophagus from the trachea

Front 144

What structure is related to the bronchopulmonary segments of the lungs?

Back 144

Tertiary segmental bronchi

Front 145

A critical timeline in lung development. Why?

Back 145

25-28th weeks. Surfactant production.

Front 146

Tracheoesophageal fistula

Back 146

Front 147

Tracheoesophageal fistula chart

Back 147

Front 148

Pulmonary hypoplasia. 2 causes.

Back 148

Front 149

How many intercostal spaces are there? With what are they filled?

Back 149

11 intercostal spaces

Filled by the 3 layers of intercostal muscles and their related fasciae

Front 150

Costal groove. Correct abbreviation for the structures in it.

Back 150

VAN (superior to inferior)

Front 151

Intercostal arteries. Source.

Back 151

Anteriorly:

-branches of internal thoracic artery << subclavian artery

Posteriorly:

-branches of the thoracic aorta

Thus, collateral circulation between the subclavian artery and the thoracic aorta

Front 152

Where is the intercostal nerve block done?

Back 152

Upper portion of the intercostal space

Front 153

Where is the reflection poiny between parietal and visceral pleura?

Back 153

Hilum of the lungs

Front 154

Innervation of pleura

Back 154

Front 155

Respiratory distress syndrome and hyaline membrane disease

Back 155

Front 156

Differential diagnosis: pleurisy, costal inflammation, mediastinal irritation

Back 156

Front 157

Open and tension pneumothorax

Back 157

Front 158

Sympathetic outflow from the thoraco-lumbar spinal cord chart

Back 158

Front 159

Sternal line of reflection (where the costal pleura is continuous with the mediastinal pleura posterior to sternum)

Back 159

Costal cartilages 2-4

The pleural margin then passes inferiorly to the level of the sixth costal cartilage

Front 160

What occupies the costomediastinal recess?

Back 160

Lingula of the left lung (during inspiration)

Front 161

Visceral and parietal pleuras borderline

Back 161

Front 162

Diaphragmatic surface of what lung is more superior?

Back 162

Right lung (owing to the liver)

Front 163

Pancoast tumor

Back 163

A tumor at the apex of the lung, may result in thoracic outlet syndrome

Front 164

Lobes and fissures of the right lung

Back 164

3 lobes: superior, middle, inferior

2 fissures:

*horizontal - separates the superior from the middle lobe

*oblique - separates the middlefrom inferior lobe

Front 165

Lobes and fissures of the left lung

Back 165

2 lobes: superior and inferior

1 fissure: oblique

The lingula of the left upper lobe corresponds to the middle lobe of the right lung

Front 166

Projection of the horizontal fissure

Back 166

Follows the curvature of the 4th rib, ending medially at the 4th costal cartilage

Front 167

Projection of the horizontal fissure

Back 167

Approximately 5th intercostal space in the midclavicular line, ending medially deep to the 6th costal cartilage

Front 168

Projection of the lungs' lobes on the chest wall

Back 168

Front 169

Locations for the auscultation of lungs

Back 169

Front 170

Aspiration of a foreign body. Where it will more probably fall?

Back 170

Front 171

2 major lymphatic vessels

Back 171

Front 172

Lymphatic drainage of the lungs

Back 172

-Superficial plexus (immediately deep to the visceral pleura)

-Deep plexus - begins deeply in the lungs and drains through pulmonary nodes which follow the bronchial tree toward the hilum

Plexuses -> bronchopulmonary (hilar) nodes -> tracheobronchial nodes -> bronchomediastinal nodes and trunk -> right lymphatic duct or thoracic duct

Front 173

Lymphatic drainage of the lungs chart

Back 173

Front 174

The lymphatic drainage from the lower lobe of the left lung

Back 174

Front 175

Right lymphatic and thoracic ducts

Back 175

Front 176

Metabolic functions of pulmonary endothelium

Back 176

-transformation of lipoproteins and prostaglandins

-production of the enzyme that converts angiotensin I to angiotensin II

Front 177

Clinical correlate

Back 177

Front 178

Main causes of lung cancer

Back 178

-smoking

-asbestos

-excessive radiation

Front 179

Mesothelioma

Back 179

Malignant tumor of the pleura

Causative agent: asbestos dust

Front 180

Histologic features of trachea, bronchi, and bronchioles

Back 180

Front 181

Back 181

Front 182

Histological layers of the trachea

Back 182

Front 183

Back 183

Front 184

Tracheal epithelial cell types

Back 184

-columnar cells

-goblet cells

-pulmonary neuroendocrine (PNE) cells (APUD cells/DNES cells - diffuse neuro endocrine system/K [Kulchitsky] cells)

-brush cells - may represent goblet cells that have secreted their products or intermediate stages in the formation of goblet or the tall ciliated cells; may be sensory receptors

-basal cells - stem cells for the ciliated and goblet cells; stem cells lie on the basal membrane but do not extend to the lumen of the trachea; along with epithelial neuroendocrine cells are responsible for the pseudostratified appearance of the trachea

Front 185

Kartagener syndrome

Back 185

Front 186

What cells give the pseudostratified appearance to the trachea?

Back 186

Basal cells (stem cells), not goblet cells! Along with epithelial neuroendocrine cells.

Front 187

Bronchial tree

Back 187

Trachea

Primary bronchi

Secondary (lobar) bronchi - 3 in right and 2 in left

Tertiary (segmental) bronchi - 10 in each lung

Front 188

Back 188

Front 189

Histology of bronchi

Back 189

Front 190

Reaction of columnar and goblet cells on irritation

Back 190

Front 191

From what cells do the bronchial metastatic tumors arise?

Back 191

Kulchitsky cells

Front 192

Cystic fibrosis and Clara cells

Back 192

Front 193

Is there cartilage or glands in the bronchioles?

Back 193

No

Front 194

Epithelial type of bronchioles

Back 194

Still ciliated but is a simple columnar or cuboidal rather than pseudostratified

Epithelial lining is composed of ciliated cells (goblet and basal cells are absent in the terminal bronchioles) and an additional type called the Clara cell

Front 195

Clara cells

Back 195

Front 196

Back 196

Front 197

Histology of terminal and respiratory bronchioles

Back 197

Front 198

COPD

Back 198

Front 199

Alveolus and blood-air barrier

Back 199

Front 200

Type I pneumocyte

Back 200

Front 201

Type II pneumocyte

Back 201

Front 202

Back 202

Front 203

Surfactant

Back 203

Front 204

Types of collagen in the alveolar wall

Back 204

Type I and II collagens, as well as elastic fibers, are in the septa

Type I collagen is present primarily in the walls of the bronchi and bronchioles

Front 205

Why infants of diabetec mothers have a higher incidence of respiratory distress syndrome?

Back 205

Front 206

Blood-gas barrier

Back 206

-Surfactant

-Squamous Type I pneumocyte

-Shared basal lamina

-Capillary endothelium

Front 207

What's the distance between the lumen of the capillary and the lumen of the alveolus?

Back 207

0.1 microns

Front 208

Pores of Kohn

Back 208

Openings in the wall of alveoli

Important in collateral ventilation

d = 10-15 microns

Front 209

Alveolar macrophages

Back 209

Front 210

Other names of the alveolar macrophages

Back 210

Front 211

When the heart begins to develop?

From what germ layer?

Back 211

Latter half of the third week

From splanchnic mesoderm + neural crest cells

Front 212

Formation of heart tube

Back 212

Front 213

Development of the heart tube chart

Back 213

Front 214

Germ layer for the truncus arteriosus (aorta, pulmonary trunk, semilunar valves)

Back 214

Neural crest

Front 215

Back 215

Front 216

Development of the veins of liver (sinusoids, hepatic portal vein, hepatic vein) and part of the inferior vena cava

Back 216

From viteline (omphalomesenteric) veins

Front 217

Development of some of the major veins of the body (brachiocephalic, superior vena cava, inferior vena cava, azygos, renal)

Back 217

From cardinal veins

Front 218

Venous systems associated with the fetal heart

Back 218

Front 219

Arterial systems associated with the fetal heart

Back 219

Front 220

Fetal circulation and shunts

Back 220

Front 221

What substances facilitate closure of the ductus arteriosus?

Back 221

-release of bradykinin

-immediate drop of prostaglandin E

Front 222

Adult vestiges derived from the fetal circulatory system

Back 222

Front 223

When does the septation of atria and ventricles occur?

Back 223

Week 4 - week 8

Front 224

Formation of atrial septum

Back 224

Front 225

Where is the foramen primum located?

Back 225

Between the inferior edge of the septum primum and the endocardial cushion; it is the only one foramen obliterated (when the septum primum later fuses with the endocardial cushions)

Front 226

Where is the foramen secundum located?

Back 226

Within the upper part of the SEPTUM PRIMUM (!) just before the FP closes

Front 227

Two clinically important types of ASD

Back 227

1. Secundum-type - most common ASD

2. Primum-type

Front 228

Secundum-type ASD

Back 228

Front 229

Primum-type ASD

Back 229

Front 230

Ventricular septation

Back 230

Front 231

Ventricular septal defect

Back 231

Front 232

Membranous VSD

Back 232

Front 233

In what conditions PDA is common?

Back 233

-premature infants

-maternal rubella infection

Front 234

Machine-like murmur

Back 234

PDA

Front 235

What substances sustain PDA?

Back 235

-Prostaglandin E (PGE)

-Low oxygen tension

Front 236

I what conditions PGE is used to keep PDA?

Back 236

Transposition of great vessels

Front 237

What substances promote closure of the ductus arteriosus in a premature birth?

Back 237

-PGE inhibitors (eg, indomethacin)

-acetylcholine

-histamine

-catecholamines

Front 238

When does the septation of the truncus arteriosus occur?

Back 238

During the 8th week

Front 239

Septation of the truncus arteriosus

Back 239

Front 240

What is the defect in classic cyanotic congenital heart abnormalities?

Back 240

Front 241

Most common cyanotic congenital heart deffect

Back 241

Tetralogy of Fallot

Front 242

Boot-shaped heart

Back 242

Tetralogy of Fallot (due to enlarged right ventricle)

Front 243

Back 243

Boot-shaped heart.Tetralogy of Fallot (due to enlarged right ventricle).

Front 244

Tetralogy of Fallot

Back 244

Front 245

Trilogy vs. tetralogy vs. pentalogy of Fallot

Back 245

Front 246

Transposition of the great vessels

Back 246

Front 247

The most common cause of severe cyanosis that persists immediately at birth

Back 247

Transposition of the great vessels

Front 248

Transposition of the great vessels chart

Back 248

Front 249

What defect is ALWAYS accompanied by a membranous VSD?

Back 249

Persistent truncus arteriosus

Front 250

Persistent truncus arteriosus

Back 250

Front 251

Non-cyanotic and cyanotic congenital heart defects at birth (3 and 3)

Back 251

Front 252

Mediastinum

Back 252

Front 253

Anterior mediastinum

Back 253

Front 254

Point of division of the mediastinum on superior and inferior

Back 254

Plane through the sternal angle of Louis and intervertebral disk between T4 and T5

Front 255

Aortic hiatus level. What contains?

Back 255

T12

Thoracic descending aorta and thoracic duct

Front 256

Location of the esophagus in the posterior mediastinum

Back 256

Immediately posterior to the left primary bronchus and the left atrium

Front 257

Level of the esophageal hiatus. What contains?

Back 257

T10

Esophagus and vagal nerve trunks

Front 258

Constrictions of the esophagus

Back 258

1. at its origin from the pharynx

2. posterior to the arch of the aorta

3. posterior to the left primary bronchus

4. at the esophageal hiatus of the diaphragm

Front 259

Location of the thoracic duct. Its origin.

Back 259

Lies posterior to the esophagus and between the thoracic aorta and azygos vein

Arises from the cisterna chyli in the abdomen (at vertebral level L1) and enters the mediastinum through the aortic hiatus of the diaphragm

Front 260

Azygos system of veins

Back 260

Front 261

4 structures of the posterior mediastinum

Back 261

1. Thoracic (descending) aorta

2. Esophagus

3. Thoracic duct

4. Azygos system of veins

Front 262

Middle mediastinum

Back 262

Contains the heart, parts of the great vessels, phrenic nerves, and the pericardium

Front 263

In what mediastinum are the pulmonary trunk and pulmonary arteries located?

Back 263

Completely in the middle mediastinum!

Front 264

Superior mediastinum

Back 264

Front 265

Where the superior vena cava is formed?

Back 265

2 brachiocephalic veins join posterior to the right first costal carilage

Front 266

On what level the superior vena cava drains into RA?

Back 266

Deep to the right third costal cartilage

Front 267

Where are aortic arch and its 3 branches located?

Back 267

Front 268

Location of the bifurcation of the trachea

Back 268

T4 level - border of the superior and inferior mediastinum

Front 269

Location of the esophagus

Back 269

Lies posterior to the trachea and courses posterior to the left primary bronchus to enter the posterior mediastinum

Front 270

Superior mediastinum structures, from ventral to dorsal

Back 270

Front 271

Is the right recurrent laryngeal nerve in the mediastinum?

Back 271

No

Front 272

Vagus nerves

Back 272

Front 273

Phrenic nerves

Back 273

Front 274

Recurrent laryngeal nerves

Back 274

Front 275

Coarctation of the aorta

Back 275

Front 276

Infantile and adult types of the coarctation of the aorta

Back 276

-infantile type - preductal - less common, occurs proximal to the DA, which remains open!

-adult type - postductal - more common, occurs distal to the DA, which usually closes and obliterates -> costal notching

Front 277

Coarctation of the aorta pictures

Back 277

Front 278

Layers of pericardium

Back 278

3 layers: an outer fobrous layer and a double-layered parietal and visceral (epicardium) serous layers

Front 279

Fibrous pericardium

Back 279

Front 280

Serous pericardium

Back 280

Front 281

Sinuses of the heart

Back 281

Front 282

Cardiac tamponade

Back 282

Front 283

Borders of the heart

Back 283

Front 284

Surfaces of the heart

Back 284

Front 285

Sulci of the heart

Back 285

1. Coronary

2. Anterior interventricular

3. Posterior interventricular

Front 286

Surface projections of the heart:

-upper right aspect

-lower right aspect

-upper left aspect

-apex

-right border

-left border

-inferior border

-superior border

Back 286

Front 287

What is crista terminalis?

Back 287

Front 288

Right atrium structures

Back 288

Front 289

Where is the SA node located?

Back 289

In the upper part of the crista terminalis

Front 290

Inside the right atrium picture

Back 290

Front 291

Left atrium structures

Back 291

Front 292

What is infundibulum (the heart)?

Back 292

The smooth area of the right ventricle leading to the pulmonary valve

Front 293

What is septomarginal trabecula (moderator band)?

Back 293

This is a band of cardiac muscle between the interventricular septum and the anterior papillary muscle that constitutes a part of the cardiac conduction system

Front 294

Right ventricle structures

Back 294

Front 295

What is aortic vestibule?

Back 295

The aortic vestibule leads to the aortic semilunar valve and ascending aorta

Front 296

Left ventricle structures

Back 296

Front 297

Right and left ventricles picture

Back 297

Front 298

Histology: cardiac muscle vs. skeletal muscle

Back 298

Front 299

Intercalated disks (heart)

Back 299

Front 300

Back 300

Front 301

Points of auscultation of the heart valves

Back 301

Front 302

How many cusps are in the aortic and pulmonary valves?

Back 302

3 cusps

Front 303

Auscultation of heart murmurs chart ("A heart murmur is heard downstream from the valve")

Back 303

Front 304

Arterial supply of the heart

Back 304

Front 305

Arterial supply to the heart chart

Back 305

Front 306

Right coronary artery branches

Back 306

Front 307

Left coronary artery branches

Back 307

Front 308

Epidemiology of vessels obstruction leading to the myocardial infarction

Back 308

Front 309

From what does the coronary sinus develop?

Back 309

Left sinus venosus

Front 310

Main vein of the coronary circulation

Back 310

Coronary sinus

Front 311

Main tributary of the coronary sinus

Back 311

Great cardiac vein (lies in the anterior interventricular sulcus)

Front 312

Venous drainage of the heart

Back 312

Front 313

Venous drainage of the heart picture

Back 313

Front 314

Where is the AV node located?

Back 314

In the interatrial septum near the opening of the coronary sinus

Front 315

Cardiac plexus

Back 315

Front 316

Phrenic nerve segments

Back 316

C3-C5

Front 317

Caval hiatus

Back 317

T8, right of the midline, within the central tendon

Inferior vena cava and some branches of the right phrenic nerve

Front 318

Esophageal hiatus

Back 318

T10, left of the midline, within the muscle of the right crus

Esophagus and the anterior and posterior vagus trunks

Front 319

Aortic hiatus

Back 319

T12, lLocated in the midline behind the two crura

Aorta and the thoracic duct

Front 320

Development of the diaphragm:

1. central tendon of the diaphragm

2. parts of the tendinous portion of the diaphragm

3. crura of the diaphragm

4. muscle periphery

Back 320

Front 321

Pain referral from the phrenic nerve

Back 321

Front 322

A congenital diaphragmatic and esophageal hiatal hernia

Back 322

Front 323

Back 323

Front 324

Back 324

Front 325

Back 325

Front 326

Back 326

Front 327

Back 327

Front 328

Back 328

Front 329

Back 329

Front 330

Back 330

Front 331

Development of the alveolar macrophages

Back 331

They are derived from monocytes

Front 332

From what does the primitive heart tube develop?

Back 332

From the lateral plate mesoderm

Front 333

Where is the coronary sinus orifice located?

Back 333

Between the inferior vena cava and the right atrioventricular orifice or tricuspid valve in the right atrium

Front 334

Linea semilunaris

Back 334

Is a curved line defining the lateral border of the rectus abdominis, a bilateral feature

Front 335

Subcostal plane

Back 335

Front 336

Transpyloric plane

Back 336

Front 337

Midclavicular lines

Back 337

Front 338

Regions and plains of the abdomen

Back 338

Front 339

Superficial fascia of the anterior abdominal wall

Back 339

Front 340

Hesselbach's triangle

Back 340

Front 341

Lacunar and pectineal ligaments

Back 341

Front 342

Femoral canal

Back 342

Front 343

Inguinal ligament

Back 343

Front 344

Superficial inguinal ring

Back 344

Front 345

Anteror abdominal wall layers

Back 345

Front 346

External abdominal oblique muscle

Back 346

Front 347

External spermatic fascia derives from ...

Back 347

External abdominal oblique muscle

Is the outer layer of 3 coverings of the spermatic cord formed at the superficial inguinal ring in males

Front 348

Cremasteric muscle and fascia derive from ...

Back 348

Internal abdominal oblique muscle

Is the middle layer of the spermatic fascia covering the spermatic cord and testis in the male. It forms in the inguinal canal.

Front 349

Internal abdominal oblique muscle

Back 349

Front 350

Transversus abdominis muscle and aponeurosis

Back 350

Front 351

Internal spermatic fascia derives from ...

Back 351

Transversalis fascia

Deepest of the coverings of the spermatic cord formed at the deep ring in the male

Front 352

Superficial inguinal ring is formed by ...

Back 352

External oblique aponeurosis

Front 353

Deep inguinal ring

Back 353

Front 354

Deep inguinal ring is formed by ...

Back 354

Outpouching of the transversalis fascia immediately above the midpoint of the inguinal ligament

The inferior epigastric vessels are medial to the deep ring

Front 355

Transversalis fascia

Back 355

Front 356

Femoral sheath

Back 356

Front 357

Where do the gonads develop?

Back 357

Within the extraperitoneal connective tissue!

Front 358

Layers of anterolateral abdominal wall and inguinal canal picture

Back 358

Front 359

Innervation of the skin and muskulature of the anterior abdominal wall

Back 359

-Ventral primary rami of T7-T12 (includes the subcostal nerve)

-Iliohypogastric and ilioinguinal branches of the ventral primary rami of L1

Front 360

Arterial blood supply to the anterior abdominal wall

Back 360

-superior epigastric branch << internal thoracic artery

-inferior epigastric and DEEP circumflex iliac << external iliac artery

Front 361

Venous drainage from the anterior abdominal wall

Back 361

Superiorly:

-superficial epigastric

-lateral thoracic veins

Inferiorly:

-great saphenous vein

Front 362

Lymph drainage from the anterior abdominal wall

Back 362

Superiorly - axillary nodes

Inferiorly - superficial inguinal

Front 363

Inguinal canal

Back 363

Front 364

Remnant of the caudal genital ligament (females)

Back 364

Round ligament of the uterus

Front 365

Homologue of the gubernaculum testis of the male

Back 365

Round ligament of the uterus

Front 366

Ilioinguinal nerve innervation in females

Back 366

Anterior part of the mons pubis and labia majora

Front 367

Female inguinal canal contents

Back 367

Front 368

Ilioinguinal nerve innervation in males

Back 368

Skin of the lateral and anterior scrotum

Front 369

Contents of the spermatic cord (6)

Back 369

Front 370

Male inguinal canal contents

Back 370

1. Ilioinguinal nerve

2. The spermatic cord

Front 371

Varicocele

Back 371

Front 372

Fascial layers of the spermatic cord

Back 372

Front 373

Boundaries of the inguinal canal

Back 373

Front 374

When does the descent of testes occur?

Back 374

During the last trimester

Front 375

When does the processus vaginalis close?

Back 375

Before birth

Front 376

What is gubernaculum?

Back 376

Fibers that guide the testis during its descent to the scrotum

Front 377

Descent of the testes

Back 377

Front 378

Where do the cancers of penis and scrotum will metastasize? Testicular cancer?

Back 378

Front 379

Cremasteric reflex limbs

Back 379

Front 380

Cryptorchidism

Back 380

Front 381

Inguinal hernias occur ... to the inguinal ligament

Back 381

superior

Front 382

Indirect inguinal hernias

Back 382

Front 383

Direct inguinal hernias

Back 383

Front 384

Cuase of the congenital indirect inguinal hernia

Back 384

Persistent process vaginalis

Front 385

Hydrocele

Back 385

Front 386

Direct vs. indirect hernias

Back 386

Front 387

Hasselbach's triangle

Back 387

Front 388

Inguinal hernias most often occur in ...

Femoral hernias most offen occur in ...

Back 388

Inguinal - men

Femoral - women (Femoral-Female)

Front 389

What does the femoral sheath contain?

Back 389

Femoral artery, vein, and canal

Front 390

Femoral hernias occur ... to the inguinal ligament

Back 390

inferior

Front 391

Femoral artery, nerve, and vein - correct order (medial to lateral!)

Back 391

VAN

Front 392

How is the primitive gut tube formed?

Back 392

Front 393

Primitive gut tube

Back 393

Front 394

Adult structures derived from each of the 3 divisions of the primitive gut tube

Back 394

Front 395

Development of gastrointestinal tract

Back 395

Front 396

Where does the liver develop? Spleen and dorsal pancreatic bud?

Back 396

Liver - ventral embryonic mesentery

Spleen and dorsal pancreatic bud - dorsal embryonic mesentery

Front 397

Rotation of the foregut

Back 397

Front 398

From what do the lower respiratory tract, liver and biliary system, and pancreas develop?

Back 398

Endodermal outgrowth of the foregut

Front 399

Cross-sectional view of foregut development and rotation

Back 399

Front 400

From what does the midgut develop?

Back 400

From the cranial and caudal intestinal loops

Front 401

Development and rotation of the midgut

Back 401

Front 402

Innervation of the parietal peritoneum

Back 402

-lower intercostal nerves

-ilioinguinal and the iliohypogastric nerves of the lumbar plexus

Front 403

What are mesenteries?

Back 403

Double-layered peritoneal membranes that suspend parts of the GI tract from the body wall

Front 404

Postnatal remnants of mesenteries

Back 404

Front 405

Peritonitis

Back 405

Front 406

lesser sac

Back 406

Omental bursa

Is a cul-de-sac formed posterior to the stomach and the lesser omentum

Front 407

Greater sac

Back 407

Formed by the larger area of the remaining peritoneal cavity

Front 408

The only communication between the lesser sac and the greater sac

Back 408

Epiploic foramen (of Winslow)

Front 409

Intraperitoneal vs. retroperitoneal organs

Back 409

Front 410

Intraperitoneal vs. retroperitoneal organs table

Back 410

Front 411

Boundaries of the epiploic foramen (of Winslow)

Back 411

Front 412

Where is the ligamentum teres of liver located?

Back 412

Falciform ligament

Front 413

What does the splenorenal ligament contain?

Back 413

Tail of pancreas and distal splenic vessels

Front 414

Composition of the lesser omentum

Back 414

-Hepatogastric ligament

-Hepatoduodenal ligament

Front 415

What does the hepatoduodenal ligament contain?

Back 415

-common bile duct

-proper hepatic artery

-hepatic portal vein

Front 416

Development of the liver

Back 416

Front 417

Development of the pancreas

Back 417

Front 418

What does the dorsal pancreatic bud form?

Back 418

Neck, body, and tail of the pancreas

Front 419

What does the ventral pancreatic bud form?

Back 419

Head and uncinate process

Front 420

Development of the spleen

Back 420

Front 421

Hypertrophic pyloric stenosis

Back 421

Front 422

Annular pancreas

Back 422

Front 423

Extrahepatic biliary atresia

Back 423

Front 424

Duodenal atresia

Back 424

Front 425

Omphalocele

Back 425

Front 426

Back 426

Omphalocele (with membrane)

Front 427

Back 427

Gastroschisis

Front 428

The amnion stems from the ... on the outer side and the ... on the inner side

Back 428

The amnion stems from the extraembryonic somatic mesoderm on the outer side and the extraembryonic ectoderm on the inner side

Front 429

Gastroschisis

Back 429

Front 430

Ileal (Meckel) diverticulum

Back 430

Front 431

Vitelline fistula

Back 431

Front 432

Drainage of meconium from the umbilicus

Back 432

Vitelline fistula

Front 433

Volvulus

Back 433

Twisting of intestines

Front 434

Malrotation of midgut

Back 434

Front 435

Hirschprung disease

Back 435

Front 436

Division of the liver

Back 436

Front 437

Visceral surface of the liver

Back 437

Front 438

Where does the gallbladder lie?

Back 438

In a fossa on the visceral surface of the liver to the right of the quadrate lobe

Front 439

Biliary ducts

Back 439

Front 440

By what is the uncinate process of pancreas crossed?

Back 440

Superior mesenteric vessels

Front 441

Site of formation of the hepatic portal vein

Back 441

Posterior to the neck of pancreas

Front 442

The only part of the pancreas that is intraperitoneal

Back 442

Tail

Front 443

Blood supply to the pancreas

Back 443

Head:

-superior pancreaticoduodenal branch << gastroduodenal artery << celiac trunk

-inferior pancreaticoduodenal branch << superior mesenteric artery

Collateral circulation between celiac trunk and superior mesenteric artery!

Neck, body, and tail: splenic artery

Front 444

Carcinoma of the pancreas

Back 444

Front 445

The splenic artery and vein reach the hilus of the spleen by traversing the ...

Back 445

splenorenal ligament

Front 446

Border between foregut and midgut

Back 446

2 part of duodenum - at the point of entry of the common bile duct

Front 447

What is mesoappendix?

Back 447

Own mesentery of the appendix

Front 448

What's longer - jejunum or ileum?

Back 448

Jejunum - 2/5

Ileum - 3/5!

Front 449

Sliding hiatal hernia

Back 449

Front 450

What is transverse mesocolon?

Back 450

Own mesentery of the transverse colon

Front 451

Border between midgut and hindgut

Back 451

Junction of the proximal two-thirds and distal one-third of the transverse colon

Front 452

What is sigmoid mesocolon?

Back 452

Own mesentery of the sigmoid colon

Front 453

Junction point between descending colon and sigmoid colon

Back 453

Pelvic brim

Front 454

Anal canal

Back 454

Front 455

Function of the puborectalis component of the pelvic diaphragm

Back 455

Front 456

Internal and external anal sphincter

Back 456

Front 457

Innervation of the external anal sphincter

Back 457

Inferior rectal branch of the pudendal nerve

Front 458

Pectinate line (rectum)

Back 458

Front 459

Comparison of features above and below the pectinate line (table)

Back 459

Front 460

Back 460

Front 461

What is located in the lamina propria of GI tract?

Back 461

-Capillary networks

-Lacteals!

-GALT (IgA production)!

Front 462

Meissner's plexus

Back 462

An interconnected network of ganglia and nerves located in the submucosa

Front 463

Auerbach's plexus

Back 463

Located between the 2 muscle layers of the muscularis externa

Front 464

Extrinsic autonomic innervation of the GI tract

Back 464

Front 465

Hirschprung disease

Back 465

Front 466

Brunner glands

Back 466

Discharge alkaline secretion in duodenum

Located in submucosa!

Front 467

Histology of GI tract table

Back 467

Front 468

Function of M cells in ileum

Back 468

Front 469

Muscularis externa of the esophagus

Back 469

Front 470

Back 470

Front 471

Gastric pits

Back 471

Front 472

Back 472

Front 473

Where are the parietal cells located?

Back 473

Upper regions of the gastric glands (under the isthmus!)

Front 474

Where are the mucus-secreting cells located in the stomach?

Back 474

Front 475

H. pylori infection

Back 475

Front 476

Where are the stem cells responsible for the regeneration of all types of cells located in the stomach?

Back 476

Isthmus!

Front 477

Where are chief cells located?

Back 477

Deep within the glands, thus they can have life span greater than 190 days (not acidic environment)

Front 478

Back 478

Front 479

The glands are ... in the cardiac and pyloric regions of the stomach and ... in the fundus and body regions

Back 479

The glands are coiled in the cardiac and pyloric regions of the stomach and straight in the fundus and body regions

Front 480

Valves of Kerckring

Back 480

Plicae circulares (circular folds) in the small intestine

Involve both mucosa and sub-mucosa

Increase the surface area by factor of 3

Front 481

Villi of the small intestine

Back 481

Front 482

Microvilli of the small intestine

Back 482

Front 483

Function of glycocalix

Back 483

Front 484

Crypts of Lieberkuhn

Back 484

Front 485

Small intestine mucosal histology

Back 485

Front 486

What cells produce mucus in the GI tract?

Back 486

Duodenum - Brunner glands

Intestine - goblet cells

Front 487

Back 487

Front 488

Maternal IgGs ingestion and IgAs secretion

Back 488

Front 489

Constipation

Back 489

Front 490

Where are the Peyer's patches located?

Back 490

Front 491

Goblet cells

Back 491

Front 492

Enterocytes

Back 492

Front 493

Paneth cells

Back 493

Front 494

Back 494

Front 495

Stain for the enteroendocrine cells

Back 495

Silver-based stains

Front 496

Where are the enteroendocrine cells located?

Back 496

Front 497

Stem cells of the intestinal epithelia

Back 497

Front 498

GALT

Back 498

Front 499

Back 499

Front 500

Does the large intestine have plicae, villi, and crypts of Lieberkuhn?

Back 500

No plicae, villi, but has short crypts of Lieberkuhn

Front 501

Why are there haustra in the colon?

Back 501

Because the colon is longer than teniae coli

Front 502

Difference in location between stem cells in stomach and small and large intestine

Back 502

Stomach - isthmus

Small and large intestine - lower part of the crypts

Front 503

Back 503

Front 504

Salivary glands

Back 504

Front 505

Intercalated and striated ducts of the salivary glands

Back 505

Front 506

Back 506

Front 507

Parotid gland pathology

Back 507

Front 508

Stensen's duct

Back 508

Parotid gland's duct, opens above the second upper molar tooth

Front 509

Parotid gland

Back 509

Front 510

Wharton's duct

Back 510

Duct of the submandibular gland, drain in the floor of the mouth near the base of the tongue

Front 511

Submandibular gland

Back 511

Front 512

Sublingual gland

Back 512

Front 513

Back 513

Front 514

Duct of Wirsung

Back 514

Main pancreatic duct

Front 515

Duct of Santorini

Back 515

Accessory pancreatic duct

Front 516

Histological difference between pancreas and salivary glands

Back 516

Front 517

Kupffer cells

Back 517

Front 518

Blood flow into the liver

Back 518

Blood flow into the liver is dual (75% from portal vein, 25% from hepatic artery)

Front 519

Space of Disse

Back 519

Front 520

How many hepatic veins are there?

Back 520

The hepatic veins are three large veins which drain the hepatic parenchyma into the inferior vena cava (IVC), named the right hepatic vein, middle hepatic vein and left hepatic vein

Front 521

Portal triad (portal tract)

Back 521

Front 522

Classic hepatic lobule

Back 522

Front 523

Back 523

Front 524

Portal lobule

Back 524

Front 525

Hepatic acinus

Back 525

Front 526

Hepatic acinus picture

Back 526

Front 527

Classic lobule vs. portal lobule vs. hepatic acinus

Back 527

Front 528

Metabolic activity of hepatocytes within the zones of the acinus

Back 528

Front 529

Ito cells (stellate cells)

Back 529

Front 530

Epithelium of the gallbladder

Back 530

Front 531

Spiral valves of Heister

Back 531

Valves in the cystic duct

Front 532

Mechanism of the development of the portal hypertension

Back 532

Front 533

3 main functions of bile

Back 533

Front 534

Back 534

Front 535

Level of the aortal bifurcation

Back 535

L4

Front 536

3 groups of the aortal branches

Back 536

-3 unpaired visceral branches

-3 paired visceral branches

-several parietal branches to the body wall

Front 537

Abdominal aorta branches

Back 537

Front 538

Visceral and parietal branches of the abdominal aorta picture

Back 538

Front 539

The most common site for an abdominal aneurism

Back 539

Front 540

Celiac artery (trunk) branches

Back 540

Arises at T12-L1 level

Supplies the structures derived from the foregut

3 branches:

1. left gastric artery (supplies most of the lesser curvature)

-esophageal branch

2. splenic artery

-branches to the neck, body, and tail of the pancreas

-left gastroepiploic artery (supplies the left side of the greater curvature of the stomach)

-short gastric branches (supply the fundus of the stomach)

3. common hepatic artery

-proper hepatic artery

*right gastric artery

-left hepatic artery

-right hepatic artery

*cystic artery

-gastroduodenal artery

*right gastroepiploic artery

*superior pancreaticoduodenal arteries (anastomoses with inferior pancreaticoduodenal branches of the superior mesenteric artery)

Front 541

Celiac artery branches

Back 541

Front 542

Superior mesenteric artery

Back 542

Arises at the L1 level just below the celiac artery

Supplies the midgut

The superior mesenteric vein is to the right of the artery

Branches:

1. inferior pancreaticoduodenal arteries - anastomose with the superior pancreaticoduodenal branches of the gastroduodenal artery

2. intestinal arteries - 12-15 branches from the left side of SMA

3. ileocolic artery

4. right colic artery

5. middle colic artery

Front 543

SMA picture

Back 543

Front 544

Inferior mesenteric artery

Back 544

Supplies hindgut

Arises at the level of L3

Branches:

1. Left colic artery

2. Sigmoid arteries

3. Superior rectal artery

Front 545

Marginal artery

Back 545

Front 546

IMA picture

Back 546

Front 547

The most common site of bowel ischemia

Back 547

Splenic flexure

Front 548

Renal arteries' level

Back 548

Upper border of the L2 vertebra

Front 549

Difference between the right and left renal arteries

Back 549

The right renal artery is longer and passes posterior to the IVC

Front 550

Gonadal arteries

Back 550

Front 551

Level of the IVC origin

Back 551

To the right of the lumbar vertebrae at the L5 level

Front 552

Where do the right and left gonadal and suprarenal veins drain?

Back 552

Front 553

How does the left renal vein pass?

Back 553

Crosses anterior to the aorta, just inferior to the origin of the superior mesenteric artery

Front 554

IVC picture

Back 554

Front 555

Aneurysm of the superior mesenteric artery

Back 555

Front 556

Hepatic portal system

Back 556

Front 557

Hepatic portal system picture

Back 557

Front 558

Are there valves in the portal system?

Back 558

No!

Front 559

Palm tree sign

Back 559

Caput medusae

Front 560

Portacaval anastomoses

Back 560

Front 561

Embryology of kidneys and ureter

Back 561

Front 562

Pronephros derivatives

Back 562

Nothing!

Front 563

Mesonephros derivatives

Back 563

Bowman's capsule into which a tuft of capillaries, or glomerulus, invaginates

Front 564

Metanephros derivatives

Back 564

1. Ureteric bud - calyces, pelvis, ureter

2. Metanephric mass - proximal convoluted tubule, the loop of Henle, and the distal convoluted tubule

Front 565

Positional change of the kidneys

Back 565

Front 566

Development of the urinary system pictures

Back 566

Front 567

Embryology of bladder and urethra

Back 567

Front 568

Urogenital sinus

Back 568

Front 569

Potter sequence

Back 569

-clubbed feet

-pulmonary hypoplasia

-craniofacial anomalies

Seen in cases of oligohydramnios (eg, bilateral renal agenesis)

Front 570

Renal agenesis

Back 570

Front 571

Back 571

Club foot or Congenital Talipes Equinovarus (CTEV)

Front 572

Pelvic and horseshoe kidney

Back 572

Front 573

Double ureter

Back 573

Front 574

Patent urachus

Back 574

Front 575

Right kidney vs. left kidney position

Back 575

T12-L3

The right kidney is positioned slightly lower than the left because of the mass of the liver

Front 576

Kidney's relation to the posterior abdominal wall

Back 576

Front 577

Ureters

Back 577

Front 578

On what muscle does the ureter lie?

Back 578

Psoas major muscle

Front 579

Critical points of the ureter for the blockage by renal calculi

Back 579

Front 580

Muscles and bony landmarks of the posterior abdominal wall

Back 580

Front 581

Blood supply to the urinary bladder

Back 581

Front 582

Lymphatic drainage of the urinary bladder

Back 582

Drain to the external and internal iliac nodes

Front 583

Innervation of the urinary bladder

Back 583

Front 584

Innervation of the external urethral sphincter

Back 584

Perineal branches of the pudendal nerve

Front 585

Urethra

Back 585

Front 586

Spastic bladder

Back 586

Front 587

Atonic bladder

Back 587

Front 588

Weakness of the puborectalis and sphincter uretrae

Back 588

Front 589

Column of Bertin

Back 589

Renal column

Front 590

Endocrine functions of kidneys

Back 590

-renin

-erythropoietin

-prostaglandins - vasodilators

Front 591

Back 591

Collections of straight tubules form the medullary rays, which run up the center axis of a renal lobule. The border of the renal lobule is defined by the interlobular blood vessels. Between the interlobular blood vessels and the medullary ray are the renal corpuscles and convoluted tubules, together constituting the cortical labyrinth.

Front 592

Organization of the kidney

Back 592

Front 593

Blood circulation in kidneys

Back 593

Front 594

Uriniferous tubule

Back 594

Nephron + collecting duct

Front 595

Renal corpuscle and Bowman's capsule picture

Back 595

Front 596

Back 596

Front 597

Back 597

Front 598

Back 598

Front 599

Podocyte foot processes

Back 599

Front 600

Erythropoietin production

Back 600

Front 601

Polkissen or Lacis cells

Back 601

Front 602

Renal corpuscle and juxtaglomerular apparatus picture

Back 602

Front 603

Juxtaglomerular complex

Back 603

Front 604

Juxtaglomerular cells. Location and function.

Back 604

Modified smooth-muscle cells!

Location: in the wall of the afferent arteriole

Function: secrete renin

Front 605

Macula densa. Location and function.

Back 605

Formed by tall cuboidal cells

Location: in the wall of the distal convoluted tubule

Function: detect sodium levels in the tubular fluid

Front 606

Intraglomerular mesangial cell

Back 606

Front 607

Extraglomerular mesangial cell

Back 607

Front 608

Adult male and female reproductive structures derived from precursors of the indifferent embryo

Back 608

Front 609

Gonads derivatives in male and female

Back 609

Male (+TDF!): testes, seminiferous tubules, rete testes

Female: ovary, follicles, rete ovarii

Front 610

Paramesonephric ducts derivatives in male and female

Back 610

Male (-MIF!): Appendix of testes (hydatid of Morgagni = remnant)

Female: Uterine tubes, uterus, cervix, and upper part of vagina

Front 611

Mesonephric ducts derivatives in males and females

Back 611

Males (+Testosterone!): Epididymis, ductus deferens, seminal vesicle, ejaculatory duct

FEmales: Duct of Gartner = remnant

Front 612

Genital tubercle derivatives in males and females

Back 612

Males (+DHT!): Glans and body of penis

Females: Clitoris

Front 613

Urogenital folds derivatives in males and females

Back 613

Male (+DHT!): ventral aspect of penis

Female: Labia minora

Front 614

Labioscrotal swellings derivatives in males and females

Back 614

Male: Scrotum

Female: Labia majora

Front 615

Hydatid of Morgagni

Back 615

Front 616

Female pseudointersexuality

Back 616

Front 617

Male pseudointersexuality

Back 617

Front 618

5α-reductase 2 deficiency

Back 618

Front 619

CAIS

Back 619

Front 620

Chordee

Back 620

A condition in which the head of the penis curves downward or upward, at the junction of the head and shaft of the penis. The curvature is usually most obvious during erection, but resistance to straightening is often apparent in the flaccid state as well.

Front 621

Hypospadias

Back 621

Front 622

Bladder exstrophy

Back 622

Also known as "Ectopia vesicae"

A congenital anomaly that exists along the spectrum of the exstrophy-epispadias complex and most notably involves protrusion of the urinary bladder through a defect in the abdominal wall. Its presentation is variable, often including abnormalities of the bony pelvis, pelvic floor, and genitalia. The underlying embryologic mechanism leading to bladder exstrophy is unknown, though it is thought to be in part due to failed reinforcement of the cloacal membrane by underlying mesoderm.

Front 623

Epispadias

Back 623

Front 624

Cryptorchidism

Back 624

Front 625

When does the descend of testes normally occur?

Back 625

Within 3 months after birth

Front 626

Vaginal process

Back 626

Front 627

Canal of Nuck

Back 627

Front 628

Hydrocele of the testes

Back 628

Front 629

Innervation of the pelvic and urogenital diaphragms

Back 629

Branches of the pudendal nerve

Front 630

Pelvic diaphragm

Back 630

Front 631

Urogenital diaphragm

Back 631

Front 632

Kegel exercise

Back 632

Front 633

Parts of the levator ani muscle

Back 633

1. Pubococcygeus - main, can be damaged in parturition

2. Puborectalis

3. Ileococcygeus

Front 634

Where is the bulbourethral gland located?

Back 634

Deep perineal pouch

Front 635

Where is the Bartholin gland located?

Back 635

Superficial perineal pouch

Front 636

Hyperplasia of the prostate

Back 636

Front 637

Where are the ovarian vessels located?

Back 637

In the suspensory ligament of ovary

Front 638

Ureter vs. suspensory ligament of the ovary location

Back 638

Front 639

Ligaments of the female reproductive tract

Back 639

Front 640

Perineum

Back 640

Front 641

Anal triangle

Back 641

Front 642

Supporting structures of the pelvic viscera

Back 642

Front 643

"Water under the bridge"

Back 643

Front 644

Pudendal nerve block

Back 644

Front 645

Urogenital triangle

Back 645

Front 646

Cowper glands

Back 646

Bulbourethral

Located in the deep perineal pouch

Front 647

Bartholin glands

Back 647

Greater vestibular glands

Located in the superficial perineal pouch

Front 648

Superficial perineal pouch

Back 648

Front 649

Deep perineal pouch

Back 649

Front 650

Colles' fascia

Back 650

Superficial perineal = Scarpa fascia in abdomen = dartos fascia of scrotum = superficial fascia of clitoris or penis

Front 651

Superficial and deep perineal pouches of male picture

Back 651

Front 652

Shaft of the penis

Back 652

Front 653

Male reproductive system

Back 653

Front 654

Perineum of female picture

Back 654

Front 655

Pelvic and perineal innervation

Back 655

Front 656

Testicular histology

Back 656

Front 657

Blood-testis barrier

Back 657

Front 658

Seminiferous tubule diagram

Back 658

Front 659

Spermatogenesis

Back 659

Front 660

Back 660

Front 661

Spermiogenesis

Back 661

Front 662

Spermatozoan diagram

Back 662

Front 663

The acrosome is derived from the ...

Back 663

Golgi complex

Front 664

Acrosome

Back 664

Front 665

Androgen binding protein and inhibin

Back 665

Front 666

Sertoli cells

Back 666

Front 667

Leydig cells

Back 667

Front 668

Back 668

Front 669

Back 669

Front 670

Rete testis

Back 670

Front 671

Epithelial lining of the epididymis

Back 671

Pseudostratified columnar epithelium wich contains stereocilia (tall microvilli)

Front 672

Where do the spermatozoa become motile?

Back 672

Epididymis

Front 673

Epididymis

Back 673

Front 674

Back 674

Front 675

Ductus (vas) deferens

Back 675

Front 676

Back 676

Front 677

Epithelial lining of the seminal vesicles

Back 677

Pseudostratified columnar epithelium

Front 678

How much (in %) do the seminal vesicles constitute to the human ejaculate

Back 678

70%

Front 679

Seminal vesicles

Back 679

Front 680

What substance provides energy for the spermatozoa's motility?

Back 680

Fructose

Front 681

Back 681

Front 682

Prostate histology

Back 682

Front 683

Epithelial lining of the prostate

Back 683

Pseudostratified columnar epithelium

Front 684

Back 684

Front 685

Penile erection

Back 685

Front 686

Ejaculation

Back 686

Front 687

Accumilation of fluid in the scrotum, penis, and anterolateral abdominal wall

Back 687

Front 688

Ovarian histology

Back 688

Front 689

Female reproductive system diagram

Back 689

Front 690

Follicular development diagram

Back 690

Front 691

Graafian follicle diagram

Back 691

Front 692

Primordial follicles

Back 692

Primary oocyte surrounded by a single layer of squamous follicular cells, which are joined to one another by desmosomes

Front 693

Primary follicles

Back 693

Develop from the primordial follicles

Oocyte is surrounded now by 2 or more layers of cuboidal cells

Front 694

What is zona pellucida?

Back 694

A thick layer of glycoprotein synthesized by both granulosa cells and oocyte

Front 695

Difference between the theca interna and theca externa (follicle)

Back 695

Theca interna - richly vascularized, synthesize androgenic steroids, that diffuse into follicle and are converted to estradiol by the granulosa cells

Front 696

Ovarian follicles

Back 696

Front 697

Back 697

Front 698

Secondary follicle

Back 698

Front 699

Graafian follicle

Back 699

Front 700

Back 700

Front 701

Ovulation

Back 701

Front 702

What do the granulosa lutein cells and theca lutein cells produce?

Back 702

From theca interna!

Front 703

Corpus luteum

Back 703

Front 704

Oviduct

Back 704

Front 705

Back 705

Front 706

Epithelial lining of the oviducts

Back 706

Simple columnar!

Some cells are ciliated!

Front 707

Layers of the oviduct

Back 707

No submucosa!

1. Mucosa

2. Muscularis

3. Serosa

Front 708

Will the Kartagener's syndrome cause impairment of the tubular transport in women?

Back 708

No

Front 709

Source of the stem cells for the functional layer of the myometrium

Back 709

The bases of the uterine glands, which lie deep in the basalis

Front 710

Epithelial lining of the uterus

Back 710

Simple columnar cells (ciliated and secretory)

Front 711

Uterus

Back 711

Front 712

Back 712

Front 713

Does the vagina have glands?

Back 713

No!

Front 714

Epithelial lining of the vagina

Back 714

Stratified sqamous

Front 715

Back 715

Front 716

Mammary glands' histology

Back 716

Front 717

Back 717

Front 718

Back 718

Front 719

Back 719

Front 720

Back 720

Front 721

Back 721

Front 722

Back 722

Front 723

Back 723

Front 724

Back 724

Front 725

Back 725

Front 726

Back 726

Front 727

4 collateral portacaval anastomoses

Back 727

1. Esophageal

2. Rectal

3. Umbilical

4. Retroperitoneal

Front 728

How does the gallbladder concentrate bile?

Back 728

It removes water through active transport of sodium and chloride ions (especially chloride!)

Front 729

Breast cancer epidemiology

Back 729

Front 730

Epithelial lining of the urethra

Back 730

Prostatic urethra - transitional epithelium

Distal urethra - stratified epithelium

Front 731

Corpora CAVERNOSA are surrounded by ...

Back 731

Tunica albuginea

Front 732

Why there is breakdown of the functional level?

Back 732

Constriction of the spiral arteries

Front 733

Fetal and maternal components of the placenta

Back 733

Front 734

pH in the vagina during estrogenic and postestrogenic phases

Back 734

Front 735

Brachial plexus segments

Back 735

C5-T1

Front 736

Brachial plexus diagram

Back 736

Front 737

Musculocutaneous nerve

Segments?

Muscles innervated?

Primary actions?

Back 737

Front 738

Median nerve

Segments?

Muscles innervated?

Primary actions?

Back 738

Front 739

What muscles are in action?

Back 739

Lumbricals 1-4

Front 740

Ulnar nerve

Segments?

Muscles innervated?

Primary actions?

Back 740

Front 741

Palmar and dorsal interossei muscles mnemonics

Back 741

Front 742

Axillary nerve

Segments?

Muscles innervated?

Primary actions?

Back 742

Front 743

Teres minor and teres major functions

Back 743

Teres major - medial rotation (we are stronger in medial rotation, thus, teres MAJOR)

Teres minor - lateral rotation

Front 744

Radial nerve

Segments?

Muscles innervated?

Primary actions?

Back 744

Front 745

Nerves of the upper limbs that provide supination and pronation

Back 745

Supination:

-Musculocutaneous nerve (biceps brachii)

-Radial nerve (supinator muscle)

Pronation:

-Median nerve

Front 746

Is the biceps brachii the most powerful flexor of the forearm?

Back 746

No! Brachialis is. Biceps is powerful supinator.

Front 747

Collateral nerves of the brachial plexus

Back 747

Front 748

Dorsal scapular nerve innervation

Back 748

Rhomboids

Front 749

Long thoracic nerve innervation

Back 749

Serratus anterior - protracts and rotates scapula superiorly

Front 750

Suprascapular nerve innervation

Back 750

Supraspinatus - abduct shoulder 0-15 degrees

Infraspinatus - LATERALLY rotate shoulder

Front 751

Lateral pectoral nerve innervation

Back 751

Pectoralis major

Front 752

Medial pectoral nerve innervation

Back 752

Pectoralis major and minor

Front 753

Upper subscapular nerve innervation

Back 753

Subscapularis

Front 754

Middle subscapular (thoracodorsal) nerve innervation

Back 754

Latissimus dorsi

Front 755

Lower subscapular nerve innervation

Back 755

Subscapularis and teres major

Front 756

Medial brachial cutaneous nerve innervation

Back 756

Skin of medial arm

Front 757

Medial antebrachial cutaneous nerve innervation

Back 757

Skin of medial forearm

Front 758

Segmental inervation to muscles of upper limbs

Back 758

Front 759

Sensory innervation of the hand

Back 759

Front 760

Is the palm sensation affected by the carpal tunnel syndrome?

Back 760

Front 761

Sensory innervation of the hand and forearm diagram

Back 761

Front 762

Sensory innervation of the lateral forearm

Back 762

Musculocutaneous nerve (C5-C6) -> lateral cutaneous nerve of forearm

Front 763

Sensory innervation of the medial forearm

Back 763

Medial cutaneous nerve of forearm (C8-T1)

Front 764

Sensory innervation of the lateral arm

Back 764

Radial nerve -> lateral cutaneous nerve of arm

Front 765

Sensory innervation of the medial arm

Back 765

Medial cutaneous nerve of arm (C8-T1)

Front 766

Sensory innervation of the lateral dorsal 3.5 distal phalangs

Back 766

Median nerve

Front 767

Erb-Duchenne palsy

Back 767

Front 768

What nerves are affected in Erb-Duchenne palsy?

Back 768

-axillary

-suprascapular

-musculocutaneous

Front 769

Back 769

Erb-Duchenne palsy

Front 770

Klumpke's paralysis

Back 770

Front 771

Back 771

Klumpke's paralysis

Front 772

Deep tendon reflexes levels

Back 772

Front 773

Deep tendon reflexes scale

Back 773

Front 774

Radial nerve injury in axilla

Back 774

Also, honeymoon palsy

Front 775

Elbow - lateral epicondyle or radial head dislocation

Back 775

Radial nerve injury

Front 776

Radial nerve injury in mid-shaft of humerus at radial groove or lateral elbow (lateral epicondyle or radial head dislocation)

Back 776

Front 777

Radial nerve injury in wrist laceration

Back 777

Front 778

Waiter's tip sign

Back 778

Erb-Duchenne palsy

Front 779

Combination of "claw hand" and "ape hand" signs

Back 779

Klumpke's paralysis

Front 780

"Wrist drop"

Back 780

Radial nerve injury

Front 781

Median nerve injury - elbow (supracondylar fracture of humerus)

Back 781

Front 782

Combination of the "hand of benediction" and "ape hand"

Back 782

Median nerve injury - elbow (supracondylar fracture of humerus)

Front 783

Median nerve injury - wrist laceration or carpal tunnel

Back 783

Front 784

Ulnar nerve injury

Back 784

Front 785

Fracture of hook of hamate

Back 785

Ulnar nerve injury

Front 786

Axillary nerve injury

Back 786

Front 787

Fracture of the surgical neck of the humerus or inferior dislocation of the shoulder

Back 787

Axillary nerve injury

Front 788

Musculocutaneous nerve injury

Back 788

Front 789

Long thoracic nerve injury

Back 789

Front 790

"Winged scapula"

Back 790

Long thoracic nerve injury (radical mastectome or stab wound to lateral chest)

Front 791

Suprascapular nerve injury

Back 791

Front 792

"Ulnar claw" vs. "Hand of benediction"

Back 792

Front 793

"Dupuytren's contracture" vs. "ulnar claw"

Back 793

Front 794

Back 794

Dupuytren's contracture

Front 795

Back 795

"Ulnar claw"

Front 796

Spinster's claw

Back 796

"Ulnar claw"

Front 797

Ulnar paradox

Back 797

Front 798

Pathogenesis of the "ulnar claw"

Back 798

Front 799

Unable to make the O.K. sign

Back 799

Anterior interosseus nerve injury

Front 800

Unable to perform the "hitch hike" sign

Back 800

Radial nerve injury

Front 801

Posterior interosseus nerve injury

Back 801

Front 802

Froment's test

Back 802

Front 803

Pronator teres syndrome

Back 803

Median nerve injury

Front 804

Supracondylar fracture of humerus

Back 804

Median nerve injury

Front 805

Fracture of medial epicondyle of humerus

Back 805

Ulnar nerve injury

Front 806

What nerve may be damaged in fracture of clavicle?

Back 806

Ulnar nerve

Front 807

Effects of lesions to branches of the brachial plexus

Back 807

Front 808

Axillary artery margins

Back 808

From the first rib to the posterior edge of the teres major muscle

Front 809

What nerve runs with the lateral thoracic artery?

Back 809

Long thoracic nerve

Front 810

Shoulder arterial collateral

Back 810

-Subscapular artery << axillary artery

-Suprascapular artery << subclavian artery

Front 811

What artery runs with axillary nerve?

Back 811

Posterior humeral circumflex artery - at surgical neck

Front 812

What artery runs with radial nerve in radial groove at midshaft of humerus?

Back 812

Profunda brachii artery

Front 813

Deep palmar arch is from ...

Back 813

Radial artery

Front 814

Superficial palmar arch is from ...

Back 814

Ulnar artery

Front 815

Common interosseus artery is from ...

Back 815

Ulnar artery

Front 816

Arterial supply to the upper limb picture

Back 816

Front 817

Collateral circulation in the hand

Back 817

Superficial and deep palmar arches (ulnar and radial arteries)

Front 818

Boundaries of the carpal tunnel

Back 818

Anteriorly - flexor retinaculum

Posteriorly - proximal row of carpal bones (lunate)

Front 819

Carpal tunnel

Back 819

Front 820

Carpal tunnel syndrome

Back 820

Front 821

Rotator cuff muscles mnemonics

Back 821

Counterclockwise: SITS!

Front 822

Humeral head dislocation

Back 822

Front 823

Most frequently damaged muscle of the rotator cuff

Back 823

Front 824

Humeral surgical neck fracture

Back 824

Front 825

Mid-shaft (radial groove) humeral fracture

Back 825

Front 826

Back 826

Front 827

Back 827

Front 828

Back 828

Front 829

Most frequently fractured and most frequently dislocated carpal bones

Back 829

Front 830

Hook of the hamate fracture

Back 830

Front 831

Lumbosacral plexus levels

Back 831

L2-S3

Front 832

Division. Level.

-Femoral nerve

-Obturator nerve

-Tibial nerve

-Common fibular nerve

-Superior gluteal nerve

-Inferior gluteal nerve

Back 832

Front 833

Lumbosacral plexus chart

Back 833

Front 834

Origin. Muscles innervated. Primary actions.

Back 834

Front 835

Origin. Muscles or skin innervated. Primary actions.

Back 835

Front 836

Segmental innervation to muscles of lower limb

Back 836

Front 837

Trendelenburg gait

Back 837

Gluteus medius (weakness in abduction) - superior gluteal nerve

Front 838

Superior gluteal nerve injury

Back 838

Front 839

Inferior gluteal nerve injury

Back 839

Front 840

Femoral nerve injury

Back 840

Front 841

Obturator nerve injury

Back 841

Front 842

Sciatic nerve injury

Back 842

Front 843

Tibial nerve injury

Back 843

Front 844

Common fibular nerve injury (neck of fibula)

Back 844

Front 845

Deep fibular nerve injury

Back 845

Front 846

Superficial fibular nerve injury

Back 846

Front 847

Most frequently damaged nerve of the lower limb

Back 847

Front 848

Piriformis syndrome

Back 848

Front 849

What nerve may be lesioned in posterior hip dislocation?

Back 849

Front 850

Sensory innervation of the lower leg and foot

Back 850

Front 851

Sural nerve

Back 851

It is made up of collateral branches of the tibial nerve and common fibular nerve.

The medial cutaneous branch arises from the tibial nerve, and the lateral branch arises from the common fibular nerve.

Front 852

Arterial supply to the legs

Back 852

Front 853

What artery supplies head of femur?

Back 853

Medial circumflex femoral artery

Front 854

Avascular necrosis of the head of the femur

Back 854

Front 855

What artery is responsible for pulse on dorsum of foot?

Back 855

Dorsalis pedis artery

Front 856

Arterial supply to lower limb picture

Back 856

Front 857

Tibial shaft fractures

Back 857

Front 858

Femoral triangle

Back 858

Front 859

Femoral sheath contents

Back 859

Femoral artery anv vein and canal

No femoral nerve!

Front 860

Mnemonics for the structures in the femoral triangle

Back 860

Front 861

Ligaments of the hip joint

Back 861

Front 862

Structures of the knee picture

Back 862

Front 863

Most frequently torn ligament at the knee

Back 863

Front 864

Tibial collateral ligament

Back 864

Front 865

The collateral ligaments are taut with knee flexion or extension?

Back 865

Extension

Front 866

Fibular collateral ligament

Back 866

Front 867

Anterior and posterior cruciate ligaments

Back 867

Front 868

Anterior and posterior cruciate ligaments chart

Back 868

Front 869

Medial and lateral menisci

Back 869

Front 870

Anterior and posterior drawer signs

Back 870

Front 871

Pain when the leg is medially rotated at the knee

Back 871

Medial meniscus tear

Front 872

3 most commonly injured structures at the knee

Back 872

Front 873

Lateral (collateral) ligament of ankle parts

Back 873

Front 874

Medial (deltoid) ligament of ankle parts

Back 874

Front 875

Most common injuries in ankle joint

Back 875

Front 876

Back 876

Front 877

Back 877

Front 878

Thoracic outlet. Scalene triangle.

Back 878

Front 879

Thoracic outlet syndrome

Back 879

Front 880

Scalene triangle picture

Back 880

Front 881

Internal (2) and external (8) carotid arteries branches

Back 881

Front 882

Subclavian artery branches (7)

Back 882

Front 883

The most significant artery of the external carotid system

Back 883

Front 884

Pharyngeal apparatus

Back 884

Front 885

Fetal pharyngeal apparatus picture

Back 885

Front 886

Section through the developing pharynx (picture)

Back 886

Front 887

Pharyngeal arch 1

Back 887

Front 888

Pharyngeal arch 2

Back 888

Front 889

Pharyngeal arch 3

Back 889

Front 890

Pharyngeal arch 4

Back 890

Front 891

Pharyngeal arch 6

Back 891

Front 892

Where do the ocular muscles (III, IV, VI) and the tongue muscles (XII) derive from?

Back 892

Mesoderm of the occipital somites (somitomeres)

Not from the pharyngeal arch mesoderm!

Front 893

Fetal pharyngeal pouches picture

Back 893

Front 894

Adult structures derived from the fetal pharyngeal pouches

Back 894

Front 895

Adult structures derived from the fetal pharyngeal grooves (clefts)

Back 895

Front 896

Branchial cyst (lateral cervical cyst)

Back 896

Front 897

Back 897

Branchial cyst (lateral cervical cyst)

Front 898

DiGeorge syndrome. Contemporary name.

Back 898

22q11.1 deletion syndrome

Pharyngeal pouches 3 and 4 fail to differentiate into the parathyroid glands and thymus.

Neural crest cells are involved.

-Immunologic problems

-Hypocalcemia

May be combined with:

-Cardiovascular defects (persistent truncus arteriosus)

-Abnormal ears

-Micrognathia

Front 899

Thyroid gland development

Back 899

Front 900

Back 900

"Wrist drop" - radial nerve palsy

Front 901

Back 901

"Winged scapula" - serratus anterior - long thoracic nerve

Front 902

Back 902

Treacher Collins syndrome

Front 903

Back 903

Pierre Robin sequence

Front 904

Treacher Collins syndrome

Back 904

Abnormal formation of pharyngeal arch 1 because of faulty migration of neural crest cells.

-Mandibular hypoplasia

-Zygomatic hypoplasia

-Down-slanted palpebral fissures

-Colobomas

-Malformed ears

Front 905

Pierre Robin sequence

Back 905

Abnormal formation of pharyngeal arch 1 because of faulty migration of neural crest cells.

Triad:

1. Poor mandibular growth

2. Cleft palate

3. Posteriorly placed tongue

Normal ears (differentiation with DiGeorge)

Front 906

What is foramen cecum (tongue)?

Back 906

Former site of the thyroglossal duct

Front 907

Development of the tongue

Back 907

Front 908

Innervation of the tongue

Back 908

Front 909

Paltoglossus muscle innervation

Back 909

Vagus nerve (via pharyngeal branch to pharyngeal plexus)

All other intrinsic and extrinsic muscles of tongue - CN XII

Front 910

Development of the face and palate

Back 910

Front 911

Cleft lip and cleft palate pathogenesis

Back 911

Front 912

First arch syndrome

Back 912

Front 913

Pharyngeal fistula and pharyngeal cyst

Back 913

Front 914

Ectopic thyroid, parathyroid, or thymus

Back 914

Front 915

Thyroglossal duct cyst or fistula

Back 915

Front 916

Cribriform plate fractures

Back 916

May result in dysosmia and rhinorrhea (CSF)

Front 917

Foramen lacerum function

Back 917

-The foramen lacerum fills with cartilage after birth.

-The artery of pterygoid canal, the nerve of pterygoid canal and some venous drainage pass through the foramen lacerum.

-Some emissary veins pass through the foramen lacerum. These connect the extracranial pterygoid plexus with the intracranial cavernous sinus and present an unopposed route for infection.

-The Foramen lacerum is a potential route for nasopharyngeal carcinoma to gain access to the cavernous sinus and affect cranial nerves.

Front 918

What do the cranial foramens contain?

1. Cribriform plate

2. Optic canal

3. Superior orbital fissure

4. Foramen rotundum

5. Foramen ovale

6. Foramen spinosum

7. Foramen lacerum

8. Internal auditory meatus

9. Jugular foramen

10. Hypoglossal canal

11. Foramen magnum

Back 918

Front 919

Jugular foramen syndrome

Back 919

Front 920

Where the tongue will deviate in CN XII lesion?

Back 920

Towards the lesioned side!

Front 921

What does the stylomastoid foramen contain?

Back 921

CN VII

Front 922

What does the carotid canal contain?

Back 922

Internal carotid artery and carotid sympathetic nerve

Front 923

What do the supraorbital, infraorbital, and mental foramens contain?

Back 923

Supraorbital, infraorbital, and mental VANs, respectively

Front 924

What does theinferior orbital fissure contain?

Back 924

-zygomatic branch of the maxillary nerve

-ascending branches from the pterygopalatine ganglion

-inferior division of ophthalmic vein

Front 925

Where does the CSF returns back to the systemic venous circulation?

Back 925

Front 926

Coronal section of the dural sinuses picture

Back 926

Front 927

What does the jugular foramen contain?

Back 927

CN IX, X, XI and internal jugular vein

Front 928

3 duplicatons of meningeal dura mater

Back 928

-falx cerebri

-tentorium cerebelli

-diaphragma sellae

Front 929

Primary tributaries that flow into the dural sinuses

Back 929

Front 930

Dural venous sinuses picture

Back 930

Front 931

How is the inferior sagittal sinus formed?

Back 931

Front 932

Dural venous sinuses

Back 932

Front 933

Cavernous sinus

Back 933

Front 934

Cavernous sinus picture

Back 934

Front 935

What does the cavernous sinus contain?

Back 935

-Lateral wall of the sinus: CN III, IV, V1, and V2

-Centrally: CN VI and internal carotid artery

Front 936

Cavernous sinus thrombosis

Back 936

Front 937

Initial symptom of cavernous sinus thrombosis

Back 937

Internal strabismus (CN VI lesion)

Front 938

Epidural hematoma

Back 938

Front 939

Lens-shaped (biconvex) hematoma at the lateral hemisphere

Back 939

Epidural hematoma (middle meningeal artery)

Front 940

Initial symptoms of uncal herniation

Back 940

The uncus can squeeze the oculomotor nerve (a.k.a. CN III), which may affect the parasympathetic input to the eye on the side of the affected nerve, causing the pupil of the affected eye to dilate and fail to constrict in response to light as it should. Pupillary dilation often precedes the somatic motor effects of CN III compression called oculomotor nerve palsy or third nerve palsy. This palsy presents as deviation of the eye to a "down and out" position due to loss of innervation to all ocular motility muscles except for the lateral rectus (innervated by abducens nerve (a.k.a. CN VI) and the superior oblique (innervated by trochlear nerve a.k.a. CN IV). The symptoms occur in this order because the parasympathetic fibers surround the motor fibers of CN III and are hence compressed first.

Front 941

Subdural hematoma

Back 941

Front 942

Crescent-shaped hematoma at the lateral hemisphere

Back 942

Subdural hematoma

Front 943

Back 943

Epidural hematoma

Front 944

Back 944

Subdural hematoma

Front 945

Subarachnoid hemorrhage

Back 945

Front 946

Xanthochromia

Back 946

Yellowish appearance of cerebrospinal fluid that occurs several hours after bleeding into the subarachnoid space caused by certain medical conditions, most commonly subarachnoid hemorrhage. Its presence can be determined by either by spectrophotometry (measuring the absorption of particular wavelengths of light) or simple visual examination.

Front 947

Orbital muscles and their innervation

Back 947

Front 948

Clinical testing of superior oblique muscle

Back 948

Ask patient to look medially and downward!

We can asses only the function of moving the eye downward.

Front 949

Function of thesuperior oblique muscle

Back 949

Abducts, depresses and internally rotates the eye

Front 950

Function of the inferior oblique muscle

Back 950

Primary action is extorsion (external rotation); secondary action is elevation; tertiary action is abduction (i.e. it extorts the eye and moves it upward and outwards).

The inferior oblique muscle is the only muscle that is capable of elevating the eye when it is in a fully adducted position.

Front 951

Back 951

Front 952

Muscles of the tongue developments

Back 952