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ANATOMY
| Question | Answer |
|---|---|
| Intracranial schwannomas are most commonly located at the | Cerebropontine angle, between the cerebellum and lateral pons |
| Adult 1º brain tumors | 1) Glioblastoma multiforme 2) Meningioma 3) Hemangioblastoma 4) Schwannoma 5) Oligodendroglioma 6) Pituitary adenoma |
| Schwannomas arise from | CN VIII; Vestibulocochlear (Acoustic neuromas) |
| The cochlear part of CN VIII mediates | Hearing. Compression leads to sensorineural hearing loss and tinnitus (ear ringing). |
| The vestibular part of CN VIII maintains | Balance. Its compression causes vertigo, disequilibrium, and nystagmus. |
| CN VII involvement leads to | Paralysis of the muscles of facial expression, loss of taste in the anterior 2/3 of the tongue, and hyperacusis (paralysis of the stapedius). |
| Compression of CN V causes | Loss of sensation around the mouth and nose, loss of corneal reflex, and paralysis of the muscles of mastication. |
| Bilateral acoustic neuromas are associated with | Neurofibromatosis type 2 |
| Meningiomas are commonly found over the | Lateral hemispheric fissure and in the parasagittal aspect of the brain convexity. |
| On light microscopy, Meningiomas have a | Spindle cells concentrically arranged in a whorled pattern; Psammoma bodies (laminated calcifications) |
| Clinically, meningiomas may manifest with | Headache, focal deficit, or seizure. |
| Meningiomas arise from | Arachnoid cells, is extra-axial (external to brain parenchyma), and may have a dural attachment ¨tail |
| Sensorineural hearing loss, tinnitus, paralysis of facial muscles, and loss of corneal reflex signify the involvement of | CN V, VII, and VIII. |
| Sensorineural hearing loss, tinnitus, paralysis of facial muscles, and loss of corneal reflex signify the involvement of CN V, VII, and VIII. Simultaneous compression of these nerves is caused by tumor of the cerebellopontine angle, most commonly | Acoustic neuromas |
| Most common malignant 1º brain tumor | Glioblastoma multiforme (grade IV astrocytoma) |
| Glioblastoma multiforme (grade IV astrocytoma) are found in | Cerebral hemispheres |
| ¨Pseudopalisading¨pleomorphic tumor cells-border central areas of necrosis and hemorrhage | Glioblastoma multiforme (grade IV astrocytoma) |
| Stain astrocytes for | GFAP (Glial fibrillary acidic protein) |
| Can cross corpus callosum ¨butterfly glioma¨ | Glioblastoma multiforme (grade IV astrocytoma) |
| Hemangioblastoma is most often | Cerebellar |
| Hemangioblastoma is associated with | von Hippel-Lindau syndrome when found with retinal angiomas |
| Hemangioblastoma can produce | Erythropoietin---> 2º polycythemia |
| Closely arranged, thin-walled capillaries with minimal interleaving parenchyma | Hemangioblastoma |
| Rare, slow growing adult 1º brain tumor | Oligodendroglioma |
| Oligodendroglioma most often in | Frontal lobes |
| Chicken-wire capillary pattern . Olygodendrocytes= ¨fried egg¨cells- round nuclei with clear cytoplasm | Oligodendroglioma |
| Pituitary adenoma, most commonly | Prolactinoma |
| Pituitary adenoma, produces | Bitemporal hemianopia due to pressure on optic chiasm |
| Sequelae of Pituitary adenoma, | Hyper-or hypopituitarism |
| Schwannomas; TREATMENT | Resection or treatment with stereotactic radiosurgery |
| ONLY nerve that exits the pelvis via the obturator foramen. | Obturator (L2-L4) |
| Obturator (L2-L4) nerve innervates | Anterior branch: gracilis, pectineus, and the adductors longus and brevis. Posterior: obturator externus and the adductor magnus. Obturator nerve injury would cause weakness and spasm of the adductor compartment muscles. |
| Adduction of the thigh | Obturator (L2-L4) |
| Obturator nerve injury would cause | Decreased thigh sensation (medial) and adduction |
| Abduction of the thigh | Superior gluteal (L4-S1) |
| Most important muscle in achieving the increased intraabdominal and intrathoracic pressure of the Valsalva maneuver | Rectus abdominis |
| The parietal pleura lines the inner surface of the chest wall and the diaphragm, and is innervated by | Somatic sensory nerves. |
| Portion of pleura that covers the surface of the lung is called the | Visceral pleura |
| Thoracentesis should be performed | Above 7th rib midclavicular line, 9th rib along midaxillary line and 11th rib along posterior scapular line. |
| If the needle is inserted higher than 9th rib in a Thoracentesis there is a risk of | Lung injury. Insertion of the needle below the 9th rib at the middle axillary line on the right may cause liver injury |
| Insertion of the needle below the 9th rib at the middle axillary line on the right during Thoracentesis may cause | Liver injury |
| Long-term sequelae of hydrocephalus include | Lower extremity spasticity due to stretching of the periventricular pyramidal tracts, visual disturbances, and learning disabilities. |
| Hydrocephalus in infants presents with | irritability, poor feeding increased head circumference and enlarged ventricles on CT. |
| Enlarged ventricles on CT in an infant | Hydrocephalus, cause is usually impaired CSF outflow due to congenital abnormalities |
| The middle ear cavity contains | 3 auditory ossicles: malleus, incus and stapes; 2 skeletal muscles: tensor tympani and stapedius |
| The stapedius muscle is innervated by | The stapedius nerve, a branch of facial nerve (CN VII). |
| Paralysis of the stapedius muscle allows wider oscillation of the stapes, and leads to | Increased sensitivity to sound (hyperacusis). |
| In the inner ear each frequency leads to vibration at specific location on the basilar membrane (tonotopy): | LOW: heard at apex near helicotrema (wide and flexible); HIGH: heard best at base of cochlea (thin and rigid) |
| In the inner ear vibration is transduced via | Specialized hair cells-->auditory nerve signaling -->brainstem |
| Ipsilateral hyperacusis is a common finding in | Bell’s palsy (peripheral facial nerve paralysis) |
| Findings in Bell’s palsy (peripheral facial nerve paralysis) | Ipsilateral hyperacusis,inability to close the eye or to smile on the affected side, ipsilateral increased salivation and loss of taste on the anterior 2/3 of the tongue. |
| Common peroneal (L4-S2) | PED= Peroneal Everts and Dorsiflexes; injured, foot dropPED |
| Tibial (L4-S3) | TIP= Tibial Inverts and Plantarflexes; injured, can´t stand on TIPtoes |
| The common peroneal nerve divides into | DEEP= innervates extensor and great dorsiflexors. SUPERFICIAL= peroneal muscles and skin of most of the toes. |
| The common peroneal nerve is particularly susceptible to damage as it traces the | Lateral neck of the fibula |
| Most commonly injured nerve in the leg due to its superficial location | Common peroneal/Fibular (L4-S2) |
| Most common causes of injuru to Common peroneal (L4-S2) | Trauma or compression of lateral aspect of the leg (e.g,casts), fibular neck fracture |
| Damage to this nerve will result in loss of knee jerk. | Femoral (L2-L4) |
| Innervates the muscles of the anterior and medial thigh | Femoral (L2-L4) |
| Provides motor innervation for the popliteus and the flexors of the foot. | Tibial (L4-S3) |
| Causes of injury of Tibial nerve (L4-S3) | Knee trauma, Baker cyst (proximal lesion); tarsal tunnel syndrome (distal lesion, deep penetrating trauma: popliteal fossa |
| Inability to curl toes and loss of sensation on sole/plantar aspect of foot | Lesion tibial nerve (L4-S3 |
| In proximal lesions tibial nerve (L4-S3) lesions | Foot everted at rest with loss of inversion and plantar flexion |
| Provides the majority of the motor and sensory input to the pelvic floor | Pudendal nerve |
| Difficulty climbing stairs, rising from seated position. Nerved injured | Inferior gluteal (L5-S2) |
| Causes of injury to superior gluteal (L4-S1) | Posterior hip dislocation, Polio |
| Pelvis tilts because weight-baring leg cannot maintain alignment of pelvis through hip abduction | Trendelenburg sign/gait (Superior gluteal; L4-S1) |
| Lesion is contralateral to the side of the hip that drops, ipsilateral to extremity on which patient stands | Superior gluteal (L4-S1) |
| Patients with common peroneal nerve damage present with | Inverted and plantarflexed foot, loss of eversion and dorsiflexion.¨Steppage gait. Loss of sensation on dorsum of foot |
| Muscles mediate foot eversion | Peroneus longus and peroneus brevis |
| Muscle mediates dorsiflexion of the foot | Tibialis anterior muscle |
| The classic finding on gait exam in patients with common peroneal nerve injury is | ‘toot drop,” affected leg lifted high off of the ground while walking due to an inability to dorsiflex the foot. The affected foot will also classically slap to the ground with each step. |
| Signs include foot drop and a characteristic high- stepping gait | Common peroneal nerve injury |
| Transduction of mechanical auditory forces into nerve impulses occurs in the organ of Corti by the following steps: | 1) Sound reaches middle ear by vibrating tympanic membrane. 2) Vibration transferred to oval window by ossicles-->basilar membrane causes bending of hair cell cilia agains tectorial membrane= nerve impulses from sound |
| Noise-induced hearing loss results from trauma to the | Stereociliated hair cells of the organ of Corti. |
| Prolonged exposure to extremely loud noises can produce hearing loss due to tympanic membrane rupture. High-frequency hearing is lost first, | Noise-induced hearing loss |
| Rupture of the tympanic membrane causes | Conductive hearing loss |
| The auditory nerve transmits sound impulses to the brainstem via | CN VIII (Vestibulocochlear) |
| The fossa ovalis is located on | Right atrial wall |
| The tricuspid valve separates | Right atrium from right ventricle. |
| The coronary sinus collects blood from the | Coronary veins. It is located on the posterior surface of the heart and drains directly into the left atrium |
| The pulmonic valve is located between | Right ventricle and pulmonary artery. |
| Aortic valve divides | Left ventricle and aorta |
| It´s the remnant of the fetal foramen ovale, a structure that allows right to left shunting of blood in the fetal circulation to bypass the fetal lungs. | Fossa ovalis |
| Puncture of the fossa ovalis is used as a means of gaining access to the | Left atrium from the right atrium |
| There are three types of groin hernias | Direct inguinal, indirect inguinal and femoral |
| Groin hernias that occur ABOVE the inguinal ligament | Direct and indirect inguinal hernias |
| Groin hernias that occur BELOW the inguinal ligament | Femoral hernias |
| Femoral hernias may present with | Upper thigh and groin pain. |
| Femoral hernias protrude through the | Femoral canal |
| Femoral hernias are lateral to and medial to | LATERAL: pubic tubercle and lacunar ligament; MEDIAL: femoral vein. |
| Femoral hernias are more common in | Females |
| Femoral hernias tend to occur on | Right side. |
| As the femoral canal is small, femoral hernias are prone to | Incarceration |
| Transversalis fascia is found between | Inner surface of transversalis muscle and the extraperitoneal fat. |
| Transversalis fascia forms the | Posterior wall of the inguinal canal. |
| A deep inguinal ring is an opening in the transversalis fascia, which is the site of protrusion of | Indirect inguinal hernias. |
| Leading cause of bowel incarceration | Femoral hernias |
| The spermatic cord contains | Ductus deferens, cremasteric, testicular arteries, artery of ductus deferens, pampiniform venous plexus, genitourinary nerve, sympathetic and parasympathetic nerves of the spermatic plexus. |
| Hesselbach triangle | Inferior epigastric vessels, lateral border of rectus abdominis and inguinal ligament |
| Parasagittal meningiomas can cause | Contralateral spastic paresis of the leg due to compression of the leg-foot motor area. |
| The primary mediators of the blood-brain barrier | Tight junctions between endothelial cells of CNS capillaries |
| Tight junctions, also known as zonula occludens, are formed via the interaction of specialized transmembrane proteins with one another, such as | Occludens and claudens, on capillary endothelial cells. |
| The tight junctions between endothelial cells in the capillary beds of the CNS form the | Blood-brain barrier |
| The head of the caudate lies in the | Inferolateral wall of the anterior horn of the lateral ventricle |
| The head of the caudate it´s separated from the globus pallidus and putamen by the | Internal capsule |
| Eye adduction depends on | Oculomotor nerve (CN Ill) and the medial rectus muscle |
| Posterior cranial fossa (C  VII-XII)-through temporal or occipital bone: | • Internal auditory meatus (CN VII, VIII) • Jugular foramen (CN IX, X, XI, jugular vein) • Hypoglossal canal (CN XII) • Foramen magnum (spinal roots of CN XI, brain stem, vertebral arteries) |
| Exit through Cribriform plate | CN I |
| Middle cranial fossa (CN II-VI)-through sphenoid bone: | • Optic canal (CN II, ophthalmic artery, central retinal vein) • Superior orbital fissure (CN III, IV, V1, VI, ophthalmic vein, sympathetic fibers) • Foramen Rotundum (C  V2) • Foramen Ovale (CN V3) • Foramen spinosum (middle meningeal artery) |
| Enter the orbit via the superior orbital fissure | The oculomotor nerve (CN Ill), ophthalmic nerve (CN VI) branches, trochlear nerve (CN IV), abducens nerve (CN VI), and superior ophthalmic vein |
| The prostate is located between the | Pubic symphysis and the anal canal |
| Superior mesenteric artery (SMA) vertebral level | L1 |
| Inferior mesenteric artery (IMA) vertebral level | L3 |
| Superior mesenteric artery (SMA) supplies | Distal duodenum and pancreas to proximal 2/3 of transverse colon |
| Inferior mesenteric artery (IMA) supplies | Distal 1/3 of transverse colon to upper portion rectum; splenic flexure is a watershed region |
| Celiac artery (T12) supplies | Pharynx to proximal duodenum; liver, gallbladder, pancreas, spleen |
| Bifurcation of abdominal aorta | L4 |
| Occurs when the transverse portion (3rd segment) of the duodenum is entrapped between the SMA and aorta causing symptoms of partial intestinal obstruction. | Superior mesenteric artery syndrome |
| What structure is entrapped or obstructed in Superior mesenteric artery syndrome | Transverse portion (3rd segment) of the duodenum |
| Apical lung tumors | Pancoast tumors |
| Pancoast tumors can cause | Horner syndrome (ipsilateral ptosis, miosis and anhidrosis) SVC syndrome, arm weakness, arm paresthesias, and hoarseness. |
| The rotator cuff is made up of the tendons of the following muscles: | supraspinatus, infraspinatus, subscapularis, and teres minor |
| Most commonly affected in rotator cuff syndrome | Supraspinatus muscle |
| Innervation of the tongue | Taste: CN VII,IX, X (solitary nucleus) Pain: CN V3, IX, X Motor: CN XII |
| Motor innervation of the tongue is provided by the | Hypoglossal nerve (CN XII) |
| General sensory innervation of the tongue (including touch pain, pressure, and temperature sensation) is provided by | • Anterior 2/3: mandibular branch of trigeminal (CN V3) • Posterior 1/3: glossopharyngeal (CN IX) • Posterior area of the tongue root: vagus nerve (CN X) |
| Gustatory innervation (taste buds) is as follows: | • Anterior 2/3: chorda tympani branch of facial nerve (CN VII) • Posterior 1/3: glossopharyngeal nerve (CN IX) • Posterior area of the tongue root and taste buds of the larynx and upper esophagus: vagus nerve (CN X) |
| Tongue develops from | 1st and 2nd branchial arches: anterior 2/3 3rd and 4th branchial arches: posterior 1/3 |
| Muscles of the tongue are derived from | Occipital myotomes |
| Gustatory innervation of anterior 2/3 of the tongue is provided by | Chorda tympani branch of the facial nerve |
| Composes the majority of the anterior surface of the heart | Right ventricle |
| Makes up most of the heart’s posterior surface | Left atrium |
| A penetrating injury at the left sternal border in the fourth intercostal space would puncture the anterior surface of the heart. Damaging which structure | Right ventricle; composes most of the heart’s anterior surface |
| Is the muscle of the urinary bladder wall | Detrusor muscle |
| The ureters cross | Over: external iliac vessels; under: gonadal vessels. Lateral: internal iliac vessels; medial: gonadal vessels |
| Aspirated or inhaled particles are most likely to become lodged in the | Right main bronchus |
| Right main bronchus is compared to left main bronchus | shorter, wider and more vertically oriented |
| Aspirate a peanut while UPRIGHT | LOWER portion of the right inferior lobe |
| Aspirate a peanut while SUPINE | SUPERIOR portion of the right inferior lobe |
| Fluid-filled site encased in bone that houses the cochlea, the semicircular canals, and the vestibule. | Inner ear |
| At the base of the cochlea, the basilar membrane is thin and rigid and best responds to | HIGH frequency sound |
| The basilar membrane at the apex of the cochlea, near the helicotrema, is large and flexible so it best responds to | LOW frequency sounds |
| LOW frequency heard at | Apex near helicotrema (wide and flexible) |
| HIGH frequency heard at | Base of cochlea (thin and rigid) |
| The parasympathetic innervation of the ovary is derived from the | Vagus nerve |
| The nerves and vessels supplying the ovary are delivered through the | Suspensory ligament of the ovary |
| Structure that runs retroperitoneally, close to gonadal vessels. At risk of injury during ligation of ovarian vessels | Ureter |
| Structures contained in the suspensory ligament of the ovary | Ovarian vessels |
| Components of the broad ligament | Mesosalpinx, mesometrium and mesovarium |
| Female remnants of the gubernaculum (band of fibrous tissue) | Ovarian ligament + round ligament of uterus |
| Male remnants of the gubernaculum (band of fibrous tissue) | Anchors testes within scrotum |
| Male remnants of the processes vaginalis (evagination of peritoneum) | Forms tunica vaginalis |
| Female remnants of the processes vaginalis (evagination of peritoneum) | Obliterated |
| Causes of injury ulnar nerve (C8-T1) | Fracture of medial epicondyle of humerus ¨funny bone¨(proximal lesion); fractured hook of hamate ( distal lesion) |
| Presentation of ulnar nerve (C8-T1) lesion | ¨Ulnar claw¨. Radial deviation wrist upon flexion (proximal lesion) Loss flexion wrist and medial fingers, abduction and adduction fingers (interossei), actions medial 2 lumbricals. Loss sensation over medial 1 1/2 fingers including hypothenar eminence. |
| Loss sensation over medial 1 1/2 fingers including hypothenar eminence. | Ulnar nerve (C8-T1) lesion |
| Wrist bones | ¨So Long To Pinky, Here Comes The Thumb¨ Scaphoid; Lunate; Triquetrum; Pisiform; Hamate; Capitate; Trapezoid; Trapezium |
| Can be palpated in anatomical snuff box | Scaphoid |
| Is the most commonly fractured carpal bone and its prone to avascular necrosis owing to retrograde blood supply | Scaphoid |
| Dislocation of lunate may cause | Acute Carpal Tunnel syndrome |
| A fall on an outstretched hand that damages the hook of hamate can cause | Ulnar nerve injury |
| Entrapment of median nerve; compression--> paresthesia, pain and numbness | Carpal Tunnel syndrome |
| Compression of the ulnar nerve at the wrist or hand, classically seen in cyclists due to pressure from handlebars | Guyon´s cannal syndrome |
| Most commonly fractured carpal bone | Scaphoid |
| Innervates the flexors of the lower leg, the extrinsic digital flexors of the toes, and the skin of the sole of the foot. | Tibial nerve (L4-S3) |
| Taste sensation from the anterior two-thirds of the tongue is mediated by | Chorda tympani branch of the facial nerve (CN VII). |
| Protrusion of the tongue is mediated by motor efferent fibers carried by | Hypoglossal nerve (CN XII). |
| Language deficit; higher-order inability to speak | Aphasia |
| Movement deficit; motor inability to speak | Dysarthria |
| Fluent speech aphasias | 1)Wernicke 2)Conduction 3)Transcortical sensory |
| NON-Fluent speech aphasias | 1)Broca 2)Global 3)Transcortical motor 4)Mixed transcortical |
| Aphasia with INTACT comprehension | 1)Broca 2)Conduction 3)Transcortical motor |
| Aphasia with IMPAIRED comprehension | 1)Wernicke 2)Global 3)Transcortical sensory 4)Mixed transcortical |
| Broca area | Inferior frontal gyrus of frontal lobe |
| Wernicke´s area | Superior temporal gyrus of temporal lobe--> auditory association cortex |
| Poor repetition but fluent speech, intact comprehension. Can be caused by damage to left superior temporal lobe and/or left supramarginal gyrus | Conduction aphasia |
| Aphasia causes word salad | Wernicke’s aphasia |
| Wernicke’s area receives its blood supply from the | Middle cerebral artery |
| When the midshaft of the humerus is fractured, there is significant associated risk of injury to | Radial nerve and deep brachial artery |
| The deep brachial artery and radial nerve course along | Posterior aspect of the humerus |
| Supracondylar fractures are associated with injury to | Brachial artery. |
| Fractures of the humerus midshaft risk injury to these structures | Deep brachial artery and radial nerve |
| As they ascend from pelvis during fetal development, horseshoe kidneys get trapped under | Inferior mesenteric artery |
| Horseshoe kidneys are associated to | Turner syndrome |
| Horseshoe kidneys increase the risk of | Ureteropelvic junction obstruction, hydronephrosis, renal stones, and rarely renal cancer (Wilms tumor) |
| Poles of both kidneys fused, but NORMAL functioning | Horseshoe kidneys |
| Shooting pain down the posterior thigh and leg that typically results from impingement of one of the spinal nerves as it leaves the vertebral column. | Sciatica |
| Compression results specifically in pain purely in the posterior thigh and leg as well as diminution of the ankle jerk reflex. | S1 root |
| Posterior thigh, splits into common peroneal and tibial nerves | Sciatic nerve (L4-S3) |
| Travels in close approximation to the inferior thyroid artery and can be injured in surgical procedures of the anterior neck (e.g. thyroidectomy), resulting in laryngeal muscle paralysis, hoarseness and dyspnea. | Recurrent laryngeal nerve |
| Together these nerves innervate all of the intrinsic muscles of the hand | Lower trunk of the brachial plexus carries nerve fibers from the C8-T1 spinal levels that ultimately contribute to the median and ulnar nerves. |
| Lower trunk | C8-T1 |
| Upper trunk | C5-C6 |
| Sudden upward stretching on the arm at the shoulder can damage the | Lower trunk of the brachial plexus (C8-T1) |
| Injury to the lower trunk of the brachial plexus would cause | Hand weakness |
| Klumpke palsy | Total claw hand; injury to Lower trunk (C8-T1) |
| Lower trunk of the brachial plexus (C8-T1) causes of injury | Infants- upward force on arm during delivery Adults- trauma (e.g, grabbing a tree branch to break a fall) |
| Improperly fitted crutches can cause | Radial nerve injury resulting in weakness of all forearm, wrist and finger flexors (“Wristdrop”). |
| 1st-arch neural crest fails to migrate --> mandibular hypoplasia, facial abnormalities | Treacher Collins syndrome |
| Meckel's cartilage (1st arch) | Mandible, Malleus, incus, spheno Mandibular ligament |
| Reichert's cartilage (2nd arch) | Stapes, Styloid process, lesser horn of hyoid, Stylohyoid ligament |
| Cartilage: greater horn of hyoid | 4th-6th arch derivative |
| Cartilages: thyroid, cricoid, arytenoids, corniculate, cuneiform | 3rd arch derivative |
| Muscles of Mastication (1st arch derivatives) | (temporalis, Masseter, lateral and Medial pterygoids), Mylohyoid, anterior belly of digastric, tensor tympani, tensor veli palatini |
| Muscles of facial expression (2nd arch derivatives) | Stapedius, Stylohyoid, platySma, belly of digastric |
| Stylopharyngeus (CN IX) innervated by glossopharyngeal nerve is derived from | 3rd branchial arch |
| 4th-6th branchial arch muscle derivatives | 4th arch: most pharyngeal constrictors; cricothyroid, levator veli palatini 6th arch: all intrinsic muscles of larynx except cricothyroid |
| CN V2 and V3 chew; derive from | 1st branchial arch |
| CN VII (facial expression) smile | 2nd branchial arch |
| CN IX (stylo pharyngeus) swallow stylishly | 3rd branchial arch |
| 4th arch: CN X (superior laryngeal branch) simply swallow 6th arch: CN X (recurrent laryngeal branch) speak | 4th-6th branchial arches |
| Persistence of cleft and pouch--> fistula between tonsillar area an lateral neck | Congenital pharyngo cutaneous fistula |
| Muscles of Mastication derive from | 1st branchial arch |
| Form posterior 1/3 of tongue | Arches 3 and 4 |
| ‘bag of worms’ appearance | Varicocele |
| Dilated veins in pampiniform plexus as a result of increased venous pressure | Varicocele |
| Most common cause os scrotal enlargement in adult males | Varicocele |
| Varicocele is most common on | Left side; left venous pressure>right venous pressure |
| LEFT gonadal vein drains into | Left renal vein |
| RIGHT gonadal vein drains into the | Inferior vena cava (IVC) |
| Lymphatic drainage ovaries/testes | Para-aortic lymph nodes |
| Lymphatic drainage distal vagina/vulva/scrotum | Superficial inguinal nodes |
| Lymphatic drainage proximal vagina/uterus | Obturador, external iliac and hypogastric nodes |
| The pleura is divided into segments, as follows: | 1. Visceral pleura: cover all surfaces of lungs, including does within the pulmonary fissures. 2. Parietal pleura: remainder not in contact with lungs |
| Parietal pleura can be subdivided as | • Costal: thoracic wall including ribs, sternum, intercostal spaces, costal cartilages, and sides of thoracic vertebrae. • Mediastinal • Diaphragmatic • Cervical: Extends with the apices of the lung into the neck. |
| The diaphragm is innervated by | C3,4 and 5 (phrenic nerve) |
| Pain from diaphragm can be referred to | Shoulder (C5) and the trapezius ridge (C3,4) |
| The clavicle is anchored laterally to the scapula at the shoulder by two major ligaments: | SUPERIORLY: Acromioclavicular; INFERIORLY: Coracoclavicular |
| At risk of injury during thyroidectomy due to its proximity to the superior thyroid artery and vein | External branch of the superior laryngeal nerve |
| This nerve innervates the cricothyroid muscle | External branch of the superior laryngeal nerve |
| ONLY muscle innervated by the external branch of the superior laryngeal nerve | Cricothyroid muscle |
| Pathway that connects the hypothalamus and the pituitary gland and is responsible for dopamine-dependent prolactin tonic inhibition. | Tuberoinfundibular dopaminergic pathway |
| Pathway primarily involved in regulating behavior | Mesolimbic-mesocortical pathway |
| Hyperactive dopaminergic pathway associated to schizophrenia | Mesolimbic-mesocortical pathway |
| This dopaminergic pathway primarily regulates coordination of VOLUNTARY movements | Nigrostriatal system |
| Degeneration of the substantia nigra thus causes decreased dopamine and subsequent increased acetylcholine; this leads to hyperkinetic disorders such as | Parkinsonism |
| Afferent limb of the light reflex pathway is the | optic nerve |
| Efferent limb of the light reflex pathway is the | Parasympathetic fibers of the oculomotor nerve. |
| On the pupillary light reflex test; When an optic nerve is damaged, light in that eye will cause | NEITHER pupil to constrict (the nerve can’t sense the light); however, light in the contralateral eye will cause BOTH pupils to constrict (because the motor function of the iris is conserved). |
| Pupillary light reflex test | Light on either retina--> via CN II-->Pretectal nuclei in midbrain aactivates Edinger-Westphal nuclei--> bilateral pupil contraction (consensual reflex) |
| Abnormal passive aBduction (valgus stress) | MCL injury |
| Abnormal passive aDduction (varus stress) | LCL injury |
| McMurray test; pain on EXTERNAL rotation | MEDIAL meniscus injury |
| McMurray test; pain on INTERNAL rotation | LATERAL meniscus injury |
| Common injury in contact sports due to LATERAL force applied to a planted leg. Classically consists of damage to | ACL+MCL+ medial or lateral meniscus |
| ACL+MCL+ medial or lateral meniscus injury | Unhappy triad |
| Eesults from an inability of the serratus anterior to hold the medial border and inferior angle of the scapula against the posterior chest wall. | Winged scapula (paralysis of serratus anterior muscle due to long thoracic nerve injury) |
| Patient unable to abduct the arm higher than the horizontal position. | Paralysis of serratus anterior muscle due to long thoracic nerve injury |
| Injury to this nerve causes winging of the scapula and inability to abduct the shoulder past 90 degrees. | Long thoracic nerve injury |
| Most posterior part of the heart | Left atrium |
| Left atrium enlargement can cause | Dysphagia (compression esophagus)+ hoarseness (compression recurrent laryngeal nerve) |
| Blocking this nerve provides anesthesia to the majority of the perineum; used as method of providing anesthesia during childbirth | Pudendal nerve block |
| Gallstone ileus results from the passage of a large gallstone (typically greater than 2.5 cm) through a cholecystenteric fistula into the small bowel where it ultimately causes obstruction at the | Ileocecal valve |
| Cholelithiasis can cause fistula between gallbladder and small intestine, leading to AIR in the biliary tree. Gallstone may obstruct ileocecal valve causing | Gallstone ileus |
| Gas is seen within the gallbladder and biliary tree on abdominal X-ray due to the presence of the fistula | Gallstone ileus |
| Repeated and prolonged kneeling can cause | Prepatellar bursitis |
| Dubbed “housemaid’s knee,” today it is most commonly seen in roofers, carpenters and plumbers. Signs and symptoms of prepatellar bursitis include knee pain, erythema, swelling and inability to knee on the affected side. | Prepatellar bursitis |
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