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Anatomy
UWORLD Round 1 2021
| Question | Answer |
|---|---|
| Where is the AV node located? | Endocardial surface of the right atrium, near the insertion of the septal leaflet of the tricuspid valve and the orifice of the Coronary sinus |
| Located in the endocardial surface of the RA, close to the site of insertion of the septal leaflet of the tricuspid valve and the orifice fo the coronary sinus. | AV node |
| What type of AFIB is treated by ablation of the AV node? | Permanent AFIB |
| What type of AFIB is treated by ablation of the pulmonary vein ostia? | Recurrent AFIB |
| If a patient is diagnosed with permanent atrial fibrillation, what area of the heart is ablated in order to correct the arrhythmia? | AV node |
| How is recurrent (transient) AFIB treated by ablation? | Ablation of the pulmonary vein ostia |
| What major vessels is composed by the Cardinal veins during embryogenesis? | Superior Vena Cava (SVC) |
| What embryological veins later give rise to the Superior Vena Cava? | Cardinal veins |
| Where do Common Cardinal veins drain directly into? | Sinus Venosus |
| What is the Perineal body? | Fibromuscular tissue between the urogenital and anal triangle |
| Fibromuscular tissue between the urogenital and anal triangle. | Perineal body |
| What is a midline episiotomy? | Vertical incision from the posterior vaginal opening to the Perineal body |
| A midline episiotomy "cuts" what area? | Transects the vaginal submucosal tissue but not the external anal sphincter or the rectal mucosa |
| What is contained in the Suspensory ligament of the Ovary? | Ovarian artery, vein, lymphatics, and nerves |
| What ovarian ligament contains the Ovarian artery, vein, lymphatics and nerves? | Suspensory Ligament of the Ovary |
| What procedure usually ligates the Ovarian artery to prevent heavy bleeding? | Oophorectomy |
| What is the major blood supply to the ovary? | Ovarian artery |
| What is the drainage of the Short Gastric veins? | Drain blood from the Gastric fundus into the Splenic vein |
| What common conditions are often seen with foreign blood clots in the Splenic veins? | Pancreatic inflammation (pancreatitis, pancreatic cancer) |
| What is a common complication of blood clots in the within the Splenic vein due to Pancreatitis? | Increased pressure to the Short Gastric veins, which lead to gastric varices in the fundus of the stomach |
| On which part of the stomach, would gastric varices appear if they were a consequence of increased Short Gastric pressure? | Fundus of stomach |
| Where does the Gastroduodenal artery lies? | Along the posterior wall of the duodenal bulb |
| What condition may cause erosions of the Gastroduodenal artery? | Posterior Duodenal ulcers |
| Posterior or anterior duodenal ulcers, may cause erosion of the Gastroduodenal artery? | Posterior Duodenal ulcers |
| What type of injury/condition causes injury to the posterior urethra? | Pelvic fractures |
| A pelvic fracture is more commonly associated with Posterior urethra or Anterior urethral injuries? | Posterior urethral injury |
| Straddle injuries cause: | Anterior urethral injury |
| What is featured clinical signs and symptoms of Posterior urethral injury due to a pelvic fracture? | Inability to void with a full bladder sensation, a high-riding bogy prostate, and blood the the urethral meatus |
| The inability to void with a full bladder sensation, is associated with Posterior or Anterior urethra damage? | Posterior urethral injury |
| What procedure is highly contraindicated if there is suspicion of an urethral injury? | Foley catheter placement |
| Blood in the urethral meatus is suggestive of anterior or posterior urethral injury? | Posterior urethral injury |
| What nerve provides sensation to the anterior 2/3 of the tongue? | Mandibular division of the Trigeminal nerve (CN V3) |
| What type of innervation is carried by the CN V3 in the tongue? | General sensation to the anterior 2/3 of the tongue |
| What provides gustatory innervation to the anterior 2/3 of the tongue? | Chorda tympani branch of the facial nerve |
| What is provided by innervation of the anterior 2/3 of the tongue by the Chorda tympani branch of the Facial nerve? | Gustatory sensation |
| What is affected or damaged, if a patient cannot taste in the anterior 2/3 of the tongue? | Chorda tympani branch of the facial nerve |
| What cranial nerve is most susceptible to ipsilateral PCA aneurysms? | Cranial nerve III |
| What are the main ocular manifestations of Ipsilateral PCA aneurysm compressing CN3? | 1. Mydriasis 2. Down and Out deviation of ipsilateral eye |
| What causes the mydriasis in CN 3 compression by ipsilateral PCA aneurysms compression? | Superficial parasympathetic fiber damage with diplopia |
| What is the anatomical course of the Median nerve in the forearm? | Between the Humeral and Ulnar heads of the pronator teres muscle, and between the flexor digitorum superficialis and flexor digitorum profundus muscles |
| What nerve is courses between the humeral and ulnar heads of the pronator teres muscle in the forearm? | Median nerve |
| Compression of the Median nerve at the between the heads of the pronator teres muscle causes --> | Sensory loss over the lateral palm and palmar aspects of the first 3 1/2 digits |
| What nerve can be suspected to be compressed or injured if the patient has lost sensation over the palmar side of the first 3 1/2 higits? | Median nerve |
| Where are the Dorsal columns located? | In the posterior Spinal cord |
| What information is conveyed by the Dorsal Columns? | Vibration, proprioception, and light touch sensation |
| What division of the Dorsal columns provides or carries sensation from the lower limbs? | Gracile fasciculus |
| What division of the Dorsal columns carries sensation for the Upper limbs? | Cuneate fasciculus |
| Which Dorsal Column division is located in the medial aspect? | Gracile fasciculus |
| If there is damage to the lateral aspect of the Dorsal Columns in the posterior Spinal cord, what tract is likely damaged? | Cuneate fasciculus |
| The Gracile fasciculus carries sensory information form the Upper or Lower limbs? | Lower limbs |
| The Cuneatus fasciculus carries sensation from the Upper or Lower limbs? | Upper limbs |
| At which point does the Gracile fasciculus enters the Spinal cord? | Below the T6 |
| At which pin tof the vertebrae does the Cuneatus fasciculus enters the Spinal cord? | Above the T6 |
| What is the most common type of Pineal gland tumor? | Germinoma |
| What are the Germinomas? | Most common type of Pineal gland tumor |
| What are clinical consequences of Germinomas? | Obstructive Hydrocephalus and Dorsal midbrain (Parinaud) syndrome |
| What malignancy is often associated with Obstructive hydrocephalus and Parinaud syndrome? | Germinomas |
| What are symptoms of Obstructive Hydrocephalus due to aqueduct stenosis? | Papilledema, headache, and vomiting |
| What is a consequence of Germinomas in the Suprasellar region? | Endocrinopathies due to Pituitary/ Hypothalamic dysfunction |
| What type of tumors are seen with Endocrinopathies due to Pituitary/ Hypothalamic dysfunction? | Germinomas |
| How is pulmonary consolidation visualized in radiographs? | Opacification with indistinct borders |
| What causes Pulmonary consolidation? | Caused by the accumulation of material in the alveoli |
| What is the most common cause of Clavicle fracture? | Commonly in children after a fall on an outstretched arm |
| What muscle pulls the distal fracture part of the clavicle down? | Deltoid muscle |
| What muscles pulling the superomedial direction the proximal part of a fractured clavicle? | Sternocleidomastoid and Trapezius muscles |
| How is the Bladder trigone composed? | Formed by 2 slit-like uretic orifices and the their internal urethral opening |
| What does blood within the uretic orifice of the bladder? | Upper urinary tract bleeding originating in the kidney or ureter |
| What is the suggested area of injury or illness if teh hematuria throughout urinary stream? | Upper urinary tract |
| What are some common (list) of upper urinary tract causes of hematuria? | 1. Renal mass (malignant/ benign) 2. Glomerulonephritis 3. Urolithiasis 4. Polycystic kidney disease 5. Pyelonephritis 6. Urothelial cancer 7. Trauma 8. Renal Papillary necrosis |
| What part of the urinary tract causes hematuria by Renal Papillary Necrosis? | Upper urinary tract |
| If the damage cause hematuria is in the upper urinary tract how is it manifested in the urine stream? | All through the urine stream |
| Terminal hematuria more likely means that the damage to the urinary system is at the: | Lower urinary tract |
| What are some common causes of Lower urinary tract hematuria? | Urothelial cancer, Urolithiasis Cystitis (infection/postradiation) BPH Prostate cancer |
| A person with cystitis is more likely to experiment hematuria at what point of the urine stream? | At the end of the stream |
| What are two common conditions the lead to Initial (stream) hematuria? | Urethritis and Trauma (catheterization) |
| The use of a Foley catheter would probably manifest with ________ hematuria. | Initial hematuria |
| What causes Cavernous Sinus Thrombosis? | Infection of the medial face, sinuses (ethmoidal and sphenoidal) or that may spread through the valveless facial venous system into the Cavernous Sinus |
| Which sinuses are most likely involved in Cavernous sinus thrombosis? | Ethmoidal and Sphenoidal |
| What is the typical clinical presentation of Cavernous Sinus Thrombosis? | Headache, fever, proptosis,adn ipsilateral deficits in CN 3, 4, 6, and V1/V2 |
| Cranial nerve deficits seen with Cavernous Sinus thrombosis are contralateral or Ipsilateral? | Ipsilateral |
| What cranial nerves are involved in Cavernous sinus thrombosis? | CN 3, 4, V1, V2, and 6. |
| Which branch of the Trigeminal nerve is not affected in Cavernous sinus thrombosis | V3 is spared |
| What neural structures are contained in the midbrain? | Optic nerve, Pretectal nuclei, Edinger-Westphal nuclei, and Oculomotor nerve |
| What reflex is mediated by neural structures in the Midbrain? | Consensual Pupillary light reflex |
| What part of the brainstem is affected if patient presents with absent Consensual Pupillary light reflex? | Midbrain |
| Which Light Reflex-associated nuclei are inside the Midbrain? | Pretectal and Edinger-Westphal nuclei |
| Which cranial nerves are components of the Midbrain? | Optic nerve and Oculomotor nerve |
| Which are two cranial nerves are tested in the Consensual Pupillary light reflex? | Optic nerve and Oculomotor nerve |
| What is the midbrain? | The forward-most portion of the brainstem and is associated with vision, hearing, motor control, sleep and wakefulness, arousal (alertness), and temperature regulation |
| What is another term used for Midbrain? | Mesencephalon |
| Which branches of the Vagus nerve go through the Esophageal hiatus? | Anterior and Posterior vagal trunks |
| What are possible consequences of damage to the Anterior and Posterior vagal trunks after Esophageal Hiatal Hernia repair? | Delayed gastric emptying and Gastric hypochloremia |
| On which tissue is the Superficial Inguinal ring? | External Abdominal Oblique aponeurosis |
| What is the Deep Inguinal ring? | Physiologic opening in the Transversalis fascia |
| Physiologic opening in the External Abdominal Oblique aponeurosis | Superficial Inguinal ring |
| What is Orchiopexy? | Surgical repair of undescended testicle lodged i the inguinal canal, by moving the testis through the Superficial Inguinal right and fixing it the scrotum |
| What is a Subgaleal hemorrhage? | Scalp hematoma that is potentially fatal neonate bleed that often occurs during delivery as emissary veins between the dural sinuses and scalp are sheared |
| What veins are sheared (damaged) leading to Subgaleal hemorrhage? | Emissary veins |
| Bleeding between the dural sinuses and the scalp | Galeal hematoma/hemorrhage |
| What Thalamic nucleus receives input from the Spinothalamic tract and Dorsal columns? | Ventral Posterior Lateral nucleus |
| From which tracts does the ventral posterolateral nucleus of the thalamus receives input? | Spinothalamic tract and Dorsal columns |
| What thalamic nucleus receives input from the Trigeminal pathway? | Ventral Posterior Medial nucleus |
| From which tract or pathway does the Ventral Posterior Medial nucleus of the Thalamus receive input informati? | Trigeminal pathway |
| What is the clinical result of damage to the Ventral Posterior Lateral and Medial nucleus of the Thalamus? | Contralateral sensory loss |
| What is a consequence of severe loss of proprioception? | Unsteady gait |
| What are some of the sensory loss seen with damage to the Ventral posterior lateral and medial nuclei of the Thalamus? | Contralateral loss of touch, pain, temperature, and proprioception |
| What nerve is at risk of damage during a Thyroidectomy? | External branch of the Superior Laryngeal nerve |
| What nerve is in close proximity to the Superior Thyroid artery and vein? | External branch of the Superior Laryngeal nerve |
| What USMLE-relevant muscle is innervated by the External branch of the Superior Laryngeal nerve? | Cricothyroid |
| What procedure is often used as definite treatment thyroid cancer and often leads to denervation of the Cricothyroid muscle? | Thyroidectomy |
| What nerve innervates the Cricothyroid muscle? | External branch of the Superior Laryngeal nerve |
| What structures are at close proximity to the the External branch of the Superior Laryngeal nerve? | Superior thyroid artery and vein |
| What is Stress Urinary incontinence? | Involuntary urine loss with increased intraabdominal pressure |
| Involuntary urine loss with increased intraabdominal pressure | Stress Urinary incontinence |
| What exercises often aid in Stress Urinary incontinence? | Kegel exercise |
| What muscle targets which pelvic muscle? | Levator ani |
| What is the purpose of Kegel exercises strengthening the Levator ani? | Improve support around the urethra and bladder |
| What determines Coronary dominance? | Determined by the coronary artery supplying the Posterior Descending Artery (PDA) |
| What gives rise to Right Coronary dominance? | PDA originates from the Right Coronary artery (RCA) |
| What is the most common Coronary dominance? | Right dominant |
| From which artery does PDA originate in right dominance coronary blood flow? | Right Coronary artery |
| In Left-Dominant coronary blood flow, the PDA is originated from which artery? | Left circumflex artery |
| What is least common Coronary blood dominance, Right, Left, or Dual? | Left dominant is the least common |
| AV node arterial irrigation is done by: | Dominant coronary artery via the AV nodal artery |
| In a patient is known the the AV node is irrigated by the Right Coronary artery via the AV nodal artery, what is the dominance of this paitent? | Right dominant |
| What is the lymph node drainage (immediate) of the vulva? | Inguinofemoral lymph node |
| Where does the lymph of the Uterus first drains into? | External iliac lymph node |
| What part of the female reproductive system first drains into the Internal Iliac lymph node? | Cervix and proximal part of Vagina |
| The distal vagina lymph drain into the : | Inguinofemoral lymph node |
| What is the immediate lymph drainage of the ovaries? | Paraaortic lymph nodes |
| The Paraaortic lymph nodes receive fluid from which part of the female reproductive system? | Ovaries |
| Which organs or parts of the Female reproductive system receive lymph into the Inguinofemoral lymph node? | Vulva and distal part of vagina |
| What procede in breast cancer exposes risk to lultine nerves? | Axillary lymph node dissection |
| In an axillary lymph node dissection, which nerve injury causes a sensory dysfunction of the skin of the axilla and medial upper arm? | Intercostobrachial nerve |
| Injury to the Intercostobrachial nerve during axillary lymph node removal, causes: | Sensor dysfunction, burning or numbness, to the skin of the axilla and medial upper arm |
| Breast cancer survivor, presents with a numbing/burning arear of skin over the axilla and super metal arm. What injury is to be suspected? | Intercostobrachial nerve injury |
| What nerves injured result in motor dysfunction due to a Axillary Lymph node dissection? | 1. Long Thoracic (Serratus anterior) 2. Thoracodorsal (Latissimus dorsi) 3. Medial Pectoral (Pectoralis major and minor) 4. Lateral Pectoral (Pectoralis major) |
| What area of the body is injured or associated with Osgood-Schlatter disease? | Anterior knee pain |
| What causes Osgood-Schlatter disease? | Repetitive quadriceps contraction in adolescents |
| How is Osgood-Schlatter disease presented? | Focal anterior knee pain and swelling due to chronic avulsion of the Tibial tubercle |
| What causes the knee pain in Osgood-Schlatter disease? | Chronic avulsion of the Tibial tubercle |
| What is the main and most useful landmark to distinguish between Direct and Indirect Inguinal hernia? | Inferior Epigastric vessels |
| The Inferior Epigastric vessels serve as a major landmark for: | Laparoscopic hernia repair to classify the type of inguinal hernia |
| What is the path of an Indirect Inguinal hernia? | Protrude through deep inguinal ring into the inguinal canal lateral to the inferior epigastric vessels |
| What groin hernia is located LATERAL to the Inferior Epigastric vessels? | Indirect Inguinal hernia |
| What groin hernia is located MEDIAL to the Inferior Epigastric vessels? | Direct Inguinal hernia |
| What groin hernia is associated with protrusion through Hesselbach's triangle? | Direct Inguinal hernia |
| Hernia protruding through Hesselbach's triangle medial to the Inferior Epigastric vessels? | Direct Inguinal hernia |
| Hernia that protrudes through the deep inguinal ring and is lateral to the Inferior Epigastric vessels? | Indirect Inguinal hernia |
| What is the Locus coeruleus? | A paired brainstem nucleus locate in the posterior rostral pons near the floor of the 4th ventricle |
| What brain-structure located at the posterior rostral pons near the floor of the 4th ventricle? | Locus coeruleus |
| Where is the principal site for Norepinephrine synthesis in the brain? | Locus coeruleus |
| What is the role and/or involvement of the Locus coeruleus? | It projects virtually to all parts of the CNS and helps control mood, arousal (reticular activating system), sleep-wake disorders, cognition, and autonomic function |
| Nucleus in the pons of the brainstem | Locus coeruleus |
| What are common GI complications of the nerve impingement due to Cauda Equina syndrome? | Constipation and difficulty urinating |
| List of symptoms associated with Cauda Equina syndrome? | 1. GI: Constipation and difficulty urinating 2. Radicular low back pain 3. Leg weakness (Sciatic nerve) 4. Saddle anesthesia (Pudendal, ilioinguinal nerves) |
| What are the roots of the Pelvic Splanchnic nerves? | S2-S4 |
| What is innervated by the Pelvic Splanchnic nerves? | Provide parasympathetic innervation to the bowel and bladder |
| What nerve group provides parasympathetic innervation to the bowel and bladder? | Pelvic Splanchnic nerves |
| What causes Cauda Equina Syndrome? | Nerve roots of the cauda equina are compressed and disrupt motor and sensory function to the lower extremities and bladder. |
| What is the Cauda equina? | A group of nerves and nerve roots stemming from the distal end of the spinal cord, typically levels L1-L5 and contains axons of nerves that give both motor and sensory innervation to the legs, bladder, anus, and perineum |
| What are the root levels typically associated with the Cauda equina? | L1-L5 |
| What is the "funny bone"? | Medial Epicondyle of the Humerus |
| What nerve is possible injured by trauma or damage to the Medial Epicondyle of the Humerus? | Ulnar nerve |
| What are common injuries that result in Ulnar nerve injury? | 1. Injured Medial Epicondyle of the Humerus 2. Injury to the Guyon's canal near the hook of Hamate and Pisiform bones of wrist |
| What common structure near the hook of hamate and pisiform wrist bones, if injured, causes ulnar nerve damage? | Guyon's canal |
| What is the Medial Humerus epindocondiyle bone often referred as? | Funny bone |
| Injury to the Ulnar nerves cause what sensory loss? | 1. Loss over the medial 1 1/2 digits 2. Hypothenar eminence |
| What are the motor deficiencies seen with Ulnar nerve injury? | 1. Weakness on wrist flexion/ adduction 2. Finger abduction/adduction 3. Flexion of the 4th and 5th digits |
| What nerve is injured if the patient presents with a flattened hypothenar eminence ? | Ulnar nerve |
| What are (mnemonic listed) the Retroperitoneal organs? | S-suprarenal (adrenal) glands A- aorta and IVC D- Duodenum (except 1st part) P- pancreas U- ureters C-colon (ascending and descending) K- kidneys E- Esophagus R-rectum (mid-distal) |
| What part of the duodenum is not a retroperitoneal organ? | 1st part of duodenum |
| Which parts of the colon are retroperitoneal organs? | Ascending and Descending colon |
| Which part of the colon is not a retroperitoneal organ? | Transverse colon |
| What are some common Bell's palsy symptoms? | 1. Unilateral facial paralysis 2. Ipsilateral decreased tearing 3. Hyperacusis 4. Loss taste sensation over the anterior 2/3 of the tongue |
| What condition affecting a cranial nerve is charachfed with a decreased tearing? | Bell's palsy |
| What condition is due to Herpes zoster infection to the trigeminal nucleus? | Herpes Zoster Ophthalmicus |
| Herpes zoster reactivation writing the trigeminal nucleus. Dx? | Herpes Zoster Ophthalmicus |
| What branch of CN V is affected by VZV reactivation? | CN V1 |
| What is the clinical presentation of Herpes Zoster Ophthalmicus due to CN V1 viral infection reactivation? | BLindness due to acute keratitis because V1 convest sensory information from the cornea |
| What causes the blindness seen in Herpes Zoster Ophthalmicus? | Acute keratitis as CN V1 conveys sensory information from the cornea |
| What foramina is used by the Olfactory nerve to reach the Olfactory bulb? | Cribriform plate |
| The projection of the olfactory nerve from the Olfactory bulb reaches what cranial lobe? | Medial Temporal lobe |
| Brain trauma that cause CN 1 rootlets to tear lead to: | Anosmia |
| How is Anosmia often interpreted by patients? | Loss of taste |
| A patient complains of a loss of taste. What other vital sense might be involved with a deficit? | Loss of smell |
| Loss of smell or anosmia, goes hand-in-hand with a: | Loss of taste |
| What are the 3 major Hip FLEXORS? | Rectus femoris, Iliopsoas, and Sartorius |
| The Rectus femoris, Iliopsoas, and Sartorius are the main: | Hip flexors |
| Of the 3 major hip flexors, which have knee movement involvement? | Rectus femoris and Sartorius |
| What are actions performed by the Sartorius? | Hip flexion Knee flexion |
| What are the actions performed by the Rectus femoris? | Hip flexion and Knee extension |
| What muscle is known to be involved in hip flexion and knee extension? | Rectus femoris |
| What nerve is often injured by damage or injury to the Carpal Tunnel? | Median nerve |
| What are the effect of Median nerve injury at the Carpal Tunnel? | Pain and numbness in the first 3 digits and lateral half of the 4th, as well as weakness of thumb flexion and opposition |
| What is the effect on the thumb motor actions in case of Median neve injury at the Carpal tunnel? | Weakness of Thumb flexion and opposition |
| A secretary presents with numbness in the first 3 1/2 digits of the right hand, due to common median nerve injury due to Carpal Tunnel syndrome. What other motor deficit may she experience? | Weakness of thumb flexion and opposition |
| Does an Median nerve injury needs to be more proximal or distal fot the forearm to cause Thenar eminence decreased sensation? | Proximal |
| What are sensory and motor deficits seen with Proximal Median nerve (forearm) injury? | - Decreased sensation over the Thenar eminence - Weakness of flexion in the wrist and 2nd & 3rd digits |
| What digits are affected by a proximal median nerve injury? | 2nd and 3rd |
| What is the responsibility of the Cerebellar hemispheres? | Motor planning and coordination of Ipsilateral extremities via their connection with the Lateral Descending motor systems |
| What are clinical features of Cerebellar hemisphere tumors or lesions? | Ipsilateral dysdiadochokinesia, limb dysmetria, and/or intention tremor |
| What is Postherniorrhaphy neuropathy? | Groin pain following hernia repair due to injury to the cutaneous nerves of the lower abdomen/groin |
| What surgical procedure often lead to injury to the ilioinguinal nerve? | Inguinal hernia repair |
| What are symptoms presented by damage to the Ilioinguinal nerve? | Pain and allodynia in the anterior scrotum (labia major in women), base of the peinis (mons pubis in women), and medial thigh |
| What nerve is injured if male patient presents with pain in the anterior scrotum, base of penis, and medial thigh? | Ilioinguinal nerve |
| What part of the thigh is expected to be painful by Ilioinguinal nerve damage? | Medial |
| What can neutralize the gastric acid secreted in an H. pylori infection? | Bicarbonate |
| What secretes bicarbonate, to help neutralize the Gastric acid due to H. pylori infection? | Submucosal glands of the duodenum (Brunner glands) and from Pancreatic duct secretion |
| Where are the Brunner glans? | Duodenum |
| What are the Brunner glands? | Submucosal glands of the duodenum that secrete bicarbonate |
| What is secreted by the Brunner glands in response to H. pylori infection and secretion of Gastric acid? | Bicarbonate |
| What is a consequence of chronic overproduction of Gastric acid due to H. pylori infection? | Hyperplasia of the Brunner glands |
| A small intestine (duodenum) biopsy demonstrates hyperplasia of the Brunner glands. What condition may be suspected as underlying cause? | Chronic H. pylori infection of the antrum |
| What forms the Carpal tunnel? | Carpal bones and the Transverse carpal ligament (flexor reticulatum) |
| Compression of the Median nerve as it passes through the carpal tunnel with 9 flexor tendons. | Carpal Tunnel syndrome |
| Which ligament is often longitudinal cut to give some relief to Carpal Tunnel syndrome? | Transverse carpal ligament |
| What wrist fracture/dislocation is associated with Median nerve compression? | Volar dislocation of the Lunate |
| What are the effect on the thumb after Median nerve injury at the level of the Carpal Tunnel? | Weakness of thumb abduction, flexion, and opposition |
| How does a Posterior Hip dislocation is due to a car accident? | Vehicle collision in which the knee strikes the dashboard |
| How is posterior hip dislocation clinically presented? | Leg appears shortened and internally rotated with the e hip held in flexion and adduction |
| What injury can cause or is associated with Sciatic nerve injury? | Posterior hip dislocation |
| Which pari (artery/nerve) run together in the posterior aspect of the humerus in the upper arm? | Deep brachial artery and Radial nerve |
| What type of facture can cause damage to the radial nerve and deep brachial artery? | Midshaft fracture of the Humerus |
| What structures may be injured in a midshaft fracture of the humerus? | Deep brachial artery and Radial nerve |
| What causes Stress urinary incontinence? | Loss of pelvic floor support and incompetent of the urethral sphincter |
| Loss of pelvic floor support and incompetence of the Urethral sphincter. Dx? | Stress urinary incontinence |
| What is a diangoinist explanation to Stress urinary incontinence? | Increased abdominal pressure greater than the urethral sphincter pressure |
| What occurs the bladder when it gets distended with urine? | The dome of the bladder rise into the Peritoneal cavity |
| A urine distended bladder is often located at the: | Peritoneal cavity |
| A rupture to the bladder dome can cause: | Spilling urine into the intraperitoneal cavity |
| What is a common reason for finding spilled urine in the Intraperitoneal cavity? | Rupture of the dome of the bladder |
| What tissues are traversed (incised) by a Cricothyrotomy? | Superficial Cervical fascia >> Pretracheal fascia >> Cricothyroid membrane |
| To which conditions or events is Sciatic neuropathy a common complication? | Hip fracture and / or arthroplasty because of the proximity of the Sciatic nerve to the hip joint |
| A patient undergoing total hip replacement, has an increased risk of developing what type of nerve deficits? | Sciatic nerve Neuropathy |
| What nerves are affected by injuring the Sciatic nerve at the pelvis? | Neurological deficits in the: 1. Sciatic nerve (knee flexion) 2. Common peroneal nerve (dorsiflexion, numbness of calf and dorsal foot) 3. Tibial nerve (plantar flexion, ankle reflex) |
| Tibial nerve damage causes deficiency of what reflex? | Ankle reflex |
| What are the neurological deficits seen with Common peroneal nerve damage? | Weakness in dorsiflexion, numbness of the calf and dorsal foot |
| What is the primary regulation of Prolactin production? | Inhibitory effects of Hypothalamic Dopaminergic pathways |
| What hormone production is would be inhibited by damage or disruption of the hypothalamic dopaminergic pathways? | Prolactin |
| What stimulators or ramps up dopamine production? | TRH |
| What is the relation between TRH and Prolactin? | Prolactin secretion is stimulated by TRH |
| What is a consequence or complication of primary hypothyroidism? | Increased levels of TRH by the hypothalamus can lead to Hyperprolactinemia |
| What are common causes of Radiculopathy? | 1. Spinal spondylosis 2. Vertebral Disc herniation |
| What causes Radiculopathies? | Compression of Spinal nerve roots |
| How is Cervical radiculopathy commonly clinically presented? | Neck and/or arm pain associated with neurologic deficits that follow a dermatomal/myotomal pattern |
| What is a common bone condition due to chronic radiculopathy, especially if due to vertebral disc herniation? | Osteophytes that form due to degenerative changes in the vertebral joints |
| What is Anisocoria? | Pupillary asymmetry |
| What causes Pupillary asymmetry (anisocoria)? | Lesion in the Ocular Parasympathetic or Sympathetic Pathways. |
| A lesion in the Ocular Parasympathetic or Sympathetic pathways, often result in: | Anicosiaria |
| Which, parasympathetic or sympathetic, ocular pathway is involved in Pupillary constriction? | Ocular parasympathetic pathway |
| Is the parasympathetic or sympathetic branch o the ocular pathway involved in pupillary dilation? | Ocular sympathetic pathway |
| If pupillary asymmetry increases as a patient enters a dim room, is indicated by a failure of a (right or left) pupils is unable to dilute, it indicates a lesion to: | Right or Left oculo sympathetic pathway. |
| How is a Psoas abscess clinically presented? | Fever, an inguinal mass, and difficulty walking |
| What diagnosis is to be suspected in patient with difficulty walking, an inguinal mass, and low-grade fever? | Psoas muscle |
| What is the Psoas sign? | Pain upon extension of the hip |
| Elicited pain upon extension of the hip. | Psoas sign |
| What is the consequence of Psoas muscle inflammation? | Pain upon extension of the hip |
| How are Psoas muscle abscess often spread? | Hematogenous or lymphatic seeding from a distant site, particularly in patients with DM, IV drug use, or immunosuppressed (HIV) |
| To which bone are the muscles of the Rotator cuff attached to? | Proximal Humerus |
| What is the function of the Rotator Cuff muscles? | Move the arm at the shoulder |
| Which Rotator Cuff muscles are involved in External rotation of the arm at the shoulder? | Infraspinatus and teres minor |
| In case the Infraspinatus is torn due to injury, which muscle tends to undergo hypertrophy in order to compensate the lack of external rotation? | Teres minor |
| How is the Pupillary Light reflex assess? | Shining light on an eye, and observing the response in that eye (direct) and the opposite eye (consensual) |
| What cranial nerve is in charge of the afferent portion of the Pupillary Light reflex? | CN II |
| What part of the Pupillary Light reflex is mediated by the CN II? | Afferent limb |
| What cranial nerve is known to mediate the efferent limb of the Pupillary light reflex? | CN III |
| What part of the Pupillary Light reflex is mediated or controlled by the Oculomotor nerve? | Efferent limb |
| Damage to the Efferent limb portion of the Pupillary light reflex, means damage to which cranial nerve? | CN III |
| In the absence of trauma or malignancy, what is the most common cause for a radiculopathy? | Nerve root compression due to vertebral spondylosis |
| Motor and sensory deficits across multiple peripheral nerves and dermatomal distribution, can be due to: | Radiculopathy |
| What causes Testicular Torsion? | Twisting of the testis around the spermatic cord (containing the gonadal artery) |
| What is a possible and severe consequence of Testicular Torsion? | Gonadal ischemia |
| From which major artery do the Gonadal arteries arise from? | Abdominal aorta |
| The Abdominal aorta gives rise to which arterial vessels involved in Testicular torsion? | Gonadal arteries |
| The RIGHT gonadal veins directly drains into the __________. | IVC |
| Where does the Left Gonadal vein drains? | Into the Left renal vein, and then to the IVC |
| If the gonadal vein is draining directly to the IVC, is it then suspected to be the right or left gonadal vein? | Right gonadal vein |
| Which vein first drains into the Left Renal vein, and then such drains into the IVC? | Left gonadal vein |
| How is the IVC formed? | Union of the Right and Left Common iliac veins at the level of the L4-L5 |
| At what vertebral level is the IVC commonly formed? | L4-L5 |
| Which union of veins form the IVC? | Right and Left Common Iliac veins |
| Union of the right and left common iliac veins | IVC |
| What parts of the body have their blood returned to the heart via the IVC? | Lower extremities, portal system, abdomen, and pelvic viscera |
| How is Viral Pericarditis often complicated by? | Pericardial effusion |
| What are the clinical features of Pericarditis? | 1. Tachycardia 2. ECG: low voltage QRS and electrical alternans 3. CXR -- Enlarged cardiac silhouette with clear lungs |
| What common condition is seen with CXR finding or an enlarged cardiac silhouette with clear lungs? | Pericarditis |
| What condition is featured with electrical alternans and low voltage QRS? | Pericarditis |
| What is the main ECG clue for Pericarditis? | Electrical alternans |
| What is the result of an occlusion to the MCA at the brain? | Contralateral hemiparesis and Hemisensory loss of the face and Upper limb, with relative preservation of lower limb function |
| What is an added symptom of MCA occlusion if it happens in the dominant hemisphere? | Aphasia |
| What is the most commonly the dominant hemisphere? | Left hemisphere |
| Contralateral hemiparesis and hemisensory loss of face and upper limb is often seen as a result of what type of stroke? | MCA occlusion |
| MCA occlusion deficits are contralateral or ipsilateral? | Contralateral |
Created by:
rakomi
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