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Nimmuk
10-12-2005, 09:53 PM
16.What artery supply gall bladder ? it comes from what ?
17.Which vein drains to where the gall bladder?

All questions are from a question bank I created.

I will try to post two a day..if you want more, just ask..need to awnsered them first..

I will provide the awsners to you later during the day!

mjbfsu
10-12-2005, 10:00 PM
1-cystic artery from liver
2- hepatic portal vein?

Nimmuk
10-12-2005, 10:04 PM
16. Cystic artery. It arises from \BRight\b hepatic artery
17.Cystic vein. It drains into It drains into cystic vein, into the portal directly into hepatic sinusoids

Nimmuk
10-12-2005, 10:12 PM
36.Venous drainage of suprarenal gland ?
39.What is the most common site of ectopic kidney?

mog
10-13-2005, 07:16 PM
36. Vague memory... 3 sources -
1) superior suprarenal artery, branch from inferior phrenic artery
2) middle suprarenal artery, direct branch from thoracic aorta
3) inferior suprarenal artery, branch from renal artery

39. (cheated... on the web) pelvic or crossed?? maybe pelvic?

This is fun! Thanks for posting.

mog
10-13-2005, 07:22 PM
Just noticed that 36 was actually venous drainage, and not arterial supply... sorry.

Right suprarenal gland - directly to IVC
Left // - left renal vein into IVC

Nimmuk
10-13-2005, 07:57 PM
Just noticed that 36 was actually venous drainage, and not arterial supply... sorry.

Right suprarenal gland - directly to IVC
Left // - left renal vein into IVC

got the first part right:

36
a. RIGHT suprarenal vein --> drains into Inferior Vena Cava
b. LEFT suprarenal vein --> left renal vein.

Check Netter's pg 257 (3rd ed)

Nimmuk
10-13-2005, 08:01 PM
[
39.What is the most common site of ectopic kidney?[/quote]

Pelvis.
* Usually in boys
* Ususally on the left side.
[ pp104 of HY]

It is all good if you get it form the web, just make sure to remember it!

Nimmuk
10-13-2005, 08:07 PM
35. Arterial supply of adrenal gland ? name all three arteries.

27. What intercostal spaces are used for liver biopsy ?

25. Biliary infection causes what stone in gall bladder?

mog
10-13-2005, 10:45 PM
Why is the ectopic kidney common in boys, and on the left side? Or is it not relavant? (if so, please ignore)

27. Intercostal space 10?? It has to be below the pleural cavity doesn't it? I'm also not so sure from which side you do that. Midaxillary?

25. You mean what type of gall stone? I have no idea...

It's good to learn anatomy with pathological aspect to it - a lot more interesting. Thanks.

Nimmuk
10-13-2005, 11:18 PM
27.Right: 8, 9 or 10
25. Yes, I meant to say what kind of stone: Pigment stone. Also Calcium bilirubinate stone.

Nimmuk
10-13-2005, 11:31 PM
7. On which side of the vertebral colums does the azygos veins lie ?
Clinical importance?


11. What infection may cause portal hypertension ?

Edit, I am a second semester student who scored over 95% in all of my first semester classes...I am aware that by no means I pretend to be an expert in this subject. I am just sharing what I know and will hope that some students will benefit from it.

LqdPls
10-16-2005, 08:54 PM
The azygous vein lies on the right side of the vertebral column in the posterior mediastinum. It serves as an anastimosis between the superior and inferior vena cava.

Liver cirrhosis can cause portal hypertension.

LqdPls
10-16-2005, 09:06 PM
Hey Nimmuck

Throw out some more questions on the Azygous/ Hemiazygous venous network.

Thanks

LqdPls
10-16-2005, 09:26 PM
In relation to the clinical significance of the azygous vein, it seems that it may also relieve the portal hypertension by way of the left gastric vein---->esophageal branch of left gastric vein---->azygous

Nimmuk
10-16-2005, 09:53 PM
In relation to the clinical significance of the azygous vein, it seems that it may also relieve the portal hypertension by way of the left gastric vein---->esophageal branch of left gastric vein---->azygous

You are right:

RIGHT side of the vertebral column.
Collateral circulation in IVC blockage. [HY pp 65]

Nimmuk
10-16-2005, 09:54 PM
11. What infection may cause portal hypertension ?

Schistosomiasis [HY - 66]

Nimmuk
10-16-2005, 10:00 PM
Brachial Plexus


1) Upper trunk injury – secondary to violent displacement of the head from shoulder (fall from motorcycle)
- waiter’s tip hand: arm is in medial rotation due to paralysis of lateral rotators
2) Lower trunk injury (Klumpke’s paralysis)
- secondary to a difficult breech delivery (birth palsy, obstetric palsy)
- may also be caused by a cervical rib or abnormal insertion or spasm of anterior and middle scalenes
- claw hand
3) Injury to the posterior cord – secondary to pressure of the crosspiece of a crutch
- crutch palsy
- loss of extensors
- wrist drop
4) Axillary nerve - dislocation of shoulder, fracture of the surgical neck of humerus
- abduction (deltoid) and lateral rotation (teres minor) are compromised
5) Long thoracic nerve - winging of scapula (serratus anterior)
- inability to elevate arm beyond horizontal
6) Radial nerve - wrist drop (extensors of forearm)
- caused by fracture of the humeral midshaft
- loss of extensors of the forearm, hand, metacarpals and phalanges
- weak hand abduction and adduction
7) Musculocutaneous nerve – weakness of supination and forearm flexion (brachialis and biceps)
8) Median nerve – caused by a supracondylar fracture
- loss of pronation, opposition of thumb, flexion of lateral IP joints, impairment of medial 2 IP joints
- ape hand (flattening of thenar eminence)
9) Ulnar nerve – fracture of the medial epicondyle
- claw hand – ring and little fingers are hyperextended at the MCP joints and flexed at the IP joints
- loss of finger ab- and adduction, flexion of the MCP joints
- loss of adduction of the thumb

Nimmuk
10-16-2005, 10:01 PM
Peripheral Nerves


1) femoral nerve
- paralysis of quadriceps femoris
- impaired hip flexion and leg extension
2) obturator nerve
– weak adduction
– lateral swinging of the limb during walking
3) sciatic nerve
- impaired hip extension and flexion at the knee
- loss of dorsiflexion at the ankle and foot eversion
- peculiar gait: increased flexion at the hip in order to lift dropped foot off the ground
4) tibial nerve
- loss of plantar flexion and impaired inversion
- shuffling gait
- characteristic clawing of toes
5) common peroneal nerve
- foot drop (tibialis anterior m) and inversion (peroneus muscles)
- loss of sensation on the dorsum of the foot and lateral aspect of the leg
6) Deep peroneal nerve entrapment
- Compression of anterior compartment muscles of the lower leg by ski boot or athletic shoes that are too tight. Causes pain in the dorsum of the foot that radiates to the space between the first two toes.
- Also leads to foot drop with consequent high-stepping gait
7) superficial peroneal nerve
- loss of foot eversion

Nimmuk
10-16-2005, 10:02 PM
Continue:

Inferior dislocation of the humerus

- common injury because inferior aspect of shoulder joint is not supported
- may damage the axillary nerve and posterior humeral circumflex vessels

Referred pain to the shoulder

- affectation of the phrenic nerve
- supraclavicular nerve (C3, C4) with similar origins as the phrenic nerve

Carpal tunnel syndrome

- reduced size of the osseofibrous carpal tunnel, compressing the median nerve (secondary to inflammation of flexor retinaculum, anterior dislocation of the lunate, arthritic changes, inflammation of the tendon and its sheath)
- weakened flexion, abduction and opposition of the thumb
- loss of extension of index and middle fingers
- sensory loss of the index, middle and lateral half of the ring fingers on the volar aspect of the hand
- atrophy of the thenar eminence in severe cases

Dupuytren’s contracture

- disease of the palmar fascia leading to thickened and contracted fibrous bands on the palmar surface of hands and fingers, pulling the digits into marked flexion at the MCP joints

Cubital fossa

- bounded laterally by the brachioradialis and medially by the pronatr teres
- roofed by the bicipital aponeurosis
- floor formed by the brachialis and supinator
- contents (from lateral-medial): radial nerve, biceps tendon, brachial artery, median nerve

Nimmuk
10-16-2005, 10:03 PM
Abdominal Arteries


1. Celiac trunk (CT) – FOREGUT
-left gastric, splenic, and hepatic arteries
2. Superior messenteric artery (SMA) – MIDGUT
- part of duodenum through proximal 2/3 of transverse colon
3. Inferior mesenteric artery (IMA) – HINDGUT
- distal 1/3 of transverse colon to upper rectum


Collaterals


1) anterior intercostal branches of the internal thoracic artery and the posterior intercostal arteries
2) superior epigastric branch of the internal thoracic with the inferior epigastric artery
3) superior pancreaticoduodenal artery from the gastroduodenal (CT) with the inferior pancreaticoduodenal artery from the SMA
4) middle colic artery from the SMA with the left colic artery from the IMA
5) marginal arteries from the SMA and IMA
6) superior rectal artery from the IMA with the middle rectal artery from the internal iliac

Nimmuk
10-16-2005, 10:07 PM
14 An obese patient is brought into the emergency room in shock and
in need of intravenous fluids. No superficial veins can be seen or
palpated. The emergency room physician decides to make an incision
to locate the great saphenous vein for the insertion of a cannula
("saphenous cutdown"). In which of the following locations should
the incision be made?

A. Anterior to the lateral malleolus
B. Anterior to the medial malleolus
C. On the dorsum of the foot, lateral to the extensor hallucis longus tendon
D. Posterior to the lateral malleolus
E. Posterior to the medial malleolus

LqdPls
10-16-2005, 10:20 PM
B. Anterior to the medial malleolus

Nimmuk
10-16-2005, 10:26 PM
You are right: Are you taking Anatomy right now?

The correct answer is B. The great saphenous vein is one of the two major superficial veins of the lower limb. It is found in the superficial fascia, where it is accessible for procedures such as saphenous cutdown and saphenous venous graft.

Nimmuk
10-16-2005, 10:30 PM
8>A child who has had abnormal development of the membranous bones has a broad skull with associated facial and dental anomalies. Which other bones are most likely to also be affected?

A. clavicles
B. Femurs
C. Metatarsals
D. Phalanges
E. Tibias

LqdPls
10-17-2005, 11:04 PM
D. (elongated?) phalanges

Nimmuk
10-17-2005, 11:35 PM
The correct answer is A, clavicles. In a syndrome called cleidocranial dysostosis, absence of part of the clavicles accompanies a broad skull, and facial and dental anomalies. Note that you could also have answered this question by noting that of the bones listed, only the clavicles form by intramembranous ossification.

Nimmuk
10-17-2005, 11:41 PM
<46>A person lifts one foot prior to taking a step. Which of the following
nerves innervates the muscle group that allows the person to maintain
balance by holding the weight of his body over the foot remaining on
the ground?

A Femoral nerve
B. First and second sacral nerves
C. Obturator nerve
D. Superior gluteal nerve
E. Tibial nerve

LqdPls
10-18-2005, 12:42 AM
D. Superior gluteal nerve (innervates the gluteas medius, which stabilizes the pelvis in relation to the action described)

Nimmuk
10-18-2005, 11:38 AM
You are right, the correct answer is D. The muscles in question are the gluteus medius and gluteus minimus, which are the innervated by the superior gluteal nerve.

Nimmuk
10-18-2005, 11:40 AM
1>A 48-year-old white female secretary presents with progressive difficultytyping over the past month. She also notes that her hands begin to feel numb and weak after typing for long periods of time. Upon testing, which of the following deficits would be predicted?

A. Difficulty in abducting the fifth finger
B. Difficulty in adducting the thumb
C. Difficulty in flexing digits two and three at the metacarpophalangeal joints
D. Loss of sensation over the lateral half of the dorsum of the hand
E. Loss of sensation over the lateral half of the palm
F. Loss of sensation over the medial half of the dorsum of the hand
G. Loss of sensation over the medial half of the palm

Raj625
10-18-2005, 01:53 PM
Is it C, since these sound like symptoms of Carpal Tunnel Syndrome which compress the median nerve, and this nerve supplies the two lateral lumbricals, it wouldn't be E b/c the Median Nerve sends a cutaneous branch to the lateral palmar surface before entering the carpal tunnel. Correct?

LqdPls
10-18-2005, 01:58 PM
I want to say loss of sensation over the lateral palm only because this sounds like a carpel tunnel syndrome. But the cutaneous branch of the median nerve passes over the carpel tunnel, therefore it would not be compressed as a result, or would it.

Anyway my choice is E. Loss of sensation over the lateral half of the palm

LqdPls
10-18-2005, 02:00 PM
I forgot about the damn lumbricals

Nimmuk
10-18-2005, 02:56 PM
No to both of you, the correct answer is C. This is a classic presentation of a patient with carpal tunnel syndrome, which typically affects females between the ages of 40 and 60 who chronically perform repetitive tasks that involve movement of the structures that pass through the carpal tunnel. One important structure that passes through the carpal tunnel is the median nerve. Patients often note a tingling, a loss of sensation, or diminished sensation in the digits. There is also often a loss of coordination and strength in the thumb, because the median nerve also sends fibers to the abductor pollicis brevis, flexor pollicis brevis, and the opponens pollicis. A final function of the median nerve distal to the carpal tunnel is control of the first and second lumbricals which function to flex digits two and three at the metacarpophalangeal joints and extend interphalangeal joints of the same digits.

Nimmuk
10-18-2005, 02:58 PM
4>A patient who has suffered severe chest trauma in an automobile accident is found to have fluid in the right pleural space. A thoracentesis reveals the presence of chylous fluid in the pleural space, suggesting a rupture of the thoracic duct. In which regions of the thorax is the thoracic
duct found?
A. Anterior and middle mediastinum
B. Anterior and superior mediastinum
C. Middle and posterior mediastinum
D. Middle and superior mediastinum
E. Posterior and superior mediastinum

mog
10-18-2005, 03:40 PM
E? I was not sure about the posterior mediastinum, but since it drains into IVC... (now am not so sure about it, too!!) This is great - thanks for posting

Nimmuk
10-18-2005, 05:21 PM
Yup, the correct answer is E. The mediastinum is divided into four regions. The region above the manubriosternal junction (level of fourth thoracic vertebra) is the superior mediastinum. The region below the manubriosternal junction is divided into the anterior mediastinum (anterior to the pericardium), the middle mediastinum (within the pericardium), and the posterior mediastinum (posterior to the pericardium). The thoracic duct enters the thorax through the aortic hiatus of the diaphragm. At this point it lies in the posterior mediastinum, the region posterior to the pericardium. As it ascends through the thorax and passes the level of the fourth thoracic vertebra, it enters the superior mediastinum.

Nimmuk
10-18-2005, 05:24 PM
22>After falling on his laterally outstretched arm, a patient suffered a
dislocation of the glenohumeral joint. Which of the following nerves
is most likely to have been injured from this dislocation?

A. Axillary nerve
B. Dorsal scapular nerve
C. Lateral pectoral nerve
D. Medial pectoral nerve
E. Suprascapular nerve

mog
10-18-2005, 08:23 PM
A!!!!!!!!!!!!!!!!

Nimmuk
10-18-2005, 09:55 PM
why?........

LqdPls
10-18-2005, 11:54 PM
The axillary nerve is in close relation to the proximal end of the humerus. It passes laterally, posterior to the humerus, distal to the anatomical neck and proximal to the shaft (surgical neck region). Therefore, dislocation of the glenohumeral joint, which usually occurs inferiorly, can damage the axillary nerve as well as the circumflex humeral artery.

mog
10-20-2005, 08:11 PM
I'm not sure if I should post individual questions here or post as a new thread. (please suggest if I should do the latter) I have a small doubt I cannot find the answers to so far...

in the heart development, there's foramen primum and secundum, and then once they get involved in some defects then they become ostium primum and secundum. Are they the same things, or what's the difference between them??

If anybody could help me, that would be great! Thanks

skidoc42
10-20-2005, 10:13 PM
Start an embryo thread...that could help. I'm too wrapped up in the physiology of the heart to recall such details from embryo...although that was one of my favorite units.

skidoc42 ;)

mog
10-20-2005, 10:36 PM
Thanks! will do.







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