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217 Cards in this Set
- Front
- Back
Amniotic Fluid Abnormalities
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p. 82
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What is polyhydramnios?
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high amount of amniotic fluid (>1.5-2L)
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What is polyhydramnios clinically associated with?
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esophageal/duodenal atresis and anencephaly both of which impair the ability of the fetus to swallow amniotic fluid
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What is the condition leading to low amniotic fluid (<0.5L) called?
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Oligohydramnios
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What 2 conditions is oligohydramnios associated with?
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Bilateral renel agenesis or posterior urethral valves (in males) which results in the failure of the fetus to excrete urine into the amniotic fluid.
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What syndrome can oligohydramnios result in?
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Potter's Syndrome
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What does the term Potter's syndrom describe?
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Bilateral renal agenesis leading to oligohydramnios which results in fetal limb and facial deformaties and pulmonary hypoplasis
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What causes Potter's syndrome?
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Malformation of the ureteric bud
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What results when the poles of both kidneys fuse during development?
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Horseshoe kidney
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What arrests the ascend of the fused kidneys?
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The horseshoe kidneys get trapped under the inferior mesenteric artery.
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Landmark Dermatomes
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p. 82
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What dermatome is found at the posterior half of the skull?
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C2
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Where is the C3 dermatome?
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neck (high turtleneck shirt)
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Where is the C4 dermatome?
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lower neck (low-collar shirt)
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Where is the T4 dermatome?
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At the nipple
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Which dermatome can be found at the level of the xiphoid process?
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T7
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Which dermatome is important for early appendicitis pain refferl to the umbilicus?
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T10
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Where is the L1 dermatome?
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At the inguinal ligament
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What dermatome is found at the knee caps?
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L4
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Which dermatomes are associated with erection and sensation of penile and anal zones?
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S2, S3, S4 (S2, 3, 4 keeps the man begging for more)
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Gallbladder pain can be reffered to the right shoulder via which nerve?
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Phrenic nerve
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Which dermatome is found at the level of the belly butten?
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T10
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Rotator Cuff Muscles
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p. 82
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Which muscles form the rotator cuff?
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Supraspinatus, Infraspinatus, Teres minor, and Subscapularis (SItS)
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Which muscle helps the deltoid abduct the arm?
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Supraspinatus
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What function does the Infraspinatus muscle have?
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laterally rotates the arm at the shoulder joint
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What is the function of the Teres minor muscle?
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to adduct and laterally rotate the arm (Possible mistake in First Aid)
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Which muscle medically rotates and adducts the arm?
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Subscapularis
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Thenar-hypothenar Muscles
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p.83
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Name the thenar muscles.
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Opponens pollicis, Abductor pollicis brevis, Flexor pollicic brevis
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Name the hypothenar muscles.
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Opponens digiti minimi, Abductor digiti minimi, Flexor digiti minimi
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What functions do the thenar and hypothenar muscles preform?
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oppose, abduct and flex (OAF)
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Unhappy triad/Knee injury
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p. 83
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What structures can be injured when a football player's cleated shoe is planted firmly in the turf and the knee is struck from the lateral side?
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medial collateral ligament (MCL), medial meniscus, and anterior cruciate ligament (ACL) (unhappy triad on the knee joint)
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What does a anterior drawer sign indicate?
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Tearing of the Anterior cruciate ligament (ACL)
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What does abnormal passive abduction indicate?
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A torn Medial collateral ligament (MCL)
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Recurrent Laryngeal nerve
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p.83
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The recurrent laryngeal nerve is a branch of which cranial nerve?
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CN X
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Which muscles does it supply?
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intrinsic muscles of the larynx except the cricothyroid muscle
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What structure does the right recurrent laryngeal nerve wrap around?
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right subclavian artery
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What structure does the left recurrent laryngeal nerve wrap around?
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arch of the aorta and the ligamentum arteriosum
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In what kind of surgery can this nerve be damaged in?
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thyroid surgery
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What happens when this nerve gets damaged?
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hoarseness
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Scalp and meninges: layers
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p. 83
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Name the layers of the scalp
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skin, connective tissue, aponeurosis, loose connective tissue, pericranium (SCALP)
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Name the meninges.
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Dura, arachnoid, and pia (DAP)
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What space is found between the dura and arachnoid?
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subdural space
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Between what meninges is the subarachnoid space located?
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between the arachnoid and the pia
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What is found in the subarachnoid space?
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CSF
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In which scalp layer are the emissary veins found?
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loose connective tissue
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Mastication Muscles
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p.84
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Which 3 muscles are responsible for closing the jaw?
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Masseter, temporalis, and medial pterygoid (M's munch)
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Which muscles opens the jaw?
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Lateral pterygoid
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Which nerve innervates the muscles that are responsible for jaw opening and closing?
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Trigeminal nerve V3
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Name the nerve that supplies the muscles of the tounge except palatoglossus.
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Hypoglossal nerve
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What nerve innervates the palatoglossus muscle?
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Vagus nerve
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The muscles with the root "palat" (except tensor veli palatini) are innervated by what nerve?
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vagus nereve
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What nerve innervates tensor veli palatini?
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mandibular branch of CN V
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Carotid Sheath
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p.84
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List the structures found in the carotid sheath (in the order from lateral, medial, posterior)
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Internal jugular vein, common carotid artery, and vagus nerve (VAN)
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Diaphragm Structures
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p.84
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What structure crosses the diaphragm at T8?
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IVC (I 8 10 EGG's AT 12)
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At what T level does the esophagus and vagus nerve cross the diaphragm?
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T10 (I 8 10 EGG's AT 12)
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What structure crosses the diaphragm at T12?
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aorta, thoracic duct, and azygous vein (I 8 10 EGG's AT 12)
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Name the innervation of the diaphragm
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C3, 4, and 5 (phrenic nerve)
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Where can the pain from the diaphragm be reffered to?
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shoulder
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Coronary artery anatomy
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p.85
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What artery supplies the SA and AV nodes?
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RCA right coronary artery
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The inferior portion of the left ventricle is supplied by what artery 80% of the time?
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RCA via the PD posterior descending artery
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In which artery does coronary artery occlusion most sommonly occur?
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LAD left anterior descending artery
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What artery supplies the anterior interventricular septum?
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LAD left anterior descending artery
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When do coronary arteries fill?
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during diastole
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What is the most posterior part of the heart?
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left atrium
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What can the enlargement of the left atrium cause?
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dysphagia
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Bronchopulmonary segments
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p 85
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What does each bronchopulmonary segment contain?
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3º (segmental) bronchus and 2 arteries (bronchial and pulmonary) in the center
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What drains along the borders of the bronchopulmonary segments?
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veins and lymphatics
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What runs with the airways?
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arteries
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Lung Relations
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p. 85
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How many lobes does the right lung has?
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3 lobes
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Which lung lobe has 2 lobes?
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left
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What is the homologue of the right middle lobe in the left lobe?
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lingula
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Which lung is the more common site for inhaled foregin body?
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right lung?
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Why is 1 lung a more common site for inhaled foregin body?
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Because of the lessvacute angle of the right main stem bronchus
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What is the relation of the pulmonary artery to the bronchus in each lung hilus?
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RALS - right lung anterior and left lung superior
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Femoral Triangle
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p.86
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What does the femoral sheath contain?
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femoral artery, femoral vein, and femoral canal (containing deep inguinal lymph node)
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Does the femoral nerve lie within the femoral sheath?
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no, it lies outside the sheath
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What do you call the entrance of abdominal contents through the femoral canal?
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femoral hernia
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What does the femoral triangle contain?
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femoral vein, aretery and nerve (VAN)
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Where does the femoral hernia protrude to?
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below and lateral to the pubic tubercle
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Abdominal Hernias
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p.86
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What are abdominal hernias?
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protrusions of peritoneum through an opening - usually sites of weakness
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What is the name of the hernia in which abdominal structures enter the thorax?
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diaphragmatic hernia
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What is the most common diaphragmatic hernia?
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hiatal hernia
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What happens in this type of hernia?
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the stomach herniates upward through the esophageal hiatus
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What can result from a defective development of pleuroperitoneal membrane in infants?
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diaphragmatic hernias
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From where does a direct hernia protrude?
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from the inguinal (Hesselbach's) triangle - bulges directly through the abdominal wall medial to the inferior epigastric artery
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Which inguinal ring does it go through?
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external inguinal ring only
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Who usually gets a direct hernia?
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older men
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What does the indirect hernia go through?
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the internal (deep) inguinal ring and external (superficial) inguinal ring and into the scrotum
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On which side of the inferior epigastric artery does the indirect hernia enter the internal inguinal ring?
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lateral to the inferior epigastric artery
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Who usually get an indirect hernia and why?
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infants, because of the failure of processus vaginalis to close
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Which structures make up Hesselbach's triangle?
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inferior epigastric artery, lateral border of rectus abdominis, and inguinal ligament
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Where does the inguinal canal start and end?
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begins at the deep inguinal ring and terminates at the superficial ring
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What does the inguinal canal transmit?
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the spermatic cord or the round ligament of the uterus and the genital branch of the genitofemoral nerve
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What structures make up the anterior wall of the inguinal canal?
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aponeuroses of the external oblique and internal oblique muscles
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What structures make up the posterior wall of the inguinal canal?
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aponeurosis of the transverse abdominal muscle and transversalis fascia
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What structures make up the superior wall of the inguinal canal?
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arching fibers of the internal oblique and transverse muscles
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What structures make up the inferior wall (floor) of the inguinal canal?
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inguinal and lacunar ligaments
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Arterial supply of stomach
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p. 87
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From where does the stomach receive its main blood supply?
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from the branches of the celiac trunk
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From where does the celiac trunk arise?
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from the front of the abdominal artery immediately below the aortic hiatus of the diaphragm
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What arteries does the celiac trunk divide into?
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left gastric, splenic, and common hepatic arteries
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What does the left gastric artery run along?
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lesser curvature of the stomach
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What artery does the left gastric artery anastomose with?
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the right gastric artery
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What does the splenic artery run along?
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runs along the superior boarder of the pancrease
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What arteries does the splenic artery give rise to?
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(dorsal pancreatic artery), short gastric arteries and left gastroepiploic artery
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What does the left gastroepiploic artery run along?
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the greater curvature of the stomach
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What does the common hepatic artery divide into?
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hepatic artery proper, right gastric artery, and gastroduodenal artery
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portal system anastamoses
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p. 88
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esophageal varices results at the anastamosis of which veins?
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left gastric vein (portal) and azygous (systemic)
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manifestation of portal hypertension at the anastamosis of the superior rectal with the middle/inferior rectal veins
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hemorrhoids
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caput medusae is at anastamosis of which veins
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paraumbilical (portal) and inferior epigastric (systemic)
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the two other sites of portal system anastamosis
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retroperitoneal vein (portal) with renal vein (systemic) and retroperitoneal vein with paravertebral vein (systemic)
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3 manifestations seen in alcoholic cirrhosis
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esoph. Varices, hemorrhoids, caput medusae "Gut, butt and caput"
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lymph drainage
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p. 88
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drains right arm and right half of head
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right lymphatic duct
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what thoracic duct drains
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everything that right lymphatic duct does not
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pectinate line
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C2
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location of pectinate line
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where hindgut meets ectoderm
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innervation, hemorrhoid type, aterial supply and venous drainage above pectinate line
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visceral innervation, internal hemorrhoids, superior rectal artery, and rectal vein to inferior mesenteric vein to portal system
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innervation, hemorrhoid type, aterial supply and venous drainage below pectinate line
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somatic innervation, external hemorrhoids, inferior rectal artery, inferior rectal vein to internal pudendal vein to internal iliac vein to IVC
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retroperitoneal structures
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p. 88
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parts of duodenum that are retroperitoneal
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2nd, 3rd and 4th parts
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parts of colon that are retroperitoneal
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descending and ascending colon
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2 big organs that are retroperitoneal
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pancreas (except tail) and kidneys
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2 major vessels that are retroperitoneal
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aorta and IVC
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digestive tract anatomy
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p. 89
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two big nerve plexuses in digestive tract and what they do
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Submucosal (Meissners) controls Secretions; Myeneteric (Auerbach's) controls Motility
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Layers of digestive tract from inside to out
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villi, lamina propria, muscularis mucosae, submucosa, serosa
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Gonadal venous drainage
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p. 89
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drainage of left ovary/testis
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left gonadal vein to left renal vein to IVC
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drainage of right ovary/testis
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right gonadal vein to IVC
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Enteric plexuses
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p. 89
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location of myenteric plexus
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b/w inner and outer layers of GI smooth muscle
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location of submucosal plexus
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b/w mucosa and inner layer of GI smooth muscle
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GI blood supply
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p. 89
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region and structures supplied by celiac artery
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foregut: stomach to duodenum, liver, gallbladder, pancreas
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hindgut is supplied by which artery
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inferior mesenteric artery
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superior mesenteric artery supplies ---
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midgut: duodenum to proximal 2/3 of transverse colon
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Kidney anatomy and glomerular structure
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p. 90
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grossly, the collecting system is made up of --
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papillae, medullary pyramids, renal pelvis and ureter
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which structures are in the renal medulla?
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proximal and distal straight tubules, loop of Henle, vasa recta
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location of macula densa
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part of DCT next to afferent arteriole
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Juxtaglomerular apparatus (JGA)
|
p. 90
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two components of JGA
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JG cells (afferent arteriole) and macula densa (DCT, senses Na)
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three factors leading to renin secretion
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decreased renal blood pressure, decreased sodium in distal tubule, increased sympathetic tone
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what secretes erythropoeitin?
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JG cells
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Ureters: course
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p. 90
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two structures under which ureters pass
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uterine artery and ductus deferens "water under bridge"
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Ligaments of the uterus
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p. 91
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which ligament contains ovarian vessels?
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suspensatory ligament of uterus
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what does round ligament of uterus contain?
|
nothing!
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which ligament contains uterine vessels?
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transverse cervical ligament
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what does broad ligament contain?
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round ligaments of uterus and ovaries and uterine tubules and vessels
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Autonomic innervation of male sexual response
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p. 91
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erection is mediated by ---- while emission is mediated by ----.
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Parasympathetics; Sympathetics "Point and Shoot"
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which nerves mediate ejaculation?
|
visceral and somatic
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Clinically important landmarks
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p. 91
|
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McBurney's point
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site of appendix, 2/3 of way from umbilicus to ASIS
|
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significance of ischial spine
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site of pudendal nerve block
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site of lumbar puncture
|
iliac crest
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Peripheral nerve layers
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p. 91
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what is covered by endoneurium?
|
single nerve fiber
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what must be rejoined in microsurgery for lim reattachment?
|
Perineurium: the Permeability barrier
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what surrounds the entire nerve?
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epineurium
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Corpuscles
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p. 91
|
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sites of meissner's corpuscles and their function
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dermis of palm, soles, and digits; involved in light discriminatory touch of hairless skin
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Sites of Pacinian corpuscles and their function
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deep skin at ligaments joint capsules, serous membranes and mesenteries; involved in Pressure, coase touch, vibration and tension
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Inner ear
|
p. 92
|
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3 components of bony labyrinth
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cochlea, vestibul and semicircular canals
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Site and composition of endolymph
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membranous labyrinth, high potassium (like ICF)
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site and composition of perilymph
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bony labyrinth, high sodium
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site of cochlear duct, utricle, saccule, and semicircular canals
|
membranous labyrinth
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what frequency does base of cochlea pick up?
|
high-frequency
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site and function of ampullae
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in semicircular canals, for angular acceleration
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site and function of maculae
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in utricle and saccule, for linear acceleration
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which frequency is lost first in hearing loss in elderly
|
high-frequency
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site of endolymph production
|
stria vascularis
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Collagen types
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p. 92
|
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most abundant protein in human body
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collagen
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collagen primarily found in basement membrane and basal lamina
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type IV. "under the floor"
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collagen type primarily found in cartilage
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type II. "carTWOlage"
|
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collagen type primarily found in bone
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type I. "bONE"
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Reticulin found in skin, blood vessels, uterus, fetal tissue, and granulation tissue
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type III.
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Collagen type X is found primarily in -----.
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epiphyseal plate
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Epidermis layers
|
p. 92
|
|
What are the layers of the epidermis from surface to base?
|
stratum corneum, stratum lucidum (in thick skin), stratum granulosum, stratum spinosum, stratum basalis. "Californians Like Girls in String Bikinis"
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Epithelial cell junctions
|
p. 93
|
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This type of junction is also called the zona occludens. (occludes diffusion across intracellular space)
|
tight junction
|
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Forming a perimeter just below the tight junction, the zona adherens (intermediate junction) is composed of ------ and ------ filaments.
|
e-cadherin & actin filaments
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Desmoplakin and ----- filaments are a part of the desmosome, also called the ----- ------.
|
keratin. Macula adherens
|
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Structures that allow adjacent cells to communicate for electric and metabolic purposes.
|
gap junction
|
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These structures connect cells to underlying extracellular matrix. Integrins are found in these structures.
|
hemidesmosome
|
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Glomerular basement membrane
|
p. 93
|
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The glomerular basement membrane is formed from fused endothelial and podocyte basement membranes and coated with ---- (pos / neg) charged ------ ------.
|
heparan sulfate
|
|
Responsible for filtering plasma according to ----- and ----.
|
charge & size.
|
|
In Nephrotic syndrome, Negative charge is lost. That's why plasma -----, which are negatively charged, are lost in the urine as a consequence.
|
protein
|
|
Principle antigen presenting cell of epidermis
|
Langerhans cell
|
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Cilia structure
|
p. 93
|
|
what is the arrangement of microtubules?
|
9+2
|
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what is dynein?
|
|
|
what happens in Kartagener's syndrome?
|
|
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Nissl bodies
|
p. 93
|
|
What are nissl bodies?
|
RER in neurons, not found in axon or axon hillock
|
|
What do nissl bodies synthesize?
|
enzymes (i.e. ChAT) and peptide neurotransmitters
|