Anatomy

Front 1

classify the different kinds of axons that travel in the named branches.
1. somatic motor
2. somatic sensory
3. visceral sensory
4. sympathetic preganglionic
5. sympathetic postganglionic
6. parasympathetic preganglionic
7. parasympathetic postganglionic

a)dorsal ramus of T6 spinal nerve
b)ventral ramus of T6 spinal nerve
c)white ramus communicans
d)gray ramus communicans
e)lumbar splanchnic nerve
f)pelvic splanchnic nerve

Back 1

a)1235
b)12345
c)34
d)35
e)34
f)36

Front 2

if there is a slipped C7/T1 disc which spinal nerve is most likely to be affected and why

Back 2

C8. a slipped cervical disc affects the nerve that exits the vertebral canal at the same level as the disc

Front 3

You are allowed to assist at surgery. You retract the pectoralis major as far as you can. The doctor yells at you to relax the retractor. Why?

Back 3

Excessive retraction of pectoralis major puts the medial pectoral nerve on stretch, with risk of injury and subsequent paralysis of the sternocostal part of the muscle

Front 4

What is the anatomical fact that allows for the possibility of retrograde cardioplegia (putting heart stopping chemicals into the coronary sinus as opposed to coronary arteries)

Back 4

the capillaries of the heart have a secondary route of drainage- thesbian veins- into the lumens of the heart chambers. Thus you can pump something backwards in the veins and it can still exit the capillaries

Front 5

W.N presents with diffuse poorly localized epigastric pain. you place your fingers along her right costal margin at midclavicular line and ask that she take a deep breath. She begins her inspiration, but pain causes her to suddenly stop before completing it. what is likely to be inflamed?

Back 5

gall bladder

Front 6

what spinal cord segments receive pain fibers from gall bladder? where would referred pain likely be felt?

Back 6

T7-T9, referred pain would be in the 7th -9th intercostal spaces on right side. it would pass near inferior angle of right scapula.

Front 7

When one performs percutaneous needle biopsy of possible cancer, there is always some risk that cancer cells will be deposited along the path of the needle as it is withdrawn. Why would a needle biopsy of a suspicious mass in the upper pole of a kidney be much riskier than that of the lower pole?

if you attempt a needle biopsy of the lower pole from the back, what three nerves are at greatest risk of being injured?

Back 7

the needle would pass through the costodiaphragmatic recess of the pleural cavity, risk spread of tumor in the pleural cavity

subcostal, iliohypogastric, ilioinguinal

Front 8

what anatomic fact about the terminal ileum makes it identifiable during laparascopic surgery? (also a guide to location of appendix)

Back 8

There is an antimesenteric fold of mesentery (fold of Treves) at this site and no other

Front 9

pancreas

Back 9

see image trunk 2003

Front 10

spinal cord levels concerned with
a)discomfort of having a full urinary bladder
b)pleasure of penile or clitoral stimulation
c)cremasteric reflex
d)vol. ability to retain urine
e)vol. ability to retain fecal matter
f)referred pain from heart attack
g)referred pain from irritation of peritoneum on undersurface of the diaphragm

Back 10

a)S3, S4
b)S2, S3,S4
c)L1
d)S2,S3,S4
e)S2,S3,S4
f)T1-T5
g)C3,C4,C5

Front 11

1st vascular structure
a)through middle of sternal angle
b)through the back just to the left of the midline at the level of the subcostal plane
c)through the right edge of the sternum at the level of the xiphisternal joint

Back 11

a)aortic arch
b)aorta
c)right atrium

Front 12

how does blood supply to the chambers, ivs, and pacemaker nodes of the heart differ between a right coronary dominant and left coronary dominant heart?
a) chambers
b)ivs
c)pacemaker nodes

Back 12

a)left ventricle gets some blood from rt. coronary a. in a right dominant heart, but not in left dominant heart
b)gets some blood from the right coronary a. in a right dominant heart, but not in a left dominant heart
c)AV node gets its blood from right coronary a. in a right dominant heart, but not in a left dominant heart.

Front 13

If you enter the peritoneal cavity through a midline incision inferior to the umbilicus, what specific portions of the bowel may present themselves to your view?

Back 13

jejunum, ileum, transverse colon, sigmoid colon

Front 14

If you picked up a section of bowel, how would you decide which portion it was?

Back 14

if it had appendices epiploical and toenia= colon

if colon has one mesentery= sigmoid, otherwise transverse

if small intestine and fate of mesentary laps edges= ileum, otherwis jejunum

Front 15

Artery that feeds most the small intestine

Back 15

SMA

Front 16

routes by which blood can reach most of the small intestine (not including SMA)

Back 16

aorta-->celiac-->common hepatic-->gastroduodenal-->rt. gastroeploic-->middle colic-->SMA

aorta-->celiac-->splenic-->pancreatic-->SMA

Front 17

During surgery to repair an inguinal hernia, you put a staple immediately medial to the deep inguinal ring. what is the worst consequence you might anticipate?

Back 17

injury to inferior epigastric vessels

Front 18

after surgery to repair hernia, patient complains of numbness over front of scrotom and on inside of thigh adjacent to scrotum. What might have happened?

Back 18

damage to ilioinguinal nerve (genitofemoral nerve)

Front 19

chronic alcoholic- dried blood around mouth, you suspect severe blood loss. no external trauma- what is most likely explanation?

why?

visible sign on abdominal wall:

Back 19

vomiting because of ruptured esophageal varices

blood flow through hepatic sinusoids is partially blocked by cirrhotic changes. Blood in portal v. is diverted through left gastric v. into esophageal venous plexus that drains also azygos/hemiazygos vv. Esophageal vv dilate and rupture.

caput medusae-dilated subcutaneous veins radiating out from umbilicus

Front 20

if supine patient aspirates blood, into which lung and which two segments will blood most likely accumulate?

Back 20

right lung, posterior segment of upper lobe, superior segment of lower lobe