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338 Cards in this Set
- Front
- Back
Implantation of blastocyst is present in which week?
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1
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The bilaminar disk is formed within which week?
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2
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Gastrulation, primitive streak, notochord, neural plate begin to form
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Within week 3
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Neural tube formed, organogenesis, extremely susceptible to teratogens
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Weeks 3-8
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Heart begins to beat, Upper and lower limb buds begin to form
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Week 4
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When do genitalia begin to have male/female characteristics?
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Week 10
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From day 0 to implantation at end of week 1, name stages of embryogenesis
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From day 0 to implantation at end of week 1, name stages of embryogenesis
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For next 9, name effect on fetus of following teratogens
ACE Inhibitors |
Renal damage
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Cocaine
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Abnormal fetal development, fetal addiction
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DES
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vaginal clear cell adenocarcinoma
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Iodide
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congenital goiter or hypothyroidism
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13-cis-retinoic acid
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extremely high risk for birth defects
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thalidomide
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thalidomide
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warfarin, x-rays
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multiple anomalies
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fetal infections
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congenital malformations
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how many umbilical arteries?
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2
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what kind of blood do the umbilical arteries carry?
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deoxygenated blood from fetus
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how many umbilical veins?
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1
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what kind of blood is carried by umbilical vein?
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supplies oxygenated blood from placenta to the fetus
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a single umbilical artery is associated with what anomalies?
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congenital and chromosomal
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What dervies from the following embyologic layers
Surface Ectoderm |
adenohypophysis, lens of eye, epithelial linings, epidermis
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neuroectoderm
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neurohypophysis, CNS neurons, oligodendrocytes, astrocytes, pineal gland
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neural crest
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ANS, dorsal root ganglia, melanocytes, chromaffin cells of adrenal medulla, enterochromaffin cells, pia, celiac ganglion, Schwann cells, odontoblasts, parafollicular - C cells of thyroid, laryngeal cartilage
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mesoderm
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dura connective tissue, muscle, bone, cardiovascular structures, lymphatics, blood urogenital structures, serous linings of body cavities (peritoneal), spleen, adrenal cortex
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endoderm
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gut tube epithelium and derivatives (lungs, liver, pancreas, thymus, thyroud, parathyroid)
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what induces ectoderm to form neuroectoderm (neural plate)?
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notochord
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what is the postnatal derivative of the notochord?
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nucleus pulposus of the intervertebral disk
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Name the precursor for the ectoderm and its purpose
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epiblast, invaginates to form primitive streak
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Cells from the primitive streak give rise to
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intraembryonic mesoderm and endoderm
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How many germ layers in second week and what are they?
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2, epiblast and hypoblast (remember rule of 2's for second week)
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How many cavities in second week and what are they?
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2, amniotic cavity and yolk sac (remember rule of 2's for second week)
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How many components to placenta in second week and what are they?
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2, cytotrophoblast and syncytiotrophoblast (remember rule of 2's for second week)
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How many germ layers in third week and what are they?
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3, (gastrula): ectoderm, mesoderm, endoderm (Rule of 3's for third week)
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In the 3-8th weeks, fetal erythropoiesis occurs in
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Yolk sac
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In the 6-30th weeks, fetal erythropoiesis occurs in
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Liver
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In the 9-28th weeks, fetal erythropoiesis occurs in
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Spleen
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Erythropoiesis occurs in the Bone marrow from the ---- week onward
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28th
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Mnemonic for remembering fetal erythropoiesis?
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Young Liver Synthesizes Blood
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Embryonic structure gives rise to:
Truncus arteriosus |
Ascending aorta and pulmonary trunk
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Bulbus cordis
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Smooth parts of left and right ventricle
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Primitive ventricle
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trabeculated parts of left and right ventricle
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Primitive atria
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trabeculated left and right atrium
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Left horn of sinus venosus (SV)
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coronary sinus
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Right horn of sinus venosus (SV)
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smooth part of right atrium
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Right common cardinal vein and right anterior cardinal vein
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SVC
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Saturation level of blood in umbilical vein?
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80%
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Foramen ovale: its function in fetal circulation?
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Most oxygenated blood reaching the heart via the IVC is diverted through the foramen ovale and pumped out the aorta to the head.
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Ductus Arteriosus: its function in fetal circulation?
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Deoxygenated blood from the SVC is expelled into the pulmonary artery and ductus arteriosus to the lower body of the fetus.
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What happens at birth, when infant takes a breath?
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Decreased resistance in pulmonary vasculature causes increased left atrial pressure vs right atrial pressure; foramen ovale closes; increase in O2 leads to decrease in prostaglandins, causing closure of ductus arteriosus.
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What drug can be given to close a patent ductus arteriosus?
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Indomethacin
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What drug can be given to keep a patent ductus arteriosus open?
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Prostaglandins
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Fetal-postnatal derivatives
Umbilical vein becomes the: |
ligamentum teres hepatis
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umbilical arteries become the:
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medial umbilical ligaments
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ductus Arteriosus becomes the:
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ligamentum arteriosum
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ductus venosus becomes the:
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ligamentum venosum
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foramen ovale becomes the:
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fossa ovalis
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allantois - urachus becomes the:
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median umbilical ligament
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notochord becomes the:
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nucleus pulposus
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urachal cyst or sinus is a remnant of the:
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allantois (urine drainage from the bladder)
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Aortic Arch Derivatives
1st arch: |
part of maxillary artery (1st is MAXimal)
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2nd arch:
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stapedial artery and hyoid artery (Second = Stapedial)
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3rd arch:
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common Carotid artery and proximal part of internal carotid artery (C is the 3rd letter of the alphabet)
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4th arch:
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on left, aortic arch; on right, proximal part of right subclavian artery 4th arch (4 limbs) = systemic
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6th arch:
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proximal part of pulmonary arteries and (on left only) ductus arteriosus. 6th arch = pulmonary and the pulmonary-to-systemic shunt (ductus arteriosus)
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branchial clefts are dervied from:
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ectoderm
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branchial arched are derived from:
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mesoderm and neural crests
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branchial pouches are derived from:
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endoderm
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mnemonic to remember branchial apparatus derivation:
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CAP covers outside from inside (Clefts = ectoderm, Arches = mesoderm, Pouches = endoderm)
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Branchial arch 1 derivatives
Meckel's cartilage: |
Mandible, Malleus,incus,sphenoMandibular ligament
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Muscles:
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Muscles of Mastication (temporalis, Masseter, lateral and Medial pterygoids), Mylohyoid, anterior belly of digastric, tesnsor tympani, tensor veli palatini
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Nerve:
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CN V3
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Branchial Arch 2 derivatives
Reichert's cartilage: |
Stapes, Styloid process, lesser horn of hyoid, Stylohyoid ligament
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Muscles:
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muscles of facial expression, Stapedius,Stylohyoid, posterior belly of digastric.
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Nerve:
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CN VII
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Branchial arch 3 derivatives
Cartilage: |
greater horn of hyoid
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Muscle:
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stylopharyngeus (Think of pharnx: stylopharyngeus is innervated by glossopharyngeal nerve.
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Nerve:
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CN IX
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Branchial arch 4 to 6 derivatives
Cartilages: |
thyroid, cricoid, arytenoids, cornicuate, cuneiform
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Muscles (4th arch):
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mostly pharyngeal constrictors, cricothyroid, levator veli palatini.
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5th arch:
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makes no major developmental contributions
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Muscles (6th arch):
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all intrinsic muscles of larynx except cricothyroid
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Nerve (6th arch):
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CNX (recurrent laryngeal branch)
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Branchial arch innervation
Arch 1 derviatives are supplied by: |
CN V2 and V3
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Arch 2 derivatives are supplied by:
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CN VII
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Arch 3 derivatives are supplied by:
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CN IX
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Arch 4 and 6 derivatives supplied by:
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CNX
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Branchial cleft derivatives
1st cleft develops into |
external auditory meatus
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2nd through 4th clefts form:
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temporary cervical sinuses, which are obliterated by proliferation of 2nd arch mesenchyme.
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Persistent cervial sinus can lead to a:
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branchial cyst in the neck
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Ear development:
Bone: Incus/Malleus come from: |
1st arch
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Bone: Stapes comes from:
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2nd arch
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Muscle: Tensor tympani (V3) comes from:
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1st arch
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Muscle: Stapedius (VII) comes from:
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2nd arch
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External auditory meatus comes from:
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1st cleft
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Eardrum, eustacian tube comes from:
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1st pharyngeal membrane
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Branchial pouch derviatives:
1st pouch develops into: |
middle ear cavity, eustacian tube, mastiod air cells (1st pouch contributes to endoderm-lined structures of ear)
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2nd pouch develops into:
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epithelial lining of palatine tonsil
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3rd pouch (dorsal wings) develops into:
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inferior parathyroids (3rd pouch contributes to 3 structures: thymus, left and right inferior parathyroids)
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3rd pouch (ventral wings) develops into:
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thymus
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4th pouch develops into:
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superior parathyroids
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Aberrant development of 3rd and 4th pouches -->
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DiGeorge's syndrome --> leads to T-cell deficiency (thymic hypoplasia) and hypocalcemia (parathyroid glands)
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Thymus
Site of: |
T-cell maturation
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Encapsulated or unencapsulated?
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encapsulated
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which branchial pouch?
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from epithelium of 3rd branchial pouches
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Lymphocyte origin?
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lymphocytes are of mesenchymal origin
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cortex is dense with:
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immature T cells
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medulla is pale with:
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mature T cells and epithelial reticular cells and contains Hassall's corpuscles. (think of the Thymus as "finishing school" for T cells. They arrive immature and "dense" in the cortex; they are mature in the medulla.
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What occurs at the corticomedullary junction?
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Positive and negative selection
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Thyroid diverticulum arises from:
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floor of primitive pharnyx, descends into neck.
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Connected to tongue by
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thyroglossal duct, which normally disappears but may persist as a pyramidal lobe of thyroid.
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Formen cecum is:
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a normal remnant of the thyroglossal duct
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The most common ectopic thyroid tissue site is the:
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Tongue!
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Tongue development
1st branchial arch forms the |
anterior 2/3 of the tongue (thus sensation via CN V3, taste via CNVII)
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3rd and 4th branchial arches form:
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posterior 1/3 of the tongue (thus sensation and taste mainly via CN IX, extreme posterior via CN X).
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Cranial nerves for taste?
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CN VII, IX, X (solitary nucleus)
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Motor innervation is via CN?
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CN XII
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define cleft lip
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failure of fusion of the maxillary and medial nasal processes
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define cleft palate
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failure of fusion of the lateral palatine processes, the nasal septum, and/or the median palatine process.
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diaphragm is derived from:
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Septum transversarium, Pleuroperitoneal folds, Body wall, Dorsal mesentery of esophagus (Several Parts Build Diaphragm. Diaphragm descends during develpoement but maintains innervation from above C3-C5. "C3, 4, 5 keeps the diaphragm alive."
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What is a hiatial hernia
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abdominal contents may herniate into the throax due to incomplete development of the diaphragm.
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What is Intramembranous bone formation
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spontaneous bone formation without preexisting cartilage.
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What is Endochondral bone formation
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ossification of carilaginous molds. Long bones form by this type of ossification at 1o and 2o centers
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What is Meckel's diverticulum
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persistence of the vitelline duct or yolk stalk. May contain ectopic acid-secreting gastric muscosa and/or pancreatic tissue.
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What is the most common congenital anomaly of the GI tract?
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Meckel's diverticulum
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Complications of Meckel's Diverticulum?
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can cause bleeding or obstruction near the terminal ileum.
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Comparison of Meckel's Diverticulum to Omphalomesenteric cyst?
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Cystic dilatation of the vitelline duct.
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It is Associated with
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intussusception and volvulus
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Mnemonic to remember Meckel's diverticulum
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The five 2's: 2 inches long, 2 feet from the ileocecal valve, 2% of population, commonly presents in first 2 years of life, may have 2 epithelia.
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Parcreas is derived from the
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foregut
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ventral pancreatic bud becomes the
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pancretic head, uncinate process (lower half of head), and main pancreatic duct.
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dorsal pancreatic bud becomes:
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everything else (body, tail, isthmus, and accessory pancreatic duct).
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Spleen arises from
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dorsal mesentery but is supplied by artery of foregut.
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Mesonephric (wolffian) duct develops into
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Develops into Seminal vesicles, Epididymis, Ejaculatory duct, and Ductus deferens (SEED)
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Paramesonephric (mullerian) duct
develops into |
Develops into fallopian tube, uterus, and part of vagina.
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Mullerian inhibiting substance is secreted by:
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the testes to suppress development of paramesonephric ducts in males.
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Bicornuate uterus:
results from and is Associated with |
incomplete fusion of the paramesonephric ducts.
urinary tract abnormalities and infertility |
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Genital tubercle (male) -->
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glans penis via dihydrotestosterone
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genital tubercle (female) -->
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glans clitoris via estrogen
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urogenital sinus (male) -->
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corpus spongiosum, bulbourethral glands (of Cowper), prostate gland: via dihydrotestosterone
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urogenital sinus (female) -->
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vestiubular bulbs, greater vestibular glands (of Bartholin), Urethral and paraurethral glands (of Skene): via estrogen
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urogenital folds (male) -->
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ventral shaft of penis (penile urethra) via dihydrotestosterone
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urogenital folds (female) -->
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labia minora via estrogen
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labioscrotal swelling (male) -->
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scrotum via dihydrotestosterone
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labioscrotal swelling (female) -->
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labia majora via estrogen
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Congenital penile abnormalities
Hypospadia |
abnormal opening of the penile urethra on inferior (ventral) side of penis due to failure of urethral folds to close.
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Epispadia
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abnormal opening of the penile urethra on superior (dorsal) side of penis due to faulty positioning of the genital tubercle.
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epispadia is associated with
|
exstrophy of the bladder
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Which is more common, hypospadia or epispadia?
|
Hypospadial; fix hypospadias to prevent UTI's
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Derivation of sperm parts:
acrosome is derived from |
the golgi apparatus and flagellum (tail) from one of the centrioles.
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what does the neck of the sperm have?
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Middle piece (neck) has Mitochondria.
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Sperm food supply is:
|
fructose
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Primary oocytes begin and complete meiosis I when?
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begin: during fetal life; complete: just prior to ovulation. Meiosis I is arrested in prOphase for years until Ovulation.
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What phase is Meiosis II arrested in?
|
Meiosis II is arrested in METaphase until fertilization. -- "An egg MET a sperm."
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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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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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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?
|
oppose, abduct and flex (OAF)
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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?
|
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?
|
Tearing of the Anterior cruciate ligament (ACL)
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What does abnormal passive abduction indicate?
|
A torn Medial collateral ligament (MCL)
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The recurrent laryngeal nerve is a branch of which cranial nerve?
|
CN X
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Which muscles does it supply?
|
intrinsic muscles of the larynx except the cricothyroid muscle
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What structure does the right recurrent laryngeal nerve wrap around?
|
right subclavian artery
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What structure does the left recurrent laryngeal nerve wrap around?
|
arch of the aorta and the ligamentum arteriosum
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In what kind of surgery can this nerve be damaged in?
|
thyroid surgery
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What happens when this nerve gets damaged?
|
hoarseness
|
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Name the layers of the scalp
|
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?
|
subdural space
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Between what meninges is the subarachnoid space located?
|
between the arachnoid and the pia
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What is found in the subarachnoid space?
|
CSF
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In which scalp layer are the emissary veins found?
|
loose connective tissue
|
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List the structures found in the carotid sheath (in the order from lateral, medial, posterior)
|
Internal jugular vein, common carotid artery, and vagus nerve (VAN)
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What structure crosses the diaphragm at T8?
|
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?
|
T10 (I 8 10 EGG's AT 12)
|
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What structure crosses the diaphragm at T12?
|
aorta, thoracic duct, and azygous vein (I 8 10 EGG's AT 12)
|
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Name the innervation of the diaphragm
|
C3, 4, and 5 (phrenic nerve)
|
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Where can the pain from the diaphragm be reffered to?
|
shoulder
|
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What artery supplies the SA and AV nodes?
|
RCA right coronary artery
|
|
The inferior portion of the left ventricle is supplied by what artery 80% of the time?
|
RCA via the PD posterior descending artery
|
|
In which artery does coronary artery occlusion most sommonly occur?
|
LAD left anterior descending artery
|
|
What artery supplies the anterior interventricular septum?
|
LAD left anterior descending artery
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|
When do coronary arteries fill?
|
during diastole
|
|
What is the most posterior part of the heart?
|
left atrium
|
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What can the enlargement of the left atrium cause?
|
dysphagia
|
|
What does each bronchopulmonary segment contain?
|
3º (segmental) bronchus and 2 arteries (bronchial and pulmonary) in the center
|
|
What drains along the borders of the bronchopulmonary segments?
|
veins and lymphatics
|
|
What runs with the airways?
|
arteries
|
|
How many lobes does the right lung has?
|
3 lobes
|
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Which lung lobe has 2 lobes?
|
left
|
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What is the homologue of the right middle lobe in the left lobe?
|
lingula
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Which lung is the more common site for inhaled foregin body?
|
right lung?
|
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Why is 1 lung a more common site for inhaled foregin body?
|
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?
|
RALS - right lung anterior and left lung superior
|
|
What does the femoral sheath contain?
|
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?
|
no, it lies outside the sheath
|
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What do you call the entrance of abdominal contents through the femoral canal?
|
femoral hernia
|
|
What does the femoral triangle contain?
|
femoral vein, aretery and nerve (VAN)
|
|
Where does the femoral hernia protrude to?
|
below and lateral to the pubic tubercle
|
|
What are abdominal hernias?
|
protrusions of peritoneum through an opening - usually sites of weakness
|
|
What is the name of the hernia in which abdominal structures enter the thorax?
|
diaphragmatic hernia
|
|
What is the most common diaphragmatic hernia?
|
hiatal hernia
|
|
What happens in this type of hernia?
|
the stomach herniates upward through the esophageal hiatus
|
|
What can result from a defective development of pleuroperitoneal membrane in infants?
|
diaphragmatic hernias
|
|
From where does a direct hernia protrude?
|
from the inguinal (Hesselbach's) triangle - bulges directly through the abdominal wall medial to the inferior epigastric artery
|
|
Which inguinal ring does it go through?
|
external inguinal ring only
|
|
Who usually gets a direct hernia?
|
older men
|
|
What does the indirect hernia go through?
|
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?
|
lateral to the inferior epigastric artery
|
|
Who usually get an indirect hernia and why?
|
infants, because of the failure of processus vaginalis to close
|
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Which structures make up Hesselbach's triangle?
|
inferior epigastric artery, lateral border of rectus abdominis, and inguinal ligament
|
|
Where does the inguinal canal start and end?
|
begins at the deep inguinal ring and terminates at the superficial ring
|
|
What does the inguinal canal transmit?
|
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?
|
aponeuroses of the external oblique and internal oblique muscles
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What structures make up the posterior wall of the inguinal canal?
|
aponeurosis of the transverse abdominal muscle and transversalis fascia
|
|
What structures make up the superior wall of the inguinal canal?
|
arching fibers of the internal oblique and transverse muscles
|
|
What structures make up the inferior wall (floor) of the inguinal canal?
|
inguinal and lacunar ligaments
|
|
From where does the stomach receive its main blood supply?
|
from the branches of the celiac trunk
|
|
From where does the celiac trunk arise?
|
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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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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What drains the lymph from right arm and right half of head
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right lymphatic duct
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What does the Thoracic duct drain
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everything that right lymphatic duct does not
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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(not painful), internal hemorrhoids (think of adenocarcinoma association), superior rectal artery(branch of IMA), and superior 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(painful!), external hemorrhoids (think of squamous cell carcinoma association), inferior rectal artery, inferior rectal vein to internal pudendal vein to internal iliac vein to IVC
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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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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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venous drainage of left ovary/testis
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left gonadal vein to left renal vein to IVC
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venous drainage of right ovary/testis
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right gonadal vein to IVC
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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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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
grossly, the collecting system is made up of -- |
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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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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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
which ligament contains ovarian vessels? |
suspensatory ligament of uterus
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what does round ligament of uterus contain?
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nothing!
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which ligament contains uterine vessels?
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transverse cervical (cardinal) 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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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?
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visceral and somatic
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Clinically important landmarks
McBurney's point |
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
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iliac crest
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Peripheral nerve layers
what is covered by endoneurium? |
single nerve fiber
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what must be rejoined in microsurgery for limb reattachment?
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Perineurium: the Permeability barrier
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what surrounds the entire nerve?
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epineurium
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Collagen types
most abundant protein in human body |
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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What are the layers of the epidermis from surface to base?
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stratum corneum, stratum lucidum (in thick skin), stratum granulosum, stratum spinosum, stratum basalis. "Californians Like Girls in String Bikinis"
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This type of junction is also called the zona occludens. (occludes diffusion across intracellular space)
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tight junction
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Forming a perimeter just below the tight junction, the zona adherens (intermediate junction) is composed of ------ and ------ filaments.
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e-cadherin & actin filaments
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Desmoplakin and ----- filaments are a part of the desmosome, also called the ----- ------.
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keratin. Macula adherens
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Structures that allow adjacent cells to communicate for electric and metabolic purposes.
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gap junction
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These structures connect cells to underlying extracellular matrix. Integrins are found in these structures.
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hemidesmosome
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The glomerular basement membrane is formed from fused endothelial and podocyte basement membranes and coated with ---- (pos / neg) charged ------ ------.
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negatively charged heparan sulfate
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Responsible for filtering plasma according to ----- and ----.
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charge & size.
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In Nephrotic syndrome, Negative charge is lost. That's why plasma -----, which are negatively charged, are lost in the urine as a consequence.
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protein
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Principle antigen presenting cell of epidermis
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Langerhans cell
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what is the arrangement of microtubules?
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9+2
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what is dynein?
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An ATPase that links peripheral 9 doublets and causes bending of cilium by differential sliding of doublets
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what happens in Kartagener's syndrome?
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due to a dynein arm defect, resulting in immotile cilia
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What are nissl bodies?
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RER in neurons, not found in axon or axon hillock
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What do nissl bodies synthesize?
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enzymes (i.e. ChAT) and peptide neurotransmitters
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What is I-Cell Disease
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Failure of golgi to add mannose-6-phos to lysosome proteins, causing their secretion outside the cell (defect of golgi)
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name organelle of protein synthesis
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Rough ER
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name organelle of protein transport
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Golgi
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name organelle of N-oligodsaccharide addition
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Rough ER
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name organelle of N-oligodsaccharide modification
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Golgi
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name organelle of proteoglycan assembly
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Golgi
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name organelle of steroid synthesis and detoxification of drugs and poisons
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Smooth ER
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Mucus-secreting goblet cells of small intestine and antibody secreting plasma cells are rich in ______ (organelle)
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Rough ER
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Liver hepatocytes and steroid producing cells of the adrenal cortex are rich in ______ (organelle)
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Smooth ER (look at function two questions above)
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T or F: Liver sinusoids have basement membranes?
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Falso
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T or F: Spleen sinusoids have basement membranes?
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True -- "barrel hoop" basement membranes line sinusoids
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Spleen sinusoids traverse the _______ pulp
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Red
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Match: T-cells are in the red or white pulp
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Red
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Match: B-cells are in the red or white pulp
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White (within the follicles)
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T or F: alpha cells make glucagon
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True
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T or F: B cells make somatostatin
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False -- beta cells make insulin
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T or F: delta cells make somatostatin
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TRUE
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Islet cells arise from what primordial structure
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Pancreatic Buds
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Zona Glomerulosa makes ________
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Aldosterone
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What zona makes the sex hormones
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Zona reticularis
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What zona makes cortisol
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Zona Fasciculata (remember GFR and "The Deeper you go, the sweeter it gets" -- i.e. salt, sugar, sex
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What is the primary regulator of the zona fasciculata
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ACTH (direct) and CRH (indirect)
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What is the primary regulator of the zona glomerulosa
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Renin-Angiotensin
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what is the primary regulator of the zona reticularis
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ACTH (direct) and CRH (indirect)
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What is the most common tumor of the adrenal medulla in adults
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Pheochromocytoma
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What is the most common tumor of the adrenal medulla in children
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Neuroblastoma
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What is the main secretory product of the medulla
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Catecholamines
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What is the main secretory product of Brunner's Glands and where do they reside
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Secrete alkaline mucus and live in the submucosa of the duodenum
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Is a lymph node a primary or secondary lymphoid organ
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Secondary
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What part of the lymph node is the site of B-cell localization and proliferation
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Follicle
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What is the function of the medulla
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Communicate with efferent lymphatics and contain lymphocytes, plasma cells, macs, and reticular cells
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The paracortex is the home of ____ cells
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T-cells
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What is the name of the syndrome associated with disfunctional paracortex
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DiGeorge's Syndrome
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What tissue is responsible for IgA secretion in the gut?
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Peyer's patch (Think IgA -- Intra-Gut Antibody) -- Stimulated B-cells from Peyer's secrete IgA into the lumen
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At what level should one perform a lumbar puncture?
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Between L4 and L5 (to keep the cord alive, keep the needle between L3 and L5)
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What structures are pierced?
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Skin, Ligaments, Epidural space, Dura, Subdural Space, Arachnoid, Subarachnoid (CSF) (NOTE: pia is NOT pierced)
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