Anatomy-First Aid 2007

Front 1

what's in the carotid sheath

Back 1

"VAN"

V=Internal Jugular "V"ein (lateral)
A=Common Carotid "A"rtery (medial)
N=Vagus "N"erve (posterior)

Front 2

which A supplies the anterior interventricular septum?

Back 2

LAD (Left Anterior Descending), which originiated from LCA (Left Coronary A)

Front 3

which A supplies the post interventriuclar septum

Back 3

80% of the time=PD (Posterior Descending), which originated from RCA (Right Coronary A)

*=Right-dominant heart

Front 4

which A supplies left ventricle

Back 4

PD (Posterior Descending=Posterior Interventricular A) supplies left ventricle (posterior part of heart).

*80% of the time, PD originates from RCA (Right Coronary A) = "Right dominant heart"

Front 5

which A supplies SA and AV node

Back 5

RCA

Front 6

"right-dominant heart" means what?

Back 6

that the PD (Posterior Descending=Posterior Interventricular) arises from the RCA (Right Coronary Artery).

80% ppl have right-dominant heart

Front 7

enlargement of which part of the heart can cause dysphagia?

Back 7

enlargement of LA can cause dysphagia b/c LA=most posterior part of heart, closest to esophagus.

Front 8

when do coronary arteries fill?

Back 8

during diastole

Front 9

Aortic area of heart
-located where?
-murmur here suggests what?

Back 9

-located in right 2nd intercostal space
-SYSTOLIC murmur here suggests AS or flow murmur (flow murmur=nl flow thru stenotic valve OR incr flow thru nl valve, i.e. pregnancy)

Front 10

Pulmonic area of heart
-located where?
-murmur here suggests what?

Back 10

-located in left 2nd intercostal space
-SYSTOLIC murmur here suggests PS (Pulmonic Stenosis) or flow murmur (flow murmur=nl flow thru stenotic valve OR incr flow thru nl valve, i.e. pregnancy)

Front 11

Tricuspid area of heart
-located where?
-murmur here suggests what?

Back 11

-5th intercostal space over sternum
-SYSTOLIC murmur here suggests:
*TR (Tricuspid Regurg)
*VSD (Ventricular Septal Defect)

-DIASTOLIC murmur suggests
*TS (Tricuspid Sten)
*ASD (Atrial Septal Defect)

Front 12

Mitral area of heart
-located where?
-murmur here suggests what?

Back 12

-located at 5th intercostal space, over cardiac apex

-SYSTOLIC murmur here suggests
*MR

-DIASTOLIC murmur here suggests
*MS

Front 13

MC sites of coronary artery occlusion?

Back 13

LAD > RCA > LCA

(LAD supplies ant interventricular septum)

Front 14

MC adrenal medulla tumor?
-does it cause HTN?

Back 14

Adults=pheochromocytoma
*==>HTN

Kids=Neuroblastoma
*does not cause HTN

Front 15

adrenal gland drainage

Back 15

left adrenal gland
==>left adrenal V (AKA suprarenal V)
==>left renal V
==>IVC

right adrenal gland
==>right adrenal vein (AKA suprarenal)
==>IVC

Front 16

neurohypophysis
-other name
-derived what which embryologic layer?
-desc

Back 16

AKA Post Pit

-derived from neural ectoderm (thus "neuro"hypophysis)
-secretes oxytocin & ADH
(these are produced in hypothalamus and shipped to neurohypophysis via hypothalamic stalk; thus if hypothalamic stalk is severed (i.e. car accident)==>no secretion of oxytocin & ADH)

Front 17

post pit
-other name
-derived what which embryologic layer?
-desc

Back 17

AKA Neurohypophysis

-derived from neural ectoderm (thus "neuro"hypophysis)
-secretes oxytocin & ADH
(these are produced in hypothalamus and shipped to neurohypophysis via hypothalamic stalk; thus if hypothalamic stalk is severed (i.e. car accident)==>no secretion of oxytocin & ADH)

Front 18

adenohypophysis
-other name
-derived what which embryologic layer?
-desc

Back 18

AKA ant pit
-derived from oral ectoderm (weird, i guess the ant pit is sort of near the motuh)
-secretes FLAT PIG + MSH:
FSH
LH
ACTH
TSH
ProlactIn
GH

and MSH (Melanotropin)

has 2 subunits:
1. alpha subunit: common subunit to TSH, LH, FSH, & hCG

[mneum: "FL-α-T hCG]

2. Beta subunit: determines hormone specificty

Front 19

islets of Langerhans
-desc
-where most numerous
-arise from what

Back 19

-islets of Langerhans= collection of α, β, & δ cells
-most numerous in tail of pancreas
-arise from pancreatic buds:
*α=peripheral
*β=central,
*δ=interspersed

*α=glucagon
*β=insulin
*δ=somatostatin

Front 20

retroperitoneal structures

Back 20

1. Duod-parts 2,3,4
2. pancreas-except tail
3. ascending colon
4. descending colon
5. kidney
6. adrenal gland
7. rectum
8. Ao
9. IVC

Front 21

foregut
-supplied by what artery
-consists of what structures

Back 21

-celiac a

Consists of:
-stomach==>proximal duod
-liver, GB, pancreas

Front 22

midgut
-supplied by what artery
-consists of what structures

Back 22

-SMA

Consists of:
-proximal duod==>2/3 of transverse colon

Front 23

hindgut
-supplied by what artery
-consists of what structures

Back 23

-IMA

Consists of:
-2/3 transverse colon==>upper portion of rectum

Front 24

what supplies blood to the stomach?

Back 24

celiac trunk:
1. left gastric

2. splenic, gives off:
--short gastrics
--splenic branches
--L gastroepiploic

3. common hepatic, gives off:
--3a. rt gastric
--3b. gastroduodenal
-----3b1. R gastroepiploic
--3c. proper hepatic
-----3c1. left and rt hepatic
-----3c2. cystic (to GB)

Front 25

where are the strong anastomoses in the stomach?

Back 25

-b/w L & R gastroepiploics

-b/w L & R gastrics

Front 26

what happens if block splenic A

Back 26

poor anastomoses b/w short gastrics

Front 27

reasoning behind portal-systemic anastomoses

-veins involved in anastomoses?
-site of anastomoses?
-clinical sign?

Back 27

In portal HTN, the goal is to avoid the liver. Thus, veins that usually drain to portal V (to supply blood to liver) instead drain into systemic veins (which are leaving the liver and about to drain into IVC). This decreases blood flow thru the liver (goal).

1. Left gastric vein usually drains into portal vein (goes from stomach to liver), but in portal HTN, it bypasses the liver & instead drains into esophageal vein (==>IVC)
==>incr blood flow thru esophageal vein
==>esophageal varices

*site of anastomoses=esophagus

2. Paraumbilical vein usually drains into portal vein (goes from umbilicus to liver), but in portal HTN, it bypasses the liver & instead drains into superior and inferior epigastric veins (==>IVC)
==>incr blood flow through epigastric veins
==>caput medusa

*site of anastomoses=umbilicus

3. Superior rectal usually drains into portal vein (goes from rectum to liver), but in portal HTN, it bypasses the liver & instead drains into middle and inferior rectal vein (==>IVC)
==>incr blood flow in inferior rectal vein
==>hemorrhoids

*site of anastomoses=rectum


SUMMARY:
Portal <==> Systemic Anastomoses:

1. L gastric V <==>Esophageal V (site of anastomoses=esophagus)
==>esophageal varices

2. Paraumbilical V <==> Sup & inf Epigastric V (site of anastomoses=umbilicus)
==>caput medusae

3. sup rectal V <==> middle & inf rectal V (site of anastomoses=rectum)
==>hemorrhoids

Front 28

if Abdominal Aorta blocked b/w the origins of SMA & IMA, what collateral circulation arises?

Back 28

1. middle colic A [SMA] <==> left colic A [IMA]

2. marginal A (connects Ao above SMA's origin with Ao below IMA's origin
==>thus bypasses block b/w SMA & IMA

Front 29

if Abdominal Aorta blocked, what collateral circulation arises?

Back 29

A. If Abdominal Aorta blocked:
-b/w origins of subclavian/internal thoracic,
-b/w origins of internal thoracic/external iliac, or
-b/w origins of subclavian/external iliac==>

*internal thoracic/mammary [subclavian] <==> superior epigastric [internal thoracic] <==> inferior epigastric [external iliac]


B. If Abdominal Ao blocked:
-b/w origins of celiac trunk & SMA==>
*superior pancreaticoduodenal A [celiac trunk] <==> inferior pancreaticoduodenal A[SMA]

C. If Abdominal Aorta blocked b/w origins of SMA & IMA==>

1. middle colic A [SMA] <==> left colic A [IMA]

2. marginal A (connects Ao above SMA's origin with Ao below IMA's origin
==>thus bypasses block b/w SMA & IMA

D. If Abdominal Aorta blocked b/w origins of IMA & internal iliac==>

*superior rectal [IMA] <==> middle rectal [int iliac]

Front 30

at what vertebral level is the celiac trunk?

Back 30

T12

Front 31

falciform ligament
-connects what?
-contains what structures?

Back 31

-connects liver & ant abdominal wall
-contains ligamentum teres (umbilical V remnant)

Front 32

hepatoduodenal
-connects what?
-contains what structures?

Back 32

-connects liver & duodenum
-contains portal triad:
portal vein (duod==>liver)
hepatic artery (to liver)
common bile duct (liver==>duod)

*to control bleeding, can compress hepatoduodenal ligmanet b/w thumb and index finger placed in epiploic foramen of winslow

Front 33

gastrohepatic ligament
-connects what?
-contains what structures?

Back 33

-connects lesser curvature of stomach & liver
-contains gastric arteries (makes sense b/c both L and R gastric arteries supply lesser curvature of stomach:
-L gastric artery comes directly off celiac trunk;
=R gastric artery comes off common hepatic A, which came off celiac trunk)

Front 34

gastrosplenic ligament
-connects what?
-contains what structures?

Back 34

-connects greater curvature of stomach & spleen
-contains no vessels

*separats greater and lesser sacs of liver

Front 35

gastrocolic ligament
-connects what?
-contains what structures?

Back 35

-connects greater curvature of stomach & transverse colon
-contains gastroepiploic arteries

*part of greater omentum

Front 36

splenorenal ligament
-connects what?
-contains what structures?

Back 36

-connects spleen to posterior abdominal wall
-contains splenic A and V

Front 37

Layers of gut wall

Back 37

Layers of gut wall (inside==>outside): "MSMS"

1. "M"=MUCOSA

1a. epithelium (absorption)
1b. lamina propria (support)
1c. muscularis MUCOSA (motility)

2. "S"=SUBMUCOSA
*contains "S"ubmucosal nerve plexus (Meissner's), which regulates "S"ecretions, BF, & absorption

3. "M"=MUSCULARIS EXTERNA
*inner circular, outer longitudinal SmM layers
*contains "M"yenteric plexus (Auerbach's), which regulates "M"otility along entire gut wall
[Myenteric plexus is located b/w inner circular and outer longitudinal layers]

4. "S"=Serosa/Adventitia

Front 38

frequencies of basal electric rhythm of:
-stomach
-duod
-ileum

Back 38

basal electrical rhythm ~ rate of peristalsis

-stomach: 3 Hz
-duod: 12 Hz
-ileum: 8-9 Hz

Front 39

Meissner's plexus

Back 39

[Meisseners AKA "S"ubmucosal nerve plexus]

-located in "S"ubmucosa
-regulates "S"ecretions, BF, & absorption
-contains cell bodies of some parasympathetic terminal effector neurons (these regulate secretion)

Front 40

Auerbach's plexus

Back 40

-Auerbach's AKA "M"yenteric Plexis

-located in "M"uscularis Externa b/w inner circular and outer longitudinal layers
-regulates "M"otility along entire gut wall
-contains cell bodies of some parasympathetic terminal effector neurons (these regulate motility)

Front 41

abdominal layers-from skin to peritoneum

Back 41

external to internal==>

Skin
Superficial fascia
External oblique
Internal oblique
Transversus abdominis
Transversalis fascia
Extraperitoneal tissue
Peritoneum

Front 42

Brunner's glands

Back 42

-located in submucosa of duodenum (the only GI submucosal glands)
-secretes alkaline mucus to neutralize acidic contents entering the duodenum from the stomach

-hypertrophy of Brunnner's glands in PUD (makes sense; in PUD, incr acid, so need more alkaline mucous to neutralize)

Front 43

Peyer's Patches

Back 43

*unencapsulated lymphoid tissue in lamina propria & submucosa of sm int, usu ileum

*contain M cells, which sample the intraluminal contents (contents of the gut lumen)
==>if there is an antigen, M cells deliver antigen to APC's (B cells)
==>stimulates B cells to leave Peyer's Patch
==>go to mesenteric lymph nodes, where the B cells differntiate into IgA-secreting plasma cells
==>IgA receives protective secretory component and is then transported across epithelium into gut lumen to kill pathogen

mneum: "IgA"= "I"ntra-"g"ut "A"ntibody (remember that IgA is the Ig associated with mucosa)

Front 44

sinusoids of liver

Back 44

(pic BRS Histo p. 244)

-deliver blood from portal vessels==>central vein

-irregular "capillaries" w/
*fenestrated epithelium
(pores= 100-200 nm diameter)
*no BM
==>allows plasma macromolecules full access to basal surface of hepatocytes thru perisinusoidal space (=space of Disse=subendothelial space b/w hepatocytes and sinusoids; thus hepatocytes do not directly contact the bloodstream)

Front 45

pectinate line
-formed by what?
-importance?
-associated A & V
-types of cancer

Back 45

(FA pic p. 278 shows venous drainage)

-formed where hindgut (supplied by IMA) meets ectoderm

ABOVE PECTINATE LINE:
-internal hemorrhoids
-not painful b/c visceral innervation
-adenocarcinoma
-supplied by Superior Rectal Artery (branch of IMA)
-drains to Superior Rectal V
==>IMV
==>portal system

BELOW PECTINATE LINE
-external hemorrhoids
-painful b/c somatic innervation
-sq cell CA
-supplied by inferior rectal artery (branch of internal pudendal A)
-drains to inferior rectal vein
==>internal pudendal V
==>internal iliac V
==>IVC

Front 46

femoral region
-contains what

Back 46

Femoral Region: N-(AVEL)

N=femoral N
A=femoral A
V=femoral V
E=Empty space
L=Lymphatics (deep inguinal lymph nodes)

Femoral Triangle= NAV

Femoral Sheath=
(AVEL)
[not N!]

Front 47

femoral triangle contains what

Back 47

NAV:

N=femoral N
A=femoral A
V=femoral V

Front 48

femoral sheath contains what

Back 48

(AVEL)
[not N!]

A=femoral A
V=femoral V
E=Empty space
L=Lymphatics (deep inguinal lymph nodes)

Front 49

hesselbach's triangle

Back 49

=site of protrusion of direct inguinal hernia

consists of:
1. inferior epigastric A
2. inguinal ligament
3. lateral side of rectus abdominis

Front 50

direct inguinal hernia
-site of protrusion
-covered by what?
-population who gets this

Back 50

-site of protrusion=abdominal wall
-bulges "directly" thru abdominal wall medial to inferior epigastric A
-penetrates external/superficial inguinal ring only (not internal/deep inguinal ring)
-covered only by transversalis fascia
-usu in older men

Front 51

indirect inguinal hernia
-site of protrusion
-covered by what?
-population that gets this?
-etiology?

Back 51

"IN"direct inguinal hernia:

-follows path of embryologic descent of spermatic cord
==>passes thru "IN"ternal/deep inguinal ring==>thru external/superficial inguinal ring==>"IN"to scrotum
-site of protrusion=internal/deep inguinal ring

-enters internal inguinal ring lateral to inferior epigastric A
-covered by all 3 layers of spermaticord (external spermatic fascia, cremasteric muscle & fascia, internal spermatic fascia)
-d/t failure of processus vaginals to close==>found in "IN"fants

Front 52

femoral hernia

Back 52

-female>male
-protrudes thru femoral canal below and lateral to pubic tubercle
*leading cause of bowel obstruction

Front 53

what is a leading cause of bowel obstruction

Back 53

femoral hernia

Front 54

diaphragmatic hernia
-describe
-et

Back 54

=abdominal structuers enter thorax
-can occur in infants d/t defective development of pleuroperitoneal membrane

SLIDING HIATAL HERNIA:
*MC
-G-E jxn slides upward above esophageal hiatus of diaphragm
==>stomach herniates upward thru esophageal hiatus

DIAPHRAGMATIC HERNIA
-cardia of stomach moves into thorax
-G-E jxn nl

Front 55

hernia more common in women?

Back 55

femoral

Front 56

hernia more common in young boys?

Back 56

indirect inguinal hernia

Front 57

hernia more common in older men?

Back 57

direct inguinal hernia

Front 58

erythrocyte
-desc
-source of energy

Back 58

-anucleate (no nucleus)
-biconcave
-source of energy=glucose
*90% degraded (anaerobically) to lactate
*10% degraded via PPP (generates NADPH)

-"Physiologic Chloride Shift": RBC membrane contains Cl-bicarb antiport

==>allows RBC to transport CO2 from periphery==>lung for excretion

(BRS Phys p.144: pump Cl- in so that can ship HCO3- out (then HCO3- goes to lungs to be converted to CO2 for expiration)

Front 59

anisocytosis

Back 59

varying sizes of RBC's

Front 60

poikilocytosis

Back 60

varying shapes of RBC's

mneum: "P"oikilocytosis=varying shaPes

(vs. ani"S"ocytosis=varing "S"izes)

Front 61

basophils
-desc
-contains what?
-basophilic stippling?

Back 61

~mast cell structurally and functionally

dark blue color ("basophilic")
mediates allergic rxn
bilobate nucleus

contains:
-heparin (anticoagulant)
-histamine (vd)
-leukotrienes (LTD-4)


basophilic stippling=
*dark blue granules (=ribosomes) in RBC's;
*seen in "TAIL" (note-these are all the microcytic anemias):
T=Thalassemias
A=Anemia of chronic dz
I=Iron deficiency anemia
L=Lead poisoning (==>sideroblastic anemia)

Front 62

basophilic stippling

Back 62

*dark blue granules (=ribosomes) in RBC's;
*seen in "TAIL" (note-these are all the microcytic anemias):
T=Thalassemias
A=Anemia of chronic dz
I=Iron deficiency anemia
L=Lead poisoning (==>sideroblastic anemia)

Front 63

which cells mediate allergic rxn

Back 63

basophil
mast cell

Front 64

mast cell

Back 64

~basophils structurally and functionally

-mediates allergic rxn
-mast cell membrane can bind IgE
-Type I hypersensitivity rxn
-degranulation==>release chemotactic factors for histamine, heparin, & eosinophils

*Cromolyn sodium prevents mast cell degranuation (Tx asthma)

Front 65

eosinophil

Back 65

-Eosinophil's Major Basic Protein defends against helminthic and protozoan infxns
-highly phagocytic for Ag-Ig complexes
-produces histaminase and arylsulfatase

Causes of eosinophilia= "NAACP":
-Neoplasm
-Allergic rxn
-Asthma
-Collagen vascular dz
-Parasites

Front 66

neutrophil

Back 66

-acute inflammatory response
-phagocytic
-large azurophilic (blue) primary granules ("lysosomes") contain:
*myeloperoxidase
*lysozyme
*lactoferritin

Front 67

monocyte

Back 67

Goljan=hallmark of chronic inflamm
-kidney-shaped nucleus

Front 68

macrophage

Back 68

-activated by gamma-IFN
-can fxn as APC via MHCII

Front 69

lymphocyte

Back 69

B lymphocytes
*produce Ig

T lymphocytes
*cellular immune response
*regulate B lymphocytes & macrophages

Front 70

plasma cell neoplasm?

Back 70

Multiple Myeloma

Front 71

B lymphocyte
-desc
-CD markers?

-arises from?
-matures where?
-after matures, where does it migrate?

Back 71

*has CD19 & CD20

*humoral immune response (Ig)
-arises from "B"one marrow stem cells
==>matures in marrow
==>migrates to peripheral lymphoid tissue (LN follicles, white pulp of spleen, unencapsulated lymphoid tissue)

-when B lymphocyte encounters Ag, it differentiates into plasma cell to produce Ig
-has memory
-can fxn as APC via MHCII

Front 72

plasma cell

Back 72

-when B lymphocyte encounters Ag, it differentiates into plasma cell to produce Ig
-off-center nucleus
-clock-face chromatin distribution
-abundant RER
-well-developed Golgi (b/c plasma cell produces lots proteins [Ig], and proteins are modified processed in Golgi]

Front 73

T lymphocyte
-desc
-CD markers?

-arises from?
-matures where?

-types of T cells

Back 73

*Th has CD3 and CD4
*Tc has CD3 and CD8

[mneum: MHC x CD = 8;
MHC 2 x CD 4 = 8 (Th)
MHC 1 x CD 8 = 8 (Tc))

*cellular immune response
-arise from BM stem cells, but matures in "T"hymus
-T lymphocytes differentiate into:
*cytotoxic T cells (MHC 1, CD8)
*helper T cells (MHC 2, CD4)
*suppressor T cells

Front 74

dendritic cells

Back 74

*professional APC's
==>thus have MHC II

-main inducer of primary antibody response
-have Fc-receptors (so they can bind Fc part of Ig)
-called "Langerhans cells" in the skin

Front 75

epidermis layers

Back 75

"Californias Like Girls in String Bikinis"

C= stratum Corneum
L= stratum Lucidum
G= stratum Granulosum
S= stratum Spinosum
B= stratum Basalis

Front 76

Epithelial cell jxns
-desc
-what structures contained

Back 76

"Junctional Complex" (for cell-to-cell attachment of columnar epithelial cells):

1. Zona Occludens (Tight junctions)
-closest to lumen (vs. basal layer)
-proteins of epithelial cells attach directly to one another==>seals off intercellular space (the space b/w adjacent epi cells)
==>no diffusion of substances from lumen into intercellular space


2. Zona Adherens (Intermediate Jxns)
-surrounds perimenter of epithelial cells just below zona occludens (which is closest to lumen, vs. basal layer)
-adheres adjacent epithelial cells to one another
*contains E-cadherin & actin filaments (E-CADHERIN promotoes ADHESION)

3. Desmosome (AKA Macula Adherens)
-small, discrete sites of attachment
-adheres adjacent epi cells to each other
*contains desmoplakin & keratin

NOT part of Junctional Complex:

4. Gap Jxns
-metabolic & electrical communication b/w adjacent epi cells

5. Hemidesmosomes
-attaches epithelial cell to underlying ECM
*contains INTEGRIn (which maintains INTEGRIty of BM)

Front 77

Zona Occludens
-desc
-what structures contained

Back 77

*part of Junctional Complex (for cell-to-cell attachment of columnar epithelial cells):


1. Zona Occludens (Tight junctions)
-closest to lumen (vs. basal layer)
-prevent mvmt of substances from lumen into intercellular space
-proteins of epithelial cells attach directly to one another==>seals off intercellular space (the space b/w adjacent epi cells)
==>no diffusion of substances from lumen into intercellular space

Front 78

Zona Adherens
-desc
-what structures contained

Back 78

*part of Junctional Complex (for cell-to-cell attachment of columnar epithelial cells):

2. Zona Adherens (Intermediate Jxns)
-surrounds perimenter of epithelial cells just below zona occludens (which is closest to lumen, vs. basal layer)
-adheres adjacent epithelial cells to one another
*contains E-cadherin & actin filaments (E-CADHERIN promotoes ADHESION)

Front 79

Macula Adherens
-desc
-what structures contained

Back 79

*part of Junctional Complex (for cell-to-cell attachment of columnar epithelial cells):

3. Desmosome (AKA Macula Adherens)
-small, discrete sites of attachment
-adheres adjacent epi cells to each other
*contains desmoplakin & keratin

Front 80

gap jxn

Back 80

NOT part of Junctional Complex
(for cell-to-cell attachment of columnar epi cells)

Gap Jxns
-metabolic & electrical communication b/w adjacent epi cells

*has CONNEXON with central channel

Front 81

hemidesmosomes

Back 81

*not part of Junctional complex (for cell-to-cell attachment of columnar epi cells)

-attaches epithelial cell to underlying ECM
*contains INTEGRIn (which maintains INTEGRIty of BM)

Front 82

unhappy triad

Back 82

-football injury

-hit on lateral side==>damage:
1. medial meniscus
2. MCL (Medial Collateral Ligament)
3. ACL (Anterior Cruciate ligament)

Front 83

(+) anterior drawer sign indicates

Back 83

torn ACL

Front 84

abnl passive abduction of leg indicates

Back 84

torn MCL

Front 85

rotator cuff muscles

Back 85

"SItS":

Supraspinatus
(superior)==>thus abducts arm (helps deltoid)

Infraspinatus
(posterior)==>thus laterally rotates arm

teres minor
(posterior)==>thus laterally rotates
(inferior)==>thus adducts

Subscapularis
(inferior)==>thus adducts
(anterior)==>thus medially rotates

Front 86

which kidney taken during transplantation?

Back 86

L kidney b/c longer renal V on left (on left, gonadal and adrenal V's dump into left renal vein, which crosses over vertebral bodies to dump into IVC, which lies on right side of vertebral bodies

vs. right renal vein-shorter b/c close to IVC b/c IVC lies on right side on vertebral bodies)

Front 87

course of ureters

Back 87

"water under the bridge"

water (ureters) go under the bridge (ovarian artery, ductus deferens)

Front 88

venous drainage of ovary/testes

Back 88

L ovary/testis
==>left gonadal vein
==>left renal vein
==>IVC

R ovary/testis
==>right gonadal vein
==>IVC

Front 89

lymphatic drainage of ovary/testes

Back 89

para-aortic LN

Front 90

suspensory ligament of ovaries:
contents?

Back 90

it's a uterine ligament (AKA ovarian ligament of uterus)

ovarian vessels

Front 91

what does transverse cervical ligament contain?

Back 91

AKA cardinal ligament (uterus)

-contains uterine vessels

Front 92

contents of cardical ligament?

Back 92

AKA transverse cervical ligament

-contains uterine vessesl

Front 93

contents of round ligament?

Back 93

-does not contian any important strucutres

=remnant of gubernaculum

Front 94

conents of broad ligament?

Back 94

mneum: "Broad" ligament so covers "broad" (big) area & thus contains many structures.

It actually contains all other uterine ligament and their contents!

1. suspensory ligament of ovaries AKA ovarian ligament of uterus
-contain ovarian vessels

2. transverse cervical (AKA cardinal) ligament
-contain uterine vessels

3. round ligament of uterus
-no important structures
-remnant of gubernaculum

Front 95

-erection is mediated by what?

Back 95

PSNS

Front 96

emission (male sex response) is mediated by what?

Back 96

SNS

Front 97

ejaculation is mediated by what nerves?

Back 97

visceral AND somatic nerves

Front 98

derivation of sperm parts

Back 98

-acrosome dervied from Golgi
-flagellum (tail) derived from one of the centrioles

Front 99

which part of sperm has mitochondria?

Back 99

"M"iddle part contains "M"itochondria

Front 100

what is food supply for sperm?

Back 100

fructose

Front 101

respiratory tree:
-conducting zone vs. respiratory zone
*contain which structures
*fxns

Which zone (conducting/respiratory) contains anatomic dead space?

Back 101

CONDUCTING ZONE contains everything from nose==>terminal bronchioes:
*nose
*pharynx
*trachea
*bronchi
*bronchioles
*terminal broncholies

-fxn of conducting zone is to warm and humidify the air
-CONDUCTING ZONE contains anatomic dead space

RESPIRATORY ZONE contains:
*respiratory bronchioles
*alveolar ducts
*alveoli

-fxn of resp zone=gas exchange

Front 102

-to where do pseudocolumnar ciliated cells extend?

Back 102

respitatory bronchioles

Front 103

to where do goblet cells extend in the respiratory tree?

Back 103

only to the terminal bronchioes (vs pseudocolumnar ciliated cells, which extend to respitatory bronchioles)

Front 104

which cells line the alveoli?

Back 104

Type I cells (97% of alveolar surfaces)

Front 105

pulmonary surfactant
-AKA
-secreted by what?

Back 105

-AKA dipalmitoyl phosphatidylcholine
-secreted by Type II pneumocytes

Front 106

dipalmitoyl phosphatidylcholine

Back 106

=pulmonary surfactant

Front 107

Type II pneumocytes

Back 107

-secrete pulmonary surfactant
-precursors of Type I and II pneumocytes
==>thus, Type II pneumocytes proliferate during lung damage

Front 108

what indicates fetal lung maturity?

Back 108

lecithin:sphingomyelin ratio of >2.0

Front 109

why is lecithin:sphingomyelin ratio important?

Back 109

>2 ==>fetal lung maturity

Front 110

bronchopulmonary segment

Back 110

-each bronchopulmonary segment has

*tertiary (segmental) bronchus [center]
*2 arteries: bronchial & pulmonary [center]
*veins [periphery]
*lymphatics [periphery]

mneum: "A"rteries run with "A"irways

Front 111

MC site for inhaled foreign body?

Back 111

R lung (b/c R bronchus is shorter & straighter)

Front 112

how many lobes in lung?

Back 112

-Right lung has 3 lobes

-"L"eft lung has 2 lobes + "L"ingula

Front 113

relation of pulm A and bronchus at each lung hilus

Back 113

rel'n of pulm A to bronchus at each hilus is "RALS":

Right Anterior;
Left Superior

Front 114

structures perforating the diaphragm

Back 114

"I 8 10 EGGS AT 12"

"I 8": 8th vertebrae==>
I=IVC

"10 EGGs": 10th vetebrae==>
EG=EsophaGus
G=vaGus

"AT 12": 12th vertebrae==>
A=Ao, Azygous
T=Thoracic duct

Front 115

muscles of respiration

Back 115

QUIET BREATHING:
-Inspiration: diaphragm
-Expiration: passive

EXERCISE:
-Inspiration:
*ext intercostals (the only abdominal muscle used during inspiration)
*scalene (neck muscle)
*sternocleidomastoid (neck muscle)

-Expiration (all abdominal muscles):
*rectus abdominis
*ext oblique
*int oblique
*transversus abdominis
*internal intercostal

Front 116

what allows anterograde mvmt of cilia

Back 116

kinesin

Front 117

what allows retrograde mvmt of cilia

Back 117

dynein

Front 118

dynein

Back 118

-Dynein=
*ATPase that links peripheral 9 doublets
==>causes doublets to slide
==>bend cilium (cilia; dynein is part of the cilia)
==>allows retrograde mvmt

Front 119

defective cilia
-what causes
-effects

Back 119

Defective cilia (d/t defective dynein arm)==>
*male/female infertility (sperm have no cilia)
*bronchiectasis
*recurrent sinusitis (no cilia in bronchioles to sweep away pathogens)