High Yield First Aid Notes

Front 1

carotid sheath

Back 1

internal jugular vein (lateral), common carotid (medial), vagus nerve (posterior)

Front 2

coronary irrigation

Back 2

circumflex (posterior left ventricle), left anterior descending (apex and left ventricular septum), acute marginal (right ventricle), posterior descending (posterior septum)

Front 3

aortic area auscultation murmurs

Back 3

aortic stenosis, flow murmur, aortic valve sclerosis

Front 4

left sternal border auscultation murmurs

Back 4

aortic insufficiency, pulmonic insufficiency

Front 5

pulmonic area auscultation murmur

Back 5

pulmonic stenosis, ASD

Front 6

tricuspid area auscultation murmurs

Back 6

pansystolic (tricuspid insuficiency, VSD), diastolic (tricuspid stenosis, ASD)

Front 7

mitral area auscultation murmurs

Back 7

systolic (mitral insufficiency), diastolic (mitral stenosis)

Front 8

wide splitting of S2

Back 8

associated with pulmonic stenosis

Front 9

fixed splitting

Back 9

associated with ASD

Front 10

paradoxical splitting

Back 10

associated with aortic stenosis

Front 11

mitral insufficiency murmur

Back 11

holosystolic low pitched blowing murmur loudest at apex and radiates to axilla

Front 12

tricuspid insufficiency murmur

Back 12

holosystolic low pitched blowing murmur loudest at tricuspid area radiates to right sternal border

Front 13

aortic stenosis murmur

Back 13

crescendo-decrescendo systolic ejection murmur following ejection click radiates to apex; pulsus parvus et tardus

Front 14

VSD murmur

Back 14

holosystolic, harsh sounding loudest at tricuspid area

Front 15

mitral prolapse murmur

Back 15

late systolic with midsystolic click

Front 16

aortic insufficiency murmur

Back 16

high-pitched blowing diastolic murmur; wide bounding pulse pressure, water-hammer pulse

Front 17

mitral stenosis murmur

Back 17

delayed rumbling late diastolic follows opening snap

Front 18

cause of tetralogy of Fallot

Back 18

anterosuperior displacement of the infundibular septum

Front 19

cause of transposition of the great vessels

Back 19

due to failure of the neural crest cells of the aorticopulmonary septum to spiral rotate

Front 20

chest x-ray in aortic dissection

Back 20

mediastinal widening

Front 21

types of embolus

Back 21

fat, air, thrombus, bacteria, amniotic fluid, tumor; fat emboli associated with long bone fractures and liposuction; amniotic fluid emboli can lead to DIC.

Front 22

Libman-Sacks endocarditis

Back 22

verrocous sterile vegetations on both sides of the valve; associated with SLE

Front 23

causes of serous pericarditis

Back 23

SLE, rheumatoid arthritis, viral infection, uremia

Front 24

causes of fibrinous pericarditis

Back 24

uremia, MI, rheumatic fever

Front 25

causes of hemorrhagic pericarditis

Back 25

TB, malignancies

Front 26

Osler-Weber-Rendu

Back 26

hereditary hemorrhagic telangiectasia; autosomal dominant; nosebleeds and skin discolorations

Front 27

Sturge-Weber disease

Back 27

congenital; affects capillaries; port-wine stain on face and leptomeningeal angiomatosis ( arteriovenous malformation)

Front 28

microglia

Back 28

CNS macrophages of mesodermal origin; HIV-infected microglia fuse to form multinucleated giant cells in CNS

Front 29

cells destroyed in multiple sclerosis

Back 29

oligodendrocytes

Front 30

perinerium

Back 30

permeability barrier surrounds a fascicle of nerve fibers; rejoin in microsurgery

Front 31

endonerium

Back 31

surrounds individual nerve fibers

Front 32

epinerium

Back 32

dense connective tissue with vessels surrounds entire nerve

Front 33

area postrema

Back 33

in the floor of the fourth ventricle; no blood-brain barrier; vomit center

Front 34

muscle that lower the jaw (open)

Back 34

lateral pterygoid

Front 35

muscle that closes the jaw (mastication)

Back 35

masseter, temporalis, medial pterygoid

Front 36

innervation of palatoglossus

Back 36

vagus nerve

Front 37

muscles of the neck innervated by vagus

Back 37

all that contain "palat" and palatoglossus

Front 38

Meissner corpuscules

Back 38

hairless skin and 40% of fingertip receptors; fine touch

Front 39

Pacinian corpuscules

Back 39

deep skin and joints; 15% of fingertip receptors; vibration

Front 40

Merkel's disks

Back 40

hair follicles and 25% of fingertip receptors; static touch

Front 41

free nerve endings

Back 41

pain and temperature from skin

Front 42

uncal herniation

Back 42

medial temporal lobe herniates through tentorium; affects CN III, posterior cerebral artery; ipsilateral ptosis and mydriasis, contralateral homonymous hemianopia

Front 43

structures irrigated by celiac trunk

Back 43

stomach, proximal duodenum, liver, gallbladder, pancreas

Front 44

collateral circulation in the abdomen

Back 44

internal thoracic/mammary (subclavian) ↔ superior epigastric (internal thoracic) ↔ inferior epigastric (external iliac); superior pancreaticoduodenal (celiac trunk) ↔ inferior pancreaticoduodenal (SMA); middle colic (SMA) ↔ left colic (IMA); superior rectal (IMA) ↔ middle rectal (internal iliac)

Front 45

portosystemic anastomoses

Back 45

left gastric vein ↔ esophageal vein --> portal; superior and inferior epigastric veins ↔ paraumbilical vein --> portal; inferior rectal vein ↔ superior rectal vein --> IMV --> splenic --> portal vein

Front 46

portocaval shunt

Back 46

between the splenic and left renal vein --> IVC; relieves portal hypertension

Front 47

how is the portal vein formed?

Back 47

IMV --> splenic vein --> SMV = portal vein; left gastric vein and paraumbilical vein drain in portal vein directly

Front 48

portal triad

Back 48

portal vein, bile duct and hepatic artery

Front 49

hepatic bile canaliculi

Back 49

contain bile secreted through apical surface of hepatocytes and drain into bile ductule of portal triad

Front 50

hepatic sinusoids

Back 50

irregular capillaries with fenestrated endothelium allows macromolecules access to basal surface of hepatocyte through perisinusoidal space of Disse

Front 51

blood flow within the liver

Back 51

portal vein --> sinusoids/space of Disse/basolateral hepatocyte --> centrilobular vein --> hepatic vein --> IVC

Front 52

billiary flow

Back 52

apical surfaces of hepatocytes --> bile canaliculi --> bile duct; bile flow is opposite to blood flow in direction

Front 53

falciform ligament

Back 53

connects liver to anterior abdominal wall; contains ligamentum teres; derivative of fetal umbilical vein

Front 54

hepatoduodenal ligament

Back 54

connects liver to duodenum; contains portal triad; associated with epiploic foramen (anteriorly)

Front 55

gastrohepatic ligament

Back 55

connects liver to lesser curvature; contains gastric arteries; cut during surgery to access lesser sac behind stomach

Front 56

gastrocolic ligament

Back 56

connects greater curvature to transverse colon/greater omentum; contains gastroepiploic arteries

Front 57

gastrosplenic ligament

Back 57

connects greater curvature to spleen; contains short gastric arteries; separates left greater and lesser sacs

Front 58

splenorenal ligament

Back 58

connects spleen to posterior abdominal wall; contains splenic artery and vein

Front 59

myenteric plexus of Auerbach

Back 59

coordinates motility; located between inner (circular) and outer (longitudinal) muscle layers

Front 60

submucosal plexus of Meissner

Back 60

regulates secretions, blood flow and absorption; located in the submucosa

Front 61

pectinate line

Back 61

where hindgut meets ectoderm

Front 62

above pectinate line

Back 62

internal hemorrhoids, adenocarcinoma; blood from superior rectal artery (branch of IMA); drainage to superior rectal vein --> IMV --> portal system; internal hemorrhoids receive visceral nerves and are not painful

Front 63

below pectinate line

Back 63

external hemorrhoids, squamous carcinoma, somatic innervation is painfull; blood from inferior rectal artery (branch of internal pudendal); drainage to inferior rectal vein --> internal pudendal vein --> internal iliac --> IVC

Front 64

femoral region

Back 64

lateral to medial: NAVEL nerve, artery, vein, empty space, lymphatic; femoral sheath contains artery, vein and deep inguinal lymph nodes

Front 65

Brunner's glands

Back 65

secrete alkaline mucus in the duodenal submucosa; hypertrophy in peptic ulcer disease

Front 66

Peyer's patches

Back 66

unencapsulated lymphoid tissue in lamina propria and submucosa of small bowel; M cells take up antigen; B cells get stimulated here, travel to mesenteric lymph nodes and differentiate into IgA secreting plasma cells

Front 67

salivary secretions

Back 67

parotid --> mostly serous, CNIX; the rest mostly mucin CN VII; all hypotonic

Front 68

carbohydrate absorption

Back 68

rate-limiting enzymes are brush-border hydrolases; glucose and galactose absorbed by Na-dependant SGLT1 transporter; fructose absorbed by facilitated diffusion by GLUT-5; transport to blood is via GLUT-2

Front 69

effects of infant deprivation

Back 69

weak, wordless, socially wanting, wary "Wah, Wah, Wah, Wah"

Front 70

anaclictic depression

Back 70

depression in infant due to continued separation from caregiver; failure to thrive

Front 71

conduct disorder

Back 71

continued behavior violating social norms before 18 years; after 18 years --> antisocial personality disorder

Front 72

oppositional defiant disorder

Back 72

child is noncompliant in the absence of criminality

Front 73

separation anxiety disorder

Back 73

fear of loss of attachment figure leading to factitious symptoms to avoid school

Front 74

autism

Back 74

severe communication problems and no relationships; repetitive behavior, savantism, low IQ

Front 75

Asperger disorder

Back 75

mild autism with difficulty in relationships and repetitive behavior but normal behavior and communications skills

Front 76

delirium Vs dementia

Back 76

delirium: altered level of consciousness, decreased attention, misperceptions; dementia: decline in cognition and behavioral changes

Front 77

schizophrenia

Back 77

more than 2 positive/negative symptoms > 6 months; schizophreniform disorder < 6 months; brief psychotic disorder < 1 month; schizoaffective disorder is schizophrenia plus mania/depression

Front 78

manic epidose

Back 78

3 or more --> distractibility, irresposibility, grandiosity, flight of ideas, activity, agitation, decreased need for sleep, talkativeness; symtoms last more than 1 week; hypomanic is subclinical and without psychosis

Front 79

major depressive episode

Back 79

5 symptoms > 2 weeks --> sleep disturbance, anhedonia, guilt, loss of energy and concentration, change in apetite, psychomotor retardation, agitation, suicidal ideation, depressed mood; dysthimia is subclinical depression > 2 years

Front 80

post-traumatic stress disorder

Back 80

nightmares and flashbacks associated with trauma > 1 month; acute stress disorder < 1 month

Front 81

generalized anxiety disorder

Back 81

anxiety, sleep disturbance, fatigue, decreased concentration, all unrelated to specific stressor > 6 months; adjustment disorder is related to specific stressor and lasts < 6months