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Gross Anatomy Midterm
Abdomen, Upper Limb, Thorax, Back, and Some Embryo Related Embryo Defects
76
Medical
Graduate
03/10/2010

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Cards

Term
What are the two layers of the external abdominal fascia?
Definition
Campers and Scarpa's, anterior to posterior.
Term
What is the superficial inguinal ring made of? What two nerves and other structure exit through it?
Definition
The aponeurosis of the external abdominal oblique. The genitofemoral and ilioinguinal nerves and spermatic cord (in men) exit through it.
Term
What two structures share the conjoint tendon?
Definition
External oblique and transversus abdominus
Term
What is the linea alba?
Definition
Vertical line formed by the rectus sheath. Is BLOODLESS.
Term
Match the layer of the anterior abdominal wall to the layer of spermatic cord.
1. External Abdominal Oblique
2. Internal abdominal oblique
3. Transversus Abdominus
4. Transversalis Fascia
5. Parietal Peritoneum
Definition
1. Ext. Spermatic Fascia
2. Cremasteric Fascia, cremaster muscle
3. No involvement
4. Int. Spermatic Fascia
5. Tunica Vaginalis
Term
Where do the gonads develop? What germ layer do they come from? What are the interstitial (Leydig) cells?
Definition
Posterior abdominal wall high up in the lumbar region. Testes descend to scrotum, ovaries to pelvis. Intermediate Mesoderm. Leydig cells arise from intermediate mesoderm between the seminiferous cords.
Term
What's a gubernaculum?
Definition
A fibrous ligament connecting the developing testes to the ant abd wall near the deep inguinal rings. Also involved in DESCENT OF TESTES.
Term
How do inguinal canals contribute to testicular development?
Definition
They form pathways for teh testes to descend from their intra-abdominal position THROUGH THE ANT ABD WALL.
Term
What's the processus vaginalis?
Definition
Evagination of the peritoneum develops ventral to gubernaculum and carries fascial abdominal layers along
Term
List 5 landmarks in testicular descent.
Definition
3rd Month: iliac fossa
7th month: deep inguinal ring
8th month: superficial inguinal ring
9th month: upper part of scrotum
Birth: lower scrotum
Term
List four factors responsible for testicular descent.
Definition
Hormonal (gonadotropic) reaction
Differential growth (elongation of upper body causes relative mvt)
Gubernaculum testes
Intraabdominal Pressure
Term
Do the testes pass through the processus vaginalis or posterior to it?
Definition
Posterior to it.
Term
List the key contents of the spermatic cord.
Definition
testicular artery, cremasteric artery, symp. nerve fibers, genital br. of genitofemoral nerve, lymphatic vessels, remnants of processus vaginalis
Term
What CAUSES cryptorchism?
Definition
A defective gubernaculum or hormonal failure.
Term
What are ectopic testes?
Definition
Testes in abnormal locations--thigh, abdominal wall, perineum or pubis. Due to abnormal tails of the gubernaculum.
Term
Where does a direct inguinal hernia (congenital) go and why can it go there?
Definition
An intestinal loop herniates into the CAVITY of the TUNICA VAGINALIS through the UNCLOSED PROCESSUS VAGINALIS.
Term
What causes a hydrocele? What's the difference between "encysted hydrocele of the cord" and "congenital hydrocele"?
Definition
In an encysted, the hydrocele is relatively cut off from both the tunica vaginalis and the peritoneum--ie, both sides have obliterated. A congeital hydrocele is due to an unclosed processus vaginalis.
Term
What are the remnants of the gubernaculum in females? In males?

What is the persisting remnant of the tunica vaginalis in females?
Definition
In females it's the ovarian ligament and round ligament of the uterus. In males, the epididymoscrotal ligament.

The Canal of Nuck
Term
Doing an appendectomy, which nerve should you be careful not to cut?
Definition
The iliohypogastric. NOT ilioinguinal--is lower towards iliac spine
Term
You're cutting towards the appendix. List the layers you pass through.
Definition
Skin
Camper's Fascia
EOA
IOA
Transverus Abdominus
Transversalis Fascia
Peritoneum
Appendix
Term
What causes pain in a hernia? Which nerve?
Definition
Intestine passing through the ring. ILIOINGUINAL NERVE.
Term
Where does indirect inguinal hernia go?

Which hernia is lateral to the inferior epigastrics and which are medial to the inferior epigastrics?
Definition
It HAS to go through the DEEP RING.

A direct hernia is medial to the inf epigastrics and pushes against the conjoined tendon, occasionally pushing through the superficial ring.
Term
Transversalis fascia gives rise to which spermatic layer?

EAO gives rise to which layer?

IAO?
Definition
Transversalis=internal spermatic fasciae

EAO-External Cremasteric Fascia

IAO-Internal Cremasteric Fascia
Term
What's a femoral hernia?
Definition
A hernia that passes under the inguinal ligament
Term
Which nerve is responsible for the cremasteric reflex?
Definition
Genital branch of GF
Term
What level is the appendix innervated at?

What type of nerve fibers carry pain sensation during periumbilical pain?

When the appendix touches the body wall, what type of nerve is carrying the pain?
Definition
T10.

Visceral afferents to the DRG

Somatic afferents from parietal peritoneum (body wall) to DRG.
Term
If you hear appendicitis or McBurney's point, what nerve should you think of?
Definition
ILIOHYPOGASTRIC. But be aware that numbness of the anterior pubic symphysis and the scrotum is the ILIOINGUINAL.
Term
What is rebound tenderness?
Definition
Doctor attempts to elicit pain by creating a wave effect in the abdominal cavity. Used to Dx appendicitis.
Term
Ligamentum teres. Where, what's it a remnant of?
Definition
Found in the liver, part of the Falciform ligament, remnant of the UMBILICAL VEIN.
Term
What is the Pouch of Douglas?
Definition
aka the Recto-Uterine pouch, where fluid will accumulate when pt is upright
Term
Which abdominal organs are 2ndarily retroperitoneal?
Definition
Pancreas, Duodenum (2nd, 3rd, 4th parts), Ascending colon, descending colon, rectum
Term
Which organs are 2ndary retroperitoneal?
Definition
Term
What abd organs are primary retroperitoneal?
Definition
Aorta, vena cava, kidneys, ureter, sympathetic trunks
Term
What's the Morrison's Pouch?
Definition
aka Hepatorenal recess, it's a peritoneal fold b/w posterior peritoneal fold of kidney. It's the most gravity-dependent area (for fluid) in the supine position.
Term
What birth defect is associated with maternal rubella infection? Does this defect occur more frequently in males or females?
Definition
Patent Ductus Arteriosus, more often in females.
Term
What birth defect is associated with Down's Syndrome?
Definition
Atrial Septal Defect, PRIMUM type.
Term
What are the diagnostic signs of placenta previa?
Definition
Lower-than-expected hCG, abdominal pain combined with missed period in sexually active females
Term
What condition results in autosomal non-disjunction? What conditions result from sex-linked non-disjunction?
Definition
Autosomal=Down Syndrome (Trisomy); Sex-linked=Turner's Syndrome (XO) or Klinefelter Syndrome (XXY).
Term
What's the Nagele rule for calculating pregnancy due date? How else can you calculate it?
Definition
Nagele=subtract 3 months from LMP, then add 1 year and seven days.

Or just add 280 days from the first day of the last period, or 266 from day of fertilization.
Term
What condition results in hypoplasia of the mandible and zygomatic bone, a down-slanting palpebral fissure (the slanting between the lower and upper eyelids), and a malformed ear?
Definition
Treacher-Collins
Term
What condition leads to hypoplasia of the mandible, cleft palate, Glossoptosis (downward displacement/retraction of the tongue) and possible respiratory difficulty? What is the cause of this disease?
Definition
Pierre-Robin Syndrome, likely due to oligohydramnios.
Term
What medical condition causes partial or complete absence of the thymus and parathyroid glands? What are the consequences and what are the causes?
Definition
DiGeorge Syndrome, which can lead to hypoparathyroidism and increased susceptibility to infection.

Causes can be genetic, alcohol-related, or due to maternal diabetes mellitus.
Term
Monozygous twins, in utero, share one _______, one ______ sac and two _____ sacs.
Definition
Placenta/chorionic sac/amniotic sacs
Term
What is twin transfusion syndrome? Is it a symptom of monozygous or dizygous twins?
Definition
Due to placental vascular anastomoses, one twin receives more blood and is thus larger than the other, although both may die. It occurs in monozygous twins.
Term
What is the embryological origin of

1. Ligamentum Teres
2. Ligamentum Venosum
3. Ligamentum Arteriosum
3. Medial umbilical ligament and superior vesical arteries?
Definition
1. Left umbilical vein
2. Ductus Venosus
3. Ductus arteriosus
4. Medial umbilical ligament and superior vesical arteries.
Term
What about premature birth can result in patent ductus arteriosus?
Definition
Hypoxia and low birth weight
Term
Which lobe is superior, caudate or quadrate?

Which drains into both right and left lobes? And does the one that drains into only ONE lobe drain into the left, or the right?
Definition
The caudate lobe is the superior lobe. IT drains into both right and left lobes. The quadrate is inferior and drains into ONLY the LEFT lobe.
Term
For liver biopsy, the needle is inserted between which ribs, in the mid-____ line?
Definition
9th and 10th ribs on the mid-axillary line.
Term
Paradoxical respiration is associated with which diaphragmatic defect?
Definition
Eventration of the diaphragm, which is in turn caused by a defective MUSCULATURE in one half of the diaphragm.
Term
What pathological condition will lead to overdeveloped accessory respiration muscles? Which muscles will be overdeveloped?
Definition
COPD (also chronic asthma)....leads to big SCM, pec, scalene muscles
Term
What pathological condition will lead to overdeveloped accessory respiration muscles? Which muscles will be overdeveloped?
Definition
COPD (also chronic asthma)....leads to big SCM, pec, scalene muscles
Term
Pump handle movement increases which direction? Bucket handle increases which direction?
Definition
Anterior-Posterior. Lateral.
Term
Which arteries supply the diaphragm? Where the these arteries originate?
Definition
Musculophrenic arteries supply the diaphragm; they are branches of the internal thoracic arteries, which are in turn derived from the subclavian
Term
What nerves innervate the parietal pleura?
Definition
Intercostal nerves (costal-cervical pleura), phrenic nerves (mediastinal and central diaphragmatic pleura) and the lower five-six intercostal nerves (peripheral diaphragmatic pleura)
Term
What nerves innervate the parietal pleura?
Definition
Intercostal nerves (costal-cervical pleura), phrenic nerves (mediastinal and central diaphragmatic pleura) and the lower five-six intercostal nerves (peripheral diaphragmatic pleura)
Term
Trace the lymphatic drainage of the lungs from hilar out.
Definition
Hilar, tracheobronchial (carinal), paratracheal, bronchomediastinal, thoracic duct
Term
Trace the lymphatic drainage of the lungs from hilar out.
Definition
Hilar, tracheobronchial (carinal), paratracheal, bronchomediastinal, thoracic duct
Term
How does oligohydramnios affect the lungs? At what stage do the lungs begin producing surfactant, and how many weeks into the pregnancy does this occur?
Definition
Can lead to insufficient surfactant in the lungs and eventually hypoplasia. @ Canalicular Stage; 16-26 weeks
Term
If a bulla of the lung bursts, what will happen?
Definition
Spontaneous pneumothorax
Term
Is the diaphragm a muscle of inspiration or expiration? For quiet expiration are any muscles needed? Which?
Definition
Diaphragm is for inspiration; expiration can occur due to the elasticity of the lungs.
Term
Which vein runs alongside the posterior interventricular artery?
Definition
Middle cardiac vein.
Term
Which vein runs alongside the posterior interventricular artery?
Definition
Middle cardiac vein.
Term
Which heart valve is attached to the interventricular septum?
Definition
Tricuspid valve--one of the major chordae tendinae is attached thusly.
Term
Where does the right marginal coronary artery run? What does it branch off of?
Definition
It runs along the diaphragmatic right edge of the heart and branches off (2nd impt branch) of the right coronary artery
Term
What structure runs with the Great Cardiac Vein?
Definition
Anterior interventricular artery, which is a branch of the left coronary artery.
Term
What causes Tetralogy of Fallot?
Definition
Misalignment of the AV septum with the AP septum in utero.
Term
Which pharyngeal arch is responsible for...
1. Arch of the aorta
2. Ductus arteriosus
3. Proximal pulmonary arteries
4. Common carotid arteries
Definition
1. 4th (left)
2 6th (dorsal-left)
3. 6th (ventral)
4. 3rd
Term
In coarctation of the aorta, where does the compression occur?
Definition
The compression is relative to the ductus arteriosus--can be preductal, ductal, or postductal.
Term
Explain the symptoms of coarctation of the aorta.
Definition
Most result from a lower blood volume in the vessels distal to the compression, especially those in the legs; rib notching results from increased intercostal arterial pressure
Term
What are the embryo origins of DiGeorge, Treacher Collins, and Pierre Robinson?
Definition
DiGeorge is caused by failure of the 3rd and 4th pharyngeal pouches to differentiate into the thymus & parathyroid glands.

Treacher and Pierre are caused by abnormal development of the 1st phar. arch due to INSUFFICIENT MIGRATION OF NEURAL CREST CELLS.
Term
Horner Syndrome is associated with what congenital heart defect?
Definition
Coarctation of the aorta
Term
What embryological structures produce the actual SYMPTOMS of Coarc Aorta?
Definition
3rd, 4th, 6th pharyngeal arteries.
Term
What is the importance of the sinus venosus?
Definition
The sinus venosus turns into the pulmonary veins and the smooth interior right atrial wall. Abnormal septation can lead to messed up pulmonary connections
Term
Fibers from which thoracic vertebral levels penetrate the diaphragm and form the Greater Thoracic Splanchnics?
Definition
T5-T9
Term
What structure runs vertically between the esophagus and the vertebral bodies?
Definition
The thoracic duct
Term
What structure runs alongside the thoracic duct, esophagus, and vertebral bodies?
Definition
Azygous vein
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