A
Do herniated discs usually occur anteriorally or posteriorally?
The herniation of the nucleus pulposus commonly occurs posterolaterally to the side of the posterior longitudinal ligament into the vertebral canal or an IV foramen.
What are the two most common surgical approaches to enter the anterior thoracic wall?
Anterior and lateral
What is the locational difference between direct and indirect hernias?
Direct- medial to inferior epigastric vessels, Hesselbach's triangle
Indirect- lateral to inferior epigastric vessels, passes through deep inguinal ring
Which bronchus is an aspirated object more likely to eneter?
The right- it's wider and more vertically oriented than the left main bronchus.
What remnant comes from the embryonic fossa ovalis?
Foramen Ovale
What are the Triangles of the Back?
Gaps in muscle tissue that are well suited for auscultation
What treatments are available for myocardial infarctions?
Restricted blood flow to the heart tissue leading to necrosis is known as a heart attack. The insertion of stents or use of coronary bypass grafts is used to restore blood flow to the affected area.
Where does the anastamosis of the superior and inferior epigastric vessels take place?
If the IVC becomes obstructed, the anastimosis of the SEV and IEV becomes a venous channel that drains into the IVC.
If the aorta is occluded, arterial circulation to the lower part of the body occurs through the superior and inferior epigastric arteries.
Where does pain indicating appendicitis start?
Pain starts at the umbilicus and moves to the RLQ, to McBurney's point.
Damage to this nerve can lead to hoarseness
Left Recurrent Laryngeal Nerve
Name the three types of excessive vertebral curvature
Kypohosis (exaggeration of thoracic curvature)
Lordosis (exaggeration of lumbar curvature)
Scoliosis (abnormal amount of lateral curvature)
What determines heart dominance?
Whichever coronary artery supplies the posterior interventricular artery dictates heart dominance. Right dominance is more common.
Where does the cystic artery normally lie in relation to the common hepatic duct?
Normally, the cystic artery arises from the right hepatic artery and runs posterior to the CHD. In about 25% of the population, the cystic artery instead passes anterior to the CHD.
What are the three common places for kidney stones to become lodged?
1. Uteropelvic junciton
2. Where the ureter crosses the pelvic brim
3. Entrance of the ureter to the urinary bladder
What is a common site for the development of breast cancer?
The superolateral (upper outer) quadrant contains a large amount of grandular tissue and is a common site for breast cancers to develop.
Where do lumbar punctures take place and why?
Between L3/L4 or L4/L5 because the dural sac has not ended, providing access to CSF, while protecting the spinal cord, as it ends with the conus medullaris at the L1/L2 IV disc and the cauda equina is at L2
What can go wrong in the potential space of the pleural cavity in the lungs?
Pneumothorax (lung collapse)
Pleural Effusion (excess serous fluid)
Hemothorax (blood accumulation)
What causes portal hypertension and what are its effects?
When the HPV becomes blocked, blood pressure increases in the hepatic portal system, which causes gastroesophogeal varices and enlargement of gastric and esophogeal veins, which may lead to internal bleeding if ruptured.
Which side is testicular varicocele more common on?
The left. TV occurs when the pampiniform plexus of veins becomes engorged with blood due to restriction of venous return from the testis. It's more common on the left because the left testicular vein drains into the left renal vein, which is subject to compression where it passes posterior to the SMA.
Where is a donor kidney usually transplanted to?
In the iliac fossa so that the damaged kidney is left in place to reduce harm to the suprarenal glands.
What is the Vertebral Venous Plexus?
Valveless veins along the spinal cord- because of the lack of valves, the VVP drains based on pressure gradients and can serve as routes for the spread of infection or metastasis of cancer
What clinical correlations are associated with the pericardium?
Pericardial Effusion (fluid accumulation in pericardial cavity)
Hemopericardium (bleeding into pericardial cavity)
Cardiac Tamponade (fluid collection in the pericardial cavity will compress the heart since the fibrous connective tissue cannot stretch)
What is caput medusae?
The superficial epigastric vein anastomoses with the lateral thoracic vein in the superficial fascia of the abdomen creating an important collateral venous channel from the femoral vein to the axillary vein.
In pts who have obstruction of the IVC or HPV, the superficial veins become engorged to accommodate increased venous return, and may be visible around the umbilicus.
What is Superior Mesenteric Artery Syndrome?
The third part of the duodenum can become compressed between the SM vessels and the abdominal aorta leading to SMAS, a gastrovascular disorder. Blockage of the duodenum results in blockage of the digestive tract.
What is Nutcracker Syndrome?
When the SMA compresses the left renal vein against the abdominal aorta, resulting in insufficient venous drainage of the left kidney, left adrenal gland, and left gonad.