Tuesday
What are the type of spontaneous abortions can a heart beat never be heard?
1. Incomplete
2. Complete
3. Missed
What side does the patient lay on for HVLA of the lumbar
The side the are rotated is on the table
What are the names of the cranial nerves that originate from the ventral surface of the pons
CN V, CN VI, CN VII, CN VIII
The vestibular apparatus is comprised of these three components
1. Semicircular canals
2. Utricle
3. Saccule
In pokemon the movie 3 a little girl mistakes the pokemon Entei as her ____.
Father
Where is the most common site for implantation for an ectopic pregnancy?
Ampulla
An ectopic pregnancy is the implantation of the blastocyst anywhere other than the endometrial lining of thee uterine cavity.
A 40-year-old female presents to the clinic with back pain for the past week. Physical exam shows no sensory deficits, 5/5 muscle strength, and +2 reflexes in both upper extremities. Osteopathic structural exam shows hypertonic paraspinal lumbar muscles, a hypertonic right quadratus lumborum, and an exhalation dysfunction of rib 12 on the right. At the L3 transverse processes, the right thumb is more posterior compared to the left and this asymmetry worsens in extension. Which of the following accurately describes the somatic dysfunction this patient has?
L3 flexed, rotated right, sidebent right
**Can you name the parts of it?
Cerebral peduncles
Superior cerebellar peduncle - mainly output/efferent pathway
-Input → ventral spinocerebellar tract; Output → contralateral cerebral cortex via thalamus (decussates at level of inferior colliculi - midbrain) and to olivary nuclei via red nucleus
Middle cerebellar peduncle
-Input → motor cortex via pontine nucleus; Output → NONE
Inferior cerebellar peduncle - mainly input/afferent pathway
-Input → vestibular nuclei, vestibular fibers of CN VIII, dorsal spinocerebellar fibers, olivocerebellar fibers; Output → vestibular nuclei
Describe how hair cells sense rotation
endolymph moves within the semicircular canals causing movement of the cupula along hair cells → mechanically-gated channels open → depolarization → signal transmission
In pokemon the movie 4 what was the sci fi trope used multiple times including to get away from a bandit?
Time travel
What is the dilated or closed status of all spontaneous abortions?
Threatened: Closed
Inevitable: Dilated
Missed: Closed
Incomplete: Dilated
Complete: Closed
1. Slump sign
2. Seated Kemp's Test
3. Standing Kemp's Test
4. Femoral Nerve Stretch
What are the 3 functional areas of the cerebellum?
** Bonus if you can name wat they are composed of
1)Cerebrocerebellum → largest division, formed by the lateral hemispheres → involved in planning motor movements and motor learning
2)Spinocerebellum → vermis + intermediate zones → involved in regulating body movements by allowing for error correction and receives proprioceptive information
3)Vestibulocerebellum → flocculonodular lobe → involved in controlling balance and ocular reflexes
A 58-year-old man who is a chronic-alcoholic presents with unsteady gait and frequent falls. Neurological examination shows a wide-based gait and difficulty with heel-to-shin testing bilaterally. MRI reveals atrophy of the midline cerebellar structure. Which part of the cerebellum is most likely affected?
The Vermis - chronic alcoholism preferentially causes degeneration of vermis
Pokemon the movie 5 takes place in this European city?
Venice, Italy
What are the 4 major types of structural abnormal uterine bleeding?
Polyps
Adenomyosis (endometrium in the myometrium)
Leiomyomas (fibroids- smooth muscle tumor)
Malignancy
What is the difference in positive findings for the Kemp Test
Pain with early motion = discogenic / radicular origin
Pain with late motion = neuroforaminal / facet / boney spur origin
What are the 3 cerebellar zones and 3 anatomical lobes of the cerebellum?
** Bonus if you can name the fissures
3 anatomical lobes → anterior, posterior and flocculonodular lobes → divided by 2 main fissures
Primary fissure → divides anterior and posterior lobes
Posterolateral fissure → divides posterior and flocculonodular lobe
3 cerebellar zones - vermis, intermediate zone, and lateral hemispheres
Vermis → midline region of cerebellum
Intermediate zones/paravermis → on both sides of the vermis
Lateral hemispheres → on the lateral side of each intermediate zone
A 45-year-old man presents with difficulty coordinating movements of his right arm. He cannot perform RAMs and finger-to-nose testing reveals past-pointing on the right. Where is the lesion?
Right cerebellar hemisphere - cerebellar lesions produce ipsilateral deficits (right cerebellar hemisphere controls coordination of right extremity)
James Team Rocket
What are the genetics, hCG levels, carcinoma risk, fetal parts, imagining description, and uterus size of a complete mole?
genetics: 46XX
hCG: highly evelvated
Carcinoma: high risk
Imaging: snowstorm
Uterus size: larger
What do the different timings of pain during the slump test tell you?
1. if pain during the patient putting their head forward it is a cervical spine pathology
2. if pain during slumping of shoulders it is thoracic spine pathology
3. Later pain with leg extension is lumbar pathology
The granule layer receives input from what fiber types? and what are the names of the nuclei they carry signal from?
Mossy Fiber
Relays information from reticular nuclei and pontine nuclei which relays information to the rest of the cerebellum via parallel fibers
Which signals are responsible for the primary output from the cerebellar cortex?
A.Excitatory signals from Purkinje cells
B.Inhibitory signals from granule cells
C.Inhibitory signals from Purkinje cells
D.Excitatory signals from climbing fibers
E.Excitatory signals from mossy fibers
Inhibitory signals from Purkinje cells - via GABA
Who said this quote, "I see now that the circumstances of ones birth are irrelevant it is what you do with the gift of life that determines who you are."
Mewtwo