Resource Settings -PLAB1-PLAB2 NOTES -Online Test Page 1 of 9 • ◦ ◦ ◦ ◦ • +44 0208 9800 039 +44 0794 0433 068 • Reports Manager • PLAB1-PLAB2 NOTES • Administration • Sign Out Resource view Resource name Anatomy Resource description ANATOMY Resource content NPLAB ACADEMY LIMITED BOW BUSSINESS CENTRE BOW ROAD 153-159 EMAIL: [email protected] Contact Numbers: 02089800039 Mobile: 07940433068 EPIDEMIOLOGY AND ANATOMY LECTURE NOTES 2013. BLOOD SUPLY OF THE UPPER LIMB 1. On the right side: Aorta-----brachiocephalic truncus-----subclavian artery ---> Axillary artery ---> Brachial artery---> radial and ulnar artery---> which form the palmer arch------ > digital arteries NB: The brachiocephalis truncus gives branch to common carotid artery and the subclavin artery gives branch to vertebral artery 2. On the left side direct from the aorta branches off common carotid artery and subclavian artery. http://www.samsonplab.co.uk/ot/resources-manager.php?resourceid=85&action=view 17/08/2014 Resource Settings -PLAB1-PLAB2 NOTES -Online Test Page 2 of 9 2. VENOUS SYSTEM A. Deep veins B. Superficial veins DEEP VENOUS BLOOD FLOW Palmer metacarpal --->deep palmer veins---->Radial and ulnar veins-------- Brachial vein------->Axillary vein---subclavian------->brachiocephalic SUPERFICIAL VEINS 1. BASILIC VEIN 2. CEPHALIC VEIN Both of which drain into brachial vein -------> subclavian vein -----(cid:1)brachiocephalic ------Superior vena cava SPECIAL NERVES: 1. FACIAL NERVE Innervates the muscles of expression and anterior 2/3 of taste and oral cavity. Branches: http://www.samsonplab.co.uk/ot/resources-manager.php?resourceid=85&action=view 17/08/2014 Resource Settings -PLAB1-PLAB2 NOTES -Online Test Page 3 of 9 1. Greater petrosal nerve : innervates the nasal glands, palates, lacrimal glands. Supplies the stapedius, chorda tympani ( submandibular gland, sublingual gland and taste of the tongue. 2. Posterior auricular nerve: muscles around the ear 3. Temporal branch of facial nerve: 4. Zygomatic branch of facial nerve 5. Marginal branch of mental nerve 6. of facial nerve 7. Cervical branch of facial nerve 2. TRIGEMINAL NERVE A. OPTHALMIC BRANCH comes out through superior orbital fissure. - Innervates the scalp, forehead, upper eye lid, conjunctiva and Frontal nerve: cornea -Nose (including the tip f the nose) -Frontal sinuses B. MAXILLARY BRANCH-comes out from the skull through foramen rotundum - Infraorbital nerve -Innervetes the cheek, upper lip, upper teeth and gums. -nasal mucosa, palate and roof of the pharynx -the maxillary, ethmoid and sphenoid sinuses and part of the meningitis C. MANDIBULAR BRANCH -Comes out from foramen foramen ovale -Innervetes the lower lip, lower teeth and gums. -chin and jaw(but not the angle of jaw which is supplied by the C2-C3) - Branches: i) supplies the sensation of the anterior 23 of the tongue Lingual nerve -Inferior alveolar nerve supplies http://www.samsonplab.co.uk/ot/resources-manager.php?resourceid=85&action=view 17/08/2014 Resource Settings -PLAB1-PLAB2 NOTES -Online Test Page 4 of 9 ii) Auriculotemporal nerve=is commonly gets injured during the tempomandibular surgery leading to loss of sensation on the auricule and skin surrounding ear iii) Buccal nerve=supplies the mucus membranes of the buccal i. e inside iv) Mental nerve: supplies the chin and lower lip (mucus membrane) it is the branch of inferior alveolar which itself is branch of mandibular branch of trigeminal. Specific nerve damage: 1. T4 is level of nipples 2. T10 is umbilicus 3. C4 over acromioclavicular joint 4. Diaphragmatic nerve usually irritated in peritonitis causing shoulder tip pain. Also known as phrenic nerve. 5. Claw hand is a sign if ulnar nerve damage. Usually the little finger and ring finger are affected 6. Wrist drop is a sign of radial nerve damage. 7. Carpal tunnel syndrome is a sign of median nerve damage and compression is at the level of the wrist. Phalen’s test or tinnel test can be used to make the diagnosis of carpal tunnel syndrome. The nerve is compressed in the carpal tunnel and treatment can be conservative or surgical (by Incision of the flexor retinaculum) 8. Foot drop can be caused by both peroneal nerve and sciatica nerve. 9. Sciatica is a term usually used to describe the lower back pain radiating all the way down the led up to knee or below it. ORTHOPAEDIC ANATOMY Radial nerve(cid:1) innervates All extensors of hand I.e. extension of wrist, fingers, elbows Therefore radial nerve palsy causes wrist drop Ulnar n nerve(cid:1) Innervates all intrinsic hand muscles, except the LOAF which are innervates by the median nerves. Therefore ulnar n palsy if claw hand Median nerve (cid:1) LOAF L- The 2 Lateral lubricals O- Opponens pollicis A- Abductor pollicis brevis F- Flexor pollicis brevis http://www.samsonplab.co.uk/ot/resources-manager.php?resourceid=85&action=view 17/08/2014 Resource Settings -PLAB1-PLAB2 NOTES -Online Test Page 5 of 9 1. Shoulder abduction: • Deltoid • Axillary • C5 1. Elbow flexion: • Biceps • Musculocutaneous • C5, C6 1. Elbow extension: • Triceps • Radial • C7 1. Finger Extension: • Extensor Digitorium superfacialis & profundus • Radial • C7 1. Finger flexion: • Flexer digitorium profundus & superficialis • Median & Ulnar • C8 1. Finger abduction : • First dorsal interosseous • Ulnar • T1 • 1. Thumb abductor: • Abductor Pollicis Brevis • Median • T1 1. Finger Adduction: • Second Palmar interossei • Ulnar • T1 Shoulder Muscles: • Pulling arm backward while the hands is on waist & move elbow backwards on resistance Rumboid muscle Serratus Anterior muscles: • Imagine you are pushing the a car. In this position you are using the serratus anerior muscle http://www.samsonplab.co.uk/ot/resources-manager.php?resourceid=85&action=view 17/08/2014 Resource Settings -PLAB1-PLAB2 NOTES -Online Test Page 6 of 9 1. Supraspintus: • Suprascpular nerve. • Lifting arms sideways between 60 and 120 degrees. 1. Infraspinatus muscle: • With a flexed elbow, move the arm inwards 1. Long flexors of little and finger ring: Flexion of distal IPJ is flexor digitorum Profundus 3 & 4 DIP (cid:1) Profundus PIP (cid:1) Suprficialis 2. Flexor pollicis loungus: • Flexes thumb Hip flexion Hip Extension L1, L2; Iliopsoas S1; Gluteus Muscle ; Sacral plexus ; Inferior gluteal nerve Knee extension L3, L4; Femoral nerve Quadriceps muscle Dorsiflexion foot L5; Tibialis antetrior muscle ;Deep Peropneal Knee Flexion: • Hamstring muscle • Sciatic nerve (foot drop) • L5, S1 • Plantar flexion of the foot: • Grastrocinemeous muscle • Posterior tibialis • S1 Reflexes 1. Supinator(cid:1) Radial nerve , C6 2. Triceps (cid:1) Radial nerve, C7, Biceps – C5 Musculocutaneous nerve 3. Finger (cid:1) Median, Ulnar nerves 4. Knee (cid:1) Femoral, L3, L4 5. Ankle (cid:1) S1, S2 DERMATOME FOR LOWER LIMB: L1 (cid:1) Pocket http://www.samsonplab.co.uk/ot/resources-manager.php?resourceid=85&action=view 17/08/2014 Resource Settings -PLAB1-PLAB2 NOTES -Online Test Page 7 of 9 L2 (cid:1) Inner thigh L3 (cid:1) Knee L4 (cid:1) Medial malleoli L5 (cid:1) Lateral Dorsum of the foot S1 (cid:1) Sole S5 (cid:1) Saddle Upper limb L4 Shoulder L5 arm 6 thumb 7 Middle finger 8 Little finger LYMPH NODES DRAINAGE 1. The cervix lymph drains into the para-aortic lymph nodes 2. Vulva lymph drains into superficial Inguinal lymph nodes ----->then into deep inguinal lymph nodes 3. Lower nodes then into deep inguinal lymph nodes 4. Body of the uterus drains into external ilia lymph nodes 5. Fundus of the uterus drains into para-aortic lymph nodes 6. Ovaries drain into para-aortic lymph nodes 7. Superior half of the rectum drains into pararectal lymph nodes --->then into inferior mesenteric lymph nodes 8. Lower half of the rectum drains into internal iliac and sacral group of LN. 9. Testes drain into paraaortic lymph nodes 10.Superficial Inguinal Lymph nodes drains fro penis, scrotum, perineum, buttock, vulva and abdominal wall below the umbilicus. http://www.samsonplab.co.uk/ot/resources-manager.php?resourceid=85&action=view 17/08/2014 Resource Settings -PLAB1-PLAB2 NOTES -Online Test Page 8 of 9 11.Usually the drain into then into and superficial lymph nodes deep inguinal external iliac then into para-aortic 12.Ovaries drain into para-aortic lymph nodes 13. Prostate drains into into external iliac 14.EXTERNAL ILIAC LYMPH NODES: drains from the glans of the penis, prostate, upper vagina, fundus of the bladder. 15.INTERNAL ILIAC NODES: drains from deeper perineum, urethra, buttock and back of the thigh. 16.PARAAORTIC LYMPH NODES drains from ovaries, testes and superior rectum 17.SUPERFICIAL CERVICAL LYMPH NODES: nodes: lower part of auricular and parotid region. 18.ANTERIOR CERVICAL LYMPH NODES: lower part of the larynx, thyroid gland and upper part of the trachea. LYMPH NODES OF THE FACE SUBMENTAL LYMPH NODES: drains from the floor of the mouth, apex of the tongue and lower lip then goes to deep cervical lymph nodes.. LYMPHATIC VESSELS FO THE TONGUE -Apical of the tongue or tip =submental -Lateral margin of the tongue= submaxilary lymph nodes -basal of the tongue =superior deep cervical LN SUBMAXILARY OR SUBMANDIBULAR LYMPH NODES= nasal cavity and gums, cheek, upper lip, lateral part of the lip, medial palpabrae commissure, lateral part of the lower lip. SUBMENTAL LYMP NODES: lower lip and floor of the mouth and apex of the tongue. BREAST: mainly drain into axillary lymph nodes http://www.samsonplab.co.uk/ot/resources-manager.php?resourceid=85&action=view 17/08/2014 Resource Settings -PLAB1-PLAB2 NOTES -Online Test Page 9 of 9 TERMINOLOGIES IN EPIDEMIOLOGY 1. INCIDENCE: Is the number of new cases divided by the total population per year who are at risk of becoming a case 2. Prevalence: The proportion of people in a given population at a given point/time who had a disease 3. Mode: is the value that occurs most frequent 4. Median : is the middle value when the values are ranked. 5. Sensitivity: Is the proportion of true positives correctly identified by a test. 6. Specificity: Is the proportion of the true negatives correctly identified by the tests. Resource start date 2014-05-13 09:44 Resource end date 2024-05-13 09:44 Back Copyright © 2013 SamsonPLAB:All Rights Reserved Web Design Company Flick Media Ltd http://www.samsonplab.co.uk/ot/resources-manager.php?resourceid=85&action=view 17/08/2014 Resource Settings -PLAB1-PLAB2 NOTES -Online Test Page 1 of 12 • ◦ ◦ ◦ ◦ • +44 0208 9800 039 +44 0794 0433 068 • Reports Manager • PLAB1-PLAB2 NOTES • Administration • Sign Out Resource view Resource name Cardiology PLAB 1 Notes Resource description Cardiology Resource content SAMSONPLAB ACADEMY BOW BUSINESS CENTRE BOW ROAD 153-159 E3 2SE, London EMAIL: [email protected] Tel: +447940433068 Cardiology lecture notes Chest Pain: 1. MI (ST elevation-STEMI) 2. Stable Angina 3. Pneumonia 4. PE 5. Pneumothorax 6. Aortic dissection 7. GERD 8. Musculoskeletal pain 9. Pericarditis 10. Acute coronary syndrome 11. Unstable Angina Acute coronary syndrome (ACS) consists of: - • STEMI • NSTEMI • Unstable Angina Unstable angina is angina which is occurs at rest or it has increased in frequency or duration or it is occurring with less effort than it used to happen before. It is therefore difficult to differentiate from Myocardial infarction. NSTEMI stands for Non ST elevation myocardial infarction. This simply means that one can have myocardial infarction without ST segment elevation on an ECG i.e. normal ECG or ST depression. It is therefore difficult to differentiate from unstable angina. http://www.samsonplab.co.uk/ot/resources-manager.php?resourceid=33&action=view 17/08/2014