Файл: Kaplan USMLE-1 (2013) - Anatomy.pdf

USMLE Step 1 • Anatomy

femoral triangle and, 306f, 308 hip and, 307, 307f

knee joint and, 308-310, 308f lumbosacral plexus in, 301, 30lf muscle innervation of, 303 nerve injuries in, 304-305 radiological images of, 3llf sensory innervation of, 305

Lower motoncurons (LMNs), 36lf, 362, 364f lesions of, 367, 368f

in ventral horn, 359, 36lf

Lower respiratory system, embryology of, 186, 187f Lumbar puncture, 179, l79f

Lumbosacral plexus, 301, 30lf terminal nerves of, 302

Lung(s), 77 cancersof,77

lobes and fissures of, 193, l 93f

lymphatic drainage of, 194-195, 194f, 195f pulmonary defense mechanisms and, 79 surfaces and regions of, 192, 192f

Lymph

circulation of, 69 described, 65 transport of, 65

Lymph nodes, 68-69, 68f cortex of, 70f medulla of, 70f

Lymphatic drainage, 65 ofbreast, 185, 186f

of lungs, 194-195, 194f, 195f

Lymphatic system general, l95f

right lymphatic duct, 194, 195f thoracic duct, 194, l95f

Lymphocyte, 67 Lysosomes, 10, l lf

M

M cells, ilea!, 69

M line, skeletal muscle, 49 during contraction, 49

Macrophages, 28, 28f alveolar, 85

immune system and, 66, 67 tissue-specific, 28

Macula adherens, 16, 18f Male reproductive system, 125f

accessory glands in, 132-133 external genitalia in, 274 genital ducts in, 130-132 penis in, 135-136 physiology of, 136, 274 testis in, 125

Mannose, phosphorylation of, 10 Marcus Gunn pupil, 440 Marfan syndrome, 32

Mast cells

lg-sensitized, degranulation of, 29

immune system and, 66

Mastectomy, radical, 185

Medial lemniscus (ML), 390 Mediallongitudinal fasciculus, 390

Medial medullary syndrome, 411, 412f Medial midbrain (Weber) syndrome, 416 Medial pontine syndrome, 415

Median nerve lesion, 290

carpaltunnel syndrome and, 295 effects of, 292

Mediastinum anterior, 206f, 208

coarctation ofaorta in, 210-211, 210f features and divisions of, 206, 206f middle, 206f, 208, 210-21 1 posterior, 206f, 207

structure of, 208f superior, 206f, 208

Medulla, in brainstem, 380f, 391 lesions of, 412f

Medulloblastoma, 348

Meiosis, in testes and ovary, 157, 158f Membranous ventricular septa] defect (VSD), 202 Meniere disease, 404

Meninges, spinal, 176, l76f Meningioma, 348 Menisci, knee joint, 309 Menk.es disease, 30f Mesangial cells, 121 Mesenteric artery

inferior, 258, 259f superior, 257, 258f

Mesoderm, 186 Mesonephros, 263, 263f

Metachromatic leukodystrophy (MLD), 334

Metanephros, 263-264, 263f, 264f

Metastatic tumors ofbrain, 348 bronchial, 81

Microfilaments, 14, 57 Microglia, 28, 59

and CNS disorders, 60-61 Microtubules, 14

and neuronal degenerative disease, 57, 58 Microvilli, 17, 18f

Midbrain, 385f, 393

cranial nerve nuclei in, 393-394, 394f, 397f lesions of,416

Middle cerebral artery, 459, 459f occlusion of, 459

Middle ear, 399, 399f diseases of, 399

Middle mediastinum, 206f, 207, 210-211 Middle meningeal artery, 314f

Middle suprarenal arteries, 259 Midgut

development and rotation of, 244 malrotation of, 249

Mitochondria matrixof, 13

membranes of, 12, 13f Mitochondrial diseases, 12 Molar pregnancies, 166 Monocyte, 66

Motilin, 94

Motility, small intestinal, 97

Motoneurons, 36lf, 362, 364f

lesions of, upper vs.lower, 367, 368f, 396 in midbrain, innervation of, 393 muscle tone/reflex activity and, 365

in ventral horn, 359, 36lf Motor homunculus, 457f Motor system, 362, 390

Mucosa, gastrointestinal, 87-88, 87f

Mucosa-associated lymphoid tissue of the gut. See Gut associated lymphatic tissue (GALT )

Mucous cells, bronchial, 8 1 Mucous secreting cells, gastric, 91 Mucus

gastric secretion of, 91 ineffective clearance of, 79

Multicellular glands, 23, 23f Multiple sclerosis (MS), 61, 334 Muscle(s)

of anterior abdominal wall, 233, 235f cardiac, 51-52, 52f-53f characteristics of, 49

lower limb, innervation of, 303 orbital, innervation of, 327, 328f posterior abdominal wall, 267 skeletal, 45-51

smooth, 53-54, 53f

upper limb, innervation of, 286-288 Muscle stretch (myotatic) reflex, 365, 366f Muscle-nerve lesions

brachial plexus, 289-292 upper limb, 288-292

Muscularis externa, gastrointestinal, 87f, 88 Muscularis mucosa, gastrointestinal, 88 Musculocutaneous nerve damage, effects of, 291 Musculocutaneous nerve lesion, 291

effects of, 292 Myelination, disorders of, 334 Myofibroblasts, 28 Myometrium, 144, 145f Myosin thick filaments, 49, 50

N

Nails, 151

Narrow-angle glaucoma, 438 Natural killer (NK) cells, 67 Nebulin, 50

Neck, 313, 313f arteries of, 3 14f

embryology of, 315-322 Negri bodies, 57

Neocortical layers, 458, 458f Neonate, postnatal circulation in, 197 Nephrin, 120

Nephron, 1 17, 1 19f, 122f

Nervous system. See also Autonomic nervous system (ANS); Central nervous system (CNS); Peripheral nervous system (PNS)

cell types of, 33f, 345

congenital malformations of, 337 development of, 335, 335f

Neural crest cells, 333

Neural systems, 362. Seealso Motor system; Sensory systems Neurocrines, gastrointestinal, 94

Neurofibrillary tangles, 58 Neurofilaments, 57

Index

Neuronal degenerative disease, 58 Neurons, 55, 345

chromatolysis of, 346f cytoskeleton of, 57-59, 58f with severed axon, 63 spinal cord, 357, 359f, 360 structure of, 56f-57f

Neuropathies, axonal transport and, 59 Neurotransmitters, autonomic and somatic, 339, 339f Neutrophil, 66

Node of Ranvier, 56f, 60 Nuclear envelope, 3 Nuclear lamina, 3 Nucleolus, zones of, 4

Nucleus ambiguus, of cranial nerves, 391 Nucleus/nuclei, 3-4, 3f

cranial nerve, 393 Nystagmus, 404, 405, 426

tests for, 405

0

Obturator nerve injury, 304 Occipital lobe, cerebral cortex, 467 Oculomotor nerve (CN III), 385f, 393 Olfactory system, 475

deficits in, 476 Oligodendrocytes, 60 Oligodendroglia, 348 Omphalocele, 249 Oogenesis, 159

Open pneumothorax, 190 Open-angle glaucoma, 438 Optic chiasm, 441, 44lf Optic nerve, 437-438 Oral cavity, 90

Orbital muscles innervation of, 327, 328f

radiological image of, 328f Ossification centers, 40 Osteoblasts, 28, 37, 37f Osteoclastogenesis, 38 Osteoclasts, 28, 38, 38f Osteocytes, 38f

in canaliculi, 37 Osteogenesis imperfecta, 30f Osteoid, 37

Osteons, 41, 42f

Osteoporosis, 38 Osteoprogenitor cells, 37, 37f Ovarian follicles, 142, l42f

atresia of, 142

folliculogenesis and, 140f-142f Ovary, 139

development of, 156, 156f meiosis in, 157, 158f

Oviducts, 143-144, 144f Ovulation, 142f, 143

corpus luteum and, 143 Ovum

fertilization of, 161, 16lf implantation of, 162

Oxyntic cells, gastric, 93f secretion from, 91, 92

USM LE Step 1 • Anatomy

p

Pain referral, 222-223, 223f Palate, development of, 319, 319f Pancoast tumor, 192

Pancreas, 106--108, 252, 252f development of,243[, 247, 248f secretions from, 107

Paneth cells, 99

Papezcircuit, 477, 477f Paracrines, 94 Parathyroid, ectopic, 320 Parietal cells,gastric, 93f

secretion from, 91, 92 Parietal lobe, cerebral cortex, 465 Parinaud syndrome, 416, 418 Parkinson disease, 433

Parotid glands, 106

Patent ductus arteriosus, 203, 203f Patent urachus, 266

Pectinate line, features above and below, 255 Pelvic diaphragm, 268, 269f

Pelvic kidney, 266 Pelvic viscera

in female, 27lf in male, 270, 270f

Pelvis

innervation of, 276

radiological images of, 278f-282f Pemphigus, 149

Pemphigus vulgaris, 1 6 Penile erection, 135, 274

Penis, 135, 135f abnormalities of,277 physiology of, 136

Pepsinogen, 91

Peptic cells, secretion from, 92 Periaqueductal gray, 418

Periarterial lymphoid sheath (PALS), 72, 72f Pericardia] cavity, 211, 212f Pericardiocentesis, 210

Pericardium, 210-2 1 1, 211f Perichondrium, 35

Perilymph distribution, in inner ear, 399, 400f Perimysium, skeletal muscle, 45, 49 Perineum, 272-276

in female, 273f innervation of, 276 in male, 274f pouches of, 273, 274f

Peripheral nervous system (PNS), 333 axonal responses in,346, 346f glial and supporting cells in, 59-60

neurotransmitters/receptors in, 339, 339f spinal nerves and, 177, 1 78f

tumors of, 348 Peristalsis

large intestinal, 102 small intestinal, 98 Peritoneal cavity, 245

Peritoneal sacs, 247f Peritoneum, 234

abdominal organs and, 245 layers of, 244, 244f membranes of, 246f

Permanent guest cells, 28-29, 28f Peroxisomes, 1 1, 12f

Persistent ductus arteriosus, 205, 205f Peyer's patches, 69, 101, lOlf

Pharyngeal apparatus, development of, 3 15, 315f arches, 316

grooves (clefts), 317 pouches, 317, 317f

Pharyngeal cyst, 320 Pharyngeal fistula, 320 Phosphorylation

ofmannose, 10

ofnuclear lamina, 3 Photoreceptor rods, 441 , 44lf Phrenic nerves, 209

Pia mater, spinal meninges and, I76, l76f Pineal body, 453

Pineal tumors,453 Piriformis syndrome, 304

Pituitary gland, cavernous sinuses and, 325f Plasma cell, 67

Pleura, 189 innervation of, 190

parietal, 189, l90f parietal layer, 191

visceral layer, 189, 191 Pleural cavity, 190, 19lf Pleural recesses, 191, 19 If Pleural reflections, 191, l9lf Pleurisy, 189, 191

Pleuroperitoneal membranes, 223 Pneumocytes, 83, 83[, 84f Pneumothorax, 190

Podocytes, 1 19-120, 1 19f

Poliomyelitis, 378[, 379

Polyhydramnios, 248 Polysomes, 5

Pons, 386f, 392 lesions of, 4l5f

Pontocerebellar angle syndrome, 415 Pores ofKohn, 84

Portal hypertension, 109 Portallobule, 109, 1 09f Portal system, 260, 26lf

Portal-caval (systemic) anastomoses, 262, 262f Posterior abdominal wall, 263-268

bony landmarks of, 267f muscles of, 267f

Posterior cerebral artery (PCA), 459f occlusion of,459

Posterior cruciate ligament (PCL), 309f, 319f Posterior mediastinum, 207, 208f

Posterior parietal association cortex, 465 lesions of, 465

Postnatal circulation, 199 shunts, 201

Precocious puberty, 453 Prefrontal cortical lesions, 464 Pregnancy

corpus luteum in, 7f ectopic, 144, 162 molar, 166

Premotor cortex, 463

Presbycusis, 399

Primary auditory cortex, 469 Primary somatosensory cortex, 465

Progressive multifocal leukoencephalopathy (PML), 334 Prolapse, uterine, 272

Proliferating zone, in bone formation, 40, 40f, 41 Pronephros, 263, 263f

Prostate gland, 133, 133f diseases of, 134 hypertrophic, 270 Prostatic carcinoma, 134

Prostatitis, 134 Proteins

in chromatin complex, 4 fibrillar, 29. See also Collagen Golgi apparatus and, 9

Proteoglycans, 32-33

Proximal convoluted tubule (PCT), 121 Pseudointersexuality

female, 276 male, 277

Pseudostratified columnar epithelium, 21, 21f Psoriasis, 149

Pudenda!nerve block, 272 Pulmonary defense mechanisms, 79 Pulmonaryhypoplasia, causes of, 187f

Pulmonaryneuroendocrine (PNE) cells bronchial, 79

tracheal epithelial, 79 Pupillary abnormalities, 440 Pupillary light reflex, 438, 439 Pylorus, 89

R

Radial glia, 59

Radial mastectomy, 185 Radial nerve lesion, 290 effects of, 292

Raphe nuclei, 418 Receptive aphasia, 466

Receptors, autonomic and somatic, 339, 339f Rectalincontinence, 268

Red pulp, splenic, 70, 71, 71f Reflexes

commonly tested, 365 visual, 438-440

Regeneration organ, 33

skeletal muscle, 50 Relative afferent pupil, 440 Remodeling, bone, 41-42 Renal agenesis, 266

Renal arteries, 259

Renal calculi, blockage by, 267 Renal corpuscle, 1 19-120, 119f

and juxtaglomerular complex, 122, 122f Reproductive system

congenital anomalies of, 276-277 embryology of, 276-277

female, 139 male, 125

Reserve zone, in bone growth, 40, 40f Respiratory distress syndrome, 189

Index

Respiratory pathway, 78, 78f Respiratory system

alveolus in, 83-85, 83f, 84f bronchi in, 81, 8lf bronchioles in, 81-82, 82f defense mechanisms in, 77 histologic features of, 78

lower, embryology of, 186, 187f lung in, 78

pathway in, 78f trachea in, 77-79, 79f

Reticular fibers, 32 Reticular formation, 418 Reticular lamina, 15 Retina, 441, 441f Retinoblastoma, 348

Retrograde axonal transport, 59, 345 Retroperitoneal organs, 245 Rheumatoid arthritis, 35 Ribosomes, 4-5

Rickets, 40 Rinne test, 402

Robin sequence, 320 Romberg sign, 371 Rotator cuff, 296, 296f

Rough endoplasmic reticulum (RER), 6, 6f hepatocyte function and, 109

s

Sacrococcygeal teratoma, 166 Sagittal sinuses, 353, 353/ Saliva, physiology of, 104 Salivary glands, 103-105, 106/ Santorini, accessory duct of, 108 Sarcornere structure, 46, 46f Sarcoplasrnic reticulum, 51, 51/

Scalene triangle, of neck, 313, 313f Scanning dysarthria, 426 Schwann cells, 60, 60f, 61f, 333 Schwannoma, 334, 348

Sciatic nerve injury, 304 Scrotum, cancer of, 236 Scurvy, 30/

Sebaceous glands, 151

Secondary brain vesicles, adult derivatives of, 336, 336/ Secretin, 94

Secretorycells, bronchiolar, 81-82 Selectin, 15

Semilunar valves, 216f, 217 Seminal vessels, 132, 133/ Serniniferous tubule, 125, 126[ Sensory homunculus, 457/ Sensory innervation

of lower limb, 305

of upper limb, 287, 288/ Sensory systems, 391

ascending pathways in, 369. See also Anterolateral (spinothalarnic) system; Dorsal column-medial lemniscal system

general pathways in, 369, 369/ Serosa

gastrointestinal, 87f, 88 small intestinal, l00 thoracic, 189

MEDICAL 491

USMLE Step :t • Anatomy

Sertoli cells,

Shoulder, radiological view of, 297f Shunts

in cyanotic congenital heart abnormalities, 204-20S in fetal circulation, 197, 198f

in non-cyanotic congenital heart abnormalities, 20lf, 202 postnatal, 201

Sinusoids, hepatic, 109 Skeletal muscle, 4S-SO characteristics of, 49 connective tissue in,

contractions of, 46, SO crossbridge cycle in, 47f innervation of, 362, 363, 363[ red vs.white fibers in, 48, 48f regenerative ability of, SO

sarcomere structure in, 46, 46f, 48f sarcoplasmicreticulum in, Sl, Slf T-tubulesystemin,

Skin, 149-1S2, lSOf

Skull, foramina of, 32lf-322f Small intestine, 97, 97f

cells in, 99-100

histologic characteristics of, 89 motility in, 97

Smooth endoplasmic reticulum (SER), 6-7, 6f hepatocyte function and, 109

Smooth muscle, 49, S3-54, S3f Solitarynucleus, ofcranial nerves, 391 Solitary olivary nucleus, 388

Space(s)

cranialmeningesand, 323 ofDisse, 1 09

perinea! pouches, 273, 274f subarachnoid. See Subarachnoid space

Spastic bladder, 268

Spastic paresis, 367

Spermatic cord, fascia! layers of, 236 Spermatogenesis, 1S9 Spermatozoan, 127, 1 28f Sphincter of Oddi, 108

Spina bifida, 337 Spinal cord, 357, 3S9f

cross section, 458f lesions of, 377-379, 377[ levels of, 376f

neural components/systems in, Sensory systems

neurons in, 359, 3S9f, 360, 364f See also Motoneurons Spinal cord hernisection, 417[

Spinal meninges, 176, l 76f Spinal nerves, 178, l 78f Spine

autonomicnervous system divisions, meninges, 176, l76f

nervesof, 178, l78f vertebral canal in, 176, l 76f vertebral column, 171, 172f

Spinocerebellar tracts, 373, 374f lesions of, 374

Spinothalarnic tract. SeeAnterolateral (spinothalamic) system Spiral ganglion, 399f, 400

492 MEDICAL

Spleen, 70-72, 7lf, 2S3 development of, 243f, 248

Splenic artery, 256, 2S7f Splenic flexure, 2S9 Spongy bone, 37, 39 Squamous epithelium

simple, 20, 2 lf stratified, 22, 22f

Stem cells

in bone growth, 40, 40f, 41 in gastrointestinal system, 94 small intestinal, 99

Stensen's ducts, 106 Stomach, 2S3

cell types in, 90-93

histologic characteristicsof, 89 secretions of, 9 1

structure of, 90-91

Stone formation, in gallbladder or bile ducts, 1 12 Stratified epithelium

cuboidal, 22, 23f squamous, 22, 22f

Subacute combined degeneration, 379, 379f, 380 Subarachnoid hemorrhage, 327f Subarachnoid space, 177

lumbar puncture and, Subclavian artery, 314f Subdural hematoma, 326, 327[ Sublingual glands, 106 Submandibular glands, 106, l06f

Submucosa, gastrointestinal, 87f, 88, 90f Subthalamus, 449

Superficial fascia, ofanterior abdominal wall, 234 Superior mediastinum, 208, 208f

Superior mesenteric artery (SMA), Supporting cells

in central and peripheral nervous systems, 59-60 in connective tissue, 27-28

Suprascapularnerve lesion, 291 Supraspinatus muscle injury, 297 Surfactant, 83, 84f

Sweat glands, 1 55 Sympathetic nervous system, Synovialjoints, 3S, 36f Syringomyelia, 379, 379f, 380

T

T lymphocytes, 67

Tabes dorsalis, 378, 378f, 380 Tanycytes, 6 1

Tau protein, S8

Temporal lobe, cerebral cortex, Tension pneumothorax, 190 Teratoma, sacrococcygeal, 166 Terminal bronchiole, 82

Testicular feminization syndrome, 277

Testis(es), 1 2S-129, 126f, 128f abnormalities of, 277 descent of, 237, 238f

1S6, 1S6f interstitial tissues of, 129, 130f meiosis in, 1S7, IS8f