Week 4

Question 1

Origin of axillary artery

Answer 1

-subclavian artery

Question 2

How is axillary artery divided

Answer 2

• 3 parts; by pec minor

- before 1st, behind 2nd, 3rd after

Question 3

Major branches from each part of the artery

Answer 3

• Major arteries of the 1st part = superior thoracic
• 2nd part = thoracoacromial artery and lateral thoracic
• 3rd = posterior circumflex, anterior circumflex, and subscapular

Question 4

Which veins terminate into axillary vein

Answer 4

• basilic and cephalic

Question 5

Alpha granule

Answer 5

• in platelet; contains fibrinogen, PDGF, TGF alpha and beta

Question 6

dense core granules

Answer 6

-contains CA, serotonin, and ADP

Question 7

What is open canalicular system

Answer 7

aids in rapid degranulation

Question 8

Granulomere

Answer 8

central portion containing granules and lysosomes

Question 9

primary aggregation

Answer 9

platelet plug, part of clotting steps

Question 10

thrombocytopenia

Answer 10

less than 150000 platelets

Question 11

megakaryocyte

Answer 11

precursor cells of platelets with a multi-lobed nucleus

Question 12

what are pro-platelets

Answer 12

cytoplasmic projections from megakaryocytes

Question 13

what are demarcation zones

Answer 13

invagination of the cell membrane of megakaryocyte

Question 14

what is endomitosis

Answer 14

serial nuclear division without cell division

Question 15

what is thrombopoietin

Answer 15

growth factor that is essential for development of megakaryocytes

Question 16

compartments of the arm

Answer 16

• divided by humerus and intermuscular septum
• anterior: flexors
• posterior: extensors

Question 17

how are the forearm and hand supplied with arterial blood?

Answer 17

• deep palmar arch
• superficial palmar arch
• digital arteries

Question 18

Elbow anastamosis

Answer 18

• permits blood flow around elbow during flexion

- contributing arteries: brachial, deep brachial, ulnar, radial

Question 19

Damage of Musculocutaneous nerve

Answer 19

• Sensory loss of numb lateral forearm
• Weakness in elbow flexion
• Weakness in forearm supination
• Absent biceps reflex

Question 20

Injury to radial nerve

Answer 20

• Loss/Weakness of posterior compartment muscles - no extension of wrist
• Results in wrist drop/Saturday night palsy

Question 21

cubital fossa boundaries

Answer 21

-cephalic vein, basilic vein, median cubital vein

Question 22

clinical significance of the median cubital vein

Answer 22

○ Presumed to protect the neuromuscular bundle in the cubital fossa such as the median nerve and the brachial artery, which pass deep to it

Question 23

How do you test the median nerve?

Answer 23

Thumb (c6) and index finger (C7)

Question 24

How do you test the ulnar nerve

Answer 24

median side of elbow

Question 25

4 main vessels of the cubital fossa

Answer 25

1. Radial nerve:Passes underneath the brachioradialis muscle and divides into its deep and superficial branches 2. Biceps Tendon: Attaching to the radial tuberosity, distal to the neck of the radius 3. Brachial artery: Bifurcates into the radial and ulnar arteries at the apex of the cubital fossa 4. Median Nerve: Leaves the cubital between the two heads of the pronation teres

Question 26

Spontaneous intracranial bleeding

Answer 26

when Platelet count is less than 10,000 cells/mL

Question 27

Low platelet count can cause

Answer 27

○ Petechiae = spotted/pinpoint superficial skin bleed ○ Anterior epistaxis = mild nosebleed ○ Immediate bleeding after surgery -Bleeding from mucocutaneous surfaces

Question 28

Psuedothrombocytopenia

Answer 28

○ When blood collected from patient is added to an anti-coagulant EDTA to prevent clotting but EDTA can cause platelets to clump together which the machine will read as one platelet thus giving the false impression of low platelet count

Question 29

Bleeding time - what is it? - when will it be abnormal? - 9 minutes in...

Answer 29

- indirect measure of platelet number and more direct measure of platelet function, vascular integrity, and platelet interaction with vascular sub-endothelium - should be abnormal in patients with thrombocytopenia, platelet function abnormalities, abnormal collagen (Ehlers-Danilo’s Syndrome) and von Willibrand disease - for children has been shown to be less than 9 minutes and in prolonged cases where the platelet count is less than 100,000/mm or when disorders of platelet adhesion or aggregation are present

Question 30

Platelet function analysis

Answer 30

- modern substitute for bleeding time | - closure time is recorded

Question 31

Platelet aggregation studies

Answer 31

- • With Platelet rich blood, light transmission is poor, and therefore when the platelets begin to become activated and begin to clump together, they take up less space in the solution and allow for more light transmission;

Question 32

PT, PTT, and thrombin time in different conditions: - hemophilia A - VWD - liver disease - patient on heaprin

Answer 32

- Hemophilia A: bleeding time and PT normal, PTT is significantly prolonged - VWD: prolonged bleeding time, PTT mildly prolonged, PT normal - liver disease: prolonged PT and PTT and thrombin time - hapin will increase thrombin time, PTT, and PT