Passing the USMLE: Basic Science

280 Pages·2009·5.954 MB·English

by  Ahmad Wagih Abdel-Halim (auth.)

Passing the USMLE: Basic Science
Passing the USMLE
Basic Science
Ahmad Wagih Abdel-Halim, MD
1 3
AhmadWagihAbdel-Halim,M.D.
Academichospitalist,McLarenRegional
MedicalCenter,Michigan
Internalmedicinefaculty,McLaren
RegionalMedicalCenter,Michigan
Clinicalinstructorofinternalmedicine,
MichiganStateUniversity(MSU),
Collegeofhumanmedicine,Lansing,
Michigan
[email protected]
EditorsandFacultyReviewers
JamiL.Foreback,M.D.,Ph.D. TrevorBanka,M.D.
InternalMedicineFaculty HenryFordHospital
McLarenRegionalMedicalCenter Detroit,MI48202
MichiganStateUniversity USA
EastLansing,MI48823 [email protected]
USA
[email protected]
ISBN:978-0-387-68980-7 e-ISBN:978-0-387-68982-1
DOI10.1007/978-0-387-68980-7
LibraryofCongressControlNumber:2008937456
#SpringerScience+BusinessMedia,LLC2009
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Preface
Basic sciences are the bedrock of a medical education. Though the breadth of basic
medicalsciencescanbecomplicatedandconfusing,afirmgraspofthisknowledgeis
essential for both passing the United States Medical Licensing Examination
(USMLE)andbuildingasuccessfulmedicalcareer.
SteponeoftheUSMLEexaminesastudent’sabilitytounderstandandapplythese
basic sciences. Most residency programs pay a great deal of attention to this score
when considering applicants, so preparing for this portion of the USMLE can be a
dauntingtask.
Thisbookwasdesignedtopresentalltheinformationnecessarytopassthisstepof
theexaminbulletformatforeasymemorization.Thetextincludeskeywords,tables,
figures,diagrams,andphotographsforincreasedretention,andshouldeliminatethe
need for any other books during your preparation. Though the basic science of
medicinecanseemlikeanendlessoceanoffacts,thisbookdistillslargetopicsdown
toonlythemostpertinentfacts.
With this book guide, mastering the USMLE will be just another step in your
medicalcareer.
Michigan,USA
AhmadWagihAbdel-Halim
v
Acknowledgements
Iwouldlike toexpress mygratitudetoeverypersonwhohelped andcontributed to
bringingthisworktolife.Iwanttothankmymomandmydadfortheirlove,support,
andencouragement;withoutthem,IwouldhaveneverbeenwhoIamtoday.
Iamdeeplyindebtedtoallmyprofessors,colleagues,andeverysinglepersonwhoI
haveevermetwhohashelpedaddtomyknowledgeevenwithoneword.
Specialthankstomyamazingeditorsfortheirhardwork;itwasapleasureworking
withthem.
Finally,IammostgratefultoSuzanneStevensforherhelp,support,andforbear-
ance,andtoallthestaffatSpringerfortheirsupportandcooperation.
AhmadWagihAbdel-Halim
vii
Contents
Preface.................................................................................................................. v
Acknowledgments.............................................................................................. vii
1 Anatomy......................................................................................................... 1
HeadandNeck................................................................................................ 2
ArterialSupply........................................................................................... 2
VenousDrainage........................................................................................ 2
CarotidSheathandNeckTriangles............................................................ 2
MuscleActions........................................................................................... 2
Larynx........................................................................................................ 2
Cricothyrotomy.......................................................................................... 3
ThyroidGland............................................................................................ 3
ParotidGland............................................................................................. 3
VertebralColumn............................................................................................ 3
AnatomicLandmarks................................................................................. 3
Curves,Joints,andStabilization................................................................ 3
IntervertebralDisks.................................................................................... 4
WhiplashInjury.......................................................................................... 4
Spondylosis................................................................................................. 5
Spondylolysis.............................................................................................. 5
Osteomyelitis.............................................................................................. 5
UpperLimb..................................................................................................... 5
ArterialSupply........................................................................................... 5
VenousandLymphDrainage..................................................................... 5
NerveSupply(Fig.1.2)............................................................................... 6
BrachialPlexusInjury................................................................................ 6
RadialNerveInjury.................................................................................... 6
UlnarNerveInjury..................................................................................... 6
MedianNerveInjury.................................................................................. 6
AxillaryNerveInjury................................................................................. 7
Joints.......................................................................................................... 7
ClavicularFracture..................................................................................... 7
SupracondylarFractureofHumerus.......................................................... 7
NursemaidElbow....................................................................................... 7
ScaphoidFracture...................................................................................... 7
Colles’Fracture.......................................................................................... 7
DupuytrenContracture.............................................................................. 8
MiscellaneousUpperLimbInjuries............................................................ 8
LowerLimb..................................................................................................... 8
ArterialSupply........................................................................................... 8
VenousandLymphDrainage..................................................................... 8
NerveSupply.............................................................................................. 8
FemoralTriangle........................................................................................ 8
KneeJoint.................................................................................................. 9
PeripheralVascularDisease(PVD)............................................................ 9
ix
x Contents
DeepVenousThrombosis(DVT)................................................................. 9
CompartmentSyndrome............................................................................ 10
FemoralNeckFracture.............................................................................. 10
KneeInjuries.............................................................................................. 10
Osgood-SchlatterDisease........................................................................... 10
MiscellaneousLowerLimbInjuries............................................................ 10
NerveInjuries............................................................................................. 11
Breast.............................................................................................................. 11
Anatomy..................................................................................................... 11
ArterialSupply........................................................................................... 11
VenousandLymphDrainageandNerveSupply....................................... 11
Aorta............................................................................................................... 11
CoarctationoftheAorta............................................................................ 11
AorticDissection........................................................................................ 12
AorticAneurysm........................................................................................ 12
ThoracicOutletSyndrome......................................................................... 12
Mediastinum,Ribs,andDiaphragm.......................................................... 12
Lungs............................................................................................................... 13
TracheobronchialTree............................................................................... 13
LungsandPleura........................................................................................ 13
BloodSupplyandLymphDrainage........................................................... 13
Heart............................................................................................................... 13
Abdomen......................................................................................................... 14
AbdominalWall......................................................................................... 14
Hernia......................................................................................................... 14
Peritoneum...................................................................................................... 15
Esophagus....................................................................................................... 15
Stomach........................................................................................................... 15
Duodenum....................................................................................................... 16
JejunumandIleum.......................................................................................... 16
Colon............................................................................................................... 16
Rectum............................................................................................................ 16
AnalCanal(Table1.3).................................................................................... 17
Liver................................................................................................................ 17
Gallbladder...................................................................................................... 17
Pancreas.......................................................................................................... 17
Spleen.............................................................................................................. 17
PelvisandPerineum......................................................................................... 18
Anatomy..................................................................................................... 18
Kidneys........................................................................................................... 18
Ureter.............................................................................................................. 18
UrinaryBladder.............................................................................................. 19
UrinaryIncontinence....................................................................................... 19
MaleUrethra................................................................................................... 20
FemaleUrethra............................................................................................... 20
BladderandUrethralTrauma......................................................................... 20
Suprarenal(Adrenal)Glands........................................................................... 21
Ovary(Fig.1.4)............................................................................................... 21
FallopianTubes(Fig.1.4)............................................................................... 21
Uterus(Fig.1.4).............................................................................................. 21
Testes(Fig.1.5)............................................................................................... 22
EpididymisandVasDeferens(Fig.1.5).......................................................... 22
Prostate(Fig.1.5)............................................................................................ 22
Penis(Fig.1.5)................................................................................................. 23
SpermaticCord................................................................................................ 23
Contents xi
2 Embryology.................................................................................................. 25
Gametogenesis.............................................................................................. 26
Meiosis(Figs.2.1–2.3)............................................................................. 26
Spermiogenesis........................................................................................ 26
Embryogenesis.............................................................................................. 27
Fertilization............................................................................................. 27
CleavageandImplantation...................................................................... 27
Gastrulation............................................................................................ 27
Placenta................................................................................................... 28
UmbilicalCord........................................................................................ 28
AmnioticFluid........................................................................................ 28
CardiovascularSystem................................................................................. 29
Blood....................................................................................................... 29
BloodVessels........................................................................................... 29
FetalCirculation..................................................................................... 29
Heart....................................................................................................... 29
PersistentTruncusArteriosus.................................................................. 30
TranspositionofGreatArteries(TGA)................................................... 30
TetralogyofFallot.................................................................................. 30
EbsteinAnomaly..................................................................................... 30
VentricularSeptalDefect(VSD)............................................................. 30
AtrialSeptalDefect(ASD)...................................................................... 31
PatentDuctusArteriosus(PDA)............................................................. 31
HypoplasticRightHeartSyndrome........................................................ 31
HypoplasticLeftHeartSyndrome........................................................... 31
GastrointestinalSystem................................................................................ 31
Embryology............................................................................................. 31
CongenitalEsophagealAtresia................................................................ 31
CongenitalHypertrophicPyloricStenosis(CHPS).................................. 32
VolvulusNeonatorum............................................................................. 32
Intussusception........................................................................................ 32
HirschsprungDisease(CongenitalMegacolon)....................................... 32
Meckel’sDiverticulum............................................................................. 32
ImperforateAnus.................................................................................... 33
AnnularPancreas.................................................................................... 33
Omphalocele............................................................................................ 33
SerosaandDiaphragm................................................................................. 33
Embryology............................................................................................. 33
CongenitalDiaphragmaticHernia.......................................................... 33
UrinarySystem............................................................................................. 33
Embryology............................................................................................. 33
PolycysticKidneyDisease....................................................................... 34
Wilms’Tumor(Nephroblastoma)........................................................... 34
HorseshoeKidney................................................................................... 34
GenitalSystem.............................................................................................. 34
Embryology............................................................................................. 34
UndescendedTestes(Cryptorchidism).................................................... 35
Spadias.................................................................................................... 35
CongenitalAdrenalHyperplasia(CAH)................................................. 35
TesticularFeminizationSyndrome.......................................................... 35
MalePhenotypicGenitalAnomalies....................................................... 35
RespiratorySystem....................................................................................... 35
Embryology............................................................................................. 35
HyalineMembraneDisease(RespiratoryDistressSyndrome)................ 36
CysticFibrosis......................................................................................... 36
xii Contents
(cid:2) -AntitrypsinDeficiency........................................................................... 36
1
KartagnerSyndrome.................................................................................. 37
HeadandNeck................................................................................................ 37
PharyngealApparatus................................................................................ 37
ThyroidGland................................................................................................. 37
Embryology................................................................................................ 37
Tongue............................................................................................................ 38
Embryology................................................................................................ 38
FaceandPalate............................................................................................... 38
Ear................................................................................................................... 38
Eye................................................................................................................... 38
Embryology................................................................................................ 38
Retinoblastoma(Cat’sEye)........................................................................ 38
RetinitisPigmentosa................................................................................... 38
CleftLip.......................................................................................................... 39
CleftPalate...................................................................................................... 39
Miscellaneous.................................................................................................. 39
NervousSystem............................................................................................... 39
Embryology................................................................................................ 39
Craniopharyngioma................................................................................... 40
Skin................................................................................................................. 40
Embryology................................................................................................ 40
Icthyosis..................................................................................................... 40
Hemangioma.............................................................................................. 40
Ehler-DanlosSyndrome............................................................................. 40
SkullandVertebralColumn............................................................................ 41
Embryology................................................................................................ 41
SpinaBifida(Fig.2.7)................................................................................. 41
Craniostenosis(Craniosynostosis).............................................................. 41
MusculoskeletalSystem................................................................................... 41
Embryology................................................................................................ 41
MarfanSyndrome...................................................................................... 42
OsteogenesisImperfecta............................................................................. 42
CongenitalAbsenceofMuscles.................................................................. 42
Limbs............................................................................................................... 42
Embryology................................................................................................ 42
Achondroplasia.......................................................................................... 42
FamousCongenitalAnomalies................................................................... 42
3 Neuroanatomy................................................................................................. 45
Cerebrum......................................................................................................... 46
Anatomy(Figs.3.1and3.2)....................................................................... 46
CerebrovascularAccident(CVA)............................................................... 49
IntracranialHemorrhage............................................................................ 50
CavernousSinusThrombosis..................................................................... 50
Concussion................................................................................................. 50
Alzheimer’sDisease.................................................................................... 50
GlioblastomaMultiforme........................................................................... 51
PseudotumorCerebri.................................................................................. 52
Meningitis................................................................................................... 52
Meningioma............................................................................................... 53
VentriclesandCerebrospinalFluid................................................................. 53
Anatomy..................................................................................................... 53
Hydrocephalus........................................................................................... 53
Arnold-ChiariMalformation...................................................................... 54
Contents xiii
Cerebellum................................................................................................... 54
Anatomy.................................................................................................. 54
CerebellarVermisSyndromes.................................................................. 54
CerebellarTumors................................................................................... 54
HypothalamusandThalamus....................................................................... 54
Hypothalamus......................................................................................... 54
Thalamus................................................................................................. 55
InternalCapsuleandLimbicSystem............................................................ 55
InternalCapsule...................................................................................... 55
LimbicSystem......................................................................................... 55
BasalGanglia............................................................................................... 55
Anatomy.................................................................................................. 55
Parkinson’sDisease................................................................................. 55
Huntington’sChorea............................................................................... 55
TardiveDyskinesia.................................................................................. 56
Wilson’sDisease...................................................................................... 56
Hemiballismus......................................................................................... 56
Brainstem..................................................................................................... 56
Anatomy.................................................................................................. 56
MidbrainLesions.................................................................................... 56
PonsLesions............................................................................................ 56
MedullaOblongataLesions..................................................................... 57
SpinalCord.................................................................................................. 57
Anatomy.................................................................................................. 57
BloodSupply........................................................................................... 58
SpinalNerves........................................................................................... 58
DorsalColumn........................................................................................ 58
LateralSpinothalamicTract.................................................................... 58
LateralCorticospinalTract..................................................................... 59
MiscellaneousTracts............................................................................... 59
SpinalCordLesions................................................................................ 59
MultipleSclerosis(MS)........................................................................... 59
Poliomyelitis(Fig.3.16)........................................................................... 59
AmyotrophicLateralSclerosis(ALS)(Fig.3.16).................................... 59
TabesDorsalis......................................................................................... 60
Brown-Se´quardSyndrome....................................................................... 60
AnteriorSpinalArteryOcclusion............................................................ 60
SubacuteCombinedDegeneration(SCD)(Fig.3.16).............................. 60
Syringomyelia.......................................................................................... 60
Guillain-Barre´ Syndrome........................................................................ 60
CranialNerves.............................................................................................. 61
I:OlfactoryNerve.................................................................................... 61
II:OpticNerve........................................................................................ 61
III:OculomotorNerve............................................................................ 61
IV:TrochlearNerve................................................................................ 61
V:TrigeminalNerve................................................................................ 61
VI:AbducensNerve................................................................................ 62
VII:FacialNerve..................................................................................... 62
VIII:VestibulocochlearNerve................................................................. 63
IX:GlossopharyngealNerve................................................................... 63
X:VagusNerve....................................................................................... 63
XI:AccessoryNerve................................................................................ 63
XII:HypoglossalNerve........................................................................... 63
Miscellaneous............................................................................................... 64
Seizures.................................................................................................... 64