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Patient is asked to look first to the nose, then look up: "up

and in" toward the bridge of the nose and in" toward the bridge of the nose

Superior oblique CN IV

Lateral rectus CN VI

Orbicularis oculi CN VII

Patient is asked to look first to the nose, then look down: "down and in" toward the tip of the nose

Patient is asked to look to the side (laterally)

Closes the eye; efferent limb of the corneal reflex

Dilator pupillae Superior tarsal

Postganglionic sympathetic Postganglionic sympathetic

Dilates the pupil Keeps the eye open

Sphincter pupillae Ciliary muscle

Postganglionic parasympathetic Postganglionic parasympathetic

Constricts the pupil Performs accommodation

Coronal Eye Diagram

Superior oblique

Inferior oblique

Superior oblique

Figure 20-8. (/A) Coronal MRI through the orbit. (B) Horizontal (axial) diagram through the orbit showing the unique origin and insertion of the inferior oblique and superior oblique muscles. In a clinical vignette question, first identify the clinical test, then match the clinical test with the appropriate muscle, and finally identify the muscle on the MRI. IR = inferior rectus; LP = levator palpebrae; LR= lateral rectus; MR= medial rectus; SO = superior oblique; SR= superior rectus. (A adapted with permission from Fleckenstein P, Tranum-Jensen J: Anatomy in Diagnostic Imaging. Philadelphia, WB Saunders, 1993, p 171; B adapted with permission from Snell RS: Clinical Anatomy for Medical Students, 5th ed. Boston, Little, Brown, 1995, p 718.) 'Because the actions of the superior rectus, inferior rectus, superior oblique, and inferior oblique muscles are complicated, the physician tests eye movements with the eye placed in a position where a single action of the muscle predominates.

Index

References in italics indicate figures; those followed by "t" denote tables

Abdomen layers of, 60 paracentesis of, 56, 57 regions of, 56, 57 scrotum, 58, 60 venous drainage of, 64-65 Abdominal aorta aneurysm of, 15, 63 branches of, 6.3, 64 imaging of, 76-79 Acetabular fossa, 156 Achalasia, 67-68 Acromioclavicular joint, 142 Acute arterial occlusion, 150 Acute mesenteric ischemia, 64 Acute myocardial infarction, 50, 50-5/ Addison disease, 110 Adductor brevis, 162, 163 Adductor longus, 162, 163 Adductor magnus, 162, 163 Adrenal cortex, 108-110 Adrenal glands arterial supply, 108 characteristics of, 108 imaging of, 76-79 venous drainage of, 108 Adrenal insufficiency, 110 Adrenal medulla, 110-111 Adrenocorticotropic hormone, 108 Alar ligaments, 1 Ampulla of Vater, 72 Amyotrophic lateral sclerosis, 16 Anal canal, 87. 88 Anal sinuses, 88 Anatomic snuffbox, 146 Androstenedione, 108 Aneurysm abdominal aorta, 15, 63

aortic, 26, 36

Angina pectoris, 50 Ankle joint, 159-162, 160-161 Ankylosing spondylosis, 3 Ankyrin, 92 Annulus fibrosus, 3 Anterior cerebral artery, 166, 166-167 Anterior chest wall, 26-28 Anterior communicating artery, 166 Anterior cranial fossa, 178—179 Anterior cruciate ligament, 157, 158 Anterior drawer sign, 157 Anterior marginal artery, 46 Anterior mediastinum, 30, 31 Anterior spinal artery description of, 14 occlusion of, 18 Anterior spinal artery syndrome, 15 Anterior tibial artery, 150, 162, 163

Anterior tibial vein, 162, 163 Aorta abdominal (see Abdominal aorta) aneurysm of, 26, 36 catheter in, 46 coarctation of the, 26 disruption of, 28 Aortic arch, 53, 164 Aortic valve, 48, 48 Ape hand, 139 Appendicitis, 71 Arachnoid, 13 Arcuate artery, 95, 96 Amold-Chiari malformation, 177 Arterial occlusive disease, 150 Artery of Adamkiewicz, 15 Aryepiglottic fold, 173 Arytenoid cartilage, 6 Arytenoid muscle, 174 Ascending colon, 82 Aschoff bodies, 52 Astrocytoma, 18, 20-21 Atlantoaxial joints, 1-2 Atlanto-occiptal joints, 1 Atria, of heart, 55 Atrioventricular nodal artery, 46 Atrioventricular node, 48 Axillary artery, 132, 133 Axillary lymphadenectomy, 26 Axillary nerve, 137 Axillary nodes, 23 Axillary vein, 23

Bacterial endocarditis, 52

Barrett esophagus, 68

Bartholin's glands, 116

Basilar artery, 166-167, 168

Basilic vein, i47

Basivertebral vein, 9

Bassini repair, 56, 58

Bell palsy, 176

Benediction hand, 139

Benign prostatic hypertrophy, 121, 123

Biceps brachii, 147

Biceps femoris, 162, 163

Bile, 72

Biliary atresia, congenital, 73

Biliary ducts, 71-72

Bitemporal lower quadrantanopsia, 166

Bladder (see Urinary bladder)

Boerhaave syndrome, 67

Bony pelvis, 124

Boxer fracture, 145. 146

Brachial artery, 132, 133

Brachial plexus anatomy of, 135, 136 anesthetic block of, 172 Brachiocephalic artery, 53 Brachioradialis, 147

BRCA1, 25 BRCA protein, 25 Breast(s) anatomy of, 23, 24 cancer of, 25-26 disorders of, 25-26 Broad ligament, 113, 115 Bronchi, 35

Bronchiectasis, 37-38, 38 Bronchogenic carcinoma, 38-41, 39-40 Bronchopneumonia, 42 Bronchopulmonary segment, 42 Brown-Sequard syndrome, 17-18 Bulbourethral glands of Cowper, 103 Bundle of His, 48

Calcaneal fracture, 162 Calcific valve disease, 50 Calculi, renal, 97-99, 98. 106-107 Capitate, 145 Cardiac tamponade, 44 Cardiac veins, 47

Cardinal ligament of Mackenrodt, 113, 126 Carina, 35

Carotid endarterectomy, 164, 169 Carotid sinus, 164-165 Carotid triangle, 169 Carpal tunnel syndrome, 144 Catheter in aorta, 46

central venous catheter, 26, 27 Cauda equina, 9, 13, 76-79 Cavernous sinus, 168-169 Cecum, 82 Celiac artery, 76-77 Celiac disease, 70

Central venous catheter insertion, 26,

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