ANATOMY Flashcards
When does the brachiocephalic vein become the subclavian?
In the root of the neck, the internal jugular (IJV) and subclavian veins unite to form the brachiocephalic veins posterior to the medial ends of the clavicles.
What defines the inferior border of the superior mediastinum?
Some critical shit that happens there
Plane of Ludwig/Transthoracic plane/sternal plane
Plane from angle of Louis (sternal angle) to inferior border endplate T4.
Bifurcation of pulmonary trunk
Bifurcation of trachea
Compare pulmonary arteries to veins
What do the main pulmonary veins drain?
Pulmonary arteries follow bronchial tree to alveoli.
Pulmonary veins follow intersegmental septa and exit hilum inferior to arteries.
Right:
Superior drains upper and middle lobe
Inferior drains LL
Left:
Superior drains UL + LIngular
Inferior drains LL
Lymphatic drainage of the breast should always been with:
Inferior border of breast? and ribs cover
After the apical nodes what happens?
How much of the lymphatic drainage of the breast is through the axillary nodes
With obstruction of usual lymphatics what can happen?
“Deep and superficial (Sappey’s) plexi merge”
Inframammary fold, breast covers ribs 2-6
Subclavian trunk -> right or left thoracic ducts
Axillary nodes drain 75%
Lymphatics may cross to contralateral side through superficial (dermal channel), deep (internal mammmary interconnections) or to the retro-pectoral nodes.
Roots of:
Sacral plexus
Sciatic nerve
Pudendal nerve
Sacral plexus
L4-S4
Sciatic nerve
L4-S3
Pudendal nerve
S2-S4
Roots of the sacral plexus:
Divided into what rami?
L4-S4.
Anterior Rami (s1-s4): Pelvic splanchnic, pudendal, perineal (S4) Anterior division of anterior rami (L4, S3) - gives off tibial sciatic branch. Posterior rami (L4, s2) - Given of common peroneal sciatic branch
What is the lymphatic drainage of:
1) Body of pancreas
2) Tail of pancreas
Pancreosplenic nodes - follow splenic to coeliac nodes.
What does the pudendal artery and nerve pass through to ext the ol pelv? what other thing goes through there?
The lesser sciatic foramen, also the tendon of internal obturator
Describe illiopsoas at the level of the symphysis:
Lateral and most bulky part is illiacus.
Where do these nodes drain:
Apical axillary
Sacral/pre sacral
Apical -> subclavian trunk - >thoracic duct
Pre sacral: Drain to any of 1) Common iliac 2) Lumbar trunks 3) Inferior mesenteric
How long is the male urethra?
Name the parts
18-22cm
Prostatic, membranous, bolbous, spongy, and navicular fossa, external urethral orifice.
How many segments of the liver are there? Give the 1 st 4 with land marks
There are 8.
The 1st is the caudate lobe
2 and 3 are left lobe (2 sup, 3 inf)
4 is high and runs the right side of falciform, laterally bounded by Cantillie’s line.
The rest circle clock wise from inferior so that 5 is superior to 8 and 6 (inferior) and 7(superior) form the borders.
Hepatic lobule components
6 portal triads (portal venue, arteriole, bile duct) at the points of a hexagram surrounding a central vein (to hepatic vein) connected by sinusoids and surrounded by hepatocytes.
Contents of middle mediastinum:
pericardium heart great vessels joining the heart ascending aorta pulmonary trunk right pulmonary artery left pulmonary artery the lower half of the superior vena cava tracheal bifurcation and both main bronchi phrenic nerves cardiac plexus tracheobronchial lymph nodes
sub sites of the oropharynx:
1) base of tongue,
2) tonsil and pillars, and
3) uvula, soft palate, and (4 is often included in 3)
4) posterior pharyngeal wall.
Lymphatic drainage of the subsides of oropharynx:
Tonsils:
Channels drain unilaterally (WELL LATERALISED TONSILS) through the reteropharynx/peripharyngeal space to jugulodiagstric/deep cervical nodes.
BOT:
Midline drains bilaterally to jugulodigastrics. and more laterally, drains unilaterally to those.
Soft palate, uvula (sometimes posterior wall included):
(1) medially to the middle third of the jugular chain,
(2) laterally to the retropharyngeal (RP) lymphatics, and
(3) anteriorly to the hard palate and subsequently into the submental and submandibular nodal group
Posterior pharyngeal wall (the epiglottis, the borders of the tonsillar complexes, and the lateral aspects of the piriform sinuses inferiorly): Drains bilaterally Predominately to IIA, also to middle deep Cx nodes (occasionally to posterior triangle).
things in the nasopharynx:
Torus Tubaris Tubal tonsils Opening of eustachian tubes Salpingopharygeal recess Pharyngeal recess
Drainage of the nasopharynx
Laterally (predominant pathway) through superior constrictors to drain into uppermost deep cervical drains (can also drain to level Va).
Posterior (roof and posterior wall): drain to upper retropharygeal nodes.