Anatomy Book Weeks 1-6

Question 1

Describe the innervation and attachments of the serrated anterior

Answer 1

Serrated anterior is innervated by the long thoracic nerve (a branch of the bronchial plexus)
Proximal attachments: anterior surface of first 8 or 9 ribs
Distal attachments : anterior surface of the medial border of the scapula

Question 2

Function of serratus anterior

Answer 2

Helps you rotate / move scapula (shoulder blade) forwards and up

Question 3

What are the main functions of the pec major and pec minor

Answer 3

Pec major: flexion and extension of the arm

Pec minor: movement of the scapula - elevated ribs for deep inspiration

Question 4

Where are the innermost intercostals

Answer 4

3rd and deepest layer of intercostal muscles - located deep into internal and external intercostals filling the 11 intercostal spaces between the ribs

Question 5

Function of the intercostal muscles

Answer 5

External intercostals : forced and quiet inhalation

Internal: forced exhalation (depress ribs and decrease space in chest cavity)

Question 6

Where does the internal thoracic artery originate and what structures does it supply

Answer 6

Supplies the anterior chest wall and breasts
Arises from the first part of the subclavian artery, running 1-2cm lateral to the sternal edge and dividing into the deep superior epigastric and musculophrenic arteries at the 6th costal cartilage

Question 7

How do the ribs move in relation to the thoracic vertebrae and sternum

Answer 7

Synovial joint permits the movement of the rib that occurs in respiration joints between ribs and vertebrae are held together by ligaments (radiate and superior Costco transverse)

Question 8

What is a bronchopulmonary segment

Answer 8

A portion of lung supplied by its own bronchus and artery

Question 9

Why might fluid collect abnormally in the pleural cavity and need to be removed (2 conditions)

Answer 9

Pleura creates too much fluid when its irritated, inflamed or infected eg in lung / breast cancer or heart failure

Question 10

What are the boundaries of the nasal cavity

Answer 10

Roof - composed of 3 parts: frontonasal, ethmoidal, sphenoidal

Medial wall - nasal septum

Lateral wall - nasal conchae

Floor - hard palate

Question 11

What kind of epithelium lines the paranasal air sinuses

Answer 11

Pseudostratified ciliated and columnar epithelium

Question 12

Where does the lymph drain from the maxillary sinus (the sinus that most commonly becomes infected)

Answer 12

One drainage pathway runs from the maxillary gingiva to the submandibular nodes

Question 13

What kind of epithelium lines the nasal cavity

Answer 13

Ciliated pseudostratified and columnar epithelium

Question 14

What is the sensory nerve supply of the nasal cavity

Answer 14

Nasal cavity receives innervation via branches of the olfactory (cranial nerve), ophthalmic and maxillary nerves

Question 15

Describe the clinical situation of paranasal sinuses and sinusitis

Answer 15

Thick, discoloured discharge from the nose. Drainage down the back of the throat
Nasal obstruction or congestion causing difficulty breathing through the nose
Pain, tenderness and swelling around eyes, cheeks, nose or forehead

Question 16

Describe the clinical situation of cranial nerves and referred pain

Answer 16

Caused by cranial neuropathies, poorly controlled diabetes or high BP, head injuries, infections, strokes and brain tumours

Symptoms include: weakness or loss of sensation in part of the face or changes in vision

Question 17

Consider the structures you would see with respect to pneumothorax

Answer 17

Pleura is pushed further away from the chest wall. Pneumothorax is more obvious with a visible pleura line and shift of the mediastinum and trachea (indicating tension)
On inspiration, mediastinum and trachea are central

Question 18

Where does the pericardium attach and which vessels pass through it

Answer 18

Pericardium is attached to the diaphragm below the mediastinal pleura on the side and the sternum in the front
Each of the great vessels passes through an adherent cuff of pericardium as it enters or leaves the pericardial sac

Question 19

What is pericarditis

Answer 19

Inflammation of the lining around your heart

Sharp pain in chest that worsens when breathing deeply or lying down

Question 20

What is a triple bypass

Answer 20

A surgical procedure to restore normal blood flow to an obstructed coronary artery

Question 21

What is cardiac tamponade

Answer 21

Results from accumulation of pericardial fluid under pressure leading to impaired cardiac filling and haemodynamic compromise

Question 22

What is cardiomegaly

Answer 22

An enlarged heart seen on any imaging test

Question 23

What is the difference between the phrenic nerve and the vagus nerve

Answer 23

Phrenic nerve goes round the front of the hilum of the lung, vagus nerve goes behind

Question 24

Define systole and diastole

Answer 24

Systole: the phase of the heartbeat when the heart muscle contracts and pumps blood from the chambers into the arteries

Diastole : the part of the cardiac cycle during which the heart refills with blood after the emptying during systole

Question 25

What is a stenosis aortic valve

Answer 25

Narrowing of the aortic valve opening which restricts blood flow from the left ventricle to the aorta

Question 26

What is a prolapsed mitral valve

Answer 26

2 valve flaps of the mitral valve don’t close smoothly or evenly, but bulge (prolapse) upwards to the left atrium

Question 27

What structures pass through the superior thoracic aperture

Answer 27

Trachea 
Oesophagus 
Left common carotid 
Right common carotid 
Phrenic (L and R) 
Left and right braciocephalic vein and artery 
Vagus nerve
Sympathetic trunk

Question 28

How is venous pressure measured

Answer 28

Measured by a central venous catheter placed through either the subclavian or internal jugular veins
Central venous pressure can be monitored using a pressure transducer or amplifier

Question 29

Describe catheterisation of coronary arteries

Answer 29

An invasive diagnostic procedure that provides information about the structure and function of the heart:
Catheter is inserted in an artery or vein in the groin, neck or arm and threaded through blood vessels to the heart

Coronary angioplasty / stenting are also done using coronary catheterisation

Question 30

Describe aortic aneurysms and coarctation of the aorta

Answer 30

Aortic aneurysms: a balloon like bulge in the aorta (can rupture which can then split the layers of the artery wall allowing blood to leak between them)

Coarctation of the aorta: birth defect in which part of the aorta is narrower than usual. Most common cause of death in coarctation is aneurysm and so resection of the aneurysmatic segment of the aorta is necessary to prevent rupture

Question 31

What is a coronary artery bypass graft

Answer 31

A surgical procedure to restore normal blood flow to an obstructed coronary artery

• sewing one end of a section of a vein over a tiny opening in the aorta and the other end over a tiny opening made in the coronary artery just below the blockage

Question 32

Where does the left coronary artery arise from

Answer 32

Arises from the left posterior sinus, the right from the anterior sinus

Question 33

Where does the anterior interventricular artery arise from

Answer 33

The left coronary artery and the posterior interventricular artery arises from the right coronary artery

Question 34

Where does the phrenic nerve run along

Answer 34

The lateral borders of the pericardial sac between the fibrous pericardium and the mediastinal pleura

Question 35

What are the right atrium and right ventricle separated by

Answer 35

The tricuspid valve

Question 36

What is the apex of the heart formed by

Answer 36

The left ventricle

Question 37

What is the sinoatrial node supplied by

Answer 37

Both divisions of the autonomic nervous system:

Parasympathetic activity: decreases the heart rate
Sympathetic activity: has the opposite effect

Question 38

Where is the sinoatrial node located

Answer 38

Close to the entry of the superior vena cava into the right atrium