anatomy Heme/Onc

Question 1

Where does the brachiocephalic become the subclavian (aka bifurcates)?

Answer 1

At the sternal clavicualar joint

Question 2

The vertebral arteries go on to supply what structure of the brain? Where does it branch off?

Answer 2

The basilar artery supports the posterior circulation of the brain in the circle of willis known as the posterior communicating branches. It branches off the subclavian

Question 3

Where does the internal thoracic artery branch off?

Answer 3

The subclavian also gives off the thyrocervical and costcervical trunks, and they go on to supply the intercostal muscles.

Question 4

Where does the dorsal scapular artery branch off?

Answer 4

The subclavian

Question 5

Where does the ophthalmic artery branch off?

Answer 5

The internal carotid then continues to go upwards to supply the circle of willis and form the middle cerebral artery

Question 6

What arteries supply the heart?

Answer 6

Ascending aorta and the coronary arteries

Question 7

Which artery runs anterior to the thorax?

Answer 7

Internal thoracic

Question 8

What is the order of the branches of the external carotid artery that supply the face?

Answer 8

Superior thyroid
Ascending pharyngeal
Lingual
Facial
Occipital
Posterior auricular
Maxillary
Superficial temporal

Question 9

What is the fun mnemonic to remember the branches of the external carotid?

Answer 9

Some Antomists Like Freaking Out Poor Medical Students

Question 10

What are the parietal (somatic) branches of the thoracic aorta? Where do they branch off?

Answer 10

Intercostal and superior phrenic
These surround the organs
They branch off of the thoracic (descending) aorta

Question 11

What are the visceral branches of the thoracic aorta? Where do they branch off?

Answer 11

Bronchial, Esophageal, Mediastinal, and Pericardial. These are the branches that supply the organs

Question 12

What are the branches of the subclavian?

Answer 12

Costocervical trunk, thyrocervical trunk, internal thoracic, vertebral, dorsal scapular artery

Question 13

What artery branches off of the thyrocervical trunk?

Answer 13

The suprascapular artery supplies a lot of the chest, shoulder, a lot of the bones and muscle there

Question 14

When the subclavian becomes the axillary, what branches does the axillary give off?

Answer 14

The thoracoacrominal artery, Subscapular artery, posterior circumflex humeral artery, anterior circumflex humeral artery, posterior intercostal arteries and anterior intercostal artery

Question 15

The lateral thoracic artery supplies the lateral border of the rib cage and the intercostal arteries. Where does it originate?

Answer 15

Thoracoacrominal artery

Question 16

Why do we worry about the circumflex arteries?

Answer 16

The posterior and anterior humeral arteries wrap around the humerus and provide blood to the upper arm. We worry about them very much during fractures because of the bleeding that can occur

Question 17

As soon as the axillary artery becomes the brachial artery at the inferior border of the teres major muscle, it begins to branch, and there is a deep artery that runs a bit more posterior and lateral to the brachial artery, which continues down to supply what?

Answer 17

Makes the radial artery and ulnar artery of the forearm. The radial and ulnar arteries then feed into the superficial palmer arch that anastomoses to supply the digital arteries of the hand.

Question 18

There is an artery that lies in between the radial and ulnar arteries. What is its name?

Answer 18

Common interosseous artery

Question 19

What are the branches of the abdominal aorta?

Answer 19

Visceral branches
- Celiac trunk: Supplies the liver, gallbladder, spleen, stomach, esophagus, duodenum
- Superior and inferior mesenterics: Supplies the small intestine and the colon
- Suprarenal: Adrenal glands
- Renal: Kidneys
- Gondal: testes or ovaries

Parietal branches
- Inferior phrenic: Supplies inferior diaphragm
- Lumbars: Posterior abdominal wall
- Median sacral: supplies the Sacrum and Coccyx

R. common iliac: Pelvis, R. lower limb, Arteries of the R. Lower limb

L. common iliac: Pelvis, L. lower limb, Arteries of the L. lower limb

Question 20

Why is the superior mesenteric artery (SMA) clinically significant?

Answer 20

Perfuses the midgut and SMA syndrome can occur where occlusion occurs in the artery and cause SEVERE abdominal pain. They will develop mesenteric ischemia

Question 21

Why is the median sacral artery clinically significant?

Answer 21

When people come in with hip fractures, the median sacral artery can bleed or become occluded

Question 22

What are the branches of the celiac trunk?

Answer 22

The common hepatic artery branches to the right to supply the gallbladder and the liver.
The splenic artery and the left gastric artery

Question 23

The abdominal aorta bifurcates into the right and left common iliac arteries. How does the common iliac artery then branch off?

Answer 23

The internal and external iliac.

Question 24

The internal iliac artery has what branches?

Answer 24

Superior and inferior gluteal arteries. Obturator artery. Pudendal artery for more pelvic blood supply

Question 25

What does the obturator artery supply?

Answer 25

The muscles of the thigh and are part of the pelvis too

Question 26

The external iliac artery travels more distally to get downward to the leg and become the femoral artery at what location?

Answer 26

The inguinal ligament

Question 27

What arteries come off of the femoral artery?

Answer 27

The deep femoral artery of the thigh is what we palpate when we palpate the femoral artery. Then the deep artery also has a lateral circumflex femoral artery and a medial circumflex femoral artery

Question 28

The femoral artery becomes the popliteal artery where?

Answer 28

In the popliteal fossa

Question 29

The popliteal artery branches into which arteries?

Answer 29

Anterior tibial and posterior tibial

Question 30

The anterior tibial branches into what structures?

Answer 30

the dorsalis pedis artery (pulse point, DP). arcuate artery, and dorsal metatarsal arteries (so top of the foot)

Question 31

The posterior tibial artery gives off what arteries?

Answer 31

Fibular artery, and helps give some medial and lateral plantar arteries of the foot

Question 32

What two structures merge to become the superior vena cava?

Answer 32

The left and the right brachiocephalic

Question 33

What two structures merge to become the brachiocephalic?

Answer 33

Right internal jugular and right subclavian

Question 34

What is the azygous system?

Answer 34

It drains the thoracic wall and empties into the SVC. Some of the lumbar veins drain here as well.

Question 35

What are the functions of vertebral veins?

Answer 35

They drain the deoxygenated blood from the head

Question 36

What are tributaries of the internal jugular vein?

Answer 36

“I Find Large Purple Spiders Most Obnoxious” Inferior petrosal sinus (ophthalmic) Facial Vein (superficial temporal vein) Lingual vein Pharyngeal veins Superior thyroid vein Middle thyroid vein Ophthalmic vein

Question 37

What are the sinuses of the brain?

Answer 37

Question 38

What are the major branches of the axillary vein?

Answer 38

The basilic (anterior and medial), the brachial (in between, a little bit posterior), and the cephalic (anterior and lateral)

Question 39

What is the median cubital vein?

Answer 39

The vein that connects the basilic and cephalic veins. This is where a lot of blood draws are performed. This continues to run and form the ulnar and radial veins, which eventually anastomose in the hand to form the deep venous palmer arch

Question 40

Name the veins

Answer 40

Question 41

Why is the hepatic portal system significant?

Answer 41

It functions as a filtration of the blood and drains the gut to the liver. When patients have cirrhosis of the liver, this clogs and backs up. This is how ascites can happen. Copudum adusae can happen, which is a swelling of the veins in the abdomen. Esophageal varices, hemorrhoids

Question 41

What do the hepatic veins supply?

Answer 41

The liver

Question 42

Where does the external iliac become the femoral vein?

Answer 42

The inguinal ligament

Question 43

The femoral vein becomes this vein that runs more medially.

Answer 43

The great saphenous vein is clinically significant because we typically use it for coronary artery bypass grafting (CABG)

Question 44

When does the thoracic aorta become the abdominal aorta?

Answer 44

After it passes through the diaphragm at T12

Question 45

What are the two leg pulses commonly palpated during a cardio exam?

Answer 45

Dorsalis pedis and posterior tibial

Question 46

Where does the IVC pass through the diaphragm to return blood to the heart?

Answer 46

T8 (vena cava has 8 letters)

Question 47

What are the veins that drain directly into the IVC?

Answer 47

The 3 hepatic veins that drain the liver, the renal veins, the lumbar veins, the RIGHT gonadal vein (the left is connected to the left renal vein)

Question 48

Which gonadal vein has a higher cause of experiencing compression?

Answer 48

The left gondal vein means that varicose seals are more likely to occur on the left testy or ovary compared to the right

Question 49

What is the term for veins that accompany arteries?

Answer 49

Vena comitantes

Question 50

Is the great saphenous on the medial or lateral side?

Answer 50

Medial because you always wanna protect it

Question 51

The term “common” suggests what?

Answer 51

There is a splitting or bifurcation

Question 52

Describe the structures missing

Answer 52

1. The brachiocephlic artery supplies the right subclavian and right common carotid artery 2. The common carotid artery supplies the internal and external carotid arteries 3. The subclavian artery supplies the vertebral and axillary arteries 4. The vertebral artery: These arteries from the left and right side of the neck move upward to merge to become the basilar artery of the brain, which will then branch to supply the cerebellum, the brain stem, and the occipital lobe (posterior portion of the brain) 5. The left internal common carotid: These arteries from the left and right side of the neck move upward and become a part of the anterior cerebral artery and middle cerebral artery to make up the anterior portion of the circle of willis. 6. The left external common carotid Has 3 branches - Facial: comes off the external. It is a very distinct artery as it has a very tortuous, curly route as it comes up deep to the mandible and emerges superfifically on the side of our face; a pulse can be palpated here - Maxillary: courses deep to the mandible and supplies muscle in this region and some structures near the oral and nasal cavities - Superficial Temporal: lateral portion of the head

Question 53

Which vessel (s) supply the middle meningeal artery? What is the significance of the middle meningeal artery?

Answer 53

The maxillary artery that ascends on the lateral aspect of the head to supply the meninges. The medial meningeal artery will run between the skull and the dura mater, which can be easily damaged with a blow to the side of the head in the pteryion leading to possible epidural hemorrhage or hematoma with rupture to the vessel

Question 54

Describe these structures What is the unique name for structures labeled #1 and #2 that durian blood from the brain?

Answer 54

1. The majority of veins follow the same naming structure as the arteries. The big exception is that to drain the brain itself, we are going to have unique structures, named intracranial dural venous sinuses. They will line the inner aspect of our skull. Responsible for filtering and draining the blood back from the vein itself. Within the skull, the dural venomous sinuses are all going to funnel back towards the jugular foramen at the formation of the internal jugular vein. 2. The internal jugular vein drains the majority of blood from our brain 3. The External Jugular vein drains the superficial aspects of the posterior neck and the jaw. The internal and external jugular veins sandwich the sternocleomastoid muscle. Has 3 branches - The retromandibular vein that drains the side of the head and some deeper structures of the face - Facial: drains into the INTERNAL jugular vein - Superficial temporal vein: contributes its drainage into the retromandibular. 4. Subclavian

Question 55

What is a unique feature of the veins of the head and neck?

Answer 55

They are valveless, meaning they are not only going to have the one-way direction of flow. This is important because this is going to be based on pressure. So if you have pressure in one region, you can actually take another route to drain the veins.

Question 56

What are the two dominant routes of blood to the brain?

Answer 56

The internal carotid artery is located more anteriorly, and the vertebral artery is located more posterioly. The brain is HIGHLY metabolic

Question 57

The right and left internal carotid arteries travel upward to the brain to supply the Circle of Willis and provide blood supply to what parts of the brain?

Answer 57

The carotid arteries turn more medially in the bone and the base of the skull, and the internal carotid artery enters its base as the carotid canal. This is going to be located within the temporal bone, then it will course medially and horizontally and then ascend up into the skull superior to the foramen lacerum. The carotids will take a turn in the skull itself, and it happens in the cavernous sinus. The internal carotid artery still has not branched as it is coming up through the space, and it curves back on itself where it is now going to join with the circle of willis (ther anteriocerebral circle)

Question 58

The right and left vertebral arteries travel upward to the brain to merge to become the ______ and provide blood supply to ____?

Answer 58

The basilar artery Vertebral artery predominantly supplies blood to the cerebellum and the posterior aspect of our brain. While the internal carotid artery is going to supply the temporal lobes laterally, as well as frontal lobes anteriorly, and the parietal lobes superiorly

Question 59

What is the vein responsible for draining deoxygenated blood from the brain toward the heart?

Answer 59

Internal jugular vein

Question 60

Which vessel is responsible for connecting the anterior and posterior sources of the blood supply to the brain?

Answer 60

Posterior communicating artery

Question 61

What vessel courses deep to the mandible and gives off branches to the oral and nasal cavities?

Answer 61

Maxillary artery

Question 62

The internal carotid supplies what portion of the brain?

Answer 62

The frontal lobe

Question 63

The dural venous sinuses are formed between the meningeal layer of the dura mater and what other structure?

Answer 63

Periosteal layer

Question 63

What vessel is a branch of the internal carotid artery?

Answer 63

Middle cerebral artery

Question 64

Venous blood draining through the dural venous sinuses eventually exits the skull through which passageway?

Answer 64

Jugular foramen

Question 65

Which venous sinus structure is unpaired?

Answer 65

Straight sinus

Question 66

Identify the borders of the right subclavian as it travels to become the axillary and brachial artery:

Answer 66

The right subclavian originates off of the brachiocephalic trunk. So, the right subclavian is shorter than the left. The right subclavian doesn’t change names until it hits the lateral border of the first rib, where it becomes the axillary artery. The name doesn’t change again until it hits the inferior border of the teres major muscle, where it becomes the brachial artery.

Question 67

The radial and ulnar arteries anastomose to become what?

Answer 67

The radial (lateral) and ulnar (medial) arteries are branches of the brachial artery. The superficial palmer arterial arch that supplies the structures of the hand

Question 67

What is the name for the bony area where the brachial artery splits into the radial and ulnar arteries?

Answer 67

Cubital fossa

Question 68

The ulnar artery travels distally to the palm of our hand through what bony structure?

Answer 68

The hypothernar eminence and forms the dominant contribution to the superficial palmer arterial arch

Question 68

The radial artery travels dorsally through what bony structure?

Answer 68

the posterior aspect of the thumb, this area is known as the anatomical snuff box where it can has branches to the carpal bones. The radial artery supplies the thumb (first digit) and the pointer finger (second digit). It forms the dominant contributionto the deep palmer arterial arch.

Question 69

What is the name for the complex network of veins present on the back part of the hand?

Answer 69

Dorsal venous network

Question 69

What are the names of the two veins found on the medial and radial parts of the forearm?

Answer 69

These are superficial veins that don’t parallel the deeper arteries. Along the medial aspect of the forearm, BASILIC vein. Along the lateral aspect of the forearm is the CEPHALIC. (starts along the thumb)

Question 70

Describe the structures

Answer 70

Question 71

What is a great site for blood draws?

Answer 71

Median cubital fossa

Question 72

Describe the cephalic vein

Answer 72

Course laterally up in a groove known as the deltopectoral groove. Located between the deltoid muscle and the pectoralis major muscle, can be really prominent in people who have relatively little body fat.

Question 73

Describe the superficial veins

Answer 73

These veins are the only ones that contain valves and when the muscle is contracted and gets more superficial on that fat or deep fascia, it can actually assist in unidirectional flow of blood back to the heart. Muscle assistance in pumping blood back to the heart, this is why you use a stress ball when you give blood

Question 74

What does the term veine commatantas?

Answer 74

Veins sandwich arteries all over the body. 2 deep veins for every single deep artery

Question 74

The union of the radial and ulnar veins forms which blood vessel?

Answer 74

Brachial vein

Question 74

Which blood vessel is found with the radial nerve in the spiral groove of the humerus?

Answer 74

Deep brachial artery

Question 75

What abdominal arteries are unpaired?

Answer 75

1. Celiac trunk: derived from the foregut 2. Superior mesenteric artery: supplies lots of the abdomen, especially the parts that derive from the midgut. Duodenum, pancreas, ⅔ of large intestine, jejunum and ileum, SI, ascending colon and ⅔ of transverse colon 3. Inferior mesenteric artery: supplies the rest of the large intestine, last ⅓ of transverse colon, all of descending and sigmoid colon, and superior ⅓ of the rectum

Question 76

What are the paired abdominal arteries?

Answer 76

1. Renal arteries: asymmetrical, because the left is shorter than the right, due to the displacement of the aorta, liver mostly, so right kidney, suprarenal gonadal arteries are also associated w/ the renal arteries. The suprarenal arteries sometime branch of the renal arteries, but sometimes they branch off the abdominal aorta. 2. Inferior phrenic artery: supports and supplies the inferior diaphragm. Can sometimes give off superior suprarenal branches 3. Gonadal arteries: branch off the abdominal aorta, just inferior to the renal arteries. These arteries are typically really long due to the embryologic descent of the gonads. (testes or ovaries) 4. Lumbar arteries: provide segmental blood supply for the lumber vertebrae and the body wall in this region. NUMEROUS and highly varied 5. Iliac arteries: the abdominal aorta bifurcates into the common iliac artery of each leg. From here, the blood will continue down into the pelvis and lower limb

Question 76

What are the three branches of the celiac trunk and what do they supply?

Answer 76

1. Splenic artery: supplies spleen and tail of the pancreas 2. Common hepatic artery: supplies liver, gallbladder, adn the head of the pancreas, parts of the duodenum, and the greater curvature of the stomach 3. Left gastric artery: lesser curvature of the stomach

Question 76

What veins coverage to become the IVC and what veins drain nto the IVC?

Answer 76

The IVC is formed by the blood supply draining the lower limb and pelvis will then receive further blood from other regions of the body: gonadal veins= on the right side, it drains directly into IVC. On the left, will drain into the renal vein, because gonadly veins= branches off the left renal vein, because it has a longer branch off the abdominal aorta.

Question 77

Describe the structures

Answer 77

Question 78

What system does not drain directly into the IVC?

Answer 78

GI blood DOES NOT directly drain into the IVC, because it must go through the hepatic portal vein

Question 78

What is the purpose and location of the hepatic portal vein?

Answer 78

The vast majority of abdominal organs, send their blood directly to the liver through a portal system. The venous drainage of these organs, are converged through 3 major pathways: 1. Superior mesenteric vein: draining blood from parts of the duodenum, all of the jejunum and ileum, the cecum, the ascending colon and ⅔ of the transverse colon 2. Inferior mesenteric vein: draining blood from the rest of the transverse colon, all of the descending and sigmoid colon and parts of the rectum. 3. Splenic vein: joins superior and inferior mesenteric vein in the spleen and surrounding areas and converges these 3 into a single vessel called the hepatic portal vein, which ensures that all the blood within these structures is bypassing systemic circulation and stocking the liver, so it can filter the nutrient rich blood, before sending it into systemic circulation. Large fats cannot be filtered this way.

Question 79

At what vertebral level does the aorta pass through the diaphragm?

Answer 79

T12

Question 80

Arterial blood supply from the branches of the celiac trunk, supplies what organ?

Answer 80

liver

Question 81

Arterial blood supply from the branches of the superior mesenteric artery supplies what organs?

Answer 81

jejunum

Question 82

Arterial blood supply from the branches of the inferior mesenteric artery supplies what organs?

Answer 82

sigmoid colon

Question 83

At what level does the abdominal aorta bifurcate into the common iliac arteries?

Answer 83

L4

Question 84

The splenic and superior mesenteric veins combine to form what?

Answer 84

The hepatic portal vein

Question 85

At what vertebral level does the IVC pass through the diaphragm?

Answer 85

T8

Question 86

The external iliac artery will pass where?

Answer 86

Deep to the inguinal ligament. The inguinal ligament separates the abdominal and pelvic cavities anteriorly

Question 87

What is the major supply of blood in the thigh?

Answer 87

femoral

Question 87

What is the longest vein in the human body?

Answer 87

The great saphenous and has no accompanying artery

Question 88

Where does the IVC bifurcates?

Answer 88

L5

Question 89

Describe these structures

Answer 89

Question 90

Describe these structures

Answer 90

Question 91

Which side (anterior or posterior) provides more blood supply to tissues?

Answer 91

posterior

Question 92

What are the four types of arterial pulses we can palpate for?

Answer 92

Dorsalis pedis, posterior tibial pulse, popliteal pulse, and femoral pulse

Question 93

Describe the general location of the dorsalis pedis pulse?

Answer 93

Between the extensor hallucis longus tendon and the second digit (toe). Find the muscle w/ foot dorsiflexed, place two fingers in the depression and have them relax the foot to evaluate pulse.

Question 94

Describe the general location of the posterior tibial pulse

Answer 94

Between the posterior surface of the medial malleoulus and the medial border of the calcaneal tendon (aka achilles). Optimally palpated when the foot is inverted in order to relax the flexor retinaculum as the posterior tibial artery passes deep to this ligament.

Question 95

Describe the general location of the popliteal pulse?

Answer 95

Inferior part of the popliteal fossa with the patient prone and knee flexed to relax the popliteal fascia and the hamstrings. Easy in a lean individual

Question 96

Describe the general location of the femoral pulse?

Answer 96

Inferior to the midpoint of the inguinal ligament

Question 97

What is the name of the femoral artery after it passes through the adducter hiatus?

Answer 97

Popliteal artery

Question 98

The dorsalis pedis is a continuation of which artery?

Answer 98

Anterior tibial artery

Question 99

What vessel is a superficial vein that arises anterior to the medial malleollus from the medial aspect of the dorsal venous network?

Answer 99

Great Saphenous Vein

Question 100

The anterior popliteal vein drains into which blood vessel?

Answer 100

Popliteal vein