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Week 8- SHANE > Dissector Info > Flashcards

Flashcards in Dissector Info Deck (43):
1

Where is the apex of the heart located?

left 5th intercostal space near the mid-clavicular line

2

Where is the coronary sulcus located on the heart?

in between the right atrium and ventricle

3

What does the right coronary artery arise from?

right aortic sinus (which comes from the ascending aorta)

4

How is the pulmonary artery related to the bronchi in the hilum of the LEFT lung?

it is located superior to the bronchus

5

How is the pulmonary artery related to the bronchi in the hilum of the RIGHT lung?

it is located ventral to the bronchus

6

Where does the esophagus cross over the descending aorta anteriorly?

level of the 8th vertebra

7

Where does the esophagus enter into the diaphragm?

level of the 10th vetrebra

8

What ribs form the costal margin of the diaphragm?

7-10

9

Where is the transpyloric plane located?

It is said to lie roughly a hand's breadth beneath the xiphoid process of the human sternum.

The plane in most cases cuts through the pylorus of the stomach, the tips of the 9th costal cartilages and at the level of the intervertebral disc between L1 and L2

10

motor and sensory supply to the abdominal wall is provided by what nerves (4 sets)?

7th-11th intercostal nerves, subcostal nerves, iliohypogastric, and iliolinguinal nerves

11

Describe the distribution of the superficial nerves in the abdomen wall.

7th intercostal- level of xiphoid process

10th intercostal- level of umbilical

iliohypogastric- suprapubic

iliolinguinal- exits the superficial ring to enter the scrotum

12

Do the inferior fibers of the internal oblique abdominis and the transverses abdominis contribute to the rectus sheath?

No. they insert on the pubic crest

13

Are inguinal hernias more common in males or females? Why?

males, because the canal and the associated structures are larger and weak following descent of the testis

14

What occupies the inguinal canal in men and women?

men- spermatic cord
women- round ligament

15

What nerve exits the inguinal canal?

iliolinguinal

16

Does the iliolinguinal nerve exit the superficial ring of the inguinal canal in men and women?

Yes. LATERAL to the spermatic cord/round ligament

17

What does the iliolinguinal nerve continue as in men and women?

men- anterior scrotal
women- labial nerve

18

What is the spermatic cord covered by as it exits the inguinal canal?

external spermatic fascia derived from the external abdominal oblique

19

The sides of the superficial ring of the inguinal canal are designated what?

lateral and medial crura

20

What is the inguinal ligament formed by?

fibers of the external abdominal oblique aponeurosis ONLY.

21

At the pubic tubercle, what does the inguinal ligament become?

lacunar ligament

22

What is the floor of the inguinal canal formed primarily by?

inguinal ligament (with some lacunae ligament)

23

What is the deep inguinal ring formed by?

reflection of the transversals fascia

24

What artery and vein would you see just medial to the deep inguinal ring?

inferior epigastric artery and vein

25

What is the roof of the inguinal canal formed by?

combined arching fibers of the internal abdominal oblique and the transverses abdominis muscles (these insert on the medial aspect of the pubic crest as the FALX INGUINALIS)

26

What forms the internal spermatic fascia of the spermatic cord

reflection of the transversalis fascia at the deep ring

27

What are the cremaster muscle and its fascia derived from?

the roof fibers of the internal abdominal oblique in the inguinal canal

NOTE: the cremaster fascia forms the middle fascia of the spermatic cord)

28

Where does the posterior wall of the inguinal canal extend from?

deep inguinal ring laterally to the falx inguinalis medially (at the medial aspect of the pubic crest)

29

What supports/strengthens the posterior wall of the inguinal canal?

medially- falx inguinalis (very strong)
laterally- inferior epigastric vessels

30

Where is the weak area of the posterior wall of the inguinal canal?

between the inferior epigastric vessels (laterally) and the falx inguinalis (medially)-- this is what direct hernias would occur

31

Do direct hernias occur medial or lateral to the inferior epigastric vessels?

medial (indirect occur lateral)

32

What is the internal spermatic fascia formed by?

trasversali fascia at deep ring

33

What is the cremaster muscle and fascia formed by?

internal abdominal oblique aponeurosis in the canal

34

What is the external spermatic fascia formed by?

external abdominal oblique aponeurosis in the canal

35

What innervates the cremaster muscle?

genitofemoral nerve

36

Are the phrenic nerves medial or lateral to the vagus nerves?

lateral

37

What rib attaches to the sternal angle?

2nd

38

When inserting a chest tube, intercostal vessels and nerves are avoided by placing the tube immediately:

above the margin of a rib. VAN triad runs directly BELOW each rib

39

A needle inserted into the 9th intercostal space along the midaxillary line would enter which space?

Costodiaphragmatic recess

40

During a heart transplant procedure, the surgeon inserted his left index finger through the transverse pericardial sinus, and then pulled forward on the two large vessels lying ventral to his finger. Which vessels were these?

The transverse pericardial sinus is an area of the pericardial cavity located behind the aorta and pulmonary trunk and anterior to the superior vena cava. So, the two large vessels lying ventral to his finger are the pulmonary trunk and aorta; the large vessel lying dorsal to his finger is the superior vena cava.

41

While observing in the OR, you see the resident insert a needle through the body wall just above the ninth rib in the mid-axillary line. She was obviously trying to enter the:

costodiaphragmatic recess

42

The ductus arteriosus sometimes remains open after birth requiring surgical closure. When placing a clamp on the ductus, care must be taken to avoid injury to what important structure immediately dorsal to it?

left recurrent pharyngeal.

The left recurrent laryngeal nerve is a branch of the vagus that wraps around the aorta, posterior to the ductus arteriosus or ligamentum arteriosum. It then travels superiorly to innervate muscles of the larynx. It's important to protect this nerve during surgery! If the left recurrent laryngeal nerve becomes paralyzed, a patient might experience a hoarse voice or even have difficulty breathing due to a laryngeal spasm

43

A 16-year-old male suffered a stab wound in which a knife blade entered immediately superior to the upper edge of the right clavicle near its head. He was in extreme pain, which was interpreted by the ER physician as a likely indicator of a collapsed lung following disruption of the pleura. If that was true, what portion of the pleura was most likely cut or torn?

cupola