Exam 2 Material Flashcards

1
Q

the pectoralis minor muscle attaches to the ____

A

coracoid process and ribs 3-5

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2
Q

what is the order of the lateral thoracic lymph nodes from inferior to superior

A

pectoral axillary nodes
lateral axillary nodes
central axillary nodes
apical axillary nodes

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3
Q

what are the medial lymph nodes deep to the pectoralis major

A

parasternal nodes

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4
Q

lymphatic and venous drainage passes from inferior part of the breast _____

A

into the abdomen

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5
Q

lymphatic and venous drainage passes from the lateral and superior part of the breast into the ____

A

axilla

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6
Q

lungs stop at _____

A

intercostal space 6-7

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7
Q

how many true ribs are there

A

7 pairs

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8
Q

how many false ribs are there

A

5 pairs

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9
Q

how many floating ribs are there

A

2 pairs

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10
Q

what is the superior part of the sternum

A

manubrium

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11
Q

what is the middle part of the sternum

A

body

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12
Q

what is the inferior part of the sternum

A

xiphoid process

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13
Q

what is significant about the carina?

A

it contains receptors that stimulate cough when irritated

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14
Q

where is the carina located

A

point where the trachea splits into the primary bronchi

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15
Q

the sternal angle is a

A

traverse plane

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16
Q

the sternal angle is at what vertebral level

A

T4-T5

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17
Q

the aortic arch begins and ends at the ___

A

sternal angle

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18
Q

what structures are found along the sternal angle?

A

2nd rib
aortic arch
bifurcation of trachea
bifurcation of pulmonary trunk
left recurrent laryngeal nerve
azygous vein
cardiac plexus nerves
thoracic duct

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19
Q

the intercostal artery, vein, and nerve run in what order inferior to superior

A

nerve-artery-vein

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20
Q

where are the intercostal nerve artery and vein located

A

behind the wing on the inferior posterior portion of the rib

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21
Q

what are the two muscles between the ribs

A

external intercostal
internal intercostal muscles

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22
Q

where are the collateral branches of the intercostal nerve artery and vein located

A

immediately superior to the rib

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23
Q

what are the 4 major muscles of respiration

A

sternocliedomastoid
external intercostals
internal intercostals
diaphragm

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24
Q

on the right side, what artery branches off to supply blood to the bronchioles and lung tissue? where does it branch

A

bronchial artery
branches at the 3rd intercostal space

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25
Q

on the left side, where does the bronchial artery originate from

A

aorta

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26
Q

where does the posterior intercostal arteries originate from?

A

aorta

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27
Q

where do the anterior intercostal arteries arise from

A

internal thoracic artery

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28
Q

what are the two terminal branches of the internal thoracic artery

A

superior epigastric artery and musculophrenic artery

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29
Q

what does the musculophrenic artery supply

A

the lateral aspect of the diaphragm and muscles

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30
Q

what does the superior epigastric artery supply

A

xiphoid area and area immediately inferior

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31
Q

what are the 3 things that dump into the right atrium

A

superior vena cava
inferior vena cava
coronary sinus

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32
Q

what does the azygos vein dump into

A

superior vena cava

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33
Q

where is the azygos vein located, and what area does it drain

A

right side of the vertebral column and it drains viscera within the mediastinum as well as back and thoracoabdominal walls

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34
Q

what veins drain into the coronary sinus

A

great cardiac vein
middle cardiac vein
small cardiac vein

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35
Q

what veins are located on the left side of the vertebral column and drain most of the posterior intercostal veins on the left side of the body

A

accessory hemiazygous and hemiazygous vein

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36
Q

where do the accessory hemiazygous and hemiazygous veins dump into

A

azygous vein on the right side
they cross the vertebral column anteriorly and connect to the azygous vein

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37
Q

where does the thoracic duct drain

A

left subclavian vein near where the internal jugular arises

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38
Q

what lies between the parietal pleura and visceral pleura

A

pleural cavity

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39
Q

what is the pressure of the pleural cavity

A

-4 to -10 mmhg

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40
Q

where is the parietal pleura

A

on thoracic wall and superior face of diaphragm

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41
Q

where is the visceral pleura found

A

covers the lungs

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42
Q

what is the acronym to remember the placement of the pulmonary arteries in relation to the bronchi

A

RALS
right anterior
left superior

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43
Q

what is the area of the lungs where you find the base of the bronchi, arteries, and veins as they enter/exit the lungs

A

hilum

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44
Q

what is the most inferior portion of the lungs called where it touches the diaphragm

A

diaphragmatic surface

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45
Q

the apex of the lungs is located _____

A

in the neck above the subclavian artery and vein

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46
Q

which bronchus is bigger?

A

right main

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47
Q

the left recurrent laryngeal nerve passes directly __ the arch of the aorta at the ___

A

under
ligamentum arteriosum

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48
Q

what does the left recurrent laryngeal nerve innervate

A

the internal laryngeal nerve (sensory), supplies sensory fibers to the laryngeal mucosa and the external laryngeal nerve (motor) innervates cricothyroid muscle

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49
Q

the right and left recurrent laryngeal nerves branch from the ___ nerve

A

vagus

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50
Q

the right recurrent laryngeal nerve innervates what

A

the intrinsic muscles of the larynx with exception of the cricothyroid muscles

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51
Q

what nerve forms the esophageal plexus

A

vagus nerve

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52
Q

what nerve travels in the mediastinum lining and innervates the diagphram

A

phrenic nerve

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53
Q

how many phrenic nerves are there

A

2- the left and right

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54
Q

what vein and artery supplies the pericardial sac and diaphragm

A

left and right pericardiacophrenic arteries and veins

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55
Q

what nerves innervate the diaphragm

A

phrenic

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56
Q

what is the pericardium

A

the membran enclosing the heart, consisting of an outer fibrous layer and an inner double layer of serous membrane

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57
Q

what is the transverse pericardial sinus

A

the passage between the aorta and pulmonary artery anteriorly and the superior vena cava posteriorly
it separates arteries and veins

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58
Q

where is the oblique pericardial sinus

A

posterior to the heart in the pericardial sac

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59
Q

how can you find the oblique sinus

A

lift the apex of the heart and place your fingers posterior to the heart
you will feel your fingers enter a space with definite borders

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60
Q

what shape is the oblique pericardial sinus

A

an inverted U

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61
Q

what are the borders of the oblique pericardial sinus

A

right side: bounded by the lines of reflection of the serous pericardium onto the inferior vena cava and right pulm veins
left side: bounded by the lines of reflection of serous pericardium onto the left pulm veins

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62
Q

the transverse pericardial sinus is located on ___ and the oblique pericardial sinus is located ____

A

superior aspect of the heart
posterior aspect of the heart

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63
Q

what are the openings of the left atrium

A

left superior pulm vein
left inferior pulm vein
right superior pulm vein
right inferior pulm vein

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64
Q

where does the pulm artery exit from

A

right ventricle

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65
Q

where is the coronary sinus located

A

posterior heart and immediately inferior to the left atrium

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66
Q

what is the purpose of the coronary sinus

A

holding chamber while heart is in systole

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67
Q

what dumps into the right atrium

A

SVC
IVC
coronary sinus

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68
Q

what is the most posterior part of the heart

A

left atrium

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69
Q

what is the fat pad that lies between the ventricles

A

intraventricular sulcus

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70
Q

what collects all of the venous blood of the heart

A

coronary sinus

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71
Q

what are the two branches of the right coronary artery

A

right marginal artery of right coronary
posterior descending artery (PDA)

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72
Q

what are the two branches off the left main coronary artery

A

circumflex
left anterior descending

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73
Q

what is the first major branch off of the left coronary artery

A

circumflex

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74
Q

where does the circumflex artery run

A

around the left aspect of the heart in the coronary sulcus under the left atrium
it supplies the left side of the heart and then goes posterior to supply only a portion of the posterior aspect of the heart

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75
Q

what is the vein that runs with the left anterior descending

A

great cardiac vein

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76
Q

what vein runs with the posterior descending artery

A

middle cardiac vein

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77
Q

what artery goes all the way to the apex

A

LAD

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78
Q

what arteries supplie 2/3 of the heart

A

LAD and circumflex

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79
Q

where does the LAD terminate

A

posterior aspect of the apex
it wraps around from the anterior aspect to the posterior

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80
Q

pectinate muscles are found within the ___

A

right atria and left atrial appendage

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81
Q

the left and right coronary arteries get their blood during ____

A

diastole

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82
Q

where is the fossa ovalis found

A

interatrial septum

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83
Q

what is the purpose of the pectinate muscles

A

provides extra squeeze to help push blood from atrium to ventricle
help to overcome the pressure gradient between atria and ventricles

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84
Q

all papillary muscles will have ___ attached to it

A

chordae tendineae

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85
Q

the small cardiac vein runs immediately inferior to the ____

A

inferior vena cava

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86
Q

the small cardiac vein runs with the ____

A

right marginal artery

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87
Q

trabeculae carneae are found within the ___

A

left and right ventricles

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88
Q

the pulmonary valve has __ cusps and they are named ____

A

3- left right and anterior

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89
Q

the aortic valve has __ cusps and they are named ____

A

3 left right and posterior

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90
Q

the mitral valve is located

A

between left atrium and left ventricle

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91
Q

the mitral valve has __ cusps and they are named ____

A

2- anterior and posterior

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92
Q

the tricuspid valve is located between the ____

A

right atrium and right ventricle

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93
Q

the tricuspid valve has __ cusps and they are called _____

A

3- septal, anterior and posterior

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94
Q

when traveling between the lungs, the esophagus runs ___ in relation to the hilum

A

posterior

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95
Q

what muscle attaches to the sternum and ribs 3-6? plays major role in respiration

A

transversus thoracis muscle

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96
Q

what are the joints that attach the anterior aspect of the ribs to the sternum

A

costochondral joint

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97
Q

where does the left recurrent laryngeal nerve branch from

A

it branches off of the left vagus nerve, goes under the ligament arteriosum and up to the larynx

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98
Q

is the laryngeal nerve sympathetic or parasynpathetic

A

parasympathetic

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99
Q

where does the intercostal nerve originate

A

spinal cord

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100
Q

the internal thoracic artery terminates into the ___

A

superior epigastric
musculophrenic arteries

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101
Q

the coronary sulcus is found between the ___ and ___

A

right atrium and right ventricle on the anterior portion of the heart

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102
Q

the left coronary artery comes out of the aortic arch on the __ aspect of the heart

A

anterior

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103
Q

the right coronary artery come out of the aortic arch on the ___aspect of the heart

A

posterior

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104
Q

the right atrium pressure is

A

5 mmhg

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105
Q

right ventricle pressure

A

24mmhg

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106
Q

left atrium pressure

A

10mmhg

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107
Q

left ventricle pressure

A

130mmhg

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108
Q

if you inflate the ETT cuff too much what nerve could be damaged

A

left recurrent laryngeal nerve

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109
Q

in the ventricle, pressure is usually ____ points higher than in the periphery

A

20-30 (SBP= 170 means >200 in ventricle

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110
Q

where is the subclavius and why is it important

A

deep and slightly inferior to clavicle
the suprascapular artery runs with it

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111
Q

ribs 8,9,10 tie back into the sternum via

A

costrochondral juncture

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112
Q

how many sets of intercostal nerves arteries and veins are there

A

11, between each rib

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113
Q

where does rib 1 and 2 receive their blood suplpy

A

costocervical trunk from subclavian artery
the costocervical trunk turns into the superior intercostal artery and then splits into 2 posterior intercostal arteries

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114
Q

what is the mediastinum

A

space between the lungs that contains the heart, great vessels, and part of the esophagus and trachea

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115
Q

what lung has what fissures

A

right lung: 2, horizontal between superior and middle…..oblique between middle and inferior

left has the oblique fissure

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116
Q

what is the cardiac notch

A

a depression of the inferior lobe if the left lung where the heart sits

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117
Q

where would you find the lingula

A

projects from the lower part of the left superior lobe and covers the heart bulge

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118
Q

list the bronchial tree

A

trachea
right and left main bronchus
lobar bronchi (secondary)
segmental bronchi (tertiary)
divisions- bronchioles

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119
Q

three functions of trabeculae carneae

A

-aid in contraction
-prevent sticking due to increased surface area
-stirs blood to prevent clotting

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120
Q

at what 3 points does the cava system and portal systems meet

A

esophagus
umbilicus
rectum

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121
Q

where do the anterior intercostal veins drain

A

internal thoracic vein

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122
Q

where do the posterior intercostal veins drain

A

azygous system

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123
Q

what veins come together to form the SVC

A

brachiocephalic veins

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124
Q

where do the pericardiacophrenic veins drain

A

internal thoracic veins

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125
Q

how many parts are the cardiac plexus

A

2, superficial and deep

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126
Q

where would you find the superficial cardiac plexus

A

inferior to the aortic arch and between the aorta and pulmonary trunk

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127
Q

where would you find the deep part of the cardiac plexus

A

between the aortic arch and the tracheal bifurcation

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128
Q

what level does the azygous vein arise from

A

L1 or L2

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129
Q

what what level does the accessory hemiazygous vein tie into the azygous vein

A

T3

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130
Q

at what level does the hemiazygous vein tie into the azygous vein

A

T4

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131
Q

where does the greater splanchnic nerve originate

A

T5

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132
Q

where does the lesser splanchnic nerve originate

A

T9-T10

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133
Q

where does the least splanchnic nerve originate

A

T12

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134
Q

what nerve does the splanchnic nerve branch from

A

sympathetic chain

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135
Q

what areas of the body does the right thoracic duct drain

A

right arm, right face and right side of sternum

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136
Q

what lymph nodes make up the axillary chain

A

superior to inferior ACLP-
apical axillary
central axillary
lateral axillary
pectoral axillary

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137
Q

what is the cisterna chyli

A

enlarged terminus of the thoracic duct that receives lymph from the digestive viscera

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138
Q

where would you find the internal thoracic artery and vein

A

lateral to the sternum

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139
Q

what does the musculophrenic artery supply

A

lateral diaphragm

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140
Q

where does the pericardiacophrenic arteries originate

A

internal thoracic arteries

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141
Q

what is the S1 sound

A

mitral and tricuspid closure

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142
Q

what is the S2 sound

A

closure of the semilunar valves- aortic and pulmonic

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143
Q

which renal vein is longer and why

A

left
because the IVC is on the right side of the body

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144
Q

what does the left testicular vein feed into

A

left renal vein

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145
Q

what does the right testicular vein feed into

A

IVC

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146
Q

what does the iliohypogastric nerve innervate

A

internal oblique/ transverses abdominus
skin in the pubic gluteal region

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147
Q

name the veins that feed into the portal vein

A

left gastric
right gastric
splenic
inferior mesenteric
superior mesenteric
left and right gastroomental veins

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148
Q

what does the ilio-inguinal nerve innervate

A

internal oblique/transversus
medial thigh
skin root of penis and anterior scrotum/mons pubis and labia majora

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149
Q

what does the genitofemoral nerve innervate

A

cremaster muscle
scrotum or labia majora

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150
Q

what is the breast mostly comprised of

A

fat

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151
Q

what does the lateral cutaneous nerve of thigh innervate

A

skin on anterior thigh

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152
Q

trace the flow of milk through the breast

A

glandular tissue–>
lactiferous sinus–>
lactiferous duct–>
tit orifice

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153
Q

what does the femoral nerve innervate

A

iliacus
pectineus
anterior thigh muscle
skin on anterior thigh

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154
Q

why is the breast a good area for bacteria to grow

A

production of milk
increased blood to produce milk
opening in body for bacteria to get in

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155
Q

why are there a lot of lymph nodes in the armpit

A

because of potential for infection in the breast

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156
Q

what is lymph

A

a colorless fluid containing WBC, part of the extracellular fluid

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157
Q

what is the purpose of lymph

A

carry dead cells and pathogens to lymph nodes

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158
Q

what does lymph nodes produce

A

monocytes and lymphocytes

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159
Q

what carries lymph from the lymph node to the venous system

A

lymphatic capillaries

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160
Q

what is the role of the lymphatic system

A

pick up dead cells and pathogens in extracellular fluid, takes lymph back to the lymph node, node cleans blood, feeds it back into the venous system which passes through the kidneys and gets filtered out

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161
Q

how many cells are in the body

A

37.5 trillion

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162
Q

what is lymphadema

A

swelling in extremities when lymph is pooling within perpheries

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163
Q

how can left sided HF affect lymph system

A

blood backs up causing lymph system to back up which can cause fluid to get dumped into lungs causing pulmonary edema

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164
Q

where does the anterior portion of the breast lymph drain into

A

abdomen lymph nodes

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165
Q

where does the medial portion of the breast lymph drain into

A

sternal lymph nodes

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166
Q

where does the superior and lateral portion of the breast drain into

A

axillary lymph nodes

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167
Q

why is radiation for breast cancer preferred over mastectomy

A

less complications

168
Q

which lymph nodes need to be positive for cancer to get a mastectomy

A

sternal lymph nodes

169
Q

what do the axillary lymph nodes encase

A

axillary vein

170
Q

where does the axillary lymph node drain into

A

subclavian vein near where it branches off from brachocephalic vein

171
Q

which intercostal space is a chest tube inserted into and why

A

5th intercostal space
so that gravity drains fluid out of the chest

172
Q

how do you determine the anterior aspect of t4-t5

A

manubrium attached to body of sternum (sternal angle)

173
Q

why is rib one unable to be palpated

A

clavicle overlaps it

174
Q

when inserting a central line, should the tip be above or below the sternal angle

A

slightly below to avoid backflow of atrium

175
Q

what is a saddle thrombus

A

clot that gets stuck where main pulmonary trunk bifurcates

176
Q

what is a chylothorax

A

presence of lymphatic fluid in thoracic cavity

177
Q

what does the thoracic duct drain

A

feet, legs, abdomen and thoracic cavity

178
Q

what is the largest lymph vessel in the body

A

thoracic duct

179
Q

where does the thoracic duct cross over to the left side

A

at the sternal angle

180
Q

what is the function of the external intercostal muscles

A

turn ribs out during inspiration

181
Q

what happens to alveoli in emphysema

A

lose elastic recoil

182
Q

what has elastic recoil to help in inspiration/expiration

A

alveoli

183
Q

what does the internal intercostal muscles do

A

aids in expiration

184
Q

what muscles attach to sternum and skull

A

sternocleidomastoid

185
Q

what muscle raises the sternum during inspiration

A

sternocleidomastoid

186
Q

what contracts down during inspiration to create room for lungs to expand

A

diaphragm

187
Q

how much fluid is in the interpleural space

A

10-20cc

188
Q

80% of blockages in the heart are in which coronary

A

left anterior descending

189
Q

what is the parenchyma of the lungs

A

site of gas exchange

190
Q

what are the lymph vessels of the thoracic wall

A

parasternal nodes
intercostal nodes
diaphragmatic nodes

191
Q

what is pleurisy

A

parietal pleura sticks to chest wall

192
Q

which pleura has more nerve endings

A

parietal pleura

193
Q

where does the right recurrent laryngeal nerve come off

A

off vagus nerve at thoracic inlet

194
Q

what provides blood supply to pericardial sac

A

left and right pericardiophrenic artery

195
Q

which artery supplies 2/3 of heart with blood

A

LAD

196
Q

what anatomical feature does the circumflex run in

A

coronary sulcus of the heart

197
Q

intra-atrial septal defect

A

when foramen ovale doesnt close, only problem if right to left shunt present

198
Q

what is S2 sound

A

closing of aortic and pulmonic valves

199
Q

where is the cysterna chyli

A

12th rib

200
Q

what holds the organs in the pelvic girdle

A

aponeurosis

201
Q

what is the most superficial abdominal muscle

A

external oblique

202
Q

what is the origin and attachment of the external oblique

A

costchondral junture of ribs and pubus

203
Q

what muscle is deep to the external oblique

A

internal oblique

204
Q

where does the internal oblique originate

A

wing of ilium, goes toward xyphoid

205
Q

how many divisions does the rectus abdominus have

A

8

206
Q

where does the transverse oblique originate and attach

A

thoracolumbar fascia near quadratus lumborum, linea alba

207
Q

where does the inguinal ligament originate and attach

A

spine of ilium to pubis

208
Q

how many layers of fascia is the linea alba composed of

A

8
2 from each muscle of the abdomen

209
Q

what muscles is the lumbar plexus located between

A

between internal oblique and transversus abdominus

210
Q

what is a bowel ileus

A

loss of peristalsis

211
Q

where is the greater omentum attached

A

greater curvature of the stomach and transverse colon

212
Q

what is the role of the greater omentum

A

abdominal policemen
moves to areas of intestine not having peristalsis, wraps around intestine, increases blood supply and carries infection away

213
Q

what is the formation of the greater omentum

A

thin, vascular
contains lymphatics
hangs freely like an apron

214
Q

where is the lesser omentum attached

A

lesser curvature of stomach and liver

215
Q

where does the mesentery originate

A

posterior aspect of the abdomen

216
Q

what is the role of the mesentery

A

keeps vessels from overlapping and constricting one another when the intestines move

217
Q

what is the mesentery

A

conduit for vessels to travel to the intestines

218
Q

what arteries does the lesser curvature of the stomach having running along it

A

left and right gastric artery

219
Q

what arteries run with the greater curvature of the stomach

A

left and right gastro-omental arteries

220
Q

what structure keeps food in the stomach

A

pyloric sphincter (shaped like olive)

221
Q

what connects the abdominal esophagus to the body of the stomach

A

cardia

222
Q

between esophagus and fundus above the cardia

A

cardiac notch

223
Q

sits on top of the body of the stomach

A

fundus

224
Q

sits below the fundus of the stomach

A

body of stomach

225
Q

when body of stomach starts getting smaller

A

pyloric antrum

226
Q

narrow area right after pyloric antrum

A

pyloric canal

227
Q

sphincter at the end of the pyloric canal

A

pyloric sphincter

228
Q

regurgitation occurs in babies because of the small pyloris and is called

A

pyloric stenosis

229
Q

part of the pyloric sphincter that opens into duodenum

A

pyloric orifice

230
Q

what are the sections of the duodenum

A

superior
descending
inferior
ascending

231
Q

what differentiates the duodenum from the jejunum

A

duodenum does not have mesentery

232
Q

what part of the duodenum is adhered to the peritoneum

A

posterior
making it partially retroperitoneal

233
Q

what part of the small intestine has mesentery attaching it to the posterior abdominal wall

A

jejunum and ileum

234
Q

vasa recta are longer in which part of the small intestine

A

jejunum

235
Q

what differentiates the jejunum from the ileum

A

ileum has peyers patches

236
Q

what part of the small intestine dumps into the cecum

A

ileum

237
Q

what stops food from moving from the cecum back into the ileum

A

ileocecal flaps

238
Q

what appendage attached to cecum

A

appendix

239
Q

what does the appendix do

A

stores e.coli/bacteria

240
Q

what does e.coli do in the cecum

A

digests bilirubin in cecum

241
Q

what makes the appendix inflammed

A

good bacteria is blocked off by fecal content, causes inflammation overtime

242
Q

name the order of the large intestine

A

cecum
ascending colon
transverse colon
descending colon
sigmoid colon
rectum
anus

243
Q

what is the corner between the ascending colon and the transverse colon

A

right hepatic flexure

244
Q

what is the corner between the transverse colon and the descending colon

A

left splenic flexure

245
Q

what are the bands running between the haustra on the outer colon called

A

taeniae coli

246
Q

what is the role of the taeniae coli

A

makes it pouch into haustra

247
Q

why are haustra important

A

fecal content churns in pockets getting water and nutrients out for absorption

248
Q

what are omental appendices

A

fatty tissues attached to taeniae coli that have visceral peritoneum on them

249
Q

what happens in diverticulitis

A

pouches of haustra with fecal content in them bulge out, fecal content gets stuck, water is continually pulled out, hardens fecal content and it gets infected

250
Q

what organ is completely retroperitoneal

A

kidneys

251
Q

what are the four branches off the abdominal aorta

A

celiac trunk
inferior/superior mesenteric
renal arteries

252
Q

what artery branches to the right off the celiac trunk

A

common hepatic artery

253
Q

what does the common hepatic artery branch into

A

proper hepatic artery and gastroduodenal artery

254
Q

what are the four branches off the gsatroduodenal artery

A

supraduodenal
posterior superior pancreaticoduodenal
anterior superior pancreaticoduodenal
right gastro-omental

255
Q

what artery supplies the superior aspect of the duodenum

A

supraduodenal artery

256
Q

what artery branches off the proper hepatic artery

A

right gastric artery

257
Q

what does the proper hepatic artery split into

A

left and right hepatic arteries

258
Q

what artery branches off the right hepatic artery

A

cystic artery

259
Q

what does the celiac trunk supply

A

stomach
liver
spleen
pancreas
duodenum

260
Q

what does the abdominal aorta supply

A

everything except kidneys and reproductive tract

261
Q

what arteries supply the kidneys

A

renal arteries

262
Q

what does the superior mesenteric artery supply

A

small intestine
appendix
cecum
ascending colon
half of transverse colon

263
Q

what artery goes behind pancreas and supplies head of pancrease and duodenum

A

posterior superior pancreaticoduodenal artery

264
Q

what does the right gastro-omental artery run with and connect to

A

runs with the greater curvature of stomach
connects with left gastro omental artery

265
Q

what is the only arterial supply to the gallbladder

A

cystic artery

266
Q

what does the right gastric artery run along and connect with

A

runs with lesser curvature of the stomach
connects with the left gastric artery

267
Q

what is the 1st branch which is superior on the left side of the celiac trunk

A

left gastric artery

268
Q

what artery is inferior of the left gastric artery

A

splenic artery

269
Q

what is a main artery off the celiac trunk without any branches

A

left gastric artery

270
Q

what are the branches of arteries off the splenic artery going to the pancreas

A

pancreatic arteries

271
Q

what are 1-3 branches of arteries at end of splenic artery moving up called

A

short gastric arteries

272
Q

what is the artery at the end of the splenic artery moving down

A

left gastro omental artery

273
Q

where do the short gastric arteries go to

A

fundus of the stomach

274
Q

what are the branches off the superior mesenteric artery in order

A

middle colic artery
right colic artery
ileocolic artery
ileal/jejunal arteries

275
Q

where does the middle colic artery go to

A

transverse colon

276
Q

where does the right colic artery go to

A

ascending colon

277
Q

what are the branches of the ileocolic artery

A

anterior cecal/ posterior cecal arteries
they join together to form the appendicular junction

278
Q

what do the ileal/jejunal arteries branch into

A

arterial arcades

279
Q

what do arterial arcades branch into

A

vasa recta-which connect to intestine

280
Q

name the branches of the inferior mesenteric artery

A

left colic
sigmoid artery
superior rectal artery

281
Q

name the branch off the left colic artery that supplies the transverse colon

A

marginal artery

282
Q

where does the left colic artery go to

A

descending colon

283
Q

where does the sigmoid artery go to

A

sigmoid colon

284
Q

what does the inferior mesenteric artery turn into

A

superior rectal artery

285
Q

what are the four lobes of the liver

A

right lobe
left lobe
caudate lobe
quadrate lobe

286
Q

what lobe of the liver is anterior to the caudate lobe

A

quadrate lobe

287
Q

what is the portal triad

A

hepatic artery
portal vein
hepatic duct

288
Q

what is the significance of having the portal triad going to each lobe

A

able to remove one whole lobe without affecting flow to the other lobes

289
Q

how much liver can be taken and still have it regenerate

A

70%

290
Q

what is the number one function of the liver

A

detoxify the body

291
Q

what does the liver produce and store

A

produces bile
stores glycogen

292
Q

what ties the liver to the diaphragm

A

falciform ligament

293
Q

what ducts go out of the liver and gallbladder

A

hepatic and cystic duct

294
Q

what are the hepatic and cystic ducts called when they join together

A

common bile duct

295
Q

what happens to bile that is not used in duodenum

A

goes back to gallbladder for storage

296
Q

why cant a person with liver disease consume as much fat as before

A

liver is diseased and doesnt make as much bile to break down fat

297
Q

can a person with a cholecystectomy consume fat

A

yes, but they only digest the fat that the liver has enough bile to make for
they no longer have gallbladder to release extra bile for digestion

298
Q

what are symptoms of eating too much fat without gallbladder

A

diarrhea
cramps
gas

299
Q

where do enzymes from the pancreas and bile from the gallbladder empty into the duodenum

A

major/minor duodenal papilla

300
Q

what provides some relief in only some people if major duodenal papilla is backed up

A

minor duodenal papilla

301
Q

what is the funnel area that the common bile duct empties into before major duodenal papilla

A

hepatopancreatic ampulla

302
Q

where do most gallstones gather

A

heptopancreatic ampulla

303
Q

what do 80% of patient with bile obstruction develop

A

pancreatitis, because pancreatic enzymes get backed up into pancreas and there is no storage

304
Q

name the exocrine products of the pancreas

A

amylase
lipase
trypsin
chymotrypsin

305
Q

name the endocrine products of the pancreas

A

insulin and glucagon

306
Q

where are RBCs stored and how long do they live

A

spleen
120 days

307
Q

what breaks down old RBCs and some pathogens in the spleen

A

megakarocytes

308
Q

what do megakarocytes break down old RBCs into

A

hemoglobin and bilirubin

309
Q

what happens when spleen is removed

A

more prone to anemia
more prone to disease (immunosuppression)

310
Q

what back muscle does the kidney lie underneath

A

erector spinae

311
Q

what is the kidney bound by and why is it significant

A

fat cells for protection and mobilization (able to move 1-3 inches)

312
Q

on the inner kidney, what is the border around the outside called

A

renal cortex

313
Q

where is the glomerulus located

A

renal cortex

314
Q

how much glomeruli do you lose after age 40

A

1% per year

315
Q

what feeds into the renal papilla

A

renal pyramid

316
Q

what feeds into the minor calyx

A

renal papilla

317
Q

what lies in between renal pyramids

A

renal columns

318
Q

what does the renal papilla dump waste into

A

minor calyx

319
Q

what does the minor calyx dump into

A

major calyx

320
Q

what does the major calyx dump into

A

renal pelvis

321
Q

what does the renal pelvis dump into

A

ureter

322
Q

what gland lies on top of the kidney

A

adrenal gland

323
Q

what muscle lies on the wing of the ilium

A

iliacus

324
Q

what muscle is medial to the iliacus

A

psoas major

325
Q

what muscle is medial to psoas major

A

psoas minor

326
Q

what muscle is superior to the iliacus and posterior to the psoas major

A

quadratus lumborum

327
Q

where do the nerves originate that compose the lumbar plexus

A

T12
L1
L2
L3
L4

328
Q

what nerve root is the subcostal nerve

A

T12

329
Q

what nerve root makes up the iliohypogastric nerve

A

L1

330
Q

what is the nerve root for the ilio-inguinal nerve

A

L1

331
Q

what is the nerve root for the genitofemoral nerve

A

L1 L2

332
Q

what muscle does the genitofemoral nerve lie on

A

psoas major muscle

333
Q

what is the nerve root for the lateral cutaneous nerve of the thigh

A

L2 L3

334
Q

what is the nerve root of the femoral nerve

A

L2 L3 L4

335
Q

what muscle does the femoral nerve sit between

A

lateral to psoas major, medial to iliacus

336
Q

what are the nerve roots of the obturator nerve

A

L2 L3 L4

337
Q

what are the roots of the lumbosacral trunk

A

L4 L5

338
Q

what nerves are blocked in the quadratus lumborum block

A

T12
L1
L2
L3

339
Q

what is the difference between and fossa and a foramen

A

fossa is a depression
foramen is a hole

340
Q

what does the fetus get oxygen and nutrition from

A

placenta

341
Q

what is the foramen ovale

A

hole between right and left atrium

342
Q

what is the ductus venosus

A

shunt where blood bypasses liver and goes into inferior vena cava

343
Q

what happens when ductus venosus doesnt shut

A

hepatoencephalopathy- blood bypasses liver and doesnt get cleaned of ammonia

344
Q

in the fetus, where does blood that bypasses liver go to

A

inferior vena cava- 60% of it

345
Q

how much blood gets cycled through the liver of the fetus

A

40%

346
Q

how does blood from head and upper extremities bypass the lungs ( in the fetus)

A

goes into right atrium-right ventricle- pulm artery- ductus arteriosus-aorta

347
Q

what does the ductus arteriosus become

A

ligamentum arteriosum

348
Q

how is mammary tissue connected to the body

A

connective tissue

349
Q

what is the layer between the pectoral muscle and the breast

A

deep pectoral fascia

350
Q

where do the internal and external obliques attach

A

pubic tubercle

351
Q

what does the obturator nerve supply

A

adductor longus
adductor brevis
adductor magnus

352
Q

what is the difference in male and female pelvis

A

male= wider pubic symphysis, narrow pubic arch

female= narrow pubic symphysis, wing of ileum flares out, oval pubic arch

353
Q

what are the three male accessory sex glands

A

seminal vesicle
bulbourethral gland
prostate

354
Q

which sex gland puts fructose in ejaculatory fluid

A

seminal vesicles

355
Q

how does the bulbourethral gland contribute to sperm survival

A

make pre ejaculate fluid that is pH neutral so that sperm can survive coming out of the urethra

356
Q

what does the prostate put into ejaculatory fluid

A

lysozymes and antibodies

357
Q

what is side effect of flomax

A

retroejaculation into bladder since sphincter is relaxed

358
Q

how do sperm move through vas deferens

A

peristalsis

359
Q

what are the three accessory female sex glands

A

mesonephric tubules
paraurethral gland
greater vestibular gland

360
Q

how do the accessory sex glands match up with each other male vs female

A

prostate gland=paraurethral gland

bulbourethral gland= greater vestibular gland

seminal vesicles=mesonephric tubules

361
Q

what structure do the penis and clitoris have in common

A

corpus cavernosa x2

362
Q

what fluid is from female ejaculation and what is its role

A

paraurethral fluid- enhances viability of sperm

363
Q

what female gland makes lubrication fluid

A

greater vestibular gland

364
Q

what is the role of the mesonephric tubules

A

add blood supply to fallopian tubes, which provides fluid/variability for fertilized egg

365
Q

where does blood get trapped during male/female erection

A

corpora cavernosa

366
Q

what structure encases the urethra in a male

A

corpus spongiosum

367
Q

which nervous system controls erection

A

parasympathetic

368
Q

which nervous system controls ejaculation

A

sympathetic

369
Q

what condition needs to be met for spermatogenesis

A

1-3 degree cooler than body genesis

370
Q

what muscle holds the testicle

A

cremaster muscle

371
Q

what is the lining around the testicle

A

tunica vaginalis

372
Q

what is the role of the pampiniform plexus

A

cobweb of veins encasing testicular artery that cools the blood

373
Q

what happens in testicular torsion

A

gubernaculum doesnt fully attach
testicle gets twisted and blood supply is cut off

374
Q

what is the function of the gubernaculum in the fetus

A

pulls testes down through the abdomen, through the inguinal canal into scrotum

375
Q

where does fertilization occur

A

ampulla

376
Q

what are the projections at the end of the infundibulum that swims the egg into the infundibulum

A

fimbrae

377
Q

what prevents the sperm from being destroyed coming through the vas deferens

A

acrosomal cap

378
Q

what stores sperm until ejaculation

A

epididymis

379
Q

what is the route of the sperm

A

seminiferous tubules
straight tubules
rete testis
efferent ductules
head of epididymis
vas deferens
seminal vesicle
prostate
urethra

380
Q

how long is each seminiferous tubule

A

25 feet

381
Q

what protects implanted egg and sperm

A

cervix

382
Q

what decreases when progesterone increases

A

estrogen

383
Q

what hormone decreases when estrogen increases

A

progesterone

384
Q

what is the number one function of progesterone

A

eliminates contractions of the uterus

385
Q

how does progesterone cause gastric reflux

A

relaxes uterus, but also relaxes esophageal sphincter

386
Q

when is progesterone made

A

after implantation

387
Q

what does the suspensory ligament contain in the female

A

ovarian artery and vein

388
Q

what is the role of the suspensory ligament

A

ties and bind ovary to wall of abdomen

389
Q

what hormone indicates pregnancy

A

HCG

390
Q

what hormone from pituitary gland stimulates ovary to produce follicle

A

FSH

391
Q

what is a follicle

A

blister like structure on ovary that takes embryonic cells to develop egg

392
Q

what hormone causes follicle to rupture releasing egg

A

leutinizing hormone

393
Q

what is the follicle that ruptured and filled with blood called and what does it produce

A

corpus luteum and progesterone

394
Q

what structures does an indirect hernia go through

A

internal ring
inguinal canal
external ring
scrotum

395
Q

what causes indirect hernia vs direct hernia

A

indirect= heritable anatomy
direct=trauma

396
Q

what structure does a direct hernia involve

A

conjoins tendon into scrotum

397
Q

what is the conjoins tendon made of

A

internal/external oblique near pubis

398
Q

where does the internal thoracic artery split into superior epigastric and musculophrenic artery

A

7th costal cartilage

399
Q

what does the azygous vein drain into

A

superior vena cava

400
Q

what is the original umbilical cord

A

round ligament

401
Q

what does the inferior vena cava drain in the abdomen

A

feet
legs
kidneys
reproductive

402
Q

what does the portal venous system drain in the abdomen

A

stomach
spleen
intestines

403
Q

What muscle does the suprascapular artery run through

A

Subclavius

404
Q

Layers of abdominal muscles from most outer to most internal

A

External oblique
Internal oblique
Transversus abdominus

405
Q

What nerve lies on top of the psoas muscle

A

Genitofemoral nerve (L1 L2)

406
Q

What nerve supply’s the lower epigastric muscles

A

Iliohypogastric nerve (L1)

407
Q

What does the ductus venosus become after first breath

A

Ligamentum venosum

408
Q

What does ductus arteriosus become after first breath

A

Ligamentum arteriosum

409
Q

What are the three branches off the abdominal aorta

A

Celiac trunk
Superior mesenteric artery
Inferior mesenteric artery

410
Q

What are the branches off the celiac trunk

A

Left gastric artery
Splenic artery
Common hepatic artery

411
Q

What branches off the common hepatic artery

A

Gastroduadenal artery

Then common hepatic become proper hepatic

412
Q

What does the proper hepatic artery split into

A

Right gastric
Left hepatic
Right hepatic

413
Q

What branches off the right hepatic artery

A

Cystic artery

414
Q

What is the first branch off the gastroduadenal artery

A

Supraduadenal artery

415
Q

What are the branches of the splenic artery

A

Left gastro o mental
Short gastrics
Pancreatics

416
Q

What’s in the spermatic cord

A

Testicular vein
Testicular artery
Vas deferens/ductus deferens