Exam 2 Material Flashcards
(416 cards)
1
Q
the pectoralis minor muscle attaches to the ____
A
coracoid process and ribs 3-5
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
3
Q
what are the medial lymph nodes deep to the pectoralis major
A
parasternal nodes
4
Q
lymphatic and venous drainage passes from inferior part of the breast _____
A
into the abdomen
5
Q
lymphatic and venous drainage passes from the lateral and superior part of the breast into the ____
A
axilla
6
Q
lungs stop at _____
A
intercostal space 6-7
7
Q
how many true ribs are there
A
7 pairs
8
Q
how many false ribs are there
A
5 pairs
9
Q
how many floating ribs are there
A
2 pairs
10
Q
what is the superior part of the sternum
A
manubrium
11
Q
what is the middle part of the sternum
A
body
12
Q
what is the inferior part of the sternum
A
xiphoid process
13
Q
what is significant about the carina?
A
it contains receptors that stimulate cough when irritated
14
Q
where is the carina located
A
point where the trachea splits into the primary bronchi
15
Q
the sternal angle is a
A
traverse plane
16
Q
the sternal angle is at what vertebral level
A
T4-T5
17
Q
the aortic arch begins and ends at the ___
A
sternal angle
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
19
Q
the intercostal artery, vein, and nerve run in what order inferior to superior
A
nerve-artery-vein
20
Q
where are the intercostal nerve artery and vein located
A
behind the wing on the inferior posterior portion of the rib
21
Q
what are the two muscles between the ribs
A
external intercostal
internal intercostal muscles
22
Q
where are the collateral branches of the intercostal nerve artery and vein located
A
immediately superior to the rib
23
Q
what are the 4 major muscles of respiration
A
sternocliedomastoid
external intercostals
internal intercostals
diaphragm
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
25
on the left side, where does the bronchial artery originate from
aorta
26
where does the posterior intercostal arteries originate from?
aorta
27
where do the anterior intercostal arteries arise from
internal thoracic artery
28
what are the two terminal branches of the internal thoracic artery
superior epigastric artery and musculophrenic artery
29
what does the musculophrenic artery supply
the lateral aspect of the diaphragm and muscles
30
what does the superior epigastric artery supply
xiphoid area and area immediately inferior
31
what are the 3 things that dump into the right atrium
superior vena cava
inferior vena cava
coronary sinus
32
what does the azygos vein dump into
superior vena cava
33
where is the azygos vein located, and what area does it drain
right side of the vertebral column and it drains viscera within the mediastinum as well as back and thoracoabdominal walls
34
what veins drain into the coronary sinus
great cardiac vein
middle cardiac vein
small cardiac vein
35
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
accessory hemiazygous and hemiazygous vein
36
where do the accessory hemiazygous and hemiazygous veins dump into
azygous vein on the right side
they cross the vertebral column anteriorly and connect to the azygous vein
37
where does the thoracic duct drain
left subclavian vein near where the internal jugular arises
38
what lies between the parietal pleura and visceral pleura
pleural cavity
39
what is the pressure of the pleural cavity
-4 to -10 mmhg
40
where is the parietal pleura
on thoracic wall and superior face of diaphragm
41
where is the visceral pleura found
covers the lungs
42
what is the acronym to remember the placement of the pulmonary arteries in relation to the bronchi
RALS
right anterior
left superior
43
what is the area of the lungs where you find the base of the bronchi, arteries, and veins as they enter/exit the lungs
hilum
44
what is the most inferior portion of the lungs called where it touches the diaphragm
diaphragmatic surface
45
the apex of the lungs is located _____
in the neck above the subclavian artery and vein
46
which bronchus is bigger?
right main
47
the left recurrent laryngeal nerve passes directly __ the arch of the aorta at the ___
under
ligamentum arteriosum
48
what does the left recurrent laryngeal nerve innervate
the internal laryngeal nerve (sensory), supplies sensory fibers to the laryngeal mucosa and the external laryngeal nerve (motor) innervates cricothyroid muscle
49
the right and left recurrent laryngeal nerves branch from the ___ nerve
vagus
50
the right recurrent laryngeal nerve innervates what
the intrinsic muscles of the larynx with exception of the cricothyroid muscles
51
what nerve forms the esophageal plexus
vagus nerve
52
what nerve travels in the mediastinum lining and innervates the diagphram
phrenic nerve
53
how many phrenic nerves are there
2- the left and right
54
what vein and artery supplies the pericardial sac and diaphragm
left and right pericardiacophrenic arteries and veins
55
what nerves innervate the diaphragm
phrenic
56
what is the pericardium
the membran enclosing the heart, consisting of an outer fibrous layer and an inner double layer of serous membrane
57
what is the transverse pericardial sinus
the passage between the aorta and pulmonary artery anteriorly and the superior vena cava posteriorly
it separates arteries and veins
58
where is the oblique pericardial sinus
posterior to the heart in the pericardial sac
59
how can you find the oblique sinus
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
60
what shape is the oblique pericardial sinus
an inverted U
61
what are the borders of the oblique pericardial sinus
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
62
the transverse pericardial sinus is located on ___ and the oblique pericardial sinus is located ____
superior aspect of the heart
posterior aspect of the heart
63
what are the openings of the left atrium
left superior pulm vein
left inferior pulm vein
right superior pulm vein
right inferior pulm vein
64
where does the pulm artery exit from
right ventricle
65
where is the coronary sinus located
posterior heart and immediately inferior to the left atrium
66
what is the purpose of the coronary sinus
holding chamber while heart is in systole
67
what dumps into the right atrium
SVC
IVC
coronary sinus
68
what is the most posterior part of the heart
left atrium
69
what is the fat pad that lies between the ventricles
intraventricular sulcus
70
what collects all of the venous blood of the heart
coronary sinus
71
what are the two branches of the right coronary artery
right marginal artery of right coronary
posterior descending artery (PDA)
72
what are the two branches off the left main coronary artery
circumflex
left anterior descending
73
what is the first major branch off of the left coronary artery
circumflex
74
where does the circumflex artery run
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
75
what is the vein that runs with the left anterior descending
great cardiac vein
76
what vein runs with the posterior descending artery
middle cardiac vein
77
what artery goes all the way to the apex
LAD
78
what arteries supplie 2/3 of the heart
LAD and circumflex
79
where does the LAD terminate
posterior aspect of the apex
it wraps around from the anterior aspect to the posterior
80
pectinate muscles are found within the ___
right atria and left atrial appendage
81
the left and right coronary arteries get their blood during ____
diastole
82
where is the fossa ovalis found
interatrial septum
83
what is the purpose of the pectinate muscles
provides extra squeeze to help push blood from atrium to ventricle
help to overcome the pressure gradient between atria and ventricles
84
all papillary muscles will have ___ attached to it
chordae tendineae
85
the small cardiac vein runs immediately inferior to the ____
inferior vena cava
86
the small cardiac vein runs with the ____
right marginal artery
87
trabeculae carneae are found within the ___
left and right ventricles
88
the pulmonary valve has __ cusps and they are named ____
3- left right and anterior
89
the aortic valve has __ cusps and they are named ____
3 left right and posterior
90
the mitral valve is located
between left atrium and left ventricle
91
the mitral valve has __ cusps and they are named ____
2- anterior and posterior
92
the tricuspid valve is located between the ____
right atrium and right ventricle
93
the tricuspid valve has __ cusps and they are called _____
3- septal, anterior and posterior
94
when traveling between the lungs, the esophagus runs ___ in relation to the hilum
posterior
95
what muscle attaches to the sternum and ribs 3-6? plays major role in respiration
transversus thoracis muscle
96
what are the joints that attach the anterior aspect of the ribs to the sternum
costochondral joint
97
where does the left recurrent laryngeal nerve branch from
it branches off of the left vagus nerve, goes under the ligament arteriosum and up to the larynx
98
is the laryngeal nerve sympathetic or parasynpathetic
parasympathetic
99
where does the intercostal nerve originate
spinal cord
100
the internal thoracic artery terminates into the ___
superior epigastric
musculophrenic arteries
101
the coronary sulcus is found between the ___ and ___
right atrium and right ventricle on the anterior portion of the heart
102
the left coronary artery comes out of the aortic arch on the __ aspect of the heart
anterior
103
the right coronary artery come out of the aortic arch on the ___aspect of the heart
posterior
104
the right atrium pressure is
5 mmhg
105
right ventricle pressure
24mmhg
106
left atrium pressure
10mmhg
107
left ventricle pressure
130mmhg
108
if you inflate the ETT cuff too much what nerve could be damaged
left recurrent laryngeal nerve
109
in the ventricle, pressure is usually ____ points higher than in the periphery
20-30 (SBP= 170 means >200 in ventricle
110
where is the subclavius and why is it important
deep and slightly inferior to clavicle
the suprascapular artery runs with it
111
ribs 8,9,10 tie back into the sternum via
costrochondral juncture
112
how many sets of intercostal nerves arteries and veins are there
11, between each rib
113
where does rib 1 and 2 receive their blood suplpy
costocervical trunk from subclavian artery
the costocervical trunk turns into the superior intercostal artery and then splits into 2 posterior intercostal arteries
114
what is the mediastinum
space between the lungs that contains the heart, great vessels, and part of the esophagus and trachea
115
what lung has what fissures
right lung: 2, horizontal between superior and middle.....oblique between middle and inferior
left has the oblique fissure
116
what is the cardiac notch
a depression of the inferior lobe if the left lung where the heart sits
117
where would you find the lingula
projects from the lower part of the left superior lobe and covers the heart bulge
118
list the bronchial tree
trachea
right and left main bronchus
lobar bronchi (secondary)
segmental bronchi (tertiary)
divisions- bronchioles
119
three functions of trabeculae carneae
-aid in contraction
-prevent sticking due to increased surface area
-stirs blood to prevent clotting
120
at what 3 points does the cava system and portal systems meet
esophagus
umbilicus
rectum
121
where do the anterior intercostal veins drain
internal thoracic vein
122
where do the posterior intercostal veins drain
azygous system
123
what veins come together to form the SVC
brachiocephalic veins
124
where do the pericardiacophrenic veins drain
internal thoracic veins
125
how many parts are the cardiac plexus
2, superficial and deep
126
where would you find the superficial cardiac plexus
inferior to the aortic arch and between the aorta and pulmonary trunk
127
where would you find the deep part of the cardiac plexus
between the aortic arch and the tracheal bifurcation
128
what level does the azygous vein arise from
L1 or L2
129
what what level does the accessory hemiazygous vein tie into the azygous vein
T3
130
at what level does the hemiazygous vein tie into the azygous vein
T4
131
where does the greater splanchnic nerve originate
T5
132
where does the lesser splanchnic nerve originate
T9-T10
133
where does the least splanchnic nerve originate
T12
134
what nerve does the splanchnic nerve branch from
sympathetic chain
135
what areas of the body does the right thoracic duct drain
right arm, right face and right side of sternum
136
what lymph nodes make up the axillary chain
superior to inferior ACLP-
apical axillary
central axillary
lateral axillary
pectoral axillary
137
what is the cisterna chyli
enlarged terminus of the thoracic duct that receives lymph from the digestive viscera
138
where would you find the internal thoracic artery and vein
lateral to the sternum
139
what does the musculophrenic artery supply
lateral diaphragm
140
where does the pericardiacophrenic arteries originate
internal thoracic arteries
141
what is the S1 sound
mitral and tricuspid closure
142
what is the S2 sound
closure of the semilunar valves- aortic and pulmonic
143
which renal vein is longer and why
left
because the IVC is on the right side of the body
144
what does the left testicular vein feed into
left renal vein
145
what does the right testicular vein feed into
IVC
146
what does the iliohypogastric nerve innervate
internal oblique/ transverses abdominus
skin in the pubic gluteal region
147
name the veins that feed into the portal vein
left gastric
right gastric
splenic
inferior mesenteric
superior mesenteric
left and right gastroomental veins
148
what does the ilio-inguinal nerve innervate
internal oblique/transversus
medial thigh
skin root of penis and anterior scrotum/mons pubis and labia majora
149
what does the genitofemoral nerve innervate
cremaster muscle
scrotum or labia majora
150
what is the breast mostly comprised of
fat
151
what does the lateral cutaneous nerve of thigh innervate
skin on anterior thigh
152
trace the flow of milk through the breast
glandular tissue-->
lactiferous sinus-->
lactiferous duct-->
tit orifice
153
what does the femoral nerve innervate
iliacus
pectineus
anterior thigh muscle
skin on anterior thigh
154
why is the breast a good area for bacteria to grow
production of milk
increased blood to produce milk
opening in body for bacteria to get in
155
why are there a lot of lymph nodes in the armpit
because of potential for infection in the breast
156
what is lymph
a colorless fluid containing WBC, part of the extracellular fluid
157
what is the purpose of lymph
carry dead cells and pathogens to lymph nodes
158
what does lymph nodes produce
monocytes and lymphocytes
159
what carries lymph from the lymph node to the venous system
lymphatic capillaries
160
what is the role of the lymphatic system
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
161
how many cells are in the body
37.5 trillion
162
what is lymphadema
swelling in extremities when lymph is pooling within perpheries
163
how can left sided HF affect lymph system
blood backs up causing lymph system to back up which can cause fluid to get dumped into lungs causing pulmonary edema
164
where does the anterior portion of the breast lymph drain into
abdomen lymph nodes
165
where does the medial portion of the breast lymph drain into
sternal lymph nodes
166
where does the superior and lateral portion of the breast drain into
axillary lymph nodes
167
why is radiation for breast cancer preferred over mastectomy
less complications
168
which lymph nodes need to be positive for cancer to get a mastectomy
sternal lymph nodes
169
what do the axillary lymph nodes encase
axillary vein
170
where does the axillary lymph node drain into
subclavian vein near where it branches off from brachocephalic vein
171
which intercostal space is a chest tube inserted into and why
5th intercostal space
so that gravity drains fluid out of the chest
172
how do you determine the anterior aspect of t4-t5
manubrium attached to body of sternum (sternal angle)
173
why is rib one unable to be palpated
clavicle overlaps it
174
when inserting a central line, should the tip be above or below the sternal angle
slightly below to avoid backflow of atrium
175
what is a saddle thrombus
clot that gets stuck where main pulmonary trunk bifurcates
176
what is a chylothorax
presence of lymphatic fluid in thoracic cavity
177
what does the thoracic duct drain
feet, legs, abdomen and thoracic cavity
178
what is the largest lymph vessel in the body
thoracic duct
179
where does the thoracic duct cross over to the left side
at the sternal angle
180
what is the function of the external intercostal muscles
turn ribs out during inspiration
181
what happens to alveoli in emphysema
lose elastic recoil
182
what has elastic recoil to help in inspiration/expiration
alveoli
183
what does the internal intercostal muscles do
aids in expiration
184
what muscles attach to sternum and skull
sternocleidomastoid
185
what muscle raises the sternum during inspiration
sternocleidomastoid
186
what contracts down during inspiration to create room for lungs to expand
diaphragm
187
how much fluid is in the interpleural space
10-20cc
188
80% of blockages in the heart are in which coronary
left anterior descending
189
what is the parenchyma of the lungs
site of gas exchange
190
what are the lymph vessels of the thoracic wall
parasternal nodes
intercostal nodes
diaphragmatic nodes
191
what is pleurisy
parietal pleura sticks to chest wall
192
which pleura has more nerve endings
parietal pleura
193
where does the right recurrent laryngeal nerve come off
off vagus nerve at thoracic inlet
194
what provides blood supply to pericardial sac
left and right pericardiophrenic artery
195
which artery supplies 2/3 of heart with blood
LAD
196
what anatomical feature does the circumflex run in
coronary sulcus of the heart
197
intra-atrial septal defect
when foramen ovale doesnt close, only problem if right to left shunt present
198
what is S2 sound
closing of aortic and pulmonic valves
199
where is the cysterna chyli
12th rib
200
what holds the organs in the pelvic girdle
aponeurosis
201
what is the most superficial abdominal muscle
external oblique
202
what is the origin and attachment of the external oblique
costchondral junture of ribs and pubus
203
what muscle is deep to the external oblique
internal oblique
204
where does the internal oblique originate
wing of ilium, goes toward xyphoid
205
how many divisions does the rectus abdominus have
8
206
where does the transverse oblique originate and attach
thoracolumbar fascia near quadratus lumborum, linea alba
207
where does the inguinal ligament originate and attach
spine of ilium to pubis
208
how many layers of fascia is the linea alba composed of
8
2 from each muscle of the abdomen
209
what muscles is the lumbar plexus located between
between internal oblique and transversus abdominus
210
what is a bowel ileus
loss of peristalsis
211
where is the greater omentum attached
greater curvature of the stomach and transverse colon
212
what is the role of the greater omentum
abdominal policemen
moves to areas of intestine not having peristalsis, wraps around intestine, increases blood supply and carries infection away
213
what is the formation of the greater omentum
thin, vascular
contains lymphatics
hangs freely like an apron
214
where is the lesser omentum attached
lesser curvature of stomach and liver
215
where does the mesentery originate
posterior aspect of the abdomen
216
what is the role of the mesentery
keeps vessels from overlapping and constricting one another when the intestines move
217
what is the mesentery
conduit for vessels to travel to the intestines
218
what arteries does the lesser curvature of the stomach having running along it
left and right gastric artery
219
what arteries run with the greater curvature of the stomach
left and right gastro-omental arteries
220
what structure keeps food in the stomach
pyloric sphincter (shaped like olive)
221
what connects the abdominal esophagus to the body of the stomach
cardia
222
between esophagus and fundus above the cardia
cardiac notch
223
sits on top of the body of the stomach
fundus
224
sits below the fundus of the stomach
body of stomach
225
when body of stomach starts getting smaller
pyloric antrum
226
narrow area right after pyloric antrum
pyloric canal
227
sphincter at the end of the pyloric canal
pyloric sphincter
228
regurgitation occurs in babies because of the small pyloris and is called
pyloric stenosis
229
part of the pyloric sphincter that opens into duodenum
pyloric orifice
230
what are the sections of the duodenum
superior
descending
inferior
ascending
231
what differentiates the duodenum from the jejunum
duodenum does not have mesentery
232
what part of the duodenum is adhered to the peritoneum
posterior
making it partially retroperitoneal
233
what part of the small intestine has mesentery attaching it to the posterior abdominal wall
jejunum and ileum
234
vasa recta are longer in which part of the small intestine
jejunum
235
what differentiates the jejunum from the ileum
ileum has peyers patches
236
what part of the small intestine dumps into the cecum
ileum
237
what stops food from moving from the cecum back into the ileum
ileocecal flaps
238
what appendage attached to cecum
appendix
239
what does the appendix do
stores e.coli/bacteria
240
what does e.coli do in the cecum
digests bilirubin in cecum
241
what makes the appendix inflammed
good bacteria is blocked off by fecal content, causes inflammation overtime
242
name the order of the large intestine
cecum
ascending colon
transverse colon
descending colon
sigmoid colon
rectum
anus
243
what is the corner between the ascending colon and the transverse colon
right hepatic flexure
244
what is the corner between the transverse colon and the descending colon
left splenic flexure
245
what are the bands running between the haustra on the outer colon called
taeniae coli
246
what is the role of the taeniae coli
makes it pouch into haustra
247
why are haustra important
fecal content churns in pockets getting water and nutrients out for absorption
248
what are omental appendices
fatty tissues attached to taeniae coli that have visceral peritoneum on them
249
what happens in diverticulitis
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
what organ is completely retroperitoneal
kidneys
251
what are the four branches off the abdominal aorta
celiac trunk
inferior/superior mesenteric
renal arteries
252
what artery branches to the right off the celiac trunk
common hepatic artery
253
what does the common hepatic artery branch into
proper hepatic artery and gastroduodenal artery
254
what are the four branches off the gsatroduodenal artery
supraduodenal
posterior superior pancreaticoduodenal
anterior superior pancreaticoduodenal
right gastro-omental
255
what artery supplies the superior aspect of the duodenum
supraduodenal artery
256
what artery branches off the proper hepatic artery
right gastric artery
257
what does the proper hepatic artery split into
left and right hepatic arteries
258
what artery branches off the right hepatic artery
cystic artery
259
what does the celiac trunk supply
stomach
liver
spleen
pancreas
duodenum
260
what does the abdominal aorta supply
everything except kidneys and reproductive tract
261
what arteries supply the kidneys
renal arteries
262
what does the superior mesenteric artery supply
small intestine
appendix
cecum
ascending colon
half of transverse colon
263
what artery goes behind pancreas and supplies head of pancrease and duodenum
posterior superior pancreaticoduodenal artery
264
what does the right gastro-omental artery run with and connect to
runs with the greater curvature of stomach
connects with left gastro omental artery
265
what is the only arterial supply to the gallbladder
cystic artery
266
what does the right gastric artery run along and connect with
runs with lesser curvature of the stomach
connects with the left gastric artery
267
what is the 1st branch which is superior on the left side of the celiac trunk
left gastric artery
268
what artery is inferior of the left gastric artery
splenic artery
269
what is a main artery off the celiac trunk without any branches
left gastric artery
270
what are the branches of arteries off the splenic artery going to the pancreas
pancreatic arteries
271
what are 1-3 branches of arteries at end of splenic artery moving up called
short gastric arteries
272
what is the artery at the end of the splenic artery moving down
left gastro omental artery
273
where do the short gastric arteries go to
fundus of the stomach
274
what are the branches off the superior mesenteric artery in order
middle colic artery
right colic artery
ileocolic artery
ileal/jejunal arteries
275
where does the middle colic artery go to
transverse colon
276
where does the right colic artery go to
ascending colon
277
what are the branches of the ileocolic artery
anterior cecal/ posterior cecal arteries
they join together to form the appendicular junction
278
what do the ileal/jejunal arteries branch into
arterial arcades
279
what do arterial arcades branch into
vasa recta-which connect to intestine
280
name the branches of the inferior mesenteric artery
left colic
sigmoid artery
superior rectal artery
281
name the branch off the left colic artery that supplies the transverse colon
marginal artery
282
where does the left colic artery go to
descending colon
283
where does the sigmoid artery go to
sigmoid colon
284
what does the inferior mesenteric artery turn into
superior rectal artery
285
what are the four lobes of the liver
right lobe
left lobe
caudate lobe
quadrate lobe
286
what lobe of the liver is anterior to the caudate lobe
quadrate lobe
287
what is the portal triad
hepatic artery
portal vein
hepatic duct
288
what is the significance of having the portal triad going to each lobe
able to remove one whole lobe without affecting flow to the other lobes
289
how much liver can be taken and still have it regenerate
70%
290
what is the number one function of the liver
detoxify the body
291
what does the liver produce and store
produces bile
stores glycogen
292
what ties the liver to the diaphragm
falciform ligament
293
what ducts go out of the liver and gallbladder
hepatic and cystic duct
294
what are the hepatic and cystic ducts called when they join together
common bile duct
295
what happens to bile that is not used in duodenum
goes back to gallbladder for storage
296
why cant a person with liver disease consume as much fat as before
liver is diseased and doesnt make as much bile to break down fat
297
can a person with a cholecystectomy consume fat
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
what are symptoms of eating too much fat without gallbladder
diarrhea
cramps
gas
299
where do enzymes from the pancreas and bile from the gallbladder empty into the duodenum
major/minor duodenal papilla
300
what provides some relief in only some people if major duodenal papilla is backed up
minor duodenal papilla
301
what is the funnel area that the common bile duct empties into before major duodenal papilla
hepatopancreatic ampulla
302
where do most gallstones gather
heptopancreatic ampulla
303
what do 80% of patient with bile obstruction develop
pancreatitis, because pancreatic enzymes get backed up into pancreas and there is no storage
304
name the exocrine products of the pancreas
amylase
lipase
trypsin
chymotrypsin
305
name the endocrine products of the pancreas
insulin and glucagon
306
where are RBCs stored and how long do they live
spleen
120 days
307
what breaks down old RBCs and some pathogens in the spleen
megakarocytes
308
what do megakarocytes break down old RBCs into
hemoglobin and bilirubin
309
what happens when spleen is removed
more prone to anemia
more prone to disease (immunosuppression)
310
what back muscle does the kidney lie underneath
erector spinae
311
what is the kidney bound by and why is it significant
fat cells for protection and mobilization (able to move 1-3 inches)
312
on the inner kidney, what is the border around the outside called
renal cortex
313
where is the glomerulus located
renal cortex
314
how much glomeruli do you lose after age 40
1% per year
315
what feeds into the renal papilla
renal pyramid
316
what feeds into the minor calyx
renal papilla
317
what lies in between renal pyramids
renal columns
318
what does the renal papilla dump waste into
minor calyx
319
what does the minor calyx dump into
major calyx
320
what does the major calyx dump into
renal pelvis
321
what does the renal pelvis dump into
ureter
322
what gland lies on top of the kidney
adrenal gland
323
what muscle lies on the wing of the ilium
iliacus
324
what muscle is medial to the iliacus
psoas major
325
what muscle is medial to psoas major
psoas minor
326
what muscle is superior to the iliacus and posterior to the psoas major
quadratus lumborum
327
where do the nerves originate that compose the lumbar plexus
T12
L1
L2
L3
L4
328
what nerve root is the subcostal nerve
T12
329
what nerve root makes up the iliohypogastric nerve
L1
330
what is the nerve root for the ilio-inguinal nerve
L1
331
what is the nerve root for the genitofemoral nerve
L1 L2
332
what muscle does the genitofemoral nerve lie on
psoas major muscle
333
what is the nerve root for the lateral cutaneous nerve of the thigh
L2 L3
334
what is the nerve root of the femoral nerve
L2 L3 L4
335
what muscle does the femoral nerve sit between
lateral to psoas major, medial to iliacus
336
what are the nerve roots of the obturator nerve
L2 L3 L4
337
what are the roots of the lumbosacral trunk
L4 L5
338
what nerves are blocked in the quadratus lumborum block
T12
L1
L2
L3
339
what is the difference between and fossa and a foramen
fossa is a depression
foramen is a hole
340
what does the fetus get oxygen and nutrition from
placenta
341
what is the foramen ovale
hole between right and left atrium
342
what is the ductus venosus
shunt where blood bypasses liver and goes into inferior vena cava
343
what happens when ductus venosus doesnt shut
hepatoencephalopathy- blood bypasses liver and doesnt get cleaned of ammonia
344
in the fetus, where does blood that bypasses liver go to
inferior vena cava- 60% of it
345
how much blood gets cycled through the liver of the fetus
40%
346
how does blood from head and upper extremities bypass the lungs ( in the fetus)
goes into right atrium-right ventricle- pulm artery- ductus arteriosus-aorta
347
what does the ductus arteriosus become
ligamentum arteriosum
348
how is mammary tissue connected to the body
connective tissue
349
what is the layer between the pectoral muscle and the breast
deep pectoral fascia
350
where do the internal and external obliques attach
pubic tubercle
351
what does the obturator nerve supply
adductor longus
adductor brevis
adductor magnus
352
what is the difference in male and female pelvis
male= wider pubic symphysis, narrow pubic arch
female= narrow pubic symphysis, wing of ileum flares out, oval pubic arch
353
what are the three male accessory sex glands
seminal vesicle
bulbourethral gland
prostate
354
which sex gland puts fructose in ejaculatory fluid
seminal vesicles
355
how does the bulbourethral gland contribute to sperm survival
make pre ejaculate fluid that is pH neutral so that sperm can survive coming out of the urethra
356
what does the prostate put into ejaculatory fluid
lysozymes and antibodies
357
what is side effect of flomax
retroejaculation into bladder since sphincter is relaxed
358
how do sperm move through vas deferens
peristalsis
359
what are the three accessory female sex glands
mesonephric tubules
paraurethral gland
greater vestibular gland
360
how do the accessory sex glands match up with each other male vs female
prostate gland=paraurethral gland
bulbourethral gland= greater vestibular gland
seminal vesicles=mesonephric tubules
361
what structure do the penis and clitoris have in common
corpus cavernosa x2
362
what fluid is from female ejaculation and what is its role
paraurethral fluid- enhances viability of sperm
363
what female gland makes lubrication fluid
greater vestibular gland
364
what is the role of the mesonephric tubules
add blood supply to fallopian tubes, which provides fluid/variability for fertilized egg
365
where does blood get trapped during male/female erection
corpora cavernosa
366
what structure encases the urethra in a male
corpus spongiosum
367
which nervous system controls erection
parasympathetic
368
which nervous system controls ejaculation
sympathetic
369
what condition needs to be met for spermatogenesis
1-3 degree cooler than body genesis
370
what muscle holds the testicle
cremaster muscle
371
what is the lining around the testicle
tunica vaginalis
372
what is the role of the pampiniform plexus
cobweb of veins encasing testicular artery that cools the blood
373
what happens in testicular torsion
gubernaculum doesnt fully attach
testicle gets twisted and blood supply is cut off
374
what is the function of the gubernaculum in the fetus
pulls testes down through the abdomen, through the inguinal canal into scrotum
375
where does fertilization occur
ampulla
376
what are the projections at the end of the infundibulum that swims the egg into the infundibulum
fimbrae
377
what prevents the sperm from being destroyed coming through the vas deferens
acrosomal cap
378
what stores sperm until ejaculation
epididymis
379
what is the route of the sperm
seminiferous tubules
straight tubules
rete testis
efferent ductules
head of epididymis
vas deferens
seminal vesicle
prostate
urethra
380
how long is each seminiferous tubule
25 feet
381
what protects implanted egg and sperm
cervix
382
what decreases when progesterone increases
estrogen
383
what hormone decreases when estrogen increases
progesterone
384
what is the number one function of progesterone
eliminates contractions of the uterus
385
how does progesterone cause gastric reflux
relaxes uterus, but also relaxes esophageal sphincter
386
when is progesterone made
after implantation
387
what does the suspensory ligament contain in the female
ovarian artery and vein
388
what is the role of the suspensory ligament
ties and bind ovary to wall of abdomen
389
what hormone indicates pregnancy
HCG
390
what hormone from pituitary gland stimulates ovary to produce follicle
FSH
391
what is a follicle
blister like structure on ovary that takes embryonic cells to develop egg
392
what hormone causes follicle to rupture releasing egg
leutinizing hormone
393
what is the follicle that ruptured and filled with blood called and what does it produce
corpus luteum and progesterone
394
what structures does an indirect hernia go through
internal ring
inguinal canal
external ring
scrotum
395
what causes indirect hernia vs direct hernia
indirect= heritable anatomy
direct=trauma
396
what structure does a direct hernia involve
conjoins tendon into scrotum
397
what is the conjoins tendon made of
internal/external oblique near pubis
398
where does the internal thoracic artery split into superior epigastric and musculophrenic artery
7th costal cartilage
399
what does the azygous vein drain into
superior vena cava
400
what is the original umbilical cord
round ligament
401
what does the inferior vena cava drain in the abdomen
feet
legs
kidneys
reproductive
402
what does the portal venous system drain in the abdomen
stomach
spleen
intestines
403
What muscle does the suprascapular artery run through
Subclavius
404
Layers of abdominal muscles from most outer to most internal
External oblique
Internal oblique
Transversus abdominus
405
What nerve lies on top of the psoas muscle
Genitofemoral nerve (L1 L2)
406
What nerve supply’s the lower epigastric muscles
Iliohypogastric nerve (L1)
407
What does the ductus venosus become after first breath
Ligamentum venosum
408
What does ductus arteriosus become after first breath
Ligamentum arteriosum
409
What are the three branches off the abdominal aorta
Celiac trunk
Superior mesenteric artery
Inferior mesenteric artery
410
What are the branches off the celiac trunk
Left gastric artery
Splenic artery
Common hepatic artery
411
What branches off the common hepatic artery
Gastroduadenal artery
Then common hepatic become proper hepatic
412
What does the proper hepatic artery split into
Right gastric
Left hepatic
Right hepatic
413
What branches off the right hepatic artery
Cystic artery
414
What is the first branch off the gastroduadenal artery
Supraduadenal artery
415
What are the branches of the splenic artery
Left gastro o mental
Short gastrics
Pancreatics
416
What’s in the spermatic cord
Testicular vein
Testicular artery
Vas deferens/ductus deferens
