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Applied Anatomy > Exam 3 > Flashcards

Exam 3 Flashcards

1
Q

The thorax is located between the ____ and _____.

A

neck and abdomen

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2
Q

The thorax provides protection for…

A

the heart, lungs, and some abdominal organs (liver, spleen, kidneys)

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3
Q

What does the superior thoracic aperture communicate with?

A

head, neck, and upper limbs

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4
Q

The inferior thoracic aperture is separated from the abdominal cavity by the _____

A

diaphragm

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5
Q

What forms the thoracic cage?

A

thoracic vertebrae, ribs, sternum

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6
Q

There are usually ____ ribs on each side of the thorax

A

12

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7
Q

Typical ribs, ribs # ___-____ have a head, neck, tubercle, and shaft

A

3-9

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8
Q

The head of a typical rib has two facets for articulation with…

A

the numerically corresponding vertebra and the vertebrae superior to it

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9
Q

The tubercle of a typical rib articulates with…

A

the transverse process (TP) of the corresponding vertebra

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10
Q

The shaft (body_ of a typical vertebra has a costal groove for what 3 structures?

A

vein, artery, and nerve

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11
Q

Ribs 1-7 are considered ___ ____ because they are connected to the sternum

A

true ribs

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12
Q

Ribs 8-10 are called ____ ____

A

false ribs

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13
Q

Ribs 11 and 12 are called ____ ____

A

floating ribs

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14
Q

Which rib is the broadest and most curved of all ribs, as well as the shortest of the true ribs?

A

1st rib

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15
Q

True or False: The 1st rib only has a single facet on its head because it only articulates with T1.

A

True

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16
Q

What vein crosses the 1st rib anterior to the scalene tubercle?

A

subclavian vein

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17
Q

The scalene tubercle of the 1st rib is an attachment point for what muscle?

A

anterior scalene

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18
Q

The subclavian artery passes _____ to the 1st rib

A

posterior

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19
Q

What trunk of the brachial plexus passes posterior to the scalene tubercle of the 1st rib.

A

inferior trunk

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20
Q

The costal cartilages contribute to the _____ of the thoracic wall.

A

flexibility

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21
Q

The costovertebral joints are individual ____ joints.

A

synovial

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22
Q

The ___ ____ is the portion of the inferior aperture of the thorax formed by the articulated cartilages of the seventh to tenth ribs

A

costal margin

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23
Q

The ____ ligament is associated with the head of the rib.

A

radiate

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24
Q

The superior costotransverse ligament runs from what to what?

A

neck of the rib to the tip of the TP of the vertebra above

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25
Q

The ___ ____ ligament runs from the tubercle of the rib to the tip of the TP of the same vertebra.

A

lateral costotransverse ligament

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26
Q

The costotransverse ligament runs from what to what?

A

rib to TP of same vertebra

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27
Q

The costotransverse ligament is more ____ than the lateral costotransverse ligament

A

anterior

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28
Q

Name the three parts of the sternum.

A

manubrium, body, and xiphoid process

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29
Q

What are the sternal notches for on the body of the sternum?

A

sternocostal articulations

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30
Q

The sternal angle also the site of the ______ joint and is connected by a plate of cartilage making it a ______ joint.

A

manubosternal; symphysis

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31
Q

What five things occur at the level of the sternal angle?

A
  1. the 2nd costal cartilage articulates with the sternum
  2. the aortic arch begins and ends
  3. the trachea bifurcates into right and left bronchi
  4. demarcates the inferior border of the superior mediastinum
  5. a transverse plane would pass through the intervertebral disc between T4-T5
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32
Q

There are both ___, ____, and _____ intercostal muscles.

A

external, internal and innermost intercostal muscles

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33
Q

There are ___ pairs of external intercostal muscles.

A

11 pairs

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34
Q

There are ____ intercostal spaces.

A

11

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35
Q

External intercostal muscles have fibers running ___ to ___

A

laterally to medially (hands in pocket)

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36
Q

The external intercostal muscles arise from the inferior margin of one rib and insert on the….

A

superior margin of the rib below

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37
Q

The intercostal spaces are named…

A

according to the superior rib

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38
Q

The external intercostal muscles run from the ____ _____ posteriorly to the ____ _____ anteriorly and continues as the….

A

vertebral column to costochondral junctions;

continues as the external intercostal membrane

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39
Q

The external intercostal muscles are most active in _____ and act to….

A

inspiration, elevates ribs; stiffen the chest wall

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40
Q

There are ___ pairs of internal intercostals.

A

11

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41
Q

Internal intercostal muscles have fibers running ___ to ___

A

medially to laterally (at right angles to the external intecostals)

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42
Q

The internal intercostals arise from the _____ margin of one rib and inserts on the superior margin of the rib below.

A

inferior

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43
Q

The internal intercostal muscles run from the ____ to the ____ ___ and continues as the…. back to the vertebral column

A

sternum to midaxillary line; continues as the internal intercostals membrane

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44
Q

The anterior fibers of the internal intercostal muscles are active in ____ and the more posterior fibers are active in ____.

A

inspiration; expiration

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45
Q

The innermost intercostals are the ___ portions of the internal intercostals.

A

internal

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46
Q

What separates the internal intercostals from the innermost intercostals?

A

the intercostal nerves and vessels

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47
Q

The innermost intercostal muscles run ___ to ____ from the angle of the rib to the midaxillary line

A

medial to lateral

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48
Q

Typically, the male nipple corresponds to what intercostal space?

A

4th intercostal space

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49
Q

What do all the intercostal muscles act to do?

A

to keep the intercostal spaced rigid and have a respiratory role as well

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50
Q

The transversus thoracis muscles are attached to the posterior aspect of the sternum and pass to the ___-___ costal cartilages

A

2nd-5th

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51
Q

What vessels run anterior to the transversus thoracis muscles?

A

internal thoracic vessels

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52
Q

The subcostal muscles extend from the internal surface if the angle of one rib to the internal surface of the rib….

A

2-3 ribs below the rib of origin.

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53
Q

True to False: The subcostal muscles are posteriorly placed meaning they are on the posterior thoracic wall.

A

True

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54
Q

What muscles are referred to as the innermost complex?

A

tranversus thoracis, innermost intercostals, and subcostal muscles.

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55
Q

The intercostal space houses the intercostal…

A

Vein, Artery, and Nerve (VAN)

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56
Q

The intercostal (thoracic) nerves are the ____ rami of __-___

A

ventral rami T1-T11

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57
Q

Name the two branches of the intercostal nerves.

A

lateral cutaneous branches, and anterior cutaneous branches

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58
Q

T12 is the ____ nerve

A

subcostal

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59
Q

Name the intercostal arteries.

A

posterior intercostal artery and anterior intercostal artery

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60
Q

The internal thoracic artery is also known as the…

A

internal mammary artery

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61
Q

The internal thoracic artery arises from the ____ artery

A

subclavian

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62
Q

The internal thoracic artery runs on the internal surface of the thorax _____ to the sternum, _____ to the transversus thoracis muscle.

A

lateral; anterior

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63
Q

Name the terminal branches of the internal thoracic artery.

A

Superior epigastric artery and musculophrenic artery, also gives rise to anterior intercostal arteries

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64
Q

Name the 3 ways the thoracic cavity changes during respiration.

A
  1. inferiorly
  2. laterally
  3. anteriorly
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65
Q

Describe how the thoracic cavity changes inferiorly during respiration.

A

vertical diameter;

contraction and relaxation of the diaphragm

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66
Q

Describe how the thoracic cavity changes laterally during respiration.

A

transverse diameter; swinging outward of ribs; “bucket handle movement”

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67
Q

Describe how the thoracic cavity changes anteriorly during respiration.

A

anteroposterior diameter; raising of anterior ends of rib; “pump handle movement”

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68
Q

The 2 internal thoracic veins are ____ ___ and run on either side of the arteries

A

venae communicantes

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69
Q

The right and left pulmonary cavities contain the ____ and the ____

A

lungs and pleurae

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70
Q

There are two pleural cavities , which are completely _____ from each other.

A

separate

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71
Q

The pleural cavities, together with the lungs occupy most of the _____ ____

A

thoracic cavity

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72
Q

What is pleura?

A

a thin serous membrane

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73
Q

Describe the visceral pleura of the lungs

A

moist and shiny
adheres to all surfaces
provides a smooth slippery surface that enables the lungs to move freely
not very well innervated

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74
Q

Describe the parietal pleura of the lungs.

A

adherent to thoracic wall and diaphragm by connective tissue

well innervated

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75
Q

The parietal pleura is given different names according to what it is associated with. These include…,which are all supplied by….

A

costal, mediastinal, diaphragmatic, and cervical pleura;

supplied by the thoracic arteries

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76
Q

The cervical pleura is called ___ ___

A

pleura cupula

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77
Q

The costodiaphragmatic recess allows…. and the costomediastinal recess acts to….

A

the lung to expand;

make room for the heart on the left side

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78
Q

What is the pleural cavity, what does it contain, and what does it allow?

A

potential space between the two pleural layers, pleural fluid, allows lungs to expand and contract freely

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79
Q

The lungs are surrounded by the ___ ___ but outside of them

A

pleural sacs

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80
Q

What is pleuritis?

A

inflammation of the pleura

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81
Q

What is pneumothorax?

A

entry of air in the pleural cavity

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82
Q

The lungs are the essential organs of _____

A

respiration

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83
Q

What is the main function of the lungs?

A

to oxygenate the venous mixed blood

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84
Q

What is the shape of each lung?

A

conical

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85
Q

What are the lungs attached to and by what structures are they attached?

A

attached to the heart and trachea by the structures in the root of the lungs (pulmonary arteries, veins, and main bronchii

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86
Q

The right lung has ___ lobe(s) and ___ fissure(s). Name each.

A

3 lobes- superior, middle, inferior

2 fissures- horizontal an oblique

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87
Q

The left lung has ___ lobe(s) and ___ fissure(s). Name each.

A

2 lobes: superior and oblique

1 fissure- oblique

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88
Q

The left lung also has a tongue like area called the ____ and the ___ ___, which is the space where the heart fits.

A

lingua; cardiac notch

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89
Q

Name the 4 parts of the lung.

A

Apex, base, root, hilum

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90
Q

The apex is the superior end that extends through the superior thoracic aperture into the roof of the neck. It is in contact with the ____ of the pleura and crosses by the ____ artery.

A

cupula; subclavian

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91
Q

The base of each lung is a ___ diaphragmatic surface that sits on top of the diaphragm

A

concave

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92
Q

The root of the lung serves as the attachment of the lung connecting the ___ surface of the lung with the heart and trachea

A

medial

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93
Q

What ligament is associated with the root of the lung

A

pulmonary ligament

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94
Q

What is the hilum of the lung?

A

space where the root is attached

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95
Q

Name the surfaces of the lung.

A
  1. costal
  2. mediastinal
  3. diaphragmatic
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96
Q

Name the borders of the lung.

A
  1. anterior-sharp
    2 posterior- more rounded
  2. inferior- around diaphragmatic surface
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97
Q

The _____ bifurcates at the level of the sternal angle into the right and left main bronchi

A

trachea

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98
Q

The _____ main bronchus is wider, shorter, and more vertical than the ____

A

right; left

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99
Q

Clinical question! If a person aspirates, it is likely to go into the ____ lung.

A

right

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100
Q

What are the bronchial walls supported by?

A

c-shaped rings of cartilage

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101
Q

Each bronchi accompanies the pulmonary artery into the hilus, where it subdivides ti form a ___ ___

A

bronchial tree

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102
Q

There are secondary bronchi or ____ bronchi for each lung. There are ___ on the left and ____ on the right. They supply the lobe of the lungs

A

lobar

2; 3

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103
Q

The secondary bronchi further branch into the ____ (____) bronchi

A

tertiary (segmental)

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104
Q

The tertiary bronchi supply _____ _____, a region also supplied by the segmental (tertiary) artery

A

brochopulmonary segments

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105
Q

Within bronchopulmonary segments there is further branching of bronchi. These are separated by…

A

adjacent segments by connective tissue septa

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106
Q

There are ___ segmental bronchi on the right and ___ on the left.

A

10; 8-10

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107
Q

Conducting bronchioles –> ____ _____ –> respiratory bronchioles –> ___ _____ –> ___ ____

A

terminal bronchioles
alveolar duct
alveolar sac

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108
Q

What occurs in the alveoli?

A

exchange of gases with capillary plexus

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109
Q

The pulmonary arteries arise from the _____ _____

A

pulmonary trunk

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110
Q

The pulmonary arteries distribute ______ blood to the lungs

A

deoxygenated

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111
Q

There is a branch of the pulmonary artery to each lobe called the ____ arteries and to the brochopulmonary segment called the ____ _____ artery

A

lobar, tertiary segmental

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112
Q

The terminal branches of the pulmonary arteries divid einto ______ in the walls of the alveoli-gaseous exchange

A

capillaries

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113
Q

The ____ arteries supply blood to the connective tissue of the bronchial tree

A

bronchial

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114
Q

There are ___ left bronchial artery(ies) and ___ right bronchial artery(ies)

A

2; 1

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115
Q

There are ___ pulmonary veins on each side, which carry _____ blood from the lungs to the left atrium.

A

2 (superior and inferior); oxygenated

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116
Q

The branches of the pulmonary veins drain multiple ____ ______

A

bronchopulmonary segments

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117
Q

Where do the bronchial veins drain?

A

near the root of the lungs

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118
Q

The lungs are visceral pleura are innervated by….which contain sympathetic, parasympathetic and GVA fibers

A

the anterior and posterior pulmonary plexuses

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119
Q

The vagus nerve is cranial nerve ___

A

ten (CN X) (vagus means wanderer)

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120
Q

The lungs and visceral pleura are relatively _____ to pain

A

insensitive

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121
Q

For the lungs are visceral pleura, sympathetic fibers are _____ to bronchial muscle (bronchidilator), ____ to the pulmonary vessels (vasoconstrictor) and _______ to alveolar glands

A

inhibitory, motor, inhibitory

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122
Q

For the lungs and visceral pleura, the parasympathetic fiber are motor to the ___ ____ of the bronchial tree, inhibitory to the ___ _____ (vasodialtor), and secretory to…

A

smooth muscle; bronchial vessels; the glands of the bronchial tree

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123
Q

The parietal pleura –> costal pleura and part of diaphragmatic pleura are innervated by…

A

intercostal nerves

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124
Q

The central part of the diaphragmatic pleura and mediastinal are supplied by ____ nerves

A

phrenic

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125
Q

The parietal pleura is _____ to pain

A

very sensitive

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126
Q

The superficial lymphatic plexus lies ____ to the visceral pleura

A

deep

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127
Q

The superficial lymphatic plexus drains into _____ lymph nodes in the hilum to the _____ lymph nodes

A

bronchopulmonary to tracheobronchial

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128
Q

What does the superficial lymphatic plexus drain?

A

the lung and visceral pluera

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129
Q

What does the deep lymphatic plexus drain?

A

structures that from the root of the lung

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130
Q

The deep lymphatic plexus drains into _____ lymph nodes along the lobar bronchi, then into the _____ lymph nodes, then into the _____ lymph nodes

A

pulmonary, bronchopulmonary, tracheopulmonary

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131
Q

From the tracheobronchial lymph nodes the lymph passes to the right and left ______ ____ ____, which usually terminate at the junction of the subclavian and internal jugular veins.

A

bronchomediastinal lymph trunks

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132
Q

What are two common sites of metastasis?

A

brain and bones

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133
Q

When we inhale, the diaphragm….

A

flattens and moves downward and the external intercostal muscles move the rib cage upward and out.

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134
Q

When we exhale, the diaphragm and intercostal muscles…

A

relax and return to their resting positions

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135
Q

Inhalation ____ the size of the internal air pressure and air from the outside rushes into the lungs to equalize the pressure.

A

decreases

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136
Q

Exhalation ___ the size of the thoracic cavity, thereby ____ pressure and forcing air out of the lungs.

A

reduces; increasing

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137
Q

The _____ is the central compartment between the two pulmonary cavities.

A

mediastinum

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138
Q

Name the parts the mediastinum is divided into.

A

Anterior, superior, middle, and posterior

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139
Q

The heart is positioned ____ in the middle of the mediastinum

A

obliquely

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140
Q

True or False: The heart lies in the median plane.

A

False. 2/3 of the heart is located on the left of the median plan while the remaining 1/3 is to the right of the median plane

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141
Q

What does the middle mediastinum contain?

A

pericardium and the heart and roots of the great vessels

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142
Q

What is pericardium?

A

a double walled fibroserous sac surrounding the heart and roots of the great vessels

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143
Q

Name the two parts of pericardium.

A

fibrous and serous

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144
Q

Describe the fibrous pericardium.

A
  • tough outer sac
  • protects heart against sudden overfilling
  • attached to the sternum
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145
Q

The fibrous pericardium is attached to the sternum by the sternopericardial ligaments and also the central tendon of the diaphragm (__________ ligament)

A

pericardiacphrenic

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146
Q

The serous pericardium consists of two layers. Name and describe where each is located.

A
  1. parietal- fused with the fibrous pericardium

2. reflected onto the heart (epicardium)

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147
Q

The potential space between opposing layers of parietal and visceral layers of serous pericardium is the ___ ____

A

pericardial cavity

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148
Q

The pericardial cavity contains the ____ ____ sinus and the ____ _____ sinus

A

transverse pericardial;

oblique pericardial

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149
Q

The middle mediastinum gets its blood supply from branches of the ____ ____ artery, specifically the ____ and _____ arteries.

A

internal thoracic,

percardiacphrenic and musculophrenic

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150
Q

The venous drainage of the middle mediastinum is….

A

azygos system of veins

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151
Q

The innervation of the middle mediastinum is…

A

vagus and phrenic (sensory fibers) and sympathetic truncks

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152
Q

The base of the heart is on its posterior surface formed mainly by the ____ ____

A

left atrium

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153
Q

The apex of the heart is formed primarily by the ___ ____ and is related to the ____ left intercostal space and midclavicular line (good for listening to heart sounds)

A

left ventricle; 5th

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154
Q

Name the four surfaces of the heart and what forms them.

A
  1. sternocostal surface- formed mainly by right ventricle
  2. diaphragmatic surface- formed by both ventricles
  3. left pulmonary surface- formed mainly by left ventricle
  4. right pulmonary surface- formed mainly by right atrium
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155
Q

The ______ surface of the heart is related to the central tendon of the diaphragm.

A

diaphragmatic

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156
Q

The left pulmonary surface occupies the…

A

cardiac notch of the left lung

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157
Q

Name the borders of the heart and what forms them.

A
  1. right- right atrium and extending between SVC and IVC
  2. inferior- mainly by right ventricle and slightly by left ventricle
  3. left- mainly by left ventricle and slightly by left auricle
  4. superior- right and left atria and auricles in an anterior view
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158
Q

The heart has ____ chambers.

A

4

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159
Q

The heart has two ____ and two ____, both lined with endocardium

A

atria, ventricles

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160
Q

What separates the atria from the ventricles? What separates the two ventricles from one another?

A

coronary groove; anterior and posterior interventricular grooves

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161
Q

The right atrium contains muscular ridges called ___ ____

A

pectinate muscles

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162
Q

The ___ ____ is a smooth vertical ridge extending from superior to inferior vena cava

A

crista terminalis

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163
Q

The fossa ovalis of the right atrium is the site of the ___ ____

A

foramen ovale

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164
Q

The ____ ____ is known as the great vein of the heart associated with the right atrium

A

coronary sinus

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165
Q

The ____ ____ is located in the right atrium and is also known as the pacemaker of the heart.

A

sinuatrial node

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166
Q

Specifically the SA node is located at the upper end of the _____ _____

A

crista terminalis

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167
Q

The infundibulum in the right ventricle is also called the ___ ____

A

conus arteriosus

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168
Q

The irregular muscular ridges of the left ventricle are called…

A

trabeculae carneae

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169
Q

What is contained in the septomarginal trabeculae or moderator band in the right ventricle?

A

the right branch of the atrioventricular bundle (AV bundle)

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170
Q

The 3 papillary muscles of the right ventricle are…

A

anterior-largest
posterior
septal (medial)-small variable in number

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171
Q

What do the papillary muscles function to do?

A

prevent prolapse when contracting

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172
Q

Each papillary muscle is attached to ____ cusps of the valves.

A

two

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173
Q

The pulmonary veins enter the posterior wall of the ___ ___

A

left atrium

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174
Q

There are ___ pulmonary veins

A

4, two right and two left

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175
Q

The left auricle of the left atrium has _____ muscles

A

pectinate

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176
Q

The _____ ventricle performs more work than the ____ ventricle because it has to pump blood out to the rest of the body

A

left, right

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177
Q

The ____ _____ is a smooth area leading up to the aorta

A

aortic vestibule

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178
Q

The muscular ridges of the left ventricle are called _____ _____

A

trabeculae carneae

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179
Q

The left ventricle has ___ and ____ papillary muscles which function to….

A

anterior and posterior; help close mitral (bicuspid) valve

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180
Q

The ____ _____ of the left ventricle attached cusps of the left atrioventricular valve to the papillary muscles

A

chordae tendinae

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181
Q

The ____ _____ is composed of muscular and membranous parts and is the partition between right and left ventricles

A

interventricular septum

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182
Q

What does VSD stand for?

A

ventricular septic defect

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183
Q

Name the 4 valves of the heart.

A
  1. tricuspid
  2. mitral (bicuspid)
  3. pulmonary
  4. Aortic
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184
Q

The tricuspid valve is located between ___ ___ and the ___ ____ and has 3 cusps named…

A

right atrium and right ventricle;

septal, anterior, posterior

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185
Q

The mitral valve is located between ___ ___ and the ___ ____ and has 2 cusps named…

A

left atrium and left ventricle;

anterior and posterior

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186
Q

The pulmonary valve is located at the beginning of the pulmonary trunk and has ____ cusps named…

A

3.

right, left and anterior

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187
Q

The aortic valve is located at the beginning of… and has 3 cusps named right, left, and posterior. It also has 3 ___ ___

A

beginning of the ascending aorta;

aortic sinuses

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188
Q

The right aortic sinus of the aortic valve contains the opening of the….
The left aortic sinus contains the opening of the…
The posterior aortic sinus contains….

A

right coronary artery
left coronary artery
no opening

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189
Q

Both the aortic and pulmonary valves have a central nodule with lateral lunules, creating _____ _____

A

semilunar valves

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190
Q

When is the first heart sound made?

A

S1 (lub)- made when blood leaves the atria and flows into the ventricles and the tricuspid and mitral valves snap shut

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191
Q

When is the second heart sound made?

A

S2 (dub)- heard when blood is expelled from the ventricle and the valves of the pulmonary artery and aorta snap shut

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192
Q

What does it mean to have a left dominant heart?

A

The posterior interventricular artery comes from the left coronary artery

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193
Q

True or False: Variations of the coronary arteries and their branching patterns are very rare.

A

False, they are very common

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194
Q

The right coronary artery supplies…

A

right atrium, most of right ventricle, part of left ventricle, SA and AV nodes

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195
Q

The right coronary artery arises from…

A

right aortic sinus

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196
Q

The right coronary artery runs is the ____ ____ between the atria and ventricles

A

coronary groove

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197
Q

Name the branched of the right coronary artery.

A
  1. marginal artery

2. posterior interventricular (descending) artery- between right and left ventricle

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198
Q

The left coronary artery supplies…

A

left atrium, most of left ventricle and part of right ventricle and most of the IV septum

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199
Q

The left coronary artery arises from…

A

left aortic sinus

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200
Q

Name the branches of the left coronary artery.

A
  1. anterior interventricular artery (LAD)/ left anterior descending
  2. circumflex artery- gives off marginal branch
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201
Q

Which artery is known as the widow maker because it is the most commonly blocked?

A

anterior interventricular descending (LAD)

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202
Q

What does the following describe?

  • main vein of the heart
  • runs in posterior part of coronary groove
  • drains most of venous blood from the heart
A

coronary sinus

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203
Q

The coronary sinus opens into the ____ ____

A

right atrium

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204
Q

What are the tributaries of the coronary sinus (6)?

A
  1. great cardiac vein
  2. middle cardiac vein
  3. small cardiac vein
  4. posterior vein of left ventricle
  5. anterior cardiac vein
  6. smallest cardiac veins
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205
Q

Name which artery the following three veins run with.

  1. great cardiac vein
  2. middle cardiac vein
  3. small cardiac vein
A
  1. anterior interventricular artery
  2. posterior interventricular artery
  3. marginal branch of right coronary artery
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206
Q

The vein is typically located ____ to the accompanying artery.

A

anterior

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207
Q

What supplies the SA node?

A

SA nodal artery (usually a branch of right coronary)

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208
Q

What supplies the AV node?

A

AV nodal artery (usually branch of right coronary)

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209
Q

Where is the AV located?

A

interatrial septum

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210
Q

The AV node distribute impulse from…

A

both atria via the right and left AV bundle

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211
Q

The AV bundle is also called…

A

The bundle of His

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212
Q

The AV bundle divides into right and left bundles which run in the _____ _____

A

interventricular septum

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213
Q

The right and left bundles of the AV node divide into….

A

subendocardial branches

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214
Q

Purkinje fibers project…????

A

into endocardium of the heart???

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215
Q

The right branch of the AV node stimulates…. while the left branch stimulates….

A

the anterior papillary muscle and wall of right ventricle;

the anterior and posterior papillary muscles and wall of the left ventricle

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216
Q

The heart is innervate by the ___ ____

A

cardiac plexus

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217
Q

Where is the cardiac plexus located?

A

in an area where the trachea bifurcates and the aorta arches

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218
Q

What is included in the cardiac plexus?

A

a. sympathetic trunk (T1-T5)
b. vagus nerve
c. GVA fibers

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219
Q

Heart muscle is relatively ____ to pain

A

insensitive

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220
Q

The sympathetic cardiopulmonary splanchnic nerve would cause a _____ in HR while the parasympathetic (vagus nerve) would cause a ____ in HR.

A

increase

decrease

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221
Q

The thoracic mediastinum is the space between….and contains all the structures of the thorax except the ____ and _____.

A

the two pleural sacs;

lungs and pleurae

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222
Q

The thoracic mediastinum extends from the ____ ____ ____ to the _____ inferiorly and from the sternum and costal cartilages anteriorly to the bodies of thoracic vertebrae posteriorly

A

superior thoracic aperture

diaphragm

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223
Q

In the supine position, the superior mediastinum extends inferiorly from the ____ ____ _____ to a horizontal plane passing through the ______ ______ and the inferior border of ____

A

superior thoracic aperture,
sternal angle,
T4

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224
Q

The main contents of the superior mediastinum are… (9 things)

A
  1. thymus
  2. great vessels
  3. phrenic and vagus nerves
  4. cardiac plexus
  5. left recurrent laryngeal nerve
  6. trachea
  7. esophogus
  8. thoracic dut
    9 prevertebral muscles
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225
Q

The thymus plays an important role in the development and maintenance of the _____ system, using ______

A

immune, T cells

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226
Q

The thymus is located posterior to the _____ and extends into the _____ _____

A

manubrium; anterior mediastinum

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227
Q

Describe a typical characteristics in the thymus gland of an an adult.

A

composed largely of fat and fibrous tissue, still continues to produce T-lymphocytes

228
Q

The thymus gland has a rich blood supply from branches of the ____ _____ _____ which is a branch of the ______ artery

A

internal thoracic artery; subclavian

229
Q

The brachiocephalic veins are also known as ____ _____

A

innominate veins

230
Q

The brachiocephalic veins are formed by the union of the ____ ______ and ______ veins

A

internal jugular and subclavian

231
Q

The right and left brachiocephalic veins join together to form the ____ ____ ___

A

superior vena cava

232
Q

The right brachiocephalic vein receives the _____ ____ duct while the left brachiocephalic vein receives the _____ duct

A

right lymphatic, thoracic

233
Q

The largest lymph vessel is the ______ duct

A

thoracic

234
Q

The superior vena cava ends in the ____ ____

A

right atrium

235
Q

What is the purpose of the superior vena cava?

A

to return blood from all structures superior to the diaphragm, except the lungs and heart

236
Q

The arch of the aorta begin at the level of the ___ ___ and ends/continues on as the _____ _____ _____

A

sternal angle, descending thoracic aorta

237
Q

The arch of the aorta passes anterior to the trachea to reach the left side of the trachea and esophagus. It then arches over the root of the left lung as it passes on the left side of the body of vertebra ___

A

T4

238
Q

Name the branches of the aorta from medial to lateral. Which is the largest?

A

M- brachiocephalic trunk (largest)
common carotid artery
L- left subclavian artery

239
Q

The brachiocephalic trunk divides into….

A

the right common carotid and right subclavian arteries

240
Q

The left subclavian artery arises ____ to the left common carotid

A

posterior

241
Q

The ______ ______ is a remnant of the ductus arteriosus, it passes from the root of the left pulmonary artery to the inferior surface of arch (connection to the aorta)

A

ligamentum arteriosum

242
Q

The vagus nerve is cranial nerve ____, and arise from the ___ of the brain

A

X (10), medulla

243
Q

The right vagus nerve enters the thorax anterior to the ___ _____ artery and on the right side of the trachea

A

right subclavian

244
Q

The right vagus nerve gives rise to the _____ ____ ____ nerve which hooks around the right subclavian artery and ascends in the neck between the trachea and the esophagus to supply the ____

A

right recurrent laryngeal, larynx

245
Q

The right and left vagus nerves pass ____ to the root of the lung

A

posterior

246
Q

The right and left vagus nerves make contributions to the following plexuses…

A

right (right vagus) and left pulmonary (left vagus) plexuses
esophageal plexus
cardiac plexus

247
Q

The left vagus nerve descends ______ to the left common carotid artery and _____ to the left subclavian artery

A

posterior, anterior

248
Q

The left vagus nerve gives off the ____ _____ _____ nerve, which hooks around the ligamentum arteriosum and passes superiorly on the right side of the aortic arch

A

left recurrent laryngeal nerve

249
Q

The left recurrent laryngeal nerve ascends to the larynx in a groove between the ______ and the _____

A

trachea and esophagus

250
Q

The phrenic nerve is the sole motor supply to the ______

A

diaphragm

251
Q

The phrenic nerve also gives partial sensory innervation to the _____ portion of the diaphragm

A

central

252
Q

The phrenic nerves travel with what artery and vein?

A

pericardiacophrenic artery and vein

253
Q

The phrenic nerves pass _____ to the root of the lung

A

anterior

254
Q

The trachea descends _____ to the esophagus and ends at the level of the ____ _____ where it divides into right and left ____ ______

A

anterior;
sternal angle
main bronchii

255
Q

The esophagus is a narrow ______ tube that connects the _____ with the _______

A

fibromuscula, pharynx with the stomach

256
Q

The inferior mediastinum is located between the inferior border of the superior mediastinum and the ______

A

diaphragm

257
Q

At the inferior border of he superior mediastinum, a horizontal plane would pass through the sternal angle and the inferior border of vertebral body ____

A

T4

258
Q

The anterior mediastinum of the inferior mediastinum lies between the body of the sternum and the _____ ______ muscles anteriorly and the ______ posteriorly

A

tranversus thoracis

pericardium

259
Q

The anterior mediastinum consists of…..

A

loose connective tissue, fat, lymph vessels, some lymph nodes, a few branches of the internal thoracic artery and inferiorly the sternopericardial ligaments

260
Q

The posterior mediastinum is located anterior to vertebrae ___-_____ and posterior to the pericardium and diaphragm

A

T5-T12

261
Q

The thoracic aorta is a continuation of the arch of the aorta and terminates anterior to the vertebral column at the level of ____

A

T12

262
Q

Name the branches of the thoracic aorta.

A

a. bronchial
b. esophageal
c. pericardial
d. mediastinal
e. posterior intercostal
f. subcostal
g. superior phrenic

263
Q

The bronchial branches of the aorta include ___ left and ___ right

A 
2 left
1 right (actually arises from the posterior intercostal artery)
264
Q

The bronchial arteries supply the blood for the…

A

bronchial tree

265
Q

The posterior intercostal artery has ___ pairs between intercostal spaces ___-____

A

9;

3-11

266
Q

The thoracic aortic plexus travels to what structures?

A

esophagus, lungs, heart, etc.

267
Q

The thoracic duct is located between….

A

the descending aorta and azygos vein

268
Q

The thoracic duct is the main lymphatic duct, conveying most of the lymph of the body to the venous systems and drain the ____ ____

A

cisterna chyli

269
Q

The thoracic duct usually empties into the venous system near the union of the ____ ____ ____ vein and ______ vein

A

left internal jugular vein, sublclavian

270
Q

The _____ system of veins consists of veins on each side of the vertebral column that drain the back and thoracic and abdominal walls

A

azygos

271
Q

True or False: It is common for the azygos system of veins to have many variations.

A

True

272
Q

The azygos system of veins is important in _____ ______

A

collateral circulation

273
Q

Name the specific veins of the azygos system.

A
  1. azygos
  2. hemiazygos
  3. accessory hemiazygos
274
Q

The azygos vein arises from the posterior aspect of the ____ ____ ____

A

inferior vena cava

275
Q

The aygos vein is a connection point between….

A

the superior and inferior vena cava

276
Q

The heamiazygos vein usually arises from the ____ vein

A

renal

277
Q

The hemiazygos vein arises on the left side and ascends as far as vertebra ___ where it crosses to the right to join the ___ vein

A

T9, azygos

278
Q

The accessory hemiazygos vein descends on the left side from ___-____

A

T5-T8

279
Q

The accessory hemiazygos vein crosses over as the level of ___ or ___ and joins the azygos vein

A

T7 ot T8

280
Q

Name the three thoracic sympathetic trunks of the thoracic region.

A
  1. greater splanchnic nerve (T5-T9)
  2. lesser splanchnic nerve (T10, 11)
  3. least splanchnic nerve (T12)
281
Q

Name the three constrictions of the esophagus.

A
  1. pharynx/ esophageal junction
  2. crossing of the aorta and left bronchus
  3. passage through diaphragm at esophageal hiatus
282
Q

The anterior vagal trunk is formed primarily by the… and the posterior vagal trunk is formed primarily by the….

A

left vagus nerve;

right vagus nerve

283
Q

The abdomen is part of the trunk and lies between the ____ and the _____

A

thorax and pelvis

284
Q

What is the most obvious feature of the anterior abdominal wall?

A

umbillicus (belly button)

285
Q

The ____ _____ is a median white fibrous band that divides into right and left halves indicated by the line joining the xiphoid process to the pubic symphysis

A

linea alba

286
Q

The ____ _____ is a curved line or groove extending form the 9th costal cartilage to the pubic tubercle

A

linea semilunaris

287
Q

The linea semilunaris indicates the….

A

lateral border of the rectus abdominus

288
Q

The pubic tubercle is the prominent rounded elevation of the body of the pubis to which the ____ ligaments attach

A

inguinal

289
Q

The inguinal ligament attaches to the ___ superiorly

A

ASIS

290
Q

The anterior abdominal wall is divided into ____ quadrants.

A

4 (right upper, left upper, right lower, left lower)

291
Q

The fatty superficial layer of subcutaneous fascia of the anterolateral abdominal wall is called….

A

Camper’s fascia

292
Q

The membranous deep layer of subcutaneous fascia that is very tight of the anterolateral abdominal wall is called….

A

Scarpa’s fascia

293
Q

The very thin, strong layer over the three muscles of the anterolateral abdominal wall is called….

A

investing (deep) fascia

294
Q

The other layers of the anterolateral abdominal wall include…

A

endoabdominal fascia, extraperitoneal fat, and parietal peritoneum

295
Q

The endoabdominal fascia is also called _____ fascia

A

transversalis fascia

296
Q

Name the three flat abdominal muscles.

A
  1. external oblique
  2. internal oblique
  3. tranversus abdominus
297
Q

The external oblique has fibers running in the direction of….

A

hand in pockets

298
Q

The internal oblique have fibers running… above the ASIS, …. at the ASIS, and …. below the ASIS

A

at right angles to the external oblique above,
horizontally at,
and downward below

299
Q

The aponeurosis of the external oblique contributes to the _____ _____ _____

A

anterior rectus sheath

300
Q

An aponeurosis refers to a….

A

broad flat tendon

301
Q

The aponeurosis of the internal oblique splits to form a sheath for the _____ _____

A

rectus abdominus (1/2 runs posterior, 1/2 runs anterior)

302
Q

The ____ _____ is the area where the internal oblique inserts into the pubic crest

A

conjoint tendon

303
Q

The transversus abdominus has fibers running….

A

more or less horizontally except for those most inferior which pass inferiorly and run parallel to the internal oblique

304
Q

The aponeurosis of the transversus abdominus contributes to the _____ _____ _____

A

posterior rectus sheath

305
Q

The internal oblique and transversus abdominus also contribute to the _____ _____

A

thoracolumbar fascia

306
Q

What are the actions of the the three flat abdominal muscles?

A
  1. formation of a strong, expandable support which provides protection for the abdominal viscera
  2. increases the intra-abdominal pressure
307
Q

The rectus abdominus is enclosed in the rectus sheath. It is the principal vertical muscles, stabilizes the pelvis during _____ allowing the thigh muscles to act efficiently

A

walking

308
Q

What forms the anterior wall of the rectus sheath?

A

the aponeurosis of the external oblique and the anterior lateral of the internal oblique

309
Q

What forms the posterior wall of the rectus sheath?

A

the posterior layer of the internal oblique and the aponeurosis of the transversus abdominus

310
Q

The posterior wall of the rectus sheath is deficient in two places, where?

A
  1. superior to the costal margin

2. inferior 1/4 arcuate line

311
Q

What is contained within the rectus sheath?

A

superior and inferior epigastric arteries and the terminal parts of the inferior 5 intercostal vessels and nerves are contained within the sheath

312
Q

The pyramidalis is a muscles located anterior to the inferior rectus present in about ____% of the population.

A

80

313
Q

The arcuate line lies a bit below the ____ ____. What happens below this point?

A

belly button;

all three flat abdominal muscles go anterior to the rectus abdominus

314
Q

The ____ _____ is endoabdominal fascia that lines the abdominal wall beneath the transversus abdominus

A

transversalis fascia

315
Q

What forms the femoral sheath?

A

the transversalis fascia and iliac fascia

316
Q

Name the 5 sets of nerves/nerves of the anterior abdominal wall.

A
  1. ventral rami T7-T11 spinal nerves and subcostal nerve (T12)
  2. iliohypogastric (L1)
  3. ilioinguinal (L1)
  4. main trunks of the intercostal nerves
  5. anterior cutaneous nerves
317
Q

The iliohypogastric nerve supplies the ____

A

groin

318
Q

The ilioinguinal nerve supplies….

A

the skin on the superomedial aspect of the thigh

319
Q

The main trunks of the intercostal nerves run between the _____ _____ and the ____ ____, and are accompanied by the inferior intercostal, subcostal, and lumbar arteries.

A

internal oblique

transversus abdominus

320
Q

What do the following anterior cutaneous nerves supply?

  1. T7-T9
  2. T10
  3. T11, T12, L1
A
  1. skin superior to umbilicus
  2. skin around umbilicus
  3. skin inferior to umbilicus
321
Q

Name the branches of the external iliac artery.

A
  1. inferior epigastric

2. deep circumflex iliac artery

322
Q

The inferior epigastric artery runs superiorly in the transversalis fascia to the ___ ____ and there it enters the rectus sheath

A

arcuate line

323
Q

The deep circumflex iliac artery runs on the deep aspect of the abdominal wall between the tranversus abdominus and internal oblique muscles. It run parallel to the ____ ___

A

inguinal ligament

324
Q

The superior epigastric which is a branch of the ___ ____ artery enters the rectus sheath superiorly just inferior to the ____ costal cartilage.

A

internal thoracic;

7th

325
Q

The superficial epigastric which is a branch of the ______ artery runs in subcutaneous tissue toward the umbilicus

A

femoral

326
Q

The venous drainage of the anterior abdominal wall is….

A

superficial epigastric–> lateral thoracic

327
Q

The lateral thoracic vein travels with the ___ ____ artery

A

lateral thoracic

328
Q

Lymphatic drainage of the anterior abdominal wall includes superficial lymph nodes. Those superior to the umbilicus drain into ____ lymph nodes while those inferior to the umbilicus drain into _____ _____ lymph nodes

A

axillary;

superficial inguinal

329
Q

The lymphatic drainage of the anterior abdominal wall also includes deep lymphatic vessels which drain into the…. and…. lymph nodes

A

external and internal iliac lymph nodes,

and lumbar lymph nodes

330
Q

What is the inguinal canal?

A

an oblique passage approx 4 cm long through the anterior abdominal wall- parallel to the medial half of the inguinal ligament

331
Q

The inguinal canal houses both a ____ _____ ring

A

deep and superificial

332
Q

The _____ ring is lateral to the inferior epigastric artery and is a slitlike opening in the transversalis fascia

A

deep

333
Q

The ______ ring is a triangular aperture in the aponeurosis of the external oblique muscle

A

superficial

334
Q

The ____ ring is the entrance to the inguinal canal and the ____ ring is the exit.

A

deep, superficial

335
Q

The _____ _____ run between the lateral and medial crura

A

intercrural fibers

336
Q

Emerging from the superficial ring is the ____ _____ in a male and the ____ ____ of the uterus in a female

A

spermatic cord;

round ligament

337
Q

The _____ nerve exits the superficial inguinal ring but does NOT run through the inguinal canal.

A

ilioinguinal nerve

338
Q

What is a direct inguinal hernia?

A

weakening of the abdominal wall-medial to inferior epigastric artery

339
Q

What is an indirect inguinal hernia?

A

enters the deep inguinal ring lateral to inferior epigastric artery

340
Q

Which hernia is more common?

A

indirect inguinal hernia

341
Q

The _________ ______ is a thin transparent serous membrane that lines the abdominal wall. The ____ ______ is a thin transparent serous membrane that invest the abdominal viscera.

A

parietal peritoneum

visceral peritoneum

342
Q

Pain is very well localized in the ______ peritoneum

A

parietal

343
Q

The visceral peritoneum is more sensitive to…

A

stretching and chemical irritation

344
Q

The _____ ______ is a potential space between the parietal and visceral peritoneum

A

peritoneal cavity

345
Q

What is a mesentery?

A

double layer of peritoneum enclosing an organ and attaching to the abdominal wall

346
Q

A mesentery functions to allow for…

A

mobility and passage of neurovascular structures

347
Q

A ______ is a double layered sheet or fold of peritoneum.

A

omentum

348
Q

The lesser omentum connects the….. and the ……

A

lesser curvature of the stomach and proximal part of the duodenum to the liver

349
Q

Describe the greater omentum.

A

fat laden, four layers, prevents viscera from adhering to the abdominal wall

350
Q

The _____ omentum acts as the “policeman” of the abdominla region, sometimes shifting positions to protect an area of infection

A

greater

351
Q

The lesser sac also called the ____ ____ is located ______ to the stomach and is a dead end of sorts`

A

omental bursa; posterior

352
Q

The greater sac is consider to be…

A

everything else outside of the lesser sac

353
Q

Give the two names for the entrance into the lesser sac.

A

omental foramen (epiplocic foramen of Winslow)

354
Q

A ____ _______ is a double layer of peritoneum that connects an organ with another organ or to the anterior abdominal wall

A

peritoneal ligament

355
Q

Two examples of peritoneal ligaments are the ______ ligament and the ______ ligament

A

hepatogastric and hepatoduodenal

356
Q

The ________ ligament contains the portal triad.

A

hepatoduodenal

357
Q

What is included in the portal triad?

A

portal vein, hepatic artery proper, and bile duct

358
Q
  1. ________ describes an organ almost completely covered with peritoneum.
  2. ______ decribes location external or posterior to the parietal paritoneum
A
  1. intraperitoneal

2. retroperitoneal

359
Q

The esophagus is a muscular tube extending from the ______ to the ______. It includes both internal circular layers and external longitudinal layers

A

pharynx to the stomach

360
Q

The upper esophageal sphincter is located at the _____ ______ and the lower esophageal sphincter is located ….

A

pharyngoesophageal junction

passing through the diaphragm

361
Q

The esophagus enters the stomach at the ____ ____

A

cardiac orifice

362
Q

The ____ _____ is a network on nerves on the surface of the esophagus

A

esophageal plexus

363
Q

The stomach is located between…

A

the esophagus and small intestine

364
Q

The lesser curvature of the stomach is ____ and the greater curvature is ____

A

concave;

convex

365
Q

Name the parts of the stomach.

A

cardiac part, fundus (expanded upper portion- often filled with air), body, pyloric part

366
Q

The ____ _____ is the point between the stomach and duodenum.

A

pyloric sphincter

367
Q

_____ are gastric folds on the internal surface of the stomach

A

rugae

368
Q

The small intestine is the location for ______ of nutrients

A

absorption

369
Q

Name the three parts of the small intestine.

A
  1. duodenum
  2. jejunum
  3. ileum
370
Q

The ______ is the shortest, widest, and most fixed part of the small intestine.

A

duodenum

371
Q

The duodenum receives opening of the _____ and ______ ducts

A

bile and pancreatic

372
Q

What shape does the duodenum have?

A

c-shaped (opening to the left)

373
Q

The duodenum is divided into _____ parts.

A

4

374
Q

Name the 4 parts of the duodenum.

A

superior, descending, inferior (horizontal), and ascending

375
Q

The descending part of the duodenum includes the _____ _____ and the major duodenal papilla.

A

hepatopancreatic ampulla

376
Q

The hepatopancreatic ampulla is also known as…. and is the site where what two ducts come together?

A

“ampulla of Vater”; bile and pancreatic ducts

377
Q

The ascending part of the duodenum has a ligament called the…. which is a slip of muscle from the diaphragm.

A

ligament of Treitz

378
Q

The ligament of Treitz functions to…

A

widen the angle of the junction of the duodenum and jejunum for better passage of contents

379
Q

The jejunum has a ticker wall, circular folds called _____ _____ and ______ vasa recta

A

plicae circulares; longer

380
Q

The jejunum is primarily located in what quadrant?

A

left upper

381
Q

The ileum is primarily located in what quadrant?

A

right lower

382
Q

The plicae circulares in the ileum are…

A

significantly decreased and absent in the terminal part

383
Q

The ileum has ______ complex arterial arcades than the jejunum

A

more

384
Q

Both the ileum and jejunum are suspended from the posterior abdominal wall by a….Within this area are the arterial arcades from which the vasa recta arise.

A

fan shaped mesentery

385
Q

The function of the large intestine focuses on….

A

absorption of water and formation of stool

386
Q

What distinguishes the large intestine from the small intestine?

A
  1. teniae coli-longitudinal bands of muscle
  2. haustra- sacculations
  3. omental appendages (appendices epiploicae)
387
Q

The ______ is the first part of the large intestine (blind pouch) just after the _______ junction

A

cecum, iliocecal

388
Q

The function of the appendix is now thought to be for….

A

storage of good bacteria

389
Q

The appendix opens into the cecum about ____ cm inferior to the ileocecal junction

A

2.5

390
Q

The ascending colon ascends of the ____ side of the abdominal cavity.

A

right

391
Q

The right colic (hepatic) flexure connects the ____ ____ and ____ ____

A

ascending colon and transverse colon

392
Q

The transverse colon is the _____ and most ______ part of the intestine

A

largest, mobile

393
Q

The left colic (hepatic) flexure connects the ____ _____ and the ____ _____

A

transverse colon and descending colon

394
Q

The descending colon is further continuous with the _______ ____

A

sigmoid colon

395
Q

The sigmoid colon has is ____-shaped and includes the ____ _____ which allows for freedom of movement.

A

S-shaped, sigmoid mesocolon

396
Q

The omental appendages of the sigmoid colon are ____ _____

A

very long

397
Q

The _____ is the fixed terminal part of the large intestine.

A

rectum

398
Q

The rectum is continuous with the anal canal which is why is is also considered a ______ organ

A

pelvic

399
Q

Reabsorption of _____ and _____, but not _____ occur in the rectum

A

water and electrolytes

not nutrients

400
Q

Name the parts of the pancreas.

A

head, neck, body, tail

401
Q

The pancreas is considered to be both a ____ and _____ gland

A

exocrine and endocrine

402
Q

The pancreas is an exocrine gland because…

The pancreas is an endocrine gland because…

A

is has a duct for pancreatic juices;

secretes glucagon and insulin into the bloodstream

403
Q

Glucagon and insuline regulate….

A

blood glucose levels

404
Q

When blood glucose levels rise, _____ is secreted.

When blood glucose levels fall, _____ is secreted.

A

insulin

glucagon

405
Q

What is type I diabetes?

A

inadequate insulin production

406
Q

What is type II diabetes?

A

insulin levels are normal but peripheral tissues no longer respond normally (typically adults, affected largely by diet and amount of physical activity)

407
Q

The pancreas is approximateld located at the level of ___ vertebrae

A

L1/L2

408
Q

True or False: The main pancreatic ducts runs through the substance of the gland.

A

True

409
Q

The main pancreatic duct unites with the ___ ____ at the hepatopancreatic ampulla, where it opens to the duodenum.

A

bile duct

410
Q

The accessory pancreatic duct(s) is/are variable and usually connect to the main pancreatic duct. Its/Their function is to drain….

A

part of the head of the pancreas

411
Q

The spleen is located in what quadrant?

A

left upper

412
Q

The spleen functions as a _____/______ organ

A

lymphatic/immune

413
Q

Name some specific functions of the spleen

A
  1. upo exposure to blood borne pathogens, B lymphocytes differentiate and produce antibodies
  2. filter blood- remove old erythrocytes (RBC) and white cells from circulation
  3. stores and concentrates blood cells and platelets
  4. important site of erythrocyte formation in infants
414
Q

The spleen is located connected to the greater curvature of the stomach by the _______ ligament and to the left kidney by the ______ ligament. It is associated posteriorly with ribs ____-____.

A

gastrosplenic ligament and splenorenal ligament;

ribs 9-11

415
Q

The _____ is the largest gland in the body.

A

liver

416
Q

The liver lies in what quadrant?

A

right upper and partly in left upper

417
Q

What protects the liver?

A

thoracic cage

418
Q

The highest point of the liver is posterior to rib ____

A

5

419
Q

Name the five main functions of the liver. (5)

A
  1. maintain normal blood glucose concentration
  2. secrete bile
  3. synthesize components of plasma
  4. uptake and excretion of bilirubin
  5. receive venous blood returning from GI tract by the portal vein
420
Q

Name any other functions of the liver you can think of.

A

a. storage of iron reserves
b. storage of fat soluble vitamins
c. blood storage
d. absorption and inactivation of lipid-soluble drugs
e. inactivation of toxins
f. major lymph producing organ

421
Q

_______ is the conversion of glucose to glycogen while _____ is the breakdown of stored glygogen

A

glycogenesis

glycogenolysis

422
Q

Secretion of bile is important in digestion of _____

A

fats

423
Q

Bile is also a vehicle for ______ as it may carry detoxified waste and potentially harmful materials to the the intestine for elimination

A

excretion

424
Q

Synthesis of components of plasma is important in ______

A

coagulation

425
Q

Bilirubin is conjugated in the _____ and excreted in the ____

A

liver; bile

426
Q

Accumulation of bilirubin in the blood results in _____ and may be due to increased production, decreased uptake, disturbance in conjugation, or obstruction of the bile duct

A

jaundice

427
Q

Absorbed products of digestion are taken up and metabolized or are transformed and returned to the ____ for utilization elsewhere.

A

blood

428
Q

The _____ ____ & ______ _____ attach the liver to the diaphragm and anterior wall.

A

falciform ligament, and coronary ligament

429
Q

The falciform ligament has a remnant of the umbilical vein, called the ____ ______

A

ligamentum teres

430
Q

The bare area of the liver is in direct contact with the ______ The ___ ____ ____ occupies a fossa in the bare area.

A

diaphragm; inferior vena cava

431
Q

The ___ ____ for the liver is similar to the hilum of the lung

A

porta hepatis

432
Q

The porta hepatis is a deep fissure on the visceral surface of the liver that contains….(5 things)

A
  1. portal vein
  2. hepatic artery proper
  3. hepatic nerve plexus
  4. hepatic ducts
  5. lymphatic vessels
433
Q

The ___ ______ is a remnant of the ductus venous- shunted blood from the umbilical vein to the IVC.

A

ligamentum venosum

434
Q

True or False. Each lobe of the liver has its own arterial supply, venous drainage, and biliary drainage.

A

True

435
Q

True or False. The lobes of the liver function independently.

A

True

436
Q

The ___ lobe of the liver is demarcated by the gallbladder fossa, and fossa for the inferior vena cava on the visceral surface and an imaginary line running from the fundus of the gall bladder to the IVC on the diaphragmatic surface

A

right

437
Q

The right lobe includes the right branch of the ___ ____ and ____ ____ ___. It also includes the right ____ ____

A

right portal vein; right hepatic artery proper;

right hepatic duct

438
Q

The anotomic right lobe includes the _____ lobe and ____ lobe, which is different from the functional subdivisions.

A

caudate and quadrate

439
Q

The left lobe includes the left branch of the ___ ____ and ____ ____ ___. It also includes the left ____ ___

A

left portal vein; left hepatic artery proper;

left hepatic duct

440
Q

The functional left lobe includes the _____ lobe and most of the ____ lobe

A

quadrate; most of caudate

441
Q

The caudate lobe receives vessels from….

A

both right and left hepatic arteries/ hepatic portal veins

442
Q

True or False: Functional lobes are independent for right and left portions of liver

A

True

443
Q

Each part of the liver receives its own primary branch of the hepatic artery and hepatic portal vein and is drained by its own ____ _____

A

hepatic duct

444
Q

For the functional lobes, there are _____ divisions and ____ hepatic segments.

A

4

8

445
Q

There are approximately ________ lobules in the liver.

A

100,000

446
Q

A typical lobule is _______ in shape with a portal triad at each corner

A

hexagonal

447
Q

The portal triad (canal) is a small branch of portal vein and hepatic artery and a bile ductule enclosed in _____ _______

A

connective tissue

448
Q

The ______ vein merges to form the hepatic veins which empty into the ___ ____ _____

A

central; inferior vena cava

449
Q

The ____ _____ are endothelial cells, Kupffer cells (phagocytic cells), and fat-storing cells

A

hepatic sinusoids, function to detoxify and reabsorb

450
Q

The liver has a double blood supply. Name the two main sources.

A
  1. Common hepatic artery

2. Portal vein

451
Q

The commmon hepatic artery accounts for ___% of the blood supply for the liver and the portal vein accounts for ____%.

A

30%, 70%

452
Q

The common hepatic artery arises from the ____ ____

A

celiac trunk

453
Q

The common hepatic artery gives off a ______ artery and continues on as the _____ ____ ______.

A

gastroduodenal; hepatic artery proper

454
Q

The hepatic artery proper then divides into…

A

right and left hepatic arteries

455
Q

The common hepatic artery carries _______ blood back to the liver.

A

oxygenated

456
Q

The portal vein in the principal _____ blood vessel.

A

afferent

457
Q

The portal vein carries venous blood containing the products of digestion absorbed from the ___ ____

A

GI tract

458
Q

Portal vein is formed by the union of the what two veins?

A

superior mesenteric and splenic veins (inferior mesenteric usually joins the splenic)

459
Q

The portal vein terminates by dividing into…

A

right and left branches

460
Q

The hepatic veins are formed by the union of the ___ _____ in its lobules and open to the ____ _____ ____

A

central veins, IVC

461
Q

lymphatic drainage of the abdominal cavity include ___ and ____ portions

A

deep and superficial

462
Q

The deep lymphatics include the hepatic lymph nodes which drain into the ______ lymph nodes which then enters the ____ ______

A

celiac; thoracic duct

463
Q

The superficial lymphatics join lymph vessels in the ___ _____ and then enter the hepatic lymph nodes

A

porta hepatis

464
Q

The ______ is a thin walled bliush green sac

A

gallbladder

465
Q

The gallbladder functions to….

A

concentrates bile and stores

466
Q

The _____ duct joins the common hepatic duct to form the ____ duct

A

cystic duct; bile

467
Q

Eating fatty food causes secretion of ______ which causes the gallbladder to contract

A

cholecystokinn

468
Q

Bile is secreted into ____ ______ which drain into interlobular bile ducts which form progressively larger ducts

A

bile canaliculi

469
Q

Right and left hepatic ducts emerge from the porta hepatis and unite to form the ___ ____ ____

A

common hepatic duct

470
Q

What two ducts join to form the common bile duct?

A

common hepatic duct and cystic duct

471
Q

The bile duct joins with the with the _______ duct to form the hepatopancreatic ampulla (ampulla of Vater), which opens to the duodenum

A

pancreatic

472
Q

Name some examples of structures considered to be intraperitoneal.

A

intestine, liver, stomach

473
Q

Name some examples of structures considered to be retroperitoneal.

A

bladder, rectum, kidney

474
Q

Name some examples of structures considered to be secondarily retroperitoneal

A

duodenum, ascending colon

475
Q

The celiac artery/trunk arises from the ____ _____ almost immediately after it pieces the ________

A

abdominal aorta, diaphragm

476
Q

The celiac artery divides into ____ main branches

A

3

477
Q

Name the three main branches of the celiac artery.

A
  1. splenic
  2. left gastric
  3. common hepatic
478
Q

The splenic artery has branches to…

A

pancreas, short gastrics (to stomach), left gastroomental

479
Q

The left gastroomental is also called the _______ artery. It supplies the greater curvature of the stomach and anastomoses with the ______ _______ artery.

A

gastroepiploic, right gastroomental

480
Q

The left gastric artery supplies… and has ________ (type not #) branches

A

lesser curvature of the stomach, esophageal

481
Q

The common hepatic has branches for the ____ ____, _____, and ____ _____ arteries

A

right gastric, gastroduodenal, and proper hepatic

482
Q

The right gastric supplies the …. and anastomoses with the left gastric artery

A

lesser curvature of the stomach

483
Q

The gastroduodenal gives off the ____ ____ and ____ _____ arteries

A

right gastromental and superior pancreaticduodenal

484
Q

The proper hepatic artery gives off the ___ ____ and ____ branch and the ____ _____

A

right hepatic, cystic, left hepatic

485
Q

The right hepatic and cystic branch go to the _______

A

gallbladder

486
Q

Name all the organs supplied by the celiac trunk.

A

stomach, spleen, liver, gallbladder, duodenum, pancreas

487
Q

The pancreas and duodenum are also partially supplied by the….

A

superior mesenteric artery

488
Q

The superior mesenteric artery gives rise to the following:…

A
  1. inferior pancreaticoduodenal
  2. jejunal and ileal branches
  3. ileocolic
  4. right colic
  5. middle colic
489
Q

The superior mesenteric artery gives off about ___-___ jejunal and ileal branches that travel in the mesentery. They form….

A

12-15; form loops and arcades/vasa recta

490
Q

The ileocolic artery gives branches to the _____ and ____ ____

A

ileum and ascending colon

491
Q

The right colic artery divides into ascending and descending branches which anastomose with the ____ ____ and ______ arteries

A

middle colic, ileocolic

492
Q

The middle colic supplies the….

A

transverse colon

493
Q

Name all that the superior mesenteric supplies.

A

pancreas and duodenum (along with supply from celiac trunk), jejunum, ileum, cecum, appendix, ascending colon, part of the transverse colon

494
Q

The inferior mesenteric artery arise just above…

A

where the aorta divides into right and left common iliac arteries

495
Q

The inferior mesenteric gives off what three branches?

A
  1. left colic
  2. sigmoidal
  3. superior rectal
496
Q

The left colic artery has several branches to the ______ ______ and _____ _____. It then anastomoses with the branches of the middle colic artery

A

transverse colon and descending colon

497
Q

The sigmoidal artery anastomoses with what?

A

left colic and superior rectal

498
Q

Name all that the inferior mesenteric artery supplies.

A

part of the transverse colon, the descending colon, sigmoid colon, rectum

499
Q

The vessels involved in the venous drainage system of the abdomen are part of the ____ _______ ______

A

hepatic portal system

500
Q

Name the three main veins of the hepatic portal system.

A
  1. superior mesenteric
  2. splenic
  3. Portal
501
Q

What does the superior mesenteric vein drain?

A

pancreas, duodenum, jejunum, ileum, appendix, cecum, ascending colon, and transverse colon

502
Q

What does the splenic vein drain?

A

spleen, stomach, pancreas;
also drains the descending colon, sigmoid colon, and rectum, by way of the inferior mesenteric vein which drains into the splenic

503
Q

What forms the portal vein?

A

union of the superior mesenteric and the splenic

504
Q

Additional tributaries of the portal vein include the ____ and _____ _____, which divides into right and left branches before entering the liver– the ____ vein usually drain into the right branch.

A

right and left gastric;

cystic

505
Q

Overall, the hepatic portal system drains the stomach, the intestines as far as the rectum, the pancreas, spleen, and gallbladder and carries this blood to the ______ where absorbed nutrients are attacked and detoxified.

A

liver

506
Q

Name the connections between the portal venous system and the systemic venous system.

A
  1. esophageal veins-draining into azygos vein
  2. rectal veins-drains into IVC
  3. paraumbilical veins- anastomosing with superficial epigastric veins
507
Q

The ____ ____ ____ is an efferent (motor) system only

A

autonomic nervous system

508
Q

The ANS is a ____ neuron system

A

2

509
Q

The ______ neuron has cell bodies in the CNS

A

preganglionic

510
Q

The postganglionic neuron has cell bodies in the…

A

autonomic ganglia

511
Q

The two divisions of the ANS are the… and ….

A

sympathetic and parasympathetic

512
Q

The sympathetic division is also called the _____ and the parasympathetic is also called the _______

A

thoracolumbar; craniosacral

513
Q

Where are the ganglia located for the sympathetic division of the ANS? For the parasympathetic?

A

S- located some distance away from the target organ

P- located close or within the walls of target organ

514
Q

The sympathetic splanchnic nerves originate in the spinal cord (cell body in the _________ celll column) and pass via……to the sympathetic chain

A

(interomedioateral); white rami communicantes

515
Q

True or False: The sympathetic splanchnic nerves pass through the sympathetic ganglia but do not synapse there.

A

True

516
Q

Where do the sympathetic splanchnic nerves synapse?

A

in preaortic (prevertebral) ganglia and postganglionic fibers are distributed to target organs

517
Q

True or False: There are both right and left greater splanchnic nerves.

A

True

518
Q

The greater splanchnic nerve is formed by ___-_____ roots from the sympathetic trunk between the ____ and _____ ganglia

A

4-5; 5th and 9th (T5-T9)

519
Q

The greater splanchnic nerves synapse in the ______ _____ near the celiac trunk

A

celiac ganglion (solar plexus)

520
Q

The postganglionic fibers of the greater splanchnic nerves distribute along branches of the ______ artery to the stomach liver, pancreas, spleen, and part of the duodenum

A

celiac

521
Q

The lesser splanchnic nerve is formed by ___ roots from the ___ and _____ sympathetic ganglion

A

2; 10th and 11th (T10-T11)

522
Q

The lesser splanchnic nerve synapses in the ______ _______ _______

A

superior mesenteric ganglion

523
Q

Postganglionic fibers of the lesser splanchnic nerve are distributed along branches of the ____ ____ artery to part of the duodenum, jejunum, ileum, cecum, appendix, ascending, and transverse colon

A

superior mesenteric

524
Q

Name the 5 main sympathetic splanchnic nerves.

A
  1. greater splanchnic nerve
  2. lesser splanchnic nerve
  3. least splanchnic nerve
  4. lumbar splanchnic nerves
  5. sacral splanchnic nerves
525
Q

The least splanchnic nerve is formed by branches of the ___ sympathetic ganglion

A

12th (T12)

526
Q

The least splanchnic nerve synapses in the _____ _______

A

aorticorenal plexus

527
Q

Postganglionic fibers of the lest splanchnic nerve are distributed to the ____

A

kidney

528
Q

The lumbar splanchnic nerves arose from the sympathetic chain at the ___-____ lumbar ganglia

A

1st-4th

529
Q

The lumbar splanchnic nerves synapse in the ___ ____ ____ (inferior mesenteric ganglion) and is distributed to the descending colon, sigmoid colon, and rectum

A

abdominal autonomic plexus

530
Q

The sacral splanchnic nerves arise from the ____ _____ ______

A

sacral sympathetic chain

531
Q

The sacral splanchnic nerves synapse in the ____ ____ _____ and is distribute in the area

A

inferior hypogastric plexus

532
Q

Parasympathetic innervation for the abdominal region includes innervation from the ____ _____ and ____ ____ ___

A

vagal trunks and pelvis splanchnic nerves

533
Q

Vagal trunks provide the parasympathetic innervation to the abdominal visceral from the _____ to the ____ _____

A

esophagus to transverse colon

534
Q

The vagal trunks form at the…

A

inferior aspect of the esophagus

535
Q

The pelvic splanchnic nerves are the only splanchnic nerves to carry what?

A

parasympathetic fibers

536
Q

Ganglia of the parasympathetic splanchnic nerves are ins the walls of the viscera meaning they are ____/______ ganglia

A

intrinsic/enteric

537
Q

The parasympathetic splanchnic nerves-pelvic splanchnic nerves arise from the sacral segment of the spinal cord (S__-S___)

A

S2-S4

538
Q

The pelvic splanchnic nerves contribute to the formation of the ____ ____ (pelvic)______

A

inferior hypogastric plexus

539
Q

The parasympathetic splanchnic nerves-pelvic splanchnic nerves supplies what?

A

descending colon, sigmoid colon, and other viscera in the pelvis and perineum

540
Q

**For General Visceral Afferent fibers carrying pain sensation up to the middle of the sigmoid colon run with _____ fibers and then through the ____ ______ to the spinal nerve and then to the ___ _____ in the spinal cord

A

sympathetic;
white rami;
dorsal root

541
Q

GVA fibers: Unconscious sensations (mostly reflex) proximal to the middle of the sigmoid colon travel along the ____ fibers

A

vagal

542
Q

GVA fibers: Fibers carrying pain and reflex information distal to the middle of the sigmoid colon travel along the….

A

parasympathetic splanchnic nerves

543
Q

The pelvic autonomic plexus (superior and inferior hypogastric) is an extension of the ____ plexus below the bifurcation of the aorta into the common iliac arteries

A

aortic

544
Q

sympathetic innervation of the pelvic autonomic plexus comes from ______ ______ ganglion while parasympathetic innervation comes from _____ ______ nerves.

A

superior sympathetic;

pelvic splanchnic

545
Q

The kidneys are located at the level of ____-_____ vertebrae on the posterior abdominal wall

A

T12-L3

546
Q

The ______ fat is located outside the fascia while the the _____ fat is directly against the kidney

A

perirenal; pararenal

547
Q

Functions of the kidneys include….

A
  1. remove excess water, salts and products of protein metabolism from blood
  2. maintain pH
548
Q

The lateral margin of the kidney is ________ while the medial margin is _____

A

convex

concave

549
Q

The renal _____ describes the cleft of the medial aspect of the kidney while the renal ____ is the actual space.

A

hilum, sinus

550
Q

The renal pelvis is an expanded part of the _____

A

ureter

551
Q

Describe the flow of urine through the kidney

A

nephron –> papilla –> minor calix–> major calix–> renal pelvis –> ureter –> urinary bladder

552
Q

The renal papilla are at the tip of the ____ ____

A

renal pyramids

553
Q

The ___ is the functional unit of the kidney

A

nephron

554
Q

Different things are absorbed at different parts of the nephron. Name some parts of a nephron.

A

Bowman’s capsule (glomerulus), proximal convoluted tubule, Henle’s loop, distal convoluted tubule, collecting tubule, collecting duct

555
Q

The kidney’s receive blood from the _____ arteries.

A

renal

556
Q

The renal arteries arise from the ____ and each divides into ____ segmental arteries

A

aorta; 5

557
Q

The renal vein drains the kidney and drains into the ____ ___ ____

A

IVC

558
Q

The kidneys are innervated by…

A

renal plexus- supplied by fibers of the lesser and least splanchnic nerves;
nerves of the ureters

559
Q

The nerves of the ureters derive from several plexuses. Visceral afferent fibers follow sympathetic fibers back to the ____ root ganglia and cord segments T11-L2

A

dorsal

560
Q

The ____ ______ is the outer and major part of the suprarenal gland

A

suprarenal cortex

561
Q

The suprarenal cortex secretes steroid hormones (________) while the inner suprarenal medulla secretes ______ (adrenaline) and ______ (noradrenaline)

A

glucocorticoids;
epinephrine
norepinephrine

562
Q

The suprarenal glands have a rich blood supply from the _____ arteries.

A

suprarenal

563
Q

The superior renal artery arises from the ……
The middle suprarenal artery arises from the ….
The inferior suprarenal artery arises from the …

A

inferior phrenic artery
aorta
renal artery

564
Q

The venous drainage of the suprarenal glands include the ____ ____ ____ which drains into the IVC and the and the ____ ____ ___ which joins the renal vein

A

right suprarenal vein

left suprarenal vein

565
Q

The suprarenal glands are innervated by the _____ plexus and the ___ _____ nerves

A

celiac;

thoracic splanchnic

Applied Anatomy (6 decks)

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