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March exams Flashcards

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1
Q

Nerve supply of the lung

A

Pulmonary plexus:

Sympathetic part comes from sympathetic chain (cervical ganglia and T1-T3)

Parasympathetic part comes from pulmonary branches of the vagus nerve

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2
Q

What supplies the diaphragm

A

Phrenic nerve

C3-C5 (brachial plexus)

Contains sympathetic, motor and sensory fibres

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3
Q

Lymphatic drainage of the lungs

A

Bronchopulmonary nodes

–> Tracheobronchial nodes –>

Paratracheal nodes

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4
Q

Blood supply of lungs and bronchi

A

Lungs and respiratory bronchioles receive oxygen from the direct diffusion

Conducting bronchioles receive blood from BRONCHIAL ARTERIES and are drained by BRONCHIAL VEINS

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5
Q

Arterial supply of the oesophagus

A

Neck (cervical), thorax and abdomen.

  • Inferior thyroid artery
  • Aortic oesophageal arteries (thoracic bit) & bronchial arteries
  • Ascending branches of left gastric arteries (abdominal portion
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6
Q

Muscles of the oesophagus

A

Top 1/3 striated (voluntary)

Bottom 2/3 smooth (autonomic)

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7
Q

Venous drainage of oesophagus

A
  • Inferior thyroid vein
  • Azygos, hemiazygos, intercostal and bronchial veins
  • Left gastric vein
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8
Q

What pathology involve the oesophagus can occur due to portal hypertension?

A

Oesophageal varices

Due to pressure building up from portal system obstruction looking for another way out; “abdominal systemic shunt to distal oesophagus”

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9
Q

Arterial supply of the trachea?

A
  • Inferior thyroid artery

- Branches of the bronchial arteries

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10
Q

Venous drainage of the trachea?

A
  • Inferior thyroid vein plexus

- Bronchial veins and azygos system

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11
Q

What level is the jugular notch and what’s significant about what’s behind it?

A
  • T2/T3

- Major vessel bifurcation to avoid unprotected area (except inferior thyroid vein)

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12
Q

What level is the manubrium and what vessel is behind it?

A

T3 and T4

SVC

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13
Q

What level is the angle of Louis and what is behind it?

A

T4/T5 and 2nd rib connects to it

RATPLANT

Rib 2
Aortic arch start and end
Tracheal bifurcation
Pulmonary trunk bifurcation
Left recurrent laryngeal nerve
Azygos system into SVC
Nerves (cardiac plexus)
Thoracic duct
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14
Q

What levels are the sternum and what organ is behind it??

A

T5-9/10

Right border of the heart

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15
Q

Where is the apex of the heart, roughly?

A

5th IC space, midclavicular line

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16
Q

Describe the intercostal muscles and their function

Muscle name, fibre direction, coverage and function

A

External:

  • Inferior and anterior (pockets)
  • Anterior aponeurosis
  • Inspiration; elevation and eversion of ribs

Internal

  • Inferior and posterior (boobs)
  • Posterior aponeurosis
  • Inspiration

Innermost

  • Horizontal
  • Forced expiration (ribs pulled down)
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17
Q

Describe a neurovascular bundle and where it is

A

VAN from top to bottom

Just inferior of rib (costal groove) in between internal and innermost muscle layers

Intercostal vein, artery, nerve

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18
Q

What is the arterial supply of the chest wall?

A
  • Intercostal arteries
  • The anterior anastomosis of the intercostal artery is the internal thoracic artery and the posterior anastomosis is the aorta
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19
Q

What structures does neurovascular bundle supply?

A

DORSAL PRIMARY RAMUS OF INTERCOSTAL NERVE: motor and sensory fibres to structures 1 HAND’S BREADTH EITHER SIDE OF SPINOUS PROCESSES

VENTRAL PRMARY RAMUS: motor and sensory fibres to the rest of the back, lateral and anterior chest wall

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20
Q

What does the collateral branch of the intercostal nerve supply?

A

Underlying intercostal muscle and pleura only

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21
Q

What does the lateral cutaneous nerve of the intercostal nerve supply?

A

Sensation to skin

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22
Q

What does the anterior cutaneous branch of the intercostal nerve supply?

A

Sensation to anterior chest wall

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23
Q

What is the surface anatomy used for insertion of a chest drain?

A

Usually 5th IC in MAL but safe triangle is the boundaries

Safe triangle:

  • 5th intercostal space
  • Lateral edge of pec major
  • Lateral edge of lat dorsi
  • Apex below axilla
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24
Q

Lymphatic drainage of the oesophagus

A
  • Upper 1/3: deep cervical nodes
    Middle 1/3: mediastinal nodes
    Lower 1/3: left gastric and coeliac nodes
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25
Lymphatic drainage of the oesophagus
- Upper 1/3: deep cervical nodes Middle 1/3: mediastinal nodes Lower 1/3: left gastric and coeliac nodes
26
What are the three phases of swallowing?
Oral Pharyngeal Oesophageal
27
What is the first phase of swallowing and what happens?
Oral phase Oral preparatory phase: bolus formation by facial muscles, muscles of mastication and tongue muscles Oral phase proper: bolus transport from mouth to pharyngeal inlet Swallow reflex initiated by somatosensory receptors in the pharynx; signals sent via vagus (X) and glossopharyneal (IX) nerves
28
What is the second phase of swallowing and what happens?
Pharyngeal phase Early: - soft palate rises to seat pharynx - bolus is propelled - hyoid bone and larynx rise to protect airway - UOS closes to seal inlet preventing regurg Late: - Hyoid bone and larynx restored to original position - Bolus cleared - UOS opened
29
What is the third phase of swallowing and what happens?
Oesophageal phase - Bolus transprot from pharynx to stomach - UOS prevents reflex - Primary peristaltic wave propels bolus from laryngopharynx to stomach - Secondary peristaltic wave is initiated by oesophageal distension if the primary wave doesn't clear the food
30
What parts of the abdomen is the stomach in?
RUQ/LUQ or epigastric, umbilical and left hypochondrium and lumbar regions
31
Which of the sphincters around the stomach is true?
Pyloric sphincter, surrounding pylorus Lower oesophageal sphincter is not a true sphincter
32
Components of the anti-reflux barrier?
- Intraabdominal pressure: higher in abdo than thorax so helps close abdominal oesophagus Angle of His (gastrooesophageal flat valve) Lower oesophageal sphincter Crura
33
Venous drainage of the stomach
Right gastric -> hepatic portal Left gastric -> hepatic portal Left gastro-omental -> hepatic portal Right gastro-omental -> SMA -> hepatic portal Middle gastric -> splenic -> hepatic portal
34
Venous drainage of the stomach
Right gastric -> hepatic portal Left gastric -> hepatic portal Left gastro-omental -> hepatic portal Right gastro-omental -> SMA -> hepatic portal Middle gastric -> splenic -> hepatic portal
35
Nervous supply of the stomach
PARASYMPATHETIC IS SECRETO-MOTOR = PERISTALSIS++: - Anterior vagus from left vagus on front of stomach - Posterior vagus from right vagus on back of stomach SYMPATHETIC = CONSTRICTS SPHINCTERS: - T5-T9 thoracic ganglia of sympathetic chains -> coeliac plexus -> gastric plexus AFFERENT SENSORY FIBRES: - travel back with the vagus nerve
36
What structures are behind the stomach?
LESSER SAC and pancreas
37
Which organ is at the greater curvature of the stomach?
Transverse colon
38
What are the three parts of the autonomic nervous system?
Sympathetic Parasympathetic Enteric
39
What are the two parts of the somatic nervous system?
Cranial nerves | Spinal nerves
40
Which abdominal structures' pain is referred to epigastric region?
Foregut - stomach to D2
41
Which abdominal structures' pain is referred to umbilical region?
Midgut - D3 to Cannon's point
42
Which abdominal structures' pain is referred to suprapubic region?
Hindgut - Cannon's point onward
43
Which pain is referred to the shoulder tip?
Subdiaphragmatic e.g. liver, gallbladder, ectopic pregnancy, duodenum
44
Which pain is referred to the shoulder tip?
Subdiaphragmatic
45
Which level is the cisterna chyli?
L2; base of thoracic duct
46
Which nodes drain the stomach?
Coeliac
47
Which nodes drain the duodenum D1/D2
Coeliac
48
Which nodes drain the liver?
Coeliac
49
Which nodes drain the gallbladder / cystic ducts?
Coeliac
50
Which nodes drain the pancreas?
Coeliac
51
Which nodes drain the spleen?
Coeliac
52
Which nodes drain the duodenum D3/D4?
Superior mesenteric nodes
53
Which nodes drain the jejunum?
Superior mesenteric nodes
54
Which nodes drain the ileum?
Superior mesenteric nodes
55
Which nodes drain the caecum?
Superior mesenteric nodes
56
Which nodes drain the appendix?
Superior mesenteric nodes
57
Which nodes drain the transverse colon?
Superior mesenteric nodes
58
Which nodes drain the transverse colon?
Superior mesenteric nodes
59
Which nodes drain the descending colon?
Inferior mesenteric nodes
60
Which nodes drain the upper part of the rectum?
Inferior mesenteric nodes
61
What are the pre-aortic lymph nodes?
It is the group name for the nodes on the front of the aorta, which are the coeliac, superior mesenteric, and inferior mesenteric
62
What are the pre-aortic lymph nodes?
It is the group name for the nodes on the front of the aorta, which are the coeliac, superior mesenteric, and inferior mesenteric
63
What is the cisterna chyli and what does it drain, and where is it located?
Its an enlargement of the lower end of the thoracic duct Drains all of the body below the diaphragm Level L2 between the aorta and IVC
64
What level are the kidneys at?
T12-L3
65
What level is the hilum of the kidney?
L1
66
Which kidney is higher?
Left; probably because the liver is on the right
67
What is in front of the right kidney?
- Ascending colon hepatic flexure (inferior pole) - Descending duodenum (medial aspect of kidney) - Suprarenal gland (superior pole) - Hepatorenal recess is a big gap between liver and anterosuperior kidney
68
Arterial supply of the kidney
Right and left renal arteries ``` Right and left renal arteries -> Anterior and posterior branches -> Segmental arteries along medullary columns -> Interlobar arteries -> Arcuate arteries -> Interlobular arteries at 90deg -> Afferent arteriole ``` Right longer than left, and passes behind IVC
69
Arterial supply of the kidney
Right and left renal arteries directly off of aorta Right renal artery longer as aorta on left; and passes behind IVC (protection!?) NOTE that superior mesenteric artery comes off the aorta at the level of the renal arteries
70
What is the arrangement of the vein, artery and ureter in the hilum?
VAU from anterior to posterior
71
What is the arrangement of the vein, artery and ureter in the hilum?
VAU from anterior to posterior
72
What is the lymphatic drainage of the right kidney?
Para-caval lymph nodes | possibly could just say lumbar lymph nodes but im unsure
73
What is the lymphatic drainage of the right kidney?
Para-aortic lymph nodes | possibly could just say lumbar lymph nodes but im unsure
74
What is the lymphatic drainage of the right kidney?
Para-aortic lymph nodes
75
Embryologically, what are the adrenal gland parts derived from?
Adrenal cortex: mesoderm Adrenal medulla: neural crest cells
76
What separates the kidneys from the suprarenals?
A thin septum
77
What separates the kidneys from the suprarenals?
A thin septum
78
What does each part of the adrenal cortex do?
ZG: mineralocorticoids; mainly aldosterone, in response to high potassium (salt and water balance) ZF: glucocorticoids (mainly cortisol) in response to ACTH (increases glucose in the blood) ZR: androgens (mainly testosterone) in response to ACTH Clinical point: if cortex isn't working properly you get high ACTH
79
What does each part of the adrenal cortex do?
ZG: mineralocorticoids; mainly aldosterone, in response to high potassium (salt and water balance) ZF: glucocorticoids (mainly cortisol) in response to ACTH (increases glucose in the blood) ZR: androgens (mainly testosterone) in response to ACTH Clinical point: if cortex isn't working properly you get high ACTH
80
What does the adrenal medulla do?
Secretes catecholamines in conditions of physical and mental stress e.g. anger, fear, hypoglycaemia, via sympathetic nervous system activation
81
Arterial supply of the adrenal glands
Superior, middle and inferior adrenal arteries Which come from the inferior phrenic, abdominal aorta and renal artery (but who cares)
82
Nervous innervation of the adrenals
SYMPATHETIC ONLY Greater splanchnic nerve (T5-T9) Lesser splanchnic nerve (T10-T11) Through sympathetic trunk and coeliac ganglion without synapsing, then into suprarenal cortex and medulla
83
Nervous innervation of the adrenals
SYMPATHETIC ONLY Greater splanchnic nerve (T5-T9) Lesser splanchnic nerve (T10-T11) Through sympathetic trunk and coeliac ganglion without synapsing, then into suprarenal cortex and medulla
84
Lymphatic drainage of right suprarenal?
Para-caval lymph nodes
85
Lymphatic drainage of right suprarenal?
Para-caval lymph nodes
86
What do neurones do?
Generate and conduct electrical impulses
87
What do astrocytes do?
Physical and metabolic support for neurones. Detoxification Transport of blood-borne material to the neurone (metabolic exchange)
88
What is the predominant type of neuroglia in CNS white matter?
Oligodendrocytes
89
What is the predominant type of neuroglia in CNS white matter?
Oligodendrocytes
90
What is the function of microglia?
Macrophages of CNS: transform into large phagocytic cells in response to tissue damage
91
What is the function of ependymal cells?
Line ventricles and secrete CSF
92
What is the spinal root value of the biceps reflex?
C5 (&6)
93
What is the spinal root value of the brachioradialis reflex?
C6 (&5)
94
What is the spinal root value of the triceps reflex?
(C7)
95
What is the spinal root value of the ankle reflex?
S1
96
What is the spinal root value of the ankle reflex?
S1
97
Describe a spinal reflex arc
Peripheral receptor is activated causing action potential generation along afferent sensory fibres Afferent fibres form excitatory synapses with: ALPHA MOTOR NEURONES which propagate action potential to HOMONOMOUS muscle causing its CONTRACTION INHIBITORY INTERNEURONES which form an inhibitory synapse with an alpha neurones within the spinal cord that innervates the antagonist muscle causing its relaxation
98
Damage to afferent arm of reflex arc causes:
Areflexia (loss of reflex)
99
Damage to efferent arm of reflex arc causes:
Areflexia
100
Damage to descending motor neurons in spinal cord above level of reflex arc
Hyperreflexia (exagerated or brisk reflexes)

Billy Anatomy (1 decks)

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