Regional gross anatomy Flashcards
(399 cards)
1
Q
what is lymph
A
fluid lost from the capillary bed that collects in tissues
2
Q
where does lymph from the lower limbs and pelvis drain into?
A
lumbar trunks
3
Q
where do lumbar trunks join w/ the end of the thoracic duct?
A
at a swelling called the cistern chyli
4
Q
lymph from the intestinal tact drains into where via the intestinal trunk?
A
the cisterna chyli
5
Q
what are the primary lymphatic organs?
A
bone marrow
thymus
6
Q
what are the secondary lymphatic organs?
A
spleen
tonsils
lymph nodes
peyers patches
7
Q
where does the thoracic duct pass through?
A
the posterior mediastinum of the thorax
8
Q
what is the right lymphatic duct formed from?
A
the right jugular and right subclavian trunks
9
Q
where is the thoracic duct found?
A
on the left side, between the aorta and the azygous vein
10
Q
which nodes drain the abdominal parts of the digestive tract?
A
pre aortic nodes at T12
11
Q
what is each spinal nerve composed of?
A
anterior roots and posterior roots that unite to form one spinal nerve
12
Q
what do somatic nerves carry?
A
motor fibres TO muscle
sensory fibres FROM skin
13
Q
what do spinal nerves divide into?
A
dorsal ramus and ventral ramus
14
Q
what do dorsal rami supply?
A
posterior body wall
15
Q
what do ventral rami supply?
A
anterolateral body wall and limbs
16
Q
what are the 4 cranial nerves that carry parasympathetic fibres?
A
cranial nerve 3 - oculomotor nerve
cranial nerve 7 - facial nerve
cranial nerve 9 - glossopharyngeal nerve
cranial nerve 10 - vagus nerve
17
Q
what is sacral outflow?
A
parasympathetics that exit from the spinal cord
18
Q
what are the nerve roots of parasympathetic sacral outflow?
A
S2,3,4
19
Q
where are the nerve roots involved in the parasympathetic sacral outflow from?
A
the pelvic splanchnic nerves
20
Q
where do cell bodies of the sympathetic nerves exit the spinal cord?
A
between T1 and L1/2
21
Q
where do ribs articulate anteriorly?
A
w/ the sternum
22
Q
where do ribs articulate posteriorly?
A
w/ the thoracic vertebrae
23
Q
how is the vertebral body connected w/ the posterior vertebral arch?
A
via the pedicles
24
Q
what are the typical ribs?
A
3-9
25
what are the 4 features of a typical rib?
head
neck
tubercle
body
26
where does the head of typical ribs articulate?
w/ the body of its own vertebra (inferior facet) and of the vertebra above (superior facet) and w/ the intervertebral disc (via the crest)
27
what are the 3 divisions of the sternum?
manubrium
body
xiphoid process
28
what is the joint between the xiphhoid process and the body of the sternum called?
xiphisternal joint
29
what kind of joint is found between vertebral bodies?
secondary cartilaginous
30
what kind of joint is found between articular facets?
synovial plane joints
31
what are the sternocostal joints?
the joints between the sternum and the costal cartilage of the ribs
32
what are the costovertebral joints?
the joints between the vertebrae and the ribs
33
what is the primary muscle of inspiration at rest?
the diaphragm
34
what are the 2 secondary muscles of respiration?
scalene muscles
serrates posterior muscles of the back
35
pectorals major is innervated by which 2 nerves?
medial and lateral pectoral nerves
36
pectoralis minor is innervated by which nerve?
medial pectoral nerve
37
what is the innervation of external oblique and rectus abdominus?
anterior rami of T7-T12
38
what is the innervation of serratus anterior?
long thoracic nerve
39
what are the 3 layers of intercostal muscles?
external intercostal
internal intercostal
innermost intercostal
40
which muscles usually span 1 or 2 intercostal spaces?
subcostal muscles
41
where in the intercostal space does the nerovascular plane sit?
between internal intercostal and innermost intercostal muscles
42
what is the function of the intercostal nerve?
supply the musculature of that intercostal space
but also gives off lateral and anterior branches which pierce through the muscle layers to provide sensory innervation to the skin
43
where do the posterior intercostal arteries branch from?
usually directly from the aorta
44
what is the arterial supply of the intercostal spaces 3-11?
posterior intercostal arteries which branch directly off the aorta
45
what is the arterial supply of the first 2 intercostal spaces?
branches off the subclavian artery (costocervical trunk which then gives off the supreme intercostal artery)
45
what is the arterial supply of the first 2 intercostal spaces?
branches off the subclavian artery (costocervical trunk which then gives off the supreme intercostal artery)
46
which intercostal spaces have an anterior intercostal artery?
ribs 1-9
47
where do anterior intercostal arteries arise from?
the internal thoracic artery (either direct or indirect branches of it)
48
where does the internal thoracic artery arise from?
the subclavian artery
49
where does the internal thoracic artery arise from?
the subclavian artery
49
where does the internal thoracic artery arise from?
the subclavian artery
50
where do anterior intercostal veins drain into?
the internal thoracic vein
51
where do posterior intercostal veins drain into?
azygous vein on the R
hemiazygous vein on the L
52
what is the function of suspensory ligaments of the breast?
anchor the breast to the dermis and provide support
53
what is the arterial supply to the breast?
medial and lateral mammary arteries
54
where does the lateral mammary artery arise from?
the lateral thoracic artery which arises from the axillary artery
55
where does the medial mammary artery arise from?
the internal thoracic artery
56
what is the venous drainage of the breast?
via medial and lateral mammary veins
57
describe the lymphatic drainage of the breast
75% of lymph towards axillary nodes
25% to parasternal and axillary nodes
58
describe the pleura of the lungs
parietal pleura covering the pulmonary cavities
visceral pleura covering the surface of the lung
59
what is the pulmonary ligament?
expansion of pleura that hangs down below the structures of the lung hilum
60
how many lobes does the R lung have and what are they?
3 lobes:
- superior lobe
- inferior lobe
- middle lobe
61
in the R lung what separates the superior and middle lobe?
horizontal / transverse fissure
62
how many lobes does the L lung have and what are they?
2 lobes:
- superior lobe
- inferior lobe
63
in the L lobe what separates the superior and inferior lobes?
the oblique fissure
64
what are the lymph nodes w/in the tissue of the lungs?
pulmonary nodes
65
what are the lymph nodes at the hilum?
hilar nodes aka bronchopulmonary
66
what are the lymph nodes at the bifurcation of the bronchus?
superior and inferior tracheobroncial nodes
67
what is the relationship between the phrenic nerves and the pericardium?
the phrenic nerves become assoc w/ the pericardium as they head down toward the diaphragm
68
explain the layers of pericardium
the fibrous pericardium is a tough connective tissue sac on the outside that blends w/ the tunica adventitia of the great vessels as they enter and leave the heart
the parietal serous pericardium lines the fibrous pericardium (pericardial sac)
the parietal serous pericardium is reflected over the surface of the heart to form the serous visceral pericardium
69
what separates the R atrium from the R ventricle?
the atrioventricular groove / coronary groove
70
what are the 2 pericardial sinuses and what do they arise as a result of?
transverse pericardial sinus
oblique pericardial sinus
arise from the arrangement of the serous pericardium
71
what lies w/in the atrioventricular groove?
the R coronary artery
72
what separate the R and L ventricles?
the inter-ventricular groove
73
what lies w/in the interventricualr groove?
the anterior inter-ventricular artery (aka the left anterior descending artery - LAD)
74
what are the 3 branches of the aortic arch?
brachiocephalic trunk
L common carotid artery
L subclavian
75
which 2 veins unite to form the superior vena cava?
the L and R brachiocephalic veins
76
what is the ligamentum arteriosum?
a fibrous remnant of the ductus arteriosis
77
what are the 4 branches of the R coronary artery?
SA nodal branch
marginal branch
posterior interventricualr artery
AV nodal branch
78
what are the 2 branches of the L coronary artery?
circumflex artery
anterior interventricualr artery (aka left anterior descending - LAD)
79
describe the venous drainage of the heart
cardiac veins which drain into the coronary sinus which return blood to the R atrium
80
which veins are the exception to draining into the coronary sinus and where do they drain instead?
anterior cardiac veins
empty directly into the R atrium
81
which veins are the exception to draining into the coronary sinus and where do they drain instead?
anterior cardiac veins
empty directly into the R atrium
82
what is the main contributor to the coronary sinus?
the great cardiac vein
83
describe the internal wall of the right atrium
areas w/ muscular ridges - pectinate muscles
smooth area - sinus venarum
ridge that separates pectinate muscles and sinus venarum - crista termainlis
84
what is the fossa ovals?
an impression on the interatrial wall (between the L and R atria)
remnant from foramen ovale
85
which valve does blood through when it goes from R atrium to R ventricle?
tricuspid
remember the R lung has 3 lobes and the valve on the RHS has 3 cusps (tricuspid)
86
what are chordae tendineae?
thin strings at the tricuspid valve that anchor the valve to papillary muscles
87
where is the moderator band found?
in the R ventricle
88
what is the function of the moderator band?
it carries part of the conduction system of the heart
89
what are the muscular ridges found in the ventricular wall?
trabeculae carneae
90
what are the features of the internal wall of the L atrium?
the internal wall of the L atrium is smooth and featureless
91
what is the L auricle?
an expansion of the L atrium
92
what are the muscular ridges in L auricle called?
musclae pectinati
93
which valve does blood flow through when it flows from the L atrium to the L ventricle?
the bicuspid valve (mitral valve)
remember the L lung has 2 lobes and the valve on the LHS has 2 cusps - bicuspid
94
what are the 2 types of heart valves?
semilunar valves
cuspid valves
95
where are the semilunar valves found?
pulmonary trunk
base of the aorta
96
where are the cuspid valves found?
between the atria and the ventricles (on both L and R side)
97
what happens to cuspid valves when there is high ventricular pressure?
the valves will close
as blood flows from the atria to the ventricles (through the cuspid valves which are open at this low pressure state), the ventricular pressure increases as the ventricles fill and this increased ventricular pressure will shut the cuspid valves
98
what happens to semilunar valves when there is high pressure?
the valves open
99
where is the SA node found?
in the wall of the R atrium (upper part of the crista terminalis)
100
where is the AV node found?
in the lower part of the interatrial septum
101
what is the parasympathetic supply to the heart and what does it do?
parasympathetic supply via the vagus nerve
acts to slow the HR and constrict coronary vessels
102
what is the sympathetic supply to the heart and what does it do?
sympathetic supply from T1-T5/6 and travels in the sympathetic chain
acts to increase the HR and dilate coronary vessels
103
what are the 2 divisions of the brachiocephalic trunk?
R common carotid
R subclavian
104
what are the L and R recurrent laryngeal nerves a branch of?
L and R vagus nerves
105
describe the path of the R recurrent laryngeal nerve
it arises as a branch and loops under the subclavian artery to travel back towards the larynx
106
describe the path of the L recurrent laryngeal nerve
it arises as a branch and loops under the aorta
107
the anterior vagal trunk is comprised mainly of nerve fibres from which vagal nerve?
L vagus nerve
108
the posterior vagal trunk is comprised mainly of nerve fibres from which vagal nerve?
R vagus nerve
109
the phrenic nerves carry fibres from the anterior rami of which spinal levels?
C3, 4, 5
remember the phrenic nerve innervates the diaphragm and C3, 4, 5 keeps the diaphragm alive
110
where does the trachea begin?
C6/7 (below the larynx)
111
where does the trachea end and what does it become?
ends by dividing into R and L main bronchi at the carina
112
at what level does the trachea divide into R and L main bronchi?
T4/5
113
where does the oesophagus lie in relation to the trachea?
directly posterior
114
where does the oesophagus begin and what is it a continuation of?
begins at the level of C6
as a continuation of the pharynx
115
where are the 3 constrictions of the aorta?
at:
- arch of the aorta
- left bronchus
- diaphragm
116
where does the thoracic aorta become the abdo aorta?
when it passes through the aortic hiatus
117
what is the system that drains the thoracic wall?
azygous venous system
118
explain the venous drainage of the R side of the thoracic wall
the R side drains directly into intercostal veins which drain directly into the azygous vein
119
what is the exception to the R side of the thoracic wall draining into the azygous vein?
the first intercostal vein on the RHS will drain directly into the R brachiocephalic vein
120
where do intercostal veins 1-4 drain into on the LHS?
L brachiocephalic vein
121
where do intercostal veins 5-8 drain into on the LHS?
accessory hemiazygous vein
122
where do intercostal veins 9-11 drain into on the LHS?
hemiazygous vein
123
where do the hemiazygous and the accessory hemiazygous veins drain into?
they both drain into the azygous vein which then drains into the SVC
124
where does the thoracic duct drain lymph from?
- lower limbs
- pelvis
- abdo
- L side of the thoracic cavity
125
where does the thoracic duct empty into the venous system?
at the L venous angle
126
what is the L venous angle?
junction of the L internal jugular vein and the L subclavian vein
127
where is the thoracic duct found?
between the aorta and the azygous vien
128
what is the sympathetic chain?
a chain of sympathetic ganglia extending the length of the vertebral column on either side
129
sympathetic outflow from the spinal cord occurs at which levels?
T1-L2/3
130
where do splanchnic nerves arise from?
the sympathetic chain
131
what are the 3 splanchnic nerves?
greater splanchnic nerve
lesser splanchnic nerve
least splanchnic nerve
132
what are the ganglia assoc w/ the greater splanchnic nerve?
T5-9
133
what are the ganglia assoc w/ the lesser splanchnic nerve?
T10 and 11
134
what is the ganglia assoc w/ the least splanchnic nerve?
T12
135
what is the function of the splanchnic nerves?
supplying sympathetic innervation to the abdo viscera
136
what is the caval opening?
an opening in the diaphragm that allows the passage of the IVC
137
what level does the IVC pass through the caval opening of the diaphragm?
T8
138
what is the oesophageal hiatus?
an opening in the diaphragm that allows the passage of the oesophagus and assoc vagus nerves
139
what level does the oesophagus (and vagus nerves) pass through the oesophageal hiatus?
T10
140
what is the aortic hiatus?
an opening in the diaphragm that allows the passage of:
- aorta
- thoracic duct
- azygous vien
141
what level do the aorta, thoracic duct and azygous vein pass through the aortic hiatus?
T12
142
where does the fascia of the anterolateral abdo wall change structure?
below the umbillicus
143
what is campers fascia?
a continuation of the superficial fascia layer across the abdo wall
144
what does campers facia continue to in males?
dartos fascia of the scrotum
145
what does campers facia continue to in males?
dartos fascia of the scrotum
146
what does campers fascia contribute to in females?
the facia of the labia major
147
what is scraps fascia?
the thin fascial layer deep to campers fascia
148
what is the inguinal ligament formed from?
aponeurosis external oblique
149
where does the inguinal ligament pass between?
ASIS and pubic tubercle
150
what is the innervation of the external oblique?
anterior rami of T7-T12
151
what is the innervation of the internal oblique?
anterior rami of T7-L1
152
what is the innervation of transversus adominus?
anterior rami of T7-L1
153
which muscle of the abdo wall does not form an aponeurosis?
rectus abdominus
154
what is the innervation of recuts abdomens?
anterior rami of T7-T12
155
what is the arcuate line?
the transition point between the strong aponeurosis and the delicate transversals fascia
156
which abdominal muscle contributes to both walls of the rectus sheath?
internal oblique
157
what is the venous drainage of the anterolateral abdominal wall?
veins drain towards the axilla or femoral vein
158
where do the arteries that supply the anterolateral abdominal wall arise from?
femoral artery or internal thoracic artery
159
which nerves supply the anterolateral abdominal wall?
anterior and lateral branches of the intercostal nerves
160
What is the arterial supply to the upper part of recuts abdominus?
Superior epigastric artery
161
Which artery is the superior epigastric artery a terminal branch of?
The internal thoracic artery
162
What is the arterial supply to the lower part of rectus adbominus?
Inferior epigastric artery
163
What artery is inferior epigastric a branch of?
External iliac artery
164
What are the nerve roots of the ilioinguinal and iliohypogastric nerve?
L1
165
Which 2 nerves supply the pubic region and medial thigh with sensory innervation?
Ilioinguinal
Iliohypogastric
166
where is the superficial drainage of the anterolateral abdo wall above the umbilicus to?
nodes in the axilla
167
where is the superficial drainage of the anterolateral abdo wall below the umbilicus to?
the inguinal region
168
what is the main nerve supply to the anterolateral abdo wall?
intercostal nerves
169
what is the scrotum?
an outpouching of skin of the abdo wall
170
in females what does the inguinal canal carry?
the round ligament
171
what allows the testes to descend from the abdo cavity towards the perineum?
the inguinal canal
172
which nerve is found in the inguinal canal?
ilioinguinal nerve
173
what is the superficial ring?
a triangular shaped defect in the aponeurosis of the external oblique
174
what is the deep inguinal ring?
an opening in the transversalis fascia
175
in males what are the structures that pass through the deep inguinal ring?
the contents of the spermatic cord:
- vas deferens
- testicular artery and veins
- genital branch of the genitofemoral nerve
176
in females what are the structures that pass through the deep inguinal ring?
- round ligament
- genital branch of the genitofemoral nerve
177
the contents of the spermatic cord are surrounded by how many layers of fascia and where do they come from?
3 layers of fascia
from the anterior abdo wall
178
which muscle does not contribute to the fascia surrounding the spermatic cord?
transversus abdominus
179
what are the contents of the speramtic cord?
- vas deferens
- testicular artery and vein
- lymphatics
- autonomic nerves
- artery to the vas deferens
- genital branch of the genitofemoral nerve
180
What is the na,e of the
181
What is the name of the smooth muscle fibres in campers fascia in the scrotum?
Dartos
182
What is the name of scarpas fascia in the perineal region?
Colles fascia
183
What isbthrbmusclenlayer
184
What is the muscle layer that continues from the spermatic cord that acts to move the scrotum up and down called?
Cremaster muscle
185
Explain the pathway of sperm production to ejaculation
- Sperm produced in the testes
- Developing sperm pass into epididymis to mature
- Mature sperm leave the testes via vas defrens
- vas deferens then pass through spermatic cord and into pelvic cavity where it joins w seminal vesicles to form ejaculatory duct
186
Describe the lymphatic drainage of the scrotum
Superficial inguinal nodes
187
Describe the lymphatic drainage of the testes
To nodes near the root of the testicular artery (either side of abdo aorta)
188
What is a mesentery?
A double lining of peritoneum
189
Why can the parietal peritoneum localise pain in the same way as the body wall?
Because it is supplied by somatic nerves
190
Explain perception of pain from the visceral peritoneum
The visceral peritoneum shares autonomic fibres w the organs it covered and therefore is sensitive to stretch and will refer pain to the body wall
191
What is the definition of intraperitoneal structures?
Completely covered by mesentery except at the point of attachment
192
What is the definition of extra peritoneal structures?
Either never related to peritoneum or lost relationship to peritoneum during development
193
What is the definition of retroperitoneal structures?
Partially covered by peritoneum and held against the body wall
194
Explain the arrangement of peritoneum in the abdo cavity
Arranged into 2 scs
- greater sac
- lesser sac
195
What is the greater omentum?
A layer of peritoneum that comes from the threaten curvature of the stomach and overhangs the transverse colon
196
Where is the greater omentum usually found?
Overlying areas where there are problems w the intestine
197
How many layers is the greater omentum?
4
198
The greater omentum carries which vessels and where do these supply?
The L and R gastro omental vessels
Supply the lesser curvature of the stomach and the greater momentum
199
What is the lesser omentum?
A double fold of peritoneum
200
Where is the lesser omentum found?
Between the liver and the lesser curvature of the stomach
201
What is the mesentery and what does it enclose?
Double layer of peritoneum
Encloses the jejunum, ileum, branches of the superior mesenteric artery and vein
202
Arterial supply to the foregut is derived from where?
The coeliac axis
203
Where does all blood from the foregut drain?
Into the hepatic portal vein
204
Where does lymph from the foregut drain to?
Para aortic nodes at T12 (coeliac nodes)
205
What are the folds on the internal surface of the stomach called?
Rugae
206
Where are the 2 fix points for the stomach?
- where the fundus meets the diaphragm (5th-6th rib on L)
- where the pyloric valve meets the duodenum (8th rib)
207
What is the arterial supply to the stomach and why?
Branches of the coeliac axis
Because the stomach is part of the foregut
208
What is the coeliac axis a branch of and where does it branch?
Anterior branch of the abdo aorta
Branches at T12
209
What are the 3 branches of the coeliac axis?
L gastric
Splenic
Common hepatic
210
Where does the R gastric artery branch from?
The hepatic artery
211
Where does blood from the stomach drain into?
The hepatic portal system
212
Where do the L and R gastric veins drain and where do they drain into?
Drain the lesser curvature
Drain directly into hepatic portal vein
213
Where does the L gastro omental (gastro epiploic) veins drain and where does it drain into?
Drains the greater curvature
Drain into the splenic vein which then drains into the hepatic portal vein
214
Where do the short gastric veins drain and where do they drain into?
Drain the fundus of the stomach
Drain into the splenic vein which then drains into the hepatic portal vein
215
where does the R gastro mental (gastro epiplpic) vein drain and where does it drain into?
drains the greater curvature
drains into superior mesenteric vein which then drains into the hepatic portal vein
216
which 2 veins untie to form the portal vein?
splenic and superior mesenteric vein
217
where does lymph from the stomach drain into?
pre aortic nodes at T12 (coeliac axis)
218
where is sympathetic innervation to the stomach derived from?
from the greater splanchnic nerves derived from the sympathetic chain in the thorax
219
where is parasympathetic innervation to the stomach derived from?
anterior and posterior vagal trunks
220
what are the folds found on the inner surface of the duodenum called?
plicae circulares
221
what controls the release of bile from the duodenum into the duodenum?
the sphincter of odi
222
where is bile made?
in the liver
223
where is bile stored and concentrated?
in the gall bladder
224
explain the dual blood supply of the duodenum
the duodenum lies at the junction of the foregut and the midgut and therefore receives blood from the coeliac axis and superior mesenteric vessels
225
what is the proximal part of the duodenum supplied by?
the superior pancreaticoduodenal artery (coeliac axis)
226
what is the distal part of the duodenum supplied by?
the inferior pancreaticoduodenal artery (superior mesenteric artery)
227
what is the venous drainage of the superior duodenum?
directly into the hepatic portal vein
228
what is the venous drainage of the inferior duodenum?
superior mesenteric vein
229
which nerves supply sympathetic innervation to the duodenum?
splanchnic nerves
230
which nerves supply parasympathetic innervation to the duodenum?
vagus nerves
231
explain the dual lymphatic drainage of the duodenum?
because the duodenum has a dual arterial supply it can send lymph to the coeliac axis (at T12) and to the superior mesenteric artery (at T11)
232
what is the ligamemtum teres?
a fibrous remnant of the umbilical vein
233
what are the 4 lobes of the liver?
L lobe
R lobe
caudate lobe
quadrate lobe
234
what is the bare area of the liver?
the area of the liver that is not covered by peritoneum,
235
what is the hilum of the liver called?
the porta hepatis
236
which structure carries the hepatic artery and the portal vein to the portal hepatis?
the lesser omentum
237
what is the name of the liver?ligament that lies between the R and L lobes of the
the falciform ligament
238
which vessel delivers the majority of the blood to the liver?
the portal vein
239
what are the properties of the majority of the blood that is delivered to the liver?
low in O2
rich in nutrients
240
where does the lymph from the liver drain to?
nodes at the coeliac axis at T12
241
where are the autonomic nerves that supply the liver from?
the coeliac axis
242
what is the consequence of the sphincter of odi usually being closed?
bile backs up into the biliary tree, through the cystic duct and into er the gall bladder
243
what is the function of the rugae and microvilli on the internal surface the gall bladder/
increase the surface area to allow more water absorption in the concentration of bile
244
where does the main duct draining the exocrine secretions from the pancreas open and where does this open into?
opens at the ampulla of vater
into the second part of the duodenum
245
explain the dual blood supply of the pancreas
- dorsal pancreatic artery (branch from splenic artery)
- superior pancreaticoduodenal artery (branch from
245
explain the dual blood supply of the pancreas
- dorsal pancreatic artery (branch from splenic artery)
- superior pancreaticoduodenal artery (branch from gasproduodenal artery) and inferior pancreaticoduodenal artery (branch from superior mesenteric artery)
246
explain the venous drainage of the pancreas
blood drains to either the splenic vein to the superior mesenteric vein which both then drain into the portal vein
247
where does lymph from the pancreas drain to?
coeliac nodes at T12
248
where is the autonomic innervation to the pancreas from?
coeliac plexus and superior mesenteric plexus
249
the gastro splenic ligament of the spleen carry which vessels?
short gastric
gastro epiploic
250
the lienorenal ligament of the spleen carry which vessels?
splenic artery and vein
251
autonomic nerves that supply the spleen are derived from where?
the coeliac plexus
252
the midgut is composed of which 2 structures?
small intestine
large intestine
253
where does the midgut receive blood from?
branches of the superior mesenteric artery
254
where does the midgut span from / to ?
from the distal 2/3rds of the duodenum to the transverse colon
255
where does the jejunum lie?
at the junction of the foregut and the midgut
256
which 2 branches of the superior mesenteric artery supply most of the small intestine?
the jejunal and ileal
257
the distal part of y?the ileum is supplied by which artery of the superior mesenteric
iliocolic
258
blood from the small intestine drains to the superior mesenteric vein via which 3 veins?
jejunal
ileal
iliocolic
259
autonomic supply to the small intestine is from where?
the superior mesenteric plexus
260
what is the function of the mesentery?
attach the jejunum and ileum to body wall
also allows passage of vessels
261
what are the 3 features of the large intestine?
haustra
teniae coli
appendices epiploicae
262
what are haustra?
sacculations of the wall
263
what are teniae coli?
longitudinal muscle collected into 3 bands
264
what are appendices epiploicae?
fatty tags
265
where does the caecum lie?
at the base of the ascending colon
266
where does the ileum open into the caecum?
at the ileocaecal valve
266
where does the ileum open into the caecum?
at the ileocaecal valve
266
where does the ileum open into the caecum?
at the ileocaecal valve
267
where does the caecum get its blood supply from?
the ileocaecal artery
268
which artery supplies the appendix and where does it run?
appendicular artery
runs in the mesoappendix
268
what is the ascending colon a continuation of?
the caecum
269
which 2 vessels supply the ascending colon and what are they branches of?
ileocolic artery
right colic artery
from the superior mesenteric artery
270
where does the transverse colon hang from?
the transverse mesocolon
271
what is the junction between the midgut and the hindgut?
the transverse colon
272
what is the arterial supply to the transverse colon and why?
branches of the superior and inferior mesenteric artery
because it is the junction of the midgut and the handout
273
what is the venous drainage of the transverse colon?
to the superior and inferior mesenteric vein
274
the dual lymphatic drainage of the transverse colon is to where?
L1 and L3
275
explain the dual supply of parasympathetic innervation to the transverse colon
proximal 2/3rds - vagus nerve (midgut region)
distal 1/3rd - pelvic splanchnic nerves (hindgut region)
276
where does the transverse colon pass from / to?
from the distal third of the transverse colon to the anal canal
277
which artery supplies the hindgut?
the inferior mesenteric artery
278
the inferior mesenteric artery is the final branch of the abdo aorta, at what vertebral level does it branch off?
L3
279
where does the descending colon become the sigmoid colon?
at the pelvic brim
280
what is the arterial supply of the descending colon?
L colic and sigmoidal branches of the inferior mesenteric artery
281
what is the venous drainage of the descending colon?
inferior mesenteric vein
282
what is the arterial supply to the sigmoid colon?
sigmoidal branches of the inferior mesenteric artery
283
what is the venous drainage of the sigmoid colon?
sigmoidal vein which drains to the inferior mesenteric vein
284
where is the autonomic supply to the sigmoid colon derived from?
the hypogastric plexus in the pelvis
285
explain the dual arterial supply to the rectum
from the abdo: superior rectal artery
from the pelvis: inferior and middle rectal arteries
286
what artery is the superior rectal artery a branch of?
inferior mesenteric artery
287
what artery is the middle rectal artery a branch of?
direct branch of internal iliac artery
288
what artery is the inferior rectal artery a branch of?
internal pudendal artery
289
explain the venous drainage of the rectum
forms a portal systemic anastamosis
superior parts drain into the portal system
distal parts drain into the systemic system (internal pudendal and internal iliac veins)
290
explain the lymphatic drainage of the rectum
split so superior parts drain to pre aortic nodes at L3 and distal parts drain to internal iliac nodes in the pelvis
291
what is a primary retroperitoneal structure?
formed on the body wall during development and maintained the relationship w/ the body wall
292
what is a secondary retroperitoneal structure?
develop outw/ the peritoneum but are covered by peritoneum in adult life
293
the hilum of each kidney lies at what vertebral level?
L1
294
what are the 3 structures found at the hilum of the kidney?
renal artery
renal vein
renal pelvis (becomes the ureter)
295
what structure is most posterior at the renal hilum?
the renal pelvis / ureter
296
which structure entering the kidney commonly has anatomical variation?
the renal artery - there can often be another renal artery outw/ the renal hilum
297
explain the pathway of urine
calyces collect the urine and drain it towards the renal pelvis which becomes the ureter to carry urine to the bladder
298
where do the renal arteries originate from?
they are lateral branches of the abdo aorta t L1
299
explain the division of the renal arteries
each renal artery divides into anterior and posterior branches and then smaller segmental arteries
300
which renal artery is longer and why?
the right renal artery is longer than the L because they come off the abdo aorta which lies to the L and so the R renal artery has further to travel to reach the R kidney
301
which renal artery is longer and why?
the right renal artery is longer than the L because they come off the abdo aorta which lies to the L and so the R renal artery has further to travel to reach the R kidney
302
where do the renal veins drain into?
the IVC
303
which 2 veins drain into the L renal vein?
the L gonadal and L adrenal veins
304
where does the R gonadal vein drain into?
directly into the IVC
305
the ureters descend the posterior abdo wall on the surface of which muscle?
psoas
306
which area of the bladder to the ureters enter?
trigone area
307
what are the 3 points of ureteric constriction?
- the junction of the ureters and the renal pelvis
- when the ureters cross the pelvic brim
- as the ureters enter the wall of the bladder
308
what are the branches of the inferior mesenteric artery in order?
left colic
sigmoidal branches
superior rectal (continuation of IMA)
309
at what level does the IMA arise from the aorta?
L3
310
at what level does the aorta bifurcate and what does it bifurcate into?
L4/5
bifurcates into the common iliacs
311
what does the left colic artery supply?
the distal third of the transverse colon and the descending colon
312
what do the sigmoidal branches supply?
the descending colon and the sigmoid colon
313
what are the 3 arteries that supply the rectum?
superior rectal artery (IMA)
middle rectal artery (internal iliac)
inferior rectal artery (internal pudendal)
314
what are the branches of the superior mesenteric artery?
inferior pancreaticoduodenal artery
middle colic artery
right colic artery
ileocolic artery
jejunal and ileal branches
315
where do all rotator cuff muscles insert except subscapularis?
greater tubercle
316
where does subscapularis insert?
lesser tubercle
317
where does the clavicle pass between?
the sternum and the scapula
318
what type of joint is the glenohumeral joint?
synovial ball and socket joint
319
what surrounds the glenohumeral joint?
a capsule
320
which artery supplies the shoulder joint?
subclavian artery
321
where do the left and right subclavian arteries branch off?
R is a branch from brachiocephalic trunk
L is a direct branch of the aortic arch
322
where does the subclavian artery become the axillary artery?
as it emerges from bemneath the clavicle and runs over the surface of the first rib
323
what is the arterial supply to the scapula and the proximal humerus?
branches from the thyrocervical trunk and axillary artery
324
what is the arterial supply to the scapula and the proximal humerus?
branches from the thyrocervical trunk and axillary artery
325
what is the arterial supply to the muscles at the lateral border of theta scapula?
the thoracodorsal artery which is from the subscapular artery
326
what are the 2 anatomical spaces in the shoulder region?
the quadrangular space
the triangular space / hiatus / interval
327
which nerve runs in the quadrangular space and what does it innervate?
the axillary nerve
innervates deltoid and teres minor
328
which artery runs alongside the axillary nerve in the quadrangular space?
the posterior circumflex humeral artery
329
which nerve runs in the triangular space and what does it innervate?
the radial artery
triceps brachii
330
which artery runs alongside the radial artery in the triangular soace?
profunda brachii artery (aka the deep brachial artery)
331
what are the 2 functions of the pectoralis major muscle?
flexion of the arm
adduction of the arm
332
what is the innervation of pectorals major?
the medial (C8-T1) and lateral pectoral nerves (C5-7)
333
what are the 2 functions of pectorals minor?
pull scapula forwards
stabilise the shoulder in movement of the upper limb
334
what is the innervation of pectorals minor?
the medial pectoral nerve (C8-T1)
335
what is the function of serratus anterior?
protractino of the scapula - move the scapula across the body wall away from the midline
336
wha is the innervation of serratus anterior?
long thoracic nerve (C5,6,7)
337
what are the 3 functions of trapezius?
depress the scapula
elevate the scapula
retract the scapula
338
what is the motor innervation to the trapezius muscle?
CN11 (spinal accessory nerve)
339
wha is the pain innervation to the trapezius?
cervical plexus (c3,4)
340
what are the 3 functions of latissimus dorsi?
extension
medial rotation of the arm
adductio of the arm
341
what are the 3 functions of latissimus dorsi?
extension
medial rotation of the arm
adduction of the arm
342
what is the innervation of latissimus dorsi?
thoracodorsal nerve (C6-8)
343
what is the function of levator scapulae?
raise the scaoula
344
what is the innervation of levator scapulae?
dorsal scapular nere (C3,4,5)
345
what is the function of both rhomboid major and minor?
retract the scapula
346
what is the innervation of both rhomboid major and minor?
dorsal scapular nerve (C3,4,5)
347
what is the main function of deltoid?
abduction of the arm
348
which muscles carry out abduction of the arm?
supraspinatus carries out the first 10 degrees
middle fibres of deltoid muscle carry out the remaining 110 degrees
349
all fibres of the deltoid muscle come together at a common insertion point, where is this?
deltoid tuberosity of the humerus
350
apart from abduction what are the other 2 functions of deltoid?
flex the arm
extend the arm
351
what is the innervation of the deltoid?
the axillary nerve (c5,6)
352
what sits in the deltopectoral groove?
the cephalic vein
353
the cephalic vein enters the axilla and joins which vein?
the axillary vein
354
where does teres major attach to the scapula?
inferior to teres minor
355
what is the function of teres major?
draw the arm closer to the body
356
what is the innervation of teres major?
sub-scapular branch of the posterior cord of the brachial plexus (C5,6)
357
where does subclavicus lie?
between the first rib and under the surface of the clavicle
358
wha is the innervation of subclavicus?
nerve to subclavicus (C5,6)
359
what are the 4 muscles of the rotator cuff?
subscapularis
supraspinatus
infraspinatus
teres minor
360
is there's major part of the rotator cuff?
no
361
which nerve innervates supraspinatus and infraspinatus?
suprascapular nerve (C5,6)
362
what is the innervation to teres minor?
axillary nerve (C5,6)
363
when does the basilic vein become the axillary vein?
when it crosses the inferior margin of teres major
364
when does the subclavian artery become the axillary artery?
when it crosses the lateral border of the first rib
365
what is the name of the branch of the first part of the subclavian artery?
superior thoracic artery
366
what are the 2 branches of the second part of the axillary artery?
thoracoacromial artery
lateral thoracic artery
367
what are the 3 branches of the third part of the axillary artery?
sub-scapular artery
anterior circumflex humeral artery
posterior humeral artery
368
the axillary artery anastsamoses around the scapula with which artery?
the subclavian
369
what are the 5 groups of lymph nodes in the axilla?
humeral
pectoral
subscapular
central
apical
370
fibres of the brachial plexus originate from which nerve roots?
C5-T1
371
what are the nerve roots of the superior trunk of the brachial plexus?
C5 and 6
372
what are the nerve roots of the middle trunk of the brachial plexus?
C7
373
what are the nerve roots of the inferior trunk of the brachial plexus?
C8-T1
374
which trunks of the brachial plexus do not give rise to nerves?
middle and inferior trunks
375
what are the 2 ligaments of the vertebral arch?
anterior longitudinal ligament
posterior longitudinal ligament
376
what is the only ligament that limits extension of the vertebral column?
anterior longitudinal ligament
377
what is the main function of the posterior longitudinal ligament?
prevent posterior herniation of the intervertebral disc
378
what are the 3 functions of ligament flavum?
help maintain curvatures
limit flexion
reinforce the walls of vertebral canal posteriroly
379
what do interspinous ligaments do?
connect adjacent spinous processes
380
above C7 the supraspinous ligament is continuous with what ligament?
nuchal ligament
381
wha is the function of the nuchal ligament?
limit flexion
382
explain the course of the spinal cord
begins at the foramen magum and ends at L1/2
383
what is the medullary cone?
the narrowing of the spinal cord at the caudal end
384
what are the 2 enlargements along the spinal cord?
cervical enlargement (C-T1)
thoracolumbar enlargement (L1-S3)
385
what is the cauda equina?
a collection of spinal nerves below the ending of the spinal cord
386
what is the filum terminale?
a remnant of hte caudal part of hte spinal cord comprised of the coverings of the cord (esp Pia mater)
387
what is the epidural space?
the space between the dura mater and the bone of the vertebrae
388
wha is the subarachnoid space?
the space between the arachnoid mater and the dura mater
389
where is CSF found?
subarachnoid space
390
what are the 3 arteries that supply the spinal cord?
anterior spinal artery
2 posterior spinal arteries
391
what are the smaller arteries that supply the nerve roots called?
radicular arteries
392
explain the venous drainage of the spinal cord
3 anterior spinal veins
3 posterior spinal veins
393
what are het smaller veins that drain the nerve roots called?
radicular veins
