Thorax & Abdomen Flashcards

(59 cards)

1
Q

Vagus nn

A

Parasympathetics to kidney walls, heart, foregut, midgut, 2/3 of transverse colon,

Autonomics: Pericardium

Somatic motor/Sens: Pharynx and Larynx via right and left recurrent laryngeal

Plexuses: Pulmonary, esophageal, cardiac

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2
Q

Phrenic nn.

A

Somatic: Pericardium

Sensory: mediastinum, diaphragm

Motor: diaphragm

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3
Q

Intercostal nn.

A

T1-T11, run in costal grooves

Runs between internal and innermost intercostal mm

Collateral branch runs thru inferior costal groove

Sensory of parietal pleura

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4
Q

Subcostal n

A

T12, Rib 12

Collateral branch inferior margin btwn internal and innermost IC mm

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5
Q

Pulmonary Plexuses

A

Mixed fibers from Vagus (parasymp, bronchoconstriction, gland secretion) and Cardiopulmonary Splanchnic nn (sympathetics, bronchodilation)

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6
Q

Iliohypogastric n

A

L1 - inferior to subcostal, superior to ilioinguinal

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7
Q

Ilioinguinal n

A

L1 - inferior to iliohypogastic, superior to lat. cutaneous. enters the inguinal canal

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8
Q

Genitofemoral n

A

L1-L2: sits atop psoas

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9
Q

Lateral cutaneous n. of thigh

A

L2-L3: lateral aspect of psoas

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10
Q

Femoral n

A

L2-L4: lateral to psoas

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11
Q

Obturator n

A

L2-L4: medial to psoas

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12
Q

Hindgut innervation

A

Parasympathetics: Pelvic splanchnic nerves to wall of hindgut organs

Sympathetics: lumbar splanchnic nerves to inferior mesenteric ganglion

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13
Q

midgut innervation

A

Parasympathetics: Vagus nn to wall of midgut organs

Sympathetics: Thoracic splanchnic nerves to celiac or superior mesenteric ganglion

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14
Q

foregut innervation

A

Parasympathetics: vagus nn to wall of foregut organs

Sympathetics: Greater thoracic splanchnic nerve to celiac ganglion

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15
Q

Foregut: Contents, blood supply, veins, lymphatics

A

Contents: Esophagus, stomach, proximal duodenum, liver, gallbladder, pancreas

Blood supply: Celiac trunk and branches

Venous drainage: gastric veins, splenic vein

Lymphatics: celiac lymph nodes to chyle cistern to thoracic duct

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16
Q

Midgut: Contents, blood supply, veins, lymphatics

A

Contents: distal duodenum, jejunum, ileum, cecum, appendix, ascending colon, proximal 2/3 of transverse colon

Blood supply: SMA

Venous drainage: SMV

Lymphatics: superior mesenteric lymph nodes to chyle cistern to thoracic duct

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17
Q

Hindgut: Contents, blood supply, veins, lymphatics

A

Contents: Distal 1/3 of transverse colon, descending colon, sigmoid colon, rectum

Blood supply: IMA

Venous drainage: IMV

Lymphatics: inferior mesenteric lymph nodes to chyle cistern to thoracic duct

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18
Q

Greater Splanchnic n

A

T5-T9: foregut sympathetics, synapse at celiac ganglia

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19
Q

Lesser splanchnic n

A

T10-T11: midgut sympathetics, synapse at superior mesenteric ganglia

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20
Q

Least splanchnic n

A

T12: kidney sympathetics, synapse at renal ganglia

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21
Q

Kidney Innervation

A

Parasympathetics: Vagus to kidney wall

Sympathetics: thoracic splanchnic nn (least splanchnic) to renal ganglion

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22
Q

Adrenal innervation

A

Sympathetic only: Thoracic splanchnic nerves, mainly greater splanchnic n.

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23
Q

Lymph drainage of abdominal wall

A

superior to umbilicus: axillary nodes

inferior to umbilicus: superficial inguinal nodes

testes/ovaries: lumbar nodes

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24
Q

Unpaired branches of aorta

A

Supply primarily retroperitoneal organs, gonads, body wall

Contains:
Subcostal aa.

Inferior Phrenic aa –> superior suprarenal aa.

Middle suprarenal aa.

renal arteries –> inferior suprarenal aa.

Gonadal aa

Lumbar aa.

25
Secondarily retroperitoneal organs
Had own mesentery during development. HAD PAD Horizontal, Ascending, Descending Duodenum Pancreas, Ascending Colon, Descending Colon
26
Primarily retroperitoneal organs
Pee and Poop are Primary: Suprarenal glands, kidneys, ureters, bladder, esophagus, rectum, aorta, IVC
27
Intraperitoneal organs
Abdominal esophagus, superior duodenum, stomach, spleen, liver, jejunum, ileum, transverse colon, signoid colon
28
Lesser omentum
Hepatogastric ligament (liver to lesser curve of stomach), hepatoduodenal ligament (liver to duodenum) Omental foramen (deep to hepatoduodenal lig.) portal triad (portal v, proper hepatic a., bile duct)
29
Divisions of ribs
ribs 1-7: Vertebrocostal or True ribs ribs 8-10: Vertebrochondral or False ribs Ribs 11-12: Vertebral or Floating ribs
30
Diaphragm openings
Caval Opening (T8): IVC Esophageal Hiatus (T10): Right crus, esophagus Aortic Hiatus (T12): Left & Right Crura, Aorta, Azygos v. thoracic duct "I ate 10 eggs at noon"
31
Anatomical warnings of breast cancer
Asymmetry in size, discharge from nipple, redness of skin, dimpling - tumor pulling suspensory ligaments retracted nipple: blocked areolar lymph nodes abnormal contours: tumor pulling suspensory ligaments Edema: tumor blocked lymph ducts
32
Pleuritis
inflammation of pleura: pain w/ activity, audible friction
33
Pneumothorax
air in pleural cavity
34
Pleural effusion
hemothorax (blood), chylothorax (lymph) Pools in costodiaphragmatic recess thoracentesis to remove fluid from costodiaphragmatic recess
35
Right lung impressions
SVC, Cardiac (Medial to hilum) Arch of Azygos (superior to hilum) esophagus (lateral to hilum)
36
Left lung impressions
Cardiac (medial to hilum) thoracic aorta (lateral to hilum) Arch or Aorta (superior to hilum)
37
Innervation of lungs and visceral pleura
Pulmonary plexuses: mixed fibers from Vagus and Cardiopulmonary Splanchnic nn sympathetics: bronchodilation Parasympathetics: bronchoconstriction, gland secretion
38
Innervation of parietal pleura
IC and phrenic nn (mediastinal)
39
Pericardial clinical correlations:
Pericarditis: audible friction, pain Cardiac tamponade: blood/fluid in pericardium Drainage by pericardiocentesis
40
Auscultation of valves
Aortic Valve: 2nd IC, right sternal border Pulmonary valve: 2nd IC, left sternal border Tricuspid: 5th IC, near sternum Bicuspid: 5th IC, distal
41
Innervation of Heart
Sypmathetics: cardiopulmonary splanchnic nn to cardiac plexus Parasympathetics: vagus nerve
42
Branches of Thoracic Aorta
Bronchial: 1 pair Esophageal: 3-5 pairs Posterior intercostal: 9 pairs Subcostal: 1 pair
43
Clinical Correlation: Rectus sheath
inferior to arcuate line, rectus sheath only composed of transversalis fascia. Weak point. Hernia risk
44
Innervation of Anterior Abdominal Wall
thoracoabdominal (from IC nn) nn (T6-T11) Subcostal n (T12) Iliohypogastric (L1) Ilioinguinal (L1)
45
Abdominal wall arteries
Posterior IC and Subcostal (outside sheath) Superior epigastric (from internal thoracic a., posterior superior rectus abdominus ) Inferior epicastric (from external iliac a, posterior inferior rectus abdominus) Superficial epigastric a. (from femoral, anterior inferior rectus abdominus)
46
Caval-Caval anastomoses
Superior epigastric vv. to internal thoracic vv to SVC Inferior epigastric vv to external iliac vv to IVC
47
hiatial hernia
sliding: abdominal espohagus and cardiac stomach slide thru esophageal hiatus paraesophageal: stomach fundus slides thru esophageal hiatus
48
direct inguinal hernia
push through abdominal fascia to enter posterior wall of inguinal canal
49
Indirect inguinal hernia
most common hernia lateral to inferior epigastric vessels herniate into deep inguinal ring and into inguinal canal
50
Suspensory Muscle/Ligament of Treitz
supports flexure of ascending duodenum
51
transverse colon innervation
proximal 2/3 vagus, distal 1/3 pelvic splanchnic nn.
52
Lateral flexures
muscular inlets on rectum, help prevent incontinence
53
Puborectalis
maintains anorectal flexure, prevents incontinence
54
Portal system
3 main tributaries: Splenic vein, SMV, IMV Blood from organs drain to portal vein, to the liver, to hepatic veins, to IVC
55
Portal vein: Foregut
Right gastric, left gastric Splenic: short gastric, left gastroomental SMV: right gastro omental
56
Portal vein: midgut
SMV, veins parallel arteries. Ileal and Jejunal vv, iliocolic, right colic, middle colic vv
57
Portal vein: hindgut
IMV veins parallel arteries left colic, sigmoid, superiorrectal
58
Portal Caval anastomoses
1. Umbilicus - Caput madusae 2. Distal esophagus - esophageal varices 3. rectum/anus - rectal varices 4. colon : hidden retroperitoneal varicies
59
Adrenal Gland blood supply
Superior Suprarenal aa: from inferior phrenic aa Middle suprarenal aa: from aorta Inferior suprarenal aa: from renal aa