Anatomy Flashcards
Safe triangle for chest drain insertion borders
anterior edge of latissimus dorsi
lateral border of pectoralis major
line superior to horizontal level of nipple
apex below the axilla
Anatomical location for chest drain insertion
5th ICS, mid axillary line
Muscles that attach the scapula to chest wall (7)
pectoralis minor omohyoid rhomboid major + minor trapezius levator scapulae serrates anterior
Muscles that originate from scapula and insert into the humerus (6)
teres minor infraspinatus supraspinatous subscapularis teres major deltoid
Rotator cuff muscles
teres minor
infraspinatus
supraspinatous
subscapularis
Muscles of the forearm (med-lat) (4,3)
superficial: pronator teres flexor carpi radialis palmaris longus pollicus digitorum superficialis
deep:
flexor pollicus longus
flexor digitorum profundus
pronator quadratus
Brachioradialis function
Elbow flexor
Beer Raising muscle
What sits behind the Brachioradialis mucle
Radial nerve (in cubital fossa)
Innervation of serrates anterior
long thoracic nerve
Long thoracic nerve roots
C5-7
Shoulder abduction + adduction nerve roots
C5
C7
Elbow flexion + extension nerve roots
C5
C7
Supination/pronation nerve root
C6
Wrist flexion + extension nerve roots
C6/C7
Finger flexion/extension nerve roots
C7/C8
Small muscles of hand nerve roots
T1
Mastectomy commonly causes which nerve injury?
long thoracic nerve
Nerves frequently injured in axillary dissection
intercostobrachial nerves
Erb’s palsy nerve root injury
C5,6
Klumpke’s palsy nerve root injury
C7,8 T1 (lower trunk)
Muscles supplied by radial nerve (4)
brachioradialis
extensors
supinator
triceps
Relation of median nerve to brachial artery
lateral –> anterior –> medial
Musculocutaneous nerve innervates which muscles (3)
biceps brachii
brachialis
coracobrachialis
Axillary artery branches
1: superior thoracic
2: thoracoacromial, lateral thoracic
3: sub scapular, ant + post circumflex humeral
Innervation of diaphragm
Phrenic nerve
C3-5
Thenar eminence laceration most likely causes damage to which nerve?
Recurrent branch of median nerve
Commonest electrolyte disturbance following crush injury?
Potassium
due to tissue lysis and necrosis
Vein that lies anterior to medial malleolus of tibia
Long saphenous vein
What does the breast lie on?
Pectoral fascia
Pectoralis major
Serratus anterior
External oblique
Nerve supply to breast
branches of intercostal nerves T4-T6
Arterial supply of breast
Internal mammary (thoracic) artery
External mammary artery
Anterior intercostal arteries
Thoraco-acromial artery
Venous drainage of breast
Superficial venous plexus to subclavian, axillary and intercostal veins
Lymphatic drainage of breast
70% to axillary nodes
Internal mammary chain
Deep cervical + supraclavicular fossa (later in disease)
Axillary LN levels
1 - inferior to pec minor
2 - behind pec minor
3 - above pec minor
Structures passing through caval foramen in diaphragm
IVC
R phrenic nerve
LNs
Structures passing through aortic hiatus in diaphragm
Aorta
Thoracic duct
Azygos vein
Structures passing through oesophageal hiatus in diaphragm
Oesophagus
Vagal trunks
L gastric vessels
Level of canal foramen
T8
Level of oesophageal hiatus
T20
Level of aortic hiatus
T12
Anatomical/congenital cause of indirect inguinal hernia
Abdo contents enter the inguinal canal through a patent processes vaginalis
Calot’s triangle borders
inferior surface of liver (superior)
cystic duct (lateral)
common hepatic duct (medial)
LN spread of pancreatic CA (5)
LNs of: coeliac axis paraduodenal peritoneum lesser curvature of stomach greater curvature of stomach hilum of spleen
Borders of perineum
pubic symphysis (anterior)
ischiopubic rami + ischial tuberosity + sacrotuberous ligament (lateral)
tip of coccyx (posterior)
MALT tissue
pharyngeal tonsil
palatine tonsils x2
tubal tonsils x2
lingual tonsil
Anatomical cause for Meckel’s diverticulum
failure of vitelline duct to obliterate
Embryological precursor of female reproductive organs
Müllerian ducts
Embryological precursor of male reproductive organs
Wolffian ducts
Anatomical cause for bronchogenic cysts
anomalous development of ventral foregut
Level of hilum of kidneys
Left - L1
Right L1-2
Only organ in direct contact with kidney
Pancreas
Posterior relations of kidneys
subcostal nerve ilioinguinal nerve iliohypogastric nerve quadrates lumborum transversus abdominis psoas major diaphragm arcuate ligaments
Fascia covering kidneys
Gerotas fascia
Gerotas fascia derived from
transversalis fascia
Structures at the renal hilum (ant to post)
renal vein
renal artery
ureter
IVC lies in front of which structure in the abdomen
right renal artery
Renal arteries are direct or indirect branches off aorta?
direct
Level of renal arteries
upper border of L2
Blood supply to ureters
renal artery aortic branches gonadal branches common iliac internal iliac
Ureter lies …. to bifurcation of iliac vessels
anterior
Ureter related to …. ligament of uterus
broad ligament
Embryological site of uranchus
medial umbilical ligament
Arterial supply to bladder
superior and inferior vesical arteries (branches of internal iliac)
Venous drainage of bladder
Vesicoprostatic/vesicouterine venous plexus to internal iliac veins
Lymphatic drainage of bladder
external iliac, internal iliac and obturator nodes
Innervation of bladder
Parasympathetic: pelvic splanchnic nerves
Sympathetic: L1 + 2 via hypogastric plexuses
Micturition control centre
Pons
Fascia separating prostate from rectum
Denonvilliers fascia
Blood supply of prostate
Internal iliacs
Artery that crosses ureter + where
Uterine artery 2cm superior to ischial spine
Urogenital triangle borders
Ischiopubic inferior rami
Ischial tuberosities
Innervation of penis
S2-4 (pudendal nerve)
Narrowest part of urethra
Membranous urethra
Cremasteric fascia derived from?
internal oblique fascial coverings
External spermatic fascia derived from?
external oblique aponeurosis
Internal spermatic fascia derived from?
Transversalis fascia
Innervation of scrotum
Ilioinguinal + pudendal nerve
Important nerve in posterior triangle LN biopsy
accessory nerve
Important nerve in posterior approach to hip
sciatic
Important nerve in Lloyd Davies positioning
common peroneal
Important nerve in axillary node clearance
long thoracic
Important nerve in pelvic cancer surgery
pelvic autonomic nerves
Important nerve in thyroid surgery
recurrent laryngeal nerves
Important nerve in carotid endarterectomy
hypoglossal nerve
Important nerve in upper limb fracture repairs
ulnar and median nerves
Important nerve in inguinal hernia surgery
ilioinguinal nerve
Which vessel do you use for conduit for coronary artery bypass
internal mammary artery
Thyroid isthmus overlies which tracheal rings?
2-4
Recurrent laryngeal nerve runs through which groove?
Tracheoesophageal groove
External laryngeal nerve supplies which muscle?
Cricothyroid
Recurrent laryngeal nerve supplies which muscles?
All intrinsic muscles of the thyroid except cricothyroid
Superior parathyroid glands derived from which pharyngeal pouch
4th
Inferior parathyroid glands derived from which pharyngeal pouch
3rd
Arterial supply to parathyroid glands
Inferior and superior thyroid arteries
Venus drainage of parathyroid glands
Thyroid veins
Adrenal zona glomerulosa secretes?
Mineralocorticoids eg aldosterone
Adrenal zona fasciculata secretes?
Glucocorticoids eg cortisol
Adrenal zona reticular is secretes?
DHEA
Androgens
Muscles that depress the hyoid bone
Sternothyroid
Sternohyoid
Thyrohyoid
Omohyoid
Infrahyoid muscles
Digastric
Mylohyoid
Stylohyoid
Geniohyoid
Anterior belly of digastric develops from which pharyngeal arch
1st
Posterior belly of digastric develops from which pharyngeal arch
2nd
Posterior belly of digastric crosses the carotid…?
superiorly
Origin of abdominal aorta
T12
Termination of abdominal aorta
L4
Branches of abdominal aorta (10)
Inferior phrenic - T12 Coeliac - T12 Sup mesenteric - L1 Middle suprarenal - L1 Renal - L1-L2 Gonadal - L2 Lumbar - L1-L4 Inf mesenteric - L3 Median sacral -L4 Common iliac - L4
How many paired branches come off abdominal aorta?
6
Which artery is divided to gain surgical access for AAA?
Left renal artery
Branches of coeliac axis
Left gastric
Hepatic branches
Splenic branches
Internal iliac artery branches
I Love Going Places In My Very Own Underwear
[From posterior division]
Ileolumbar
Lateral sacral
Gluteal (superior)
[From anterior division] Pudendal (internal) Inferior vesicle/Uterine Middle rectal Vaginal Obturator Umbilical
Gastroduodenal artery supplies
Pylorus, proximal part of duodenum, indirectly to pancreatic head
Level of origin of inferior vena cava
L5
Level of carval foramen passing through diaphragm
T8
Level of aortic hiatus
T12
Level of oesophageal hiatus
T10
Level of hepatic vein
T8
Level of inferior phrenic vein
T8
Level of suprarenal veins + renal vein
L1
Level of gonadal vein
L2
Level of lumbar veins
L1 to 5
Level of common iliac vein
L5
Level of formation of IVC
L5
IVC branches
I like to rise so high
Iliacs Lumbar Testicular (right)/ovarian Renal Suprarenal (right( Hepatic vein
How many collateral venous circulation to IVC
4
Azygos
Internal mammary venous
Long thoracic venous system (2 pathways)
Level of superior mesenteric artery
L1
SMA supplies?
Duodenum to mid transverse colon
SMA branches
Middle colic Iliocolic (+ appendicular) Inferior pancreaticoduodenal Right colic Jejunal + ileal
Cremasteric reflex caused by
Genitofemoral nerve