Anatomy

Question 1

Describe the anatomy of the liver

Answer 1

Macroscopic

Microscopic

Question 2

Describe the anatomy of the spleen

Answer 2

LUQ organ responsible for Haematological/Immune function…

Question 3

Describe the structure of the eyeball/globe

Answer 3

The eyeball is comprised of 3 layers and 2 segments:

Outer layer - sclera/cornea
Middle layer - choroid, ciliary body, iris
Inner layer - retina

Anterior segment - anterior/posterior chamber from cornea to iris/iris to lens
Posterior segment - vitreous body

Question 4

Describe the anatomy of the intercostal space

Answer 4

The intercostal space is found between each rib and consists of:
—Neurovascular bundle
—Intercostal muscles (external, internal, innermost)

Question 5

Describe the Circle of Willis

Answer 5

The Circle of Willis is formed from anterior and posterior supply to try and ensure collateral blood supply in the event of failure from one input
Anterior supply from internal carotid arising through carotid canal to give off middle cerebral, anterior cerebral, anterior communicating and posterior communicating

Posterior supply from vertebral arteries arising from brachiocephalic trunk/subclavian to merge to the basilar artery and give off posterior cerebral artery and join the anterior system via posterior communicating.
Posterior supply gives off (in order):
—Anterior spinal artery
—Posterior inferior cerebellar (posterior spinal)
—Anterior inferior cerebellar
—Pontine
—Superior cerebellar

Question 6

What is the course of the Phrenic Nerve?

Answer 6

Arises from C3,4,5 (predominantly 4)
Descends anterior to anterior scalene, posterior to SCM/carotid sheath
Passes along brachiocephalic vein/IVC/lung hilum to diaphragm

Question 7

What is the blood supply to the bowel?

Answer 7

Arterial:
—Coeliac axis T12
—Superior L1 mesenteric
—Inferior L3 mesenteric

Venous:
Portal vein collects:
—Superior mesenteric vein
—Inferior mesenteric vein
—Splenic vein

Question 8

What is the innervation of the nose?

Answer 8

1. Trigeminal V2 Sphenopalatine branch:
—Nasopalatine
—Lesser palatine
—Greater palatine
2. Trigeminal V1 Nasociliary branch:
—Ethmoidal nerve (septal branch)

Question 9

What is the innervation to the scrotum/penis?

Answer 9

L1 - ilioinguinal nerve
S2,3,4 - dorsal nerve of the penis
S2 - perineal nerve
S3 - posterior cutaneous nerve of thigh

Question 10

What nerves do you need to block for the scalp block?

Answer 10

—Supraorbital
—Supratrochlear
—Zygomaticotemporal
—Auriculotemporal
—Greater occipital
—Lesser occipital
—Great auricular

Question 11

1. What is the thoracic inlet?

2. What structures pass through it?

Answer 11

1. Connects thoracic cavity to root of neck
   - Manubrium, T1 vertebra, medial border of first rib

2.
Airway - trachea, oesophagus
Vascular - brachiocephalic/common carotic/subclavian vessels
Nerves - Vagus, Phrenic, Sympathetic chain

Question 12

What are the pleura?

Answer 12

• Serous membranes covering lung/mediastinum/diaphragm/inside of chest wall
• Visceral & parietal

Pleural fluid = max. 10 mls
Pressure = -1cmH2O
Blood supply: bronchial arteries
Innervation: Vagus/Sympathetic or intercostal/phrenic

Question 13

What are the boundaries of the pleura?

Answer 13

Superior: C7/Thoracic inlet
Inferior: diaphragm down to T12 posteriorly
Anterior: T8
Mid-axillary: T10
Posterior: T12

Question 14

Describe the innervation of the heart

Answer 14

Sympathetic - T1-T4
—Terminate on SA/AV nodes, muscle fibres, coronary arteries
—R side ->chRonotropy
—L side ->L ventricle

Parasympathetic - Vagus
—Terminate on SA/AV nodes, coronary arteries

Superficial plexus:
—aortic arch between phenic/vagus nerves

Deep plexus:
—inferior to aortic arch

Question 15

Blood supply to trachea?

How can trachea be damaged?

Answer 15

Inferior thyroid artery and vein
Bronchial artery

Internal: inhalation (FB, burn, caustic), aspiration, rupture
External: trauma, compression, iatrogenic