anatomy Flashcards
What are the three layers of pericardium called?
Fibrous, Parietal serous, and visceral serous
when do the coronary arteries fill?
diastole
where do the coronary arteries arise from
the aortic sinuses
Give the percentages of how often the posterior descending artery is supplied by the right/left/both coronary arteries
70% right, 20% codominance, 10% left
where does the coronary sinus drain?
right atrium
what is the average cardiac output?
5L
Give the percentage constitution of the blood
55% fluid, 45% cellular (1% is WBC)
from which cells are platelets formed?
megakaryocytes
from which cells are neutrophils formed?
myeloblasts
from which cells are lymphocytes formed?
lymphoblasts
what does the mediatinum contain
everything in the chest apart from the lungs. heart, oesophagus, trachea etc.
at what level is the mediastinum divided into superior and inferior
T4/T5
what are the functions of the pericardial fluid between the serous layers?
prevents friction as the heart beats and protects against shock/motion
what is the function of the trabecular carnae?
to prevent suction in the ventricles. round depressions in the muscle
what is the function of the trabecular carnae?
to prevent suction in the ventricles
what is the function of the chordae tendinae?
attach the papillary muscles to the valves
what is the function of the papillary muscles
they contract to prevent prolapse or inversion of the valves during systole
what are the branches of the aorta, travelling from the right to the left?
brachiocephalic trunk - right subclavian + right common carotid. left common corotid, left subclavian
what are the anterior surface branches of the right coronary artery?
right marginal
what are the anterior surface branches of the left coronary artery?
left anterior descending (diagonal branch), circumflex, left marginal
which artery are the SAN and AVN supplied by?
right coronary (usually)
where on the chest do you listen to the different heart valves?
tricuspid - right 4th intercostal space in line with the sternocostal margin. pulmonary - left 2nd intercostal space in line with the sternocostal margin. mitral - 5th intercostal space at the midclavicular line. aortic - right 2nd intercostal space in line with the sternocostal margin
at what level is the top of the aortic arch?
T3/T4
at what level does the descending aorta pass behind the diaphragm?
T12
at what level does the oesophagus pierce the diaphragm?
T10
at what level does the IVC pierce the diaphragm?
T8
at what level does the celiac trunk branch?
L1
at what level does the descending aorta bifurcate?
L4
at what level does the descending aorta start?
T4/T5
what is the normal heart rate?
60-100 bpm
normal bp?
120/80 mg/merc
what are the 7 pulses?
carotid, femoral, radial, brachial, poploteal, posterior tibial, dorsalia pedis
what happens at level T4/T5
the descending aorta begins and the mediasteinum is divided into superior and inferior
what vein does the right coronary drain into?
small and middle cardiac veins
what vein does the post. interventricular drain into?
left post. ventricular vein
what vein does the left coronary drain into?
great cardiac vein
what vein does the left ant. descending drain into?
great cardiac vein
what vein does the right marginal drain into?
small and middle cardiac veins
what vein does the left marginal drain into?
left marginal and great cardiac vein
what are the layers of an artery wall?
tunica interna (endothelial cells), tunica media (smooth muscle), tunica externa (collagen and elastic tissue)
what are the layers of an vein wall?
tunica interna (endothelial cells), tunica media (smooth muscle), tunica externa (collagen and elastic tissue)
how thick are capillaries?
5 micrometres
what is haematopoesis?
the formation of blood cellular components
what does erythropoetin do?
stimulates proliferation and differentiation to make new RBCs. stimulates erythropoesis.
lifespan of: RBCs, platelets, neurophils
120 days, 7-10 days, 6 hours
structure of Hb
4 proteins. 2x alpha, 2x beta, 4 harm groups, ferrous 2+ ions
what is th function of coagulation proteins?
circulate in an inactivated form. help convert fibrinogen to fibrin to create clots. intrinsic and extrinsic pathways unite to form the common pathway.
what is lamina flow?
the smooth concentric flow of bloos that is desired?
what level is the sternal angle?
T4/T5
list the parts of the sternum
manubrium, sternal body, xiphoid process (and sternal angle)
what is the bony process of the scapula called?
acromion
what is the shoulder blade called?
scapula
what is the coracoid and where is it?
bony process inferior to the clavicle
what is the blood supply to the breasts and the venous drainage?
mammary arteries from the subclavian. venous drainage by the axillary vein and subclavian.
what is the innervation to the breasts?
4th and 6th intercostal nerves.
what is the lymph drainage of the breasts?
axillary lymph nodes
what is the origin and insertion of the pectorals major?
origin: clavicular head, sternal head, 6 first costal cartilages and the aponeurosis of the external oblique. insertion: lateral lip of the bicipital groove of the humerus
what is the origin and insertion of pectorals minor?
origin: 3,4,5 costal cartilages. insertion: coracoid process of the scapula
which nerves supply the pectorals major?
medial and lateral pectoral nerves
what are the actions of the pectorals major?
adduction and flexion of the humerus. rotation and attachment of upper limb.
what is the surface marking for the apex of the lung and the lower border?
superior to the medial end of the clavicle. between ribs 6 and 7 in midclavicular line
what are the surface markings for the horizontal and oblique fissures of the lungs?
right and left lung O fissures = intercostal space between 5 and 6, midclavicular line. horizontal fissure on right lung = 3 and 4 mid.clav
where does the phrenic nerve originate from, what is its route and what does it supply?
C3,4,5. passes anterior to the hilum. the left runs over the aortic arch and lateral to the side of the pericardium. the right runs parallel to the brachiocephalic vein. It then pierces the diaphragmic dome and supplies the diaphragm
what is the path of the vagus?
the vagus is cranial nerve 10 and originate from the medulla. it passes posterior to the hilum. left vagus passes left of the aortic arch. they join the oesophagus and enter the abdominal cavity through the oesophageal hiatus (left is anterior and right is posterior)
path of the recurrent laryngeal?
the RRL loops under the right subclavian artery and ascends. the LRL loops under the ligamentum anteriosum (link between the descending aorta and left pulmonary artery). they both ascend to the larynx.
what is the transverse sinus of the pericardium
where the aorta and plum vessels ext the pericardium
what is the azygos vein and where does it run?
right side of thoracic vertebral column. drains into SVC at T5-T6. another route for blood if IVC blocked further down. connects IVC and SVC
what is right border of heart formed by?
right atrium and ventricle. from 3-6 costal cartilages. 1.25cm from sternal margin
where is the apex of the heart?
left 5th intercostal space, 8-9cm from midline
where is the left border of the heart?
formed by left ventricle. IC space 2-6. 2.5 cm from costal margin
describe the venous drainage back into the IVC
two brachiocephalic trunks formed from left and right internal jugulars and left and right subclavians. the external jugular drains into the subclavian.
where do the left and right phrenic nerves pierce the diaphragm?
left - pierces left hemidiaphragm. right - passes through vena caval foramen.
what is the crista terminals?
smooth thick proportion of muscle that is crescent shaped at the opening of the right atrial appendage. SAN is part of it.
what is the fossa ovalis?
the embryological remnant of the foramen ovale which was the shunt between the right and left atria.
what are the musculi pectinati?
small ridges in wall of atria
what is the seoptmarginal trabeculum?
located in right ventricle. allows coordination of papillary muscles because it contains the right bundle of the AV bundles.
where is the thoracic duct, what is its function and where does it drain in to?
posterior to oesophagus. drains all of the lymph from the lower half of the body. drains into the left subclavian and internal jugular veins
where does the hemiazygos vein drain in to and which side of the body is it on?
azygos vein and left
what are the 3 splanchnic nerves, where do they originate from and what do they supply?
greater = T5-T9, supplies foregut. lesser = T10-T11, supplies midgut. least = T12, supplies hind gut.
what is the sympathetic chain?
white rami from T1-L2; afferent fibres. grey rami is at all segments and is efferent.
which lung is a peanut more likely to occlude?
the right because the main bronchus is straighter and bigger.
what are the two main functions of the larynx?
holds vocal folds and has the valve that closes the lower reap tract so that you don’t inhale food. (epiglottis)
describe the folds of the larynx. what are they formed of and how do they function?
vestibular folds - fixed in place, vascular and pink, and formed by a mucous membrane covering the vestibular ligament. vocal folds - mobile, avascular and white, and formed by a mucous membrane covering the vocal ligament.
what is the gap between the vocal folds and arytendoid cartilages called?
rima glottidis
what are the 6 cartilages of the larynx?
unpaired = thyroid, cricoid, epiglottis. paired = arytenoid, cuneiform and corniculate.
what are intrinsic and extrinsic muscles for?
intrinsic = chnging pitch. extrinsic = movement of larynx
what 3 sections is the laryngeal cavity divided into ?
vestibular - between inlet and vest. folds. middle - between vest. folds and vocal folds. lower - between vocal folds and cricothyroid cartilage
Name the extrinsic muscles and their actions. what is their nerve supply?
They attach to the hyoid bone which moves the larynx. elevation = diagsric, stylohyoid, mylohyoid, geniohyoid, thyrohyoid.
depression = sternothyroid, sternohyoid, omohyoid. nerve supply = ansa cervicalis (C!-3) and branches of hypoglossal.
nerve supply to the intrinsic muscles of the larynx?
all recurrent laryngeal except the cricothyroid which is supplied by the external laryngeal branch of the superior laryngeal branch of the vagus
what is the thyroid? what hormones does it release? How is it stimulated?
largest endocrine gland in the body. Controls metabolic rate and has a role in protein production. produces: triodothyronine (3iodines), thyroxine (4 iodines), calcitonin (controls Ca2+ levels). Hypothalamus receives signals info about metabolic rate etc. Releases thyrotropin releasing hormone (TRH) into anterior pituitary which then releases throid stimulating hormone (TSH). This increases release of T3 and T4 from the thyroid.
what are the parathyroids? How do they develop. what is the clinical significance?
they release parathyroid hormone. 4 of them, posterior to the thyroid gland. superior 2 glands develop from the 4th pharyngeal pouch, inf. from the 3rd. hyperparathyroidism increased the release of Ca from your bones, and can be destructive for your bones, can lead to a parathyroidectomy.
how many lobes does the thyroid gland have?
left, right and sometimes pyramidal.
what are the 4 facial sinuses and how are they innervated?
maxillary - largest, common site of infection because of gravity, respiratory muscosa, innervated by V1, pyramidal. frontal - asymmetrical, triangular, innervated by supra-orbital nerve from V1
sphenoid - pituitary gland can be surgically accessed through S sinuses. innervation by V1 and V2
ethmoid - innervated by V1 and V2
what are the openings for the sinuses?
maxillary - middle meatus frontal - middle meatus sphenoid - sphenoethmoidl recess ant. ethmoid - middle meatus middle ethmoid - middle meatus post. ethmoid - inf. meatus
what is the semilunar hiatus?
location of opening of frontal, maxillary and anterior ethmoid sinuses.
what is the pterygopalatine ganglion?
parasympathetic ganglion found in pterygopalatine fossa, innervated by greater petrosal nerve
what are the functions of the facial sinuses?
humidify and heat air, immunological defence, buffer against facial trauma
what humidity does air need to be to be inhaled?
98%
what are turbinates?
bony shelves inside the nasal cavity to heat and humidify air. air is heated to 31-33 degrees
what drains into the inferior meatus?
nasolacrimal duct
what drains into the middle meatus?
frontal, ant. + middle enthmoidal and maxillary sinuses
what are the palatine tonsils? where are they situated?
lymphoid tissue. pharyngeal constrictor muscle
what is the palatine tonsilar blood supply and drainage?
tonsilar branch of facial artery and paratonsilar vein
what is the hard palate formed by?
the palatine processes of the maxillary bone and horizontal palatine bones
what is the soft palate formed by? what is the nerve supply?
levator palatini - elevates S palate
tensor palatini - opens pharyngotympanic tube
uvuli muscularis - elevates uvula and closes naso and oro pharyngeal gap
palatoglossus - depresses palate and elevates back of tongues
palatopharyngeus - depresses palate and elevates pharynx. all vagus apart from tensor palatini which is trigeminal.
what is the carotid sheath and what does is contain?
fibrous connective tissue surrounding the vasculature of the neck: common and internal carotid, jugular vein and vagus nerve and deep cervical lymph nodes
how is speech created?
rotation of the arytenoid cartilage on the cricoid.
what is the sensory innervation of the nasopharynx?
CN V2
what is the sensory innervation of the oropharynx and laryngopharynx?
CN X and IX
what are the constrictor muscles innervated by?
the vagus via the pharyngeal plexus
what are the muscles of the pharynx?
stylopharyngeus, palatopharyngeus, salpingopharyngeus
what is the stylopharyngeus innervated by?
CN IX
what is the right border of the heart formed by?
right atrium between 3rd and 6th costal cartilages. 2-3cm from midline
what is the left border of the heart formed by?
left ventricle and left atrial appendage. slopes upwards and medially to 2nd costal cartilage.
what is the superior border of the heart formed by?
line between 2nd and 3rd costal cartilages.
what is the inferior border of the heart formed by?
right atrium and ventricle, apex part of the left ventricle
describe the anatomy of the right hilum of the lung.
one bronchus posterior. two arteries anterior. 3 veins anterior and inferior to arteries
describe the anatomy of the left hilum of the lung.
one bronchus posterior. one artery superior to bronchus. 2 veins that are inferior and anterior to bronchus.
describe the dermatomes of C4 C6 C7 C8 T5 T10 T12 L5 S1 S5
C4 = clavicle C6 = thumb C7 = middle finger C8 = little finger T5 = nipples T10 = umbilicus T12 = inguinal area L5 = big toe S1 = little toe S5 = anus
what is a myotome/dermatome?
dermatome is an area of skin that is supplied by a spinal root. myotome is a group of muscles that is supplied by the same spinal root.
what are the parasympathetic ganglions of the face?
pterygopalatine - lacrimal gland. otic - parotid gland. ciliary - sphincter pupillae, ciliary muscle. submandibular - submandibular and sublingual glands.
what are the atypical ribs?
1st = subclavian groove. 2nd = serratus anterior attaches on top. 11 + 12 have no neck and facets for vertebrae.
where do the right and left bronchial veins drain into?
right drains into azygous. left drains into hemiazygous.
what forms the left border of the heart?
left auricular appendage left pulm veins and left ventricle
what is the trachea innervated by?
recurrent laryngeal.
what is surfactant made of?
phospholipoprotein.
where does water collect in the lungs?
costadiagphramatic recess.
which ribs does the diaphragm attach to?
ribs 7-12.
what attaches the mediasteunim to the diaphragm?
central tendon.
where is the left lung displaced?
ribs 4-6
