Anatomy Flashcards
what three pairs of muscles are involved in the closing of the jaw
masseter
temporalis
medial pterygoid
where does the masseter muscle attach and what does it do
close the jaw
angle of the mandible and the zygomatic arch
where does the temporalis muscle attach and what does it do
close the jaw
coronoid process of the mandible to temporal fossa
what does the medial pterygoid muscle do and where does it attach
closes the jaw
the angle of the mandible ( medial) and to pterygoid plates of the sphenoid bone
which muscles open the jaw
lateral pterygoid
what do the lateral pterygoid muscles do and where do they attach
open the jaw
condyle aspect of the angle of the mandible and the pterygoid plate of the sphenoid bone
what nerves supply the muscles that open and close the jaw
mandibular division of trigeminal nerve CN V3
where does the CNV3 attach in the brain (pons, medulla etc)
the pons
NB CN V trigeminal is the only cranial nerve to attach to the pons
where does CN V3 pass through in the skull
passes through the sphenoid bone in the foramen ovale
which tonsils are visible when the mouth is open
palatine tonsil
within the oral cavity the superior half of the oral cavity and palate is supplied by what
general sensation is CN V2
the gingivae of oral cavity and floor of the mouth inferiorly is supplied by what
CN V3
the sensory part of the gag reflex is supplies by which nerve fibres
CN IX-glossopharyngeal
the motor part of the gag reflex is supplied by which nerve fibres
CNIX-glossopharyngeal and CN X vagus
what is CN VII also known as
facial nerve
where does the facial nerve CN VII connect to the CNS
junction between the pons and medulla
how does the facial nerve leave the skull
through the temporal bone through the stylomastoid foramen
where does the glossopharyngeal nerve connect to the CNS
medulla
what is the course of the glossopharyngeal nerve
directly towards the jugular foramen in the posterior cranial fossa
what does CN IX leave the skull through and through which bone
junction between the temporal bone and the occipital bone through the jugular foramen
what re the names of the four extrinsic muscles of the tongue
genioglossus
hypoglossus
palatoglossus
styloglossus
where are the four pairs of intrinsic muscles on the tongue located
dorsally and posteriorly
what are the extrinsic muscles of the tongue supplied by
hypoglossus, genioglossus and styloglossus are upplied by CN XII hypoglossal but palatoglossus is supplied by CN X
where does the hypoglossal CNXII attach to the CNS
at the medulla
where does the CNXII leave the skull
through the occipital bone in the hypoglossal canal in anterior wall of the foramen magnum
where does CNXII pass through after it has passed through the skull
descends in neck lateral to carotid sheath
at hyoid bone it passes anteriorly towards the lateral aspect of the tongue
supplies most of the muscles of the tongue
what do the muscles on the posterior of the pharynx all insert onto
the midline raphe
what type of muscles are those on the posterior aspect of the pharynx
circular (constrictor muscles)
they are VOLUNTARY
where are the longitudinal muscles of the pharynx located
on the inner layer
what are the longitudinal muscles of the larynx supplied by
stylopharyngeal is supplied by CNIX all others palatopharygeus and salpingopharygeus are supplied by CNX
in the ENS what does parasympathetic innervation due to the pace of peristalsis
parasympathetic innervation increases the rate of peristalsis
how does sympathetic stimulation affect the rate of peristalsis
it slows down the rate of peristalsis
where is the cricopharygeus muscle
C6
where does the oesophagus terminate
when it enters the cardia of the stomach
is the cricopharygeus a physiological or an anatomical sphincter
anatomical
is the lower oesophageal sphincter a physiological or anatomical sphincter
physiological
which factors produce a sphincter effect at the lower oesophageus sphincter
contraction of the diaphragm
intraabdominal pressure is slightly higher than intragastric pressure
oblique angle at which oesophagus enters the stomach
side effects of hiatus hernia
oesophageal reflux
where is the fundus
the superior aspect of the stomach
in which bone of the skull does the foramen ovale pass through
sphenoid
in which bone of the skull does the stylomastoid foramen pass through
temporal bone
in which region is the stomach usually located
left hypochondrium
what is the ‘indentation’ at the lesser curvature of the stomach called
incisura angularis
what are the infoldings on the stomach called
rugae
what is the small intestine made up of
the duodenum
jejunum
ileum
what is the large intestine made up of
4 main things 6 parts to the colon Colon: caecum appendix ascending colon transverse colon descending colon sigmoid colon Rectum Anal Canal Anus
what are the two ‘turns’ in the colon called
hepatic flexure and splenic flexure
what is contained within the foregut
oesophagus to mid-duodenum
liver, gallbladder, spleen and 1/2 of pancreas
what is contained within the mid-gut
mid-duodenum to proximal 2/3rd of transverse colon
1/2 of pancreas
what is contained within the hindgut
distal 1/3 of the transverse colon to proximal 1/2 of the anal canal
the 9 regions of the abdominal cavity are divided along which planes
mid-clavicular, subcostal and transtubercular
the 4 quadrants are divided along which planes
median and trans-umbilical planes
which muscles make up the ‘6 pack’
rectus abdominis
what do the abdominal muscles do when injury threatens
they contract
is the parietal membrane continuous or discontinuous
continuous
pus, blood or faeces in the peritoneal cavity will cause what
sever and painful inflammation of the peritoneum (peritonitis)
give an example of an intraperitoneal organ
the liver
is the liver mobile or not and why
mimimally mobile because it is enclosed in peritoneum
give example of retroperitoneal organs
pancreas and kidneys
organs with a mesentery examples
parts of intestines
covered in visceral peritoneum
visceral peritoneum wraps behind the organs to form a double layer mesentery
what divides the peritoneal cavity into a greater sac and a lesser sac
omenta
how do the lesser and greater omentum communicate
the omentum foramen
what does the portal triad lie in relation to the omental foramen
the free edge of the lesser omentum
the pouches in the peritoneum are part of which part of the sac
the greater sac
what is another name for the retrouterine pouch
pouch of douglas
how can ascites fluid be drained from the peritoneal cavity
in a procedure called paracentesis
where should the needle be paced in paracentesis
lateral to the rectus sheath
why does the needle have to be lateral to the rectus sheath to remove fluid
to avoid the inferior epigastric artery
what does the pain from organs (visceral) tend to be in nature
dull, achy and nauseating
what is the character of the pain from the body wall tend to be like
sharp and stabbing
what is the body wall of the abdomen supplied by (from skin to parietal peritoneum)
somatic sensory nerves
somatic motor nerves
sympathetic nerve fibres
what are the organs of the abdomen supplied by
visceral afferents
enteric nervous system
autonomic motor nerves-parasympathetic and sympathetic
where do sympathetic nerves leave CNS
T1-L2
where do the sympathetic nerves of the abdomen synapse
preganglionic ganglia
where are the prevertebral ganglia
anterior to the aorta at the exit points to the major branches of the abdominal aorta
how do the sympathetic nerve fibres get from the CNS to the abdominal organs
postsynaptic sympathetic nerve fibres pass from the prevertebral ganglia (celiac, superior mesenteric etc) onto the surface of the arterial branches leaving the abdominal aorta
they take part in periarterial plexuses
where do the sympathetic nerve fibres for the adrenal gland leave the spinal cord
T10-L1
where do the adrenal gland nerves synapse
directly onto the cells
how are the nerves carried to the adrenal gland
with the periarterial plexuses to the adrenal gland
how do the parasympathetic nerve fibres get form the CNS to the abdominal organs
Cranial nerves
S2,3,4
what do the parasympathetic splanchnic nerves supply
smooth muscle/glands of the descending colon to anal canal
where does pain form the foregut tend to be felt
in the epigastric region
where does pain from the midgut tend to be felt
in the umbilical region
where does pain in the hindgut tend to be felt
in the pubic region
where do pain fibres from the foregut abdominal organs enter the spinal cord
T6-T9
where do pain fibres from the midgut structures enter the spinal cord
T8-T12
where do pain fibres from the hindgut structures enter the spinal cord
T10-L2
Where does pain from the appendix tend to be initially felt
nauseating pain in the umbilical area then get more somatic pain as it spreads to the parietal pleura
where are the abdominal body wall nerves found
7th-11th intercostal nerves
travel anteriorly then leave the intercostal spaces
in the plane between the internal oblique and transversus abdominus as thoracoabdominal nerves
where does the subcostal nerve come off CNS
T12 anterior ramus
where does iliohypogastric and ilioinguinal nerve come off CNS
half of L1 anterior ramus
they are off different halves
which dermatome supplies the umbilicus
T10
what are the two pouches of the greater sac of the peritoneum called in a female
rectouterine and uterovesical
where within the peritoneum is the inferior vena cava located
in the retroperitoneum
where does the hepatic portal vein drain blood from
foregut, midgut and hindgut structures
where does the splenic vein drain blood from
from the foregut
where does the foregut venous drain into
the splenic vein drains the blood from the foregut structures to the hepatic portal vein
where does the hindgut venous drainage
the inferior mesenteric vein drains the blood from the hindgut structures to the splenic vein
where do the structures of the midgut drain into
the superior mesenteric vein which drains blood from the midgut structures to the hepatic portal vein
where do the foregut structures of the lymph drain into (in relation to lymphatics)
the foregut structures drain their lymph via nodes located along the splenic artery towards the coeliac nodes
where are the lymphatics for the midgut structures located
along the superior mesenteric artery (draining towards the superior mesenteric nodes)
what type of muscle is the pyloric sphincter made up of
smooth muscle
what type of muscle is the external anal sphincter made up of
skeletal muscle
what is bilirubin
normal by product of the breakdown of red blood cells
where is bilirubin made
in the spleen
what is bilirubin used to form and where is this product formed
bilirubin is used to form bile in the liver
what is the biliary tree
a set of tubes connecting the liver to the 2nd part of the duodenum
where does the pancreas excrete digestive enzymes
into the 2nd part of the duodenum
what does the gallbladder do
store AND CONCENTRATE BILE
where is the portal triad found
in the free edge of the lesser omentum
what is contained within the portal triad
the hepatic artery
hepatic portal vein
common bile duct
what is the common bile duct part of
the common bile duct which is part of the biliary tree linking the stomach to duodenum
where in the peritoneum is the aorta and IVC
retroperitoneum
where does the celiac trunk arise
T12
what does the celiac trunk supply
the organs of the foregut
what does the celiac trunk trifurcate into
splenic artery
hepatic artery
left gastric artery
how is the splenic artery different to most arteries
it has a very tortuous course whereas most arteries are relatively straight
where is the spleen located
its an intraperitoneal organ within the left hypochrondrium
deep to ribs 9-11
should you be able to palpate a normal spleen
no
where does the blood supply to the stomach come mainly from
right and left gastric arteries which run along the lesser curvature
where does the right and left gastro-omental arteries run
along the greater curvature and anastomose together
where does the blood supply from the liver come from
the hepatic artery
which branches into right and left hepatic artery
how can the structure of the liver be described
4 anatomical segments or 8 functional segments
what are the 4 anatomical segments of the liver
right lobe, left lobe, caudate lobe, quadrate lobe
how many functional segments does the liver have and what does each segment have
8 functional segments and each has its own blood supply (hepatic artery, hepatic portal vein) venous drainage and bile drainage
how is venous drainage in the liver carried out
venous drainage from the liver is via 3 main hepatic veins to the IVC
how are the IVC and hepatic veins different to other veins
they lack valves
how does the lack of valves in the IVC and hepatic veins affect the liver
a rise in central venous pressure is directly transmitted to the liver and the liver can enlarge as it engorges with blood (hepatomegaly)
what is contained within a liver lobule
central vein in middle and an interlobular portal triad at each corner
what are sinusoids like in structure
sinusoid is quite like a large capillary
what are sinusoids lined by
hepatocytes
what does the central vein do
collects ‘cleaned’ blood and drains into the hepatic veins
what are the 2 clinically important areas of the peritonea cavity related to the liver
hepatorenal recess (morison's pouch) subphrenic recess
where are the recesses in the liver located
in the greater sac
when may the hepatorenal recess be of greatest clinical relevance
it is one of the lowest parts of the peritoneal cavity when the patient is supine
so pus from an abcess in the subphrenic recess can drain into the hepatorenal recess when a patient is bedridden
what does the IVC drain from the liver
it drains the cleaned blood from the hepatic veins into the right atrium
what ligaments attach the liver to the diaphragm
the coronary ligaments
which ligament in the liver attaches it to the anterior abdominal wall
the falciform ligament
what is the ligamentum teres/round ligament a remenant of
the embryological umbilical vein
where does the gallbladder lie in relation to the duodenum
the gallbladder lies anterior to the duodenum
what is the gallbladder made up of
the gallbladder has a body and a neck-the neck narrows to become the cystic duct
how does bile flow in and out of the gallbladder
via the cystic duct
where will gallstone pain originate
in the epigastric region
but pain can also present in the hypochondrium with or without pain referral to the right shoulder as a result of anterior diaphragmatic pain
what is surgical removal of the gallbladder called
cholecystectomy
what is another name for jaundice
icterus
what is icterus caused by
increased in levels of bilirubin
what is bilirubin a normal breakdown product of
red blood cells
what does a liver lobule normally contain
central vein in the middle and an interlobular portal triad at each corner
what does the cystic duct unite with to form the bile duct
hepatic duct
what is the course of the bile duct in relation to other organs
travels posteriorly to the 1st part of the duodenum
what does the common bile duct then join with
the main pancreatic duct
what does the joining of the common bile duct and the main pancreatic duct form
the hepatopancreatic duct or the ampulla of Vater
where does the hepatopancreatic duct/ampulla of Vater drain into
the second part of the duodenum
what does the amupulla of Vater drain to the second part of the duodenum through
the major duodenal papilla
what is the greater omentum
a double layer of visceral peritoneum that hangs down from the stomach (greater curvature)
where does the greater omentum extend from
the greater curvature of the stomach, passing in fornt of the small intestine and reflects on itself to ascend to the transverse colon before reaching the posterior abdominal wall
where does the lesser omentum extend form
the liver to the lesser curvature of the stomach
what is a mesentery
a fold of membranous tissue that arises from the posterior wall of the peritoneal cavity
what is an anatomical sphincter
discrete areas where muscle completely encircles the lumen of the tract
what does ERCP stand for
Endoscopic Retrograde Choliangiopancreatography
what does ERCP look at
pancreas and the biliary tree
what can cause jaundice
obstruction of the biliary tree
what type of organ is the pancreas
retroperitoneal
what are the functions of the pancreas
exocrine-acinar cell (pancreatic digestive enzymes into main pancreatic duct
endocrine-islets of Langerhans (insulin and glucagon)
what is the blood supply to the pancreas
foregut and midgut organ
mainly branches form the splenic artery-pancreatic branches
gastroduodenal artery-superior pancreaticoduodenal
superior mesenteric artery-inferior pancreaticduodenal
what is one of the causes of pancreatitis
blockage of the ampulla by a gallstone
bile is then diverted into the pancreas leading to irritation and inflammation
what are the four parts of the duodenum
superior (duodenal cap)
descending
horizontal
ascending
where is the duodenum located
the superior part is intraperitoneal but all other parts are retroperitoneal
where does the duodenum begin
at the pyloric sphincter
what hormones does the duodenum secrete into the blood
gastrin, CCK
where does pain form a duodenal ulcer tend to be felt
in epigastric region
what supplies blood to the duodenum
gastroduodenal artery-superior pancreaticoduodenal
superior mesenteric artery-inferior pancreaticoduodenal
what are folds in the jejunum called
pilicae circularis
what is the difference in the mucosa of the jejunum and the ileum
mucosa of (distal) ileum is much smoother
where does most of the lymph of the body drain into
the left venous angle
where is the venous angle
the junction between subclavian and internal jugular veins
what is another name for angular stomatitis
angular cheilitis
where does the rectum lie
in the pelvis
where does the anal canal and anus lie
in the perineum
where does the sigmoid colon become the rectum
anterior to S3, anterior to the tip of the coccyx
where does the rectal ampulla lie
immediately superior to the levator ani muscle
what is the levator ai made up of
iliococcygeus, puborectalis, pubococcygeus
what does the coeliac trunk trifurcate into
splenic artery, left gastric artery and hepatic artery
what do sympathetics do to peristalsis
inhibit peristalsis
what do parasympathetics do to peristalsis
stimulate peristalsis
where do the pudental nerves exit the pelvis
via the greater sciatic foramen
