Anatomy Flashcards
1
Q
Where is the isthmus of the thyroid gland?
A
Anterior to tracheal cartilages 2-4
2
Q
What are the layers of the thorax from superficial to deep?
A
Skin, Superficial fascia, Deep fascia, External intercostal, Internal intercostal, Innermost intercostal, Ribs/joints, Parietal pleura
3
Q
What are the 3 parts of the parietal pleura?
A
Cervical,
Mediastinal,
Costal,
Diaphragmatic
4
Q
Where does the trachea split?
A
At the carina - T4/5
5
Q
Where do the ribs attach to the vertebral column (3 points)?
A
T1-12
Are attached to rib above, below and transverse process (of inferior)
(T11+12 only attach to 1 vertebrae + transverse process)
6
Q
Which part of the rib articulates with the vertebrae and the transverse process?
A
Head = vertebrae Tubercle = transverse process
7
Q
What are the joints between the sternum and the clavicle, the sternum and the costal cartilage and the costal cartilage and costal cartilage called?
A
Sternoclavicular = sternum and clavicle Sternocostal = sternum and costal cartilage Costochondral = rib and costal cartilage Interchondral = costal margin
8
Q
Where does the neurovascular bundle run?
A
In the costal groove inferior to the rib between the internal and innermost intercostals
9
Q
What is the blood supply and drainage to the posterior and anterior intercostal spaces?
A
Posterior:
Thoracic aorta,
Azygous vein (is on right)
Anterior:
Internal thoracic artery (runs down from subclavian)
Internal thoracic vein (drains into brachiocephalic)
10
Q
Where do the intercostal nerves arise from?
A
Anterior rami of spinal nerves T1-12
11
Q
What order are the vessels of the intercostal neurovascular bundle?
A
From superior to inferior: (VAN) Vein Artery Nerve
12
Q
Where are the attachments of the diaphragm?
A
L1-3,
Sternum,
Lower 6 ribs + costal cartilages
13
Q
What passes through the diaphragm at T8, 10 and 12?
A
T8 = IVC T10 = oesophagus + vagus nerve T12 = aorta, thoracic duct + azygous vein
14
Q
How many pulmonary arteries and veins supply each lung?
A
1 pulmonary artery
2 pulmonary veins
15
Q
What is the purpose of the accessory/hemiazygos vein and where does it run?
A
Drains the left intercostal spaces into the azygous vein
The accessory hemiazygos drains the superior aspects and the hemiazygos drains the inferior aspects
It runs down the left side of the vertebral column and crosses it at roughly T9 into the azygos vein
16
Q
What is the purpose of the bronchial arteries, where do they arise from and how many are there?
A
Supply the lungs and pleura
Arise from the thoracic aorta (anterior)
2 to the left lung and 1 to the right lung
17
Q
Which structure does the vagus nerves follow down the thorax?
A
Oesophagus
18
Q
What is contained within the carotid sheath and what structure protects this?
A
Vagus nerve,
Common carotid,
Internal jugular
Protected by sternocleidomastoid
19
Q
Where do the bronchial veins drain into?
A
Partially the pulmonary veins (decreases the O2 content of these)
and the azygos/hemiazygos veins
20
Q
Describe the course of the phrenic nerve?
A
Arises from the anterior rami of cervical spine nerves C3,4,5
Travels down anterior surface of scalene muscle and anterior to both lung roots
Sits on the lateral aspects off the fibrous pericardium
21
Q
What does the phrenic nerve supply?
A
Somatic motor to the diaphragm Somatosensory to: mediastinal parietal pleura, fibrous pericardium, diaphragmatic parietal pleura, diaphragmatic parietal peritoneum
22
Q
What muscle anchors the scapula to the ribs and what is its nervous supply, what occurs if this is paralysed?
A
Serratus anterior
Long thoracic nerve
Winged scapula
23
Q
What muscles are connected to the clavicle?
A
Trapezius,
Deltoid,
Sternocleidomastoid,
Pectoralis major
24
Q
What are the origins and insertion of the pectorals minor muscle?
A
Scapula and rib 3,4,5
25
What is the trapezius muscle?
Large muscle covering most of the back
26
Describe the latissimus dorsi
Largest muscle of the back,
Paired structure,
Wraps around the side of body
27
What are the parts of the mediastinum?
Superior,
Inferior (posterior, middle, anterior)
They are split at the sternal angle (transverse thoracic plane)
28
What is contained within the superior mediastinum?
The roots of the great vessels
29
What are the layers of heart tissue from external to internal?
Epicardium,
Myocardium,
Endothelium
30
Which great vessels are at the front and back of the heart?
```
Front = exit vessels (pulmonary trunk + aorta)
Back = entrance vessels
```
31
Which is more anterior, the pulmonary trunk or the aorta?
Pulmonary trunk (use for rotation of the heart)
32
What is the transverse pericardial sinus?
Where a finger can be inserted posterior to aorta and pulmonary trunk, anterior to SVC
33
What chambers are on the anterior, inferior and base of the heart?
Anterior: right ventricle
Base: left ventricle
Posterior: right and left atrium
34
What are the types of heart valve?
Tricuspid and mitral = leaflet
| Pulmonary and aortic = semilunar
35
What supports the cusps of the valves?
Chordae tendineae connected to papillary muscles
36
What is the ligament arteriosum?
A remnant of the ductus arteriosus that connects the arch of the aorta to the left pulmonary artery
37
What artery supplies the SA node?
SA nodal branch of right coronary artery
38
What is the line that separates the smooth and rough parts of the interior of the right atrium?
Cristae terminalis
39
What type of joints are costochrondral?
Synovial
40
On imaging how is the difference between the internal thoracic artery and vein detected?
Thoracic artery branches off the subclavian vein distal to the splitting of the brachiocephalic trunk
Thoracic vein drains proximal to the venous angle
41
What chain of lymph nodes runs parallel and deep to the sternum and what drains into them?
Parasternal lymph nodes
| Drains breast tissue
42
At which point do the subclavian vessels change their name to axillary?
Lateral border of the first rib
43
What is the most posterior, most superior and most inferior structure passing through the hilum?
```
Posterior = airway
Superior = artery
Inferior = vein
```
44
Where does the azygos vein drain into the SVC?
Superior to the hilum - passes from posterior and loops over it
45
Which vagus nerve does the recurrent laryngeal nerve branch off?
Right only
46
What are the attachment points of the external oblique?
```
Superiorly = superficial aspects of lower ribs
Inferiorly = anterior part of iliac crest and pubic tubercle
```
47
What are the attachment points of the internal oblique?
```
Superiorly = inferior border of the lower ribs
Inferiorly = thoracolumbar fascia of the lower back and iliac crest
```
48
Where are the attachment points of the transversus abdominus?
```
Superiorly = deep aspects of the lower ribs
Inferiorly = thoracolumbar fascia of the lower back and the iliac crest
```
49
What nerves supply the abdominal muscles?
The thoracoabdominal nerves - continuation of 7-11th intercostal nerves
50
Where is the split between the superior and inferior mediastinum?
From the sternal angle to T4
51
Where is the safe triangle for drainage of a pneumothorax?
Anterior border of the latissimus dorsi,
| Posterior border of the pectorals major,
52
What are the 2 types of hiatus hernia?
Paraoesophageal hiatus hernia = loop of stomach slides through hiatus
Sliding hiatus hernia = bulge of stomach through hiatus
53
What are the inguinal ligaments made from?
The inferior border of the external oblique aponeuroses
54
What are the entrance and exit of the inguinal canal and where are these?
```
Entrance = deep ring (midpoint of the inguinal canal)
Exit = superficial ring (pubic tubercle)
```
55
What is contained within the spermatic cord?
```
Pampiniform venous plexus,
Testicular artery,
Vas deferens,
Autonomic nerves,
Lymphatic drainage
```
56
What is contained within the inguinal canal in males and females?
Males: Spermatic cord
Females: round ligament of the uterus
57
What is the difference in route of a direct and indirect hernia?
Direct: a finger of peritoneum forces directly through the wall of the inguinal canal and out the superficial ring
Indirect: a finger of peritoneum travels though the deep ring and out of the superficial ring of the inguinal canal
58
What are the sensory nerves of the nasal cavity, the larynx and the pharynx?
Nasal cavity: trigeminal (CNV)
Pharynx: glossopharyngeal (CNIX)
Larynx: vagus (CNX)
59
What are the sympathetic nerves to the heart and lungs called and what level do they leave the vertebral column?
Cardiopulmonary splanchnic nerves
| T1-5
60
Where does the parasympathetic innervation fo the heart come from?
Vagus nerve (CNX)
61
Which cranial nerves are parasympathetic?
CN III, VII, IX, X (oculomotor, facial, glossopharyngeal and vagus)
62
What type of autonomic nerves are pelvic splanchnic nerves?
Parasympathetic
| Pelvic = Parasympathetic
63
Where is the baroreceptor found and what nerve do they travel in?
Aortic arch
| Vagus nerve
64
What nerve increases cardiac rate and force and what decreases the rate?
Sympathetic (cardiopulmonary splanchnic nerves) increase rate + force
Parasympathetic (vagus) decrease rate
65
Which side of the central sulcus is somatomotor and which is somatosensory?
```
Somatomotor = anterior (parietal lobe)
Somatosensory = posterior (frontal lobe)
```
66
What type of pain is bony pain (broken bone, slipped spinal disk) or pleural pain felt as?
Somatic pain
67
What type of pain is tracheal, aortic and oesophageal?
Visceral
68
Where does the thoracic duct run?
Through the diaphragm at the aortic hiatus,
Up the thorax between the thoracic aorta and the azygous vein in the posterior mediastinum,
Above the arch of the aorta follows the oesophagus to the left venous angle
69
Which side of the thorax is mainly arterial and which is mainly venous?
```
Right = venous
Left = arterial
```
70
What structures are in the posterior mediastinum?
```
Thoracic duct,
Thoracic aorta,
Oesophagus,
Trachea and 2 main bronchi (ish),
Azygous vein
```
71
What is the difference between radiating and referred pain?
Radiating: felt at the site of injury and a site distal to it
Referred: felt at just a site distal to that of the cause of the pain
72
Which is usually the most dominant coronary artery?
Right coronary artery
73
Which artery is most commonly occluded in an MI?
LAD
74
What vessels are most commonly used in CABG?
Radial artery,
Internal thoracic artery,
Great saphenous vein (from leg)
75
What artery supplies the SA and AV nodes?
Right coronary artery
76
What drains into the left atrium of the heart?
Left and right superior and inferior pulmonary veins (4 total)
77
What 2 vessels form the SVC?
Right and left brachiocephalic veins
78
What 2 vessels form the brachiocephalic trunk?
Internal jugular vein and subclavian vein (anterior to scalenus)
79
What groove do the right coronary artery, coronary sinus and the left anterior descending (LAD) artery travel in?
RCA = coronary groove
LAD = anterior interventricular groove
Coronary sinus = atrioventricular groove
80
Where does the vagus nerve pass through the diaphragm?
At T10 (with oesophagus)
81
What are the first anterior branches of the descending (thoracic aorta)?
Bronchial arteries
82
What drains into the right and left venous angles?
Right venous angle: Right lymphatic duct
| Left venous angle: Thoracic duct
83
What lymph nodes are at the bifurcation of the trachea and what are at the hilum?
```
Bifurcation = tracheobronchial
Hilum = Bronchopulmonary
```
84
What is the swelling of lymph under the diaphragm?
The cisterna chyli
85
Where does the right phrenic nerve pass through the diaphragm?
```
At T8 (with the IVC)
- to supply diaphragm from the inferior aspect
```
86
What is the order of vessels in the superior mediastinum from anterior to posterior?
```
Brachiocephalic veins + SVC
Arch of the aorta
Trachea
Oesophagus
thoracic duct
```
87
Where do the vagus nerves supply somatosensory, somatomotor and parasympathetic to?
Somatosensory: palate, larynx, laryngopharynx
Somatomotor: pharynx and larynx
Parasympathetic: thoracic and abdominal organs
88
After the recurrent laryngeal nerves have branched off what kind of fibres are contained within the vagus nerves?
Parasympathetic
89
Describe the dentition from anterior to posterior
```
On each side; have maxillary and a mandibular (top/bottom);
2 incisors,
1 canine,
2 pre-molars
3 molars
```
(8 total - 8th = wisdom tooth)
90
Where are the muscles of mastication found and which ones open and close the jaw?
Close:
Masseter (at bottom on angle of the mandible)
Temporalis (temporal bone)
Medial pterygoid (runs vertically between temporalis and masseter)
```
Open:
Lateral pterygoid (runs laterally under temporalis)
```
91
What nerve innervates the muscles of mastication and which foramen does it pass through?
Trigeminal (CNV) - sensory and motor
| Formaen ovale
92
What type of tissues are tonsils and what are the visible tonsils that are usually removed?
Lymphoid tissue
| Paletine tonsils
93
What type of taste buds have taste function and what have sensory function?
Taste:
Circumvallate,
Foliate,
Fungiform
Sensory:
Filiform (FEELiform)
94
What nerves supply taste and sensation to the posterior and anterior parts of the tongue?
Posterior: all glossopharyngeal
Anterior:
Taste = facial (CNVII)
Sensory = trigeminal (CNV)
95
What provides the sensory and motor innervation of the gag reflex?
```
Sensory = glossopharyngeal
Motor = vagus
```
96
Which branches of the trigeminal nerve supply the superior and inferior gingiva?
Superior: V2
Inferior: V3
97
What nerve supplies the salivary glands?
Parotid: Glossopharyngeal (CNIX)
| Submandibular + sublingual: facial (CNVII)
98
What are the 3 salivary glands and where are they?
Parotid (by ear - drains to upper 2nd molar)
Submandibular (under angle of mandible)
Sublingual (under tongue)
99
What are the 4 pairs of extrinsic muscles in the tongue and what nerves supply them?
Hypoglassal (CNXII):
Genioglossus,
Hyoglassus,
Styloglossus
Vagus (CNX):
Palatoglossus
100
What is the upper oesophageal sphincter called and what vertebral level is it at?
Cricopharyngeus
| C6
101
What type of muscles are in the pharynx? Describe their action and nerve supply
3 circular muscles - overlap to give squeezing action (upper, middle and lower constrictors)
3 longitudinal muscles
All innervated by vagus nerve
102
Describe the process of swallowing and the nerve supply of this?
1. Close lips to prevent drooling (orbicularis oris - CNVII)
2. Tongue (CNXII) pushes food towards oropharynx
3. Pharyngeal constrictor muscles (CNX) push food inferiorly towards oesophagus
4. Longitundinal muscles of pharynx (CNX) contract to raise larynx
103
What type of autonomic nerve increases peristalsis and what decreases it?
Parasympathetic increases
| Sympathetic decreases
104
What is the parasympathetic supply to the oesophagus?
Vagus nerve
105
What are the 3 constrictions of the oesophagus?
```
Cervical = cricopharyngeus muscle (UOS)
Thoracic = arch of aorta + left main bronchus
Diaphragmatic = passing through diaphragm (LOS)
```
106
What is the change in mucosal lining of the oesophagus at the lower oesophageal sphincter called?
Z line
107
What are the parts of the stomach?
```
Fundus = very top (gas and air collection)
Cardia = at oesophageal entrance
Body = middle
Pyloric antrum = by pyloric sphincter
Incisura angularis = in lesser curvature
```
108
What are the parts of the large intestine?
```
Caecum,
Appendix,
Ascending,
Transverse,
Descending
```
109
Name the foregut, midgut and handout organs
Foregut:
Stomach, Liver, 1/2 pancreas, 1/2 duodenum, gall bladder, spleen
Midgut:
1/2 duodenum, jejunum, ileum, ascending colon, 2/3 transverse colon, caecum, 1/2 pancreas
Hindgut:
1/3 transverse colon to proximal 1/2 anal canal
110
Name the intraperitoneal and the retroperitoneal organs
Retroperitoneal: SAD PUCKER
S-suprarenal
A-aorta/IVC
D-duodenum
```
P-pancreas
U-ureters
C-colon (ascending + descending)
K-kidneys
E-(o)esophagus
R-rectum
```
111
What splits the peritoneal cavity into a greater and lesser sac?
Lesser omentum (between liver and duodenum/stomach)
112
What is the mesentery proper?
The part of the mesentery that attaches to the small intestine
113
What vasculature runs in the lesser omentum?
Portal triad
114
What is the only entrance to the lesser sac?
Omental foramen
115
What are the pouches found in the greater sac in males are females (where fluid from ascites would collect)?
Males: rectovesical pouch
Female: rectouterine (posterior) and vesicouterine (anterior) pouches
116
Where must the needle be placed for paracentesis?
Lateral to the rectus sheath
117
Where does the parasympathetic innervation of the abdomen come from?
```
Vagus nerve (until end of midgut)
Pelvic splanchnic nerves (S2,3,4)
```
118
Where is foregut, midgut and handout pain felt?
```
Foregut = epigastric
Midgut = umbilical
Hindgut = pubic
```
119
What vasculature does each functional lobe of the liver have?
Branch of hepatic artery,
Branch of hepatic vein,
Bile drainage,
IVC drainage
120
What are the 2 ligaments in the lesser omentum?
Hepatoduodenal,
| Hepatogastric
121
What are the arteries that supply the lesser and greater curvature of the stomach and what structures are they contained within?
Lesser curvature:
Left and right gastric arteries
Lesser omentum
Greater curvature:
Left and right gastro-omental
Greater omentum
122
Where does fluid drain into when lying supine?
Hepatorenal recess, greater sac
123
What 2 major veins form the hepatic vein?
Splenic vein and superior mesenteric vein
| IMV drains into splenic
124
Where does the blood supply to the gall bladder come from?
Cystic artery - branch of right hepatic artery
125
What types of cells carry out the exocrine and endocrine functions of the pancreas?
Exocrine: acinar cells
Endocrine: islets of langerhans
126
Where does the bile duct drain into the duodenum?
The ampulla of Vater with the main pancreatic duct
127
What sphincter controls the release of bile into he duodenum?
Sphincter of Oddi
128
What is the blood supply to the pancreas?
Superior and inferior pancreaticoduodenal arteries (coeliac trunk and SMA)
129
Which quadrants are the jejunum and ileum found in?
All 4
130
What are the differences between the jejunum and the ileum?
```
Colour: jejunum darker
Vasculature: jejunum more vascular
Thickness: jejunum thicker
Mesenteric fat: ileum has more fat
Circular folds: jejunum has more and larger folds
Peyers patches: only in ileum
```
131
What is the vascular supply and drainage of the jejunum and ileum?
Supply: SMA via jejunal and ileal arteries
Drainage: SMV via jejunal and ileal veins
132
What are the collections of lymph nodes in the abdomen?
```
Celiac (drains foregut organs)
Superior mesenteric (drains midgut organs)
Inferior mesenteric (drains hindgut organs)
Lumbar (drains kidneys, lower limbs, posterior abdo wall and pelvis)
```
133
Where is fat absorbed into in the small intestine?
Lacteal vessels that drain into the lymphatic drainage
134
What is the course of lymph drainage in the abdomen?
Superficial lymph nodes,
Deep lymph nodes,
Thoracic duct
135
Where are the potential sites for pus collection on either side of the colon?
Paracolic gutters
136
What are teniae coli?
3 bands of longitudinal muscle that run the length of the large intestine
137
What are the order of branches off the SMA?
```
Inferior pancreaticoduodenal,
Middle colic,
Right colic,
Iliocolic branches
(jejunal and ileal arteries)
```
138
Where does the appendicular artery arise from?
The SMA (iliocolic branch)
139
What is the difference between the arcades and vasa rectae in the jejunal and ileal blood supply?
Jejunal: longer vasa rectae, larger and fewer arcades
Ilial: shorter vasa rectae, smaller and more arcades
140
What arteries branch off the IMA?
Left colic,
Sigmoid arteries,
Superior rectal artery
141
What is the blood supply to the rectum and anal canal?
```
Superior rectal (from IMA)
Middle and inferior rectal from internal iliac (beyond pectinate line)
```
142
What is the venous drainage of the rectum?
Superior rectal vein to IMA (then to splenic and hepatic portal)
Middle and inferior rectal veins to internal iliac vein (and IVC)
143
What muscle forms the pelvic floor?
Levator ani
144
At what point does the rectum transition into the anal canal?
Tip of the coccyx
145
What is the anus?
The distal end orifice that faeces pass through
146
What is the most posterior organ?
Rectum
147
What lies anterior to the rectum in males and females?
Males: prostate
Females: vagina/cervix
148
What type of muscle is the levator ani and what is its nervous supply?
```
Skeletal
Pudendal nerve (S2,3,4) - somatic
```
149
What forms the external anal sphincter?
A branch of the levator ani (puborectalis)
| Increases rectal angle when contracted
150
What forms the internal anal sphincter?
A thickening of the walls of the GI tract
151
Where does the sympathetic and parasympathetic innervation of the rectum/anal canal come from?
Sympathetic: T12-L2
Parasympathetic: S2,3,4 (with pudendal nerve)
152
What does the pectinate line indicate?
The line between he parts of the GI tract formed from endoderm and ectoderm
Signifies the difference between visceral dn somatic structures
153
What are the changes in the nervous supply, the arterial supple, the venous drainage and the lymphatic drainage either side of the pectinate line?
```
Above pectinate line:
Autonomic,
IMA,
Hepatic portal (via IMV),
Inferior mesenteric nodes
```
```
Below pectinate line:
Somatic/pudendal,
Internal iliac artery,
IVC (via internal iliac vein),
Superficial inguinal nodes
```
154
What are the collections of lymph nodes draining pelvic organs?
```
Internal iliac (inferior pelvis)
External iliac (lower limbs + superior pelvis)
Common iliac (combines internal and external iliac)
```
155
What foramen do the trigeminal, facial, glossopharyngeal, vagus and hypoglossal nerves pass through?
```
V1; superior orbital fissure
V2; foramen rotundum
V3; foramen ovale
VII; internal acoustic meatus
IX; jugular foramen
X; jugular foramen
XII; hypoglossal canal
```
156
What are the types of synovial joint and give an example of each?
```
Pivot (atlanto-axial),
Plane (carpals),
Hinge (elbow/knee),
Biaxial (carpal-metacarpal/metcarpal-phalangeal),
Ball&socket (hip/shoulder)
```
157
What does the cervical spine have that the rest of the spine doesn't?
Vertebral foramen
158
What are the different vertebrae in the cervical spine?
C1 = atlas; no spinous process
C2 = axis; odontoid process
C7; larger spinous process (first palpable)
159
What kind of joints connect vertebrae?
Facet joints (synovial)
160
Where do spinal nerves leave the vertebral column?
Intervertebral foramen (only point where a spinal nerve exists)
161
What is the sleeve that covers bones and what is its purpose?
Periosteum - innervates and vasculates the bone
162
What is the central and outer part of the skeleton?
Axial and appendicular
163
What connects the transverse process to the vertebral body and what connects it to the spinous process?
Vertebral body; pedicle
| Spinous process; lamina
164
What are the bones of the hands and the feet?
Hands:
Carpals = wrist
Metacarpals = palm
Phalanges = fingers
Feet:
Tarsals = hind foot
Metatarsals = forefoot
Phalanges = toes
