Anatomy Flashcards
Where is the isthmus of the thyroid gland?
Anterior to tracheal cartilages 2-4
What are the layers of the thorax from superficial to deep?
Skin, Superficial fascia, Deep fascia, External intercostal, Internal intercostal, Innermost intercostal, Ribs/joints, Parietal pleura
What are the 3 parts of the parietal pleura?
Cervical,
Mediastinal,
Costal,
Diaphragmatic
Where does the trachea split?
At the carina - T4/5
Where do the ribs attach to the vertebral column (3 points)?
T1-12
Are attached to rib above, below and transverse process (of inferior)
(T11+12 only attach to 1 vertebrae + transverse process)
Which part of the rib articulates with the vertebrae and the transverse process?
Head = vertebrae Tubercle = transverse process
What are the joints between the sternum and the clavicle, the sternum and the costal cartilage and the costal cartilage and costal cartilage called?
Sternoclavicular = sternum and clavicle Sternocostal = sternum and costal cartilage Costochondral = rib and costal cartilage Interchondral = costal margin
Where does the neurovascular bundle run?
In the costal groove inferior to the rib between the internal and innermost intercostals
What is the blood supply and drainage to the posterior and anterior intercostal spaces?
Posterior:
Thoracic aorta,
Azygous vein (is on right)
Anterior:
Internal thoracic artery (runs down from subclavian)
Internal thoracic vein (drains into brachiocephalic)
Where do the intercostal nerves arise from?
Anterior rami of spinal nerves T1-12
What order are the vessels of the intercostal neurovascular bundle?
From superior to inferior: (VAN) Vein Artery Nerve
Where are the attachments of the diaphragm?
L1-3,
Sternum,
Lower 6 ribs + costal cartilages
What passes through the diaphragm at T8, 10 and 12?
T8 = IVC T10 = oesophagus + vagus nerve T12 = aorta, thoracic duct + azygous vein
How many pulmonary arteries and veins supply each lung?
1 pulmonary artery
2 pulmonary veins
What is the purpose of the accessory/hemiazygos vein and where does it run?
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
What is the purpose of the bronchial arteries, where do they arise from and how many are there?
Supply the lungs and pleura
Arise from the thoracic aorta (anterior)
2 to the left lung and 1 to the right lung
Which structure does the vagus nerves follow down the thorax?
Oesophagus
What is contained within the carotid sheath and what structure protects this?
Vagus nerve,
Common carotid,
Internal jugular
Protected by sternocleidomastoid
Where do the bronchial veins drain into?
Partially the pulmonary veins (decreases the O2 content of these)
and the azygos/hemiazygos veins
Describe the course of the phrenic nerve?
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
What does the phrenic nerve supply?
Somatic motor to the diaphragm Somatosensory to: mediastinal parietal pleura, fibrous pericardium, diaphragmatic parietal pleura, diaphragmatic parietal peritoneum
What muscle anchors the scapula to the ribs and what is its nervous supply, what occurs if this is paralysed?
Serratus anterior
Long thoracic nerve
Winged scapula
What muscles are connected to the clavicle?
Trapezius,
Deltoid,
Sternocleidomastoid,
Pectoralis major
What are the origins and insertion of the pectorals minor muscle?
Scapula and rib 3,4,5
What is the trapezius muscle?
Large muscle covering most of the back
Describe the latissimus dorsi
Largest muscle of the back,
Paired structure,
Wraps around the side of body
What are the parts of the mediastinum?
Superior,
Inferior (posterior, middle, anterior)
They are split at the sternal angle (transverse thoracic plane)
What is contained within the superior mediastinum?
The roots of the great vessels
What are the layers of heart tissue from external to internal?
Epicardium,
Myocardium,
Endothelium
Which great vessels are at the front and back of the heart?
Front = exit vessels (pulmonary trunk + aorta) Back = entrance vessels
Which is more anterior, the pulmonary trunk or the aorta?
Pulmonary trunk (use for rotation of the heart)
What is the transverse pericardial sinus?
Where a finger can be inserted posterior to aorta and pulmonary trunk, anterior to SVC
What chambers are on the anterior, inferior and base of the heart?
Anterior: right ventricle
Base: left ventricle
Posterior: right and left atrium
What are the types of heart valve?
Tricuspid and mitral = leaflet
Pulmonary and aortic = semilunar
What supports the cusps of the valves?
Chordae tendineae connected to papillary muscles
What is the ligament arteriosum?
A remnant of the ductus arteriosus that connects the arch of the aorta to the left pulmonary artery
What artery supplies the SA node?
SA nodal branch of right coronary artery
What is the line that separates the smooth and rough parts of the interior of the right atrium?
Cristae terminalis
What type of joints are costochrondral?
Synovial
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
What chain of lymph nodes runs parallel and deep to the sternum and what drains into them?
Parasternal lymph nodes
Drains breast tissue
At which point do the subclavian vessels change their name to axillary?
Lateral border of the first rib
What is the most posterior, most superior and most inferior structure passing through the hilum?
Posterior = airway Superior = artery Inferior = vein
Where does the azygos vein drain into the SVC?
Superior to the hilum - passes from posterior and loops over it
Which vagus nerve does the recurrent laryngeal nerve branch off?
Right only
What are the attachment points of the external oblique?
Superiorly = superficial aspects of lower ribs Inferiorly = anterior part of iliac crest and pubic tubercle
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
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
What nerves supply the abdominal muscles?
The thoracoabdominal nerves - continuation of 7-11th intercostal nerves
Where is the split between the superior and inferior mediastinum?
From the sternal angle to T4
Where is the safe triangle for drainage of a pneumothorax?
Anterior border of the latissimus dorsi,
Posterior border of the pectorals major,
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
What are the inguinal ligaments made from?
The inferior border of the external oblique aponeuroses
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)
What is contained within the spermatic cord?
Pampiniform venous plexus, Testicular artery, Vas deferens, Autonomic nerves, Lymphatic drainage
What is contained within the inguinal canal in males and females?
Males: Spermatic cord
Females: round ligament of the uterus
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
What are the sensory nerves of the nasal cavity, the larynx and the pharynx?
Nasal cavity: trigeminal (CNV)
Pharynx: glossopharyngeal (CNIX)
Larynx: vagus (CNX)
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
Where does the parasympathetic innervation fo the heart come from?
Vagus nerve (CNX)
Which cranial nerves are parasympathetic?
CN III, VII, IX, X (oculomotor, facial, glossopharyngeal and vagus)
What type of autonomic nerves are pelvic splanchnic nerves?
Parasympathetic
Pelvic = Parasympathetic
Where is the baroreceptor found and what nerve do they travel in?
Aortic arch
Vagus nerve
What nerve increases cardiac rate and force and what decreases the rate?
Sympathetic (cardiopulmonary splanchnic nerves) increase rate + force
Parasympathetic (vagus) decrease rate
Which side of the central sulcus is somatomotor and which is somatosensory?
Somatomotor = anterior (parietal lobe) Somatosensory = posterior (frontal lobe)