Anatomy Flashcards
Borderline between foregut and midgut
duodenal papilla
Blood supply of midgut
superior mesenteric artery
Innervation of foregut
sympathetic; greater splanchnic nerve (T5-9 psinal cord segments)
Dermatome of T5-T9
Epigastric region
Parasympathetic innervation of midgut
vagus nerve
Secondary retroperitoneal organs
All of those that are GI and retroperitoneal. Those that were intraperitoneal in embryonic development and became retroperitoneal later via folding.
Main differences between jejunum and ileum
- Jejunum is thicker and more vascular - Jejunum wider lumen - Jejunum has circum mucosal folds that are large, tall, closely packed. - Peyer’s patches: aggregated lymphatic follicles in the lamina propria of the ileum and lower jejunum (MALT)
Parasympathetic innervation of hindgut
S2-4
Significance of the L colic flexure
Transition of parasympathetic innervation from vagus to S2,3,4 (midgut to hindgut)
McBurney’s point
the base of the appendix. The tip of the appendix could be anywhere.
Sympathetic innervation of gut results in….
inhibition of peristaltic movement. stress –> constipation.
What happens to GIT sphincters in parasympathetic innervation?
Sphincters open up. Parasympathetic innervation induces peristalsis. S2-3-4 keeps the poo on the floor (peristaltic movement opens sphincter and poop comes out).
Visceral afferent fibres travel with…
sympathetic visceral afferents for the most part… EXCEPT for visceral afferents that detect distension of stomach. Those travel w parasympathetic fibres to hypothalamus to tell us to stop eating.
Referred pain…
Starts as dull pain in the midline. When inflammation worsens and begins to involve the peritoneum, then the pain becomes localized correctly and is ~sharp~.
A: dura mater
B: arachnoid mater
b) subarachnoid space
A: a branch of dorsal ramus
B: ventral ramus
C: dorsal root ganglion
What what vertebral level does the spinal cord terminate?
It terminates at L1-L2
At what vertebral level does the subarachnoid space terminate?
It extends past the end of the spinal cord (L1/L2) to the inferior border of S2 (interface with S3)
Where goes the lymphatic drainage from the breast?
75% to axillary lymph nodes and the rest go to parasternal lymph nodes.
Describe the innervation of the breast
supplied by the 2nd-6th intercostal nerves
The nipple is innervated by the 4th intercostal nerve.
Describe the blood supply to the breast
The blood is supplied by the axillary artery, internal thoracic artery, and anterior intercostal arteries
What is this artery?
The internal thoracic artery. It supplies the breast along with the axillary artery and the anterior intercostal arteries that branch from it.
What are the boundaries of the thoracic inlet and outlet?
Inlet: T1, rib 1, sternum
Outlet: Closed by the diaphragm
What is the anatomical and clinical importance of the plane from the sternal angle to T4/5 intervertebral disk? (4)
Important for counting ribs (articulates with rib II), bifurcation of trachea, beginning and end of aortic arch, top of middle mediastinum (and divides superior and inferior mediastinum).
Describe the neurovascular contents of an intercostal space
Intercostal vein, artery, and nerve (in that order from posterior to inferior)
(the posterior artery component arises from the aorta and the anterior component arises from the thoracic artery)
Describe the course of an intercostal neurovascular bundle and the importance of this for intercostal nerve blocks and the insertion of chest drains.
The bundle travels along the top of each intercostal space in the costal groove of the rib above.
Intercostal nerve is the anterior ramus of a thoracic spinal nerve (T1-T11) and is the least protected structure in the costal groove because it is at the bottom.
*** look into this more
Origin of the phrenic nerve and what it does
C3,4,5 keeps you alive! It innervates the diaphragm.
What is the clnical importance of the fact that the pleural cavities rise above the level of the 1st rib?
Injuries of the neck may therefore implicate the lungs.
At which vertebral level does the trachea bifurcate?
T4/5
L and R coronary ostia (openings for coronary artery originating from aorta)
what remnants of fetal circulation are still visible in the adult heart?
fossa ovalis (formerly: foramen ovale)
ligamentum arteriousum (formerly: ductus arteriosus)
Differences between heart chambers
R ventricle has moderator band
Ventricles have papillary muscle with chrodae tendinae and trabeculae. Atria have musculi pectinati.
Where does the esophagues pass the the diaphragm?
T10
What indentations are normally seen in the esophagus on barium swallow
aorta, left main bronchus, left atrium.
the diagnostic importance of the relationship between the esophagus with the arch of aorta, L main bronchus, and L atrium
fidelity of transesophageal achocardiogram
Where does the trachea bifurcate
T4/5
Clinical importance of the different sizes and courses of the L and R primary bronchi
Right is fatter and steeper. Means that it is more common for intubation to slip into R only or for foreign body to end up there.
Course of Vagus nerve
Origin, course, and function of phrenic nerve
c3-5; innervates diaphragm (and heart a bit)
why can pathology of the thorax present as a change in voice?
bc L recurrent laryngeal nerve branches fromt he vagus nerve, which goal sall the way down to loop under the art of aorta and behind the ligamentum arteriosum before innervating the larynx.
Parasympathetic and sympathetic divisions of the spinal column
subcostal and transtubercular planes
normal surface location of the appendix
RLQ.
Dermatomes of the anterior abdominal wall
Intercostal nerves of T6-T11
Subcostal nerves T12 & L1
Cutaneous innervation of the anterior abdominal wall
T1-T11
Innervation of anterior abdominal musculature
Lol I don’t know
Positions of the inguinal rings
Deep inguinal ring is in the fascia tranversalis
Superficial inguinal ring is in the external oblique aponeurosis
Direct vs indirect inguinal hernias
Direct inguinal hernias bypass the deep inquinal ring to get into the inguinal canal
What goes through the inguinal canal?
Male: spermatic cord
Female: round ligament
*both contain remnants of the processes vaginalis
Conjoint tendon
arises from the fusion of internal oblique aponeurosis and tranverse abdominus aponerosis, medial to inguinal canal
Differentiate intraperitoneal vs retroperitoneal
intraperitoneal = suspended by mesentery
Retroperitoneal = attached to the posterior abdominal wall
name components of the GI system athat are intraperitoneal and retroperitoneal
Components of dorsal mesentery
greater omentum, mesentery of small intestine, transverse mesocolon, signoid mesocolon, mesoappendix.
hepatoduodenal ligament and its contents (3)
contents: hepatic portal vein, hepatic artery, common bile duct
greater and lesser peritoneal sacs
Innervation of the foregut
Celial ganglion on either side of the celiac arter (trunk). Sympathetic innervation T5-T9 (greater and lesser splanchnic nerves) and parasympathetic innervation from vagus nerve.
Main features of the ileum
Thinner walls, no circular folds, many peyer’s patches.
what is the significance of the left colic flexture with respect to parasympathetic innervation
Parasympathetic innervation switches from vagus to S2-4
Sympathetic and parasympathetic input to the prevertebral plexus and the route the fibres take to the viscera (I don’t know)
Innervation of the midgut
superior mesenteric ganglion near root of superior mesenteric artery. Sympathetic from T10-11 (lesser splanchnic) and parasympathetic from vagus nerve.
Hindgut innervation
Inferior mesenteric ganglion near root of inferior mesenteric artery. Sympathetic from T12-L1 and Parasympathetic from S2-4.
Be able to identify the greater sciatic foramen, lesser sciatic foramen, and obturator canal
Name two of the three anatomical characteristics that differentiate the large intestine from the small bowel
Haustra coli, tenia coli, epiploic/omental appendages; also lumenal diameter
The majority of the lymph generated in the breast structures drains into the
Axillary lymph nodes
Which embryological regions are separated at the level of the major duodenal papilla?
Foregut & midgut
Name and locate the subsections of the broad ligament
Visualize the relationship between the ureter and the uterine artery
Visualize the realtionship between the ureter and the vas deferens
List the branches of the pudendal nerve
Dorsal nerve of penis or clitoris
Perineal nerve
Inferior rectal nerve
Describe the position of the deep perineal pouch
Note its position relative to the perineal membrane and the superficial perineal pouch
