Anatomy Flashcards
1
Q
muscle opening law
A
lateral pterygoid
2
Q
muscles closing jaw
A
masseter, temporalis, medial pteryoid
3
Q
what innervates the muscles of the jaw
A
mandibular divison of trigeminal nerve
4
Q
on what joint is the jaw held and what prevents it from dislocating
A
temporomandibular joint
articular tubercle
5
Q
space between teeth and lips
A
vestibule
6
Q
where is the parotid gland found and where does it empty
A
in front of ear
buckle and 2nd molar
7
Q
where is the sublinqual gland found and where does it empty
A
under oral cavity
base of mouth
8
Q
where is the submandibular gland found and where does it empty
A
base of jaw
frenulum of tongue
9
Q
what is sensation in upper mouth supplied by
A
CN V2
10
Q
what is sensation in lower mouth supplied by
A
CN V2
11
Q
state the numbers of the teeth
A
1,2 - incisor
3 - canine
4,5 - premolar
6,7,8 - molar
12
Q
what nerves control the gag reflex
A
sensory - IX
motor- IX, X
13
Q
what nerves control anterior 2/3 tongue
A
sensory - CN V3 (mandibular of trigeminal)
Special sensory - VII (facial)
14
Q
what nerves control the posterior 1/3 tongue
A
sensory/special sensory - IX (glossopharyngeal)
15
Q
true/false - the palatoglossus/styloglossus, hyoglossus and genioglossus are all supplied by XII
A
false - palatoglossus has vagal innervation
16
Q
what do Palatoglossus Styloglossus Hyoglossus
Genioglossus control
A
tongue position
17
Q
what is the cricopharyngeus
A
C6, upper oesophageal sphincter
18
Q
constrictor muscles are voluntary but contract ___
A
sequentially
19
Q
constrictor muscles have ___ innervation
A
vagal
20
Q
what innervation does the longitudinal inner layer pharynx have and what does it do?
A
elevates pharynx and larynx to close laryngeal inlet
CN X, IX
21
Q
describe anatomy of swallow
A
closure of lips
tongue pushes bolus to oropharynx
sequential contraction of constrictor muscles
inner longitudinal pharyngeal muscles contract to prevent aspiration
bolus reaches oesophagus
22
Q
where does the oesophagus begin
A
inferior edge of cricopharyngeus
23
Q
what runs on the surface of the oesophagus
A
oesophageal plexus
24
Q
where does the oesophagus pass through diaphragm
A
T10
25
the lower oesophageal sphincter is anatomical/physiological and how does it work?
physiological - higher intra-abdominal pressure over intragastric
26
4 parts of the stomach
cardia
fundus
body
pyloric antrum
27
where does the stomach lie
below left hemidiaphragm in left hypochondrium, epigastric and umbilical region
28
the stomach is said to be J shaped due to a ___ curvature on the left and a ____ on the right
greater
| lesser
29
small intestine
duodenum
jejunum
ileum
30
large intestine
```
caecum
appendix
ascending, transverse, descending, sigmoid colon
rectum
anal canal
anus
```
31
where does the foregut range from and what is contained in it
oesophagus to mid duodenum
| liver, gallbladder, spleen, half of pancreas
32
where does the midgut range from and what is contained in it
mid duodenum to proximal 2/3 transverse colon
| half of pancreas
33
where does the hindgut range from and what is contained in it
distal 1/3 transverse colon to proximal 1/2 anal canal
34
divisions of the 9 regions of the abdominal cavity
mid-clavicular
subcostal
trans-tubercular
35
9 stomach regions
```
epigastrum
pubic
umbilical
right/left lumbar
right/left iliac fossa
right/left hypochondriac
```
36
4 body quadrants and their divisions
median and trans-umbilical planes
| right/left upper/lower quadrants
37
muscles of anterolateral abdominal wall
rectus abdominis
externa/internal oblique
transversus abdominis
38
where is the peritoneal cavity located
between the visceral and parietal peritoneum
39
what is mesentery
double layer peritoneum
40
what are intraperitoneal organs?
organs completely covered by peritoneum
41
what are retroperitoneal organs and give examples
organs not fully covered by the peritoneum and so are located in the retroperitoneum
Pancreas and kidneys
42
what organ is held suspended by mesentery?
small intestine
43
what is the greater omentum
4 layer structure covering intestine
| originates from greater curvature of stomach
44
where does the lesser omentum span
lesser curvature of stomach from inferior of liver
45
where do the greater peritoneal sac and lesser peritoneal sac communicate through
omental foramen
46
pouch formed by peritoneum in men
rectovesicle pouch
47
pouches formed by peritoneum in women
vesico-uterine pouch
| recto-uterine pouch
48
describe the process of paracentesis
needle insertion lateral to rectus sheath avoiding inferior epigastric artery
49
nerve innervation modalities to abdominal wall?
somatic sensory
motor
sympathetic
50
nerve innervation modalities to visceral peritoneum and abdominal cavity organs
visceral afferent
| ANS/ENS
51
where do sympathetic nerves leave the spinal cord for abdomen
T5-L2
52
describe path of sympathetic nerves from spinal cord to abdomen
enter sympathetic chains and pass through to abdominopelvic splanchnic nerves
synapse at prevertebral ganglia and travel down periarterial plexuses
53
why is sympathetic innervation unique to the adrenal gland
travels T10-L1
| synapses directly onto adrenal cells
54
describe path of CN X
travel from surface of oesophagus
travels on periarterial plexus to organs
synapse in ganglia on organ
55
how much of the GI tract is supplied by vagal innervation
GI tract to distal of transverse colon
56
where do pelvic splanchnic nerves come from, where do they supply
S2-S4
| smooth muscle and glands of descending colon to anal canal
57
foregut pain is often ____
epigastric
58
midgut pain is often _____
umbilical
59
hindgut pain is often ____
pubic
60
where do nerve bundles reach on spinal cord for the gut?
foregut - T6-9
midgut - T8-T12
hundgut - T10-L2
61
where is liver/gallbladder pain felt
right lumbar/hypochondrium, extending to back, patients shoulder tip
62
where is stomach pain felt
epigastric, interscapular or umbilical
63
where is appendix pain felt
umbilical, moving to right iliac fossa
64
where is splenic pain felt
right lumber or right of back
65
where is small intestine pain felt
umbilical region, or epigastric if duodenal
66
what make up the thoracoabdominal intercostal nerves
7-11th intercostal nerves
67
what makes up the subcostal nerve
T12, anterior ramus
68
what makes up the iliohypogastric nerve
half of the anterior ramus of L1
69
what makes up the ilioinguinal nerve
half of the anterior ramus of L1
70
what is bilirubin?
by product of breakdown of RBC
71
where does breakdown of RBC occur
spleen
| liver
72
where is bile formed
liver
73
function of gallbladder
stores and concentrates bile
74
what is bile essential for
normal fat absorption
75
what is found in the portal triad
hepatic artery
hepatic portal vein
common bile duct
lymphatics and nerves
76
what is the celiac trunk and where does it supply
first of three branches of abdominal aorta at T12
| supplies foregut organs
77
the celiac trunk trifurcates to what?
splenic artery
hepatic artery
left gastric artery
78
what are the anatomical relations of the spleen?
anterior to lower diaphragm
posterior to stomach
superior to splenic fixture
lateral to left kidney
79
functions of the spleen?
break down RBC to bilirubun
immunological protection
storage of blood
80
what ribs protect the spleen
9-11
81
the left and right gastric arteries anastomose together and run on the greater/lesser curvature of the stomach
lesser
82
the left and right gastro-omental arteries anastomose together and run on the greater/lesser curvature of the stomach
greater
83
from what vessels does blood flow to the liver
hepatic artery
| hepatic portal vein
84
in what quadrant is the liver located
upper right, extending into upper left
85
anatomical relationships to the diaphragm
diaphragm, superior, anterior and posterior
anterior stomach is medial
gallbladder posterior and inferior
right kidney, adrenal IVC, abdominal aorta posterior
86
what ribs offer protection to the liver
7-11
87
4 anatomical lobes of the liver
right, left, caudate, quadrate
88
how many functional segments does the liver have?
8
89
what does each functional segment of the liver have?
hepatic arterial, hepatic portal and bile supply
90
what is the hepatorenal recess
morisons pouch
| one of the lowest points of peritoneal cavity when patient is supine
91
what are the 2 pouches of the peritoneal cavity
hepatorenal
| sub-phrenic
92
function of the hepatic portal vein
drains blood from foregut, midgut and hindgut for first pass metabolism
93
function of the splenic vein
drains blood from foregut to hepatic portal vein
94
function of the inferior mesenteric vein
drains blood from hindgut to splenic vein
95
function of the superior mesenteric vein
drains midgut blood to hepatic portal vein
96
function of the IVC in hepatic blood supply
drains blood from 3 hepatic veins to right atrium
97
anatomical relationships of the gallbladder
posterior of liver, anterior of duodenum
98
the neck of the gallbladder narrows to become?
the cystic duct
99
where would gallstones likely impact on a patient
the cystic duct
100
where does blood supply to the gallbladder come from?
cystic artery, from right hepatic artery (usually)
101
where would pain in the gallbladder
epigastric as T6-9 but may be in hypochonrium or roght shoulder if there is diaphragmatic irritation
102
what is jaundice
yellowing of sclera/skin due to blood bilirubin increase
103
what composes common bile duct and where does it drain to
common hepatic duct (L+R hepatic duct)
Cystic duct
2nd part of duodenum
104
the common bile duct combines with the main pancreatic duct to form the ___ and drains into duodenum via ____
ampulla of vater
| major duodenal papilla
105
3 sphincters of the biliary tree
bile duct sphincter
pancreatic duct sphincter
sphincter of oddi
106
What is ERCP and what is it used for
endoscopic retrograde cholangiopancreatography
| studies biliary tree and pancreas and may be used to treat certain pathologies
107
describe how jaundice forms due to biliary obstruction
biliary obstruction causes bile to back up into liver and overspills into blood, with bilirubin
108
causes of biliary obstruction
gallstones
| carcinoma at head of pancreas
109
what are the 4 parts of the pancreas
head
neck
body
tail
110
where does the head of the pancreas lie
over superior mesenteric vessels
111
where does body of pancreas lie
L2
| aorta
112
where is tail of pancreas anterior to
left kidney
113
anatomical relationships of pancreas
posterior to stomach
duodenum to right, spleen left
anterior to left/ right kidney, IVC, SMA/SMV
splenic vessels superoposteriorly
114
where does sympathetic and parasympathetic innervation to the pancreas come from
sympathetic - abdominopelvic splanchnic nerves
| parasympathetic - vagus nerves
115
blood supply to pancreas?
gastroduodenal to superior pancreaticoduodenal
| SMA to inferior pancreaticoduodenal
116
causes of pancreatitis
blocked ampulla of vater causing direction of bile to pancreas
117
where is pancreatic pain felt
epigastric and/or umbilical and may radiate to back
118
true/false - all of the duodenum is foregut
false - the first 2 parts are but the rest is midgut
119
4 parts of the duodenum
superior
descending
horizontal
ascending
120
duodenal ulcer pain presents as ___
epigastric
121
blood supply to duodenum?
gastroduodenal - superior pancreaticoduodenal
| SMA - inferior pancreaticoduodenal
122
where does jejunum begin
duodenaljejunal flexure
123
where does ileum end
ileocaecal junction
124
what are plicae circularis
folds in the mucosa of jejunum
125
where does blood supply to jejunum and ileum come from
jejunal and ileal arteries, from SMA
126
describe venous drainage from jejunum and ileum
drains via jejunal and ileal veins, drains to SMVs and onto hepatic portal vein
127
main abdominal lymph node groups
celiac
superior mesenteric
inferior mesenteric
lumbar
128
where is fat within chylomicrons absorbed into from enterocytes
lacteals
129
what parts of the colon are mobile
caecum and appendix
transverse
sigmoid colon
hepatic/spenic flexure - barely
130
what parts of the colon are not mobile
ascending colon
| descendin colon
131
where are the paracolic gutters found and in what sac of the peritoneum would they be found
lateral edge of ascending and descending colon and abdominal wall
part of greater sac of peritoneal cavity
132
where is the appendiceal orifice
posteromedial wall of caecum
133
the sigmoid colon has a long mesentery for good movement, what is the disadvantage of this
sigmoid volvulus
| causes obstruction of infarction
134
3 midline branches of abdominal aorta?
Celiac trunk
SMA
IMA
135
what anastomosis connects SMA to IMA
marginal artery of drummond
136
branches of SMA?
```
inferior pancreaticoduodenal
jejunal and ileal arteries
ileocolic artery
right colic artery
middle colic artery
appendicular artery
```
137
branches of IMA
left colic artery
sigmoid colic artery
superior rectal artery
138
true/false - IMA supplies all of rectum and anal canal
false - internal ileac supplies below pectinate line
139
3 anastomoses of portal circulation
distal end of oesophagus
skin around umbilicus
rectal/anal canal
140
describe distal end of oesophagus anastomosis
inferior systemic to hepatic portal and most superior GI to azygous vein
141
describe skin around umbilicus anastomosis
blood flows around umbilicus via epigastric arteries before joining IVC
142
describe rectal/anal canal anastomosis
rectum and superior anal canal to IMV, most inferior of GI tract to internal ileac veins
143
what is portal hypertension and describe the consequence
increased BP in portal veins
| causes blood to be diverted to anastomoses and so dilate and become varicose
144
function of the rectum
hold faeces until appropriate to defecate
145
what level does the sigmoid colon become rectum
S3, rectosigmoid junction
146
when does rectum become anal canal
tip of coccyx and prior passing through levator ani
147
rectal ampulla is superior/inferior to levator ani
superior
148
anatomical relationships of the rectum
peritoneum covers superior
rectouterine/rectovesical pouch anterior to superior rectum
prostate anterior to inferior rectum
cervix/vagina anterior to inferior/middle rectum
149
true/false - levator ani is usually relaxed
false - it is usually tonically contracted
150
what nerves supply levator ani
nerve to levator ani
| pudendal nerve
151
contraction of the puborectalis causes?
decreased anorectal angle to allow defecation
152
when does internal anal sphincter relax
rectal distention
153
when is the external anal sphincter contract and what nerve does this
response to rectal distention and internal sphincter relaxation
pudendal nerve
154
where do sympathetic fibres to rectum originate from and what do they do
exit T12-L2
contract internal anal sphincter
inhibit peristalsis
155
where does nerve to levator ani and pudendal exit and what do they supply
nerve to levator ani -S2-S4
pudendal -S3-S4
contract external anal sphincter and puborectalis
156
describe the path of the pudendal nerve
exits pelvis via greater sciatic foramen
enters lesser sciatic foramen to enter perineum
panches to supply structures
157
how can labour lead to faecal incontinence or weakened muscle wall
stretch of pudendal nerve or muscle tear during labour
158
where do visceral afferents and parasympathetics run and what do they stimulate
S2-S4
visceral afferents - sense stretch and ischaemia
parasympathetic - inhibit internal anal sphincter and stimulate peristalsis
159
lymphatic drainage below pectinate line?
superficial inguinal nodes
160
internal iliac lymphatics drain?
inferior pelvic structures
161
external iliac lymphatics drain?
drains lower limb, superior pelvic structures
162
common iliac lymphatics drain what and drain to what?
drains internal and external iliac nodes to lumbar nodes
163
blood supply to rectum?
IMA
164
blood supply to anus?
internal iliac artery
165
Venous drainage of rectum
IMV to portal system
166
venous drainage of rectum
internal iliac vein to systemic venous
167
what is a rectal varice?
dilation of collateral veins between portal/systemic systems
usually related to portal hypertension
168
what is a haemorrhoid
prolapses of rectal venous plexuses due to raised pressure
| not postal hypertension
169
what are the ischioanal fossae
fat and connective tissue that lie on each side of the anal canal
170
what is a hernia
structure passing through another and ending in the wrong place
171
what factors are required usually for herniation
structural weakness
| increased pressure ie intraabdominal pressure
172
sites of herniation
```
femoral
diaphragmatic
inguinal
incisional
spigelian
umbilical
epigastric
```
173
what muscle is most superficial and extends from linea alba to linea semilunaris
rectus abdominis
174
what is the most superficial muscle running from the linea semilunaris across the lateral abdominal wall and in what direction is its fibres
external oblique muscle
| anteroinferior
175
what muscle lies beneath the external oblique and what direction does its fibres run
internal oblique
| anterosuperior
176
what muscle is deep to internal oblique and in what direction do its fibres run?
transversus abdominis
| horizontal
177
what exactly is the inguinal ligament and where does it attach?
thickening of external oblique muscle
| superior iliac spine to pubic tubercle
178
what is the inguinal canal, how long is it, what direction does it run and what is the entry and exit
oblique passage between abdomen and perineum
4cm
inferomedially
superficial/deep inguinal ring
179
contents of the inguinal canal?
spermatic cord in males
round ligament of uterus in females
ilioinguinal nerve
blood and lymphatics
180
anterior border of inguinal canal?
external oblique muscle
| internal oblique muscle
181
posterior border of inguinal canal?
transversalis fascia
| conjoint tendon
182
superior border of inguinal canal?
transversalis fascia
external oblique aponeurosis
arches of internal oblique and transversus abdominis
183
inferior border of inguinal canal
gutter of infolded inguinal ligament
184
borders of hesselbachs triangle and significance?
inferior epigastric artery
inguinal ligament
lateral border of rectus abdominis
site of direct inguinal herniation
185
what is direct inguinal herniation
directly through abdominal wall structures in hesselbachs triangle
186
what is indirect inguinal herniation
use of inguinal canal to allow abdominal contents to herniate
187
surface anatomy - deep inguinal ring?
superior to halfway point along inguinal ligament
188
surface anatomy - superficial inguinal ring
superior and lateral to pubic tubercle
