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Gross Anatomy > Anatomy Exam 2 > Flashcards

Anatomy Exam 2 Flashcards

1
Q

What are the three attachment points of the Pectoralis major?

A

humerus, sternum, clavicle

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2
Q

What is the subclavius muscle attached to?

A

Clavicle

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3
Q

What muscle gives the subclavian artery and vein their name?

A

Subclavius

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4
Q

What artery runs through the subclavius muscle?

A

Suprascapular (branch off the thyrocervical trunk), crosses to the anterior superior aspect

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5
Q

What structure is deep to the clavicle?

A

Subclavius (and suprascapular artery, as it runs through the subclavius)

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6
Q

What type of nerve block assists with the pain associated with broken ribs?

A

Anterior serratus block

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7
Q

Involvement of which lymph nodes indicates more advanced breast cancer?

A

Parasternal nodes

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8
Q

What type of blood cells are in lymph nodes?

A

lymphocytes and monocytes

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9
Q

What vessel do the axillary lymph nodes wrap around?

A

Axillary vein (easy metastasis)

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10
Q

How many pairs of ribs are there?

A

12 pairs:
7 true ribs
3 false ribs
2 floating ribs

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11
Q

Why is the sternal angle (angle of lewis) important?

A

Great landmark

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12
Q

What structures can be identified using the sternal angle landmark?

A

Rib (2)
Aortic arch (beginning and end)
Tracheal Bifurcation
Pulmonary trunk bifurcation
Left recurrent laryngeal nerve
Azygos
Nerves: cardiac plexus
Thoracic duct

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13
Q

What occurs if the balloon of the cuff of an ET tube is overfilled with air?

A

pressure injury (necrosis) to left recurrent laryngeal nerve

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14
Q

What is the difference between the left recurrent laryngeal and the right recurrent laryngeal nerves?

A

Right is simply a branch of the vagus whereas the left is inferior to the aortic arch and posterior to ligamentum arteriosum

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15
Q

What is the most common presentation of bronchogenic carcinoma?

A

Chronic hoarseness due to location of lf recurrent laryngeal and mediastinal lymph nodes

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16
Q

Where does the azygos vein drain into?

A

Superior vena cava

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17
Q

What structures drain into the right atrium?

A

Superior vena cava, inferior vena cava, and coronary arteries

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18
Q

What does the thoracic duct drain lymph from?

A

feet, legs, abdomen

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19
Q

Where does the thoracic duct dump into the venous system?

A

Where the LIJ comes off the left subclavian

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20
Q

What is the largest lymph vessel in the body?

A

Thoracic duct

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21
Q

What is a concern when placing a left IJ central line?

A

Chylothorax

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22
Q

Why is the right thoracic duct less significant that the left?

A

It is only draining lymph from the right arm and right side of face

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23
Q

Where is the sternal angle in relation to the spine?

A

right between T4 and T5

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24
Q

What are the muscles between the ribs called?

A

external and internal intercostals

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25
Q

Which intercostal muscles run like putting your hands in your pockets?

A

Externals

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26
Q

Which intercostal muscles are there two sets of?

A

Internals

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27
Q

What are the two sets of internal intercostal muscles called?

A

internals and innermost

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28
Q

What is the function for having two sets of internal intercostal musclses?

A

they seperate the artery, vein, and nerve

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29
Q

What is the function of the wing of the rib?

A

to protect the important structures: artery, vein, and nerve

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30
Q

Which intercostal muscles are responsible for inspiration?

A

externals

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31
Q

Which intercostal muscles are responsible for exhalation?

A

internals

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32
Q

What is the function of the subcostal and transversus thoracis muscles?

A

aid in exhalation

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33
Q

Where does the internal thoracic/mammary artery arise from?

A

subclavian

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34
Q

What is the first inferior branch off the subclavian?

A

internal thoracic/mammary artery

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35
Q

What artery is lateral to the sternum?

A

internal thoracic/mammary artery

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36
Q

Where do the anterior intercostal arteries originate from?

A

internal thoracic/mammary artery

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37
Q

Where do the posterior intercostal arteries originate from?

A

Aorta

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38
Q

What does the internal thoracic/mammary artery split into?

A

Superior epigastric and musculophrenic

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39
Q

Which artery supplies the diaphram?

A

Musculophrenic

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40
Q

When does the anterior intercostal artery become the posterior?

A

about midrib

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41
Q

Where does the lung tissue blood supply come from?

A

Right lung: third posterior intercostal artery
Left lung: a branch from the aorta

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42
Q

Where does the deoxygenated blood from the lung tissue go?

A

pulmonary vein (which causes there to be a small amount of deoxygenated blood in the systemic circulation)

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43
Q

Is there oxygen in venous blood?

A

about 50%

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44
Q

Where does the anterior intercostal vein dump blood into?

A

azygos system

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45
Q

What are the two divisions of the azygos on the left side?

A

Accessory hemiazygos (superior) and hemiazygos (inferior)

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46
Q

What drains blood for the superior portion of the left lung?

A

accessory hemiazygos

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47
Q

What drains blood for the inferior portion of the left lung?

A

hemiazygos

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48
Q

What is the cisterna chyli?

A

reservoir for lymph

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49
Q

Are there an anterior and posterior intercostal nerve?

A

no, because they only have one source, the spinal cord

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50
Q

Where is the anterior cutaneous branch nerve?

A

lateral to the sternum

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51
Q

Which intercostal nerve will be blocked during an anterior serratus block?

A

lateral cutaneous branch

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52
Q

What is the lining of the thoracic cavity called?

A

parietal pleura

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53
Q

What is the covering on the lung tissue called?

A

Visceral pleura

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54
Q

What is the space between the parietal and visceral pleuras called?

A

pleural cavity

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55
Q

What should the pressure in the pleural cavity be?

A

negative (-5-10mmHg)

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56
Q

What is the movement of the sternum, diaphragm, and ribs during inspiration?

A

up and out, diaphragm down to increase size of pleural cavity

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57
Q

What is a natural process, inspiration or expiration?

A

expiration

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58
Q

What prevents atelectasis in the lung?

A

surfactant

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59
Q

What is lost in the lung tissue of patients with emphysema?

A

recoil of alveoli

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60
Q

How many lobes are in the right lung?

A

3:
superior
middle
inferior

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61
Q

How many lobes are in the left lung?

A

2
superior
inferior

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62
Q

What fissure is present in the left lung?

A

Oblique

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63
Q

What fissure separates the superior and middle lung lobes?

A

Horizontal

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64
Q

What is the central spot in the lung called?

A

Hilum

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65
Q

What are are three things in the hilum of the lung?

A

Bronchus
Pulmonary artery
Pulmonary vein

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66
Q

How can the bronchus be differentiated from other structures in the hilum?

A

It is cartlaginous

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67
Q

What does RALS tell us?

A

Where the pulmonary artery is located in relation to the bronchus
Right: Anterior
Left: Superior

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68
Q

What does the costal surface of the ribs refer to?

A

against the anterior portion of the ribs

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69
Q

Where are the apex and base of the lung in relation to the rest of the lung?

A

Apex: superior
Base: inferior

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70
Q

What does the left lung have that the right lung doesnt?

A

Lingula of the inferior lobe

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71
Q

What fissure separates the middle and inferior lobes of the right lung?

A

Oblique

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72
Q

Which primary bronchus is larger and straighter, left or right?

A

Right

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73
Q

Which lung does pneumonia normally occur in and why?

A

Right, its larger and straighter
AND the right branches earlier than the left

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74
Q

What two areas do the parasympathetic nervous system originate from?

A

Cervical and sacral spinal cord

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75
Q

What is the name of the area where the trachea splits into the right and left bronchus?

A

Carina

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76
Q

Why is the carina loaded with nerve receptors?

A

to initiate cough reflex

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77
Q

What are the nerve roots of the phrenic nerve? What does it inervate?

A

C3, 4, 5
Diaphram

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78
Q

What runs with the phrenic nerve?

A

Pericardiophrenic artery and vein

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79
Q

What is the originating point of the pericardial sac?

A

Oblique pericardial sinus

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80
Q

What is the purpose of the transverse pericardial sinus?

A

good to cross clamp for bypass

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81
Q

What is the most anterior great vessel?

A

Pulmonary artery

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82
Q

What is the most posterior & lateral great vessel?

A

Aorta

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83
Q

Where does the left atrium sit?

A

The posterior aspect of the heart

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84
Q

Where do the pulmonary veins go?

A

left atrium

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85
Q

How many pulmonary veins are there?

A

3-5

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86
Q

Where is the coronary sinus?

A

Posterior venous structure where all the venous coronary veins empty

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87
Q

What does the coronary sinus empty in?

A

right atrium

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88
Q

What coronary artery is posterior to the pulmonary trunk?

A

Left coronary artery

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89
Q

What are the two branches of the Left coronary artery?

A

Left anterior descending (LAD)
Circumflex

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90
Q

What are the two branches of the Right coronary artery?

A

Marginal
Posterior interventricular/descending artery (PDA)

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91
Q

What does the obtuse marginal branch off?

A

Circumflex

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92
Q

What is the most important thing about the coronary arteries?

A

They receive blood supply during diastole

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93
Q

Which valves are semilunar valves?

A

Aortic and Pulmonic (true cusp valves)

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94
Q

What prevents the coronary arteries from receiving blood flow during systole?

A

The cusps on the aortic valve

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95
Q

T/F the AV valves are cup valves

A

FALSE- they are leaflet valves, you cannot totally differentiate the areas other than free wall vs septal areas

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96
Q

In what percent of the population does the circumflex supply blood to the PDA and what is that called?

A

10-30%, left dominance, covers 80% of heart rather than 2/3s

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97
Q

Where do most coronary artery blockages occur?

A

LAD

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98
Q

What vein runs with the LAD?

A

Great cardiac vein

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99
Q

What vein runs with the PDA?

A

Middle cardiac vein

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100
Q

What vein runs with the RCA/marginal?

A

Small cardiac vein

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101
Q

What vein runs off the lateral surface of the coronary sinus?

A

Small cardiac vein

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102
Q

What lines the right atrium and the LAA?

A

Pectinate muscles

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103
Q

T/F there are two valves entering the right atrium

A

TRUE: inferior vena cava valve and coronary sinus valve

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104
Q

Which semilunar valve has an anterior cusp?

A

Pulmonic

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105
Q

Which semilunar valve has a posterior cusp?

A

Aortic

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106
Q

Which valve connects the right atrium to the right ventricle?

A

Tricuspid (anterior, posterior, septal leaflets)

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107
Q

Which valve connects the left atrium to the left ventricle?

A

Mitral (anterior and posterior leaflets)

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108
Q

What is the function of chordae tendineae?

A

Prevent valve from prolapsing into atrium

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109
Q

What muscles line the ventricles?

A

Trabeculae carneae

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110
Q

What are the functions of Trabeculae carneae?

A
  1. create turbulence prevent stagnant blood
  2. prevents ventricles from sticking together
  3. aids in contraction
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111
Q

What atrioventricular valve has a septal leaflet?

A

Tricuspid

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112
Q

What is the purpose of the placenta?

A

to transfer oxygen and nutrients into the baby’s blood, baby has its OWN blood

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113
Q

What percent of fetal blood flow (nutrient rich, coming from placenta) bypasses the fetal liver?

A

60%

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114
Q

What structure in fetal circulation allows some of the blood to bypass the fetal liver?

A

Ductus Venosus -> inferior vena cava

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115
Q

What structure in the fetal heart allows blood to bypass the heart?

A

Foramen Ovale

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116
Q

Where does the venous blood from the fetus’ head go?

A

Superior vena cava -> right atrium -> right ventricle -> pulmonary artery -> Ductus arteriosus -> aorta

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117
Q

Fetal blood circulation:

A

Placenta, umbilical cord, ductus venosus, foramen ovale, left atrium, left ventricle, aorta, body

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118
Q

What structure allows blood flow from the fetal pulmonary artery to go into systemic circulation via the aorta?

A

Ductus arteriosus

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119
Q

What occurs if the baby’s ductus venosus does not close?

A

Hepatoportal shunts which causes hepatic encephalopathy

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120
Q

What three things occur when you take your first breath?

A
  1. Foramen ovale -> fossa ovale
  2. Ductus venosus -> ligamentum venosus
  3. Ductus arteriosus -> ligamentum arteriosus
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121
Q

What occurs when the ventricles contract?

A

the AV valves close and the semilunar valves open

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122
Q

Which valves close during diastole?

A

Semilunar valves

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123
Q

What causes S1 and S2 heart sounds?

A

closure/blood catching in valves

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124
Q

Where does the sympathetic nervous system innervation come from?

A

Sympathetic chain ganglion

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125
Q

What nerve supplies sympathetic innervation to the heart?

A

branches from the superior, middle, and inferior ganglion send branches to create the cardiac plexus

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126
Q

What is the cisterna chyli?

A

A lymph reservoir in the thoracic cavity

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127
Q

What is the first branch off the sympathetic chain ganglion?

A

Greater splanchnic

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128
Q

Where does the greater splanchnic branch off the sympathetic chain ganglion?

A

T5

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129
Q

What branches off the greater splanchnic and when?

A

Lesser splanchnic, at T9-10

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130
Q

What branches off the lesser splanchnic nerve and when?

A

Least splanchnic, at the diaphram

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131
Q

What is the function of the splanchnic nerves?

A

Visceral/organ sympathetic nerve innervation

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132
Q

What is the function of the gray and white rami?

A

Link between the ganglion and the peripheral intercostal nerves
Connect the sympathetic nervous system to the peripheral nerve

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133
Q

Which lung lobe is most susceptible to developing pneumonia?

A

Right inferior lobe

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134
Q

What is the name of the white band of fascia that covers the abdomen?

A

Aponeurosis of the external oblique

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135
Q

What is the name of the midline abdominal line called?

A

Linea alba

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136
Q

What is the technical name for the “6-pack”

A

Rectus abdominis

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137
Q

What are the three bands of muscles that support the abdomen?

A
  1. external oblique
  2. internal oblique
  3. transversus abdominis
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138
Q

How do the fibers of the external oblique run?

A

from the costovertebral junction to toward the pubis- like hands in pockets

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139
Q

Why is the inguinal ligament important?

A

thick band of demarcation, valuable landmark for blocks

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140
Q

When does the femoral nerve begin to branch?

A

When it passes under then the inguinal ligament

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141
Q

What is the ASIS?

A

Anterior superior illiac spine

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142
Q

What is the linea alba?

A

it is the midline area where the superficial and deep fascia surrounding the the abdominal muscles comes together

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143
Q

How many layers of fascia are in the abdomen?

A

there is a layer on the superficial and deep aspect of each muscle. there are four groups so that means there are a total of eight layers

144
Q

Why are midline abdominal incisions preferred?

A

there are no blood vessels, so it decreases blood loss.
is also very strong and increases strength of scar

145
Q

How does the linea alba receive nutrition since there are no blood vessels present?

A

Osmosis

146
Q

T/F the external inguinal ring is more prevalent in females

A

False, more prevalent in males due to the need of the testicle to descend through this area

147
Q

How do the fibers of the internal oblique run?

A

extend off the wing of the ilium toward the xiphoid process

148
Q

How do the fibers of the transverse abdominis run?

A

comes off the thoracolumbar fascia and wraps around to the linea alba, so horizontally

149
Q

What abdominal block in useful for lower back pain?

A

Quadratus lumborum block

150
Q

What nerves are included in a Quadratus lumborum block?

A
  1. Lateral cutaneous (L2, L3)
  2. Genitofemoral (L1, L2)
  3. Subcostal (T12)
  4. Iliohypogastric (L1)
151
Q

How can the Quadratus lumborum be found?

A

abdominal ultrasound, identify the three muscles, should be directly behind where the transverse abdominis connects to the thoracolumbar fascia

152
Q

What structures does the linea alba connect to?

A

xiphoid process and pubis

153
Q

What is the mesentary?

A

Fatty tissue that is bound to the intestines to supply with blood, veins, and lymphatics

154
Q

Where does the mesentery originate from?

A

the parietal peritoneum surrounding the abdominal cavity comes together in the base of the floor above the vertebrae connects together and wraps around the intestines and becomes visceral peritoneum

155
Q

What’s the difference between parietal and visceral peritoneum?

A

parietal surrounds the abdominal cavity then comes together to form the mesentery the surrounds the intestine which THEN becomes the visceral peritoneum

156
Q

What differentiates the parietal and visceral peritoneum from each other?

A

the fidunculation where the peritoneum comes together

157
Q

Why cant the intestines simply fall out?

A

they are technically attached to the posterior aspect of the abdominal cavity via the mesentery.

158
Q

Where does the greater omentum originate from?

A

The greater curvature of the stomach (lower part) and the transverse colon

159
Q

Where are the abdominal nerves in relation to the abdominal muscles?

A

they are deep to the internal oblique and superficial to the transverse abdominis

160
Q

What are the roots of the abdominal nerves?

A

T10-L2

161
Q

Is a bowel ileus normally global or segmental?

A

Segmental

162
Q

What occurs in the bowel that causes diarrhea?

A

Lack of peristalsis, “hollow pipe”

163
Q

What occurs to the omentum during a bowel ileus?

A

The intestines with peristalsis work the mesentery to the ileus segment to increase blood flow and lymphatic to promote healing

164
Q

In the setting of infectious peritonitis, what is usually done with the greater omentum?

A

it is very difficult to fully clean so it is frequently removed
If abdomen is clean it remains and is wrapped around injury

165
Q

What is the lesser omentum connected to?

A

lesser curvature of the stomach and liver

166
Q

The vessels that supply the lesser curvature of the stomach are referred to as:

A

left and right gastric

167
Q

The vessels that supply the greater curvature of the stomach are referred to as:

A

left and right gastro-omental

168
Q

T/F the lesser omentum lays pendulously like the greater omentum

A

FALSE, it is a tight band

169
Q

What organ(s) are retroperitoneal?

A

Kidneys

170
Q

What structure lays on top of the intestines like an apron?

A

The greater omentum

171
Q

If an artery goes to the right side of the lesser curvature of the stomach it is called:

A

Right Gastric

172
Q

If an artery goes to the left side of the lesser curvature of the stomach it is called:

A

Left Gastric

173
Q

If an artery goes to the right side of the greater curvature of the stomach it is called:

A

Right gastro-omental

174
Q

If an artery goes to the left side of the greater curvature of the stomach it is called:

A

Left gastro-omental

175
Q

What area of the stomach do the short gastric arteries supply?

A

The fundus of the stomach (the tip, not the curvature)

176
Q

What is the most identifiable artery in the abdomen and why?

A

Splenic artery- coiled like a snake (only one in the body)

177
Q

What structure is the splenic artery adhered to?

A

Pancreas

178
Q

What is the name of the curve where the esophagus connects to the fundus of the stomach?

A

Cardial notch

179
Q

What is the name of the portion of the stomach where the esophagus enters?

A

Cardia

180
Q

What 4 structures are distal to the body of the stomach?

A

Pyloric antrum -> Pyloric canal -> Pyloric sphincter -> duodenum

181
Q

What are the four sections of the duodenum?

A
  1. Superior
  2. Descending
  3. Inferior
  4. Ascending
182
Q

What part of the intestine is partially retroperitoneal?

A

duodenum and large intestine

183
Q

What does the ascending part of the duodenum become?

A

Jejunum

184
Q

T/F duodenum has messentary

A

False because it is partially retroperitoneal

185
Q

How can the duodenum and the jejunum be differentiated?

A

The jejunum has mesentery while the duodenum does not due to being partially retroperitoneal.

186
Q

When does the duodenum become jejunum?

A

When it picks up mesentery

187
Q

What are the three abdominal branches off the aorta?

A
  1. Celiac trunk
  2. Superior mesenteric
  3. Inferior mesenteric
188
Q

How many branches come off the celiac trunk?

A

Sixteen

189
Q

What are the first 3 branches off the celiac trunk?

A
  1. Left gastric
  2. Splenic
  3. Common hepatic
190
Q

When does the common hepatic become the proper hepatic artery?

A

after it gives rise to the gastroduodenal

191
Q

What structure sits in the loop that is formed by the pyloric antrum and the duodenum?

A

Head of the pancreas

192
Q

What are the branches of the gastroduodenal artery?

A
  1. Supraduodenal
  2. Posterior superior pancreaticoduodenal
  3. Anterior superior pancreaticoduodenal
  4. Right gastro-omental
193
Q

What is the first inferior branch off the common hepatic artery?

A

Gastroduodenal

194
Q

What does the posterior superior pancreaticoduodenal supply blood to?

A

head of the pancreas and the duodenum

195
Q

After giving rise to the posterior superior pancreaticoduodenal, the gastroduodenal splits into:

A
  1. Anterior superior pancreaticoduodenal
  2. Right gastro-omental
196
Q

The anterior superior pancreaticoduodenal artery loops around and becomes the:

A

anterior inferior pancreaticoduodenal

197
Q

What two pancreaticoduodenal arteries arise from the superior mesenteric artery?

A
  1. Posterior inferior pancreaticoduodenal
  2. Anterior inferior pancreaticoduodenal
198
Q

What structures are included in the Foregut?

A

Esophagus
Stomach
Liver
Gallbladder
Pancreas
Spleen
Top of the Duodenum

199
Q

What structures are in the Midgut?

A

Mid-duodenum
Small intestines
Ascending colon
most of Transverse colon

200
Q

What artery supplies the Foregut?

A

Celiac trunk

201
Q

What artery supplies the Midgut?

A

Superior mesentery

202
Q

What structures are in the Hindgut?

A

Descending colon
Sigmoid colon
Rectum

203
Q

What artery supplies the Hindgut?

A

Inferior mesentery

204
Q

What is the name of the arteries that branch off the superior mesentery and supply the small intestine?

A

jejunal or ileal arteries

205
Q

The Jejunal or ileal arteries come together to form rounding segments called (& what are their purpose):

A

jejunal or ileal arcades
they allow collateral blood flow during peristalsis

206
Q

What is the name of the straight vessels that branch off the arterial arcades to supply blood to the intestine?

A

Vasa recta

207
Q

Which section of small intestine has longer vasa recta?

A

Jejunum

208
Q

How many feet of jejunum are there?

A

18-22 feet

209
Q

What is the only situation where the arterial arcades are not sufficient to provide blood flow to the intestine?

A

complete torsion, intussusception, or strangulation as these block off multiple groups of arterial arcades

210
Q

Where does the ilium enter the large intestine?

A

Cecum

211
Q

What part of the colon is the appendix attached to?

A

Cecum

212
Q

What is contained in the appendix?

A

a large number of bacteria and lymphatics

213
Q

What are the three things the large intestine is responsible for?

A
  1. absorbing water and electrolytes
  2. absorbing vitamins (B and K)
  3. uses bacteria to break down things that the digestive enzymes cannot
214
Q

T/F there are no digestive enzymes in the colon

A

true, they are primarily present in the jeujunum

215
Q

Where in the GI tract is the majority of water reabsorbed?

A

Small intestine and jejunum

216
Q

The right colic flexure is also known as:

A

Hepatic

217
Q

Full large intestine:

A

Cecum -> ascending colon -> right colic (Hepatic) flexure -> transverse colon ->left colic (Splenic) flexure -> descending colon -> sigmoid colon -> rectum -> anal canal

218
Q

The left colic flexure is also known as:

A

Splenic

219
Q

What are taeniae coli?

A

They are smooth muscle bands that bring the tissue of the colon to form pouches that aid in stool formation

220
Q

That are Haustra of the colon?

A

Little pouches formed by taeniae coli

221
Q

What is the name of the structure inside the cecum that prevents the backflow of fecal content into the illium?

A

Ileo-cecal folds (similar to a valve)

222
Q

What is the actual function of the appendix?

A

reload the intestine with bacteria

223
Q

What bony structure protects the cecum?

A

The wing of the right ilium

224
Q

T/F the colon is fully retroperitoneal

A

False; only partially retroperitoneal
not free floating

225
Q

Where do the jejunal arteries arise from?

A

superior mesenteric artery

226
Q

What are the three large arteries that branch off the superior mesenteric artery?

A
  1. Middle colic artery
  2. Right colic artery
  3. Ileocolic artery
227
Q

What is the most inferior branch of the superior mesenteric artery?

A

Ileocolic

228
Q

What are the three branches of the Ileocolic artery?

A
  1. Anterior cecal
  2. Posterior cecal
  3. Apendicular artery
229
Q

What artery supplies blood to the transverse colon?

A

Middle colic artery

230
Q

What artery supplies blood to the ascending colon?

A

Right colic artery

231
Q

What are the 3 branches of the inferior mesenteric artery?

A
  1. Left colic artery
  2. Sigmoid arteries (3)
  3. Superior rectal artery
232
Q

What artery supplies the descending colon?

A

left colic artery

233
Q

What artery supplies the sigmoid colon?

A

the sigmoid branches off the inferior mesenteric artery

234
Q

Where are the marginal arteries and what is their purpose?

A

They work similarly to the arcades in the small intestine.

235
Q

Marginal arteries of the intestine are a branch off the:

A

Left colic

236
Q

What is the function of the falciform ligament?

A

Adheres the liver to the diaphragm to prevent movement

237
Q

what was the round ligament originally?

A

Umbilical cord

238
Q

What structure separates the right and left lobes of the liver?

A

round ligament

239
Q

What are the four lobes of the liver?

A
  1. left lobe
  2. right lobe
  3. quadrate lobe (anterior)
  4. caudate lobe (posterior)
240
Q

What are the three parts of the gallbladder?

A
  1. fundus
  2. neck
  3. body
241
Q

Where does the arterial blood flow to the liver originate from?

A

Celiac trunk

242
Q

Where does the right gastric arise from and when?

A

Normally comes off the proper hepatic after the common hepatic gives rise to the gastroduodenal. Can also come off before then- focus on where it goes.

243
Q

What are the two branches of the proper hepatic?

A

Right and left hepatic

244
Q

What artery does the cystic artery branch off?

A

Right hepatic

245
Q

What is the one branch of the right hepatic artery?

A

Cystic artery

246
Q

What is the first branch off the gastroduodenal?

A

supraduodenal

247
Q

What is the name of the opening that allows secretion of digestive enzymes into the duodenum?

A

Major duodenal papilla

248
Q

What two things together create gallstones?

A

Salt and Cholesterol (80-90% ppl with stones develop pancreatitis due to the bile duct blocking the outflow tract of the pancreas)

249
Q

What is the area of the cystic duct and the pancreatic duct called?

A

Hepatopancreatic ampulla

250
Q

How does bile aid in digestion?

A

by emulsifying fats

251
Q

What occurs to the bile if you eat something that doesnt contain fat?

A

the sphincter will be closed and it will be returned to be stored in the gallbladder

252
Q

What are the three digestive enzymes secreted by the pancreas?

A
  1. amylase
  2. lipase
  3. triptosyn
253
Q

What is a major complication of an ERCP?

A

pancreatitis

254
Q

What does the spleen contain?

A

RBCs: megakaryocytes (also plays a role in immune system)

255
Q

What three structures are in the renal hilum?

A
  1. Renal artery
  2. Renal vein
  3. Renal pelvis
256
Q

Describe the kidney from the outermost layer to the urethra.

A

Renal capsule -> Renal cortex -> Renal medulla/pyramid/column -> Renal papilla -> minor calyx -> Major calyx -> Renal pelvis -> Ureter -> Bladder -> urethra

257
Q

Where are the glomeruli of the kidney?

A

Renal cortex

258
Q

What is the renal papilla?

A

The area where all the glomeruli come together

259
Q

What structure is at the pole of the kidney?

A

Adrenal gland

260
Q

What is special about the kidneys?

A

they are fully retroperitoneal
they are also encased in fat to protect and allow mobility

261
Q

What part of the urinary tract is full of nerve endings?

A

Ureter

262
Q

What is special about the bladder?

A

The detrusor muscle has fibers crossing in many different directions that aids in contraction to move all the urine to the neck of the bladder to be expelled

263
Q

What are two valves in the bladder called?

A

Trigone of the bladder (contraction causes the valves to be blocked off to prevent backflow of urine into ureters)

264
Q

Why are UTIs more common in females than males?

A
  1. length of urethra
  2. men have an internal and external sphincter, while women only have external
265
Q

Distal to the branch of the inferior mesenteric artery, what occurs to the aorta?

A

branches into the left and right common iliac arteries

266
Q

What muscle runs parallel to the abdominal aorta bilaterally?

A

Psoas muscle

267
Q

What is the name of the muscle that lines the ilium of the pelvis?

A

Iliacus

268
Q

What two abdominal muscles come together?

A

Iliopsoas

269
Q

T/F there is an iliopsoas major and minor?

A

TRUE

270
Q

What are the branches of the portal vein?

A
  1. Splenic
  2. Superior mesenteric vein
271
Q

What are the two venous systems of the abdomen and what are the differences?

A
  1. Portal system (returns blood from stomach, spleen, intestines to liver for detoxify blood from food we eat)
  2. Cava system (returns blood to IVC for circulation)
272
Q

What structures are drained by the Cava venous system?

A

feet, legs, kidneys, reproductive glands

273
Q

What occurs after the blood from the GI tract goes into the portal vein?

A

It goes to the hepatic veins that eventually dump into the superior vena cava

274
Q

Where are the three areas that cava and portal venous systems are connected and why?

A
  1. Esophagus
  2. Umbilicus
  3. Rectum
    Pressure relief mechanism
275
Q

What vessel is the dilated esophageal varices in the setting of portal hypertension

A

Azygos vein branches around the esophagus

276
Q

What three things occur in the setting of portal hypertension due to the communication between the two abdominal venous systems?

A
  1. esophageal varices
  2. Captus medusa (umbilical veins)
  3. hemorrhoids
277
Q

What is the ganglion impar?

A

Where the two sides of the sympathetic chain ganglion come together at the coccygeal vertebrae

278
Q

Which abdominal nerve is immediately superficial to the psoas muscle?

A

Genitofemoral (L1,L2)

279
Q

T/F abdominal vena cava runs down the middle of the abdomen

A

False, it runs down the right side

280
Q

Which renal vein is longer, left or right?

A

Left because it has to cross over the aorta

281
Q

What can become a problem concerning the left renal vein?

A

It runs under the superior mesenteric artery so blood can back up into the kidney and the left testicle nutcracker syndrome

282
Q

Where does the left testicular/ovarian vein return blood to?

A

Left renal vein, while the right one returns to the vena cava

283
Q

Which 3 abdominal nerves have L1 roots?

A
  1. Iliohypogastric
  2. Ilio-inguinal
  3. Genitofemoral
284
Q

Which 4 abdominal nerves have L2 roots?

A
  1. Genitofemoral
  2. Lateral cutaneous
  3. Femoral
  4. Obturator
285
Q

Functionally what is the difference between the Ilio-inguinal and the Genitofemoral nerves?

A

The genitofemoral also has branches that supply the head of the femur

286
Q

Which three abdominal nerves have branches that feed the head of the femur and which can be blocked?

A
  1. Genitofemoral (block)
  2. Lateral cutaneous (block
  3. Obturator (dont block, motor and sensory function)
287
Q

Why does 40% of fetal blood from the placenta have to go through the liver?

A

to provide oxygen to it

288
Q

What causes the ducus in the fetal circulation to close?

A

The pressure change that occurs when the baby takes their first breath

289
Q

The breast tissue is mostly made up of:

A

Fatty tissue

290
Q

There is a very small difference between a mammary gland and a:

A

sweat gland

291
Q

How is the breast attached to the chest?

A

Small fibrous attachments, but no ligamentous attachments

292
Q

What two areas does the lymph from breast tissue drain to?

A

Parasternal and axillary nodes

293
Q

How much of the breast tissue is glandular?

A

1/3

294
Q

What’s the difference between the pelvis in a male and female?

A

Male: more circular pelvic canal
Female: Wider wings of ilium, more oval pelvic canal

295
Q

What are the three parts of the pelvis?

A
  1. Wing of the ilium
  2. Ichium
  3. Pubis
296
Q

What is the difference between the pubic symphysis in males and females?

A

Pubic symphysis is much thicker in men

297
Q

What two things cause differentiation in sex during embryonic development?

A

Chromosomes and hormones

298
Q

What three genital areas are present in both genders before differentiation?

A
  1. Glans
  2. Genital folds
  3. Anal tubercle
299
Q

What are the accessory sex glands that are similar in both male and female?

A

Male: Seminal vesicles, bulbourethral glands, and prostate
Female: Paraurethral gland, greater vestibular gland,

300
Q

What female accessory sex gland is the same are the seminal vesicles in the male?

A

mesonephric tubules

301
Q

What female accessory sex gland is the same are the prostate in the male?

A

paraurethral glands

302
Q

What is the function of the mesonephric tubules?

A

attach ovary to the the fallopian tube

303
Q

What does the prostate produce?

A

Prostate specific antigen and fructose (to supplement sperm), also lysosomes and antibodies

304
Q

What female gland produces similar fluid to the prostate?

A

Paraurethral gland (contains PSA and fructose)

305
Q

What is the function of the female greater vestibular glands?

A

produce a slimy fluid/lubricant

306
Q

What are the structures inside the penis?

A
  1. Corpus cavernosa
  2. Corpus spongiosum (+ urethra)
307
Q

What penile tissue allows an erection to occur?

A

Corpus cavernosa

308
Q

T/F a female has a Corpus cavernosa

A

true

309
Q

Why do the cervical folds interlock?

A

to protect baby during gestation

310
Q

Where is the egg dropped during ovulation?

A

Technically, the abdominal cavity. The fimbriae of the uterine tube “swim” the egg into the tube

311
Q

Where does fertilization of the egg actually occur?

A

The ampulla of the uterine tube

312
Q

What structures are in the suspensory ligaments in the female?

A

Ovarian artery and vein (also holds the ovary to the inferior abdomen)

313
Q

Where do the testicles go after formation?

A

Through the internal inguinal ring and external ring

314
Q

What is the mesometrium and what are the two divisions?

A

broad ligament in the female that hold everything in place
1. Mesovarium (holds ovary and uterus to body wall)
2. Mesosalpinx (holds uterine tube to ovary)

315
Q

What is the name of the pocket formed as the cervix extended into the vagina?

A

vaginal fornix

316
Q

What is the purpose of the ligament of the ovary?

A

attach the ovary to the uterus

317
Q

What does the suspensory ligament attach?

A

ovary to body wall

318
Q

What occurs when estrogen levels peak?

A

They stimulate follicle stimulating hormone

319
Q

What does follicle stimulating hormone do?

A

stimulates the ovaries to produce follicles

320
Q

How many eggs die per cycle?

A

about 1,000

321
Q

What does follicle stimulating hormone stimulate?

A

Luteinizing hormone

322
Q

What is the purpose of luteinizing hormone?

A

causes the follicle to rupture, fluid flushes it out

323
Q

What are the three divisions of the uterine tube?

A

Infundibulum, ampulla, and isthmus

324
Q

What causes the release of hGg hormone?

A

fertilized egg attachment in the uterine tube

325
Q

What is typically true regarding estrogen and progesterone?

A

inversely related

326
Q

What hormones are produced from the anterior pituitary?

A

FSH and LH

327
Q

What triggers the anterior pituitary to release FSH and/or LH?

A

estrogen

328
Q

What is the best endometrial phase for an egg?

A

secondary phase

329
Q

What hormone maintains pregnancy and where does it come from?

A

progesterone, corpus luteum until pregnancy is more mature

330
Q

What occurs once the follicle ruptures?

A

it releases the egg, then fills with blood and fibrin- is then called a corpus luteum.

331
Q

What hormone does the corpus luteum secrete?

A

progesterone, until HcG is produced then the uterus produces progesterone

332
Q

What is the purpose in progesterone?

A

causes muscle relaxation

333
Q

What is the purpose of the acrosomal cap on the sperm?

A

allows sperm to penetrate egg with proteolytic enzymes, protects DNA, assists in temperature regulation

334
Q

What structure does the male urethra go through?

A

prostate

335
Q

What is the purpose of the pampiniform (venous) plexus?

A

decrease the temperature of the arterial blood going to the testicle to preserve function of spermatogenesis

336
Q

What 3 structures are in the spermatic cord?

A
  1. Vas (ductus) deferens
  2. Testicular artery
  3. Testicular vein
337
Q

What temperature do the testicles need to maintain for spermatogenesis?

A

2-3 degrees less than body temperature

338
Q

What is the purpose of the cremaster muscle?

A

constricts/relaxes in response to temperature to control testicular temp

339
Q

What is the lining of the scrotum called?

A

Tunica Albuginea

340
Q

What is the purpose of the epididymis of the testicle?

A

storage for sperm and provide acrosomal cap

341
Q

What part of the testicle produces sperm?

A

Seminiferous tubule

342
Q

How much seminiferous tubules are in each testicle?

A

1-2 miles

343
Q

What is the path of the sperm through the testicle?

A

Seminiferous tubule -> straight tubule -> Rete testis -> efferent ductules -> head of the epididymis -> body of the epididymis -> tail of the epididymis -> ductus (vas) deferens

344
Q

When does the sperm get the acrosomal cap?

A

in the epididymis

345
Q

What is the sperm able to return into the body through the vas deferens?

A

because it receives an acrosomal cap in the epididymis

346
Q

How many sperm are ejaculated at a time?

A

20-100 million sperm

347
Q

What male accessory sex gland provides 40-60% of the liquid needed for ejaculation?

A

seminal vesicle

348
Q

How does the sperm move up the vas deferans?

A

peristalsis

349
Q

What is contained in seminal vesicle fluid?

A

fructose, lysosomes, and antibodies to protect the sperm

350
Q

What is the purpose for the bulbourethral gland?

A

produce pre-ejaculate to prepare the urethra/increase pH to prevent killing sperm ALSO neutralizes the vaginal pH

351
Q

What structure dilates when a male is sexually aroused?

A

The arteries entering the corpus cavernosum, constricts the veins- causes blood to pool, increases pressure

352
Q

What occurs to the blood vessels when ejactulation occurs?

A

the veins are dilated and the arteries are constricted, losses errection

353
Q

What nervous system is activated for an erection to occur?

A

Parasympathetic (point)

354
Q

What nervous system is activated for ejaculation to occur?

A

Sympathetic (shoot)

355
Q

What are the roots of the lumbar plexus?

A

T12-L4

Gross Anatomy (3 decks)

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