Anatomy Exam 3 Flashcards
To make anatomy your bitch
1
Q
Portal Triad
A
o Hepatic artery
o Portal vein
o Bile duct
2
Q
Branches of the celiac trunk
A
o Left gastric artery
o Splenic artery
o Common hepatic artery
3
Q
Portal vein is formed by union of
A
o Superior and inferior mesenteric veins
o Splenic vein
4
Q
Three layers of stomach muscle (external to internal)
A
Longitudinal, circular, oblique
5
Q
Structures supplied by the celiac trunk
A
Liver, gallbladder, inferior esophagus, stomach, pancreas, spleen, and duodenum
6
Q
Passage of the superior mesenteric artery between the pancreas and duodenum
A
The artery passes deep to the pancreas and superficially to part 3 of the duodenum
7
Q
The common hepatic artery divides into
A
Hepatic artery proper and gastroduodenal artery
8
Q
The splenic artery gives rise to the following arteries
A
Splenic branches, left gastro-omental, posterior gastric, short gastric arteries
9
Q
The gastroduodenal artery divides into
A
Right gastro-omental and anterior superior pancreaticoduodenal artery
10
Q
The pancreas is greedy with blood supply and grabs it from
A
Common hepatic, gastroduodenal, pancreaticoduodenal, splenic, and superior mesenteric arteries
11
Q
Sites of the mesocolons
A
Transverse mesocolon and sigmoid mesocolon (there is also a mesoappendix)
12
Q
Fun facts about the descending colon
A
It is the narrowest part of the large intestine and is retroperitoneal
13
Q
Structure of arteries in jejunum
A
Short arcades and long vasa recta
14
Q
Structure of arteries in ileum
A
Long arcades and short vasa recta
15
Q
Marginal artery
A
Connect the superior and inferior mesenteric arteries. Supplies blood to the colon and runs along the MARGIN on the colon
16
Q
Four lobes of the liver
A
Right, left, caudate, and quadrate
17
Q
Where does the portal triad enter the liver?
A
At the porta hepatis
18
Q
The hepatic portal vein drains blood from what organs?
A
The GI tract, spleen, pancreas, gallbladder, and sinusoids of the liver.
19
Q
The common bile duct enters where in the duodenum?
A
the Hepatopancreatic ampulla, which is on the 2nd (descending) part of the duodenum
20
Q
Quadrate lobe of the liver is next to
A
The gallbladder
21
Q
The caudate lobe of the liver is next to the
A
IVC
22
Q
The closed ductus venosus becomes
A
ligamentum venosum
23
Q
The obliterated umbilical vein becomes
A
Ligamentum teres
24
Q
Ligaments of the spleen and what they contain (HINT: think about the branches of the splenic artery)
A
Gastrosplenic ligament (short gastric vessels and left gastro-omental vessels) and splenorenal ligament (splenic vessels and the tail of the pancreas)
25
Location of the taenia coli
Ascending, transverse, descending, and sigmoid colon. It is not present in the rectum. Duh.
26
Big-ass tendon on the diaphragm is called
the central tendon of diaphragm
27
What runs through the median arcuate ligament?
The aorta
28
The nerve located below the 12th rib is called
the subcostal nerve
29
This nerve pierces the psoas muscle
Genitofemoral
30
Occasional variations of the kidney
More than two kidneys, horseshoe kidney, multiple ureters,
31
Number of lumbar arteries and veins
4 lumbar arteries
| 5 lumbar veins
32
Location of drainage from left and right testicular/ovarian veins
Left testicular goes to left renal vein
| Right testicular goes directly to the IVC
33
The gastro-omental arteries are also called ______
Gastroepiploic arteries
34
Number of sigmoid arteries
4
35
What is the terminal branch of the inferior mesenteric artery?
The superior rectal artery
36
What is the critical point?
The point at which the last artery to the colon branches from the superior rectal artery. Past this point, there are poor or no anastomotic connections
37
Inferior phrenic arteries supply blood to _______
The suprarenal glands. These glands have a rich blood supply from multiple arteries.
38
Everything that developed from where drains into the portal system?
The foregut, midgut, and hindgut
39
Was the kidney multilobular during development?
Oh hell yea.
40
The portal vein is made of what three veins?
Superior and inferior mesenteric veins and the splenic vein
41
What veins drain blood from the liver to the IVC?
The hepatic veins
42
Anastamoses can occur between the portal vein and the IVC called _______
Portocaval anastamoses
43
Which artery supplies the small intestine?
Superior mesenteric
44
The nutcracker is comprised of what three vessels?
The AA, SMA, and left renal vein
45
Left crus of the diaphragm is inserts where?
Body of L2
46
Right crus of the diaphragm inserts where?
Body of L3
47
The cremaster nerve is innervated by ____
genitofemoral nerve
48
Structures derived from foregut and it's blood supply
Esophagus, stomach, duodenum, liver, gallbladder, pancreas, and spleen. These get their blood supply from the celiac artery.
49
Structures derived from midgut and it's blood supply
Lower duodenum, jejunum, ileum, cecum, appendix, ascending colon, hepatic flexure, and proximal two thirds of the transverse colon. These structures are supplies by the superior mesenteric artery.
50
Structures derived from hindgut and it's blood supply
Distal 1/3 of the transverse colon, descending colon, sigmoid colon. These are supplied by the inferior mesenteric artery.
51
The salcral plexus is formed from what nerves?
The ventral rami of S1-3 and part of S4
52
Who's the smartest person in the anesthesia program?
You are!
53
Muscles supplied by the subcostal nerve
ALL the abdominal muscles: external and internal oblique, transversus abdominis, rectus abdominis, and pyramidalis.
54
Path of the ilioypogastric nerve
Pierces the transversus abdominis near the iliac crest, runs along until it pierces the internal oblique near the ASIS, eventually exiting to become cutaneous.
It innervates the transversus and internal oblique
55
Path of ilioinguinal nerve
Runs around the wall, pierces the transversus near the ASIS, pierces the internal about halfway down the inguinal ligament and enters the spermatic cord.
56
The lumbosacral trunk is made of what nerves?
Lower part of L4 and all of L5
57
Names of the splanchnic nerves and the ganglia they enter
T5-T9 form the greater splanchnic nerve which goes to the celiac ganglion
T10 and T11 form the lesser splanchnic and goes to the superior mesenteric ganglion
T12 becomes the least splanchnic and also goes to the superior mesenteric ganglion
L1-3 form the lumbar splanchnic and goes to the inferior mesenteric ganglion
58
Adrenal medulla is formed from _____
Neural crest material
59
Do we have PSNS fibers in the upper of lower limbs?
No
60
The greater splanchnic nerve enters this ganglion
Celiac
61
The lesser and least splanchnics enter what ganglion?
Superior mesenteric
62
The lateral arcuate ligament passes over what muscle?
Quadratus lumborum
63
What is contained within the medial arcuate ligament?
The psoas muscle and sympathetic chain
64
The psoas and iliacus muscles insert where on the femur?
The lesser trochanter
65
Branch from the external iliac artery
Inferior epigastric artery
66
The glans penis is formed by the terminal part of ______
Corpus spongiosum
67
Innervation of the scrotum
Anterior scrotal branch of the ilioinguinal nerve and the posterior scrotal branch from the perineal branch of the pudendal nerve.
68
The pudendal nerve exits through the greater sciatic foramen between what two muscles?
The piriformis and coccygeus
69
What are the nerve origins of the pudendal nerve?
S2-4
70
What is the terminal branch of the pudendal nerve?
The dorsal nerve of penis (or clitoris)
71
Branches of the perineal nerve
Deep branch- supplies all of the perineal muscles
Superficial branch- (posterior scrotal/labial branch) supplies the scrotum or labia majora
72
Drainage of veins from penis and clitoris
Deep dorsal vein of penis- drains into prostatic and pelvic venous plexuses
Superficial dorsal vein of penis- drains into the external pudendal vein, which leads to the great saphenous vein.
Deep dorsal vein of clitoris- ends in lower part of vesical plexus
73
The round ligament of the uterus is analagous to what male counterpart?
The gubernaculum
74
The round ligament of the uterus begins and terminates where?
From the broad ligament to the labia majora (the lady-sac)
75
What passes over the ureter in the male and female?
Female- uterine artery
Male- vas deferens
76
Venous blood from the bladder drains to _______
the prostatic or vesical plexuses of veins
77
The urogenital diaphragm consists of what two muscles?
The sphincter urethrae and the deep transverse perineal muscles
78
The pelvic diaphragm consists of what muscles?
The levator ani and coccygeus muscles
79
What structure provides the most support for the uterus?
The pelvic diaphragm, specifically, the levator ani.
80
Divisions of the internal iliac artery
Posterior division- gives rise to the iliolumbar, lateral sacral, and superior gluteal arteries
Anterior division- gives rise to the inferior gluteal, internal pudendal, umbilical, obturator, superior and inferior vesical arteries, middle rectal, and uterine arteries.
81
The inferior vesical artery in men will be what artery in women?
Vaginal artery
82
Where does the ovarian artery arise from?
The abdominal aorta
83
Name of the obliterated foramen ovale
Fossa ovalis
84
The obliterated umbilical vein becomes
Ligamentum teres
85
The obliterated ductus venosus becomes
ligamentum venosum
86
The obliterated umbilical arteries become
The medial umbilical ligaments
87
The obliterated ductus arteriosus becomes
Ligamentum arteriosum
88
The pleura of the lungs are innervated by what nerves?
The intercostal nerves and the phrenic nerves. The parietal pleura is very sensitive to pain.
89
The pericardium encloses what?
The heart and the roots of the great vessles
90
Joint between the rib and the cartilage of the rib
Costochondrial joint
91
Junction between the manubrium and the sternum is called
Sternal angle
92
Number of costal notches in the sternum
7
93
The right pulmonary artery passes between what two structures?
The right superior and middle lobar bronchi
94
The Left pulmonary artery passes over what?
The left superior lobar bronchus
95
The first two intercostal arteries come from where?
The costocervical trunk
96
The superior epigastric artery arises from what artery?
The internal thoracic artery
97
Referred anginal pain comes from what nerves?
Supraclavicular
98
The internal thoracic artery bifurcates into what two arteries?
The superior epigastric and musculophrenic.
99
Pericardial sinus that you are able to pass all the way through
The transverse pericardial sinus
100
Which coronary artery is referred to as the widow-maker?
The anterior interventricular
101
The anterior cardiac veins drain directly where?
To the right atrium
102
All cardiac veins except _______ drain into _______
1) except anterior cardiac veins
| 2) Coronary sinus
103
The SA nodal branch of the coronary arterial system from from what artery?
From the right atrial brach, which is a branch off the right coronary
104
What is the moderator band?
A muscular band of heart tissue found in the RV that brings cardiac impulses to the anterior papillary muscle. It also functions to prevent over-distention of the ventricle.
105
Number of papillary muscles in the RV
3. Anterior, posterior, and septal (one for each leaflet)
106
Weird, spider-web like musculature that makes up the wall of the ventricles
Trabeculae carneae
107
Number of papillary muscles in the L ventricle
2. Anterior and posterior (one for each leaflet)
108
Small part in the middle of each leaflet on the aortic valve to make a complete seal
Nodules
109
What articulates with the manubrium?
The clavicle, first rib, half of the second rib, and the sternum.
110
Which rib articulates at the sternal angle?
The second rib
111
What ribs articulate with the sternum?
The 2nd through 7th
112
What are the true ribs?
Ribs 1-7, which are connected to the sternum by their
113
What are the false ribs?
Ribs 8-12
114
What is the most important joint in the entire universe?
Sternoclavicular. Although Snoop Dogg would disagree.
115
Where are the intercostal nerves located?
On the inferior surface of the ribs
116
Muscles of inspiration
Diaphragm; external, internal (interchondral part), and innermost intercostals; SCM, levator costarum, serratus anterior, scalenus, pec major and minor, and serratus posterior superior.
117
Muscles of expiration
Muscles of the anterior abdominal wall, internal intercostal (costal part), and the serratus posterior inferior.
118
Where does the thoracic duct drain into?
The left subclavian vein
119
The ligamentun arteriosum connects what two structures?
The left pulmonary artery and the arch of the aorta
120
The bronchial arteries arise from what vessel?
The thoracic aorta
121
Which is larger, that right or left atrium?
The right is larger, however, it has thinner walls
122
The rounded upper margin of the fossa ovalis is called ______
The limbus
123
This is the most posterior chamber of the heart
The left atrium
124
This cardiac vein travels with the anterior IV artery
Great cardiac vein
125
This cardiac vein travels with the posterior IV artery
Middle cardiac vein
126
This cardiac vein travels with the right marginal artery
The small cardiac vein
127
Function of the ductus venosus
Shunts oxygenated blood from the umbilical vein to the ICV, partially bypassing the liver (portal circulation)
128
Drainage of the azygous vein
The azygous vein arches over the root of the right lung and empties into the SVC
129
The vagus nerve supplies what?
All of the thoracic and abdominal viscera, except the descending and sigmoid colon and the viscera of the pelvis. The pelvic viscera are supplied by the pelvic splanchnic nerves, from S2-4
130
The posterior vagal trunk is formed by
The right vagus nerve
131
The anterior vagal trunk is formed by
The left vagus nerve
132
This is the most anterior chamber of the heart
The right ventricle
133
What is Ryan's favorite color?
Blue
134
At which intercostal space is the apex of the heart located?
The left 5th intercostal space
135
Modalities carried by the white rami communicantes
Pre-gangionic sympathetic GVE and GVA fibers.
136
The cardiac notch and lingula are located on what lobe?
The left superior lobe
137
The superior intercostal vein is formed by the union of which veins?
2-4 posterior intercostal veins
138
Path of the pudendal nerve
Formed from S2-4 and leaves the pelvis through the greater sciatic foramen below the piriformis and enters the perineum via the lesser sciatic foramen and the pudendal canal in the lateral wall of the ischiorectal fossa
139
These are the only splanchnic nerves that carry PSNS fibers
The pelvic splanchnic nerves
140
The large bony prominence at the top of the sacral spine
The sacral promontory
141
This is the only intraperitoneal structure in the pelvis
The uterine tubes
142
Primary function of the sacral sympathetic trunks
To provide postsynaptic fibers to the sacral plexus for sympathetic innervation of the lower limbs. Gray rami from the sacral ganglia are sent to each anterior rami of the sacral and coccygeal nerves. Branches from the gray rami are also sent to the median sacral artery and the inferior hypogastric plexus.
143
What nerve bundles combine to form the hypogastric plexus?
The pelvic splanchnic nerves and the hypogastric nerves.
144
Main arteries that enter the true pelvis
The internal iliac (that produces anterior and posterior divisions), the median sacral, the paired gonadals (from the aorta), and the superior rectal.
145
Branches that come off the external iliac artery
The deep circumflex iliac and the inferior epigastric
146
Rather than having a uterine artery that gives rise to the vaginal artery, men have ______
An inferior vesicle artery that gives rise to a prostatic artery
147
What is a good landmark to find the ureter?
The ureter normally traverses over the bifurcation of the common iliac artery
148
The ejaculatory duct is formed by the combination of _______
The ductus deferens and the duct of the seminal gland
149
The ischiorectal fossa contains _______
A special type of liquified fat cell that allows for distention of the rectum
150
Construction of the urogenital diaphragm
From superficial to deep:
1) Perineal membrane (inferior fascia)
2) Muscular layer (external urethral sphincter and deep transverse perineal muscle)
3) Superior fascia of the urogenital diaphragm
151
What is the deep perineal pouch?
It is a potential space containing muscles and vessels located between the perineal membrane and the superior fascia of the urogenital diaphragm. It contains two muscles: the external urethral sphincter and the deep transverse perineal muscle.
152
What is the superficial perineal pouch?
Space between the perineal membrane and the skin. It contains the external genitalia, muscles for those genitalia, and the nerves and vessels that supply them.
153
The perineal membrane gives attachment for ______
The external genitalia
154
What forms the body of the clitoris?
The two crura of the clitoris join together to form the body
155
Why is the perineal body important?
It is the main anchoring point of the muscles of the perineum
156
Three muscles found in the superficial perineal pouch of the male
Bulbospongiosus, ischiocavernosus, and the transverse perineal.
157
The pudendal canal is formed by what and encloses what?
Formed by the obturator membrane and encloses the pudendal nerve, artery, and vein.
158
What passes through the lesser sciatic foramen?
The obturator internus, pudendal nerve, internal pudendal artery and vein
159
What is in the spermatic cord?
Good question.
160
Deep dorsal vein of the penis drains into
the prostatic venous plexus
161
The superficial dorsal vein of the penis drains into
the superficial external pudendal vein
162
Veins from the scrotal sac return to the _______ while veins from the the _____
From sac to the indernal pudendal vein, and from right testicle to IVC and left testicle to L renal vein
163
Nerve innervating the cremaster muscle
Genitofemoral
164
Nerve providing cutaneous innervation of the spermatic cord
Ilioinguinal nerve
165
Is the membranous urethra located in the deep or superficial perineal space?
Deep
166
Borders of Hasselbach's Triangle and what type of hernia occurs here?
Inguinal ligament, rectus abdominis muscle and the inferior epigastric vessels. Direct inguinal hernias occur here.
167
The pelvic diaphragm is formed by _______ while the urogenital diaphragm is formed by _______
1. Levator ani and coccygeous
| 2. Sphincter urethrae and the deep transverse perineal
168
The pericardiacophrenic artery is a branch of what artery?
Internal thoracic
169
The inferior rectal artery is a branch of what artery?
The internal pudendal artery
170
Sympathetics reaching the liver and gallbladder synapsed in what ganglion?
Celiac
