Anatomy HSF II Lecture 1 Flashcards
Ribs that attach Vertabrae to Sternum
True Ribs 1-7
Cartilages that attach to cartilages of ribs superior
False Ribs 8-10
Ribs that have cartilages ending in posterior abdominal wall musculature
Floating Ribs
Cartilages of 7-10 combine for form ?
Infrasternal Angle
Boundaries of Superior thoracic Apperature
Ist thoracic vertabrae, Ist Pair of Ribs and Superior Border of Manubrium, 1st pair of ribs and 1st vertebrae
Levator Costae
O: Transverse Processes of Vertabrae
I: Inferior Rib
F: Weakly Elevate the rib at their angle
Serratus Posterior Superior
O: Spinous Processes under thoracic Vertabrae; I: Ribs 3-6. Raises the Ribs
Serratus Posterior Inferior
O: Lumbar Vertabrae to Lower ribs 9-10. Function Depresses the ribs
Scalene
O: Transverse Process Cervical Spine. I: Anterior and Middle : Rib 1. Posterior: Rib 2. Functio: Flex neck. Elevate Respiratory Organs. (insertion and origin reverse when needed for respiration such as asthma). Usually just holds neck stable
Intercostal Space
Located Between Innermost and Internal Innercostal. VAN (Vein : suprior) Nerve: inferior. Nerve: Ventral Ramus, Somatic motor to innercostal muscles and sensory to skin overlying costals
In terms of introducing a needle to interocostal space where does the nerve lie and where should the needle go
Nerve lies inferior to ribs and the needle should only go to superior border of the ribs
Hemiadaphram
Paralysis of one side of diaphragm, paradoxical movement. The side working goes down increases abdominal pressure and it pushes up on the side not working. Side not working elevated higher than it should be
Two Parts of Diaphragm
Muscular Part with fibers converging to Central Tendon
Central Tendon which is aponeurotic and fused with inferior surface of pericardium
3 muscular parts of the diaphgram
Sternal: Attaches diaphragm to posterior Sternum
Costal: Attaches Diaphgram to costal Cartilages
Lumbar: Attaches diaphgram to Crura
Originiations of Right and Left Crus of Lumbar portion of diaphgram
Right Crus: First 3 lumbar vertabrae
Left Crus: First 2 Lumbar Vertabrae
Ligament that passes over the aorta from Diaphgram
Median Arcuate LIgament
Ligaments that pass from diaphgram over psoas and quadratus lamborum
Medial and Lateral Arcuate Ligaments
Vena Cava foramen for Inferior Vena Cava inserts?
Central Tendon T8-T9 disc
Contents of Central Tendon
Inferior vena Cava, Right Phrenic Nerve, Lymphatic Vessels
Contents through Right Crus at T-10 Esophageal Hiatus
Esophagus, Vagal Trunks, Esophageal Branches of left gastric Vessels
Aortic Hiatus Location
Posterior to Diaphgram between Crura and T-12
Contents of Aortic Hiatus
Aorta, Thoracic Duct, Azygous Vein
Impact of Contraction of Diaphgram on Vena Cava Aorta and Esophagus
Esophagus contract: prevents stomach contents from going into esophagus
Vena Cava: Dilates increases blood Flow
Aorta: No impact on it because it doesnt pass diaphgram
Condition where esophagus isn’t able to keep stomach contents from going into thorax
Hiatal Hernia
Pericardiophrenic Aretery
Comes from Internal Thoracic Artery, runs alongside Phrenic Nerve. Supplies Pericardium and Diaphgram
Musculophrenic Artery
Branches of Internal Thoracic artery and gives some blood to diaphgram
Superior Phrenic artery
Comes off the aorta and supply superior part of diaphgram
Inferior Phrenic Artery
Once aorta goes behind diaphgram it gives off inferior phrenic. It supplies the inferior diaphgram
Motor Innervation of Diaphgram
C3 C4 C5 keeps you alive
Sensory of Diaphgram
Phrenic Nerve: Central Portion
Intertcostal Nerves T7-T 12: Peripheral parts
Autonomic Innervation Overrides what?
Somatic Innervation
Fusion of four structures that form the diaphgram
Septum transversum , Dorsal Esophgeal mesentry, peripheral rim of body wall, Pleruperitoneal membranes
Septum Transversum origination
Mesoderm that originally develops from cervical myotomes and then migrates caudally. It is innervated by Cervical Spinal Cord Segments
Herniea caused by congenital Abnormalities of diaphgram
Foramen of morgani, Foramen of Bochdalek, Central Tendon Deficiency and large esophgeal hiatus
Acquired Herniae
Sliding: Upper stomach and lower esophagus slide upwards together when patient bends or lies down
Rolling: Cardia remains in normal position and fundus rolls upwards. (no regurgitation)
What lies in the Fatty tissue of breast
15-20 lobes of grandular tissue
Where are mammary glands drained?
At nipple by lactiferous ducts
Pigment around nipple
Areola
What happens to Lobules during lactation
Smaller
What supports the lobules
Connective tissue suspensory ligaments
Space between breast tissue and pectoral Fascia
Retromammary Space
Scrinched Skin around lymphatic system infected. Builds up in dermis around hair follicle
Peau d’ Orange
What fills up during cancer and causes assymetery as breast moves up and down pectoral wall
Retromammary Space
What is important part of breast tissue, not normally thought of as part of breast
Axillary Tail
Arterial supply to breast is via mammary branches of
Internal Thoracic, Lateral Thoracic, Thoracoacromial and posterior intercostal arteries (this branches from thoracic aorta)
Venous drainage occurs via tributaries to
Axillary Vein and internal thoracic vein
Why is lymphatic drainage important?
Due to its roll in breast cancer
Apporximately 75% of lymphatic drainage occurs to
Lateral, subscapular, central, pectoral and apical Lymph nodes
Axillary nodes not usually involved in breast ancer
Lateral and Subscapular
Nodes involved in cancer
Apical Pectoral Central
25% drainage goes to
infraclavicular, supraclavicular and parasternal Nodes
Interpectoral Node
Between pec major and minor. Dangerous to drain here
Positive cancer biopsy of this node indicated cancer probably spread to blood
Scalene Node Cancer in supraclavicular area
Path of Lymph
Pectoral to central to apical
