Anatomy Revision

Question 1

The coeliac trunk comes off the aorta at the level of _______ and supplies the _______

Answer 1

T12

foregut

Question 2

The superior mesenteric artery comes off the aorta at the level of _______ and supplies the _______

Answer 2

L1

midgut

Question 3

The inferior mesenteric artery comes off the aorta at the level of ______ and supplies the _______

Answer 3

L3

hindgut

Question 4

What does the foregut include?

Answer 4

stomach, liver, gallbladder, 1/2 of pancreas, part of the duodenum

Question 5

What does the midgut include?

Answer 5

1/2 pancreas, rest of duodenum to 2/3 of transverse colon

Question 6

What does the hindgut include?

Answer 6

rest of the colon to part way down the anal canal

Question 7

The abdominal aorta bifurcates at the level of ____

Answer 7

L4

Question 8

The liver has a dual blood supply from __1____

deoxygenated blood from the liver drains into ___2___

Answer 8

1) the left and right hepatic arteries (branches of the hepatic artery proper) and from the hepatic portal vein
2) hepatic veins which drain into the inferior vena cava

Question 9

The inferior vena cava arises from the confluence of the ____1____ just inferior to the _____2____ It then ascends to the posterior abdominal wall to the ___3___ of the aorta, it then passes through a ___4_____ before entering the thorax

Answer 9

1) common iliac veins
2) bifurcation of the abdominal aorta
3) right
4) fossa on the posterior surface of the liver

Question 10

The ___1_____ vein drains the hindgut and drains into the ___2____ vein

The __3____ vein drains the foregut which drains into the ____4____

The ___5____ vein drains the midgut which drains into the _____6_____

Answer 10

1) inferior mesenteric
2) splenic vein
3) splenic vein
4) hepatic portal vein
5) superior mesenteric
6) hepatic portal vein

Question 11

3 branches of the coeliac trunk?

Answer 11

splenic artery, left gastric artery and common hepatic artery

Question 12

Which branch of the coeliac trunk has a very torturous course?

Answer 12

the splenic artery

Question 13

Describe blood supply to the stomach?

Answer 13

Lesser curvature is supplied by the left gastric artery (direct branch of the coeliac trunk) and right gastric artery (branch from the hepatic artery proper). These two arteries anastomose.

Great curvature is supplied by the left gastro-mental artery which comes from the splenic artery and the right gastro-omental artery which comes from the gastro-duodenal artery. These two arteries anastomose.

Question 14

What branches does the common hepatic artery give off?

Answer 14

Gives off the gastroduodenal then two terminal branches are the right gastric and the hepatic artery proper

Question 15

What two arteries does the gastroduodenal artery give off?

Answer 15

the supraduodenal and the superior pancreaticoduodenal

Question 16

Blood supply to the gallbladder is via the _____

Answer 16

cystic artery

Question 17

Branches of the superior mesenteric artery?

Answer 17

inferior pancreaticoduodenal, middle colic artery, right colic artery, ileocolic branches, appendicular branches and jejunal and ileal arteries

Question 18

Branches of the inferior mesenteric artery?

Answer 18

left colic artery, sigmoid arteries and superior rectal artery

Question 19

Describe peritoneal pouches found in female and males?

Answer 19

Males: 1 pouch, rectovesical
Females: 2 pouches, vesicouterine and rectouterine (pouch of douglas)

Question 20

Describe an overview of the blood supply to the heart?

Answer 20

Coronary arteries are the first branch of the aorta and they supply blood to the heart
RCA supplies SA and AV nodes, RA, most of RV, some of LV and some of the septum
LCA supplies, LA, LV, some or RV, most of septum

Question 21

Describe the electrical condition route in the heart?

Answer 21

Originates in SA node, spreads by cell to cell conduction to atrioventricular node.
From AV node impulse passes by special pathway through bundle of His.
This has left and right ventricles, passes through purkinje fibres.
The Bundle of His and its branches and the network of Purkinje fibers allow rapid spread of action potential to the ventricles
Excitation of the ventricles spreads by cell to cell conduction again.

Question 22

Which two major arteries supply blood to the brain?

Answer 22

internal carotid arteries and vertebral carotid arteries

Question 23

Explain how to distinguish between an upper motor neuron lesion of the facial nerve (a stroke) vs a lower motor neuron lesion (bells palsy)?

Answer 23

To distinguish clinically between a LMN cause and UMN cause of the facial palsy, a patient with forehead sparing (i.e. no involvement to the occipitofrontalis muscle) will have a UMN origin to the palsy, due to the bilateral innervation of the forehead muscle).

Question 24

The lymphatic vessels of the lungs originate from _______1_________ All lymph from the lung leaves along the root of the lung into _____2______ and these then drain into ______3______ The inferior lobes of both lungs drain into the centrally placed ___4____ which primarily drain to the right side. The other lobes of each lung drain primarily to the ____5________ From here lymph traverses a variable number of ___6____ and enters the ______7_______

Answer 24

1) superficial subpleural and deep lymphatic plexuses
2) bronchopulmonary lymph nodes
3) inferior or superior tracheobronchial lymph nodes
4) inferior tracheobronchial nodes
5) ipsilateral superior tracheobronchial lymph nodes
6) paratracheal nodes
7) brochomediastinal trunks

Question 25

What is unusual about lymphatic drainage from the left lower lobe?

Answer 25

the lymph primarily drains to the right side whereas the rest of the lobes drain ipsilaterally

Question 26

Where does lymph from the parietal pleura drain?

Answer 26

it drains into lymph nodes of the thoracic wall e.g. intercostal, parasternal, mediastinal and phrenic

Question 27

Explain what the lines of pleural reflection are?

Answer 27

The relatively abrupt lines along which the parietal pleura changes direction as it passes from one wall of the pleural cavity to another, three lines of pleural reflection outline the extent of the pulmonary cavities on each side: sternal, costal and diaphragmatic

Question 28

What are the two recesses found in the pleural cavity? How are they formed?

Answer 28

costodiaphragmatic
costomediastinal
because the lungs don’t fill the whole cavity

Question 29

Which muscles contract every inspiration and relaxation causes passive expiration?

Answer 29

External intercostals
Diaphragm
(internal intercostals and innermosts?)

Question 30

The intercostal muscles are innervated by the _______

Answer 30

intercostal nerves

Question 31

In forced inspiration which additional muscles may be active?

Answer 31

sternocleidomastoid, scalene muscles, pectoralis major and minor

Question 32

In forced expiration which additional muscles may be active?

Answer 32

muscles of the anterolateral abdominal wall 
rectus abdominus 
external oblique
internal oblique
transversus abdominus

Question 33

The diaphragm nerve supply is _______

Answer 33

phrenic nerve, anterior rami of C3,4 and 5

Question 34

Which structures are normally palpable in the abdomen?

Answer 34

Xiphoid process/costal margin, rectus abdominis, sigmoid colon, caecum, lower border of liver, lower pole of right kidney may be palpable, abdominal aorta pulse may be palpable, full/distended bladder, enlarged uterus, sacral promontory may be palpable

Question 35

What is meant by referred pain?

Answer 35

Referred pain is pain that is felt in a different part of the body from the actual source.

Question 36

Give some examples of referred pain?

Answer 36

Examples involving the abdomen include liver/diaphragm referred to shoulder, stomach referred to between shoulder blades, pancreas referred to mid-back, kidneys referred to thighs etc

Question 37

A fracture of the surgical neck of the humerus risks injuring the __1___ which would result in ___2___ motor deficit and sensory deficit in ___3____

Answer 37

1) axillary nerve
2) loss of abduction of the shoulder
3) regimental/ badge patch area

Question 38

A fracture of the mid-shaft of the humerus risks injuring the __1__ which would result in ___2__ motor deficit and sensory deficit in ___3___

Answer 38

1) radial nerve
2) a wrist drop and possibly loss of elbow extension
3) posterior forearm, posterior hand lateral side

Question 39

supracondylar fractures and nerve injury ____

Answer 39

waiting for this to be clarified

Question 40

A posterior dislocation of the hip risks injuring the __1__ which would result in ___2__ motor deficit and sensory deficit in ___3___

Answer 40

1) sciatic nerve
2) weak extension of hip joint, flexion of knee, loss of all movements of ankle and foot
3) loss of sensation of posterior thigh, all skin inferior to knee except the medial calf

Question 41

A fibular neck fracture risks injuring the __1__ which would result in ___2__ motor deficit and sensory deficit in ___3___

Answer 41

1) common fibular nerve
2) foot drop
3) dorsal of foot, cleft between big and second toe

Question 42

The anterior surface of the heart is formed mainly by the ____1_____, the posterior surface (base of the heart ) is formed by ____2____ and the inferior (diaphragmatic) surface is formed by ____3______

The right border is formed by the ______4_______ and the left border is formed mainly by the ___5_______

Answer 42

1) right ventricle
2) both atria
3) both ventricles
4) right atrium (also IVC and SVC)
5) left ventricle (also part of the left atrium).

Question 43

Name the ‘space’ posterior to the pulmonary trunk and ascending aorta and anterior to the superior vena cava. What is the clinical significance of this space?

Answer 43

Transverse pericardial sinus – it allows cardiac surgeons to identify/clamp the ascending aorta/pulmonary trunk during surgery.

Question 44

What foramen do the two arteries that supply the brain pass through in the skull?

Answer 44

vertebral artery passes through the foramen magnum

internal carotid passes through the carotid canal

Question 45

Name 2 functions of pleural fluid?

Answer 45

allows the two layers of pleura to slide over each other during respiration
provides surface tension to prevent two layers from separating

Question 46

Where does lymph from the majority of the body drain into?

Answer 46

the left venous angle

Question 47

Where does lymph from the right superior quadrant of the body drain into?

Answer 47

the right venous angle

Question 48

The dorsalis pedis artery is a continuation of what artery?

Answer 48

the anterior tibial artery

Question 49

At what vertebral level does the arch of the aorta begin?

Answer 49

T4/T5