Anatomy unit 4 lecture - combined Flashcards
cardiopulmonary developmental milestones
22nd day pericardial cavity forms; the elongates to form truncus arteriosus (aorta); bulbous cordis (pulmonary trunks); ventricle; atrium; sinus venosis; bends on 23rd day; interatrial and interventricular walls form weeks 4-8;
atrial septal defect
lead to congestive heart failure; atrial arrythmias; stroke; usually right side heart failure; excess blood flow to R atrium
ventricular septal defect
increased blood flow to R ventricle; similar symptomsm as atrial septal defect
defects in Tetralogy of Fallot
ventricular septal defect; overriding aorta which straddles the VSD; pulmonary stenosis; R ventricular hypertrophy
superior mediastinum
area above heart; above sternal angle and T4-5 intervertebral space (transverse thoracic plane)
anterior mediastinum
in front of heart
posterior mediastinum
behind heart
middle mediastinum
heart and pericardial sac
positional landmarks of heart
apex of left ventricle at 5th intercostal space 3.5 inches from midline; base points superior posterior towards right shoulder
layers of pericardium
fibrous outer sac; serous pericardium includes parietal and visceral
transverse pericardial sinus
posterior wall of pericardial sac; passage between aorta/pulmonary trunk and superior vena cava
oblique pericardial sinus
between (pulmonary veins; inferior vena cava) and left atrium; lies posterior to heart
obtuse margin of heart
lies next to lung
acute margin of heart
lower part of heart; lies on diaphragm
left coronary artery
supplies left atrium; ventricle; portions of septum; branches into circumflex and left anterior descending
right coronary artery
supplies right atrium; ventricle; SA node; posterior portion of left ventricle
small cardiac vein
sits in AV groove
middle cardiac vein
parallels right coronary artery
limbus of heart
surrounds fossa ovalis
pectinate muscles
found in right atrium
tricuspid valve
between right atrium and ventricle
prenatal blood flow
oxygenated blood through umbillical VEIN; hepatic portal vein first; ductus venosus joins inferior vena cava to right side of heart; free flow through foramen ovale mostly R->L; ductus arteriosus branch off pulmonary arteries for a lot of blook to bypass lungs; aorta to body; branches from internal iliac go back through umbilical arteries to mother
transition from prenatal to postnatal
BP falls in inferior vena cava and R atrium; pressure differential b/w atria causes foramen ovale to close; aeration of lungs accompanied by fall in pulmonary vascular resistance
conducting system of heart
SA node; AV node; pause; interventricular bundle branches of purkinje cells to bottom of ventricles; papillary muscles contract beginning at apex of heart to empty ventricles
intrinsic rates of conducting system
SA node 60-80; AV node 40-50; purkinje fibers 30
sympathetic control of heart
directly from T1-4 spinal nerves; indrectly from cervical ganglia to cardiac plexus
parasympathetic controlk of heart
vagus nerve
costodiaphragmatic recesses
where ribs meet diaphragm
costomedial recesses
area behind sternum anterior to heart
order of things running in intercostal space
VAN from superior to inferior; in subcostal groove (below rib)
thoracic duct
cysterna chyli at L1-2; runs just anterior to vertebral bodies between aorta and azygos vein; terminates left venous angle (union of left jugular and subclavian veins)
right lympatic duct
drains only right arm and right thorax; empties into right venous angle
segmental levels of sympathetic chain innervating viscera in mediastinum
T5-12
diaphragmatic hiatuses
aortic hiatus (aorta; thoracic duct; greater splanchnic nerves; azygos and hemiazygos veins; median arcuate ligament); esphogeal hiatus; lateral arcuate ligaments (quadratus lumborum); medial arcuate ligaments (psoas); Caval opening (inferior vena cava)
costal facets on thoracic vertebrae
T1-full facet and a half facet; T2-8 half facets; T9 superior demi facet; T10-12 full facets
tubercle of rib articulates with ____ vertebrae
same; transverse process
quiet inspiration and expiration
mostly diaphragm and external intercostals
forced inspiration
first two ribs elevated by contraction of scalenes and SCM; all intercostals; serratus posterior superior; levators costorum; sacrospinalis; diaphragm
forced expiration
quadratus lumborum; intercostals; serratus posterior inferior; abdominals
parent arteries of intercostal arteries
aorta and internal thoracic arteries
radiate ligament of ribs
surrounds head of rib and articulation with vertebral body
lateral costotransverse ligaments
transverse process to rib
superior costotransverse ligaament
runs from superior aspect of one rib to transverse process above it
intertransverse ligaments
transverse process to transverse process
rib angle
sternal to articular facets
xyphoid process articulates with rib ___
7
kidney location
retroperitoneal; T12-L3; anterior to quadratus lumborum; lateral to psoas major
spleen location
intraperitoneal; left side of superior lateral abdominal quadrant; posterior to ribs 9-11; between stomach and diaphragm
renal artery/vein orientation
vein anterior to artery; left renal vein goes under superior mesenteric artery; renal arteries direct branches from aorta; renal veins drain into inferior vena cava
urine path
glomerulus; proximal convoluted tubule; loop of henle; distal convoluted tubule; collecting duct; minor calyx; major calyx; renal pelvis; ureter (in hilum)
PNS innervation to kidney and spleen
vagus
SNS to kidney and spleen
thoracic splanchnics (kidney primarily least splanchnic)
spleen white pulp
largest lymphoid organ (secondary); location of lymphocyte maturation and proliferation
spleen red pulp
prenatally: hematopoietic; postnatally: destroy old RBC; recycle iron; store RBC and platelets
scrotal layers; superficial to deep
scrotal skin; dartos fascia; external spermatic fascia; cremaster muscle; internal spermatic fascia
developmental equivilants
clitoris=glans penis (both have curua); scrotum=labia majora; midline raphe=labia minora
two ducts that merge to form ejaculatory duct
ductus deferens; seminal vesicles
sections of broad ligament
mesometrium (uterus); mesosalpinx (fallopian tubes); mesovarian (ovaries)
round ligament of uterus
bilateral; anterior/lateral; connect uterus to inguinal canal
uterosacral ligament
connects uterus to sacrum; posterior/lateral
proper ovarian ligament
ovary -> uterus
suspensory ligament of ovary
contains ovarian artery and vein
sections of fallopian tube
(ovary); fimbria; infundibulum; ampulla; isthmus; (uterus)
PNS nerve supply to genitals
pelvic splanchnic; S2-4; synapse on organ walls
SNS nerve supply to genitals
sacral splanchnic; S1-4 to inferior hypogastric plexus
contents of pudendal canal
pudental nerve; internal pudendal artery and vein
three rectal artery parent branches
internal pudendal->inferior rectal; anterior div of internal iliac->middle rectal; inferior mesentaric->superior rectal
contents of urogenital triangle
SUPERFICIAL: bulbospongiosus; ischiospongiosis. superficial transverse perineal; DEEP: sphincter urethra; deep transverse perineal
contents of anal triangle
levator ani (puborectalis; pubococcygeus; iliococcygeus); coccygeus; piriformis
three branches of pudendal nerve (S2-4)
inferior rectal; perineal branches; dorsal nerve to penis/clitoris
external intercostal OIAN
O: inferior border of rib above; I: Superior surface of rib below; A: Elevate ribs by pulling them closer together; N: intercostal n
internal intercostal OIAN
O: inferior border of rib above; I: Superior surface of rib below; A: Elevate ribs by pulling them closer together; N: intercostal n
innermost intercostal OIAN
O: close to the articulation of the rib with transverse process; I: anterior to membranous portion of internal intercostals; A: draw ribs together and if supported from above elevate ribs; N: intercostal n
subcostal OIAN
O: rib near angle in lower thoracic area; I: 2-3 ribs below on superior border of rib; A: draw ribs together; N: intercostal nn
transversus thoracis OIAN
O: lower 1/3 body of sternum; I: lower border of ribs 2-6 (direction up and out); A: draw ribs down; N: intercostal T1-8
levators costarum OIAN
O: TP of C7-T12; I: outer surface of rib below between tubercle and angle (down and out); A: raise ribs; N: posterior rami of thoracic spinal nerve
Serratus posterior superior OIAN
O: ligamentum nuche and SP C7-T3; I: upper borders and external surfaces of ribs 2-5; A: elevate ribs for inspiration: N: intercostal T1-4
serratus posterior inferior OIAN
O: SP T11-L3; I: inferolateral ribs T9-12; A: uncertain; N: anterior rami spinal nerve T9-12
diaphragm OIAN
O: dorsum of xyphoid process; lower ribs; lumbocostal arches above bodies of L1-2; I: central tendon; A: draw central tendon down increasing thoracic volume; N: phrenic C3-5
anterior scalene OIAN
O: TP of C3-6; I: 1st rib; A: elevate 1st rib; flex and lateral bend lower cervical spine; N: C4-6
middle scalene OIAN
O: TP of C2-7; I: 1st rib; A: laterally bend c-spine and elevate rib; N: C3-8
posterior scalene OIAN
O: TP 5-7; I: 2nd rib; A: laterally flex lower cervical spine and elevate 2nd rib; N: C6-8
sternocleidomastoid innervation
C1-2 and CN 12 (spinally accessory)
quadratus lumborum OIAN
O: iliac creast; iliolumbar ligament; I: Inferior border rib 12 and TP L1-4; A: extend and laterally flex lumbar spine; depress last rib; fix last two ribs during respiration; N: anterior rami T12-L4
puborectalis OIAN
most medial levator ani muscle; pudendal nerve S2-3
pubococcygeus OIAN
O: dorsal surface of pubis; I: forms sling around anus; inserts into sacrococcygeal ligament A: maintain normal function of external anal sphincter; N: pudendal S-2
iliococcygeus OIAN
outer levator ani O: tendinous arch of true pelvic rim (ATLA); I: coccyx and anococcygeal raphe
coccygeus OIAN
tail wagging muscle O: apex of ischial spine and sacrospinous ligament; I: margin of coccyx and lowest part of sacrum; A: draws coccyx forward; N: sacral spinal nerves S3-4
piriformis OIAN
O: surface of sacrum; pelvic sacral foramina: I: superior border of greater trochanter; I: L5-S2 nerve to piriformis
obturator internus OIAN
innervation nerve to obturator internus L5-S1
cremaster OIAN
O: inguinal ligament; pubic tubercle and pubic crest; I: loop: A: pulls testes up; N: genital branch of genitofemoral L1-2