B Pages Flashcards
Endothoracic fascia
lines the thorax between the intercostal muscles and the pleura; equivalent to the transversalis fascia of the abdomen
Superficial abdominal fascia
- Superficial fatty layer (Camper’s fascia)
- Deep membranous layer (Scarpa’s fascia)
- Deep membranous layer (Scarpa’s fascia)
continuous with the superficial fascia of the scrotum
Transversalis fascia
between the transversus abdominis muscle and the extraperitoneal fat; continuous with the pelvic fascia (epimysium of the iliacus muscle)
Renal fascia
details- separates the perirenal and pararenal layers of fat surrounding the kidney
Superficial fascia of the penis and scrotum
continuous with Scarpa’s fascia of the anterior abdominal wall and the superficial perineal fascia (Colle’s fascia)
Deep penile fascia (Buck’s fascia)
surrounds the corpus spongiosum and the corpora cavernosum
External spermatic fascia
continuous with the aponeurosis of the external oblique muscle
Cremasteric fascia
continuous with the internal oblique muscle
Internal spermatic fascia
continuous with the transversalis fascia
Abdominal fascia list
- Superficial abdominal fascia
- Transversalis fascia
- Renal fascia
- Superficial fascia of the penis and scrotum
- Deep penile fascia (Buck’s fascia)
- External spermatic fascia
- Cremasteric fascia
- Internal spermatic fascia
Pelivs and Perineum fascia list
- Superficial perineal fascia (Colle’s)
- Perineal membrane
- Obturator fascia
- Fascia of the pelvic diaphragm
Superficial perineal fascia (Colle’s)
continuous with the superficial fascia of the penis and scrotum; defines the superficial boundary of the superficial perineal space (pouch)
Perineal membrane
defines the deep boundary of the superficial perineal space (pouch) and the inferior (superficial) boundary of the deep perineal space (pouch)
Obturator fascia
covers the pelvic surface of the obturator internus muscle
Tendinous arch of the levator ani
attachment for the levator ani muscle
Fascia of the pelvic diaphragm
- Inferior fascia (anal fascia)
- Superior fascia
Inferior fascia (anal fascia)
covers the inferior surface of the levator ani and coccygeus muscles
Superior fascia
covers the superior surface of the levator ani and coccygeus muscles
Obturator fascia compenent
Tendinous arch of the levator ani
Thoracic cage joints
- Costovertebral (costocorporeal)
- Costotransverse
- Sternocostal
Sternocostal
synovial classification- plane
Costovertebral (costocorporeal)
synovial classification- plane
Costotransverse
synovial classification- plane
Pelvis joints
- Lumbosacral
- Sacroiliac
- Pubic symphysis
Lumbosacral
classification- symphysis
Sacroiliac
synovial classification- plane
Pubic symphysis
classification- symphysis
pelvic ligaments
- Inguinal (L. inguen, groin)
- Sacroiliac
- Sacrospinous
- Sacrotuberous
Inguinal (L. inguen, groin)
attachments- from anterior superior iliac spine to pubic tubercle
- Lacunar (L. lacus, pit, hollow or lake)
- Pectineal
Lacunar (L. lacus, pit, hollow or lake)
attachments- from medial end of inguinal ligament to medial end of pecten pubis
Pectineal
attachments- to pectin pubis
Sacroiliac
- Ventral
- Dorsal
- Interosseous
Dorsal Sacroiliac
attachments- from lateral sacral crest to posterior superior iliac spine
Interosseous Sacroiliac
attachments- between the articular surfaces
Sacrospinous
attachments- from ischial spine to lateral margin of sacrum
Sacrotuberous
attachments- from posterior iliac spine & lateral margin of sacrum to ischial tuberosity
Lymphatic Trunks
- Thoracic duct
- Right lymphatic duct
Right lymphatic duct
(drains nodes of the right thorax, right upper extremity, and right head and neck)
Thoracic duct
drains nodes of the right and left lower extremities, pelvis, abdomen, left thorax, left upper extremity, and left head and neck)
Lymph Nodes
- Breast
- Thoracic
- Abdominal and Pelvic
Breast nodes
Parasternal Inguinal Infraclavicular Axillary Apical axillary
Parasternal node
function- drain medial breast bilaterally
Inguinal node
function- may drain inferior breast
Infraclavicular node
function- may drain superior breast
Axillary node
function- predominant drainage of the breast
Apical axillary node
function- drain superior breast and other axillary nodes
Thoracic nodes
- Parietal
- Visceral
Thoracic parietal nodes
- Parasternal
- Intercostal
- Diaphragmatic
- Posterior mediastinal
Parasternal thoracic node
function- drain medial aspect of breast, upper abdominal wall, anterior pleura & part of liver
Intercostal thoracic node
function- drain lateral & posterior thoracic wall
Diaphragmatic thoracic node
function- drain liver, pleura & diaphragm
Posterior mediastinal thoracic node
function- drain pleura & esophagus
Visceral
- Pulmonary
- Bronchopulmonary
- Tracheobronchial (inferior & superior)
- Paratracheal
Pulmonary thoracic Visceral node
function- drain lung
Bronchopulmonary thoracic visceral node
function- drain pulmonary nodes & bronchi
Tracheobronchial (inferior & superior) thoracic visceral node
function- drain bronchopulmonary & posterior mediastinal nodes, trachea & heart
Paratracheal thoracic visceral node
function- drain tracheobronchial nodes
Abdominal and Pelvic
- Preaortic
- Lateral aortic (para-aortic)
- Retroaortic
Preaortic abdominal node
function- drain abdominal viscera supplied by the celiac, superior mesenteric and inferior mesenteric arteries
Lateral aortic (para-aortic) abdominal node function
function- drain the kidneys, suprarenal glands, ureter, posterior abdominal wall, testes, ovarys, uterine tubes, superior uterus & iliac nodes
Lateral aortic (para-aortic) abdominal components
- Common iliac
- External iliac
- Internal iliac
common iliac node function
function- drain internal and external iliac nodes
External iliac node function
function- drain inguinal nodes, abdominal wall, perineum and lower pelvic viscera
Internal iliac node function
function- drain pelvic viscera, perineum and gluteal region (skin drains to inguinal nodes)
Retroaortic abdominal node
function- drain the posterior abdominal wall
muscles of thorax
- Intercostal (external)
- Intercostal (internal & innermost)
- Transversus thoracis
Intercostal (external) muscle
attachments- from rib to rib oriented from superior-lateral to inferior-medial
actions- elevation of ribs
innervation- intercostal nerve
blood supply- anterior & posterior intercostal a.
Intercostal (internal & innermost) muscle
attachments- from rib to rib oriented superior-medial to inferior-lateral
actions- depression of ribs
innervation- intercostal nerve
blood supply- anterior & posterior intercostal a.
Transversus thoracis muscle
attachments- from posterior sternum to costal cartilages
actions- depress ribs
innervation- intercostal nerves
blood supply- internal thoracic & anterior intercostal a
Muscles of the abdomen
- Cremaster (G. kremaster, a suspender)
- Diaphragm
- External oblique
- Internal oblique
- Quadratus lumborum
- Rectus abdominis
- Transversus abdominis
Cremaster (G. kremaster, a suspender) muscle
attachment- from the medial edge of the internal oblique to spermatic cord
actions- elevation of testis
innervation- genitofemoral nerve
blood supply- cremasteric a.
Diaphragm
attachments- from xiphoid process, inner surface of the lower ribs & costal cartilages, medial & lateral arcuate ligaments & lumbar vertebrae via the crura to the central tendon
actions- inspiration (negative thoracic pressure by inferior displacement)
innervation- phrenic nerve
blood supply- musculophrenic, inferior phrenic, subcostal & lower posterior intercostal a.
External oblique
attachments- from lower 8 ribs to iliac crest & rectus sheath
actions- flexion & rotation of the trunk, & compression of the abdominal cavity
innervation- ventral rami T7-12
blood supply- superior epigastric, inferior epigastric, subcostal, lower posterior intercostal, lumbar, superficial circumflex iliac & deep circumflex iliac a.
Internal oblique
attachments- from thoracolumbar fascia to inguinal ligament, iliac crest & rectus sheath
actions- flexion & rotation of the trunk, & compression of the abdominal cavity
innervation- lower thoracic & L1 ventral rami
blood supply- superior epigastric, inferior epigastric, subcostal, lower posterior intercostal, lumbar, superficial circumflex iliac & deep circumflex iliac a.
Quadratus lumborum muscle
attachments- from 12th rib to iliolumbar ligament & iliac crest
actions- extension & lateral flexion of the trunk, and fixes 12th rib during respiration
innervation- ventral rami T12-L3
blood supply- subcostal, lumbar & iliolumbar a.
Rectus abdominis muscle
attachments- from xiphoid process & adjacent costal cartilages to pubic crest & tubercle
actions- flexion of trunk & compression of abdominal cavity
innervation- lower thoracic ventral rami
blood supply- superior epigastric, inferior epigastric
Transversus abdominis msucle
attachments- from lower six costal cartilages & thoracolumbar fascia to inguinal ligament, iliac crest & rectus sheath
actions- compression of the abdominal cavity
innervation- lower thoracic & L1 ventral rami
blood supply- superior epigastric, inferior epigastric, subcostal, lower posterior intercostal, lumbar, superficial circumflex iliac & deep circumflex iliac a.
Muscles of the pelvis
- Iliacus (details under Lower Extremity)
- Psoas (details under Lower Extremity)
- Piriformis (details under Lower Extremity) (L. pirum, pear)
- Obturator internus (details under Lower Extremity)
- Pelvic diaphragm
Coccygeus muscle
attachments- from ischial spine & sacrospinous ligament to coccyx
actions- supports & compresses posterior pelvic floor
innervation- ventral rami S4-5
blood supply- inferior gluteal, internal pudendal & inferior rectal a.
Levator ani muscle
attachments- from pubic symphysis, obturator fascia &; ischial spine to midline raphe &; anococcygeal ligament
actions- supports pelvic viscera, & compresses rectum & vagina
innervation- pudendal nerve (inferior rectal branches) &; S4
blood supply- inferior gluteal, internal pudendal, inferior rectal & inferior vesical a.
Muscles of the perineum
- Bulbospongiosus
- Ischiocavernosus
- Sphincter ani externus
- Sphincter urethrae
- Compressor urethrae
- Sphincter urethrovaginalis
- Deep transverse perineus
- Superficial transverse perineus
Bulbospongiosus
attachments- in male from median raphe & perineal body (central tendon) to surround bulb of penis; in female from the perineal body to surround vestibular bulb, vaginal orifice & clitoris
actions- in male empties urethra, maintains erection & contracts during ejaculation; in female constricts vaginal orifice & contributes to erection of clitoris
innervation- perineal branch of pudendal nerve
blood supply- internal pudendal a.
Ischiocavernosus
attachments- from ischial tuberosity & ramus to aponeurosis surrounding crus of penis or clitoris
actions- compresses crus during erection
innervation- perineal branch of pudendal nerve
blood supply- internal pudendal a.
Sphincter ani externus
attachments- from perineal body (central tendon) to anococcygeal raphe
actions- closes anal canal & fixes perineal body
innervation- inferior rectal branch of pudendal nerve
blood supply- internal pudendal a.
Sphincter urethrae
attachments- surrounds urethra
actions- compresses urethra
innervation- perineal branch of pudendal nerve
blood supply- internal pudendal a
Compressor urethrae
attachments- from the ischiopubic ramus to midline passing ventral to the urethra and inferior to the sphinchter urethrae (with a variable number of fibers fanning out medially to to reach the vagina in females and thus replacing the deep transverse perineus)
actions- compresses urethra
innervation- perineal branch of the pudendal nerve
blood supply- internal pudendal a.
Sphincter urethrovaginalis
attachments- from perineal body, surrounds vagina & urethra to meet contralateral muscle inferior to compressor urethrea
actions- compresses urethra & vagina
innervation- perineal branch of the pudendal nerve
blood supply- internal pudendal a.
Deep transverse perineus
attachments- from ischial tuberosity to perineal body (central tendon)
actions- fixes perineal body
innervation- perineal branch of pudendal nerve
blood supply- internal pudendal a.
Superficial transverse perineus
attachments- from ischial tuberosity to perineal body (central tendon)
actions- fixes perineal body
innervation- perineal branch of the pudendal nerve
blood supply- internal pudendal a.
Cervical plexus components (most branches in head and neck)
-Phrenic nerve
Phrenic nerve (C3-5)
function- sensory & postganglionic sympathetic innervation to pericardium & central tendon (& adjacent pleura & peritoneum); motor (lmn) & postganglionic sympatheic innervation to diaphragm
Thoracic spinal nerves
- Dorsal rami
- Ventral rami
Dorsal rami
- Medial branch
- Lateral branch
Medial branch of dorsal rami
function- sensory & postganglionic sympathetic innervation to back muscles & overlying skin; motor (lmn) innervation of back muscles
Lateral branch of dorsal rami
function- sensory & postganglionic sympathetic innervation to back muscles & overlying skin; motor (lmn) innervation of back muscles
Ventral rami
- Intercostal n. (T1-6)
- Intercostal n. (T7-11)
- Subcostal nerve (T12)
Intercostal n. (T1-6) of ventral rami function
function- sensory & postganglionic sympathetic innervation to intercostal muscles, parietal pleura & skin; motor (lmn) innervation of intercostal muscles
Intercostal n. (T1-6), of ventral rami, branches
- Lateral cutaneous branch
- Anterior cutaneous branch
- Collateral branch
- Intercostobrachial n. (T2 only)
Lateral cutaneous branch of Intercostal n. (t1-6)
function- sensory & postganglionic sympathetic innervation of skin overlying lateral aspect of intercostal space
Anterior cutaneous branch of Intercostal n. (t1-6)
function- sensory & postganglionic sympathetic innervation of skin overlying anterior aspect of intercostal space
Collateral branch of Intercostal n (t1-6)
function- redundant with remainder of nerve
Intercostobrachial n. (T2 only) of intercost n. (t1-6)
function- sensory & postganglionic sympathetic innervation of skin overlying proximal, medial aspect of arm
Intercostal n. (T7-11) of ventral rami
function- sensory & postganglionic sympathetic innervation to intercostal muscles, anterior abdominal muscles, peripheral diaphragm, parietal pleura & parietal peritoneum; motor (lmn) innervation of intercostal muscles and muscles of anterior abdominal wall
Intercostal n. (T7-11) of ventral rami components
- Lateral cutaneous branch
- Anterior cutaneous branch
- Collateral branch
Lateral cutaneous branch of intercostal n (t7-11)
function- sensory & postganglionic sympathetic innervation of skin overlying lateral aspect of intercostal space & adjacent anterior abdominal wall
Anterior cutaneous branch of intercostal n (t7-11)
function- sensory & postganglionic sympathetic innervation of skin overlying rectus abdominis muscle
Collateral branch of intercostal n. (t7-11)
function- redundant with remainder of nerve
Subcostal nerve (T12) of the ventral rami
function- sensory & postganglionic sympathetic innervation to skin overlying lateral and anterior abdominal wall, parietal peritoneum & muscles of anterior abdominal wall; motor (lmn) innervation of muscles of anterior abdominal wall
Lumbar nerves
- Dorsal rami
- Ventral rami
Dorsal rami of lumbar nerve components
- Medial branch
- Lateral branch
Medial branch of the dorsal rami of the lumbar nerves
function- sensory & postganglionic sympathetic innervation to back muscles & overlying skin; motor (lmn) innervation of back muscles
Lateral branch of the dorsal rami of the lumbar nerves
function- sensory & postganglionic sympathetic innervation to back muscles & overlying skin; motor (lmn) innervation of back muscles
Ventral rami of the lumbar nerves components
- Iliohypogastric nerve (L1)
- Ilioinguinal nerve (L1)
- Genitofemoral nerve (L1-2)
- Lateral cutaneous nerve of the thigh
- Muscular branches
Iliohypogastric nerve (L1) of the ventral rami
function- sensory & postganglionic sympathetic innervation of skin overlying lower anterior abdominal wall; sensory, postganglionic sympathetic & motor (lmn) innervation of muscles of the anterior abdominal wall
Ilioinguinal nerve (L1) of the ventral rami
function- sensory & postganglionic sympathetic innervation of skin overlying proximomedial thigh, root of the penis & scrotum or mons pubis & labium majorum; sensory, postganglionic sympathetic & motor (lmn) innervation of muscles of the anterior abdominal wall
Genitofemoral nerve (L1-2) of the ventral rami components
- Genital branch
- Femoral branch
Genital branch of the Genitofemoral nerve (L1-2)
function- sensory & postganglionic sympathetic innervation of the skin overyling part of the labium majorum or scrotum; sensory, postganglionic sympathetic & motor (lmn) innervation of the cremaster muscle
Femoral branch of the Genitofemoral nerve (L1-2)
function- sensory & postganglioinc sympathetic innervation of skin overlying the femoral triangle
Lateral cutaneous nerve of the thigh of the ventral rami
function- sensory & postganglionic sympathetic innervation of the skin overlying the lateral aspect of the thigh
Muscular branches of the ventral rami
function- sensory, postganglionic sympathetic and motor (lmn) innervation of the psoas and quadratus lumborum muscles