Block 2 Review Slides from Thoracic Cavity2-end Flashcards
Inguinal Canal:
Openings:
Deep inguinal ring:
• opening in _________ fascia
• located about __ inch above inguinal ligament, halfway between ASIS and pubic tubercle
• inferior epigastric vessels pass _____ to deep _____ ring
- opening in transversalis fascia
- located about 1⁄2 inch above inguinal ligament, halfway between ASIS and pubic tubercle
- inferior epigastric vessels pass medial to deep inguinal ring
Jejunum and Ileum
Lymph Drainage:
• The lymph vessels pass through many intermediate ________ nodes and finally reach the
superior _______ nodes, which are situated around the origin of the superior ______ artery.
Lymph Drainage:
• The lymph vessels pass through many intermediate mesenteric nodes and finally reach the
superior mesenteric nodes, which are situated around the origin of the superior mesenteric
artery.
Arteries of the Anterior Abdominal Wall:
-branches of ____________ artery (terminal branch of internal thoracic artery)
• contribute to supply ______ abdominal wall, just inferior to _____ margin
branches of musculophrenic artery (terminal branch of internal thoracic artery)
• contribute to supply anterior abdominal wall, just inferior to costal margin
Abdominal cavity structures:
Stomach:
Relations:
Anteriorly:
• \_\_\_\_\_\_ abdominal wall
• left costal margin
• Diaphragm
• _(right/left)_ lobe of liver
Posteriorly (stomach bed): • Diaphragm • Spleen • _(upper/lower)_ part of left kidney • _(left/right)_ suprarenal gland • splenic artery • Pancreas • transverse mesocolon (separated from stomach by lesser sac)
Relations: • anteriorly: • anterior abdominal wall • left costal margin • Diaphragm • left lobe of liver
- posteriorly (stomach bed):
- Diaphragm
- Spleen
- upper part of left kidney
- left suprarenal gland
- splenic artery
- Pancreas
- transverse mesocolon (separated from stomach by lesser sac)
External Oblique:
Superficial inguinal ring
• opening in _____ oblique aponeurosis located immediately _____ to pubic tubercle
• it is the anterior (superficial) opening of _____ canal
- opening in external oblique aponeurosis located immediately superior to pubic tubercle
- it is the anterior (superficial) opening of inguinal canal
Celiac Trunk:
branches of splenic artery:
- numerous pancreatic branches (as many as 10):
- supply ____, ____ and ____ of pancreas
Left gastroepiploic (gastroomental) artery: • originates near \_\_\_\_ of spleen • reaches greater curvature of stomach in \_\_\_\_\_\_\_\_\_\_ ligament and runs along greater curvature from _(left/right)_ to _(left/right)_ → anastomoses with right gastroepiploic artery
Short gastric arteries (5 or 6 in number):
• originate ____ to hilum of spleen
• reach stomach in gastrosplenic ligament and supply _____ of stomach
Terminal branches;
• enter spleen through its hilum
branches of splenic artery:
• numerous pancreatic branches (as many as 10):
• supply neck, body and tail of pancreas
Left gastroepiploic (gastroomental) artery:
• originates near hilum of spleen
• reaches greater curvature of stomach in gastrosplenic ligament and runs along greater curvature
from left to right → anastomoses with right gastroepiploic artery
Short gastric arteries (5 or 6 in number):
• originate close to hilum of spleen
• reach stomach in gastrosplenic ligament and supply fundus of stomach
Terminal branches;
• enter spleen through its hilum
Pancreas
Blood supply
- Lymph Drainage:
• Lymph nodes are situated along the arteries that ____ the gland.
• The efferent vessels ultimately drain into the ____ and superior _____________ lymph nodes.
Lymph Drainage:
• Lymph nodes are situated along the arteries that supply the gland.
• The efferent vessels ultimately drain into the celiac and superior mesenteric lymph nodes.
Liver:
- right limb of _ (right sagittal fissure) formed:
• anteriorly by _____ for gallbladder
• posteriorly by groove for ___
- left limb of H (left sagittal fissure) formed:
• anteriorly by fissure for _____ ligament of liver (ligamentum teres hepatis)
• posteriorly by fissure for ligamentum venosum
- right limb of H (right sagittal fissure) formed:
- anteriorly by fossa for gallbladder
- posteriorly by groove for IVC
- left limb of H (left sagittal fissure) formed:
- anteriorly by fissure for round ligament of liver (ligamentum teres hepatis)
- posteriorly by fissure for ligamentum venosum
Celiac Truck
Branches:
Right gastric artery
- usually originates from proper ______ artery
- descends to ____ end of stomach
- runs to the left along _____ curvature of stomach
- anastomoses with _(right/left) gastric artery
- usually originates from proper hepatic artery
- descends to pyloric end of stomach
- runs to the left along lesser curvature of stomach
- anastomoses with left gastric artery
Anterior Abdominal Wall
Vertical and horizontal planes:
- _______ plane that passes through lower part of body of L_
- located about midway between ____ notch of ____ and pubic symphysis
- horizontal plane that passes through lower part of body of L1
- located about midway between jugular notch of sternum and pubic symphysis
The jejunal mesentery is attached to the _____ abdominal wall above and to the (right/left) of the aorta,
whereas the ileal mesentery is attached _____ and to the (left/right) of the aorta.
The jejunal mesentery is attached to the posterior abdominal wall above and to the left of the aorta,
whereas the ileal mesentery is attached below and to the right of the aorta.
The jejunal wall feels thicker because the permanent infoldings of the _____ membrane, the _____
circulares, are larger, more numerous, and _____ set in the jejunum, whereas in the upper part of the ileum
they are smaller and more ____ separated and in the lower part they are absent.
The jejunal wall feels thicker because the permanent infoldings of the mucous membrane, the plicae
circulares, are larger, more numerous, and closely set in the jejunum, whereas in the upper part of the ileum
they are smaller and more widely separated and in the lower part they are absent.
Abdominal Aorta Branches: - visceral branches: UNPAIRED: • celiac trunk • \_\_\_\_\_\_ mesenteric artery • inferior mesenteric artery PAIRED: • \_\_\_\_ suprarenal arteries • \_\_\_ arteries • gonadal (testicular/ovarian) arteries
Branches: • visceral branches: • unpaired: • celiac trunk • superior mesenteric artery • inferior mesenteric artery • paired: • middle suprarenal arteries • renal arteries • gonadal (testicular/ovarian) arteries
Lymphatic drainage of thymus?
Lymphatic drainage:
- the internal thoracic arteries (parasternal)
- the tracheal bifurcation (tracheobronchial)
- in the root of the neck
Phrenic Nerve: - branch of \_\_\_\_\_ \_\_\_\_\_\_ - contains fibers from \_\_\_\_\_ \_\_\_\_ of \_\_, \_\_ and \_\_ spinal nerves
branch of CERVICAL PLEXUS
contains fibers from VENTRAL RAMI of C3, C4 and C5 spinal nerves
parts of the SVC and where are they located
upper part located in:
superior mediastinum
lower part located within:
pericardial sac, in middle mediastinum
Duodenum
- Relations of first part:
Anteriorly:
• The quadrate lobe of the ____ and the _______
Anteriorly:
• The quadrate lobe of the liver and the gallbladder
Arteries of the Anterior Abdominal Wall:
deep circumflex iliac artery
• originates from distal part of external iliac artery (just above inguinal ligament)
• runs superiorly and laterally toward ASIS and continues along iliac crest
• supplies lower lateral part of anterior abdominal wall
deep circumflex iliac artery
• originates from distal part of external iliac artery (just above inguinal ligament)
• runs superiorly and laterally toward ASIS and continues along iliac crest
• supplies lower lateral part of anterior abdominal wall
Pancreas
Blood Supply
- Veins:
• The corresponding veins drain into the ____ system.
Veins:
• The corresponding veins drain into the portal system.
Inguinal Canal: Openings: Superficial inguinal ring: • opening in aponeurosis of \_\_\_\_\_\_\_ oblique • located immediately \_\_\_\_\_ to pubic tubercle
- opening in aponeurosis of external oblique
* located immediately superior to pubic tubercle
Thoracic Duct
- (Largest or smallest) lymphatic channel of the body?
- Where does it begin?
- Where does it pass thru?
-Ascends in _____ mediastinum behind esophagus, with azygos vein to its right and descending thoracic aorta to its left in superior mediastinum ascends along (right/left) border of
esophagus to _____ thoracic aperture
• in root of ___ arches to the left, posterior to __(right/left) common carotid artery and (right/left) internal
jugular vein
• terminates at ___ of (right/left) subclavian and left internal ____ veins
Largest lymphatic channel of the body
• begins in upper part of posterior abdominal wall (L2 level)
• sometimes begins as a dilated sac (cisterna chyli), but more often by direct confluence of
right and left lumbar lymph trunks and intestinal lymph trunk, which collect lymph from
lower limbs, pelvis and abdomen
• passes through aortic hiatus of diaphragm
• ascends in posterior mediastinum behind esophagus, with azygos vein to its right and
descending thoracic aorta to its left in superior mediastinum ascends along left border of
esophagus to superior thoracic aperture
• in root of neck arches to the left, posterior to left common carotid artery and left internal
jugular vein
• terminates at union of left subclavian and left internal jugular veins
the SVC is formed where? Where does it go and describe the path? Tributary:
• azygos vein joins SVC just before it enters pericardial sac
posterior to 1st right costal cartilage, at right border of sternum, by union of right and left
brachiocephalic veins
Descends vertically to terminates in upper part of RA, posterior to 3rd right costal
cartilage
Testicular Veins
- form a _____ around testicular artery (pampiniform plexus)
- as it ascends, plexus becomes _____ in size and eventually a ____ testicular vein is formed on each side.
- runs _ on posterior abdominal wall (behind peritoneum)
- right testicular vein drains into ___
- left testicular vein drains into (right/left) renal vein
• form a plexus around testicular artery (pampiniform plexus)
• as it ascends, plexus becomes reduced in size and eventually a single
testicular vein is formed on each side.
• runs up on posterior abdominal wall (behind peritoneum)
• right testicular vein drains into IVC
• left testicular vein drains into left renal vein
Gallbladder
• ____-shaped sac lying on visceral surface of ____
• stores ____ and concentrates it by absorbing ____
- Pear-shaped sac lying on visceral surface of liver
* stores bile and concentrates it by absorbing water
Duodenum
• Parts of the Duodenum:
The duodenum is situated in the ______ and _____ regions and, for purposes
of description, is divided into ____ parts:
Duodenum
• Parts of the Duodenum:
• The duodenum is situated in the epigastric and umbilical regions and, for purposes
of description, is divided into four parts:
major tributaries to brachiocephalic veins?
from neck:
-vertebral and inferior thyroid veins
from thorax:
-internal thoracic vein
Duodenum:
Blood supply
Veinous drainage:
• The superior pancreaticoduodenal vein drains into the ______ vein
• The inferior vein joins the superior _______ vein.
- Veinous drainage:
- The superior pancreaticoduodenal vein drains into the portal vein
- The inferior vein joins the superior mesenteric vein.
Pancreas
Blood Supply:
-Arteries:
• The splenic and the superior and inferior pancreaticoduodenal arteries supply the pancreas.
Pancreas
- Blood Supply:
- Arteries:
- The splenic and the superior and inferior pancreaticoduodenal arteries supply the pancreas.
External Oblique:
Inguinal ligament:
• ____ border of external oblique aponeurosis that extends from ____ to pubic tubercle
• it is folded _____ on itself forming a _____ structure called inguinal ligament forms boundary
between ____ and thigh
• lower border of external oblique aponeurosis that extends from ASIS to pubic tubercle
• it is folded backward on itself forming a trough structure called inguinal ligament forms boundary
between abdomen and thigh
Internal Oblique:
Where is it located?
What is the origin?
Insertion?
-Location:
located immediately deep to external oblique
-Origin: thoracolumbar fascia, iliac crest and lateral 2⁄3 of inguinal ligament
Insertion:
-on an anterior view, upper fibers run superiorly and medially (similar to
internal and innermost intercostals) while lower fibers are more horizontal
Thymus relations (anterior and posterior)?
anterior relations:
- sternum and adjacent parts of upper 3 costal cartilages,
- anterior margins of pleural sacs and lungs
posterior relations:
- pericardial sac,
- left brachiocephalic vein,
- aortic arch & its branches, trachea
External Oblique: Fascia lata (deep fascia of thigh) attaches \_\_\_\_\_\_ to inguinal ligament
(deep fascia of thigh) attaches superiorly to inguinal ligament
Thymus Appearance?
Thymus
• Appearance
• varies considerably with age
• largest in early part of life (until puberty)
• progressively involutes thereafter, and is largely replaced by fat
Left Phrenic Nerve:
- Crosses __(right/left)__ side of ____ arch
-passes ____ to root of __(right/left)__ lung
- Descends between ___ sac and ___ pleura
- reaches diaphragm close to ___ of heart
• terminal branches pierce diaphragm to supply ____ part of _______ covering _____ surface
of diaphragm
- Crosses LEFT side of AORTIC arch
- Passes ANTERIOR to root of LEFT lung
- Descends between PERICARDIAL sac and MEDIASTINAL pleura
- Reaches diaphragm close to APEX of heart
- Terminal branches pass pierce diaphragm to supply CENTRAL part of PERITONEUM covering INFERIOR surface of diaphragm
the brachiocephalic veins are formed by union of? where?
subclavian & internal jugular veins at root of neck
(posterior to
sternoclavicular joints)
Gallbladder:
Parts:
Fundus
• anterior, _____ end which projects below ____ border of liver
• it is in contact with _____ abdominal wall at level of tip of right _th costal cartilage
Body
• middle part of ____________ (between fundus and neck)
• contacts visceral surface of liver (superiorly) and transverse ____ and duodenum (inferiorly)
Neck
• narrow, tapering end, ____ the fundus and directed toward ____ hepatis
• usually makes an _-shaped bend and becomes continuous with ____ duct
Parts:
Fundus
• anterior, rounded end which projects below inferior border of liver
• it is in contact with anterior abdominal wall at level of tip of right 9th costal cartilage
Body
• middle part of gallbladder (between fundus and neck)
• contacts visceral surface of liver (superiorly) and transverse colon and duodenum (inferiorly)
Neck
• narrow, tapering end, opposite the fundus and directed toward porta hepatis
• usually makes an S-shaped bend and becomes continuous with cystic duct
Duodenum
Superiorly:
• The entrance into the lesser sac (the ____ foramen)
Superiorly:
• The entrance into the lesser sac (the epiploic foramen)
Arteries of the Anterior Abdominal Wall:
• superficial epigastric and superficial circumflex _____ arteries (branches of femoral artery)
supply _________ structures of ______ part of anterior abdominal wall
• superficial epigastric and superficial circumflex iliac arteries (branches of femoral
artery)
supply superficial structures of lower part of anterior abdominal wall
Rectus Abdominis:
It is ______ and thicker below, broader and _____ above
It is narrower and thicker below, broader and thinner above
At the jejunal end of the mesentery, the ___ is deposited near the root and is scanty near the intestinal wall.
At the ileal end of the mesentery, the ____ is deposited throughout so that it extends from the root to the _____ wall.
At the jejunal end of the mesentery, the fat is deposited near the root and is scanty near the intestinal wall.
At the ileal end of the mesentery, the fat is deposited throughout so that it extends from the root to the
intestinal wall.
Jejunum and Ileum
Nerve Supply:
• The nerves are derived from the ________ and ______ (vagus) nerves from the superior _______ plexus.
Nerve Supply:
• The nerves are derived from the sympathetic and parasympathetic (vagus) nerves from the
superior mesenteric plexus.
Difference between jejunum & Ileum
The jejunum lies _____ in the upper part of the peritoneal cavity below the (right/left) side of the transverse mesocolon; the ileum is in the lower part of the cavity and in the ____.
The jejunum lies coiled in the upper part of the peritoneal cavity below the left side of the transverse
mesocolon; the ileum is in the lower part of the cavity and in the pelvis.
Thoracic Sympathetic Trunk:
3 thoracic splanchnic nerves (greater, lesser and lowest/least):
• originate from _(lower/upper) part of thoracic sympathetic trunk (_th ganglion and below), pierce
diaphragm and terminate in _______ (subdiaphragmatic) ganglia in abdomen
• Contain __________ sympathetic and _____ afferent fibers
• 3 thoracic splanchnic nerves (greater, lesser and lowest/least):
• originate from lower part of thoracic sympathetic trunk (5th ganglion and below), pierce
diaphragm and terminate in prevertebral (subdiaphragmatic) ganglia in abdomen
• Contain preganglionic sympathetic and visceral afferent fibers
Duodenum
First Part of the Duodenum:
• The first part of the duodenum begins at the _____ and runs upward and backward on the
______ plane at the level of the _st lumbar vertebra.
First Part of the Duodenum:
• The first part of the duodenum begins at the pylorus and runs upward and backward on the
transpyloric plane at the level of the 1st lumbar vertebra.
