Chapter 4: Heart and Lungs Flashcards
Thoracic cage
-surrounds and supports organs in thoracic cavity and superior abdominal cavity
-provides support for upper limbs
-plays a role in breathing
Superior thoracic aperture
-structures passing between thoracic cavity and neck pass through this
Inferior thoracic aperture
-structures passing between thoracic cavity and abdominal cavity
Sternum
-breastbone
What structures does the sternum contain
-manubrium
-body
-xiphoid process
-sternal angle
-suprasternal (jugular) notch
-clavicular notches
What does manubrium articulate with
-first and second ribs
What do clavicular notches articulate with
-clavicles to form sternoclavicular joints
How many pairs of ribs are there in total
12
What are the true ribs
1-7
What are the false ribs
8-12
Vertebrocostal ribs
-pairs 8-10
-attach indirectly to the sternum
-attach to costal cartilages and articulate indirectly with the 7th costal cartilage
Floating ribs
-only attach posteriorly to the thoracic vertebrae as they do not attach to the sternum in any manner and are particularly short
-they do not have a neck or tubercle
Surface features of ribs
-head
-neck
-tubercle
-body
-costal angle
-costal groove
Intercostal spaces
-spaces between neighbouring ribs
Why is rib 1 atypical
-shortest true rib
-single facet on head
-lacks angle and costal groove
-has 2 grooves for subclavian vessels
-scalene tubercle
Why is rib 2 atypical
-tuberosity for serratus anterior muscle
Why is rib 10 atypical
-single facet on head
Why is rib 11 atypical
-single facet on head
-short neck
-lacks tubercle
-has a slight costal groove
Why is rib 12 atypical
-single facet on head
-lacks tubercle, angle and costal groove
Costovertebral joints
-costal demifacets: on vertebrae T1-T9
-costal facets: on vertebrae T1 and T10-T12
-on heads of ribs 1-12
Costotransverse joints
-on tubercle of ribs 1-10
-transverse costal facets: on transverse processes of matching vertebrae
Ligaments of the costovertebral joint
-fibrous capsule
-radiate and intraarticular ligaments
-only on joints 2-9
Ligaments of the costotransverse joint
-fibrous capsule
-medial costotransverse
-superior costotransverse
-lateral costotransverse
Movements of the costovertebral joints
-internal rotation and elevation of head of rib
Movements of costotransverse joints 1-6
-internal rotation of neck of rib
Movements of costotransverse joints 7-10
-posteromedial translation of neck of rib
Arteries of the intercostal space
-internal thoracic artery
-anterior intercostal arteries
-posterior intercostal arteries
-subcostal artery
Veins of the intercostal space
-anterior intercostal veins
-posterior intercostal veins
-subcostal vein
Nerves of the intercostal space
-intercostal nerves
-subcostal nerve
External intercostal muscles
-origin: inferior border of one rib
-insertion: superior border of immediate rib below
-innervated by intercostal nerves
-elevate the ribs
Internal intercostal muscles
-origin: costal groove of one rib
-insertion: superior border of immediate rib below
-innervated by intercostal nerves
-depress the ribs
Innermost intercostal muscles
-origin: costal groove of one rib
-insertion: superior border of immediate rib below
-innervated by intercostal nerves
-depress the ribs
Transversus thoracic muscle
-origin: inferoposterior surface of body of sternum and xiphoid process and sternal ends of costal cartilage of ribs 4-7
-insertion: internal surface of costal cartilages of ribs 2-6
-depresses ribs and supports intercostal spaces and thoracic cage
Diaphragm sternal part origin
-posterior aspect of xiphoid process
Diaphragm costal part origin
-internal surfaces of lower costal cartilages and ribs 7-12
Diaphragm lumbar part origin
-medial and lateral arcuate ligaments, bodies of vertebrae L1-L3 and anterior longitudinal ligament
Diaphragm insertion
-central tendon of diaphragm
Openings of the diaphragm
-aortic hiatus
-esophageal hiatus
-caval foramen
-openings for greater and lesser splanchnic nerves, and superior epigastric vessels
Recesses of the diaphragm
-costo-diaphragmatic recess
-costomediastinal recess
Innervation of the diaphragm
-phrenic nerves (C3-C5)
-sensory innervation of peripheries via 6th-11th intercostal nerves
Blood supply of the diaphragm
-lowest 5 intercostal arteries
-subcostal arteries
-superior phrenic arteries
Function of the diaphragm
-main muscle responsible for respiration
-increases abdominal pressure during defecation, vomiting and voiding
-applies pressure on the esophagus to prevent acid reflux
Parts of the abdominal surface of the diaphragm
-skeletal muscle
-central tendon
Openings of the abdominal surface of the diaphragm
-aortic hiatus
-esophageal hiatus
-caval foramen
Innervation of the abdominal surface of the diaphragm
-left and right phrenic nerves (C3-C5)
Blood supply of the abdominal surface of the diaphragm
-left and right phrenic arteries (branches of the abdominal aorta)
Where is the heart located
-between the lungs and in the mediastinum
-about 2/3 of it lies in the bodys midline
Surfaces of the heart
-anterior surface
-inferior surface
-right surface
-left surface
Surface projection
-refers to the outlining of the dimensions of an organ on the surface of the body
Surface projection points of the heart
-superior right point
-superior left point
-inferior right point
-inferior left point
Pericardium
-sac that surrounds and protects the heart
Portions of the pericardium
-fibrous pericardium
-serous pericardium
Superficial fibrous pericardium
-prevents overstretching of the heart
-provides protection
-anchors heart to mediastinum
Deep serous pericardium layers
-outer parietal layer
-inner viceral layer
Outer parietal layer
-lines inside of the fibrous pericardium
Inner visceral layer
-adheres to hearts surface
Pericardial cavity
-between parietal and visceral serous pericardial layers
-contains pericardial fluid
Pericardial fluid
-lubricating fluid that reduces friction between the membranes as the heart moves
Layers of the heart wall
-outer epicardium
-middle myocardium
-innermost endocardium
Outer epicardium
-visceral layer of the serous pericardium
Middle myocardium
-composed of thick cardiac muscle tissue
Innermost endocardium
-composed of connective tissue covered by endothelium that is continuous with the endothelium of the blood vessels
Chambers of the heart
-right atria
-left atria
-right ventricle
-left ventricle
Auricle
-structure in the atrias
-allows atrium to hold a larger volume of blood
Where do atria receive blood from
-receive blood from major systemic veins and pulmonary veins
Where do ventricles pump blood to
-pump blood into systemic and pulmonary
Pulmonary pump
-consists of the right atrium and right ventricle
-pumps blood towards the lungs
Systemic pump
-consisting of the left atrium and left ventricle
-pumps oxygenated blood towards the rest of the body
Major grooves of the surface of the heart
-coronary sulcus
-anterior interventricular sulcus
-posterior interventricular sulcus
Right atrium
-receives deoxygenated blood from 3 veins
-superior vena cava
-inferior vena cava
-coronary sinus
Superior vena cava
-brings blood from most parts of the body superior to the heart
Inferior vena cava
-brings blood from all parts of the body inferior to the diaphragm
Coronary sinus
-brings blood from most of the vessels draining the wall of the heart
Pectinate muscles
-internal parallel ridges on the superior and right atrial walls
Crista terminalis
-smooth muscular ridge in the superior portion of the right atrium
-divides the musculi pectinati and the right atrial appendage from the smooth surface of the right atrium
Interatrial septum
-on the interior of the heart
-separates the atria
-has an oval depression called fossa ovalis
Right atrioventricular valve (tricuspid valve)
-blood in right atrium flows into right ventricle through
Trabeculae carnae
-irregular surface of ridges on inner surface of right ventricle
Chordae tendinae
-ensure that the cusps of the tricuspid valve permit blood to flow into the right ventricle but prevent backflow of blood into right atrium
Interventricular septum
-separates the 2 ventricles
Where does the left atrium receive blood from
-receives oxygenated blood from the lungs via four pulmonary veins
Atrioventricular valve (bicuspid)
-blood in the left atrium flows into left ventricle through this
What forms the apex of the heart
-left ventricle
Trabeculae carnae
-irregular surface of ridges on the inner surface of the left ventricle
Aortic valve flow
-left ventricle pumps oxygenated blood through aortic valve into the ascending aorta
Left and right coronary arteries
-ascending aorta gives rise to these
-they deliver blood to the walls of the heart
Ductus arteriosus
-during fetal life this structure shunts blood from pulmonary trunk to aorta
-shortly after birth this closes
Ligamentum arteriosum
-remnant of ductus arteriosus after it closes
Myocardial walls of atria function
-relatively thin
-pump low pressure blood into ventricles
Myocardial walls of ventricles function
-relatively thick
-pump high pressure blood greater distances
Which ventricle has a thicker wall
-left
Fibrous skeleton of heart
-dense connective tissue of the heart wall
Fibrous skeleton of the heart tissue rings
-right atrioventricular ring
-left atrioventricular ring
-pulmonary fibrous ring
-aortic fibrous ring
Fibrous skeleton function
-provides a structural foundation for heart valves
-helps prevent overstretching of valves
-insertion point for cardiac muscle bundles
-electrically insulates atria and ventricles for proper action potentials
Heart valves function
-open and close in response to pressure changes as heart contracts and relaxes
-prevents backflow of blood in the heart
2 atrioventricular valves
-right atrioventricular valve (tricuspid)
-left atrioventricular valve (bicuspid)
2 semilunar valves
-pulmonary valve
-aortic valve
Pulmonary valve location
-between pulmonary trunk and right ventricle
Aortic valve location
-between aorta and left ventricle
Semilunar valves function
-permit ejection of blood from ventricles
-prevent backflow of blood into heart
Coronary (cardiac) circulation
-flow of blood through the blood vessels that penetrate the myocardium
Left coronary artery divisions
-anterior interventricular branch
-circumflex branch
Right coronary artery divisions
-inferior interventricular branch
-marginal branch
Principal tributaries of coronary sinus
-great cardiac vein
-middle cardiac vein
-small cardiac vein
-anterior cardiac veins
What does the great cardiac vein accompany
-LAD artery
What does the middle cardiac vein accompany
-PDA artery
What does the small cardiac vein accompany
-runs parallel to inferior margin of coronary/AV sulcus
What does the anterior cardiac veins accompany
-runs along right inferior margin of right ventricle
Autorhythmic cells
-happens to 1% of cardiac muscle fibres during embryonic development
Function of autorhythmic cells
-act as natural pacemaker
-form the cardiac conduction system to conduct action potentials throughout myocardium
Components of the cardiac conduction system
-sinoatrial node (SA node)
-atrioventricular node (AV node)
-atrioventricular bundle (bundle of his)
-right and left bundle branches
-subendocardial conducting network
What controls pace of contractions
-nervous system
-hormones
Cardiac plexus
-includes sympathetic and parasympathetic nerves
Sympathetic control of heart rate
-increases heart rate
-dilation of arteries
Parasympathetic control of heart rate
-decreases heart rate
2 circuits of blood circulation
-systemic circulation
-pulmonary circulation
Which side of the heart does systemic circulation
-left side
Systemic circulation
-left side of heart receieves oxygenated blood from lungs
-then pumps this blood into aorta which branches into smaller arteries
-these arteries carry blood to all organs
-capillaries merge to deliver deoxygenated blood into systemuc venules which merge to form systemic veins and carry blood to right atrium of heart
Which side of the heart does pulmonary circulation
-right side
Pulmonary circulation
-receives deoxygenated blood from systemic circulation and pumps it into pulmonary trunk
-this branches into pulmonary arteries that carry blood to left and right lungs
-in the lungs the pulmonary capillaries are site of gas exchange and the blood becomes oxygenated
-the oxygenated blood flows into pulmonary veins and returns to left atrium
What shape are the lungs
-cone shaped
Where are the lungs located
-thoracic cavity
-extend from diaphragm to above the clavicles and lie against the ribs
What separates the 2 chambers of the lungs
-heart
-mediastinum
Pleural membrane
-layer that covers and protects the lungs
Layers of the pleural membrane
-parietal pleura
-visceral pleura
Parietal pleura
-lines the walls of thoracic cavity
Visceral pleura
-adheres to the lungs
Pleural cavity
-between 2 pleura
-contains lubricating fluid that is secreted by the membranes
Base of the lungs
-broad inferior portion
Apex of the lungs
-narrow superior portion
Costal surface of the lungs
-lies against the ribs
Mediastinal surface of lungs
-medial
-contains hilum
Hilum of the lungs
-where bronchi, blood vessels, lymphatic vessels and nerves enter and exit the lung
Cardiac notch
-left lung
-on medial surface
-heart rests on this
Lobes of left lung
-superior lobe
-inferior lobe
Oblique fissure (left)
-separates superior and inferior lobe
Lobes of the right lung
-superior lobe
-middle lobe
-inferior lobe
Upper part of oblique fissure (right)
-separates superior and inferior lobe
Lower part of oblique fissure (right)
-separates inferior and middle lobe
Horizontal fissure (right)
-borders superior portion of middle lobe
Right main bronchus divisions
-superior bronchi
-middle bronchi
-inferior lobar bronchi
Left main bronchus divisions
-superior bronchi
-inferior lobar bronchi
Lobar bronchi divisions
-segmental (tertiary) bronchi
Segmental (tertiary) bronchi function
-supply air to the bronchopulmonary segments of each lung
Lobule
-small compartment in each bronchopulmonary segment
Lobule contents
-lymphatic vessel
-arteriole
-venule
-respiratory bronchiole
Respiratory bronchiole divisions
-alveolar ducts
Alveolar duct
-contains about 100 alveolar saccule and pulmonary alveoli
Alveolar saccule
-terminal dilation of an alveolar duct and is composed of 20-30 pulmonary alveoli
Pulmonary alveolus
-cup shaped
-lined by simple squamous epithelium
-supported by thin elastic membrane
Arteries supplying blood to the lungs
-pulmonary arteries
-bronchial arteries
Pulmonary arteries
-how blood is delivered to the lungs from the right ventricle
-blood is also returned to heart
Bronchial arteries
-deliver oxygenated blood to bronchi and bronchioles of the lungs
Innervation of the lungs
-pulmonary plexus
Pulmonary plexus
-formed by branches of the vagus nerve
Pulmonary ventilation
-inhalation and exhalation of air between pulmonary alveoli of lungs and atmosphere
Inhalation (inspiration)
-when alveolar pressure is lower than atmospheric pressure
Principal muscles of inhalation
-diaphragm
-external intercostal muscles
Diaphragm innervation
-phrenic nerve
Exhalation
-air pressure in pulmonary alveoli is greater than atmospheric pressure
Muscles of exhalation
-passive process
-does not require muscles
-caused by relaxation of inspiratory muscles
Labored breathing muscles
-abdominal muscles
-internal intercostal muscles
Mediastinum
-compartment of thorax located in midline of the body
-contains most of thoracic viscera, apart from lungs
Mediastinum attachments
-vertically attaches to thoracic inlet
-bounded laterally by medial surfaces of pleura
Thoracic plane of ludwig
-imaginary line extending from sternal angle to T4-T5 space
-divides mediastinum into superior and inferior divisions
Inferior division of mediastinum divisions
-anterior compartment
-middle compartment
-posterior compartment
What divides the compartments of the inferior division of the mediastinum
-pericardial sac
Anterior mediastinum
-posterior to the body of sternum
-anterior to pericardium
Middle mediastinum
-bounded by pericardium
-encloses heart and origins of the great blood vessels
Posterior mediastinum
-posterior to pericardium
-anterior to vertebrae
Structures that belong to both superior and inferior mediastinum
-esophagus
-azygos veins
-vagus nerve
-phrenic nerve
Where do most mediastinal organs drain
-thoracic duct
Where does right side of thorax and right side of head drain
-right lymphatic trunk
Superior border of mediastinum
-thoracic inlet
Inferior border of mediastinum
-diaphragm
Anterior border of mediastinum
-sternum and costal cartilages of 1-5 ribs
Posterior border of mediastinum
-vertebral bodies of superior thoracic vertebrae
Lateral border of mediastinum
-parietal pleura of each lung
Contents of superior mediastinum
-thymus
-trachea
-superior vena cava
-aortic arch
-esophagus
-vagus and phrenic nerves
Contents of anterior mediastinum
-some remnants of thymus
Contents of middle mediastinum
-pericardial sac
-heart
-vena cava roots
-pulmonary trunk
-pulmonary arteries and veins
-root of aorta
-main bronchi and phrenic nerves
Contents of posterior mediastinum
-descending thoracic aorta
-azygos veins
-esophagus
-thoracic duct
-vagus nerves
-sympathetic trunk
Abdominal wall function
-protect abdominal viscera
-maintain stability
-assist in actions that involve increase of intra-abdominal pressure (coughing, vomiting, defacation)
Divisions of abdominal wall
-anterolateral wall
-posterior abdominal wall
Anterolateral abdominal wall layers
-skin
-superficial fascia
-muscles and associated fascia
-parietal peritoneum
Posterior abdominal wall layers
-lumbar vertebrae
-pelvic girdle
-posterior abdominal muscles and associated fascia
Lateral flat muscle group
-external oblique
-internal oblique
-transversus abdominis
Anterior vertical muscle group
-rectus abdominus
External oblique
-outermost muscle
-fibres run inferomedially
-origin: 5 to 12 rib
-insertion: anterior layer of rectus sheath
Internal oblique
-fibres run superomedially
-origin: thoracolumbar fascia, iliac crest and iliopectineal arch
-insertion: lower costal cartilages and linea alba
Tranversus abdominus
-horizontal fibres
-origin: inner surface of lower costal cartilages, thoracolumbar fascia, iliopectineal arch and iliac crest
-insertion: linea alba
Transverse fascia
-located below transversus abdominus
What forms the inguinal ligament
-inferior margin of external oblique
Semilunar lines
-formed by divisions of the internal oblique and correspond with lateral margins of rectus abdominis
-extend from 9th costal cartilage to pubic tubercle
Transversalis fascia
-separates the anterior abdominal wall from extraperitoneal fat
Divisions of the rectus sheath
-anterior layer
-posterior layer
Arcuate line
-where inferior epigastic artery and vein perforate the rectus abdominis
Rectus abdominus muscles
-run vertically on either side of anterior abdominal wall
-separated by linea alba
Tendinous intersections
-3 narrow bands on rectus abdominis muscles
-what results in 6 pack shape
Origins of vessels of anterolateral abdominal wall
-internal thoracic vessels
-external iliac vessels
-intercostal vessels
-femoral artery
-greater saphenous vein
Origin of main nerves of anterolateral abdominal wall
-lumbar and sacral plexuses
Inguinal canals
-naturally occuring paired canals in lateral lower regions of anterior abdominal wall
Inguinal canals function
-serve as a conduit for male gonads from point of origin to final destination
Deep inguinal ring
-origin of each inguinal canal
-located at medial half of inguinal ligament
Superficial inguinal ring
-termination of each inguinal canal
-located superolateral to pubic tubercle
Layers of abdominal wall from superficial to deep
-skin
-superficial fascia
-muscles
-transversalis fascia
-extraperitoneal fat
-peritoneum
Anterolateral abdominal wall muscles from deep to superficial
-transversus abdominis
-internal oblique
-rectus abdominis
-external oblique
-mnemonic spells out “TIRE”
Posterior abdominal wall muscles
-psoas major and minor
-iliacus
-quatratus lumborum
Arteries of the anterolateral abdominal wall
-internal thoracic
-posterior intercostal and subcostal arteries
-inferior epigastric artery
-deep and superficial circumflex arteries
Veins of the anterolateral abdominal wall
-superior and inferior epigastric
-thoracoepigastric
-subcostal
Nerves of the anterolateral abdominal wall
-thoracoabdominal
-lateral cutaneous branches of 7-11
-subcostal
-iliohypogastric
-ilioinguinal
Arteries of the posterior abdominal wall
-abdominal aorta
-subcostal
-inferior phrenic
-lumbar arteries
Veins of the posterior abdominal wall
-inferior vena cava
-inferior phrenic veins
-lumbar veins
-common iliac veins
Nerves of the posterior abdominal wall
-aortic plexus
-periarterial plexus
What is the peritoneum
-largest serous membrane of the body
2 main layers of the peritoneum
-parietal peritoneum
-visceral peritoneum
Parietal peritoneum
-lines the wall of the abdominopelvic cavity
Visceral peritoneum
-covers some of the abdominal organs
Peritoneal cavity
-space in between the 2 layers of the peritoneum
-contains lubricating serous fluid
Intraperitoneal
-structures that are almost completely enveloped by visceral peritoneum and attach to the abdominal walls by a mesentery
Intraperitoneal organs
-liver
-spleen
-stomach
-first part of duodenum
-jejunum
-ileum
-cecum
-vermiform appendix
-tranverse colon
-sigmoid colon
Retroperitoneal
-structures that lie between parietal peritoneum and posterior abdominal wall
-not supported by mesentery and have a layer of parietal peritoneum resting on anterior surface
Retroperitoneal organs
-rest of the duodenum
-pancreas
-ascending colon
-descending colon
-adrenal glands
-kidneys
-ureters
-upper rectum
-aorta
Function of the folds of the peritoneum
-bind viscera of GI tract to eachother and to abdominal wall
-contain blood vessels, lymphatic vessels, and nerves that supply abdominal organs
5 major folds of the peritoneum
-greater omentum
-falciform ligament
-lesser omentum
-mesentery
-mesocolon
Greater omentum
-longest fold
-extends from stomach and duodenum to the small intestine and the up to the transverse colon
Falciform ligament
-attaches liver to anterior abdominal wall and diaphragm
Lesser omentum
-suspends stomach and duodenum from the liver
-pathway of blood vessels entering the liver
Mesentery
-largest fold
-binds the jejunum and ileum of small intestine to posterior abdominal wall
Mesocolon
-binds sigmoid colon to posterior abdominal wall
-carry blood vessels and lymphatic vessels to the intestines
What shape is the stomach
-j shaped
4 main regions of the stomach
-cardia
-fundus
-body
-pyloric part
Cardia of the stomach
-surrounds superior opening of esophagus into the stomach
Fundus of the stomach
-rounded portion superior and to the left of the cardia
Body of the stomach
-large central portion inferior to fundus
Regions of the pyloric part
-pyloric antrum
-pyloric canal
-pylorus
Pyloric antrum
-connects to the stomachs body
Pyloric canal
-leads to the pylorus
Pylorus
-leads to the duodenum
Gastric folds
-allow stomach to distend and accomodate considerable amount of food
Pyloric sphincter
-how the pylorus communicates with the duodenum
Lesser curvature of the stomach
-concave medial border
Greater curvature of the stomach
-convex lateral border
Blood supply of the stomach
-branches of celiac artery
Where does blood drain into from the stomach
-hepatic portal vein
Parasympathetic innervation of the stomach
-celiac ganglia
Blood supply of the lesser curvature of the stomach
-left and right gastric arteries
Blood supply of fundus and upper body of stomach
-short and posterior gastric arteries
Blood supply of the greater curvature of the stomach
-left and right gastro-omental arteries
Function of the small intestine
-site of most digestion and almost all absorption of nutrients
3 regions of the small intestine
-duodenum
-jejunum
-ileum
Duodenum classification
-retroperitoneal
Location of duodenum
-pyloric sphincter to jejunum
4 parts of the duodenum
-superior limb
-descending limb
-inferior limb
-ascending limb
Jejunum location
-left upper quadrant of abdominal cavity
Ileum location
-right lower quadrant of abdominal cavity
Duodenojejunal flexure
-where jejunum begins
Ileocecal junction
-where ileum ends
Blood supply of the jejunum and ileum
-superior mesenteric artery
Ileal orifice
-where the ileum joins the large intestine
Innervation of the small intestine
-superior mesenteric plexus
Large intestine classification
-ascending and descending parts of colon are retroperitoneal
-remaining parts and rectum are attached by mesocolon
3 principal regions of the large intestine
-cecum
-colon
-rectum
Anal canal
-where rectum terminates
Cecum location
-lower right portion of abdominal cavity
What is the appendix attached to
-cecum
Mesoappendix
-mesentery of the appendix
Colon location
-merges from open end of cecum
4 segments of the colon
-ascending
-transverse
-descending
-sigmoid
Ascending colon
-ascends on the right side of the abdominal cavity to right colic flexure
Transverse colon
-travels across left side of abdominal cavity to left colic flexure
Descending colon
-descends on left side of abdominal cavity to the level of the iliac crest
Sigmoid colon
-travels medially from the left iliac crest to the level of the third sacral verebra
Rectum location
-descends anterior to sacrum and coccyx
Anal columns
-mucous membrane that contains blood vessels
Anus
-opening to exterior
-normally closed by 2 sphincters
Sphincters of the anus
-internal anal sphincter
-external anal sphincter
Internal anal sphincter
-smooth muscle tissue
-involuntary
External anal sphincter
-skeletal muscle tissue
-voluntary
Blood supply of ascending colon
-right colic and ileocolic arteries
Blood supply of transverse colon
-middle colic artery
Blood supply of descending colon
-left colic artery
Blood supply of sigmoid colon
-sigmoid arteries
Liver location
-under the diaphragm in the upper right quadrant of the abdominal cavity
-vertebral levels T7-L2
2 surfaces of the liver
-convex diaphragmatic surface
-concave visceral surface
Visceral surface of the liver
-covered with visceral peritoneum
-except at porta hepatis and gallbladder fossa
Gallbladder fossa
-where gallbladder rests against liver
Porta hepatis
-passage for structures to pass to and from liver
Structures of the porta hepatis
-hepatic portal vein
-hepatic arteries
-common bile duct
2 principal lobes of the liver
-right lobe
-left lobe
Divisions of the left lobe of the liver
-quadrate lobe
-caudate lobe
What separates the lobes of the liver
-falciform ligament
Ligamentum teres
-free border of the falciform ligament
-extends from liver to umbilicus
Common hepatic duct
-formation of the right and left hepatic ducts
-exits the liver
Common bile duct
-formation of common hepatic duct and cystic duct
-drains bile into descending limb of duodenum
Where is bile stored
-gallbladder
Blood supply of the liver
-hepatic artery
-hepatic portal vein
Innervation of the liver
-parasympathetic innervation from vagus nerve
-sympathetic innervation from greater splanchnic nerves
What shape is the gall bladder
-pear shaped
Parts of the gallbladder
-fundus
-body
-neck
Blood supply of the gallbladder
-cystic artery
Drainage of blood from the gallbladder
-cystic veins
Innervation of the gallbladder
-celiac plexus
-vagus nerves
Pancreas classification
-retroperitoneal
Location of the pancreas
-posterior to greater curvature of the stomach
4 major regions of the pancreas
-head
-neck
-body
-tail
Ducts of the pancreas
-pancreatic duct
-accessory duct
Pancreatic duct
-joins the bile duct to form hepatopancreatic ampulla
Accessory duct
-empties into duodenum
Blood supply of the pancreas
-superior and inferior pancreaticoduodenal arteries
-plenic and superior mesenteric arteries
Drainage of blood from the pancreas
-hepatic portal vein
Innervation of the pancreas
-celiac and superior mesenteric plexuses
Structures of the urinary system
-2 kidneys
-2 ureters
-urinary bladder
-urethra
Shape of the kidneys
-kidney bean shaped
Kidney location
-just above the waist between the peritoneum and posterior abdominal wall
-between T12-L3 on left side and between L1-L4 on the right side
Protection of the kidneys
-ribs 11 and 12
Which kidney is slightly lower
-right kidney is lower than left kidney
Hilum of the kidney
-allows passage of ureter, blood vessels and lymphatic vessels, and nerves
3 layers of protective tissue of the kidney
-renal capsule
-perirenal fat capsule
-renal fascia
Renal capsule
-inner layer
-dense irregular connective tissue that serves as a barrier against trauma
Perirenal fat capsule
-intermediate layer
-protects and insulates the kidney
Renal fascia
-outer layer
-anchors the kidney to surrounding structures and to the abdominal wall
Regions of the kidney
-renal cortex
-renal medulla
Renal cortex
-outer light red layer
Renal medulla
-inner dark red-brown region
Renal pyramids
-in the renal medulla
Renal papillae
-apexes of the renal pyramids
Nephrons
-functional unit of the kidney
-produce urine
Pathway of urine
-filtrate from nephrons drains into papillary ducts and onwards to minor and major calyces
-these deliver urine into renal pelvis and the urine exits kidney by flowing into ureter
Renal sinus
-cavity in the kidney that accomodates renal pelvis and calyces
Blood supply of the kidneys
-right and left renal arteries
-right and left renal veins
Innervation of the kidneys
-celiac and aorticorenal ganglia
-renal plexus
Ureter function
-transport urine into the urinary bladder
What allows transport of urine by the ureters
-peristaltic waves
-hydrostatic pressure
-gravity
Ureters classification
-retroperitoneal
Blood supply of the ureters
-renal arteries
-testicular/ovarian arteries
-common iliac arteries
-inferior vesical arteries
Innervation of the ureters
-renal plexuses
Urinary bladder location
-located in pelvic cavity posterior to pubic symphysis
-in males, anterior to rectum
-in females, anterior to vagina and inferior to uterus
Do males or females have a smaller bladder capacity
-females
Trigone
-triangle shaped area at floor of urinary bladder
Urethral openings
-2 posterior corners of the urinary bladder
Internal urethral orfice
-anterior corner
-opening into urethra
3 layers of the urinary bladder
-inner mucosa
-intermediate detrusor muscle (muscular layer)
-outer layer
Inner mucosa layer of the urinary bladder
-this permits bladder to inflate and deflate to accommodate varied urine volumes
Intermediate detrusor muscle (muscular layer) of the urinary bladder layers
-inner longitudinal layer
-middle circular layer
-outer longitudinal layer
Internal urethral sphincter
-circular fibres around opening to urethra
External urethral sphincter
-skeletal muscle
-inferior to internal urethral sphincter
Outer layer of urinary bladder
-advetitia on posterior and inferior surfaces
-serosa on superior surface
Micturition
-how urine is expelled
-involuntary and voluntary muscle contractions
Blood supply of the urinary bladder
-superior, middle and inferior vesical arteries
Drainage from the urinary bladder
-internal iliac vein
Innervation of the urinary bladder
-hypogastric sympathetic plexus
-2 and 3 sacral nerves
Urethra
-small tube leading from internal urethral orifice in the floor of the urinary bladder to the exterior
Urethra location in females
-posterior to pubic symphysis
-embedded in anterior wall of vagina
External urethral orifice location in females
-between clitoris and vaginal opening
Layers of female urethra
-deep mucosa
-superficial muscular layer
3 regions of the male urethra
-prostatic urethra
-intermediate urethra
-spongy urethra
Layers of the male urethra
-deep mucosa
-superficial muscular layer
Openings of the male urethra
-prostatic urethra openings
-spongy urethra openings
Prostatic urethra openings function
-deliver secretions from the prostate and the 2 seminal glands
-delivers sperm from the ductus vas deferens
Spongy urethra openings function
-ducts from bulborethral glands transports both urine and semen
Greater false pelvis
-superior to the pelvic inlet
Lesser true pelvis
-between pelvic inlet and pelvic outlet
Pelvic inlet
-bounded by linea terminalis
-formed by pubic symphysis and pubic crest, pectineal line and arcuate line of ileum
Pelvic outlet
-bounded by pubic symphysis, inferior rami of pubis and ischial tuberosities, sacrotuberous ligaments and tip of coccyx
Pelvic diaphragm parts
-levator ani
-coccygeus muscles
Levator ani
-arises from pubic bone, ischial spine and tendinous arch of levator ani muscle
Levator ani fibres divisions
-puborectalis muscle
-pubococcygeal muscle
-iliococcygeal muscle
Urogenital hiatus
-allows passage of urethra and genital canal
Rectal hiatus
-allows passage of rectum
Levator ani function
-control intra-abdominal pressure
-bears the weight of pelvic contents
-participates in closure of the rectum
Innervation of levator ani
-sacral plexus
Ligaments of the pelvic wall
-sacrospinous
-sacrotuberous
Functions of the ligaments of the pelvic wall
-stabilize sacrum on the pelvic bones by resisting upward tilt
Sacrospinous ligament
-origin: ischial spine
-insertion: sacrum and coccyx
Sacrotuberous ligament
-origin: PSIS, sacrum, coccyx
-insertion: ischial tuberosity
Greater sciatic foramen
-lies superior to the sacrotuberous ligament and ischial spine
Lesser sciatic foramen
-lies inferior to ischial spine and sacrospinous ligament
Obturator foramen
-has obturator canal at the top which is bordered by obturator membrane
Muscles of the pelvic wall
-obturator internus and piriformis
Obturator internus and piriformis
-origin: pelvic cavity
-insertion: femur
3 parts of the hip bone
-pubis
-ilium
-ischium
Parts of the pubis
-body
-superior ramus
-inferior ramus
Parts of the ilium
-body
-iliac wing
Parts of the ischium
-body
-ramus of the ischium
Perineal region divisions
-urogenital triangle
-anal triangle
Urogenital triangle
-anterior portion
-bounded by interischial line
Perineal membrane
-seals the urogenital triangle
Muscles of the perineal membrane
-bulbospongiosus
-ischiocavernosus
-transversus perineal muscles
Perineal membrane muscles innervation
-pudendal nerves
Ischiorectal fossa
-lies between urogenital diaphagm and pelvic diaphragm
Contents of the ischiorectal fossa
-abdominal fat
-pudendal artery, vein and nerve
-inferior rectal nerve and artery
Perineal body
-fibromuscular mass
-located between the 2 triangles
Muscles attached to the perineal body
-external anal sphincter
-bulbospongiosus
-transverse perineal muscles
Testis function
-sperm production
Testis location
-in the scrotum
Epididymis
-highly coiled tube attached to posterior surface of each testis
Parts of the epididymis
-head
-body
-tail
Which part of the epididymis is continuous with the vas deferens
-tail
Ductus (vas) deferens
-comprises the spermatic cord
Ejaculatory duct
-where ductus deferens terminates and joins the duct of the seminal vesicles
What is the most distal structure of the male reproductive canal
-urethra
Urethra function
-expels urine and sperm
3 major accessory glands of male reproductive system
-seminal vesicles
-prostate glands
-bulborethral glands
3 parts of the penis
-root
-body
-glans
Root of the penis
-attaches penis to perineum
-contains bulb of he penis
-contains paired crus of penis
2 erectile tissues of the body of the penis
-corpus spongiosum
-corpora cavernosa
Outermost internal female sex organ
-vagina
Where is vagina located
-posterior to urinary bladder and urethra
-anterior to rectum
Vaginal fornix
-formed from vagina and cervix
Vaginal orifice
-opens into vaginal vestibule
Blood supply of the vagina
-internal iliac artery
Innervation of the vagina
-inferior hypogastric plexus
-pelvic splanchnic nerves
3 parts of the uterus
-body
-cervix
-pouches
Body of the uterus
-main part
-connected to fallopian tubes
-has a base and an internal chamber
Cervix
-internal portion of the uterus
-has 2 openings
-cervical canal
Pouches of the uterus
-rectouterine pouch
-vesicouterine pouch
Peritoneal ligaments of the uterus
-broad ligament
-round ligament
Broad ligament of the uterus parts
-mesometrium
-mesovarium
Blood supply of the uterus
-uterine artery
Normal pelvic orientation
-anteverted anteflexed posture
Anal columns
-series of longitudinal ridges of the rectum
Anorectal juction
-border between rectum and anal canal
Anal valves
-inferior ends of anal canals
Anal sinuses
-recesses of the anal columns
Pectinate line
-indicates junction of the superior and inferior part of the anal canal
Innervation of the rectum
-rectal plexus
Blood supply of the rectum
superior and inferior rectal artery
Drainage of the rectum
-external and internal rectal venous plexuses
Anal canal
-terminaton of the large intestine
Anorectal flexure
-where the rectum narrows
Supply of the internal iliac artery
-pelvic wall and organs
-gluteal region
-thigh
Branches of the internal iliac artery
-parietal branches
-visceral branches
Supply of the external iliac artery
-lower limb
-muscles
-lower abdominal wall
Branches of external iliac artery
-inferior epigastric
-deep circumflex iliac arteries
Veins of the pelvis
-internal iliac artery