Exam 2 Flashcards
Levator Palpebrae Superioris
Innervation: CNIII (superior)
Action: Raises eyelid
Superior rectus
Innervation: CN III, Superior
Action: Elevates, Adducts eye (medial rotation)
Medial Rectus
Innervation: CNIII, Inferior
Action: Adduct eye
Inferior Rectus
Innervation: CNIII, inferior
Action: Depresses, adducts eye (lateral rotation)
Lateral Rectus
Innervation: Abducent (VI)
Action: Avducts eye
Inferior Oblique
Innervation: CN III, inferior
Action: Elevates, abducts, and laterally rotates
Superior Oblique
Innervation: Trochlear (IV)
Action: Depress, abduct, medially rotates
Ophthalmic artery
From: Internal Carotid
CLP SAP DS
Central Artery of Retina
Lacrimal Artery
Posterior Cilliary
Supraorbital
Anterior Ethmoidal
Posterior Ethmoidal
Dorsal Nasal
Supratrochlear
Cilliary Muscle:
Innervation: Parasympathetics from CNIII
Action: Controls shape of lens
Far: Flat lens
Close, thick lens
Cilliary Process:
Produce aqueous humor
Canal of Schlemm
Covered by endothelium, receives aqueous humor from Anterior chamber via Trabeculae
Opthalmic Nerve
V3, from Trigeminal NFL Nasociliary Frontal Lacrimal
Frontal Nerve
From: Opthalmic nerve
Supratrochlear (medial)
Supraorbital (lateral)
Glaucoma
Blockage of Trabeculae leading to no aqueous fluid moving into canal of Schlemm. Vision impaired by pressure on retina.
Open angle: Blockage
Close angle: Blockage by iris.
Cataracts:
Clouding of the lens
Postremal Champer
Filled with vitreous humor.
Fovea
Center of visual axis, only cones, no blood vessels.
Optic disc
No photoreceptors, blind spot.
Papilledema
Increase in CSF pushes on back of optic disc, causing it to bulge.
Superior Constrictor
Innervation: Vagus (X)
Action: Swallowing
Middle Constrictor
Innervation: Vagus (X)
Action: Swallowing
Inferior Constrictor
Innervation: Vagus (X)
Action: Swallowing
Stylopharyngeus
Innervation: CN IX
Attachment: thyroid
Salpingopharyngeus
Innervation: X
Tensor Veli Palatini
Innervation: V3
Vagus in Larynx
Branches:
External laryngeal (sup) Internal Laryngeal (inf) Recurrent laryngeal (Runs around Aorta on Left side, Subclavian on Right side)
Inferior laryngeal artery
From: Inferior Thyroid (from thyrocervical of subclavian)
Runs with: Recurrent laryngeal.
Superior laryngeal Artery
From: Superior thyroid (from External carotid)
Runs with: Internal laryngeal
Diaphragm
Innervation: phrenic
Origin: xiphoid, lower 6 ribs, l1-l3
Insertion: Central tendon
Action: Draws central tendon forward during inspiration
Quadratus lumborum
Innervation: Ventral rami of T12, L1-4
Origin: Transverse process of T12-L1 + 12th rib
Insertion: Iliac crest
Action: extends and abducts column
External carotid
From: Common carotid SALFORMS Superficial temporal Ascending pharyngeal Lingual Facial Occipital posterior auRicular Maxillary Superior thyroid artery
Coccygeus
Innervation: S4, S5
Origin: Sacrospinous ligament
Insertion: Coccyx
Action: Supports Pelvic Vicera
Celiac Trunk
Supplies: Foregut
Divides: T12
Branches:
Left Gastric
Splenic
Common Hepatic
Left Gastric
Anastomosis with R. Gastric
Anastomosis:
L. Gastric(Cystic) R. Gastric(Hepatic proper)
L. Gastroomental (splenic) R. Gastroomental (Common Hepatic/gastroduodenal)
Common Hepatic
From: Celiac Trunk
Branches:
Gastroduodenal
Hepatic Proper
Hepatic Proper
From: Common Hepatic
Branches:
Right Gastric
Left Hepatic
Right Hepatic
Right Hepatic
From: Hepatic Proper
Branches:
Cystic Artery to Gallbladder
Gastroduodenal
From: Common Hepatic
Branches:
Superior Pancreaticoduodenal
Right Gastroomental
Splenic
From: Celiac
Branches:
Short Gastric
Left gastroomental
Foregut:
Stomach, liver, gallbladder, pancreas, spleen, half of duodenum
Midgut
half of duodenum, jejunum, ilium, cecum, ascending colon, 2/3rd of transverse colon.
Hindgut
Left 1/3rd of transverse colon, descending, sigmoid, rectum
Blood supply to rectum:
Superior Retal (Inf. Mesenteric) Middle Rectal Artery (internal illiac) Inferior Rectal (internal pudental)
Superior rectal inferior rectal (in anal column).
Embryologic origin of Trigone
Mesoderm, everything else endoderm
Sclera vs. Cornea?
Sclera: Opaque, with blood vessels
Cornea: Transparent and avascular (ant 1/6th)
Where is Aqueous humor made?
Cilliary process
Where is aqueous humor reabsorbed?
Canal of Schlemm
Boundaries of the pharynx?
Nasopharynx (skull to soft palate)
Oropharynx
(soft palate to hyoid bone)
Laryngopharynx (hyoid to esophagus)
Boundaries of the larynx
Epiglottis to trachea
Where can you find Stylopharyngeus?
Between the superior and middle constrictors
What is the developmental internal spermatic fascia?
Fascia transversalis
Internal oblique turns into what in the scrotum?
Cremasteric muscle.
What abdominal muscle is not represented in the scrotum?
Transversus abdominus
What does the peritoneal become in the scrotum?
Tunica vaginalis
What does the external oblique become in the scrotum?
External spermatic fascia and inguinal ligament (not in scrotum)
What does the transversals fascia become in the scrotum?
Internal Spermatic fascia
What does scamper’s fascia turn into in the scrotum?
Colle’s fascia
What does fatty camper’s turn into in the scrotum?
Dartos muscle, gives scrotum its ridges.
Nerve lies over psoas
Genitofemoral N
Nerve that lies over quadratus lumborum
subcostal, ilioinguinal, iliohypogastric
Nerve that lies between External and internal oblique muscle
Iliohypogastric
Nerve that lies between transverse abdominus and internal oblique
Ilioinguinal
Nerve that lies over iliacus
lateral femoral cutaneous
Where does true pelvis start?
arcuate line of pelvis
What muscle lies above the crua in the superficial pouch?
Ishiocavernosum
What muscle lies above the bulb of the penis in the superficial pouch?
Bulbospongiosum
What Muscle lies along the inferior border of the UG triangle in the superficial pouch?
Superficial Transverse peroneal
Where do you do a nerve block for pelvic female procedures?
Ishial Spine, blocks internal pudental nerve.
Erection pins down what vessel between fascia?
Deep dorsal vein
What muscles make up deep pouch?
Sphincter urethra
Deep transverse perennial
Pathway of pudendal nerve
Comes out of greater sciatic foramen
Goes into lesser sciatic foramen
travels through Alcock’s canal (thickening of obturator internus fascia)
Turns into perennial, then posterior scrotal
Inferior Fascia in females is called
perineal membrane
Where does the Sciatic nerve emerge in gluteal region?
between piriformis and superior gemellus
Four arteries that contribute to cruciate anastomosis
Lateral circumflex femoral transverse artery
Medial circumflex femoral transverse artery
Inferior gluteal
Ascending branch from 1st perforating artery
What dermatome covers the knee cap and big toe?
L4
What dermatome does the lateral posterior leg?
S1
What dermatome does the medial posterior leg?
S2
Car bumper damage to thigh affects what?
Common fibular nerve
Presents as: no dorsiflexion
Anterior tibial runs with what nerve?
Deep fibular nerve
Nerve that provides skin between big toe and 2nd metatarsal
Deep fibular nerve
Dorsalis pedis can be found
Lateral to extensor hallucis tendon
Knee flexors
Semimembranosus Semitendinosus Biceps Sartorius Gracilis Popliteus Plantaris Gastrocnemius
Knee Extensors
Quadriceps femoris
Tensor Fascia Lata
Gluteus Maximus
Hip Medial rotators:
Tensor Fascia Lata
Gluteus Min
Gluteus med
(all superior gluteal)
Hip Lateral rotators
Sartorius Gluteus max Inferior Gemellus Superior Gemellus Obturator internus Obturator Externus Piriformis Psoas Major Quadratus femoris
Plantarflexors
Peroneus Brevis Peroneus Longus Flexor Digitorum longus Flexor Hallucis longus Gastrocnemius Soleus Plantaris Tibialis posterior
Dorsiflexors
Extensor Digitorum longus
Extensor Hallucis Longus
Tibialis anterior
Peroneus tertius
Inverters
Tibialis anterior
Tibialis posterior
Everters
Peroneus Longus
Peroneus Brevis
Peroneus Tertius
Functional component of Sclera
Composed of both cornea and sclera .
Cornea: focus’ light unto medium.
Functional component of uvea
aka: choroid.
Absorbs stray photons.
Colliery body (muscle, process, coal of scheme)
parasympathetic lens thickening.
Functional component of retina
Ganglia, interneurons, photoreceptors.
Retroperitoneal organs
SAD PUCKER Suprarenal Aorta/IVC Duodenum (prt 2+3) Pancreas Ureter Colon (ascending + Descending) Kidney Esophagus Rectum
Point at which Celiac artery comes off of Aorta
T12
Describe the order of Heptic Artery, duct, portal vein
Portal vein = posterior
hepatic duct = right
Hepatic artery = left
Describe the ducts from liver to duodenum
Right and left hepatic duct join at common hepatic. Common hepatic duct joined by cystic duct, becomes common bile duct. Is joined by pancreatic duct enters duodenum part 2 at hepatopancreatic ampulla (ampulla of vader). Exits at main duodenal papilla.
What ligament enclose the portal triad?
Hepatoduodenal
Name the boundaries of the H
Ligamentum teres + ligamentum venosum (right)
IVC + Cystic duct (left)
Parasympathetics to Hindgut
Pelvic splanchnic
Sympathetic to hindgut
Lumbar splanchnics
Parasympathetic to midgut and foregut
Vagus
Sympathetic to midgut and foregut
Thoracic splanchnics
Consequence of portal hypertension
Esophageal varices + hemorrhoid
Jejunum + illium sympathetics
T5-T9
Vein Anastomosis
Left gastric vein + Esophageal vein
Superior rectal vein + middle inferior rectus
Pierces the psoas major
genitofemoral nerve
What does the functional left liver lobe contain?
Caudate and quadrate
What does the anatomical left liver lobe contain?
Not caudate and quadrate
Epiploic appendices are absent from:
CAR
Cecum, Appendix, rectum
What spinal segment does appendix pain travel through?
T10
What are the three sites for ureter constriction?
Uretopelvic (where it leaves the kidney
Pelvic inlet (where it goes over common iliac)
Uretovesicular (where it enters bladder, smallest)
Describe the arcuate ligaments
Median, medial, lateral
Median = aorta
medial = posts major
Lateral = quadratus lamborum
Divided by L and R crus
IVC tributaries
R gonadal Common iliac Hepatic renal LUmbar veins Inf phrenic vein
Suprarenal blood supply
Inferior suprarenal from Right renal
Middle suprarenal from abdominal aorta
Superior suprarenal from inferior phrenic
Suprarenal vein drainage
Right side: IVC
Left side: left renal vein
Passes through deep inguinal ring
Spermatic cord/round ligament
Genital branch of genitofemoral
Cremasteric muscle
spermatic cord contents
3 arteries:
Testicular, cremasteric, vas
3 veins:
vas, pampiform plexius, vestige of vaginalis
3 nerves:
genital n, sympathetic plexus (one around testicular artery and another around vas artery).
Above arcuate line
Rectus sheath has aponeurosis of ext. and int. oblique in front, and internal, and transverse abdomens behind.
Below arcuate line
Rectus sheath has aponeurosis of external oblique, int. oblique, and transverse abdomens in front, and nothing behind (transversals fascia)
What is the crotch of the bronchi called?
Carina
Left vs right main bronchus?
Left is longer, smaller diameter. Left divides into upper and lower.
Right is shorter, larger diameter. Divides into apertural for upper, intermedium for middle and lower loves.
Sternal angle projects back to what part of spine?
T4
Organization of L lung at hilum.
Both vessels ant to bronchus.
Artery superior to Vein.
Organization of R lung at hilum.
Artery and vein ant. to bronchioles, artery and bronchioles same level.
When does blood from right ventricle enter pulmonary trunk?
Systole
What supplies tissue of lungs, bronchiole supply or pulmonary supply?
Bronchiole supply
Child vs. Adult respiration
Adult: change in thoracic wall size + diaphragm moves down
Child: just diaphragm moving down.
Pleural recesses
Costodiaphragmatic (back, bigger)
Costomedialstinal (front)
Contents of posterior mediastinum
Aorta, esophagus, vagus, azygos + hemi, thoracic duct, symp chain.
Bifurcation of Trachea
T4-5
Where do intercostal nerves come out?
Between innermost and internal intercostal muscles
Lacrimal drainage
Drain at punch lacrimal through lacrimal caniculus (duct) to lacrimal sac. Lacrimal sac drains to nasal sinus through nasolacrmal duct.
What nasociliary branch carries parasympathetic nerves to eye
Short cilliary nerves
Muscle that originates from anterior aspect of orbit
Inferior oblique
Where do the optic nerve axons pierce the sclera?
Lamina cribosa
Buccinator
Innervation: VII
Levator veli palatini
Innervation: pharyngeal n (X)
Mylohyoid
Innervation: V3
Glossopharyngeal nerve
GLOAP glossopharyngeal nerve lesser patrosal Otic ganglion Auriculotemporal n Parotid gland
Palatoglossus
Innervation: X
Abductor of the vocal cords
Posterior cricothyroid (all others adduct)
Nerve supply to intrinsic muscles of the larynx
All done by inferior laryngeal (from recurrant) except for: cricothyroid (done by external laryngeal from superior laryngeal)
Damage to piriform fossa
damage to internal laryngeal, lose sensation above vocal chord
What is the cristae termina
From which the pectinate originate
Pharyngeal pouches
Ears, tonsil, bottom to top
Auditory tube 1 Tonsil 2 Inferior parathyroid3 Thymus superior Parathyroid 4
Aortic arches
1 Regress 2 Regress 3 Common carotid 4 L. Aorta R. Subclavian 5 Regress 6 L. ductus arteriosum+ pulmonary artery R. pulmonary artery
Ventral Vs. Dorsal mesentery
Ventral: foregut, falciform + lesser omentum
Dorsal: All of the gut, post body wall