EXAM II Flashcards
Name the 5 muscles of the posterior abdominal wall and list their functions
- Psoas major - Flexes thigh at hip, unilaterally side-bends trunk to the same side (via lumbar plexus)
- Psoas minor - Assists in extension and flexion of the trunk, unilaterally side-bends trunk to the same side (via lumbar plexus)
- Quadratus lumborum - Extends and laterally flexes vertebral column, flexes rib 12 during inspiration
- Iliacus - Flexes thigh at hip. Flexes pelvis on thigh with the lower limb fixed (femoral n.)
- Transversus abdominis
Which posterior abdominal wall is the most lateral muscle?
Quadratus lumborum
Which rib does the diaphragm extend up towards?
5th rib
What are the boundaries of the diaphragm? (3)
Xiphisternal joint
Costal margin
Body of TV12
The respiratory diaphragm contains a central tendon. What are the 3 peripheral origins that insert on the central tendon?
- Sternal origin
- Costal origin
- Lumbar origin
Where does the left and right crus of the diaphragm meet at?
The aortic hiatus
Right crus is longer than the left crus
What are the 3 arcuate ligaments/lumbocostal arches that are formed by the posterior origins of the diaphragm in the inferior diaphragm? (the arcuate ligaments go over the posterior wall structures)
- Median (exactly in middle)
- Medial (both sides of median)
- Lateral (outermost)
What structure(s) doe the median arcuate ligament cover?
Aorta
What structure(s) does the medial arcuate ligament cover?
Psoas major muscle
Sympathetic trunks
What structure(s) does the lateral arcuate ligament cover?
Quadratus lumborum muscle
Subcostal nerve, artery, and vein
At what location on the posterior abdominal wall is a potential site for hernias? What is it located?
Vertebrocostal/lumbocostal triangle
Lateral to the lateral arcuate ligament/quadratus lumborum
List the 3 hiatuses that go through the diaphragm and what passes through them
I Ate(T8) Ten(eggs; T10) At(Noon; T12)
- (inferior) Vena Caval foramen; T8 - IVC, terminal branches of right phrenic nerve, lymphatics from liver
- Esophageal hiatus; T10 - esophagus, anterior and posterior vagal trunks, lymphatics
- Aortic Hiatus; T12 - aorta and thoracic duct
Sternocostal hiatus - superior epigastric vessels
What are the vessels of the superior (3) and inferior surface (2) of the diaphragm?
Superior - (PMS) pericardiacophrenic, musculophrenic, superior phrenic artery
Inferior - inferior phrenic artery and vein via celiac trunk or aorta (right passes posterior to IVC, left passes posterior to esophagus, posterior branches give off superior suprarenal artery)
State the motor and sensory nerve(s) that supply the diaphragm
Motor - phrenic n. (C3,4,5) run with the inferior phrenic artery
Sensory (2) - phrenic n. (sensory from central tendon) and intercostal n. (via peripheral part)
The term “retroperitoneal” may be used to describe the location of certain abdominal organs. This means that such organs are located:
a) Between the visceral and partial layers of the peritoneum
b) Posterior to the parietal peritoneum
c) In the peritoneal cavity
d) Between folds of the parietal peritoneum
Posterior to the parietal peritoneum
What part of the vertebrae constitutes where the aorta bifurcates?
L4
List the components of the renal system
Kidneys (left kidney sits far left over abdominal aorta) Suprarenal glands Ureter Urethra Urinary bladder
What is the anatomical relationship of the kidney and muscles of the posterior ab wall?
Sits anterior to quadratus lumborum
What is the pathway of urine drainage?
Minor calyx
Major calyx
Renal pelvis
Ureter
Name the potential space that is apart of the endopelvic fascia
Retrorectal space
Between sacrum and rectum
Which septum of the rectal region separates the rectum from the prostate and the seminal vesicles in males?
Rectovesical septum (urorectal)
Describe ischioanal abcesses
Infections from within the anal canal, pelvic infection, etc. that can spread into the ischioanal fossae and spread through the superficial and deep postanal spaces to the other side
Describe the anatomical location of the ureters
Retroperitoneal
Crosses the pelvic brim where the common iliacs bifurcate
Enters bladder wall obliquely
Describe the “water under the bridge” phenomenon in terms of the ureter going to the bladder
Where the ureter crosses inferiorly to the uterine artery to enter the bladder
Describe the relationship of the ureter in the male
Ureter crosses inferior to the ductus deferens to enter to bladder (another aspect of water under the bridge)
Describe the anatomical location of the urinary bladder
Located within the retropubic space
Inferior to the peritoneum
Posterior to the pubic symphysis
Trigone = internal smooth thickened area defined by openings of the two ureters and the urethra
Describe the anatomical relationship of the ovarian arteries (where do they arise from)
From the aorta, cross anterior to the ureter and go over the bifurcation of the common iliac arteries
Run in the suspensory ligament
Internal vs. External hemorrhoids
Internal - internal rectal veins that prolapse into the anal canal and often strangulate
External - clotted blood in the external rectal veins. Usually caused by increased abdominal pressure or straining
Describe the anatomical location of the vagina
Muscular tube between the bladder and rectum, inferior to the uterus
Opens through the perineal membrane into the vestibule
Which muscle supports the vagina? Membrane?
Pubovaginalis part of the lavator ani muscle and perineal membrane
Both are important in preventing prolapse of pelvic structures
Explain the anatomical location of the female urethra. Where does it begin? What does it pass through?
Begins at the internal urethral orifice of the bladder
Passes through the external urethral sphincter, perineal membrane, then through the perineum and vestibule
Females have no true internal urethra sphinctor
In the female, which artery does the ureter pass inferior to?
Inferior to the uterine artery along the lateral sides of the uterus
Describe the anatomical location of the uterus
The fundus is normally ante erred and anteflexed
The axis of the uterus is angled Anteriorly relative to the vagina and the top of the fundus flexes Anteriorly over the bladder
Explain the anatomical location of the ovaries, where are they located? What suspends them?
Near the attachment of the broad ligament to the lateral pelvic wall
Suspended from the lateral pelvic wall by the suspensory ligament of the ovary, containing ovarian arteries, veins, nerves and lymphatics
Describe the three forms of peripheral nerve blocks; what is the landmark?
Sacralspinous ligament
Performed to block uterine contraction sensations
- Pudendal block = blocks S2-S4 dermatomes & inferior part of vagina
- Ilioinguinal block = blocks anterior vulva
- Posterior femoral cutaneous nerve/perineal branches
Function of the bulbourethral glands, where is it located?
Lubricates the urethra
Superior to perineal membrane embedded within sphincter urethrae (external urethral sphincter)
Opens into spongy urethra
List the two non diaphragmatic pelvic muscles
- Obturator internus
2. Piriformis
What 3 muscles make up the lavator ani muscle?
PIP
Pubococcygeus
Iliococcygeus
Puborectalis - forms loop around anus
Which of the following cranial bones is not paired?
Palatine
Sphenoid
Parietal
Maxilla
Sphenoid
Which cranial foramen permits passage of the Mandibular nerve (V3)?
Foramen ovale
Foramen spinosum
Foramen rotundum
Jugular Foramen
Foramen ovale
Which of the following nerves is in the lateral wall of the cavernous sinus?
Optic CN II
Mandibular V3
Trochlear CN IV
Facial CN VII
Trochlear CN IV
Excess CSF is removed from the subarachnoid space by:
Ependymal cells Microglia Astrocytes Arachnoid granulations Choroid plexus
Arachnoid granulations
What is the main function of the cranial meninges?
To enclose and protect blood vessels that supply the brain and circulate CSF
Where do the cranial dural septa arise from? List the four dura septa
Arise from the meningeal layer of the dura mater that extends as flat partitions/septa deep into the cranial cavity which house venous sinuses
- Falx cerebri
- Falx cerebelli
- Tentorium cerebelli
- Diaphragma sellae
Define what a brain ventricle is
Cavities or expansions within the brain that are derived from the lumen/opening of the embryonic neural tube
Continuous with one another and the central canal of the spinal cord
Where are the lateral ventricles located?
In the cerebrum
Separated by a thin medial partition = septum pellucidum
Where is the third ventricle and fourth ventricle located?
3rd ventricle = diencephalon; communicates with the lateral ventricles via interventricular foramen
4th ventricle = pons and cerebellum
CSF flow = from 3rd ventricle thru mesencephalic aquaduct into 4th ventricle
CSF flows thru subarachnoid space & removes waste products. Excess CSF flows into arachnoid villi —> dural venous sinuses. Pressure allows CSF to be released into blood without permitting any venous blood to enter subarachnoid space. The greater pressure in CSF in subarachnoid space assures CSF movement into venous sinuses
What 3 distinct locations in the CNS is the blood-brain barrier markedly reduced?
CHP
Choroid plexus
Hypothalamus
Pineal gland
The portion of the adult brain including the epithalamus, thalamus, and hypothalamus is derived from which secondary brain vesicle?
a. Telencephalon
b. Diencephalon
c. Myelencephalon
d. Metencephalon
e. Mesencephalon
Diencephalon
Clusters of gray matter containing neuron cell bodies that lie within masses of white matter is/are the:
a. cortex
b. cerebral ganglia
c. cerebral nuclei
d. cerebral peduncles
e. ventricles
Cerebral nuclei
List the 4 muscles of mastication
Mature Men Love T; CN V3 (mandibular)
Masseter
Medial Pterygoid
Lateral Pterygoid
Temporalis
Differentiate between buccal nerve and buccal branch
Differentiate between mandibular branch and mandibular nerve
Buccal n. = via Trigeminal nerve (CN V3)
Buccal branch = via Facial nerve (CN VII)
Mandibular n. = via Trigeminal nerve (CN V3)
Mandibular branch = via Facial nerve (CN VII)
What are the two arterial branches via the internal carotid? What do they supply?
- Supraorbital
- Supratrochlear
Both supply the skin and muscles of forehead and anterior scalp
What is the anatomical location of the parotid gland, where does it receive sensory innervation from? Parasympathetic innervation?
Laterally in the face, just anterior to the ear
Sensory innervation = great auricular nerve via spinal sensory innervation
Parasympathetic = glossopharyngeal via posterior auricular nerve via facial n. (CN VII)
What artery supplies the orbit and eyeball? Venous drainage?
Ophthalmic artery via internal carotid artery
Drainage via superior and inferior ophthalmic veins
