Feb5 M3-Anatomy Lecture 5 Flashcards
3 muscles near the kidney
laterally: transversus abdominus on the outside
posterior: quadratus lomborum
medially: psoas
psoas major origin
sides of vertebrae T12 to L5, IV (intervertebral) discs and transverse processes
psoas major insertion
lesser trochanter of the femur (protrusion in the back) after it joined the iliacus muscle (iliopsoas)
psoas minor def and insertion
thin tendon like white muscle
insertion: sides of vertebrae T12 and L1, IV discs and transv processes
psoas minor insertion
superior ramus of the pubic bone
does psoas minor act at the hip joint
no bc doesn’t cross it (doesn’t go below the pelvis)
quadratus lomborum origin
medial half of 12th rib and transverse processes of L1 to L5
quadratus lomborum insertion
iliac crest of the ilium
iliacus origin and insertion
iliac fossa and ala of the sacrum
insertion: tendon of psoas muscle
iliacus and psoas form what + function of iliacus
iliopsoas muscle. iliacus powerful for lifting the leg
iliac crest, iliac fossa and ala of sacrum location
iliac crest = top of ilium
iliac fossa = interior surface of ilium
ala of sacrum = surface of sacrum medial to iliac fossa
superior pubic ramus location
(bone) anterior branch of ilium between iliac fossa and pubic symphysis (cartilage)
transversus abdominis location
most posterior abd wall muscle. horizontal. starts in the back and extends to the front (muscle part stops at mid clavic line)
attachement of the diaphragm (what supports it)
central tendon
where diaphragm fibers come from (origins)
sternum at the front
ribs on the side
some from the back too
3 holes in diaphragm are for what
IVC, esophagus and aorta (not closed whole, space in the back)
what forms external sphincter of LES
right crus of diaphragm
3 ligaments in diaphragm
median arcuate l.
medial arcuate l.
lateral arcuate l.
what median arcuate l. does + how many
helps close the gap where aorta passes. one median arcuate l.
what medial arcuate l. does + how many
there are two. let psoas pass the diaphragm
what lateral arcuate l. does + how many
there are two. arch over the quadratus lomborum
function of lateral arcuate l.
are connective tissue origins for lumbar fibers of the diaphragm
how right and left phrenic n cross the diaphragm
right crosses at IVC
left crosses posteriorly THROUGH the diphragm, by itself
how vagus crosses diaphragm
with esophagus (anterior vagal trunk is left vagus. posterior vagal trunk is right vagus)
what is below the lateral arcuate l. (crosses it from above diphragm and behind it, to below diaphragm)
subcostal nerve
what runs down the side of the back wall and the column
sympathetic trunk
name of 3 apertures of the diaphragm and what forms there
caval foramen (hole in central tendon) esophageal hiatus (right crus) aortic hiatus (right and left crura (crura in plural of crus) + median arcuate l.)
what goes through caval foramen
IVC, right phrenic n., lymphatics
what goes through esophageal hiatus
esophagus, esophageal vessels, vagus nerve, lymphatics
what goes through aortic hiatus
aorta, thoracic duct, azygos vein
3 man arteries to GI system and what they supply and logic for that
celiac trunk until half of duodenum (foregut)
SMA until 2/3 of transverse (midgut) IMA last third of transverse to anus (hindgut)
blood supply to the diaphragm
phrenic arteries
blood supply to the adrenals
phrenic arteries, aorta, renal arteries
gonadal vessels originate where
aorta
lumbar arteries are what
origin from aorta, like posterior intercostals but with no ribs anymore
renal veins and renal arteries diff in size
- right renal vein shorter than left
- right and left renal a. same size (aorta central)
most superior drainage in IVC in the abdomen
right, middle and left hepatic veins
what drains the diaphragm and drain where
phrenic veins. drain into IVC
where right and left adrenal veins drain
- left adrenal v drains in left renal v AND IVC
- rigth adrenal v drains in IVC
where right and left gonadal veins drain
- left gonadal v drains in left renal v
- right gonadal v drains in IVC
what’s found around the celiac trunk
celiac ganglion
posterior and anterior to left renal vein
posterior: aorta
anterior: SMA
how to figure out if gonadal vessels (arteries for ex) are male or female (testicular or ovarian vessels)
male: run straight bc go to deep inguinal ring + vas deferens coming out of deep inguinal ring too. don’t go in pelvis
female: go to pelvis, near ureter (bc ovaries in pelvis)
divisions of the PNS
sensory (afferent) (somatic and visceral sensory)
motor (efferent) (somatic or autonomic (SS and PSS))
how many cervical, thoracic, lumbar and sacral nerves + one other
8 cervical 12 thoracic 5 lumbar 5 sacral 1 coccygeal nerve
names of plexuses related to spinal nerves
- cervical nerves: cervical plexus superior and brachial plexus inferior
- lumbar nerves: lumbar plexus
- sacral nerves: sacral plexus
how skin innervation is achieved
branchings of intercostal, lumbar and sacral nerves
anatomy of 1 spinal nerve near the spine (on one side)
dorsal root ganglion and ventral root branch. then join and give off again ventral ramus and dorsal ramus
why spinal nerve called a mixed nerve
carries both sensory and motor info
how sensory information goes to the spine depending if comes from front or back of the body
front of body: travels in ventral ramus and then dorsal root ganglion (dorsal root ganglio is SENSORY)
back of body: dorsal ramus and dorsal root ganglion
how motor info goes to the body (to front or back of the body)
to front: ventral root ganglion (ventral root is motor) and then ventral ramus
to back: ventral root and then dorsal ramus
reflex arc def
neural circuit that goes through the spine. sensory through dorsal root and then motor ‘‘reflex’’ through ventral root
what connects SS chain to the spinal nerve
rami communicantes connect SS chain-spinal nerve and SS chain-ventral ramus
names of spinal nerves branchings that innervate the skin (specific names for those from ventral ramus)
lateral cutaneous branch and anterior cutaneous branch (near the sternum) of the intercostal/lumbar/sacral nerve
what section of the PNS do nerves below the thorax belong to and what nerves does this start with
T12 + lumbar plexus (L1 to L5). sensory and motor SOMATIC.
T12 = what nerve
subcostal
L1 what nerves
iliohypogastric (sup) and ilioinguinal (inf)
L1 and L2 form what nerve together (L2 mainly) + its branches
gentifemoral (has genital and femoral branches in pelvis)
what nerves below genitofemoral nerve do
all go to the legs (no pelvis anymore
nerve after genitofemoral
lateral cutaneous nerve of the thigh (L2 and L3)
nerve after lateral cutaneous nerve of the thigh
femoral nerve (L2, L3 and L4)
nerve after femoral nerve
obturator nerve (L2, L3 and L4)
nerve after obturator nerve
lumbosacal trunk (L4)
origin of T12 and L1 to L4 nerves
- T12 from ventral ramus of 12th thoracic nerve
- L1 to L4 from ventrla rami of nerves of the lumbar plexus
nerves on quadratus lomborum m.
subcostal (T12), iliohypogastric (L1) and ilioinguinal (L1
nerves on psoas m.
genitofemoral (L1 and L2) and femoral (L2, L3, L4) (lateral side)
nerves on iliacus m.
lateral cutaneous nerve of the thigh (L2,L3) comes between genitofemoral n and femoral n
where obturator n passes (L2,L3,L4)
medial to the psoas
PSS innervation to the gut
- vagus (cranial n X) to all organs except adrenals (comes from esophagus). stops at 2/3 of the transverse colon
- pelvic splanchnic nerves (ventral rami of S2 to S4) from last third of transverse colon to the rectum
pelvic splanchnic nerves origin and what they also innervate
ventral rami of S2, S3 and S4. also go to bladder, uterus and genitalia
SS chain and SS innervation origin and which part is abdominal
T1 to L2.
T5 to L2 is abdominal
(T1 to T4 is thorax)
SS preganglionic fibers come from where, go where, synapse where
spine, white rami communicantes, pass through SS chain BUT DON’T SYNAPSE THERE, synapse in periaortic ganglia
how SS innervation from L3 to S3 is achieved
nerves from SS chain travel down below the L2 level
white vs grey rami communicantes (SS chain)
white = motor (efferent)
(periaortic) SS ganglia IN THE ABDOMEN (6)
celiac, aorticorenal, superior mesenteric, inferior mesenteric, superior hypogastric, inferior hypogastric
celiac ganglion nerves come from where and what celiac ganglion supplies
T5 to T9 formed (thoracic) greater splanchnic n.
celiac supplies liver, GB, stomach, spleen, adrenal medulla (nerves don’t synapse in celiac g), kidney
aorticorenal ganglion nerves come from where and what aorticorenal ganglion supplies
- from celiac ganglion.
- aorticorenal g supplies small intestine and bowel
superior mesenteric g supplies what + its nerves come from where
- T10 to T12
- supplies small intestine and bowel
inferior mesenteric g supplies what + its nerves come from where
- from L1 and L2 (lumbar splanchnic nerves)
- supplies sigmoid
superior hypogastric g supplies what + its nerves come from where
- from L3, L4, L5
- supplies rectum
inferior hypogastric ganglion supplies what + its nerves come from where
- from S1, S2 and S3
- supplies genitalia, bladder and uterus
name of SS nerves from L1 and L2
lumbar splanchnic nerves
name of SS nerves from L5 to S3
sacral splanchnic nerves
greater, lesser and least splanchnic nerves are in what category
thoracic splanchnic nerves
name of PSS nerves from S2 to S4
pelvic splanchnic nerves
why adrenal medulla receives preganglionic fibers
its cell bodies are similar to ganglion cells. embryo tissue that made postgang nerves also made adrenal medulla
nerves travelling in white rami communicantes
visceral sensory and motor (SS efferents specifically) (visceral motor is autonomic)
how visceral sensory info gets to the brain
goes through SS periarotic ganglia then white rami communicantes, ventral ramus, dorsal root (sensory)
thoracic duct origin
from sac called cisternae chyli
lymphatic drainage of the legs
all to cisternae chyli and then thoracic duct
what upper body lymphatics drain in thoracic duct + where thoracic duct drains
left arm and left part of the head (and legs in lower body) to thoracic duct to left subclavian vein
how gut lymph nodes and urinary system lymph nodes (kidney, bladder, ureter) drain to thoracic duct
follow the gut arteries (celiac, SMA, IMA, etc.) back to aorta where cisternae chyli is
rule for gut lymph nodes names
same name as artery they follow. node on SMA = superior mesenteric node
where right arm, right thorax and right side of the head lymphatics drain
right lymphatic duct goes to right internal jugular vein or right subclavian vein