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1
Q

Describe the anatomy of the TMJ

A

Articulation between condyle of the mandible and the mandibular fossa of the temporal bone
Articular disc allows a small degree “subblux” for greater movement
Superior cavity for translation
Inferior cavity for rotation

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2
Q

List the muscles of mastication

A

Temporalis
Masster
Medial pterygoid
Lateral pterygoid

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3
Q

Which of the 4 muscles of mastication is for opening

A

Lateral pterygoid

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4
Q

Which nerve innervates the muscles of mastication

A

Mandibular division of the trigeminal nerve

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5
Q

Where does the temporalis muscle span

A

Coronoid process of mandible to temporal fossa

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6
Q

Where does the masseter muscle span

A

Angle of mandible to zygomatic arch

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7
Q

Where does the medial pterygoid span

A

Angle of mandible to pterygoid plate of sphenoid bone

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8
Q

Where does the lateral pterygoid span

A

Condyle of mandible to pterygoid plate of sphenoid bone

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9
Q

What is the sensory innervation of the oral cavity

A

Superior half CNV2

Inferior half CNV3

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10
Q

What is the sensory aspect of the gag reflex

A

CN IX

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11
Q

What is the motor aspect of the gag reflex

A

CN IX & CN X

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12
Q

Describe the course of the salivary ducts

A

Parotid: crosses face and secretes into mouth by upper 2nd molar

Submandibular: enters floor of mouth and secretes via lingual caruncle

Sublingual: lays in floor of mouth secretes via several ducts superiorly

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13
Q

What nerve innervated the sublingual salivary gland

A

CN VII

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14
Q

What nerve innervated the sub mandibular salivary gland

A

CN VII

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15
Q

What nerve innervates the paratoid salivary gland

A

CN IX

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16
Q

List the extrinsic muscles of the tongue

A

Genioglossus
Hypoiglossus
Styloglossus
Paloatoglossus

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17
Q

What is the innervation of the genioglossus

A

CN XII

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18
Q

What is the innervation of the hypoiglossus

A

CN XII

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19
Q

What is the innervation of the styloglossus

A

CN XII

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20
Q

What is the innervation of the palatoglossus

A

CN X

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21
Q

What is the funciton of the extrinsic muscles of the tongue

A

To change the position of the tongue during: mastication, swallowing and speech

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22
Q

What is the funciton of the intrinsic muscles of the tongue

A

Modify the shape of the tongue during its functions

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23
Q

What is the innervation of the circular muscle of the pharynx

A

CN X

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24
Q

Explain the musculature of the pharynx

A

3 circular skeletal constrictor muscles that insert to the midline raphe
External layer overlap each other and contract sequentially

3 longitudinal skeletal muscles form the inner layer
Attach to larynx and contract to shorten the pharynx

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25
What is the innervation of the longitudinal muscle of the pharynx
CN IX & CN X
26
Explain the process of swallowing
The lips are closed to prevent drooling (orbicularis oris, CN VII) The tongue pushes the bolus posteriorly (CN XII) Sequential contraction of the circualr muscles of the pharynx (CN X) pushes the bolus to the oesophagus The inner longitudinal layers contract (CN IX, CN X) to raise the larynx to close off the laryngeal inlet The food reaches the oesophagus
27
Describe the route of the oesophagus
Starts from the cricopharyngeus muscle at the level of C6 Posterior to trachea and anterior to the vertebral bodies at rib 1 In chest posterior to heart (contact with left atrium) In abdomen through diaphragm at T10 where it connects to the stomach immediately at the cardia
28
State the major features of the oesophagus
Anatomical upper sphincter (criocopharyngeus) Physiological lower oesophageal sphincter Oesophageal plexus runs on the surface to supply the smooth muscle
29
State the major observation of the oesophagus on Ba swallow
``` Cervical constriction - Cricopharyngeus muscle Thoracic constriction (s) - Arch of the aorta - Left main bronchus Diaphragmatic constriction - Result of passing through hiatus of the diaphragm (T10) ```
30
What is the Z-line
The differentiation between the stomach endothelium and that of the oesophagus
31
State the areas of the stomach
Cardia, immediately after the oesophageal entrance Fundus, superior part of the stomach Body, major section Pyloric antrum, final section just proximal to pyloric sphincter
32
Where in the abdomen does the stomach lie
Left hypochondrium, epigastric and umbilical region
33
What is posterior to the stomach
Spleen, left kidney, splenic artery, pancreas
34
What is lateral to the stomch
Left side: body wall | Right side: liver, gallbladder
35
What are the areas of the mouth (dentistry)
Upper and lower left and right dental arches
36
How are teeth numbered
1 to 8 from medial to lateral
37
What numbers are the incisors
1 & 2
38
What numbers are the canines
3
39
What numbers are the premolars
4 & 5
40
What numbers are the molars
6 to 8 | 8 is the wisdom tooth
41
What are the components of the foregut
Oesophagus to mid duodenum Liver + gall bladder Spleen 1/2 of the pancreas
42
What are the components of the mid gut
Mid duodenum to proximal 2/3 of the transverse colon | 1/2 of the pancreas
43
What are the components of the hindgut
Distal 1/3 of the transverse colon to the proximal 1/2 of the anal canal
44
What are the order of the large intestine segments
Caecum (appendix), ascending colon (hepatic flexure), transverse colon (splenic flexure), descending colon and sigmoid colon
45
What is an intraperitoneal organ
Almost completely covered in visceral peritoneum and has minimal mobility
46
What are organs with a messentary
A double folding of the peritoneum internationally to allow mobility
47
Is the liver intraperitoneal or retroperitoneal
Intraperitoneal
48
Is the stomach intraperitoneal or retroperitoneal
Intraperitoneal
49
Is the spleen intraperitoneal or retroperitoneal
Intraperitoneal
50
Is the kidney intraperitoneal or retroperitoneal
Retroperitoneal
51
Is the pancreas intraperitoneal or retroperitoneal
Retroperitoneal
52
Which parts of the colon are retroperitoneal
Ascending and descending
53
What is the name of the messentery to the appendix
Mesoappendix
54
Where is the sympathetic supply to the abdomen from
T5 to L2 | Abdominopelvic splanchnic nerves
55
Where do sympathetic nerves synapse to the abdominal organs
At prevertebral ganglia which are located anterior to the aorta, exit at the same points as the vessels from the aorta
56
Explain the afferent nerves in the abdomen
They join together form the periatrial plexuses in which they hitch a ride with the arteries
57
sympathetics to the adrenal glands
Sympathetic fibres from T10-L1 enter the abdominopelvic splanchnic nerves Do not synapse with the prevertebral ganglia Carried from pariatrial plexus from the prevertebral ganglion to the adrenal gland
58
Explain the parasympathics to the abdomen
The vagus nerve enters on the oesophagus surface to enter the periaterial plexus Carried from here to the organ walls where they synapse The pelvic splanchnic nerves (S2-4) supply the smooth muscle and glands of the descending colon to anal canal
59
Where is foregut pain refered to
Epigastric region | entering at T6-T9
60
Where is the midgut pain refered to
Umbilical region | entering at T8-T12
61
Where is the hindgut pain refered to
Pubic region | entering at T12-L2
62
Describe the somatic nerves to the abdominal wall
``` The thoracoabdominal nerves - 7 to 11 intercostal nerves Subcostal nerve - T12 anterior rami Lilohypogastric - Half of L1 anterior ramus Llionguinal nerve - Other half of L1 anterior ramus ```
63
What is the surface anatomy of the liver
Located mostly in the Right Upper quadrant
64
``` What are the anatomical relationships of the liver Diaphragm Gallbladder Hepatic flexure of colon Right kidney IVC Abdominal aorta Stomach ```
Inferior is the right hemi diaphragm Posterior and inferior is the gallbladder Inferior is the hepatic flexure of colon Posterior is the right kidney, IVC and abdominal aorta Posterior at the mid/left side is the stomach
65
How are the liver segments numbers
Numbered from the lingula and numbered clockwise untill VIII
66
What is the content of the portal triad
Portal vein Hepatic artery Bile duct
67
What are the branches of the coeliac trunk | From left to right
``` Common hepatic artery - Hepatic artery proper - Gastrodudenal artery -- supraduodenal artery Left gastric artery Splenic artery ```
68
What artery supply the lesser curvature of the stomach
The left gastric artery
69
What artery runs posterior to the stomach
Splenic artery
70
What is the position of the spleen
``` Anterior of the diaphragm Posterior of the stomach Superior to the splenic flexure Lateral of the left kidney Deep to ribs 9-11 ```
71
What is the blood supply to the spleen
Splenic artery from the coeliac trunk
72
Where does the coeliac trunk come from the aorta
T12
73
What is the major blood supply to the stomach
Right (from hepatic artery proper) and left gastric arteries along the lesser curvature Right and left gastro-omental arteries along the greater curvature Posterior gastric arteries from the splenic is the minor supply
74
What is the blood supply to the liver
Right and left hepatic arteries steming from the hepatic artery proper Most blood from the hepatic portal vein
75
Where is the hepatorenal recess
Between the liver and right kidney
76
Where is the sub-phrenic recess
Between the liver and the diaphragm
77
Which vessels form the hepatic portal vein
Splenic vein (foregut) - Inferior mesenteric vein (hindgut) Superior mesenteric vein (midgut) IVC, retroperiotoneal and drains cleaned blood to the hepatic vein
78
Define the triangle of callot
Formed between cystic duct, hepatic duct and cystic artery
79
How does bile leave the gall bladder
Through the cystic duct
80
Explain the biliary tree
Right and left hepatic duct joining to the common hepatic duct Cystic duct from the gall bladder Cystic and common hepatic joining to form the bile duct Bile duct drains to the 1st part of duodenum through ampulla of vater and sphincter of oddi
81
What is the position of the pancreas
Retroperitoneal | Lies transversely across the posterior abdomen
82
What are the parts of the pancreas
Head (with uncinate process) Neeck Body Tail
83
What are minor duodenal sphincters
These are entrances of the accessory pancreatic ducts
84
What is the blood supply to the duodenum
Gastroduodenal artery to superior pancreaticoduoduodenal artery to inferior pancreaticoduodenal artery
85
Does the jejunum of ileum have a thicker wall
Jejunum is thicker
86
Describe the circular folds of the jejunum
Large, tall and closely packed folds
87
Describe the circular folds of the ileum
Low and sparse folds
88
Blood supply to jejunum?
Jejunal arteries from the superior mesenteric artery
89
Blood supply to ileum
Ileal arteires from the superior mesenteric artery
90
What level does the superior mesenteric artery leave the abdominal aorta
L1
91
What is the blood drainage from the jejunum
The jejunal vein
92
What is the blood drainage from the ilium
The ileal veins
93
Are the vasa recta shorter in the jejunal or ileal arteires
The ileal arteries | They also have more arcades
94
What is the lymph drainage of the abdomen
``` Named for the major vessels they site on Coeliac Superior mesenteric Inferior mesenteric Lumbar (on posterior abdo wall) ```
95
What are the spaces to the side of the colon
``` Paracolic gutters (left and right) These are part of the greater sac ```
96
What is McBurney's point
1/3 way between ASIS to umbilicus | Max tenderness in appendicitis
97
What is the level of the inferior mesenteric artery
T3
98
List the branches of the superior mesenteric artery from right to left
``` Jejunal and ileal arteires Appendicular Ileocolic branches Right colic artery Middle colic artery Inferior pancreaticoduodenal artery ```
99
List the branches of the inferior mesenteric artery from right to left
Left colic artery Sigmoid arteries Superior rectal artery
100
What is the anatomosis of the colic arteries
Marginal arteires of drummond
101
What is the blood supply to the rectum
Superior rectal artery (from IMA) | Middle and inferior rectal arteries from the internal iliac artery
102
Whats the veins of the abdomen
IVC Hepatic portal Splenic along with splenic artery Superior and inferior mesenteric veins
103
Where are the anastamosis of the portal-systemic vein systems
Distal end of oesophagus Skin around umbilicus Rectum/anal canals Where portal hypertension shows
104
Whats the venous drainahe of the rectum and anal canal
Superior rectal vein to the inferior mesenteric vein | Middle and inferior rectal veins to the internal iliac vein
105
What is the muscle of the pelvic floor
Levator ani
106
What is the lowest point of the standing patient in a male
Rectovesical pouch
107
What is the lowest point of the standing patient in a female
``` Rectouterine pouch (of Douglas) Vesicouterine ```
108
What is the major part of the levator ani muscle
Puborectalis | - Band from pubic bone wrapping around the anal canal
109
What are the anal sphincters
Internal smooth muscle | External skeletal muscle
110
What is the nervous innervation of the external anal sphincter
Pudendal nerve (S2-S4)
111
What is the sympathetic innervation of the rectum and anal canal
T12 to L2
112
Parasymapthetic innervation of the rectum is from where
S2 to S4
113
What is the somatic motor supply to the levator ani
Nerve to levator ani (S3, S4)
114
Define the pectinate line
The line between the somatic and autonomic innervations
115
Important note on blood supply to rectum memory
Hindgut section by superior rectal artery (from IMA) Body wall from the middle and inferior rectal artery (internal illeac artery)
116
What is the organisaton of drainage of the rectum
The middle and inferior rectal vein for a venous plexus in the rectal wall

Anatomy (6 decks)

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