Gross Anatomy Quiz 2 Flashcards
Effect of the ANS on the Heart
sympathetic
Increases: HR Force of contraction BP Respiratory rates
Dilates (relaxes coronary vessels (smooth muscle)
Caval Hiatus Structures
Inferior Vena Cava
How high does the diaphragm go on expiration
6th rib
origins of diaphragm
Sternal : posterior xiphoid process
Costal : internal surfaces of lower costal cartilages 7-12
Lumbar : medial and lateral arcuate ligaments
anterior longitudinal ligament
bodies of vertebrae L1, L2, L3
Innervation of the heart
Afferent Parasympathetic fibers
Vagal cardiac nerves
Function:feedback on blood pressure
Pulmonary valve stenosis
Valve cusps are fused
Conus arteriosus is underdeveloped, producing restriction of right ventricular outflow
Cause hypertrophy of the right ventricle
Produces a fixed split S2 murmur
S2 problem
Horner syndrome
Ptosis (drooping of the superior eyelid)
Pupillary constriction
Sinking in of the eyeball (enophthalmos)
Vasodilation and absence of sweating on the face and neck (anhydrosis),
RCA supplys
R atrium
SA, AV nodes
Posterior Septum
Aortic valve insufficiency
Backrush of blood into the left ventricle
Causes blowing high pitched murmur
Phrenic nerve roots
C3, C4, C5
what provides vascular drainage for left side of thoracic cavity
hemiazygous
How does blood flow into the coronary arterioes
Retrograde flow from aorta
Thet are filled during diastole (resting)
Tachycardia is risk because no rest!
NAV
Nerve (lateral)
Artery
Vein (medial
Ligaments that are part of Lesser omentum
Gastropcephalic ligament
Hepatoduodenal ligament
Lesser omentum
what runs between the anterior scalene and middle scalene
brachial plexus
subclavian artery
subclavian vein
what holds the breast up to the chest wall
suspensory ligament
Lobular Carcinoma In Situ
Believed to be a benign condition that predicts invasive breast cancer in the future
(not necessarily at the same site)
Breast cancer node path
axillary nodes
infra clavicular nodes
supraclavicular nodes
Pulmonary valve incompetence
Valve does not close completely
Results in a backrush of blood into the right ventricle
Causes blowing decrescendo murmur
S2 problem
Anterior interventricular supplys
both ventricles
Anterior septum
What does scalene muscle do
raise ribcage during inspiration
Heart cavity layers
Fibrous pericardium parietal pericardium pericardial cavity epicardium (visceral pericardium) myocardium endocardium
Superior messteric artery supplies
jejunum
cecum
ascending colon
LCA Supplys
L Atrium
L ventricle
AV Bunds
septum
most common site of breast cancer
Upper outer quadrant
Lactiferous ducts
moves milk from lobule
to lactiferous sinus
and then out nipple
What serves as the internal barometer
External jugular vein
Aortic Hiatus Structures
Aorta
Azygous vein
Thoracic Duct
where does the azygous drain
superior vena cava
Esophageal Hiatus Structures
Esophagus
Vagus
How to determine whether superficial or deep penetrating trauma to neck
Deeper or shallower than the platysmas
costal muscles
external costal
internal costal
innermost costal
What innervates the diapraghm
Phrenic nerve
C3, C4, C5
High cervical injuries result in death due to
failure to breath
Circumflex supplys
left atrium
left ventrical
comes off LCA
Lateral EKG
I
AVL
V5
V6
most external muscle in thorax
external oblique
Most common cancer of the breast
Intraductal carcinoma
Percent of adults with ASD
15-25% (not significant)
When significant, R atrium enlarges, RVH
how does the heart attach to the vessels, diaphragm and the sternum
fibrous attachments
Right marginal supplys
Right ventricle and apex
Comes off RCA
Where does the azygous vein drain into
Inferior vena cava
carotid triangle
Omohyoid
sternocleidomastoid
angle of jaw
Effect of the ANS on the Heart
Parasympathetic
Decreases: HR Force of contraction BP Respiratory rates
Constricts coronary vessels
Microcalcifications
Show up on mammogram
risk factor for producing breast cancer
Central venous lines in neck vs peripheral line
IJV
Subclavian
EJV is peripheral
Alimentry System
The alimentary system extends from the lips to the anus
Inferior messteric artery supplies
desecnding colon
sigmoid
rectum
What does the hemiazygous vein drain into
the azygous
Celiac trunk artery supplies
liver gall bladder
stomach spleen
Duodenum
Innervation of the heart
Afferent Sympathetic fibers
Afferents to upper thoracic and lower cervical ganglia
Function:feedback on blood pressure, pain sensation
Aortic valve stenosis
Most frequent valve abnormality
Common in the 6th decade of life
Due to calcified valves
Causes left ventricular hypertrophy as the heart works harder to pump blood through aortic valve
Causes mid-systolic murmur that is harsh
S1 problem (during systole)
Fat in the breast
Fat lobule
most common type of cancer of the breast
Intraductal carcinoma
Innervation of the heart
Efferent Sympathetic fibers
Cardiac nerves from the lower cervical and upper thoracic ganglia
Function:increasing heart rate, increasing the force of contraction of the myocardium
Nerve supply to pericardium
Phrenic nerves (C3-C5)– sensory also the arm nerves which is why cardiac pain can be refered to arm
Vagus nerves (CN X)-uncertain
Sympathetic trunks – vasomotor
3 Hiatus
Aortic Hiatus (Aorta, Azygous vein, Thoracic Duct)
Esophageal Hiatus (Esophagus, Vagus)
Caval Hiatus (IVC)
What happens when venous pressure rises
EJV becomes more prominent
nipple
has multiple openings for breast feeding
Left marginal supplys
Left ventricle
Comes circumflex of LCA
Most common cause of a blue (cyanotic) baby
Tetralogy of Fallot
What does observation of distention of the EJV reveal
Signs of heart failure
obstruction of SVC
enlarged supraclavicular lymph nodes
increased intrathoracic pressure
3 layers of heart wall
endocardium (lines valves and heart)
Myocardium (thickest)
Epicardium (thin external layer)
SMA
Superior messenteric artery
Comes off the abdominal aorta
is superior to inferior messenteric artery
supplies blood to the small intestine, large intestine
Efferent
Motor
SAME DAVE
Sensory Dorsal
Afferent Afferent
Motor Ventral
Efferent Efferent
vestibular folds
false vocal cords
more lateral to true vocal cords
Tetralogy of Fallot
Pulmonic stenosis
Right Ventricular Hypertrophy
Overriding Aorta
Vetricular Septal Defect
Most common cause of a blue (cyanotic) baby
When are the coronary arteries filled
during diastole
rest period
due to retrograde flow from aortic arch
Innervation of the heart
Efferent Parasympathetic fibers
Vagus nerve
Function:reducing the heart rate, reducing the force of contraction of the heart, vasoconstriction of the coronary arteries
invasive ductal carcinoma
cancer has invaded the basement membrane of the duct of the breast
Most common invasive form of breast cancer
why do the breasts enlarge
the lobules enlarge due to milk
Ligaments that are part of Greater omentum
Gastrophrenic ligament
Gastrosplenic ligament
Gastrocolic ligament
Greater omentum
Milk producing structures in breast
Lobules
Celiac trunk
left gastric artery
Splenic artery
Common hepatic artery
What is anterior to anterior scalene and anterior to brachial plexus
phrenic nerve
process for EJ placement
Trendelenburg
Take deep breath
turn head away
EJ crosses over sternocleidomastoid
lactiferous sinus
collects and holds milk
most common location of cancer in breasts
upper outer quadrant
Afferent
Sensory
SAME DAVE
Sensory Dorsal
Afferent Afferent
Motor Ventral
Efferent Efferent
Posterior interventricular supplys
both ventricles
posterior septum
Pansystolic
All the way through systole (contraction)
VSD Murmur
Inferior EKG leads
II
III
AVF
DCIS
Ductal Carcinoma In Situ
Precursor to breast cancer
(at same site)
Hasn’t invaded the basement membrane,
is contained within the duct
Retro peritoneal structures
Rectum Ascending colon descending colon Right kidney Bare portion of liver
Right upper quadrant of abdomen
Liver gall bladder R kidney Adrenal gland Colon - Hepatic flexure, right transverse Duodenum Head of pancreas Small intestine Pyloris of stomach
Left upper quadrant of abdomen
Stomach Tip of liver Spleen Most of pancreas Left kidney Adrenal gland Colon - splenic flexure, left transverse Small intestine - jejunum
Right lower quadrant of abdomen
Colon - ascending
Cecum
Appndix
Small intestine - ileum
Left lower quadrant of abdomen
Colon - Descending, sigmoid
Small intestine
Where is the appendix located
At the tip of the cecum (large intestine)
lower right quadrant
Umblicus level
L3/L4
Should you suture muscle or fascia
Don’t suture muscle, muscle won’t hold suture,
Suture fascia
The six common causes of abdominal protrusion
The six common causes of abdominal protrusion begin with the letter F:
food, fluid, fat, feces, flatus, and fetus
Eversion of the umbilicus may be a sign of
increased intra-abdominal pressure, usually resulting from ascites
Top and bottom margin of abdominal quadrants
Xiphoid is upper margin of top abdominal quadrants
Pubis is lower margin
One of most common LLQ pain is diverticulitis
One of most common LLQ pain
is diverticulitis
Pain out of proportion to exam
Arterial supply problem
Faking it
What does the pylorus do
Pylorus stores food and is a valve to stop retrograde flow
Common cause of upper abdominal pain in pediatrics
pneumonia
Portal triad =
Biliary duct, Hepatic artery, Bile duct
Each section of liver has its own portal vein, hepatic vein and hepatic artery
redundancy
The celiac trunk
is a branch of the abdominal aorta, arising immediately inferior to the aortic hiatus of the diaphragm (T12 vertebral level).
divides into the left gastric, common hepatic, and splenic arteries.
supplies the liver, gallbladder, inferior esophagus, stomach, pancreas, spleen, and duodenum.
Where are the papilla
2nd segment of duodenum
Ascending duodenum
Minor is above the major
Portal venous system drains
all of the bowel
Portal hypertension
= hemorrhoids, espophageal varicies, caput medussa
2 ways to drain distal esophagus
= Azygous vein, Left gastric
Chronic inflammation
(ulcerative colitis, Crohn disease)
Right Varicocele
Right varicocele always abnormal
Rupture of an aortic aneurysm
(localized enlargement of the abdominal aorta) causes severe pain in the abdomen or back.
(FAST)
Focused Assessment with Sonography for Trauma
Fast exam
Pericardial
Right flank (hepatorenal view or “Morison’s pouch”)
Left flank (perisplenic view)
Pelvic (retrovesical views)
Thoracic (pneumothorax and hemothorax)
Retroperitoneal
Kidneys ureter bladder adrenal gland esophagus dudodenum Pancreas except tail IVC Aorta
Where is iron absorbed in the body
duodenum
proximal jejunum
What suspends the duodenum
The ligament of treitz (duodenal ligament)
What is line between upper GI bleeding and lower GI bleeding
The ligament of treitz
Proximal to ligament is upper gi bleeding
Distal is lower gi bleeding
Grey turner sign
common in hemorrhagic pancreatitis
bifurcation of iliac arteries
L4/L5
Listen to bruits of illiacs at
L4/L5
Each section of liver has its own
portal vein, hepatic vein and hepatic artery
redundancy
This opening is the narrowest part of the biliary passages and is the common site for?
The bile duct joins the main pancreatic duct, forming the hepatopancreatic ampulla, which opens on the major duodenal papilla.
impaction of a gallstone.
Dome of bladder
intra peritoneal
Pectinate line
Hemmorhoids above the line are painless
Rectal sensation below pectinate line due to
S2, S3, S4
Crossover location of SMA
Superior mesenteric artery goes over the left renal vein
Gonadal veins
Left gonadal vein goes off the left renal vein
Right gonadal vein comes off the IVC
What goes over the right ureter
Right gonadal vein
Right varicoseal is always abnormal
could be a mass
left can have back flow
right doesn t have that issue
What are the anterior branches off the abdominal aorta
celiac trunk
SMA
IMA
Where does the thoracic duct empty
SVC
Level of kidney
L1-L2
Color of fluid on ultrasound
Black
