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Anatomy > Interval 3 > Flashcards

Interval 3 Flashcards

1
Q

Foregut

A

-ends at the entrance of bile duct in second part of duodenum

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2
Q

Spleen

A

not gut tube derivative, mesoderm derivative

  • receives blood flow from celiac artery
  • filters RBC and is lymphatic
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3
Q

Teres ligament

A
  • round ligament of the liver

- remnant of fetal circulation

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4
Q

Greater omentum

A

dorsal mesentery remnant

extends from greater curvature of the stomach

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5
Q

parts of the stomach

A
  • fundus
  • body
  • antrum
  • pyloric canal
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6
Q

lesser omentum

A

ventral mesentery remnant

CONTAINS:

  • hepatpduodenal ligament
  • bile duct
  • proper hepatic artery
  • portal vein

*epiploic foramen: inferior edge of the ventral mesentery

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7
Q

If you block the splenic artery, what else becomes blocked?

A

-stomach

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8
Q

Pancreas development

A
  • in ventral (head) and dorsal (rest) mesentery
  • enveloped by foregut and midgut duodenum (the head shares its blood supply with these areas)

N/B/T: blood supply from the splenic artery

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9
Q

transverse plane

A

separates the mediastinum between T4 and T5

-heart lies below the transverse plane

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10
Q

heart growth

A
  • into the pericardium from posterior aspect
  • has two serous pericardium layers: parietal and visceral (epicardium)
  • parietal pericardium has an outer fibrous layer (because there is no wall to cling to, this is nonserous)
  • heart is in the middle mediastinum
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11
Q

pericardial space

A

-potential space

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12
Q

How many vessels must be cut to remove the heart?

A

-8

inferior vena cava (right atrium)

superior vena cava (right atrium)

4 pulmonary veins (left atrium)

pulmonary trunk (right ventricle)

ascending aorta (left ventricle)

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13
Q

myocardium

A

formed by cardiac muscle

most prominent in the ventricles

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14
Q

Chorda tendineae

A

hold leaflets of valves

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15
Q

Right and left border of the heart

A

RIGHT: 3rd-6th intercostal cartilages, finger breadth from sternum

LEFT: midclavicular line in the 5th intercostal cartilage to 2nd

INFERIOR: xiphoid left to right

SUPERIOR: 2nd left intercostal space to 3rd on right

*1/3 of heart is to the right of median plane

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16
Q

Right border structures

A

-right atrium, SVC, IVC

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17
Q

Left border structures

A

-left ventricle and left auricle

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18
Q

Inferior border structures

A

-right ventricle

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19
Q

Superior border structures

A

-left and right atria, ascending aorta, pulmonary trunk, SVC

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20
Q

Where are the visceral and parietal pericardium continuous?

A
  • pulmonary veins
  • SVC
  • IVC
  • great arteries
  • everywhere else the heart is free within the cavity
  • serous fluid allows frictionless beating
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21
Q

Innervation of parietal layers of the pericardium

A

-sensory branches of the phrenic nerves

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22
Q

transverse pericardial sinus

A

-between ascending aorta and PT and SVC

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23
Q

oblique sinus

A

-inferior to the pulmonary veins and left of the IVC

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24
Q

Coronary arteries

A
  • supply arterial blood to the heart

- arise from the right/left aortic sinuses

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25
Q

Right coronary artery

A
  • long
  • courses in the coronary sulcus
  • supplies the right atrium and right ventricle
  • nodal branches supply SA and AV nodes
  • marginal branch supplies right ventricle
  • typically gives rise to posterior interventricular artery
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26
Q

posterior interventricular artery

A
  • from the right coronary artery
  • courses in the posterior interventricular sulcus
  • supplies right/left ventricle and posterior part of interventricular septum
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27
Q

Left coronary artery

A

-short artery that originates from left aortic sinus into the anterior interventricular artery and circumflex artery

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28
Q

anterior interventricular artery

A
  • LAD
  • courses in the anterior interventricular sulcus
  • supplies right and left ventricles and 2/3 of the interventricular septum (AV bundle)
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29
Q

Circumflex artery

A
  • LCX
  • courses in the coronary sulcus
  • supplies the left atrium and left ventricle
  • marginal branch arises from here and supplies the left ventricle
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30
Q

Right atrium

A

smooth-walled: sinus venarum
-SVC, IVC, ostium of coronary sinus, and openings of anterior cardiac veins

rough-walled: pectinate muscles

*poorly oxygenated blood

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31
Q

crista terminalis

A

separates the sinus venarum from the pectinate muscles

contains the fossa ovals (in the interatrial septum)
-remnant of the foramen ovale (shunts blood from lungs)

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32
Q

Right atrioventricular orifice

A

opens into the right ventricle

closed by the 3 leaflet of the tricuspid valve

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33
Q

right ventricle

A

rough walled part-trabeculae carneae

smooth walled part - conus arteriosus (infundibulum) which leads to the PT (separated by the semilunar valve)

3 papillary muscles (anterior, posterior, septal)

separated by interventricular septum (membranous and muscular)

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34
Q

Chorda tendineae

A

attach to papillary musches and to leaflets of the tricuspid valve

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35
Q

left atrium

A

smooth-walled part

rough-walled part: auricle, contains pectinate muscles

contains the left atrioventricular orifice which opens into the left ventricle (closed by 2 leaflets of the mitral valve)

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36
Q

left ventricle

A

muscular wall: trabecilae carneae (twice as thick as the wall of the right ventricle)

smooth walled: aortic vestibule - leads to ascending aorta

-2 papillary muscles (anterior/posterior) with chordae tendineae attach to edges of mitral valve

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37
Q

semilunar valve

A

at the junction between vestibule and ascending aorta

3 cusps: right, left, posterior

-aortic sinus distal to each

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38
Q

Papillary muscles in ventricles during contraction

A

contract and keep the cusps of tricuspid and mitral valves rom opening

-valves close due to increased pressure

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39
Q

Cardiac conduction

A

-wave of depolarization

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40
Q

SA Node

A

in the sinus venarum of right atrium

pacemaker (depolarizes faster than others)

wave spreads to both atria which contract

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41
Q

AV Node

A

in the interatrial septum

stimulated by depolarized atria

delays depolarization from passing to the ventricles so atria can fully contract

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42
Q

AV Bundle of HIs

A

arises from cells of AV node, passes into interventricular septum

-right/left branches

causes each of the papillary muscles in the ventricles to contract (keeps AV valves shut when ventricles contract)

43
Q

Purkinje Fibers

A

spread a wave of depolarization to cardiac muscle cells in the right and left ventricles

44
Q

Great cardiac vein

A

courses with the LAD and drains into the coronary sinus (right atrium)

45
Q

Complete AV block

A

-atria and ventricles become dissociated and beat independently

46
Q

Heart innervation

A

-autonomic (parasympathetic and sympathetic)

47
Q

Cardiac plexus

A
  • both autonomic fiber types that reach the heart pass through plexus
    1) superficial cardiac plexus: inferior to the arch of the aorta
    2) deep cardiac plexus: anterior to bifurcation of trachea
48
Q

Types of autonomic fibers in cardiac plexus

A

1) preganglionic parasympathetic axons from vagus nerves CN X
2) postganglionic parasympathetic axons
3) postganglionic sympathetic axons from cervical and upper thoracic splanchnic nerves

49
Q

Sensory fibers in the cardiac plexus

A
  • innervate baroreceptors/chemoreceptors in the heart, course with vagus nerve and enter CNS
  • use sympathetic nerves to carry pain to CNS
  • angina pain could therefore be referred to T1-T5 dermatomes
50
Q

What does sympathetic innervation do in the heart

A
  • accelerates heart rate

- increases the force of cardiac contraction (by increasing rate of depolarization of cells in SA/AV)

51
Q

What does parasympathetic innervation do in the heart

A
  • slows heart rate
  • decreased the force of cardiac contraction
  • promotes vasoconstriction of coronary arteries
52
Q

First heart sound (S1 lupp)

A
  • made by the closing of the mitral and tricuspid valve

- systole

53
Q

Second heart sound (S2 dubb)

A
  • closing of the aortic and pulmonic valves
  • beginning of diastole
  • valves close by the backflow of blood
54
Q

Celiac Artery

A

-branches from the abdominal aorta at T12

3 branches:

1) splenic artery
2) common hepatic artery
3) left gastric artery

55
Q

Splenic artery supplies

A

1) spleen
2) neck, body, tail of pancreas
3) left side of the greater curvature of the stomach (left epiploic artery)
4) fundus of the stomach

56
Q

Left gastric artery supplies

A
  • lesser curvature of the stomach
  • abdominal part of the esophagus
  • ulcers in the stomach can erode it
57
Q

common hepatic artery splits into:

A
  • proper hepatic: part of lesser curvature, branches to left/right hepatic which supply liver
  • gastroduodenal: supplies duodenum, superior head of pancreas, right side of greater curvature (right epiploic artery)
  • subject to erosion by penetrating ulcer of the posterior wall of the first part of the duodenum
58
Q

Liver

A
  • functions as both exocrine and endocrine gland

- suspended by remnants of the ventral mesentery: falciform ligament, coronary ligaments, lesser omentum

59
Q

Anatomic lobes of the liver

A

-left, right, quadrate, and caudate

60
Q

Functional lobes of the liver

A
  • left and right (equal size)
  • both with own blood supply, venous/biliary drainage

left: quadrate lobe and part of caudate
right: part of caudate

61
Q

Liver blood supply

A
  • 70% from portal vein (poorly oxygenated)

- 30% from proper hepatic (well oxygenated)

62
Q

Proper hepatic artery splits into

A

-left and right

63
Q

Portal triad

A

-hepatic ducts, portal vein, and proper hepatic artery enter/exit and porta hepatis and form the triad

64
Q

common hepatic ducts

A
  • right and left, drain liver
  • join to form the common hepatic duct which joins the cystic duct to form bile duct which joins with the pancreatic duct to form the hepatopancreatic ampulla
65
Q

gallbladder function

A
  • store and concentrate bile produced/secreted by liver

- blood supply: cystic artery

66
Q

parts of the lesser omentum:

A

-hepatoduodenal and hepatogastric ligaments

67
Q

epiploic foramen:

A
  • communication of omental bursa with great cavity

- bounded by hepatoduodenal ligament

68
Q

hepatoduodenal ligament contains:

A
  • hepatic portal vein
  • proper hepatic artery
  • bile duct
69
Q

gastrocolic ligament

A

part of the greater omentum which extends from the greater curvature to the transverse colon

70
Q

pancreas head blood supply

A

-pancreaticoduodenal branches of the gastroduodenal (celiac)

AND

superior mesenteric arteries

71
Q

Foregut innervation

A
  • parasympathetic and sympathetic axons

- visceral sensory fibers

72
Q

Parasympathetic innervation in the foregut:

A

-vagus nerves and neurons in terminal ganglia

73
Q

Sympathetic innervation in the foregut:

A
  • preganglionic sympathetic axons in lower thoracic splanchnic nerves (T5-T9)
  • neurons in the celiac ganglia
74
Q

Visceral pain in foregut:

A
  • fibers course back to the spinal cord in greater splanchnic nerves
  • pain is referred to T5-9 dermatomes
  • sensations other than pain carried to CNS via vagus nerve
75
Q

Midgut intestinal blood supply:

A
  • superior mesenteric artery

- starts at L1

76
Q

Branches of superior mesenteric arteries

A
  • anterior/posterior inferior pancreaticduodenal branches: supply duodenum and head/uncinate of pancreas
  • intestinal branches: supply the ileum
  • ileocolic, right, and middle colic: supply midpart of colon
  • ileocolic: distal ileum, appendix, cecum, proximal part of ascending colon
  • right colic: ascending colon
  • middle colic: 2/3 of transverse colon
77
Q

ligament of Treitz

A

fibromuscular band that supports the duodenojejunal flexure

78
Q

Jejunum

A

thicker walls, larger diameter, more prominent circulares, and greater vascularity than ileum

79
Q

Ileocecal junction

A

where ileum ends

colon is continuous with the ileum here

80
Q

Colon characteristics:

A
  • larger diameter than intestine
  • taeniae coli: 3 smooth muscle bands
  • Haustrations
  • omental appendices: fat suspended by coli
81
Q

Vermiform appendix

A
  • supplied by the appendicular artery, branches from ileocolic
  • inflammation due to stool or hyperplasia (childern) stimulates visceral pain fibers which course back in the lower splanchnic nerves and cause colicky pain referred to umbilical
  • McBurney’s point: base of appendix
82
Q

Midgut innervation:

A

parasympathetic and sympathetic axons

visceral sensory fibers

83
Q

Parasympathetic innervation in the midgut:

A

-preganglionic parasympathetic axons in vagus nerves/neurons in terminal ganglia

84
Q

Sympathetic innervation in the midgut:

A
  • preganglionic axons in the lower thoracic splanchnic nerves from T5-12
  • neurons in the celiac and superior mesenteric ganglia
85
Q

Visceral pain fibers in the midgut:

A
  • course back to the spinal cord and lower thoracic splanchnic nerves
  • referred pain from small intestine: t5-10 dermatomes
  • referred pain from cecum, appendix, ascending colon and transverse: T10-12
86
Q

Arterial supply to the hindgut:

A
  • branches of the inferior mesenteric artery (L3):
  • left colic artery: descending colon/transverse
  • sigmoid arteries: sigmoid
  • superior rectal artery: rectum and canal to the pectinate line
87
Q

SIgmoid colon

A

also teniae coli, haustrations, and omental appendages

sigmoid rectal junction marks end of these

88
Q

Hindgut innervation

A

parasympathetic and sympathetic axons

visceral sensory fibers

89
Q

Parasympathetic innervation of the hindgut:

A

preganglionic parasym axons in splanchnic nerves S2-4 and terminal ganglia

90
Q

Sympathetic innervation of hindgut

A

preganglionic sym axons from splanchnic nerves T11-L2

neurons in the inferior mesenteric ganglia

91
Q

referred pain in hindgut

A

-T11-L2 dermatomes

92
Q

hepatic portal vein:

A

-receives poorly oxygenated blood from gastrointestinal structures

93
Q

superior mesenteric vein

A

-drains the midgut and unites with the splenic vein (drains foregut)

94
Q

inferior mesenteric vein

A

-drains the hindgut, empties into the splenic veins

95
Q

Stomach drainage

A

left and right gastric veins

empty into the portal vein

96
Q

Hepatic veins

A

NOT portal

drain blood from the heptic sinusoids

empty into inferior VC

97
Q

Sympathetic, postganglionic splanchnic nerves:

A

presynaptic fibers enter paravertebral ganglia via white rami

synapse in upper thoracic and lower cervival ganglia

*do not reenter spinal cord, do not form gray ramus

** go direction to the thoracic viscera above the diaphragm

98
Q

Sympathetic, preganglionic splanchnic nerves:

A

greater, lesser, and least thoracic

-enter via white rami but do not synapse with paravertebral

run through sympathetic chain without synapsing

  • they are myelinated, preganglionic fibers
  • ultimately try to find prevertebral ganglia in the abdomen/pelvis where they synapse
99
Q

Parasympathetic, preganglionic splanchnics

A

S2-4, exit with these spinal nerves and go straight to destination

  • synapse at those intrinsic ganglia and postganglionic fibers
  • includes the vagus nerve

NOTE: NO SUCH THING AS PARASYMPATHETIC POSTGANGLIONIC SPLANCHNICS

100
Q

ascending aorta

A

left ventricle

101
Q

descending aorta

A

to the left of the midline, goes down the body

102
Q

transverse mesocolon

A

connects transverse colon to the posterior wall of abdomen

peritoneum

103
Q

sigmoid mesocolon

A

peritoneal fold that connect sigmoid to the pelvic wall

Anatomy (9 decks)

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