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HDS > Mod 2: Anatomy > Flashcards

Mod 2: Anatomy Flashcards

1
Q

Parts of the parietal pleura around lungs

A

Cervical
Costal
Diaphragmatic
Mediastinal

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2
Q

Thoracic wall includes

A

rib cage + sternum

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3
Q

Functions of thoracic wall

A

protects organs
attachment for muscles of respiration
attachment for muscles of upper limb, back, and abdomen (supports wt of upper limbs)
resists neg (sub-atm) internal pressure

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4
Q

True
False
Floating ribs

A

True (vertebrocostal): 1-7
False (vertebrochondral): 8-10
Floating (vertebral or free): 11-12

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5
Q

Inf articular facet of rib articulates with…

Articular facet of tubercle…

A

Inf articular facet: with costal facets of NUMERICALLY CORRESPONDING thoracic vert
Articular facet of tubercle: with TRANSVERSE PROCESS of CORRESPONDING thoracic vert

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6
Q

Synovial joint
Synchondroses
Symphyses

A 
Synovial: 
--free mvmt
--synovial fluid
--articular/hyaline cartilage
Synchondroses
--primary cartilaginous joints
--bending, but not mvmt
--hyaline cartilage
--Synostosis when cartilage is replaced by bone
Symphyses
--secondary cartilaginous joints
--slight or no mvmt
--fibrocartilage
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7
Q

In what kind of joint may cartilage be replaced with bone?

What is this called?

A

Syncondroses – when replaced by bone, called:

Synostosis

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8
Q

What joints result in synostosis as we age?

A

xiphisternal

manubriosternal

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9
Q

Functions of thorax

A

Respiration (pleura/pleural cavities containing the lungs)
Circulation (mediastinum with heart and great vessels)
Nutrition (esophagus passes inf in post mediastinum through the diaphragm to empty into the stomach)

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10
Q

What divides sup and inf mediastinum?

Ant, middle, post?

A

Sup-inf: sternal angle (T4-T5)
Ant: in front of heart
Mid: heart
Post: behind heart

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11
Q

Sup mediastinum from superficial –> deep

A 
Super:
Thymus
Sup vena cava/ RL brachiocephalic vv
Aorta (ascending and aortic arch)
Pulmonary arteries
Trachea
Esophagus
Trachea (lymph nodes below bifurcation)
Azygos v
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12
Q

Intercostal n AKA

A

spinal nerve ventral ramus

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13
Q

Intercostal aa
Ant branches from…
Post branches from…

A

Ant: internal thoracic (from subclavian)
Post: descending aorta/ 1st and 2nd from subclavian via supreme intercostal a

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14
Q

Openings in diaphragm

A

caval hiatus: inf vena cava (T8)
esophageal hiatus (T10)
aortic hiatus: descending aorta (T12)

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15
Q

Diaphragm innervated by…

A

phrenic n (C3-C5)

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16
Q

Most lymph from breast drains to…

Clinical significance?

A

axillary lymph nodes (through the sup lat quadrant and axillary process)
Axillary lymph nodes are the first site to examine to determine if cancer is metastasizing

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17
Q

Borders and contents of superior thoracic aperture (AKA thoracic inlet/outlet)

A 
Ant border: sternal manubrium and 1st rib costal cartilages
Post border: T1 centrum
Lateral border: 1st ribs
Contents:
--trachea
--esophagus
--aortic arch and its branches
--sup vena cava
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18
Q

Borders and contents of inferior thoracic aperture

A 
Ant border: xiphisternal joint and costal margins
Post border: T12
Lat border: 12th ribs
Contents
--diaphragm
--esophagus
--aorta
--inf vena cava
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19
Q

Inhalation vs Exhalation mechanics

A

Inhalation: thoracic resp pressure must be LESS than atm pressure (volume must INC)
–contraction of diaphragm
–vertical dimension of thorax inc by 2-10 cm as abdominal contents are forced down
Exhalation: resp pressure is GREATER than atm pressure (volume must dec)
–relaxation of diaphragm
–lungs and chest walls elastic recoil

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20
Q

Rib mvmts allow chest circumference to be … in an avg male

A

increased by 7.5 - 10 cm

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21
Q

Trachea begins below…

Trachea divides into right and left main bronchi at…

A

Begins below cricoid cartilage

Divides into R and L main bronchi at STERNAL ANGLE (T4)

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22
Q

Carina

A

keel-like ridge

cartilaginous projection of the last tracheal ridge associated with the cough reflex

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23
Q

Compare R and L main bronchi

A

R: wider, shorter, and more vertical than left

**foreign objects trapped more easily

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24
Q

Parietal pleura in contact with thoracic wall via…

A 
endothoracic fascia
(separates intercostal muscles from pleura)
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25
Q

Where do visceral and parietal layers connect in lung?

A

at hilum

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26
Q

Pleural cavity

A

potential space b/w layers of the pleural sac

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27
Q

Recesses

Def and names in lungs

A

potential spaces created by uninflated lungs not filling the entirety of the pulmonary cavities

  • -Costodiaphagmatic recess
  • -Costomediastinal recess
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28
Q

What follows the pattern of bronchi?

A

arterial branching

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29
Q

tertiary bronchus + tertiary branch of pulmonary artery

A

bronchopulmonary segment

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30
Q

What kind of neurons carry all afferent information?

What are the parts of this neuron?

A

Pseudounipolar
cell body: spinal ganglion –DRG (outside CNS)
periph process: carry signals from structure being innervated
central process: transmits signals to CNS

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31
Q

Autonomic innervation AKA

A

general visceral motor

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32
Q

What kind of neurons carry efferent information?

A

multipolar

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33
Q

Sympathetic trunk

A

preganglionic axons travelling among paravertebral ganglia makes continuous chains

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34
Q

Cervical sympathetic ganglia

A

the 3 cervical sym ganglia are formed by the fusion of 8 paravertebral ganglia

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35
Q

Stellate ganglion

A

inf cervical ganglion fuses with T1 to make the stellate ganglion

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36
Q

Ganglion impar

A

fusion of left and right coccygeal ganglia at the terminal end of the sym trunk

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37
Q

Describe innervation of thoracic viscera

A

sym innervation directly from paravert ganglia via sym organ nn (AKA cardiopulmonary splanchnic nn)
**all sym organ nn are postganglionic (synapsed at a paravertebral ganglion somewhere on sym trunk)

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38
Q

What paravertebral ganglia contribute to sym organ nn?

A

All paravertebral ganglia above T6

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39
Q

Neural plexuses

A

cardiac plexus
pulmonary plexus
formed by interweaving of sym and parasym axons

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40
Q

Heart innervated by what spinal levels?

A

T1-T5

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41
Q

Describe innervation of abdominal viscera

A 
Abdominopelvic splanchnic nn
Lower thoracic splanchnic nn
--greater (T5-T9)
--lesser (T10-T11)
--least (T12)
Lumbar splanchnic nn (L1-L4)
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42
Q

How do thoracic splanchnic nn enter abdomen?

A

pierce diaphragm

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43
Q

Where do most splanchnic nn synapse?

A

on subdiaphragmatic/ preaortic/ prevertebral ganglia located centrally on post abdominal wall
(located along aorta, lumbar/sacral vert column)

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44
Q

How do postganglionic n fibers travel to organ being innervated?

A

travel in periarterial plexuses surrounding the supplying arteries

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45
Q

What kind of axons travel to adrenal medulla?

Why?

A

Prevertebral axons travel to adrenal medulla and synapse in the organ, stimulating release of hormones
–displaced paravert ganglion

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46
Q

Major difference b/w organ nn and splanchnic nn

A

Organ nn: have already synapsed

Splanchnic nn: prevert nn that have not yet synapsed

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47
Q

Innervation of:
foregut
midgut
hindgut

A

foregut: greater splanchnic (T5-T9)
midgut: mostly lesser splanchnic with some overlap from greater and least spinal segments; T9-T12
hindgut: least splanchnic with some overlap from lesser and lumbar splanchnic nn; spinal segments T12-L2/4

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48
Q

Preganglionic cell bodies of sym NS located…

of parasym NS located…

A

sym: intermediolateral column of spinal cord
parasym: medulla oblongata or S3-S4 levels of spinal cord

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49
Q

Location of vagus n

A 
in mediastinum (b/w heart and lungs), post to root of lungs
vagal trunks then follow esophagus down into abdomen, through esophageal hiatus to participate in subdiaphragmatic plexus
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50
Q

Vagus nn transition from a … position in the sup thorax to a … position in the inf thorax

A

Vagus nn transition from a right/left position in the sup thorax to a ant/post position in the inf thorax

  • *left vagus n becomes ant vagal trunk
  • *right vagus n becomes post vagal trunk
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51
Q

What kind of sensation does not reach conscious awareness?

What does?

A

Does not reach conscious awareness: autonomic motor

Does: visceral sensation (uncomfortable, dull, difficult to localize)

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52
Q

What stimuli result in visceral sensation?

A 
ischemia
inflammation
distension
cramping
NOT from cutting, burning, squeezing
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53
Q

How does visceral sensation travel back to CNS (most)?

Pelvic viscera?

A

Most: travel back to dorsal horn of SC via the same pathway that sym motor innervation used to reach the organ UNTIL IT REACHES THE MIXED SPINAL N, AT WHICH POINT SENSORY INFO IS DIVERTED TO DORSAL ROOTS
Pelvic viscera: travel back to SC via parasym pelvic splanchnic n

54
Q

Recurrent laryngeal nn branches from…
R wraps around
L wraps around

A

branches from vagus (CN X)
R wraps around brachiocephalic a
L wraps around aorta

55
Q

What spinal levels correspond to phrenic n?

A

C3, C4, C5

56
Q

Types of nn in cardiac, pulmonary, esophageal plexuses

A

Sym and parasym

includes vagus CN X

57
Q

Bifurcation of trachea at what level?

A

T4/T5

58
Q

Carina

A

keel-like structure at bifurcation of trachea

59
Q

Right vs left bronchi

A

Right runs more vertically
wider
shorter

60
Q

Most posterior structure in sup mediastinum

A

esophagus

61
Q

Describe course of R vs L recurrent laryngeal nn

A

R: ventral/anterior
L: b/w esophagus and trachea

62
Q

Thymus

A

diminishes at puberty
immune sys organ
Can compress trachea if inflamed or bound by vessels (especially infants)

63
Q

Thoracic duct drains at the junction of…

A

subclavian and brachiocephalic on LEFT side

64
Q

Cisterna chyli

A 
large lymph node
stores lymph fluid
T12
right side b/w aorta and azygos
crosses to left side T4-T5
65
Q

Where are pulmonary aa located in relation to pulmonary vv?

A

aa on top of vv

66
Q

What side of heart has ox/deox blood?

A

Ox: left
Deox: right

67
Q

Coronary sinus

A

venous drainage of the heart tissue itself

68
Q

Coronary aa supply blood to…
Coronary vv drain blood from…
Coronary sinus drains to…

A

aa: supplies myocardium
vv: drain myocardium
coronary sinus drains to right atrium

69
Q

Crista terminalis

A

Right atrium

separates rough ant wall from smooth post wall

70
Q

Musculi pectinate

A

Right AND Left atria
R: internal muscular ridges, fan out anteriorly from crista terminalis
L: pouch-like appendage containing MUSCULI PECTINATE

71
Q

Sinus venarum

A

Right atrium

smooth-walled cavity extending posteriorly from cristal terminalis

72
Q

Right auricle

A

Right atrium

small, conical muscular pouchlike structure (flap of tissue)

73
Q

Interatrial septum

A

Right atrium

forms posteromedial wall of right atrium

74
Q

Fossa ovalis

A

Right atrium

remnant of fetal foramen ovale – oxy blood from placenta passed from right –> left atria

75
Q

Conus arteriosus (infundibulum)

A

Right ventricle

smooth-walled, cone-shaped structure that gives rise to the pulmonary trunk

76
Q

Trabeculae carnae

A

Right AND Left ventricle
muscle ridges and bulges
**finer and more numerous in left ventricle

77
Q

Papillary muscles

A

Right AND Left ventricles
R: irregular m bundles on ventricular wall of AV valve (ant, post, septal mm)
L: 2 (ant, post) connected to 2 cusps of mitral valve

78
Q

Chordae tendinae

A

Right AND Left ventricles
slender, fibrous threads that arise from apices of papillary muscles
**thicker but less numerous in left ventricle

79
Q

Septomarginal trabeculae

A

Right ventricle
AKA moderator band
elevated trabeculae carnae crossing the cavity of the ventricle from the interventricular septum to the base of the ant papillary muscle
–carries the right AV bundle

80
Q

Left auricle

A

Left atrium

pouch-like appendage, containing MUSCULI PECTINATE

81
Q

Valvule of foramen ovale

A

Left atrium

fetal valve, preventing blood from flowing backward from left to right atria

82
Q

How many openings into right atrium?

Left

A

Right: 3 (sup and inf vena cava, coronary sinus)
Left: 4 (4 pulmonary vv)

83
Q

Difference b/w traeculae carnae in right and left ventricles

Difference b/w chordae tendinae

A

Trabeculae carnae: Finer and more numerous in left ventricle

Chordae tendinae: thicker but less numerous in left ventricle

84
Q

What is the first branch of from the aorta leaving the heart?

A

R and L coronary aa

85
Q

AV valves

Semilunar valves

A

AV: mitral and tricuspid
Semilunar: pulmonary and aortic

86
Q

Auscultation points for heart valves

A

Aortic: 2nd intercostal space to right of sternal border
Pulmonary: 2nd intercostal space to left of sternal border
Tricuspid: 5th-6th intercostal space near left sternal border
Mitral: near apex of heart in 5th-6th intercostal space in the midclavicular line

87
Q

How many cusps/leaflets in each valve of heart?

A

3 in tricuspid, pulmonary, and aortic valves

2 in mitral (bicuspid)

88
Q

What layer of the valves is continuous with chordae tendinae?

A

ventricularis layer

89
Q

Describe boundaries of abdomen

A

b/w abdominal diaphragm (concave inf) and pelvic diaphragm (concave sup)
abdomen ends at sup pelvic inlet

90
Q

Nine regions of abdomen defined by what lines?

Quadrants?

A

Nine regions:

  • -2 midclavicular planes
  • -transpyloric plane (L1)
  • -interspinous plane (S1)
Quadrants
RUQ: liver
LUQ: spleen
RLQ: appendix
LLQ: sigmoid colon
91
Q

Muscles of abdominal wall reinforced posteriorly by what structure?

A

lumbar spine

92
Q

Intra-abdominal pressure is increased to expel the 4 F’s

A

fluid (urine)
flatus
feces
fetuses

93
Q

What abdominal m is absent in 1/5 of people?

A

pyramidalis

94
Q

Abdominal obliques correspond with what muscles?

A

EAO: external intercostal m
IAO: internal intercostal m
Transversus abdominus: transversus thoracis

95
Q

What muscles of abdomen fuse to conjoint tendon?

Where does tendon attach?

A

IAO and transversus abdominus

Insert on pecten pubis

96
Q

layers of ant abdominal wall: superficial –> deep

A 
Camper's
Scarpa's
EAO
IAO
Transversus abdominus
Transversalis fascia
97
Q

Scarpa’s fascia continuous with what fascia of other parts of body?
Clinical significance?

A

Colle’s: perineum
Tunica dartos: scrotum
Superficial: penis

If urine leaks, can accumulate in abdomen

98
Q

All lymph channels inf to umbilicus drain to… nodes
Most lymph channels up to umbilicus drain to…nodes
Lymph channels near midline drain to … nodes

A

Inf to umbilicus: superficial inguinal lymph nodes (at groin)
Sup to umbilicus: axillary lymph nodes
Midline: parasternal or ant diaphragmatic lymph nodes

99
Q

Iliohypogastric and ilioinguinal nn – describe course

branch from what level?

A

Pierce TA to enter plane b/w TA and IAO (similar to intercostal nn)
Iliohypogastric then pierces IAO to enter plane b/w IAO and EAO, then pierces EAO aponeurosis to innervate surrounding skin
Ilioinguinal: in most people exits superficial inguinal ring to innervate skin near genitalia and inner thigh (in 30% of people, will end after piercing IAO)
branch from L1

100
Q

Inguinal region extends b/w … and …

A

ASIS and pubic tubercle

101
Q

Gubernaculum

A

cord made of CT and smooth muscle
runs from site of future scrotum/labium majorum to gonad
also attaches to lower front of peritoneal sac –> forms processus vaginalis (eventually obliterates – if not, hydrocele)

102
Q

Hydroceles

A

Buildup of serous fluid
Processus vaginalis fails to obliterate
forms in tunica vaginalis (serous covering of testis)
can occur in testis or cord

103
Q

Testicular torsion

A

twisting of testis and spermatic cord along their long axes
immediate treatment – could result in testicular necrosis
Once untwisted, both testis fixed to scrotal septum to prevent future occurrences

104
Q

Describe inguinal canal in adult

A

due to gubernaculum’s retraction during development
oblique – ensures that increased abdominal pressure closes canal, mitigating likelihood of herniation
4 cm long
parallel and superior to medial half of inguinal lig

105
Q

Lig of superificial inguinal canal

Fibers they originate from

A

Lacunar lig: from deep fibers of inguinal lig (floor)
Reflected lig (from inguinal lig)
Medial and lateral crus: from EAO aponeurosis (on either side of ring)
Intercrural: from EAO epimysium (roof)

106
Q

Tunica vaginalis

A

covers testis on all but post sides (parietal and visceral layers)
promotes free mvmt of testes within the spermatic cord and scrotum (fluid allows mvmt)

107
Q

Tunica albigenia

A

tough fibrous coating of testes (light-colored, below tunica vaginalis)

108
Q

Where are sperm produced?

A

seminiferous tubules

109
Q

Viscera of foregut

A 
abdominal esophagus
stomach
liver
gallbladder
pancrease
spleen
proximal half of duodenum
110
Q

Viscera of midgut

A 
Distal half of duodenum
jejunum
ileum
cecum
appendix
ascending colon
right 2/3 of transverse colon
part of pancreas
111
Q

Viscera of hindgut

A

Left 1/3 of transverse colon
descending colon
sigmoid colon
rectum

112
Q

Describe course of spenic artery

A

runs left along neck, body, and tail of pancreas

enters spleen b/w the folds of the SPLENORENAL LIG (lienorenal lig)

113
Q

Describe course of common hepatic a

A

courses rightward superior to the neck of the pancreas b/f dividing into proper hepatic and gastroduodenal

114
Q

Ant/post superior pancreaticoduodenal a supplies…

A

1st and 2nd parts of duodenum and head of pancreas

115
Q

gastric aa at … curvature of stomach

gastro-omental aa at … curvature of stomach

A

gastric: lesser curvature

gastro-omental: greater curvature

116
Q

Describe course of L gastric a

A

ascends retroperitoneally to the esophageal hiatus then courses along the lesser curvature of stomach

117
Q

Right colic a can branch from

A

ileocolic a
middle colic a
sup mesenteric a

118
Q

What aa participate in arterial arcades?

A 
sigmoidal branches (from inf mesenteric)
intestinal aa (from superior mesenteric)
119
Q

Terminal branch of superior mesenteric?

Inf mesenteric?

A

Sup: ileocolic
Inf: sup rectal

120
Q

Superior rectal a anastamoses with…

A 
Middle rectal (from internal iliac)
Inf rectal (from internal pudendal)
121
Q

Appendicitis

A

inflammation of appendix resulting from occlusion causing bacteria to grow in the appendix (fecalith, inflammation of lymphoid tissue, cancer worms)
–rupture results in spread of bacteria through the peritoneal cavity –> causes peritonitis and death
pain begins as diffuse visceral pain at T10
then causes localized somatic pain that radiates to RLQ

122
Q

McBurney’s point

A

point 1/3 of the distance b/w ASIS and umbilicus –> location of base of appendix
REBOUND pain is McBurney’s sign
(stretching peritoneum, then letting it go)

123
Q

Kidney at what vert level?

A

T12-L3

124
Q

Which kidney is higher?

Why?

A

Left is higher

due to presence of liver on R side

125
Q

Describe location of hilum of kidneys in life

A

kidneys positioned obliquely so hilum faces 45 deg anteromedially
due to protruding lumbar vert column

126
Q

Renal lobe

A

pyramid + surrounding cortex

127
Q

Ureters
what kind of muscle?
what structure do they cross?

A

smooth m

cross into pelvis at bifurcation of common iliac

128
Q

Hormones secreted by suprarenal glands

A

corticosteroidds
androgens
epinephrine, adrenaline
(part of HPA axis)

129
Q

Position of suprarenal glands on kidneys

A

medial side rather than right on top

130
Q

Shape of R vs L kidneys

A

R: pyramid
L: crescent

HDS (14 decks)

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