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Gross III > Part II. Anatomy Of Midgut/hindgut Derivatives Pg 60-72 > Flashcards

Part II. Anatomy Of Midgut/hindgut Derivatives Pg 60-72 Flashcards

1
Q

Where does the jejunum begin?

A

Begins at at duodenojejunal flexure (left side of L2 vertebra)

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2
Q

Is the jejunum and ileum retroperitoneal or intraperitoneal?

A

Intraperitoneal because they are suspended by mesentary

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3
Q

Where does the ilium end?

A

Ends at ileocecal junction

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4
Q

The jejunum is located primarily in what abdominal quadrant?

A

Upper left

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5
Q

The ileum is located primarily in what abdominal quadrant?

A

Lower right abdomen and some pelvis

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6
Q

What is the primary function of the ileum and jejunum?

A

absorption of foodstuffs (large surface area present)

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7
Q

Fold of peritoneum attaching jejunum/ileum to posterior abdominal wall

A

Mesentary

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8
Q

The mesentary extends from what two landmarks on the small intestine?

A

Extends obliquely and inferiorly from duodenojejunal junction to ileocecal junction

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9
Q

What is located between the two layers of mesentary?

A

BVs, nerves, lymph nodes and fat

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10
Q

The superior mesenteric artery (SMA) branches from Abdominal Aorta at what vertebral level?

A

L1, between the 2 layers of mesentery

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11
Q

The 15-18 arteries branching from left side of Superior Mesenteric Artery that unite to form arterial arcades and supply the jejunum and ileum?

A

Jejunum and ileal arteries

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12
Q

The short, straight vessels that pass from the arterial arcades to the jejunal and ileal wall?

A

Vasa recta

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13
Q

Which arterial arcades are longer and fewer in number?

A

Jejunal arcades

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14
Q

Which arterial arcades are shorter and greater in number?

A

Ileal arcades

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15
Q

Venous drainage for the jejunum and ileum is via what?

A

Superior mesenteric vein

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16
Q

Where in relation to the superior mesenteric artery is the superior mesenteric vein usually found?

A

Anterior and right of the superior mesenteric artery

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17
Q

The superior mesenteric vein usually merges with what other vein to drain to the hepatic portal vein?

A

Splenic vein

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18
Q

The primary nodes for lymphatic drainage of the jejunum and ileum?

A

Mesenteric nodes

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19
Q

The secondary nodes for lymphatic drainage of the jejunum and ileum?

A

Superior mesenteric nodes

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20
Q

Lymphatic drainage of the jejunum, ileum, appendix, cecum and colon ultimately goes to the thoracic duct via what?

A

Chyle cistern

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21
Q

The jejunum and ileum are innervated by what plexus?

A

Perivascular plexus

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22
Q

Sympathetic innervation to the jejunum and ileum is via what nerve and which spinal nerve levels contribute?

A

Greater and Lesser Splanchnic N (T8-T10)

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23
Q

Preganglionic sympathetic neurons that supply the jejunum and ileum will synapse where?

A

Celiac and Superior Mesenteric ganglia

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24
Q

Sympathetic innervation to the jejunum and ileum will stimulate what?

A

reduce motility and secretion, vasoconstriction

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25
Q

Parasympathetic innervation to the ileum and jejunum is via what?

A

Vagal trunks

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26
Q

The preganglionic parasympathetic fibers that supply the jejunum and ileum will synapse where?

A

myenteric and submucosal plexuses

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27
Q

Parasympathetic innervation to the jejunum and ileum with stimulate what?

A

increase motility and secretion, vasodilation occurs secondarily

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28
Q

Visceral afferents from the jejunum, ileum will accompany sympathetics and refer pain to what dermatomes?

A

T8-T10

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29
Q

What are the functions of the large intestines?

A
  • Responsible for completing absorption (primarily water)

- Compacts and temporarily stores indigestable materials as feces

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30
Q

What are the general regions of the large intestines?

A
  • Cecum (with appendix)
  • Ascending, Transverse, Descending and Sigmoid colon
  • Rectum
  • Anal canal
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31
Q

What are the 3 longitudinal strips of smooth muscle in outer layer of muscularis externa of the large intestines?

A

Tenia coli

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32
Q

The presence of the tenia coli on the large intestines causes sacculation in the wall of the colon between the tenia coli. What are these sacculations called?

A

Haustra

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33
Q

What are the small fatty projections on the outside of the large intestine?

A

Epiploic appendages

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34
Q

The cecum is located in which abdominal quadrant?

A

Right lower

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35
Q

The blind pouch at inferior portion of ascending colon that can become distended by gas or feces?

A

Cecum

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36
Q

Is the cecum intraperitoneal or retroperitoneal?

A

Intraperitoneal although it has no mesentary and is therefore fairly mobile

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37
Q

What prevents reflux from cecum to ileum?

A

Ileocecal valve

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38
Q

The blind intestinal diverticulum at posteromedial aspect of cecum?

A

Appendix

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39
Q

The appendix used to be considered vestigial but now is know to contain a large amount of what kind of tissue?

A

mucosal GALT, a type of lymphatic tissue of the gut

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40
Q

The short triangular mesentary that spans between the cecum and proximal appendix?

A

Mesoappendix

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41
Q

What is the arterial supply to the cecum?

A

Ileocolic artery which is a terminal branch of superior mesenteric artery

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42
Q

What is the arterial supply to the appendix?

A

Appendicular artery which is a branch of ileocolic artery (off superior mesenteric artery)

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43
Q

What is the path of venous drainage from the cecum and appendix?

A

Ileocolic vein -> superior mesenteric vein -> hepatic portal vein

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44
Q

The primary nodes for lymphatic drainage of the cecum and appendix?

A

Ileocolic nodes

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45
Q

Secondary nodes for lymphatic drainage of the cecum and appendix?

A

Superior mesenteric nodes

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46
Q

Sympathetic innervation to the cecum, appendix and ascending colon is via what nerve and what spinal nerve levels contribute?

A

Lesser Splanchnic N (T10)

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47
Q

The preganglionic sympathetic neurons that supply the cecum, appendix and ascending colon will synapse where?

A

Superior mesenteric ganglion

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48
Q

Parasympathetic innervation to the cecum, appendix and ascending colon is via what?

A

Vagal trunk

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49
Q

The preganglionic parasympathetic neurons that supply the cecum, appendix and ascending colon will synapse where?

A

Myenteric and submucosal plexus

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50
Q

Visceral afferents from the cecum, appendix and ascending colon will accompany sympathetics to what dermatome?

A

T10 dermatome (level of umbilicus)

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51
Q

The leftward bend of the ascending colon at the liver?

A

R Colic (hepatic) Flexure - where the transition to transverse colon occurs

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52
Q

Is the ascending colon intraperitoneal or retroperitoneal?

A

Retroperitoneal and lies on the right side of the posterior abdominal wall with the right paracolic gutter present laterally

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53
Q

The anterior surface of the ascending colon is covered by what?

A

Parietal peritoneum

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54
Q

What are the three arteries that contribute blood supply to the ascending colon?

A
  • right colic artery off of the ride side of the superior mesenteric artery
  • marginal artery which parallels inner aspect of the entire colon
  • ileocolic artery which is a terminal branch of the superior mesenteric artery
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55
Q

What is the path of venous drainage from the ascending colon?

A

Ileocolic vein and Right colic vein -> superior mesentary vein -> hepatic portal vein

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56
Q

Primary nodes for lymphatic drainage of the ascending colon?

A

Paracolic, ileocolic and right colic nodes

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57
Q

Secondary nodes for lymphatic drainage of the ascending colon?

A

superior mesenteric nodes

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58
Q

The transverse colon is the largest and most mobile portion of the large intestine that crosses abdomen from what landmark on the right to what landmark of the left?

A

from R Colic Flexure (hepatic) to L Colic Flexure (splenic)

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59
Q

What suspends the transverse colon?

A

Transverse mesocolon

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60
Q

The transverse colon is suspended and usually hangs at the level of what?

A

Umbilicus

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61
Q

Arterial supply to the transverse colon

A

Meddle colic artery which is a branch of the superior mesenteric artery

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62
Q

The middle colic artery, which supplies the transverse colon pass through what structure where it divides into right and left branches.

A

Transverse mesocolon

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63
Q

The left and right branches of the middle colic artery contribute to the formation of what artery around the inner edge of the transverse colon?

A

Marginal artery

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64
Q

What is the path of venous drainage of the transverse colon?

A

Middle colic vein -> superior mesenteric vein -> hepatic portal vein

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65
Q

Primary nodes for lymphatic drainage of the transverse colon?

A

Middle colic nodes

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66
Q

Secondary nodes for lymphatic drainage of the transverse colon?

A

Superior mesenteric nodes

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67
Q

Sympathetic innervation to the transverse colon is via what nerve and what spinal level contributes?

A

Lesser splanchnic N (T11) and superior mesenteric plexus

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68
Q

Parasympathetic innervation to the transverse colon is via what?

A

Vagal Trunks and superior mesenteric plexus

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69
Q

Is the descending colon retroperitoneal or intraperitoneal?

A

Retroperitoneal (i.e., parietal peritoneum only anteriorly, adventitia posteriorly) with left paracolic gutter present laterally

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70
Q

The descending colon extends from where to where?

A

from L Colic Flexure to left iliac fossa where it transitions to sigmoid colon

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71
Q

S-shaped segment of the colon that connects the descending colon to the rectum?

A

Sigmoid colon

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72
Q

Where do the tenia coli stop?

A

At the end of the sigmoid colon about 15cm from anus

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73
Q

Is the sigmoid colon retroperitoneal or intraperitoneal?

A

Intraperitoneal and usually has long mesentary

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74
Q

Arterial supply to the descending colon and sigmoid colon?

A
  • Left colic artery (branch of inferior mesenteric artery
  • marginal artery creates an anastomoses between middle colic artery and left colic artery (branches of superior and inferior mesenteric arteries, respectively)
  • sigmoidal arteries which are 2-4 branches from the inferior mesenteric artery
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75
Q

What is the path of venous drainage fro descending and sigmoid colon?

A

Inferior mesenteric vein -> splenic vein -> hepatic portal vein

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76
Q

Primary nodes for lymphatic drainage of the descending and sigmoid colon?

A

Paracolic or left colic nodes

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77
Q

Secondary nodes for lymphatic drainage of the descending and sigmoid colon?

A

Inferior and superior mesenteric nodes

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78
Q

Sympathetic innervation to the descending and sigmoid colon is via what nerve? What spinal cord levels contribute?

A

Least and Lumbar Splanchnic N (T12-L3)

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79
Q

Preganglionic sympathetic neurons that supply the descending and sigmoid colon will synapse on which ganglia?

A

Least splanchnic nerve synapses on Superior Mesenteric and lumbar splanchnic nerve synapses on Inferior Mesenteric ganglia

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80
Q

Parasympathetic innervation to the descending and sigmoid colon is via what nerve

A

Pelvic Splanchnic N (S2-S4) - Pass through Inferior Hypogastric Plexus

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81
Q

The artery to the midgut is what?

A

Superior mesenteric artery

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82
Q

There are 5 main branches from superior mesenteric artery. What are they and what do they supply?

A
  • Inferior Pancreaticoduodenal A – pancreas and duodenum
  • Jejunal/Ileal A – jejunum and ileum
  • Middle Colic A – transverse colon
  • R Colic A – ascending colon
  • Ileocolic A – distal ileum and cecum
83
Q

The middle colic artery (off of superior mesenteric artery) gives off a branch that will anastomose and connect to the left colic artery. What is this branch?

A

Marginal artery

84
Q

The ileocolic artery (a branch off superior mesenteric artery) gives off a branch that supplies the appendix. What is that branch?

A

Appendicular A

85
Q

The vascular structures that form a loop to connect two jejunal arteries is called?

A

Jejunal arcades

86
Q

The vascular structures that form a loop to connect two ileal arteries is called?

A

Ileal arcades

87
Q

The straight vessels that branch off of jejunal arcades?

A

Jejunal vasa recta

88
Q

The straight vessels that branch off of ileal arcades?

A

Ileal vasa recta

89
Q

The inferior mesenteric artery has 3 main branches. What are they and what do they supply?

A
  • L Colic A – descending colon
  • Sigmoid A – sigmoid colon
  • Superior Rectal A – terminal branch to superior portion of rectum
90
Q

Are the kidneys retroperitoneal or intraperitoneal?

A

Retroperitoneal

91
Q

What vertebral level on the posterior abdominal wall are the kidneys found?

A

T12-L3 (in supine)

92
Q

Which kidney is displaced slightly lower and why?

A

The right is displaced lower by the liver

93
Q

What structures associate with the right kidney?

A

Liver, duodenum, ascending colon

94
Q

What structures associate with the left kidney?

A

Stomach, spleen, pancreas, descending colon

95
Q

There are three nerves that pass posterior to the kidney. What are they?

A

Subcostal N, Iliohypogastric N and Ilioinguinal N

96
Q

What are the main functions of the kidneys?

A
  • Remove salts and metabolic wastes from blood while preserving nutrients
  • Maintain appropriate water balances in body
  • Secrete substances into blood that regulate blood pressure and erythropoiesis
97
Q

Urine that is produced in the kidneys pass through ______ to the urinary bladder.

A

Ureter

98
Q

The kidneys are surrounded by what kind of tissue that is located INSIDE the renal fascia?

A

Perirenal fat

99
Q

What gland sits superomedially to each kidney in the perirenal fat?

A

Suprarenal gland

100
Q

What is the function of the Suprarenal gland?

A

Produce corticosteroids, androgens, epinephrine and norepinephrine

101
Q

The kidneys are surrounded by what kind of tissue that is located OUTSIDE the renal fascia?

A

Pararenal fat

102
Q

What is the purpose of the perirenal and pararenal fat surrounding the kidneys?

A

Hold the kidneys in place and cushion them

103
Q

What is the vertical, concave cleft on the medial surface of the kidney?

A

Hilum

104
Q

The hilum of the kidney is the point of passage for what?

A

Renal artery and vein
Nerves
Lymphatics
Ureter

105
Q

What is the anterior to posterior order of structures inside the renal hilum?

A

Renal vein -> renal artery -> ureter

106
Q

What is the fat filled space within the kidneys that houses the renal pelvis and calicoes?

A

Renal sinus

107
Q

What is the flattened, funnel-shaped origin of the ureter called?

A

Renal pelvis

108
Q

The renal pelvis collects urine from _______ directly and _______ indirectly.

A

Major calyces : minor calyces

109
Q

Arterial supply to the kidney is via what?

A

Renal artery which is a branch of the abdominal aorta

110
Q

The renal artery branches from the abdominal aorta at approximately what vertebral level?

A

L1-L2 IVD

111
Q

Which renal artery is longer, right or left?

A

Right because it branches off of the abdominal aorta which is on the left side of the abdomen

112
Q

Which renal artery passes posterior to the IVC, right or left?

A

right

113
Q

At the renal hilum, the renal artery will divide into what?

A

Anterior and posterior rami

114
Q

The anterior ramus of the renal artery will further divide into what?

A

Anterior, superior and inferior segmental arteries

115
Q

The posterior ramus of the renal artery will further divide into what?

A

Posterior and inferior segmental arteries

116
Q

Do the segmental arteries of the kidneys anastomose or are they end arteries?

A

End arteries which means that obstruction leads to cessation of function and death of segment

117
Q

The left renal vein receives what tributaries?

A
  • left inferior phrenic vein
  • left suprarenal vein
  • left gonadal vein (testicular vein in males, ovarian vein in females)

NOTE: the right renal vein does not receive the corresponding tributaries due to the presence of the IVC on the right

118
Q

The inferior vena cava receives what tributaries around the area of the right kidney?

A
  • right inferior phrenic vein
  • right suprarenal vein
  • right gonadal vein (testicular vein in males, ovarian vein in females)
119
Q

Are the venous tributaries from the kidneys to the renal vein segmentally restricted like the segmental arteries of the kidneys?

A

No

120
Q

Where do the renal arteries drain to?

A

IVC

121
Q

Primary lymphatic drainage from the kidneys is via what?

A

Lumbar lymph nodes

122
Q

Efferent lymphatic drainage of the kidneys is ultimately through what?

A

Thoracic duct

123
Q

Sympathetic innervation of the kidneys is via the renal plexus which is supplied by what nerves?

A

Lesser and least splanchnic nerves

124
Q

The presynaptic sympathetic fibers that supply the kidneys will synapse on what ganglion?

A

Aorticorenal ganglion

125
Q

What is the effect of sympathetic stimulation to the kidneys?

A

Vasoconstriction (which leads to lower urine output)

126
Q

Parasympathetic innervation to the kidney is via the renal plexus and supplied by what?

A

Posterior vagal trunk

127
Q

Parasympathetic stimulation of the kidneys produces what?

A

Vasodilation (which leads to higher urine output)

128
Q

visceral afferent pain from the kidneys refers through the sympathetics to what cord segment dermatomes?

A

T10-T12, usually as back pain

129
Q

The muscular duct spanning from the kidney to urinary bladder

A

Ureter

130
Q

Is the ureter intraperitoneal or retroperitoneal?

A

Retroperitoneal

131
Q

The ureter has 3 points of constricted. Where are they?

A
  • Junction between renal pelvis and ureter
  • Point where ureter crosses brim of pelvic inlet
  • Point where ureter passes through wall of urinary bladder
132
Q

What is the arterial supply to the abdominal part of the ureter?

A

Renal artery
Gonadal artery
Abdominal aorta

133
Q

What is the venous drainage of abdominal part of ureter?

A

Renal vein

Gonadal vein

134
Q

Primary nodes for the lymphatic drainage of abdominal part of ureter

A

Lumbar or common iliac lymph nodes

135
Q

Efferent lymphatic drainage of the abdominal part of ureter is ultimately to where?

A

Thoracic duct

136
Q

Sympathetic innervation to the abdominal part of the ureter is from what spinal levels? Via what plexi?

A

T11-L2 via renal, aortic and hypogastric plexuses

137
Q

Sympathetic innervation to het abdominal part of the ureter has what effect?

A

Leads to increased peristaltic activity

138
Q

Where is the suprarenal (adrenal) gland located?

A

Between the superomedial kidney and thoracic diaphragm. It is enclosed in perirenal fat but in a separate fascial compartment from the kidney

139
Q

What shape is the right suprarenal gland?

A

Triangular or pyramidal shape

140
Q

The right suprarenal gland contacts what 4 structures?

A

Right kidney
Thoracic diaphragm
IVC
Liver

141
Q

What shape is the left suprarenal gland?

A

Crescent or semilunar in shape

142
Q

What 5 structures does the left suprarenal gland contact?

A 
Left kidney
Thoracic diaphragm
spleen
stomach
Pancreas
143
Q

From right to left, what structures are located between the 2 Suprarenal glands?

A

IVC -> R Crus of Thoracic Diaphragm -> Celiac Ganglion -> Celiac Trunk -> Superior Mesenteric A -> L Crus of Thoracic Diaphragm

144
Q

What does the suprarenal cortex secrete?

A

Corticosteroids and androgens

145
Q

Embryologically, what is the suprarenal cortex derived from?

A

Mesoderm

146
Q

Embryologically, suprarenal medulla is derived form what?

A

Neural crest (i.e. ectoderm)

147
Q

What does the suprarenal medulla secrete?

A

Epinephrine and norepinephrine

148
Q

The secretions of the suprarenal medulla activate sympathetic activities such as:

A
  • Increases heart rate and blood pressure
  • Dilates bronchioles
  • Increases blood flow to brain and skeletal muscle
149
Q

Secretion from the suprarenal medulla is regulated by sympathetic innervation where presynaptic neurons will synapse on _________.

A

Medullary cells

150
Q

What is the arterial supply to the suprarenal glands?

A
  • Superior Suprarenal A branching from Inferior Phrenic A
  • Middle Suprarenal A branching from Abdominal Aorta
  • Inferior Suprarenal A branching from Renal A

NOTE: These branch to produce up to 50 or more arteries which enter gland

151
Q

What is the path of venous drainage from the right suprarenal gland?

A

Right suprarenal vein -> IVC

152
Q

What is the path of venous drainage from the left suprarenal gland?

A

Left suprarenal vein -> left renal vein

153
Q

Efferent lymphatic drainage from the suprarenal glands is to what nodes?

A

lumbar lymph nodes and then to Thoracic Duct

154
Q

Sympathetic innervation of suprarenal glands is via what?

A

Lesser and Least Splanchnic N and Celiac Plexus

155
Q

What is the effect of sympathetic stimulation to the suprarenal glands?

A

Increase epinephrine secretion

156
Q

Parasympathetic innervation of the suprarenal glands is via what?

A

Posterior vagal trunk and celiac plexus

157
Q

What is the effect of parasympathetic stimulation to the suprarenal glands?

A

Action is unknown

158
Q

The primary muscle of inspiration?

A

Thoracic diaphragm

159
Q

What happens when the thoracic diaphragm contacts?

A

It descends to increase the volume of the pulmonary cavities

160
Q

What structure attaches the parietal pericardium to the central part of the diaphragm?

A

Pericardiophrenic ligament

161
Q

The muscle fibers of the thoracic diaphragm converge radially on what structure?

A

Central tendon

162
Q

The opening for what passes through the central tendon of the thoracic diaphragm?

A

IVC

163
Q

The muscular region of the diaphragm has 3 parts:

A

Sternal part
Costal part
Lumbar part

164
Q

The sternal part of the diaphragm is attached where?

A

2 slips of muscle attaching to posterior aspect of xiphoid process

NOTE: Not always present or obvious

165
Q

The costal part of the diaphragm is attached where?

A

Wide muscular slips attaching to internal surfaces of inferior 6 costal cartilages - forms left/right domes of diaphragm

166
Q

The lumbar part of the diaphragm is attached where?

A

Muscular crura that ascend to central tendon from 3 upper lumbar vertebrae

167
Q

Where does the crura of the thoracic diaphragm arise from?

A
  • Anterior surface of superior lumbar vertebral bodies and associated IVDs
  • Anterior Longitudinal L
168
Q

Where does the right crus of the diaphragm arise from?

A

from L1-L3 or L4 vertebrae

169
Q

The fibers of the right crus of the diaphragm pass _______ (right/left) of the aortic hiatus.

A

Right

170
Q

The fibers of the left crus of the diaphragm pass _______ (right/left) of the aortic hiatus.

A

Left

171
Q

Where does the left crus of the diaphragm arise from?

A

from L1-L2 or L3 vertebrae

172
Q

The fibers of the right crus encircle what landmark?

A

Esophageal hiatus

173
Q

The thoracic diaphragm has 3 arcuate ligaments. What are they?

A
  • median arcuate ligament
  • medial arcuate ligament
  • lateral arcuate ligament
174
Q

What ligament arches over anterior aspect of abdominal aorta at aortic hiatus and unites R/L crura at aortic hiatus?

A

Median arcuate ligament

175
Q

What is the thickened fascia superior to Psoas Major Muscle that spans from L1 vertebral body to L1 transverse process and blends with ipsilateral crus?

A

Medial arcuate ligament

176
Q

What is the thickened fascia superior to Quadratus Lumborum Muscle that spans from L1 transverse process to 12th rib?

A

Lateral arcuate ligament

177
Q

What is the caval opening?

A

The opening in the central tendon of the thoracic diaphragm for IVC and right phrenic nerve and lymphatics

178
Q

Where (vertebral level) is the caval opening located?

A

right of median plane (level with T8/T9 IVD)

179
Q

How does the caval opening in the thoracic diaphragm affect venous return?

A

Diaphragm contraction widens the lumen of the IVC and facilitates venous return

180
Q

What is the vertebral level of the esophageal hiatus?

A

T10

181
Q

What is the oval opening in the right crus of the diaphragm?

A

Esophageal hiatus

182
Q

What passes through the esophageal hiatus?

A
  • Esophagus
  • Anterior/Posterior Vagal Trunks
  • Esophageal Branch of L Gastric A
183
Q

What attaches the esophagus to the diaphragm?

A

Phrenicoesophageal ligament

184
Q

What is the function of the lower esophageal sphincter?

A

Diaphragm contraction causes constriction as esophagus passes Right Crus to seal off thoracic and abdominal cavities

185
Q

Where is the aortic hiatus located?

A

posterior to diaphragm (level with T12) between R/L crura and posterior to Median Arcuate L

NOTE: this means that aortic blood flow is unaffected by diaphragm contraction

186
Q

What structure pass through the aortic hiatus?

A
  • aorta
  • thoracic duct
  • azygos/hemazygos vein
187
Q

What passes through the sternocostal foramen in the diaphragm?

A

Superior epigastric artery and vein

188
Q

When the diaphragm contracts and increases volume of the thoracic cavity while decreasing the volume of the abdominal cavity what happens to the intrathoracic and intraobdominal pressure?

A
  • Intrathoracic pressure decreases

- intraabdominal pressure increases

189
Q

The diaphragm is most superior in location when in what body position?

A

Supine

190
Q

The diaphragm is most inferior in location when in what body position?

A

Sitting or standing

191
Q

What is the arterial supply to the superior surface of the thoracic diaphragm?

A
  • Pericardiacophrenic A centrally from Internal Thoracic A
  • Musculophrenic A anteriorly from Internal Thoracic A
  • Superior Phrenic A posteriorly from Thoracic Aorta
192
Q

What is the arterial supply to the inferior surface of the thoracic diaphragm?

A
  • Inferior Phrenic A from Abdominal Aorta (Branch just superior to celiac trunk or may arise from it)

NOTE : this is the Primary blood supply to diaphragm

193
Q

What is the venous drainage from the superior surface of the thoracic diaphragm?

A
  • Pericardiacophrenic V and Musculophrenic V drain to Internal Thoracic V
  • Superior Phrenic V drains to IVC
  • Some posterior venous drainage is to azygos system of veins
194
Q

What is the venous drainage from the inferior surface of the thoracic diaphragm?

A

Inferior Phrenic V

  • On right side usually drains to IVC
  • On left side usually drains to L Suprarenal V

NOTE: Inferior venous drainage is primary for diaphragm

195
Q

What are the primary nodes for lymphatic drainage form the thoracic diaphragm?

A

Anterior and posterior diaphragmatic nodes

196
Q

What are the secondary nodes for lymphatic drainage from the thoracic diaphragm?

A

Parasternal and posterior mediastinal notes

197
Q

Efferent lymphatic drainage from the thoracic diaphragm ultimately continues to where?

A

Thoracic duct

198
Q

Motor innervation of the thoracic diaphragm is from what?

A

Phrenic N (C3-C5 ventral rami)

199
Q

Phat is the path of the phrenic nerve through the thoracic cavity?

A

Passes between parietal pericardium and mediastinal pleura as it descends to the diaphragm

200
Q

Central sensory innervation (pain/proprioception) for the diaphragm is via what nerve?

A

Phrenic

201
Q

Where is the referred pain from diaphragmatic pleura or diaphragmatic peritoneum?

A

base of neck and shoulder region via C3-C5

202
Q

Peripheral sensory innervation to the thoracic diaphragm is via what nerves?

A

Intercostal Ns (T5-T11) and Subcostal N

203
Q

Referred pain from peripheral regions of the diaphragm will go to what dermatomes?

A

Overlying dermatomes of intercostal nerves (T5-T11) and subcostal nerve (T12)

Gross III (20 decks)

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