Revision GA1 Flashcards
articulations of first rib
3
single facet on head articulates with body of T1 vertebra
tubercle articulates with transverse process of T1
forms a synchondrosis with the manubrium of sternum
describe the first rib
atypical til with short, flattened body
atypical bony features on superior surface of first rib
two grooves where it is crossed by the subclavian vessels
where is the scalene tubercle and what is its function
between subclavian grooves on superior surface of first rib
attachment of anterior scalene
what is the pleura
serous membrane divided into visceral pleura (covers lungs) and parietal pleura (lines thoracic cavity)
subdivisions of parietal pleura
diaphragmatic
cervical
costal
mediastinal
at which point are the parietal and visceral pleura continuous
at the lung root
what is the pulmonary ligament and what is its function
a sleeve of pleura hanging down below the lung root
allows expansion of pulmonary vessels
what is the costodiaphragmatic recess
space where the parietal pleura hangs down below the level of the lungs between the ribs and diaphragm
what is the venous drainage of the heart (generally)
cardiac veins to coronary sinus to right atrium
what is the course of the great cardiac vein
runs with anterior inter ventricular artery
what is the course of the small cardiac vein
runs with right marginal artery
what is the course of the middle cardiac artery
runs with posterior interventricular artery
which cardiac veins drain directly into the right atrium
anterior cardiac veins draining the right atrium wall
what is the oesophagus
fibromuscular tube that allows passage of food from the pharynx to the stomach
at which vertebral level does the oesophagus begin
C6
relations of the oesophagus in the superior mediastinum
lies anterior to vertebral bodies T1-T4
lies posterior to trachea
in which division of the inferior mediastinum does the oesophagus lie
posterior mediastinum
describe the course of the oesophagus in the posterior mediastinum in relation to the aorta
initially is medial (to the right) of the aorta
crosses anterior to the aorta before passing through the oesophageal hiatus
at which level is the oesophageal hiatus
T10
which structures are responsible for the three constrictions of the oesophagus
aorta
left bronchus
diaphragm
what is the scrotum
out pouching of the layers of the abdominal wall
what are the layers of the scrotal wall
superficial layer = colle fascia and dartos muscle
external fascia = external oblique
cremaster muscle = internal oblique
inter fascia = transversals fascia
contents of scrotum
testes
epididymis
lower end of spermatic cord
lymph drainage of scrotum
superficial inguinal nodes
attachments of lesser omentum
liver and lesser curvature of stomach (and first part of duodenum)
what is the lesser omentum made of
double layer of peritoneum
which structures are contained in the free edge of lesser omentum
hepatic artery (left bile duct (right) portal vein (posterior)
the lesser omentum contributes to the boundaries of which structures
lesser sac
omental foramen
what is the largest lymphoid organ in the body
spleen
where is the spleen
left hypochondrium deep to ribs 9-11
arterial supply of spleen
splenic artery
course of splenic artery
arises from coeliac axis
runs along bod and tail of pancreas into lienorenal&spell ligament to hilum of spleen
venous drainage of spleen
splenic vein
course of splenic vein
from hilum
along posterior surface of pancreas
joins SMV to form portal vein
another name of parasympathetic nervous system
craniosacral outflow
parasympathetic outflow occurs in which nerves
CN III, VII, IX, X
S2-S4
action of parasympathetic nervous system
‘rest and digest’
decrease HR, respiration
increase gut motility
parasympathetic action of CN III
constriction of pupils and accommodation
parasympathetic action of CN VII
submandibular and sublingual salivary glands, lacrimal gland, palatine glands
parasympathetic action of CN IX
parotid gland
parasympathetic action of CN X
viscera of thorax and abdomen (up to midgut)
parasympathetic innervation to pelvic and hindgut organs
sacral outflow (S2-S4)
what structures do the margins of rectus abdominis contribute to
medial margins = linea alba
lateral margins = linea semilunaris
blood supply to rectus abdominis
MAINLY inferior epigastric
also superior epigastric
action of rec abd.
flexion of trunk
support of abdominal wall
innervation of rec abd.
T7-12
what are ureters
smooth muscle tubes that transmit urine from the kidneys to the bladder
course of ureters
begin at renal pelvis
pass retroperitoneally over surface of psoas
cross bifurcation of common iliac artery
pass along lateral wall of pelvis to enter base of bladder at trigone
where are the three constrictions of ureter
junction with renal pelvis
crossing pelvic brim
entering bladder
blood supply of ureters
renal, gonadal and superior vesical arteries
equivalent veins
which intercostals run inferomedially
external intercostals
action of intercostals
raise ribs on inspiration
what is the function of papillary muscles
prevent valve prolapse
prevent back flow of blood to atria by keeping valve closed
which structures passes through space posterior to median arcuate ligament
aorta
azygous vein
thoracic duct
which structure opens into the 2nd part of duodenum
ampulla of vater/bile duct/pancreatic duct
which abdominal muscle has transverse fibres
transversus abdominis
lymph drainage of gall bladder
cystic/hepatic/coeliac/pre-aortic T12
what is found in dorsal root ganglion
sensory nerve cell bodies
which vessel supplies the right side of greater curvature
right gastroepiploic artery
branch of gastroduodenal
gives anterior intercostal branches to intercostal spaces 7-9
musculophrenic artery (branch of internal thoracic)
the tubercle of a typical rib articulates with…
transverse process of own vertebra
in the mid-clavicular line, the parietal pleura extends to level of…
rib 8
which structure forms the apex of the heart
left ventricle
which valve prevents backflow to right atrium
tricuspid valve
what is the third branch of the aortic arch
left subclavian
what is the most anterior structure at the lung root
pulmonary vei n
which structure crosses the diaphragm at T8
IVC
the superficial ring is formed from an opening of which structure
aponeurosis of external oblique
quadrates lumborum attaches to: costal margin T12 vertebral body T11 vertebral body 12th rib 10th rib
12th rib
abdominal aorta bifurcates at…
L4
which artery is contained in the gastrosplenic ligament
short gastric artery
what are the nerve roots of the genitofemoral artery
L1, L2
numerous plicae circularis are a fear of which structure
jejunum
what is the most posterior structure at the renal hilum
ureter
what is the largest direct branch of the coeliac axis
splenic
pain from the stomach is referred where
stomach
which muscle can both raise and depress the ribs
internal intercostal
which muscle is innervated by medial and lateral pectoral nerves
pac major
which muscle lies immediately superficial to neuromuscular plane of thorax
internal intercostal
the internal thoracic vessels lie immediately anterior to this muscle
transversus thoracis
which structures prevent back flow of blood the ventricles
semilunar valves
aortic and pulmonary valves
what is a feature unique to the right ventricle
moderator band
which feature separates the muscular and smooth parts of the wall of the right atrium
crista terminalis
the sinoatrial node is located in the upper portion of this structure
crista terminalis
what is the most anterior structure in the superior mediastinum
thymus
which structure crosses the diaphragm at T10
oesophagus
which part of the aorta is found in the middle mediastinum
ascending aorta
where does the azygos vein empty
SVC
the vagus nerve forms a plexus on the surface of which structure
oesophagus
attachments of rec abd
pubic bone, xiphoid process and costal cartilages 5-7
which structure forms the majority of the anterior wall of the inguinal canal
external oblique
innervation of iliac
femoral nerve
which abdominal muscle is not present in everyone
pyramidalis
the fascia over which muscle forms the lateral arcuate ligament
Quadratus lumborum
which artery forms a communication between the superior and inferior mesenteric arteries
marginal artery
the right gastroepiploic is a branch of which artery
gastroduodenal
the left colic is a branch of which artery
IMA
the left gastric is a branch of…
coeliac axis
supplies food to caecum
ileocolic
surface marking of gallbladder
right 9th costal cartilage
proximal attachment of greater omentum
greater curvature of stomach
junction of foregut and midgut
duodenum
site of portal-systemic anastomosis
rectum
what is the duodenum
C-shaped continuation of the gut tube from the pyloric valve to the jejunum
what is the first part of the duodenum
1st part is duodenal cap
receives fluid from stomach
what is the 2nd part of the duodenum
descending part
which structures drain into 2nd part of duodenum
main pancreatic duct and bile duct
opening at the hepatoduodenal ampulla (of Vater)
what is the 3rd part of the duodenum
transverse
crosses the mesentery and superior mesenteric vessels
what is the 4th part of duodenum
ascending
joins jejunum at root of mesentery
what is the arterial supply to the jejunum
superior pancreaticoduodenal artery (gastroduodenal) inferior pancreaticoduodenal (SMA)
lymph drainage of pancreas
to pre-aortic nodes at T12 and L1
what is the inguinal canal
oblique passage through the anterior abdominal wall for structures to pass from the abdominal cavity to scrotum/labia major
where does the inguinal canal begin and end
begins at deep inguinal ring (defect in transversalis fascia)
ends at superficial inguinal ring (defect in external oblique aponeurosis)
anterior wall of inguinal canal
external oblique and internal oblique laterally
roof of inguinal canal
internal oblique and transverses abdominis
floor of inguinal canal
inguinal ligament
posterior wall of inguinal canal
trasversali fascia and conjoint tendon medially
what is the conjoint tendon
union of internal oblique ad transversalis fascia aponeurosis
contents of inguinal canal
spermatic cord (M) round ligament (F) ilioinguinal nerve
renal arteries arise at…
L1
gonadal arteries arise at…
L2
inferior phrenic a arises at…
T12
lumbar arteries arise at
L1-L5
attachments of Quadratus lumborum
iliac crest
to 12th rib and L1-L4 transverse processes
action of quad lumb.
unilateral = lateral flexion bilateral = assists in forced expiration and support of 12th rib
what is the sympathetic chain
a system of interconnected ganglia that lie either side of the VC
sympathetic outflow occurs at which spinal levels
T1-L1/2
which rami communicans are associated with inflow/outflow
inflow = grey outflow = white
parts of the sternum
manubrium
body
xiphoid process
joints of sternum
manubriosternal joint (2ndry cartilaginous) xiphisternal joint
features of manubrium of sternum
sternal notch in superior broder at midline
clavicular notches each side
where are the costal notches
notch 1 = manubrium
notch 2 = sternal angle
notches 3-6 = margin of body
notch 7 = xiphisternal joint
where are the posterior and anterior intercostal arteries found
costal groove in intercostal space
where do the 1st and 2nd posterior intercostal arteries arise
supreme intercostal artery
branch of costocervical trunk of subclavian
where do posterior intercostals 2-11 arise
direct branches of descending aorta
where do anterior intercostal arteries 1-6 arise
internal thoracic artery
terminal branches of internal thoracic
musculoprenic and superior epigastric
where do anterior intercostal arteries 7-9 arise
musculophrenic artery
which chamber forms the base of the heart
left atrium
describe the internal surface of left atrium
mostly smooth walled
muscular auricule anteriorly, with musculi pectinati
how do structures pass from thorax to abdomen
either through diaphragm or posterior to arcuate ligaments
level of caval opening
T8
contents of caval opening
IVC
level of oesophageal hiatus
T10
contents of oesophageal hiatus
oesophagus and vagal trunks
level of aortic hiatus
T12
what forms the aortic hiatus
space posterior to median arcuate ligament
where do the greater and lesser splanchnic nerve pass to reach abdomen
openings in the crura at T12
where do the least splanchnic and sympathetic chain enter abdomen
posterior to medial arcuate ligament at T12
parasympathetic innerve to proximal transverse colon
vagus nerve
function of gallbladder
store and concentrate bile
fibres direction of internal oblique
superomedial
head of rib 1 articulates with
body of T1 vertebra
what is the name of roughened area on the superior surface of rib 1
scalene tubercle
root values of phrenic nerve
C3,4,5
which structure runs alongside the right marginal artery
small cardiac vein
which artery passes through root of mesentery
SMA
what is the most posterior structure at the renal hilum
ureter
what is the root value of the Iliohypogastric nerve
L1
where is scarpa’s fascia found
anterior abdominal wall between umbilicus and pubic bone
the descending colon is supplied by the
left colic artery
which liver lobes does the gall bladder lie between
right lobe
quadrate lobe
the inferior mesenteric vein drains directly into which vein
splenic vein
which ribs are posterior to the left kidney
11 and 12
the funds of stomach is related to which dome of diaphrag m
left dome
which structure is a junction between the midgut and hindgut
transverse colon
which structure lies immediately superficial to neurovascular plane of thorax
internal intercostal
which structure allows expansion of the pulmonary vessels
pulmonary ligament
primary muscle of respiration
diaphragm
lymphatic drainage of lungs is to
hilar nodes
what initiates the heart beat
SA node
which artery supplies the posterior 2/3 of inter ventricular septum
posterior interventricular artery
the thymus can be found in which areas of the mediastinum
superior and anterior
what is the first branch of the aortic arch
brachiocephalic trunk
the carina is a which vertebral level
T4/5
which muscle lies inferior to medial arcuate ligament
psoas
external oblique contributes to which aspect of the rectus sheath
external oblique
which abdominal muscle attaches to ribs 5-7, pubic tubercle and xipohoid process
rectus abdominis
what lies posterior to rectus abdomens after the arcuate line
tranvsersalis fascia
which muscle’s only action is to tense lineament alba
pyramidalis
which artery passes in lienorenal ligament
splenic artery
left gastric is a direct branch of
coeliac axis
superior pancreaticodudoenal is a branch of
gastroduodenal
which artery passes under neck of pancreas
SMA
the gastro-epiploic arteries supply which structure
greater curvature of stomach
lymph from stomach –>
pre-aortic T12
lymph from sigmoid colon –>
pre-aortic L3
what colour is the lymph on the intestinal trunk
milky-white
lymph from superficial layers of anterior abdominal wall below the umbilicus –>
superficial inguinal nodes
primary action is to raise ribs on inspiration
external intercostal
receives motor innervation form logn thoracic nerve
serratus anterior
fibres radiate from lateral borders of sternum
transversus thoracis
innervated by medial pectoral nerve only
pec minor
can both raise and depress the ribs
internal intercostals
what is located in the upper portion of crista terminalis
SA node
moderator band is unique to…
right ventricle
what are the muscle ridges in the ventricles called
trabeculae carneae
the origin of the coronary arteries is closely associated with which structure
aortic valve
what attaches to margins of cuspid valves
chordae tendineae
the thoracic aorta is located in which part of mediastinum
posterior only
the azygos vein drains into…
SVC
the left recurrent laryngeal nerve is associated with which vessel
arch of aorta
which structure lies immediately posterior to trachea
oesophagus
the SVC is found in which areas of mediastinum
superior and middle
what is the superficial inguinal ring
triangular opening in aponeurosis of external oblique situated close to pubic bone
which branch of genitofemrial nerve can be found in superficial inguinal ring
genital branch
describe movements to increase AP dimensions of thorax in inspiration
ribs 1-6 and sternum move anterior and superiorly
pump handle movement
describe movements to increase lateral dimensions of thorax in inspiration
ribs 7-12 move laterally
bucket handle movement
describe movements to increase vertical dimensions of thorax in inspiration
contraction and descent of diaphragm
how does blood enter left atrium
via 4 pulmonary veins
oxygenated blood
how does blood leave left atrium
via left atrioventricular canal
mitral valve prevent reflux of blood
borders of posterior mediastinum
transverse thoracic plane (T4/5)
diaphragm
pericardium
bodies of T5-12
contents of posterior mediastinum
oesophagus
throacic aorta
lymphatic duct
azygos/hemiazygos vein
protraction of scapula =
anterior movement around the body wall
membranous fascia of anterior abdominal wall below the umbilicus
scarpa’s fascia
lymph from the superficial anterior abdominal wall above the umbilicus drains to
axillary nodes
the ventral ramus supplies innervation to which structures
anterior and lateral body walls
limbs
a movement possible at shoulder but not at wrist =
rotation
the anatomical term for the space posterior to the stomach
lesser sac
gives anterior intercostal branches to intercostal spaces 7-9
musculophrenic artery
the costal cartilage of which rib articulates with the sternal angle
rib 2
in the mid-axillary line the parietal pleura extends to the level of which rib
rib 10
surface marker for T10 dermatome
umbilicus
deep inguinal ring forms an oval opening in this structure
transversals fascia
separates the middle and lower lobes of the right lung
oblique fissure
region analogous to the middle lobe of the right lung
lingula
region where the parietal and visceral pleura are continuous
hilum
the transverse fissure is unique to which lung
right lung
passes through an opening in the central tendon of diaphragm
oesophagus
