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Sectional Anatomy > Sectional Anatomy > Flashcards

Sectional Anatomy Flashcards

1
Q

Gross Anatomy, Microscopic Anatomy & Physiology

A

Emphasis on BODY SYSTEMS

Look at SHAPE, LOCATION, FUNCTION

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2
Q

Sectional Anatomy

A

Regions of the body
Relationships with all structures of given region
Anatomy viewed in SLICES

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3
Q

Superior, Cranial, Cephalic

A

Toward head or above

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4
Q

Inferior, Caudal,

A

Towards feet or below

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5
Q

Anterior, Ventral

A

Towards front of structure or surface

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6
Q

Posterior, Dorsal

A

Towards back of structure or surface

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7
Q

Medial

A

Toward midline

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8
Q

Lateral

A

Towards side of body

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9
Q

Superficial, External

A

Near body surface

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10
Q

Deep, Internal

A

Away from body surface

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11
Q

Proximal

A

Closer to point of origin or trunk

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12
Q

Distal

A

Further from the point of origin or trunk

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13
Q

Ipsilateral

A

On same side

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14
Q

Contralateral

A

On opposite sides

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15
Q

Visceral

A

Referring to organs

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16
Q

Parietal

A

Body walls

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17
Q

Prone

A

Patient lying face down

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18
Q

Supine

A

Patient lying face up

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19
Q

True Lateral

A

On right or left side at 90 degrees LATERAL DECUBITUS

Name = side touching table

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20
Q

Lateral Oblique

A

Angle less than 90 degrees

Name = side touching able and surface closest to table

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21
Q

Erect

A

Standing or sitting upright

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22
Q

Semi-erect

A

Partially upright

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23
Q

Trendelenburg

A

Feet higher than head

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24
Q

Reverse trendelenberg

A

Head higher than feet

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25
Q

Body cavities

A

Natural spaces containing internal organs
SEPARATES, PROTECTS, SUPPORTS
Allows movement and expansion

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26
Q

Dorsal cavity

A

Posterior and superior
CNS
Cranial and spinal cavities

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27
Q

Cranial

A

contains brain and associated structures

Surrounded by bones

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28
Q

Spinal

A

Contains spinal cord and nerves

Protected by spinal vertebrae

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29
Q

Ventral cavity

A

Large space in anterior aspect of body
Organs known as viscera
Thoracic and abdominopelvic

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30
Q

Thoracic

A

Superior portion of ventral cavity
Lungs and heart
Diaphragm separates from abdominopelvic cavity
Pleural cavity and mediastinum

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31
Q

Pleural cavity

A

Contains lungs

Lubricated to reduce friction

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32
Q

Mediastinum

A

Between the pleural cavities

Heart located in pericardium

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33
Q

Abdominopelvic cavity

A

Diaphragm to pelvis
Lined with serous membrane
Subdivided into superior abdominal cavity and inferior pelvic cavity with no muscular separation

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34
Q

Abdominal cavity

A

Upper portion abdominopelvic cavity

Inferior surface of diaphragm to superior bony pelvis

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35
Q

Pelvic cavity

A

Lower portion abdominopelvic cavity
Within bony structure of pelvis
True and false pelvis

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36
Q

True pelvis

A

Pelvic inlet to birth canal

Bladder reproductive organs

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37
Q

False pelvis

A

Above pelvic brim below iliac crests

Small intestine colon

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38
Q

Anatomical landmarks

A 
Sternal notch
Xiphoid process
Subcostal margin
Iliac crests
Symphysis pubis
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39
Q

Arteries

A

Carry blood away from heart
Carry oxygenated blood except pulmonary arteries
Thick walls to withstand high pressure and high blood flow
3 layers

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40
Q

Lumen

A

Innermost portion of artery

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41
Q

Tunica intima

A

Inner layer of artery wall

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42
Q

Tunica media

A

Muscular middle layer of artery wall

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43
Q

Tunica adventitia

A

Outermost portion of artery wall

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44
Q

Aorta

A 
Starts at AORTIC HIATUS level of T12
PROXIMAL portion = more POSTERIOR
DISTAL portion = more ANTERIOR
LEFT of MIDLINE
BIFURCATES at L4
RETROPERITONEAL
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45
Q

Celiac Axis/=Trunk

A

First major branch of aorta
1cm in length
ANTERIOR aspect of aorta
Has 3 branches: COMMON HEPATIC ARTERY, LEFT GASTRIC ARTERY, SPLENIC ARTERY

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46
Q

Common Hepatic Artery

A

Branches toward the right and liver

Divides into HEPATIC ARTERY PROPER and GASTRODUODENAL ARTERY

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47
Q

Splenic Artery

A

Travels left along SUPERIOR aspect of PANC

Carries blood to SPLEEN and PANC TAIL

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48
Q

Left Gastric Artery

A

Travels along left and upward path along lesser curvature of stomach

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49
Q

Right and Left Adrenal (SUPRARENAL) Artery

A

Paired
Arise from LATERAL side of aorta
Between celiac axis and SMA
Course OBLIQUELY to adrenal glands

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50
Q

Superior Mesenteric Artery SMA

A

Second ANTERIOR branch of aorta
Travels ANTERIOR then INFERIOR
Supplies SMALL INTESTINE, ASCENDING COLON, TRANS COLON

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51
Q

Renal Arteries

A

Paired
LATERAL branches of aorta
Just INFERIOR to level of SMA
RRA slightly INFERIOR and LONGER than LRA
Renal arteries run POSTERIOR to renal veins
RRA passes POSTERIOR to IVC

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52
Q

Gonadal Arteries ( ovarian, testicular)

A

Paired, originate from ANTERIOR aorta
INFERIOR to renal arteries
Travel INFERIORLY OBLIQUELY

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53
Q

Inferior Mesenteric Artery IMA

A

ANTERIOR branch at L3
Travels INFERIORLY and LEFT
Supplies LEFT TRANS COLON, DESCENDING AND SIGMOID COLON AND RECTUM

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54
Q

Lumbar Arteries

A

Paired with 4-5 sets
LATERAL POSTERIOR
Supply LUMBAR REGION

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55
Q

Median Sacral Arteries

A

Most INFERIOR branch

Supplies SACRUM

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56
Q

Common Iliac Arteries

A

Aorta BIFURCATES at L4 into RIGHT and LEFT common iliac arteries
Arteries travel INFERIOR LATERAL
Sit ANTERIOR yo COMMON ILIAC VEINS
Further branch into internal and external iliac arteries

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57
Q

Veins

A

Return blood to the heart
Carry deoxygenated blood back to heart except pulmonary veins
Low pressure blood flow so walls collapsible
Large veins formed by union of smaller veins

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58
Q

Inferior Vena Cava IVC

A 
Largest vein in the body
Formed by union of common iliac veins at L5
Pierce’s DIAPHRAGM at T8
SUPERIORLY = more ANTERIOR
INFERIORLY = more POSTERIOR
RIGHT of MIDLINE 
RETROPERITONEAL
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59
Q

Common Iliac Veins

A

Formed by union of external and internal iliac veins at S1
Travel OBLIQUELY from LATERAL to MEDIAL
Sit POSTERIOR to common iliac arteries and ureters

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60
Q

Lumbar veins

A

4-5 pairs
Enter at LATERAL walls of IVC
Drain into IVC or AZYGOS system

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61
Q

Gonadal veins ( ovarian, testicular)

A

Paired
Ascend along path of PSOAS muscle and run ANTERIOR to ureters
RIGHT GONADAL VEIN = DIRECT TRIBUTARY
LEFT GONADAL VEIN = DRAINS INTO LEFT RENAL VEIN

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62
Q

Renal Veins

A

Exit renal hilum and drain into LATERAL IVC
Sit ANTERIOR to renal arteries
RRV = SHORTER and INFERIOR to LRV
LRV = runs POSTERIOR to SMA but ANTERIOR to AORTA
LEFT GONADAL and LEFT SUPRARENAL drain into LRV

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63
Q

The Adrenal veins

A

Travel along same path as arteries
Small not seen on US
RIGHT ADRENAL directly into IVC but LEFT ADRENAL into lEFT RENAL

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64
Q

The Hepatic veins

A

Right Middle and Left = each drain different lobe
Travel from INFERIOR ANTERIOR position to SUPERIOR POSTERIOR TO DRAIN INTO IVC
Empty into IVC just INFERIOR to DIAPHRAGM each with own entrance into IVC
One of two venous systems

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65
Q

Liver

A

Largest organ in the body
INTRAPERITONEAL
Fibrous GLISSONS CAPSULE covers external surface
Almost completely covered by visceral peritoneum
Size and shape are variable but triangular from anterior window

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66
Q

Function of liver

A

Metabolic activities
PRODUCTION and SECRETION of bile
Filtration of blood to remove toxins

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67
Q

Location of liver

A

RUQ sometimes extends into LUQ
Right hypochondriac and epigastric region sometimes left hypochondriac
Right kidney, gallbladder, right colon all inferior

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68
Q

Surfaces of liver

A

Diaphragmatic and visceral

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69
Q

Diaphragmatic surface of liver

A

Dome shaped/ convex and smooth
ANTERIOR, SUPERIOR, PARTI POSTERIOR in contact with diaphragm
Peritoneal membrane covers most of ANTERIOR SUPERIOR surface
BARE AREA = posterior surface with no peritoneum, boundaries are coronary and triangular ligament
FALCIFORM LIGAMENT divides ANTERIOR surface into LEFT and RIGHT

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70
Q

Visceral surface of liver

A

INFERIOR surface with OBLIQUE orientation
Covered with peritoneum
In contact with several organs forming grooves and undulations on surface

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71
Q

Lobes - traditional method

A

Liver divided into 4 lobes based on surface structure
FALCIFORM LIG boundary for right and left lobe
Quadrate and caudate part of right lobe but their own section

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72
Q

Lobes- functional/segmental method`

A

Liver divided into lobes according to hepatic function- true morphological and physiological divisions
Boundaries are different than traditional method
Each lobe has its own arterial blood supply and separate biliary drainage
Right and left lobe are further divided into segments
Named based on Couinauds classification
Lobes= divisions according to anatomy
Segments = divisions according to function

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73
Q

Liver lobes and major segments

A

Imaginary plane drawn joining gallbladder fossa to IVC - coincides with the MAIN LOBAR FISSURE and MIDDLE HEPATIC VEIN
This plane divides the RIGHT and LEFT functional lobes of the liver
MAIN LOBAR FISSURE = anatomical division
MIDDLE HEPATIC VEIN = ultrasound division

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74
Q

Right lobe of liver

A

Divided into ANTERIOR and POSTERIOIR segments
RIGHT INTERSEGMENTAL FISSURE = anatomical division
RIGHT HEPATIC VEIN and RIGHT PORTAL VEIN = ultrasound division
HEPATIC = superior PORTAL = inferior

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75
Q

Left lobe of liver

A

Divided into MEDIAL (USED TO BE QUADRATE) and LATERAL segments
LEFT INTERSEGMENTAL FISSURE = anatomical division
LEFT HEPATIC VEIN and LEFT PORTAL VEIN = ultrasound division
- superior - inferior

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76
Q

Caudate lobe of liver

A

POSTERIOR and SUPERIOR in liver
Separate structure and receives blood from both right and left side
ANTERIOR BOUNDRY = LPV adn LIG VENOSUM
POSTERIOR BOUNDARY = IVC

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77
Q

Couinauds classification

A

Important for surgery
8 segments numbered from 1-8
Caudate lobe is number one

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78
Q

Normal variants of liver

A

Reidels lobe = inferiority segment of right lobe reach iliac crests

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79
Q

Ligaments and peritoneal attachments of liver

A

Fibrous stretchy attachments
Tether liver to abdominal cavity
Good ultrasound landmarks
Form boundaries for lobes and segments

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80
Q

FALCIFORM ligament

A

Peritoneal fold
Connects liver to diaphragm adn anterior abdominal wall
Runs along anterior surface from diaphragm to umbilicus
Continuous with LIG teres on visceral surface
Division between RIGHT and LEFT SUBPHRENIC SPACES

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81
Q

Ligamentum teres

A

Known as round ligament
Arises from umbilicus adn is remnant of fetal Left umbilical vein
Connects to FALCIFORM LIG on ANTERIOR INFERIOR surface
Extends POSTERIORLY on INFERIOR surface to join LIG VENOSUM
DIVIDES LEFT LOBE INTO MEDIAL ADN LATERAL SEGMENTS AS ULTRASOUND SEGMENTS

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82
Q

Ligamentum Venosum

A

Obliterated remnant of ductus Venosus in fetus
MARKS DIVISION OF CAUDATE LOBE FROM LEFT LOBE OF LIVER on ultrasound
Runs aPOSTERIORLY from LIG TERES at level of PORTA HEPATIS on visceral surface
Attaches INFERIOR surface of liver to stomach or duodenum

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83
Q

Fissures

A

Groove cleft or deep furrow in organ
Form NATURAL DIVISION
Liver has several issuer where other structures run within them

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84
Q

right Intersegmental fissure

A

DIVIDES RIGHT LOBER INTO ANTERIOR POSTERIOR segments

Right hepatic vein runs through it more SUPERIORLY. And portion of right portal vein more INFERIORLY

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85
Q

Left Intersegmental fissure

A

DIVIDES LEFT LOBE INTO MEDIAL AND LATERAL segments
Fissure divides into thirds - cranial = left hepatic vein in upper part
Middle = anterior portion of left portal vein caudal = LIG teres in lower

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86
Q

main lobar fissure

A

Called middle Intersegmental fissure of interlobar fissure
DIVIDES RIGHT AND LEFT LOBES
Middle hepatic vein runs SUPERIORLY
Can be seen in transverse plane as hyperechoic from GB to RPV

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87
Q

Hepatic veins

A

Drain blood from liver to IVC
Course INFERIOR ANTERIOR to SUPERIOR POSTERIOR
3 major hepatic veins drains into IVC with accessory in 30% of pop
RHV = RIF
LHV = LIF
MHV= MLF
Hepatic veins join IVC just below diaphragm
RHV= RL
MHV= MLL ARL
LHV= LL
Wall less hyperechoic

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88
Q

Hepatic arteries

A

Supply 20-30% of blood to liver

Right branch of celiac axis

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89
Q

Common hepatic artery

A

Origin at celiac axis to junction at gastroduodenal artery

EXTRAHEPATIC

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90
Q

Hepatic artery proper

A

From GDA to bifurcation of righ tand left hepatic arteries
Courses SUPERIORLY and RIGHT LATERAL
PORTA HEPATIS= entrance/exit to liver
PORTAL TRIAD = hepatic artery, portal vein, and bile duct at PH it is PHA + CBD + MPV
ANTERIOR to MPV
MEDIAL to CBD
EXTRAHEPATIC

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91
Q

Right and left hepatic artery

A

INTRAHEPATIC
Travel in unison with biliary duct adn portal vein
RHA= RIGHT LOBE AND BRANCHS TO CAUDATE
LHA= LEFT LOBE

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92
Q

The portal system

A

Carries nutrient rich blood from GI tract to liver about 70-80% of blood
Portal systems does not connect directly to IVC but to hepatic veins first
Blood flows toward and within lobes
MAIN PORTAL VEIN formed by union of SMV and SPLENIC VEIN at PORTAL CONFLUENCE behind neck of pancreas at L2

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93
Q

SMV

A

Drains SMALL INTESTINE ASCENDING COLON TRANS COLON
Courses superiorly to meet splenic vein at portal confluence
Distal end terminates POSTERIOR SURFACE of PANC NECK
On RIGHT of SMA

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94
Q

Splenic vein

A

Drains SPLEEN and PANC ADN STOMACH
Courses from hilum of spleen to meet SMV on RIGHT OF MIDLINE travels POSTERIOR SURFACE PAN
INFERIOR to SA
Terminates behind neck of pan at portal confluence
ANTERIOIIR to aorta IVC SMA and renal vessels

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95
Q

IMV

A

Drains left small bowel descending colon sigmoid and rectum

Joins SV posterior to body of pan left of midline

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96
Q

Main portal vein

A

EXTRAHEPATIC
Origin at junction of SMV and SV behind neck of Panc
Ascends obliquely toward right side
Enters liver at PORTA HEPATIS
POSTERIOR to HAP AND BILARY DUCTS ( CBD AND CHD)
Bifurcates into right and left portal veins at hilum
Located POSTERIOR TO SUODENUM AND ANTERIOR TO IVS
Encloses by free edge of LESSER OMENTUM

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97
Q

Right portal vein

A

Intrasegmental

Divides into ANTERIOR AND POSTERIOR branch’s in right lobe

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98
Q

Left portal vein

A

Intrasegmental
Ascends anteriorly
Divides into MEDIAL AND LATERAL branches in left lobe

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99
Q

The biliary system

A

Produces. Concentrates, secretes, and transports bile from liver to duodenum
Bile formed in liver cells ( HEPATOCYTES) and drains through ducts
Bile used in digestion of fats in diet

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100
Q

Location of biliary system

A

RUQ

Right hypochondrium and epigastric region

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101
Q

Gallbladder

A

Reservoir for bile
Oblong/ pear sac
Locates in depression on visceral surface of liver
INTRAPERITONEAL = binds neck and body to liver
Anterior landmark dividing right and left lobe with MLF
LATERAL to IVC MEDIAL to RIGTH KIDNEY

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102
Q

Neck of gallbladder

A

Narrow tapered superior portion FIXED

MLF extends SUPERIORLY to RPV

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103
Q

Body of gallbladder

A

Middle portion between neck adn fundus FIXED

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104
Q

Fundus of gallbladder

A

INFERIOR ANTERIOR portion MOBILE

Sometimes extends beyond inferior margin of right lobe

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105
Q

Normal variants of gall bladder

A

Pharygian cap = fold in fundus
Junctional fold = fold at junction of neck and body
Hartmanns pouch = small posterior pouch near neck

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106
Q

The duct system

A

Pathway of ducts collecting and transporting bile secreted by liver to small intestine
Subdivided into INTRAHEPATIC and EXTRAHEPATIC
Ductal network has several branched along path

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107
Q

INTRAHEPATIC ductules

A

Very small bile ducts within liver collecting bile secretions from liver tissue
Branches get LARGER along biliary tree
Follow course of hepatic arteries and portal veins ( portal triad)
Not usually on ultrasound except when blocked

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108
Q

Right and left hepatic ducts

A

RHD= bile from right lobe
LHD = bile from left lobe
Join at liver hilum

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109
Q

Common hepatic duct

A

Formed at junction of RHD and LHD
Distal end courses along anterior aspect of R/MPV
Terminates at junction of CYSTIC DUCT

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110
Q

Cystic duct

A

Drains gallbladder and merges with CHD to FORM CBD

Contains SPIRAL VALVES OF HEISTER - not true valves just folds that provide structural support

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111
Q

Common bile duct

A

Formed at union of CD and CHD
Travels INFERIORLY towards HEAD OF PANC
Junction of PANCREATIC DUCT AND CBD FORM AMPULLA OF VATER (DOOR WAY INTO DUODENUM) that dumps into DUODENUM AT SPHINCTER OF ODDI (DOOR)
6-8 cm
ANTERIOR to MPV and LATERAL to HEPATIC ARTERY PROPER
DISTAL CBD travels ALONG or within POSTERIOR aspect of PANC HEAD

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112
Q

Pancreas

A

Elongated lobular gland
Lies in TRANSVERSE and OBLIQUE across MIDLINE and extends toward spleen at TRANSPYLORIC LEVEL
NO CAPSULE = hard to see on ultrasound
Predominately RETROPERITONEAL except portion of TAIL
ENDOCRINE ( 1% ISLETS OF LANGERHANS)
EXOCRINE ( 99% ENZYMES for DIGESTION)
Duct system transports bile and pancreatic juices to the duodenum

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113
Q

Location of pancreas

A

Right upper quadrant and left upper quadrant

Epigastric and left hypochondrium regions

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114
Q

Head of pancreas

A

Bulbous portion located RIGHT of MIDLINE
Surrounded by ALL 4 PARTS OF DUODENUM
Lateral head edge= created by medial curve of DESCENDING DUODENUM
Medial head edge= marked by SMV and NECK of PANCREAS
IVC lies POSTERIOR to head
RRA and RRV travel POSTERIOR to head
Accessory pancreatic ducts found within pancreatic head

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115
Q

Landmarks of head of pancreas

A

GASTRODUODENAL ARTERY lies along ANTEROLATERAL portion of head
CBD is positioned along POSTEROLATERAL aspect of head
- eats pancreatic duct at HEPATOPANCREATIC AMPULLA ( ampulla of vater) within central portion of head
- AMPULLA OF VATER drains secretions towards medial wall of the DESCENDING DUODENUM via SPHINCTER OF ODDI

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116
Q

Uncinate process

A

POSTEROMEDIAL EXTENSION of pancreatic head
Directly POSTERIOR to SMV and ANTERIOR TO IVC
Variable in size

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117
Q

Neck of pancreas

A

Directly ANTERIOR to SMV near PORTAL VEIN
Directly POSTERIOR to PYLOROUS of STOMACH
RIGHT side of SMA

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118
Q

Body of pancreas

A

Most ANTERIOR portion of Panc between neck and tail
Lies POSTERIOR to ANTRUM of STOMACH
Lies ANTERIOR to AORTA SMA SPLENIC VEIN LRV LRA SPINE
INFERIOR to SPLENIC ARTERY

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119
Q

Tail

A

Most SUPERIOR portion of Panc

Extends from LEFT LATERAL EDGE OF SPINE to HILUM OF SPLEEN

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120
Q

Anatomical relationships to tail of pancreas

A

ANTERIOR to UPPER/MIDDLE portion LK
POSTERIOR to STOMACH AND TRANSVERSE COLON
LATERAL to SPINE
MEDIAL to SPINE
SPLENIC ARTERY runs SUPERIOR surface of PANC TAIL
SPLENIC VEIN runs Alaina MID POSTERIOR surface of PANC TAIL

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121
Q

Main pancreatic duct/ duct of warsung

A

Extends entire length of Panc centrally ( 2mm in diameter)
Joins distal CBD in HEAD OF PANC
- forms AMPULAA OF VATER
Seen in ultrasound

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122
Q

Accessory pancreatic duct/ duct of santorini

A

Secondary drainage of UPPER ANTERIOR portion of PANC HEAD

Enters MEDIAL aspect of DESCENDING DUODENUM about 2 cm PROXIMAL to AMPULLA OF VATER

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123
Q

The urinary system

A

Maintains CHEMIACAL BALANCE - water electrolytes blood pressure regulation and ph balance
Excretes liquid waste products
Consisted of kidneys ureters bladder urethra

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124
Q

Kidneys

A 
2 bean shaped organs 
OBLLIQUE lie in abdomen at T12-L4
Left kidney is HIGHER than right (liver pushes everything down )
9-12cm 
RETROPERITONEAL
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125
Q

structural relationships in the kidney

A

LATERAL to SPINE AORTA IVC
ANTEROLATERAL to PSOAS MUSCLE
ANTERIOR to QUADRATUS LUMABORM MUSCLE
UPPER POLE LIES POSTERIOR AND MEDIAL TO LOWER POLE

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126
Q

Outer portion of kidney

A

Between the RENAL CAPSULE and BASE OF PYRAMIDS= PARENCHYMA

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127
Q

Outer cortex

A

Between RENAL CAPSULE and MEDULLA
Contains the NEPHRONS
COLUMNS OF BERTIN= CORTEX extends BETWEEN PYRAMIDS

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128
Q

Inner medulla

A

Between CORTEX and SINUS

PYRAMIDS= HYPOECHOIC TRIANGLES 8-18

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129
Q

Inner portion/renal sinus

A 
Includes CALYCES (major and minor) RENAL PELVIS, VESSELS
Packed with FAT so HYPERECHOIC
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130
Q

Minor calyx

A

8-18 = correspond to number of pyramids

Receives the APEX of pyramids

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131
Q

Major calyx

A

2-3

Receive URINE from MINOR CALYX

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132
Q

Renal pelvis

A

Flared portion of UPPER URETER

POSTERIOR to RENAL VESSELS

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133
Q

Vessels

A

RENAL VEIN is ANERIOR to RENAL ARTERY

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134
Q

Coverings of the kidney

A

Renal capsule= adheres DIRECTLY to the kidney
Renal fascia/gerota’s fascia = attaches kidney to POSTERIOR abd. Wall
Perirenal fat= DIRECTLY SURROUNDING KIDNEY
Pararenal fat
CAPSULE-PERI-GEROTAS-PARA

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135
Q

Normal variants of kidneys

A

Dromedary hump- only on LEFT kidney localized bulge of lateral border
Hypertrophied column of Bertin = indents renal sinus and varies
Parenchymal junctional defect= junction of upper and middle third of kidney
Horseshoe kidney- congenital fusion of lower lobes
Ectopic kidney- kidney located outside normal renal fossa

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136
Q

Ureters

A

Paired MUSCULAR tubes that carry URINE from kidney to urinary bladder
Travel INFERIORLY through RETROPERITONUEM
Extend from RENAL HILUM to POSTERIOR portion of BLADDER at TRIGONE
DECREASE in DIAMETER as they course TOWARD BLADDER
Lower half located in PELVIS
ANTERIOR to INTERNAL ILIAC ARTERIES
POSTERIOR to OVARY
Enter bladder at OBLIQUE angle on POSTEROLATERAL surface
Pelvic pathologies in female pelvis cause obstruction of ureter and can effect kidney

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137
Q

Ureteral junctions

A

Uteropelvic junction UPJ = junction at RENAL PELVIS and URETER
Uterovesicular junction UVJ = junction between LOWER URETERS and BLADDER where stones go

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138
Q

Bladder

A

Hollow symmetrical organ and muscular
Reservoir for urine
4 layers= MUCOSA-SUBMUCOSA-MUSCULARIS-SEROSA
Fixed INFERIORLY at BASE
POSTERIOR to SYMPHYSIS PUBIS and ANTERIOR to UTERUS VAGINA
Variable size and shape based on distention
Relatively mobile except INFERIORLY AT NECK
SUPERIOR surface COVERED with PERITNOEUM
Peritoneal reflections from potentional spaces in pelvis

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139
Q

Apex of bladder

A

SUPERIOR portion

COVERED with peritoneum

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140
Q

Base

A

INFERIOR portion

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141
Q

TRIGONE

A

Triangular area in base of bladder accommodating bladder inlets and outlets
Inlets= UVJs
Outlets = urethra

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142
Q

Urethra

A

Female = short muscular tube 4cm
POSTERIOR to PUBIC SYMPHYSIS runs OBLIQUELY INFERIORLY ANTERIORLY
Male = first passes through PROSTATE the UROGENITAL DIAPHRAGM then PENIS
15-20 cm

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143
Q

Adrenals

A

Bilateral
RETROPERITONEAL
Pyramid shaped
CAP on SUEPRIOR pole of kidney and sit slightly MEDIAL to kidney

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144
Q

Structure of adrenal

A

Capsule = outer surfaces
Cortex
Medulla = inner portion

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145
Q

Structural relationships of adrenals

A

Right adrenal = POSTERIOR and LATERAL to IVC
Left adrenal = POSTERIOR to PANC TAIL
LATERAL to AORTA
SEPARATED BY PERIRENAL FAT AND CAPSULE

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146
Q

The spleen

A

INTRAPERITONEAL
Part of bodies defense system but not essential to life
Homogeneous, smooth surface, hilum

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147
Q

Functions of spleen

A

Defense- produces lymphocytes phagocytes plasma cells and antibodies
Hematopoeises= red blood cell formation
Filters out old RBCs and platelets
Blood reservoir 200-400mL

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148
Q

Size and shape of pancreas

A

Variable - crescent or inverted comma

Normal adult = 12-13 cm long and 7-8 cm wide

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149
Q

Location of spleen

A

Left upper quadrant

Left hypochondrium

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150
Q

Splenic hilum

A

Central on visceral surface with no peritoneal covering

Structures = splenic artery and vein, lymph vessels and nerves

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151
Q

Splenic variant

A

Accessory spleen/Splenule= 10 % o pop at splenic hilum very small may have multiple

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152
Q

Gastrointestinal lining

A

4 layers = mucosa- submucosa-muscularis- serosa

Give GI tract distinct songraphic appearance because of different echogenicities

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153
Q

Digestive pathway

A

Salivary glands - region of mouth

Release enzymes that initiate breakdown of food adn help lubricate mouth

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154
Q

The esophagus

A

Muscular tube extends from below mouth to entrance of stomach
Courses through stomach just ANTEROR to THORACIC SPINE
Pierces diaphragm at T10
Peristalsis, gravity, swallowing move food and fluid to stomach
ANTERIOR and LEFT of AORTA
TERMINAL END = GASTROESOPHAGEAL JUNCTION (GE JUNCTION)

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155
Q

GE junction

A

Allows food into stomach and prevents gastric juices from refluxing
INFERIOR to DIAPHRAGM
ANTERIOR to AORTA and CRUX of DIAPHRAGM
POSTERIOR to LEFT LOBE OF LIVER

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156
Q

Stomach

A

Large pouch shaped organ responsible for collection and breakdown of food and drink
Secretes gastric juices (hydrochloride acid and pepsin)
Food reduced and converted to solution to move through intestine called CHYME
Located BETWEEN the ESOPHAGUS and DUODENUM
INTRAPERITONEAL
Left upper quadrant
Internal folds call RUGAE used to increase surface area for expansion

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157
Q

Cardia of stomach

A

Entrance into stomach on SUPERIOR MEDIAL aspect

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158
Q

Fundus of stomach

A

Rounded portion ABOVE GE junction

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159
Q

Body of stomach

A

Major portion between PYLORIC and FUNDUS regions

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160
Q

Pylorus of stomach

A

Antrum- wider portion near MIDLINE of body
- TRANSPYLORIC PLANE at L1-L2
- ANTERIOR to PANC BODY
Canal- narrow portion between antrum and duodenum=communicates with duodenum
- TRANSPYLORIC level L1-L2, RIGHT of MIDLINE, POSTERIOR TO LIVER, ANDTERIOR PANC HEAD

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161
Q

Greater curvature of the stomach

A

Left border

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162
Q

Lesser curvature of the stomach

A

Right border
Cardiac orifice to pyloric orifice
Site of attachment of lesser omentum to liver

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163
Q

Small intestine

A

6-7m in length

Right lower quadrant and left lower quadrant

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164
Q

Duodenum

A

Shortest connects to PYLORUS and PYLORIC SPHINCTER
EPIGASTRIC REGION
SUPERIOR-DESCENDING - TRANSVERSE-ASCENDING

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165
Q

Superior/bulb/ 1st part of duodenum

A

INTRAPERITONEAL
ANTERIOR to PANC HEAD
POSTERIOR to GALLBLADDER FUNDUS

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166
Q

Descending / 2nd part of duodenum

A

RETROPERITONEAL
VERTICAL portion
RIGHT LATERAL to PANC HEAD
POSTERIOR to TRANS COLON

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167
Q

Transverse / 3rd part of duodenum

A

RETROPERITONEAL
ANTERIOR to AORTA and IVC
INFERIOR to PANC HEAD

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168
Q

Ascending/ 4th part of duodenum

A

RETROPERITONEAL
INFERIOR and MEDIAL to PANC HEAD
ANTERIOR to AORTA

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169
Q

Jejunum

A

INTRAPERITONEAL

Tightly coiled tubes located in UMBILICAL region

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170
Q

Ileum`

A

Final and longest portion

Terminates at junction of cecum and ascending colon called ILEOCECAL JUNCTION

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171
Q

Large intestine

A

Frames small intestine
Greater in diameter
Has HAUSTRA = puckered sacs
Multiple division

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172
Q

Cecum

A

Pouch like portion at origin of ASCENDING COLON
Right lower quadrant and right iliac region
APPENDIX extends from INFERIOR portion= blind ended tune, INFERIOR AND MEDIAL, 6-10cm , right lower quadrant

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173
Q

Colon - ascending colon

A

SUPERIOR path on RIGHT of body
RETROPERITONEAL
HEPATIC FELXURE = 90 degree turn at liver into transverse colon

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174
Q

Colon- transverse colon

A

HORIZONTAL across MIDLINE
INTRAPERITONEAL
HEPATIC FLEXURE to SPLENIC FLEXURE

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175
Q

Colon - descending colon

A

Starts at SPLENIC FLEXURE SUPERIORLY
INFERIOR path on LEFT side of body
RETROPERITONEAL

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176
Q

Sigmoid

A

S shaped terminal end

Left iliac and suprapubic region

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177
Q

Rectum

A

TRUE PELVIS

POSTERIOR to BLADDER

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178
Q

Anus

A

External orifice

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179
Q

The peritoneal cavity

A

Potential space between the PARIETAL PERITONEUM and teh VISCERAL PERITONEUM
Sterile spaces from abdomen to pelvis
Closed to external environment EXCEPT in female it is open because FALLOPIAN TUBES pierce it.
Contain small amount of CLEAR SEROUS. FLUID that serves as LUBRICANT
Many folds and potential spaces

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180
Q

The peritoneum

A

Is SEROUS membrane (very thin like sera wrap)
-lubricated for motion adn acts as barrier for infection
SUPPORTIVE layer to ANCHOR structures
PARIETAL- covers ABDOMINAL and PELVIC WALLS
VISCERAL- covers SOLID and HOLLOW VISCERA

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181
Q

Intraperitoneal organs

A 
Liver not bare area
Glassbladder
Spleen
Stomach
Ovaries
1st part of duodenum
Transverse colon
CANT APPRECIATE ALL SPACES TILL SOMETING IS IN IT LIKE BALLON
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182
Q

Peritoneal folds - Mesenteries

A

Peritoneal folds CONNECTING SMALL AND LARGE BOWEL to POSTERIOR abdominal wall
SUPPORT VESSELS. LYMPHATICS, NERVES
PREVENTS TWISTING OF BOWEL

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183
Q

Mesentary

A

DOUBLE layer fold
LARGE and FAN SHAPED
Encloses JEJUNUM, ILEUM, and CONNECTS THEM TO POSTERIOR abdominal wall

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184
Q

Mesocolon

A

PERITNOEUM attached to COLON

CONNECTS TRANSVERSE ADN SIGMOID to POSTERIOR abdominal wall

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185
Q

Omentum

A

Double layer of peritoneum

Folds of mesentary from STOMACH to INTRAABDOMINAL sites

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186
Q

Greater omentum

A

APRON like fold
CONNECTS greater curvature of the stomach and trans colon
POSITION= drapes INFERIOR and ANTERIOR over TRANS COLON and SI then POSTERIOR and superior to attach to trans colon

187
Q

Lesser omentum

A

DOUBLE layer omentum

CONNECTS lesser curvature of stomach and 1st part of DUODENUM to VISCERAL surface of LIVER

188
Q

Peritoneal sacs

A

Large POTENTIAL spaces

189
Q

The greater sac

A

Most space in peritoneal cavity
DIAPHRAGM to PELVIS
Smaller spaces within it
CONNECTS and COMMUNICATES with lesser sac in EPIGASTRIC region

190
Q

Location of greater sac

A

ANTERIOR to LESSER SAC SUPERIORLY
POSTERIOR to LESSER SAC INFERIORLY
Surrounds SMALL BOWEL INFERIORLY
SUPERIOR to PELVIC STRUCTURES

191
Q

The lesser sac/ omental bursa

A

LOCATION = POSTERIOR to STOMACH

ANTERIOR to PANC

192
Q

Openings between teh sacs

A 
Called NECK
EPIPLOIC FORAMEN
FORAMEN OF WINSLOW
OMENTAL FORAMEN 
PORTA HEPATIS AND PORTAL TRIAD align with ANTERIOR margin of OPENING
193
Q

Compartments - Supracolic spaces- subphrenic

A

Between the DIAPHRAGM and ANTERIOR SUPERIOR LIVER

FALCIFORM LIGAMENT boundary between RIGHT and LEFT

194
Q

Compartments-supracolic-subhepatic

A

INFERIOR to VISCERAL LIVER
RIGHT= MORISONS POUCH - lowest part where the fluid collects
LEFT= ANTERIOR to ANTRUM of STOMACH

195
Q

Compartments - infracolic spaces- right paracolic gutter

A

Space between ASCCENDING COLON and RIGHT LATERAL abdominal wall

196
Q

Compartments- infracolic spaces- left paracolic gutter

A

Space between DESCENDING COLON and LEFT LATERAL abdominal wall

197
Q

The retroperitoneum

A

Located POSTERIOR to PERITONEUM
Anchored to POSTERIOR abdominal wall
Lined ANTERIORLY by peritoneum
Not mobile

198
Q

Retroperitoneal structures

A 
Kidneys
Ureters 
Adrenals
Pancreas (not tail)
2nd 3rd 4th part of duodenum 
Aorta
IVC
Ascending and descending colon
199
Q

Boundaries of retroperitoneal

A

POSTERIOR to PERITONEAL CAVITY
ANTERIOR to TRANSVERSE FASCIA
DIAPHRAGM to PELVIC BRIM

200
Q

Potential spaces - anterior pararenal space

A

POSTERIOR to PERITONEUM
BETWEEN PERIATAL peritoneum and ANTERIOR RENAL FASCIA
Crosses midline

201
Q

Potential spaces- perirenal space

A

Enclosed by RENAL FASCIA

Contains PERIRENAL FAT, KIDNEYS, ADRENALS

202
Q

Potential spaces- posterior pararenal space

A

POSTERIOR to RENAL FASCIA
Between POSTERIOR RENAL FASCIA and TRANSVERSALIS FASCIA
No solid organs
Little fat

203
Q

Pelvic Regions

A

Right Iliac
Hypogastrium
Left iliac

204
Q

Bony Structures of the pelvis

A

Framework=sacrum coccyx innominate(hip bones)
Function = support and transmit weight of body
Protect pelvic viscera
Birth canal in females
Muscle attachment
Attach legs to torso

205
Q

Sacrum

A

Posterior midline portion
Triangular shaped from 5 fused vertebral segments
S1 articulates (connects) with L5 superiorly
+sacral promontory on S1
-anterior ridge
- landmark marks posterior portion of true pelvic inlet
S5 articulates with coccyx
Lateral portions connect with os coxae at sacroiliac joints laterally

206
Q

Coccyx

A

Inferior portion of vertebral column
Tailbone
3-5 rudimentary vertebrae (poorly developed)
Site of muscle attachment

207
Q

Hip bones / Os Coxae / Innominate

A

Each hip bone is formed by ILIUM ISCHIUM PUBIS

The 3 bones fuse at puberty to form one unit

208
Q

Ilium

A

Largest and most superior
Ala = superior large flaring portion
Iliac fossa = inner aspect of ala, upper basin covered with iliacus muscle
Iliac crest = most superior portion, palpable
SI joint = articulation betweeen ilium and sacrum posteriorly

209
Q

Pubis

A

Consists of a body and 2 rami (superior and inferior)
Superior ramus extends laterally from body to connect with ilium
Inferior ramus extends inferiorly to meet ischium
Meet anteriorly to form pubis symphysis
OBTURATOR FORAMINA = large opening formed by junction of public rami and ischium

210
Q

Ischium

A

Inferior and posterior extending from ilium
Connect with public rami anteriorly
Ischial tuberosity = bulky interior and posterior area
Bone supports body in seated position

211
Q

Pelvic wall muscles

A 
Psoas 
Iliacus
Iliopsoas
Obturator
Piriformis
212
Q

Psoas muscle

A

Long muscle located lateral to vertebral bodies extending from upper abdomen to pelvis

213
Q

Iliacus

A

Triangular shaped
Extends from iliac crest of ilium and sacrum and lines each iliac fossa
Psoas muscle joins iliacus in pelvis to become iliopsoas

214
Q

Iliopsoas

A

Travels anteriorly over pelvic brim
Inserts into lesser trochanter of femur
Powerful flexor of thigh

215
Q

Obturator

A

Internal and external parts
Originated from obturator foramen and attaches into greater trochanter of femur
Aids in lateral rotation

216
Q

Piriformis

A

Triangular shape
Large part of posterolateral wall of pelvic cavity
Originates on anterior surface of sacrum and inserts into breather trochanter of femur
Responsible for lateral rotation and abduction of flexed hip

217
Q

Pelvic diaphragm (floor) muscles

A

Levator ani

Coccygeus

218
Q

Levator ani

A

Largest and most important muscle in diaphragm
Two levator ani muscles originate from the pelvic wall of pubis and fibers converge to insert into coccyx and muscles of the opposite size
+puboccocygeus and iliococcygeus
Integrity of pelvic floor depends on appropriate function of these muscles
KEEPS EVERYTHING UP

219
Q

Coccygeus

A

Smaller of two diaphragm muscle
Two coccygeus muscles form posterior aspect of pelvic floor
Originates on the spine of ischium
Triangular sheet fans out to insert on the sacrum and coccyx

220
Q

Potential spaces in pelvis

A 
Female = anterior cul de sac
                   Posterior cul de sac
                   Space of retzius 
Male= posterior cul de sac
              Space of retzius
221
Q

Female - Anterior cul de sac/vesicouterine pouch

A

Peritoneum drapes over posterior bladder wall and anterior surface of uterus
Usually empty but some loops of bowel

222
Q

Female - posterior cul de sac/rectouterine pouch/pouch of Douglas

A

Peritoneum covers the anterior surface of rectum and posterior surface of uterus
MOST DEPENDANT

223
Q

Female - space of retzius

A

Small space anterior to bladder posterior to symphysis pubis

Filled with extraperitoneal fat

224
Q

Male - posterior cul de sac/ rectovesicular pouch/ pouch of Douglas

A

Peritoneum covers th anterior surface of rectum and posterior surface of bladder
MOST DEPENDANT

225
Q

Space of retzius

A

Small space between symphysis pubis and anterior to bladder

Filled with extraperitoneal fat

226
Q

Uterus

A

Hollow muscular organ
Pear shaped
PRIMARY FUNCTION- menstraution, pregnancy, labor
5 regions
Uterine wall has 3 layers
Size- 7-8 cm
Varies in size and shape - prepubertal, repro. Age, gravida, postmenopausal, disease

227
Q

Regions of uterus (inferior to superior)

A 
Cervix
Isthmus
Body/corpus
Cornua
Fundus
228
Q

Uterus - cervix

A 
Lowest most inferior 
Cylindrical shape
Extends from isthmus and projects into vagina
Endocervical canal 2-3 cm
Internal os=superior opening 
External os= inferior opening
FIXED
229
Q

Uterus - isthmus

A

Narrowest portion of uterine body

Superior to cervix

230
Q

Uterus - body/corpus

A

Largest portion
Between cervix and fundus
Somewhat mobile

231
Q

Uterus - cornua

A

lateral extension of uterus continuous with Fallopian tubes

232
Q

Uterus - fundus

A

Widest, roundest most superior portion

Superior to insertion of Fallopian tubes and cornua

233
Q

Uterine wall (inner to outer)

A

Endometrium
Myometrium
Perimetrium

234
Q

Uterine wall - endometrium

A

Inner layer
Highly vascular
Composed of epithelial and glandular
FUNCTIONALIS AND B…

235
Q

Uterine wall - myometrium

A

Middle MUSCULAR layer
Thickest
Muscle allow enlargement and contraction

236
Q

Uterine wall - perimetrium/serosa

A

Outer layer composed of serous peritoneum

Covers outer surface of uterus continuous with broad ligament

237
Q

Uterus location

A 
Anterior to rectum
Inferior to peritoneum
MEDIAL TO OVARIES
posterior to distended bladder
Superior to empty bladder
238
Q

Uterine positions

A

Anteverted
Anteflexed
Retroverted
Retroflexed

239
Q

Anteverted

A

Uterus tilts anteriorly

240
Q

Anteflexed

A

Uterus bends in body anteriorly

241
Q

Retroverted

A

Uterus tilts posteriorly

242
Q

Retroflexed

A

Uterus bends in body posteriorly

243
Q

Vagina

A

Muscular tube
Cervix to external orifice
Between bladder (anterior) and rectum (posterior)
Fornices - spaces in upper vagina where it encircles cervix

244
Q

Fallopian tubes/uterine tubes/oviducts

A

Paired
Muscular tube extending from cornua of uterus to ovaries within peritoneum
Along superior margin of broad ligament
Conducts ovum from ovary to uterus by peristalsis of muscle wall
Conducts sperm toward ovum
Location of fertilization of ovum and sperm
Tube open into peritoneal cavity

245
Q

Segments of Fallopian tube (uterus-ovary)

A

Interstitial
Isthmus
Ampulla
Infundibulum

246
Q

Fallopian tube - interstitial

A

Narrowest part of tube

Encloses within muscular wall of uterus superiorly (cornua)

247
Q

Fallopian tube - isthmus

A

IImmediately adjacent to the uterine wall laterally

Short straight narrow part of tube

248
Q

Fallopian tube- ampulla

A

Longest most coiled section
Widens laterally
Most common site of fertilization

249
Q

Fallopian tube - infundibulum

A

Funnel shaped lateral portion of tube
Fimbria at the ends to sweep ovum into tube
Close proximity to ovaries
Opens into peritoneum

250
Q

Ovaries

A

Bilateral
Ellipsoid / almond shapes
Storehouse for ova
Production of estrogen and progesterone
Size varies - age,menstrual phase, pregnancy
In reproductive ovary many follicles are normal

251
Q

Location of ovary

A

True pelvis
Lateral to uterus
POSTERIOR TO BROAD LIGAMENT
anterior to ureter, gonadal vessels and IIA

252
Q

Blood supply and drainage for female pelvis

A

Uterine arteries branch off IIA
+Uterine Artery travels superiorly along lateral aspect of uterus
* branches supply uterine layers
+ joins ovarian artery at level of Fallopian tubes
Venous vessels follow arteries in same way

253
Q

Female pelvis - ligaments

A

Broad
Round
Cervical
Ovarian

254
Q

Female ligaments- broad

A

Peritoneal extensions support uterus and enclose oviducts
+ double fold
Extends from anterior and posterior uterus to lateral pelvic wall
Divides pelvis into anterior and posterior compartments
Prevents SIDE TO SIDE

255
Q

Female ligaments - round

A

Extends from lateral walls of uterus to anterior pelvicwall
Responsible for anterior tilt and stabilizing of fundus
(Retro and anteflexed have too long or short round ligaments)

256
Q

Female ligaments - ovarian

A

Between ovary and lateral uterus

257
Q

Female ligaments- cervical/cardinal

A

From lateral cervix to pelvic floor

Stabalizes cervix and prevents downward displacement of uterus

258
Q

Scrotum

A

Saclike structure continuous with abdominal wall
+ contains testes epididymus and part of ductus deferens
EXTERNALLY sac divided into lateral compartments by MEDIAN RAPHE/RIDGE/SEPTUM

259
Q

Muscles related to scrotum

A

Dartos

Cremaster

260
Q

Dartos

A

Thin muscular layer lies below skin of scrotum
Gives wrinkled appearance to scrotum
Merges centrally to form internal scrotal septum
+INTERNALLY DIVIDES SCROTUM INTO 2 SACS

261
Q

Cremaster

A

Surrounds each testis
Arises from internal oblique muscles of abdomen
Lifts and lowers testes towards and away from body (temp control)

262
Q

Testes

A

Primary reproductive organ producing sperm and male sex hormones
Testes arise from level of kidneys in fetus and descend into scrotum after 7th month
Ovoid paired glands
Suspended in scrotal sac

263
Q

Testicular coverings

A

Tunica albuginea

Tunica vaginalis

264
Q

Tunica albuginea

A

Dense outer capsules adhering to both testes
Extensions p (septa) Inward divides each testi into lobules
Septa converges posteriorly at MEDIASTINUM

265
Q

Tunnica vaginalis

A

Serous sac derived from peritoneum
Consists of 2 layer
+visceral
+ parietal

266
Q

Internal testicular architecture - seminiferous tubules

A

1-3 convoluted tuber per lobe
Sperm production
Converge at mediastinum testes and empty into straight tubule towards mediastinum teste amd rete teste

267
Q

Internal testicular architecture - straight tubule

A

Short section to tube connecting the seminiferous tubule to rete testis

268
Q

Internal testicular architecture- mediastinum testes

A

Located posterior aspect of testis ti support converging tubules
Wedge of connective tissue on posterior aspect of testis
Continuous with tunica albuginea and septa
Structural support
Encloses rete testis

269
Q

Internal testicular architecture- rete testis

A

Network of ducts in posterior aspect of testis
Ducts located within mediastinum testes
Inlet - straight tubules
Outlet - efferent ductile

270
Q

Internal testicular architecture- efferent ducts

A

Ducts exiting the rete testis and connecting to th ductus epididymus

271
Q

Epididymus

A

Tightly coiled tubular structure
Located on posterolateral surface of each testis
Storage and maturation of sperm
Continuous with ductus deferens

272
Q

Epididymus - Head/globus major

A

Largest portion
Superior to testis
Formed by efferent ductules

273
Q

Epididymus- body

A

Along posterolateral aspect of testis

Ductus epididymus travels along length of body and tail

274
Q

Epididymus- tail / globus minor

A

Empties into ductus deferens within spermatic chord at inferior border of testis

275
Q

Ductus deferens / vas deferens

A

Long tube originating from tail of epididymus
Proximal end widens to meet duct draining the seminal vesicles to form ejaculatory duct
Ascends within the spermatic cord and travels through inguinal canal to pelvis
Within pelvis- travels along lateral pelvic wall to posterior bladder
Crosses between ureter and bladder
Descends medially to seminal vesicles and urteter
Joins ejaculatory duct near base of bladder
Opens into prostatic urethra

276
Q

Seminal vesicles

A

Paired accessory glands
Coiled tubes form pouches or vesicles
Each SV duct joins the vas deferens ronform ejaculatory Duct
Secretions of SV provide energy to sperm

277
Q

Spermatic cord

A 
Paired
Outer tough covering extending from testis to pelvis providing protection 
Encases numerous structures
    Vas deferens
     Arteries and veins
     Nerves and lymph
278
Q

Seminal vesicles - location

A

Posterior and inferior of bladder
Lateral to ductus deferens
Superior to prostate
Anterior to rectum

279
Q

Ejaculatory duct

A

Extensions of seminal vesicles
Direct SV secretions to prostatic urethra
Ducts travel obliquely in posterior aspect of prostate

280
Q

Prostate

A

Composed of fibromuscular and glandular tissue
+ secretions aid in motility and fertility of sperm
Conical in shape
Proximal urethra travels centrally through prostate
Ejaculatory ducts descend inferiorly through posterior portion of gland and open into prostatic urethra
Glandular portion has 3 zones

281
Q

Prostate - peripheral zone

A

Largest zone
Posterior and lateral to distal prostatic urethra
Surgical capsule isolates it
CANCER

282
Q

Prostate- central zone

A

Extends from base of prostate to verumtanum
Surrounds ejaculatory ducts
Located between peripheral and transitional zone

283
Q

Prostate - transitional zone

A

Smallest zone

Located on lateral aspect of proximal urethra

284
Q

Prostatic orientation

A

Base - superior portion of glands adjacent to neck (base) of bladder
Apex - inferior portion of gland in contact with pelvic diaphragm

285
Q

Prostate location

A

Midline inferior to base of bladder
Superior to pelvic diaphragm
Anterior to rectum
Posterior to symphysis pubis

286
Q

Penis

A

External reproductive organ

3 cylindrical masses of erectile tissue

287
Q

Penis - corpora cavernosa

A

Dorsilateral location

Becomes enlarge when filled with blood

288
Q

Penis - corpus spongiosum

A

Midventral location
Encircles spongy urethra
Expands distally to form glans penis

289
Q

Blood supply and drainage - male pelvis

A

Testes
- arterial blood supply originates in the abdomen and venous blood returns to abdomen
+ arterial - testicular Artery originates off aorta
+ venous - right testicular vein drains into IVC and left drains into LRV
Penis
- blood supply to penis and urethra via internal pudendal arteries which are branches off the IIA
- main venous drainage of penis is the superficial and deep dorsal veins which connect with the pudendal venous plexus

290
Q

Arteries and arterioles

A

Strong and flexible
Blood flow from arteries to arterioles
High pressure system

291
Q

Veins and venuoles

A

Less elastic than arteries
Blood flow from venuoles to veins
Low pressure system

292
Q

Capillaries

A

Link betweeen arteries and veins
Webs of microscopic vessels
Main exchange between blood and tissue fluids, gases, wastes

293
Q

Vessel differences

A 
Arteries
   - tunica media
           \+ thicker 
            \+ holds shape
    - no valves
Veins
   - tunica media
         \+ much thinner 
          \+ veins more compressible 
    - valves
         \+ present
          \+ one way flow towards heart
         \+ in upper and lower extremities only
   - has both deep and superficial venous systems
294
Q

Aortic arch branches (1,2,3)

A

1) brachiocephalic/innominate
2) left common carotid artery
3) left subclavian

295
Q

Brachiocehalic/innominate

A

First branch off aortic arch
Anterior position compared to other branches
Branches into red got common carotid artery and right subclavian artery

296
Q

Left common carotid artery

A

Second branch of aortic arch

Middle and posterior to innominate

297
Q

Left subclavian

A

Third branch of aortic arch

Most posterior branch

298
Q

Arterial branches of upper extremities (proximal to distal)

A

Left arm - subclavian
Right arm - brachiocephalic branches into right subclavian

Axillary Artery
Brachial Artery
Radial Artery 
Ulnar artery
Palmar Artery
Digital artery
299
Q

Subclavian Artery

A

Travel horizontally toward shoulders

Become axillary arteries @ level of humoral head (armpit)

300
Q

Axillary Artery

A

Extension of subclavian
Originates @ level of humoral Head
Shout segment travel along axilla(armpit)

301
Q

Brachial Artery

A

In region of upper/mid humerus axillary becomes brachial
Continues to elbow
@ elbow divides into ulnar and radial arteries

302
Q

Radial Artery

A

Travel along LATERAL forearm to wrist

Located on THUMB SIDE of arm

303
Q

Ulnar Artery

A

Travel along MEDIAL arm to wrist

304
Q

Palmar arteries

A

Distal extensions of radial and ulnar arteries

Form deep and superficial arches in hand

305
Q

Digital arteries

A

Arteries to fingers

306
Q

Deep veins of upper extremities (distal to proximal)

A 
Digital and palmar veins
Radial vein
Ulnar vein
Brachial veins
Axillary veins
Subclavian veins 
Right and left brachiocephalic veins
307
Q

Digital and palmar veins

A 
Return blood from fingers and hands
Palmar arches (superficial and deep)
308
Q

Radial veins

A

Ascends along the LATERAL aspect of forearm

309
Q

Ulnar veins

A

Ascends along MEDIAL aspect of forearm

RADIAL AND ULNAR UNITE BELOW ELBOW TO FORM BRACHIAL VEINS

310
Q

Brachial veins

A

Often Paired
Travel superior to join basilic vein
Union of basilic and brachial form axillary vein

311
Q

Axillary vein

A

Travel up medial aspect of arm

Passes behind clavicle to form subclavian

312
Q

Right and Left brachiocephalic Veins

A

Formed by junction of subclavian veins to jugular veins

R and L join to form superior vena cava which drains into right atrium

313
Q

Superficial veins of upper extremities

A

Cephalic
Basilic
Median cubital vein

314
Q

Cephalic veins

A

Starts at lateral aspect of hand
Ascends along lateral arm
Drains directly into the axillary vein (then becomes subclavian)

315
Q

Basilic vein

A

Starts at medial aspect of hand
Ascends along posterior medial aspect of arm
Located MEDIAL to brachial vein
Joins brachial veins to form axillary vein

316
Q

Median cubital vein

A

Joins cephalic and basilic at the elbow joint

317
Q

Arteries of lower extremities (proximal to distal)

A 
Aorta
Common iliac arteries
Internal and external iliac arteries
Common femoral arteries
Superficial and deep femoral arteries
Popliteal Artery
Anterior Tibial Artery
Tibioperoneal trunk - posterior tibial artery and Peroneal artery
318
Q

Aorta - arteries of legs

A

Bifurcates at L4 into right and left common iliac arteries

319
Q

Common iliac arteries

A

Travel inferiorly and slightly lateral in pelvis
Common iliac arteries pass laterally and anterior to common iliac veins
Divide into internal and external arteries

320
Q

Internal iliac artery

A

Descend posterior and medial into pelvis

Supplies pelvic viscera and muscles

321
Q

External iliac arteries

A

Travels laterally toward leg

322
Q

Common femoral Artery

A

External iliac becomes the common femoral artery at inguinal ligament

323
Q

Superficial and deep femoral Artery

A

Common femoral Artery bifurcates to become superficial femoral Artery (femoral Artery) and deep femoral Artery (profunda)

324
Q

Popliteal Artery

A

The superficial femoral Artery travels down thigh and passes through adductor canal to become popliteal Artery
Posterior to knee
Popliteal Artery ANTERIOR to popliteal vein

325
Q

Anterior tibial Artery

A

Branches off popliteal Artery
Travels along anterior part of lower leg
Becomes dorsalis pedis arteries in foot

326
Q

Tibioperoneal trunk

A

Branches into posterior tibial artery ( posterior and medial) and th peroneal Artery (posterior and lateral)

327
Q

Deep veins of the leg

A

*accompany Artery and share same name

Anterior tibial Veins
Posterior tibial veins
Peroneal veins
Popliteal veins
Superficial femoral  vein
Deep femoral vein
Common femoral vein
External iliac vein
Common iliac vein
328
Q

Anterior tibial Veins

A

Paired
Ascend along anterior aspect of lower leg
Unite to form the anterior tibial trunk which drains into the popliteal vein

329
Q

Posterior tibial vein

A

Paired
Ascend along posterior medial aspect of lower leg
Drain into tibioperoneal trunk

330
Q

Peroneal veins

A

Paired
Lie deeper than posterior tibial Veins
Runs adjacent to fibula

331
Q

Popliteal vein

A

Formed by union of anterior tibial trunk and tibioperoneal trunk
Located in posterior knee
Vein POSTERIOR to artery
Becomes superficial femoral vein superior to knee at adductor hiatus

332
Q

Superficial femoral vein

A

Popliteal vein becomes superficial vein superior to knee

Also none as femoral vein

333
Q

Common femoral vein

A

Superficial femoral vein joins deep femoral vein at inguinal ligament to become common femoral vein

334
Q

External iliac vein

A

As it enters pelvis the common femoral vein becomes the external iliac vein
Takes a superior and medial course
Then Joins internal iliac vein to form common iliac vein

335
Q

Common iliac veins

A

Forms at level of SI joint
Common iliac veins unite at L5 to form IVC
Veins run POSTERIOR to arteries

336
Q

Superficial venous system

A

*veins running superficial to deep fascia
Greater saphenous vein
Lesser(smaller) saphenous vein

337
Q

Greater saphenous vein (GSV)

A

Longest vein in body
Ascends along medial aspect of leg
Extends from foot to groin
Empties into CFV

338
Q

Lesser (small) saphenous vein

A

Ascends along calf laterally to greater saphenous vein

Empties into popliteal vein

339
Q

Perforating veins

A

Connects deep and superficial venous systems

340
Q

The central nervous system

A 
Components 
    - brain and spinal cord
Cavities 
    - immersed in cerebrospinal 
Nerves
341
Q

Brain information

A

Located in cranial cavity ( subdivision of dorsal cavity)
Weighs 3 pounds
Has regions of white matter and gray matter
Enclosed by protective meninges
Surrounded by cerebrospinal fluid (provides cushioning and protection)
Responsible for transmitting electrochemical messages in body

342
Q

Main sections of brain

A

Cerebrum
Cerebellum
Brainstem

343
Q

Nerve cell construction

A

Nerves made up of white matter and gray matter

344
Q

White matter

A

Composed of nerve cell axons which are covered with myelin

Axons carry nerve impulses between neurons

345
Q

Grey matter

A

Composed of nerve cell bodies which are unmyelinated
Nerve cell bodies are control centers
Route sensory and motor stimuli and create a response

346
Q

Th cerebrum

A

Largest part of brain
Divided into right and left hemispheres
- connected in midline by corpus callosum
- separated by falx cerebri
- each hemisphere has 4 lobes
Consists of both white matter and grey matter
- grey matter
+ cortex (outer layer) and basal nuclei (deep in midline)
- white matter
+ lies deep to cortex
4 lobes correspond to the adjacent cranial bone
- parietal, temporal, frontal, occipital

347
Q

The cerebrum- folds and grooves

A 
Gyri- small folds
Sulci- shallow grooves
Fissures- deep grooves
     \+ longitudinal 
     \+ lateral (Sylvian)
348
Q

Corpus callosum

A 
Bundle of white matter located in midline 
Creates connection between right and left hemispheres 
    - neural bridge 
FORMS ROOF OF LATERAL VENTRICLES 
4 parts 
  - rostrum
  - genu
  - body
  - splenium
349
Q

Basal nuclei/ganglia

A

Distinct regions of grey matter located deep within the cerebral white matter
Serve as relay stations for sensory stimuli
Lie adjacent to the lateral ventricles
Examples
+caudate nucleus
+ lentiform nucleus
-putamen, globus pallidus

350
Q

Thalamus

A

Ovoid masses of grey matter
Base of cerebral hemispheres
Relay stations for nerve impulses
Right and left thalami located on either side of third ventricle
+ FORM LATERAL WALL OF THIRD VENTRICLES
the massa intermedia is tissue bridge between right and left thalami
+ passes through third ventricle in the midline

351
Q

The brain stem

A

Connects brain to spinal cord
Controls vital function such as breathing rate and heart rate
3 parts
- midbrain, pons, medulla oblongata

352
Q

Midbrain

A

Superior and smallest portion of brainstem
Directly superior to pons
Surrounds cerebral aquaduct

353
Q

Pons

A

Prominent anterior bulge
Located between the midbrain and medulla oblongata
Acts as a bridge between the cerebrum and cerebellum
FORMS ANTERIOR WALL OF FOURTH VENTRICLE
controls involuntary function

354
Q

Medulla oblongata

A

Inferior portion of brainstem
Extends from pons to the foramen magnum
Continuous with spinal cord
Regulates vital function

355
Q

The cerebellum

A

Consists of right and left hemispheres
Situated posterior to pons and medulla oblongata
FORMS POSTERIOR WALL OF FOURTH VENTRICLE
center for motor function
Tentorium cerebelli separates the cerebrum from cerebellum

356
Q

Parts of cerebellum

A

Vermis

Cerebellar peduncles

357
Q

Vermis

A

Midline structure

Connects two hemispheres of the cerebellum

358
Q

Cerebellar peduncles

A

Nerve tracts that connect the cerebellum to the other parts of the brain stem
Superior, middle, and inferior peduncles

359
Q

Cavities in the brain

A

The ventricles

- lateral (2), third, fourth,

360
Q

The ventricles

A

Fluid filled cavities within the brain
All four ventricles are interconnected by channels
Ventricles both produce and provide pathway for CSF to circulate

361
Q

Cerebrospinal fluid (CSF)

A

Clear colorless fluid
Produced by choroid plexus of ventricles
Circulates in subarachnoid space
Acts as protective cushion, buoyancy, and nourishment
Drains into the blood via Duran sinuses

362
Q

Lateral ventricles

A

Paired
Largest of ventricles
C shaped
One lateral ventricle / hemisphere

363
Q

Lateral ventricles - location

A

Lateral to midline
Separated medially by Cavum septum pallucidum
Communicates with third ventricle via foramen of Monroe

364
Q

Lateral ventricles - feature

A

Body- central portion
Horns - extensions of body
Frontal/anterior
Occipital/posterior
Temporal/inferior
Tigone/atria - triangular area of the body connected to all horns
Interventricular foramen (foramen of Munro) - channel between the lateral ventricles and the third ventricle

365
Q

Lateral ventricles - relationships

A

Anterior horns medial to posterior horns
Anterior horns superior to posterior horns
Anterior horns anterior to foramen of Munro
Third ventricle medial to lateral ventricles

366
Q

Lateral ventricle - cavum septum pallucidum

A

Thin triangular membrane
Midline inferior to corpus callosum
SEPARATES MEDIAL WALLS OF LATERAL VENTRICLES

367
Q

Choroid plexus

A 
Lines area within each ventricles
Produces continuous supply of CSF
Location
  - floor of lateral ventricles
 - roof of third ventricle
 - posterior wall of fourth ventricle
368
Q

Third ventricle

A

Midline slit like cavity
Inferior to lateral ventricles
LATERAL WALLS FORMED BY RIGHT AND LEFT THALAMI
massa intermedia of the thalamus runs through third ventricle

369
Q

Third ventricle- cerebral aqueduct (aqueduct of Sylvius)

A

Connection between the third and fourth ventricle

Aqueduct extends posterior from third ventricles

370
Q

Fourth ventricle

A

Inferior and posterior to third ventricle
Diamond shape
Anterior to cerebellum and posterior to pons
Three channels drain fourth ventricle

371
Q

Fourth ventricle - foramen of magendie

A

Single posterior MIDLINE opening

Connected to central canal of spinal chord

372
Q

Fourth ventricle - foramen of luschka

A

2 LATERAL openings

373
Q

Meninges

A 
3 distinct membranes that cover the brain and spinal cord
Function 
 - protect neural cells
 - provide support for vessels
 - creates venous sinuses in the head
 - forms partitions in head 
 - allow for circulation of CSF 
Layers - dura mater, arachnoid, pia mater
374
Q

Meninges- dura mater

A

Strong outer covering
Double layered membrane
- periosteal- adheres to bone
- meningeal - adheres to brain and spinal cord
Subdural space lies inferior to dura mater

375
Q

Meninges- dura mater - dura partitions

A

Falx cerebri
- projects vertically between the cerebral hemisphere
- runs along longitudinal fissure
Falx cerebelli
- vertical separations of the cerebellar hemispheres
- inferior and posterior to the falx cerebri
Tentorium cerebelli
- horizontal fold in transverse fissure
- separates cerebrum and cerebellum

376
Q

Meninges- dura mater - dura venous sinuses

A

Dura layers separates along fissure to form sinuses
- all veins of head drain into the sinuses
- blood moves from the sinuses to internal jugular veins
- communicates with the arachnoid area
Major dura sinuses
- superior, inferior, transverse, straight, sigmoid

377
Q

Meninges- arachnoid

A

Middle layer of meninges
Cobweb appearance
Arachnoid villi/granulation
- outgrowths of arachnoid kid mater penetrate the dura
- outgrowths project into venous sinuses
- allow for reabsorption of fluid into venous system

378
Q

Meninges- arachnoid- subarachnoid space

A

Important area for circulation of CSF
Surrounds brain and spinal cord
Receives CSF from ventricles
Between arachnoid and pia

379
Q

Meninges- arachnoid- subarachnoid- cisterns

A 
Widened areas located within the subarachnoid space 
Pools of CSF
Located at base of skull
CISTERNA MAGNA
 -largest pool
 - continuous with spinal space
380
Q

Meninges- pia mater

A 
Delicate connective tissue
Adheres directly to surface of the brain
Follows contour of brain
 -enters grooves and fissures
Highly vascular
381
Q

Arterial pathways in the brain

A

Internal carotid arteries
Vertebral arteries
Circle of Willis

382
Q

Internal carotid arteries

A

Branches of common carotid arteries
Take tortuous (twisty) route within the brain
Connect with middle cerebral arteries

383
Q

Vertebral arteries

A

Branches of subclavian arteries
Ascend cranially through transverse foramina of cervical spine
Enter skull through foramen magnum
Unite to form basilar Artery in posterior brain

384
Q

The circle of Willis

A

Arterial circle of major vessels @ base of brain
Unites anterior and posterior blood supply
Collateral blood flow between hemispheres (In case of blockage)
Allows continuous flow to brain in cases of damages to one area

385
Q

Parts of circle of Willis (posterior to anterior)

A

Posterior cerebral arteries (R&L)
- branch from the basilar artery
Posterior communicating arteries (R&L)
- runs between posterior cerebral arteries and middle cerebral arteries
Middle cerebral arteries (R&L)
- branch from internal carotid arteries
Anterior cerebral arteries (R&L)
- bilateral anterior arteries
Anterior communicating artery
- single midline Artery
- connects R and L anterior cerebral arteries

386
Q

The spinal cord

A 
Nerve cable
Continuous with brain medulla
Extends to level of L2
Cord tapers distally
Nerves associated with each vertebrae 
Cervical and lumbosacral widening
387
Q

Spinal cord features

A

Conus medullaris
Cauda equine
Filum terminale
Denticulate ligaments

388
Q

Spinal cord features- conus medullaris

A

Distal tapering of the cord

Tip should not extend below level of L2

389
Q

Spinal cord features- cauda equine

A

Nerve bundles inferior to the conus medullaris

Horses tail appearance

390
Q

Spinal cord features- filum terminale

A

Slender strand from the cornus medullaris to the coccyx

Anchors spinal cord

391
Q

Spinal cord features- denticulate ligaments

A

Secure cord laterally to vertebral canal

392
Q

Anatomy of the neck - function

A 
Support for head
Allow for motion of head
Passage way for
  -respiratory and digestive systems
  - spinal cord
  -major blood vessels
  - nerves and lymph
Contains important organs
393
Q

Bony components of the neck

A 
C-spine
 - 7 vertebra
Hyoid bone
 - anterior (C3 level)
 - mobile
 - muscle attachment and aid to keep airway open
394
Q

Soft tissue and glands of the neck

A

Thyroid
Parathyroid
Salivary glands

395
Q

Thyroid gland

A 
Butterfly shaped
 - 2 lobes bridged by and isthmus
Thin and fibrous capsule
Endocrine gland (hormones)
Extends from level of C5 to T1
Rich blood supply
396
Q

Thyroid gland - right and left lobes

A 
Lateral to midline
Wrap posteriorly from the isthmus
Superior and inferior poles
Posterior to the strap muscles 
Anterior to longus Colli muscle
397
Q

Thyroid gland- right and left lobes- isthmus

A

Relatively thin midline bridge
Anterior to trachea and esophagus
Sits @ C5 level

398
Q

Parathyroid gland

A

Four small glands
Lie on posterior surface of each thyroid gland
Lie external to the fibrous capsule
Regulate calcium levels

399
Q

The salivary glands

A 
Accessory glands for digestion
Lie in jaw and lower ear area
Produce and secrete saliva into the oral cavity via ducts
3 paired salivary glands 
 - parotid, sublingual, submandibular
400
Q

The salivary glands- parotid

A

Largest
Wedges between the mandible and sternocleidomastoid muscle
Extends from the ear orifice to the angle of mandible
Drain vie STENSENS DUCT into the mouth

401
Q

The salivary glands- submandibular

A

Second largest
Located at the angle of the jaw behind the mandible
Drainage via WHARTONS duct situated posterior to teeth

402
Q

The salivary glands- sublingual

A

Smallest of salivary glands
Lie under tongue
Drain via BARTHOLINS duct

403
Q

The pharynx

A 
Fibromuscular passageway 
 - respiratory and digestive function 
“Throat”
Tonsils located in the pharynx
3 sections
 -nasopharynx, oropharynx, laryngopharynx
404
Q

The pharynx- nasopharynx

A

Superior portion of pharynx
Directly behind the nose
Adenoids tonsils on posterior wall
Auditory tubes enter laterally

405
Q

The pharynx- oropharynx

A

Middle portion of the pharynx
Directly behind the mouth
Palatine tonsils on posterior wall

406
Q

The pharynx- laryngopharynx

A

Inferior portion of the pharynx

Adjacent to opening of the larynx and esophagus

407
Q

The larynx

A

Modified part of air passage
- voice production
Important cartilages
- thyroid
+ shield shape
+ anterior ridge forms Adam’s apple
- cricoid cartilage
+ inferior to thyroid cartilage
+ marks start of esophagus and trachea
Epiglottis
-elastic flap that prevents food from entering trachea

408
Q

Trachea

A 
Airway to the lungs
Divides into right and left main bronchi
Reinforced by C shaped cartilage
Passes through mediastinum
Bifurcation at level of L5
Location
 - anterior to esophagus
 - posterior to thyroid isthmus
409
Q

Esophagus

A 
Muscular canal from the mouth to the stomach
Travels through the mediastinum
Sits directly anterior to spine
Posterior to trachea and heart
Ends at GE junction
410
Q

Vasculature of the neck

A 
Carotid arteries
Vertebral arteries
Jugular veins
Location
 - lateral aspect of neck
 - lateral to thyroid gland
411
Q

Vasculature neck- common carotid arteries

A

Common carotids have no side branches
Surrounded by carotid sheath
Bifurcates into the internal and external carotids
Thyroid lobes medial to common carotids
CCAs MEDIAL to jugular veins
Right common carotid is branch of brachiocephalic artery
Left common carotid is second branch of aortic arch

412
Q

Vasculature neck- internal carotid arteries

A

Enter at base of the skull through temporal bone
NO BRANCHES
Connect to circle of Willis
Supply blood to the brain

413
Q

Vasculature neck- external carotid arteries

A

Numerous branches
Tortuous path
Blood supply to face and scalp

414
Q

Vasculature neck- vertebral arteries

A 
First branch off subclavian Artery
Bilateral
Ascend through transverse foramina if cervical vertebra
POSTERIOR to CCA
Enter head via foramen magnum
Form basilar veins within the head
415
Q

Vasculature neck- internal jugular vein

A 
Bilateral
Drain venous sinuses of the head
Lie LATERAL to internal and common carotids
Run within carotid sheath
Collapse easily with compression
416
Q

Vasculature neck- carotid sheath

A

Strong fascia surrounds structures to prevent easy compression
Surrounds
- CCA, IJV, and vagus nerve
+ vagus nerve lies POSTERIOR to vessels and in between CCA and IJV

417
Q

Muscles of face and neck - functions

A

Facial expression
Mastication
Support of head and neck structures
Movement

418
Q

Muscles of neck and face - masseter

A

Primary muscle of chewing
Lies deep to parotid gland
Elevates mandible

419
Q

Muscles of neck and face- platysma

A

Large thin muscular sheath
Extends from mandible to clavicle
Anterior to strap muscles and sternocleidomastoid muscle
Creates ridges in neck

420
Q

Anterior muscles of neck- sternocleidomastoid muscle (SCM)

A

Broad muscle crossing diagonally in the neck
Extends from sternum and clavicle to mastoid tip
Lateral and anterior to strap muscles
Turns head from side to side and flexes neck

421
Q

Anterior muscles neck- strap muscles

A 
Anterior and lateral to thyroid 
Sternohyoid
 - closest to  midline, sternum to hyoid
Sternothyroid
 -posterior and lateral to sternohyoid
 - close contact with anterior thyroid surface
Omohyoid
 -lateral to sternohyoid
 -anterior to sternothyroid
422
Q

Posterior muscles neck

A 
Scalene
Levator scapulae
Trapezius
 -most posterior
 - superficial
423
Q

Cervical lymphatic system

A 
Extensive lymphatic network in neck
More than 1/3 of the body’s total number of lymph nodes
Location
 -deep nodes clustered along vessels
 - along lower jaw
 - anterior and inferior to ear
424
Q

The thorax

A 
Area between the neck and abdomen
Framework
 -bones, muscles, cartilage
Functions
 -respiration, protection of vital organs, pathway
425
Q

Thoracic cage

A 
Formed by
 - sternum and costal cartilages (anterior)
 - ribs and intercostal spaces (lateral)
 - vertebral column (posterior)
     \+ 12 thoracic vertebrae
426
Q

The sternum

A 
Dagger appearance 
Anterior thoracic bone
Parts 
 -manubrium=handle 
    \+ superior part
    \+ square shaped
 - body
    \+ long and narrow
    \+ ribs attach to body laterally 
    \+ hinge joint located between the body and manubrium for respiration 
 -xiohoid/xiphoid process
    \+ small inferior tip
427
Q

Superficial landmarks of the sternum

A 
Suprasternal/jugular notch
 - central depression
 - superior surface of manubrium
Sternal angle
 - hinge joint
 -palpable ridge 5cm below notch
 - level of aortic arch 
Xiphoid process
 - where right and left costal margins meet
428
Q

Ribs of thoracic cage

A

7 true ribs
- connect DIRECTLY to the sternum
5 false ribs
- INDIRECTLY connect to sternum
+ ribs 8-10 = costal cartilage articulate with each rib above
+ ribs 11-12 = floating ribs (no anterior attachment)

429
Q

Thoracic cavity

A

3 compartments

  • 2 pleural spaces
  • mediastinum
430
Q

The thoracic inlet

A 
Superior thoracic aperture
Small yet very important 
Numerous structures pass through this opening
  - trachea and esophagus
  - arteries and veins
  - nerves and Lymph
  - apex of lungs
431
Q

The thoracic outlet

A

Larger than inlet

Diaphragm forms partition between the thorax and abdomen

432
Q

The diaphragm

A

Partition between the thoracic and abdominal cavity
Upward arching some
Crura attach the diaphragm to the lumbar spine
- right and left
Openings
- I8 10Eggs At12

433
Q

Muscles of chest - anterior

A

Pectoralis major

434
Q

Muscles of the chest- posterior

A

Trapezius & latissimus
- superficial
Rhomboid and levator scapulae
- deep to trapezius

435
Q

Muscles of the chest- intercostal

A

Located between the ribs
Allow for expansion/contraction during respiration
3 layers
-external, internal, innermost
Often a window used when scanning difficult patients

436
Q

The lungs

A

Apex
- domed superior portion that projects about the inlet
Base
- inferior aspect
-broad
-rest on diaphragm extend lower in back and sides than front
Hilum
- depression on mediastinal surface where structures enter and exits
+ primary bronchi, pulmonary blood vessels, lymph nodes, nerves
Primary bronchi
-right and left
Secondary bronchi
- branch from primary bronchi
- one branch per lobe (right=3, left =2)
Tertiary bronchi
-bronchial tree
-alveoli
+ functional unit of the lung ; oxygen and carbon dioxide exchange

437
Q

The pleura

A

Double layer membrane sac which encloses the lungs
+visceral = adheres directly to lung surface
+ parietal = lines wall of thoracic cavity and upper surface of diaphragm

438
Q

The pleural cavities

A 
Right and left spaces
Situated lateral to mediastinum 
Fluid or air can collect in these cavities 
 -pneumothorax = air in cavity
 - pleural effusion = fluid in cavity
439
Q

The thymus gland

A 
Immunity
Location
 -anterior to great vessels
 - posterior to manubrium
Bilobed structure 
Size
 - largest during childhood
 - atrophies with age and almost disappears
440
Q

The heart

A 
Muscular organ
Main pump of body
Has oblique lie in mediastinum 
 -45* angle toward left side
Sits slightly left of sternum 
Site of attachment of great vessels
441
Q

Th heart - cardiac orientation

A 
Apex
 - projects inferior , anterior and left
 - formed entirely by left ventricle 
Base
 - projects superior and posterior
 - pulmonary and aortic vessel sit superior to base
442
Q

The heart- cardiac cycle

A

Rhythmic cycle
- chambers alternately contract and relax
Systole= contraction
Diastole = relaxation
Once complete cycle of filling and emptying = one heart beat

443
Q

Heart structures

A 
4 chamber and 4 valves
 - atria
     \+ upper chambers
     \+ receiving chambers
 - ventricles 
     \+ lower chambers
     \+ pumping chambers
 - valves
     \+ 4 total
          ~ 2 types = semilunar and atrioventricular
444
Q

The heart valves

A 
2 types
 -atrioventricular 
 - semilunar
Each type consists of 
 - ring/annulus = opening
 - leaflets 
     \+ AV leaflets also have papillary muscles and chords tendinae 
          ~ serve as anchors for the leaflets
445
Q

Atrioventricular valves

A 
Inflow valves
Blood flows from atria to ventricles
AV valves open during ventricular diastole
AV valves
 - tricuspid and mitral (bicuspid)
446
Q

Semilunar valves

A 
Outflow valves
Valves between the great vessels and the ventricles
Contain 3 crescent shaped cusps
Opens during ventricular systole
Semilunar valves
 - aortic and pulmonary
447
Q

The heart walls

A 
Epicardium
 - outer layer
 - smooth thin visceral
Myocardium
 -middle layer
 - thick contractile muscle
Endocardium
 -inner layer
 - thin membrane lining chambers
448
Q

Pathway of blood through the heart

A 
Vena Cavae
Right atrium
Tricuspid valve
Right ventricle
Pulmonary valve
Pulmonary artery (trunk)
Lungs
Pulmonary veins
Left atrium
Mitral valve
Left ventricle
Aortic valve
Thoracic aorta
Coronary arteries
449
Q

Pathway- vena cavae

A

Return deoxygenated blood to right side of heart
Both drain into right atrium
-superior vena cava
+ formed by union of right and left brachiocephalic veins
- inferior vena cava
+ formed by union of common iliac veins
+ carries blood from abdomen to the right atrium

450
Q

Pathway - right atrium

A

Receives SVC and IVC
AV valve (tricuspid) located at outlet
Located ANTERIOR in chest cavity

451
Q

Pathway- tricuspid valve

A

Located between the right atrium and right ventricle
Contains 3 leaflets of cusps
Has vertical orientation

452
Q

Pathway - right ventricle

A

Receives blood from right atrium
Has ANTERIOR position in heart
Ejects blood into the pulmonary artery
Contains chordae tendinae and papillary muscles

453
Q

Pathway- pulmonary valve

A

Semilunar valve
3 leaflets
Outflow valve from right ventricle to pulmonary artery
Pulmonary valve located anterior to aortic valve

454
Q

Pathway- pulmonary artery (trunk)

A

Originates at right ventricle
Divides into right and left pulmonary arteries
Carried DEOXYGENATED blood AWAY from heart to lungs

455
Q

Pathway - lungs

A

Remove carbon dioxide and add oxygen to the blood

456
Q

Pathway - pulmonary veins

A

Four veins
Superior and inferior veins from each lung
Carries OXYGEN rich blood TO the left atrium

457
Q

Pathway- left atrium

A

Receives oxygenated blood via pulmonary veins
MOST POSTERIOR part of heart
The interatrial septum divides the atria medially

458
Q

Pathway- mitral valve

A 
Locate between the left atrium and ventricle
Bicuspid valve
 - 2 unequal leaflets
     \+ anterior (larger)
     \+ posterior (smaller)
459
Q

Pathway - left ventricle

A

Receives blood from the atrium via the mitral valve
Contains chordae tendinae and papillary muscles
Muscles of the left ventricle is much thicker than right (pump to all body)
Pressure greater in left than right

460
Q

Aortic valve

A

Semilunar valve
- 3 leaflets
Located between the left ventricle and aorta
Positioned POSTERIOR to pulmonary artery

461
Q

Pathway - thoracic aorta

A

Candy cane shape
Travels superiorly, curves posterior then dives inferior toward diaphragm
3 branches (anterior to poster)
- brachiocephalic (innominate), left common carotid, left subclavian

462
Q

Pathway- coronary arteries

A

Supply oxygen and nutrients to heart muscle
Allow for continual contraction and relaxation of heart
Arise just above cusps of aortic valve
- right and left coronary arteries

463
Q

Electrical activity in heart

A

Electrical input initiates the heart contraction and relaxation
Impulses start in the right atrium and travel toward the ventricles

464
Q

Path of electrical impulse

A

Stars contraction in right atrium at SINOATRIAL NODE (SA)
- pacemaker of heart
Impulse travels along nodal pathway
Moves from the SA node to the ATRIOVENTRICULAR NODE (AV)
from AV node onwards to the AV BUNDLE (BUNDLE OF HIS)
AV bundles branch into right and left bundles along interventricular septum
Impulse continues to the PURKINJIE FIBERS in ventricular muscles

Sectional Anatomy (1 decks)

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