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BMSc Anatomy > Sem 1 -Thorax and Abdomen > Flashcards

Sem 1 -Thorax and Abdomen Flashcards

1
Q

what is lymph

A

clear fluid lost from the capillary bed which drians into lymphatic vessels and into lymph nodes

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2
Q

what do lymph nodes contain

A

lymphocytes and macrophages

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3
Q

describe the movement of lymph

A

periphery to midline and upper thorax

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4
Q

what colour is lymph

A

clear unless from intestines then may be a milky yellow - called chyle

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5
Q

where are lymphocytes produces

A

bone marrow

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6
Q

what are the primary lymphoid organs

A

bone marrow

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7
Q

where does lymphocyte maturation take

A

thymus = T cells, bone marrow = B cells

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8
Q

what are the secondary lymphoid organs

A

spleen, tonsils, lymph nodes, peyers pateches (GALT), MALT, BALT

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9
Q

what is the function of the lymphatic system

A

to remove interstitial fluid, protien, cells from tissue and move them into the blood stream

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10
Q

what is the ANS and describe it

A

autonomic nervoud system - non-concious control of both motor and sensory functions

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11
Q

what structures are involved in the ANS

A

spinal nerve (ant = motor, post = sensory), dorsal ramus = sensory to post body wall, ventral ramus = motor to anterolateral body wall and limbs

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12
Q

descibe sympathetic outflow and function

A

T1-L1/2

speeds up processes generally

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13
Q

descibe parasympathetic outflow and function

A

Craniosacral outflow - CN 3, 9, 10 and S2, S3, S4

slows down processes generally

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14
Q

what are white rami communicantes

A

presynpatic fibres of spinal nerve to sympathetuc trunk - ventrla motor fibres (only occurs in T1-L1/2)

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15
Q

what are grey rami communicantes

A

postsynaptic fibres from sympathetic trunk to all spinal nerves

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16
Q

what froms the thoracic cage

A

12 pairs of ribs
sternum
12 T vertebrae

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17
Q

what bones are closely associated with thoracic cage but are not part of it

A

clavicle and scapula

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18
Q

what forms the superior thoracic inlet/aperture

A 
Ant = manubrium 
Post = T1 body
Lat = 1st pair of ribs and their costal cartilages
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19
Q

what forms the inferior thoracic inlet/aperture

A 
Ant = xiphisternal joint 
Post = T12 body
Lat = 11th and 12th ribs and the costal cartilage of ribs 7-10
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20
Q

what ribs are true

A

1-7

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21
Q

what ribs are false

A

8-10

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22
Q

what ribs are floating

A

11-12

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23
Q

what ribs are typical

A

3-9

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24
Q

what ribs are atypical

A

1, 2, 10, 11, 12

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25
Q

desribe the structure of a typical rib

A

Head = articulates with IV disc and sup and inf demifacets of body (sup if of that ribs level)
Tubercle = articulates with transverse process and costotransverse ligaments
Costal angle = most curved part of ribs
Costal groove = infernal surface of inferior border

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26
Q

descibe the vertebral body

A

weight bearing portion

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27
Q

descibe the pedicles

A

attach the VB to the vertebral arch

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28
Q

descibre the articular processes

A

from zygopophysial joints between inf and sup articular processes between vertebrae

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29
Q

desribe the lamina

A

posterior extension of the arch which meets to form spinous process

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30
Q

describe the transverse process

A

muscle attachment and rib artiulation

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31
Q

describe the spinous process

A

supraspinous ligament attachment and muscle attachment

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32
Q

describe the sup and inf demifacets

A

articulate with the head of the rib, superior facet is of that vertebrae and rib, inferior id of the vertebrae below

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33
Q

describe the structure of rib 1

A

Head has a single facet rather than 2
Grooves for the subclavian arteru and vein (closest to costal cartilage)
Scalene tubercle between the above grooves for the attachemnt of anterior scalene muscle
attachemnt for middle scalene near the costal angle

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34
Q

describe the structure of rib 2

A

Tuberosity for serratus anterior attachement

Posterior scalene also attaches to this rib

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35
Q

describe the structure of rib 10 to 12

A

Head has a single facet rather than 2

Ribs 11 nd 12 have no neck or tubercle

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36
Q

describe the structure of the manubrium

A

Sup border = jugular notch
Clavicular notches either side of this
Manubriosternal joint = sternal angle at T4/5 or Rib 2

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37
Q

descibe the structure of the body of sternum

A

Attachment for ribs 3-6

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38
Q

describe the structure of the xiphoid process

A

Xiphisternal joint at T9 - where rib 7 articulates

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39
Q

Intervertebral discs form what sort of joints

A

secondary cartilaginous joints = symphysis

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40
Q

what type of joint are zygopophysial joints

A

synovial plane joints

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41
Q

what do the artciular facets in the T region allow

A

for rotational movement between vertebrae

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42
Q

what sort of joint do the ribs form with the sternum

A 
1 = Synchondrosis (primary cartilaginous joint) with sternum - other ribs are synovial plane joints 
2-7 = synovial plane joints
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43
Q

what sort of joints form between ribs 6-12

A

interchondral joinrs
synovial joints betwene 6+7, 7+8, 8+9
fibrous joint between 9+10

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44
Q

what two movements do the ribs contribute to in respiration

A

pump handle and bucket handle movements

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45
Q

what ribs take part in the bucket handle movement andwhat part of the rib moves more during this movement

A

ribs 7-12 (inf ribs)

lateral rib has most movement

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46
Q

what ribs take part in the pump handle movement andwhat part of the rib moves more during this movement

A

ribs 1-6 (sup ribs)

ant aspect of the rib moves most

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47
Q

what are the changes of the rib cage during repiration

A

anterior and posterior = sternum
laterally = lower rib cage
verticaly = diphragm descends and flattens

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48
Q

what muscles contribute to the thoracic wall

A

intercostals
subcostals
transversus thoracis

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49
Q

what are the secondary muscles of inspiration

A 
pectoralis major 
pectoralis minor
rectus abdominis
serratus anterior 
serratus posterior superior
serratus posterior inferior
scalene muscles
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50
Q

describe neurovascular supply to pectoralis major

A

medial pectoral nerve (C8, T1) and lateral pectoral nerve (C5-C7)
branches from thoracoacromial artery and internal thoracic artery

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51
Q

describe the attachments of pectoralis major

A 
origin:
ant surface medial half of clavicle
ant surface of sternum 
costal cartilage 1-6 
anterior layer of anterior rectus sheath

insertion:
greater tubercle of humerus

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52
Q

describe neurovascular supply to pectoralis minor

A

medial pectiral nerve (C8, T1)

thoracoacromial artery

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53
Q

describe the attachments of pectoralis minor

A

origin:
anterior surface of costal cartilage 3-5

insertion:
medial border and coracoid process of scapula

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54
Q

describe neurovascular supply to serrtaus anterior

A

long thoracic nerve C5-7

superior and lateral thoracic nerves and thoracodorsal artery branches

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55
Q

describe the attachments of serrtaus anterior

A

origin:
ribs 1-2, ribs 3-6, wibs 7-9

insertion:
scapula superior anlge and medial border

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56
Q

describe neurovascular supply to serrtaus posterior superior

A

2nd to 5th intercostal nerves

intercostal arteries

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57
Q

describe the attachments of serrtaus posterior superior

A

origin:
nuchal ligament, spinous process of C7-T3

insertion:
superior border of ribs 2-5

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58
Q

describe neurovascular supply to serrtaus posterior inferior

A

anterior rami of T9-L2

intercostal arteries

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59
Q

describe the attachments of serrtaus posterior infeiror

A

origin:
spinous process of T11-L2

insertion:
inferior border of ribs 9-12

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60
Q

describe neurovascular supply to scalene muscles

A 
anterior = ant rami C3-7
middle = ant rami C4-7
posterior = ant rami C5-7

inferior thyroid artery

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61
Q

describe the attachments of scalenes

A

ant origin
transverse process C3-6
ant insertion
tubercle and sup border fo rib 1

middle origin
transverse process C2-7
middle insertion
sup border rib 1

post origin
transverse process C5-7
post insertion
external surface of rib 2

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62
Q

desribe fibres, attachemtns, action and membrane replacement of external intercostal muscle

A

inferomedial fibres
tubercles of ribs to costocondral junction
raise ribs in inspiration
anterior membrane replacement by ant intercostal memrbrane

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63
Q

desribe fibres, attachemtns, action and membrane replacement of internal intercostal muscle

A 
inferolateral fibres
sternum to angle of ribs 
interosseus part = depress ribs 
interchondrous part = elevate ribs 
posterior membrane replacement by intercostal membrane
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64
Q

describe the subcostal muscles

A

blend with innermost intercostal
span 1-2 intercostal spaces
attach to angle of rib

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65
Q

describe the transversus thoracis muscle

A

side fo sternum to 2-6 costal cartilages

vessels at side of sternum are superficial to this muscle

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66
Q

descirbe the intercostal veins

A

anterior veins to internal thoracic vein

posterior veins to azygoz/hemiazygos venous system

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67
Q

describe the intercostal arteries

A

posterior 3-11 from subcoastal thoracic aorta
posterior 1 and 2 from supreme intercostal artery

anterior from internal thoracic artery (from subclavian artery)
branches 1 and 2 are direct branches 7-9 come off indirect branches musculophrenic artery and superior epigastric artery

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68
Q

desdibe the intercostal nerves

A

have sensory branches to the skin

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69
Q

name the most notable dermatomes

A 
T4 = nipple
T10 = umbilicus
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70
Q

desribe the anatomy of the breast

A 
lies of pectoralis major 
opens at lactiferous duct 
fibrous tissue with suspensory ligaments
medial and lateral mammary arteries 
lateral thoracic artery from axillary 
medial from interna thoracic artery
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71
Q

lymph drainage of the breats

A

axillary nodes and maybe parasternal

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72
Q

what is pleura

A

serous membrane that produces a lubricating fluid

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73
Q

what are the differnet types of pleura

A

visceral and parietal which are continuous with each other at the hilum of the lung

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74
Q

what is the pulmonary ligament

A

extention of pleura that allows for expansion of the hilum

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75
Q

what holds the pleura in place

A

endothoracic fascia

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76
Q

what is the suprapleural memebrane

A

thick membrane that attaches to rib 1 and transverse processes of C7 to prevent the lungs going into the neck

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77
Q

surface markings of the lungs

A

midclavicular line
lung = rib 6, parietal pleura = rib 8

mid axilary line
lung = rib 8, parietal pleura = rib 10

scapular line
lung = rib 10, parietal pleura = rib 12

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78
Q

what are the recesses associated with teh lungs

A 
costodiaphragmatic = angle of diaphragm to thoracic wall 
costomediastinal = posterior to the sternum larger on the left
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79
Q

what are the 3 lung syrfaces

A

costal
diaphragmatic
mediastinal

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80
Q

what are the borders of the lung

A

anterior
posterior
inferior

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81
Q

describe the right lung

A

3 lobes

oblique and transverse fissures

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82
Q

describe the left lung

A

2 lobes and lingula

oblique fissure

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83
Q

how do the phrenic and vagus nerves relate the lung hilum

A 
vagus = posterior
phrenic = anterior
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84
Q

describe the mediastinal surface of the R lung

A

right atrium
SVC impression
azygos vein arches over hilum
oesophagus post to hilum

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85
Q

describe the mediastinal surface of the L lung

A

Left ventricle
arch of aorta above hilum
descending aorta behind hilum

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86
Q

describe the locations of the structures of the hilum

A

most posterior = bronchus
ant sup = arteries
ant inf = veins

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87
Q

how many segments does the R bronchial tree split into `

A

3 lobes
3 segments superioly
2 segments middle
5 segments inferiorly

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88
Q

how many segments does the L bronchial tree split into

A

2 lobes
5 segments superiorly
5 segments inferiorly

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89
Q

lymphatic drianage of the lung

A 
parenchyma = pulmonary 
hilum = hilar
carina = superior and inferior tracheobronchial nodes
trachea = paratracheal
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90
Q

boundaries of superior mediastinum

A 
Sup = superior thoracic inlet 
Inf = transthoracic plane T4/5 (rib 2)
ant = sternum 
post = bodies of T1-T4
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91
Q

describe course of R and L vagus nerves

A 
R = anterior to R subclavian and loops under it 
L = between common carotid and L subclavian and loops under arch of aorta posterior to ligamentum arteriosum
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92
Q

what plexuses does the vagis nerve contribute to

A

Caridac = deep to ach of aorta at T4/5
R and L pulmonary nodes = on the main bronchi
Oeosphageal = surface o oesophagus
Ant (left vagus) and post (right vagus) vagal trunks pierce diaphragm at T10

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93
Q

describe course of R and L phrenic nerves

A

R = with brachiocephalic vein blending with RA piercing diaphragm near IVC opening at T8

L = between L subclavian and L carotid blending with LV and piercing letft of the pericardium

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94
Q

what level does the trachea begin and end

A

C6/7 to T4/5

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95
Q

what are the anterior and posterior borders of the trachea formed by

A 
Ant = C shaped cartilage 
Post = trachealis muscle
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96
Q

what level does the IVC pierce diaphrgam

A

T8

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97
Q

what level does oesophagus pierce diaphragm

A

T10

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98
Q

what level does aorta pierce diaphragm

A

T12

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99
Q

what are the 3 main constritions of the oesophagus

A

arch of aorta (T4/5)
L bronchus (T6)
Diaphrgam (T10)

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100
Q

what are the boundaries of the anterior inferior mediastinum

A 
sup = transverse thoracic plane 
inf = diaphgram 
ant = body of sternum 
post = fibroum pericardium
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101
Q

what is located int he middle inferior mediastinum

A

heart

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102
Q

what shape is the heart

A

trapezoid

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103
Q

what are the layers from superficial to deep of the heart

A

epicaridum (serous pericardium) –> myocardium –> endocardium

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104
Q

what vessels drain into the RA

A

SVC, IVC, coronary sinus, Thesbian veins, anterior cardiac veins

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105
Q

describe the fibrous pericardium

A

blends sup with adventitia of great vessels

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106
Q

what becomes the central tendon of the diaphrgam

A

fibrous pericarium

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107
Q

describe the serous pericardium

A

reflects onto the heart at the great vessels - visceral and parietal parts

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108
Q

describe the transverse pericaridal sinus

A

horizontal sinus posterior to the pulmonary tynk and ascening aorta

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109
Q

describe the oblique pericardial sinus

A

vertical sinus posterior to the LA

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110
Q

what forms these borders of the heart :

  • base
  • R border
  • L border
  • apex
  • sup borer
A 
base = LA
R border = RA
L border = LV and L auricle
apex = LV
sup border = RA, LA and auricles
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111
Q 
what forms each surface of the heart:
- anterior
- diaphrgamatic 
left pulmonar y 
base
A

ant = RA
diaphragmatic = LV RV
left pulmonary = LV
base = LV

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112
Q

what are the branches of the RCA

A

SA nodal
R marginal
AV nodal
Post interventricular

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113
Q

what are the branhes of the LCA

A

LAD

left circumflex

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114
Q

what branches from the LAD

A

diagonal branch

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115
Q

what branches from the left circumflex

A

L marginal branch

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116
Q

what groove goes the LAD run in

A

anterior interventricular

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117
Q

what groove does the L circumflex run in

A

L arioventricular groove

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118
Q

what are the coronary veins and where do they run

A

great cardiac in anterior interventicular groove
middle cardiac in posterior interventricular groove
small cardiac with R marginal artery
L posterior ventricular on post wall of LV
oblique vein of LA

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119
Q

describe the internal surface of the RA

A

Pectinate muscles = rough area
Crista terminalis = around the fossa ovalis
Fossa ovalis
Sinus venarum = smooth area

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120
Q

describe the internal surface of the LA

A

smooth and featureless

pectinate muscles at the auricle

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121
Q

describe the internal surface of the RV

A

chordae tendinae
moderator band - IV septum to ant papillar
papillary muscles
trabeculae carnae

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122
Q

describe the internal surface of the LV

A

chordae tendinae
papillary muscles
trabeculae carnae
thick muscular wall

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123
Q

what are the 4 valves of the heart

A

mitral - pulmonary - tricuspid - aortic

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124
Q

when are the semilunar valves open and closed

A 
open = high pressure
closed = low pressure
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125
Q

when are the cuspid valves open and closed

A 
open = low pressure
closed = high pressure
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126
Q

what is the function of the fibrous skeleton

A

helps with the structure of the valves and helps with electrical conduction

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127
Q

describe the innervation to the heart

A

SA nodes near SVC opening in RA
AV node near AV septum in RA –> into LBB and RBB with purkinje fibres
RBB to moderator band

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128
Q

what is the parasymp and symp innervation to the heart

A 
parasymp = intrinsic ganglia and vagal plexus
symp = T1-5/6 in cervical and thoracic paravertebral ganglia
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129
Q

what are the boundaries of the posterior inferior mediastinum

A 
sup = transthoracic plane
inf = diaphragm 
ant = pericardium 
post = bodies of T5-T12
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130
Q

where does the R 1st posterior intercostal vein drain

A

right brachiocephalic vein

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131
Q

where do the R 2nd to 11th posterior intercostal veins drain

A

azygos vein

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132
Q

where do the L 1st to 4th posterior intercostal veins drain

A

L brachiocephallic vein

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133
Q

where do the L 5th to 8th posterior intercostal veins drain

A

accessory hemiazygos vein crosses midline at T8

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134
Q

where do the L 9th to 11th posterior intercostal veins drain

A

hemi-azygos vein crosses midline at T9

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135
Q

what forms the SVC

A

L and R brachiocephalic veins + axygos veins + inferior thyrid vein

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136
Q

what level is the arch of the aorta

A

T4/5

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137
Q

what are the greater splanchnic nerves and where do they synapse

A

T5-T9 ganglion

synapse at coeliac and sup mesenteric ganglion

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138
Q

what are the lesser splanchnic nerves and where do they synapse

A

T10-T11 ganglion

synapse at sup mesenteric and aorticorenal ganglia

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139
Q

what are the least splanchnic nerves and where do they synapse

A

T12 ganglion

synapse at the aorticorenal ganglion

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140
Q

where is the caval opening

A

T8 in central tendon

141
Q

where is the oeosphageal hiatus

A

T10 in the crus

142
Q

where is the aortic hiatus

A

T12 posterior to teh mediaN arcuate ligament

143
Q

what are the layers of the abdominal wall

A

skin –> sup fascia –> muscle layers and their deep fascia –> extraperitoneal fascia –> parietal peritoneum

144
Q

descirbe the superficial facia of the abdomen

A

above umbilucus - normal arrangement
below umbilicus in 2 layers
- fatty layer = campers fascia
- membranous layer = scarpas fascia

145
Q

what does campers fascia form in the perineum

A

fascia of thigh and perineum
males = dartos muscle, penis fascia
females = labia majora

146
Q

what does scarpas fascia form in the perineum

A

fascia of thigh to form fascia lata
males = penis fasciam dartos fascia, fundiform ligament
females = labia majora

147
Q

what are the muscles of the abdominal wall

A 
external oblique 
internal oblique 
transversus abdominis
rectus abdominis 
pyramidalis
148
Q

describe neurovascular supply to external oblique

A

ant rami T7-T12

lower posterior intercostal artery, subcostal artery and deep circumflex iliac atery

149
Q

describe attachments of external oblique

A

ribs 5-12, iliac crest and linea alba

150
Q

describe neurovascular supply to internal oblique

A

ant rami T7-T12 and L1

subcostal artery

151
Q

describe attachments of internal oblique

A

thoracolumbar fasixia, inguinal ligament, iliac crest to ribs 9-12

152
Q

describe neurovascular supply to transversus abdominis

A

ant rami T7-L1

subcostal artery, superior epigastric

153
Q

describe attachments of transversus abdominis

A

thoracolumbar fascia, inguinal ligament, iliac crestm costal carilage 7-12 to linea alba, pubic crest and pectineal line

154
Q

describe neurovascular supply to pyramidalis

A

ant ramus T12

inf epigastric artery

155
Q

describe attachments of pyramidalis

A

pubis to linea alba and rectus

156
Q

describe neurovascular supply to rectus abdominis

A

ant rami T7-T12

inf and sup epigastric arteries

157
Q

describe attachments of rectus abdominis

A

pubic tubercle crest and symphysis to xiphoid process and costal cartilage 5-7

158
Q

describe the rectus sheath

A

above umbilicus

  • external and 1/2 oblique ant to rectus
  • 1/2 internal and transversus post to rectus

below umbilicus
- external, internal and transversus ant to rectus leaving transversalis fascia below

159
Q

where is the transition in the rectus shetah

A

arcuate line 1/2 way from umbilicus to pubic bone

160
Q

what fascia helps to form the renal fat pad

A

extraperitoneal fasia

161
Q

what nerves corme from L1 level

A

ilioinguinal

iliohypogastric

162
Q

what nerve coems from T12 level

A

subcostal

163
Q

what nerves come from T7-T11 level

A

intercostal nerves

164
Q

what are the three folds on the posterio surface of the abdominal wall

A 
mediaN = urachus remnant
mediaL = umbilical artery remnant 
lateral = inf epigastric vessles
165
Q

where is the superficial inguinal ring located in comparison to the deep ring

A

more medial - closer to the pubic bone

166
Q

what shape is the superficial inguinal ring and why

A

triangular - srtong walls (crura) make the shape

167
Q

what layer is the superficial inguinal ring located in

A

external oblique aponeurosis

168
Q

what fasica in the perineum arises from the external oblique aponeurosis

A

external spermatic fascia

169
Q

what structures exit the superficial inguinal ring

A

ilioinguinal nerve (L1)

170
Q

what layer is the deep inguinal ring located in

A

transversalis fascia

171
Q

where is the deep inguinal ring located

A

1/2 way between ASIS and pubic tubercle

172
Q

what shape is the deep inguinal ring

A

oval

173
Q

where are the inferio epigastric vessle sin relation to the deep inguinal ring

A

medial

174
Q

what structures pass throught the deep inguuinela ring

A

genital branch of genital femoral nerve
round ligament of uterus
vas deferens
testicular vessels

175
Q

what forms each of the walls of the inguinal canal

  • ant
  • post
  • roof
  • floor
  • lateral walls
A

ant = aponeurosis of external oblique and internal oblique in the lat 1/3
post = transversalis fascia and cojoint tendon in the medial 1/3
roof = fibres of internal oblique and transversus abdominis
floor = inferior rolled edge of external oblique and lacunar ligamet
laetral walls = supported by internal oblique

176
Q

what is the cojoint tendon

A

common insertion of internal oblique and transversus into the pubic crest and pectineal line

177
Q

what is the lacunar ligament

A

medial edge of the femoral ring where femoral vessles pass into the lower limb

178
Q

what is the inguinal ligament

A

floor of the inguinal canal fromed by external oblique

179
Q

why is the inguinal canal an oblique passge

A

to try and prevent herniation

180
Q

what muscles flatten the inguinal canal in increased abdominal pressure

A

internal oblique and transversus abdominis

181
Q

what is a direct hernia

A

pushes through weakness in the wall of canal

182
Q

what is an indirect hernia

A

enters via weakness of deep inguinal ring

183
Q

what is a femoral hernia

A

hernaites into the back of the femoral sheath

184
Q

what abdominal wall structure forms the external spermatic fascia

A

external oblique

185
Q

what abdominal wall structure forms the internal spermatic fascia

A

transversalis fascai

186
Q

what abdominal wall structure forms the creamster muscles

A

internal oblique

187
Q

what abdominal wall structure forms the colles fascia

A

scarpas fasica

188
Q

what does the colles fascia contain

A

dartos muscle - temp control

189
Q

what is the function of te cremaster muscle

A

pulls up testes for temp control

190
Q

what layer of the abdominal wall forms no layers in the spermatic cord and why

A

transversus abdominus because processus vaginalis passes under this in development

191
Q

what lymph nodes drain the testis and epididymis

A

paraortic nodes at root of testicular artery L2

192
Q

what lymph nodes drain the scrotal wall and fascia

A

superficial inguinal nodes

193
Q

in the spermatic cord whats structure si most medial

A

vas deferens

194
Q

what is the function of the vas deferens

A

carries sperm from the epididymis to the urethra

195
Q

what does the testicular artery supply and where is it from

A

supplies epididymis and comes from L2 aorta

196
Q

what plexus do the testicular veins form

A

pampiniform plexus

197
Q

where does the artery of vas deferens come from

A

inferior vesicular

198
Q

what does the genital branch of the genitofemoral nerve supply

A

cremaster muscle

199
Q

when do the testes descend in development

A

IU months 7 and 8

200
Q

what forms the gubernaculum

A

mesenchymal cells

201
Q

what nerves are responsible for the sensitivity of the parietal peritoneum

A

lat and ant body wall = T6-T12
central diaphrgam = phrenic
pelvic lining = obturator nerve

202
Q

what are the fat stores of the abdomen

A

mesentery - 2 layers of peritoneum
omentum - 4 layers of peritoneum
appenices epiplociae

203
Q

what does intraperitoneal mean

A

completey covered by peritoneum

204
Q

what does retroperitoneal mean

A

partially covered by peritoneum

205
Q

describe the greater omentum

A

hangs off greater curvature of the stomac carrying gastroepiploic vessels

206
Q

where does R gastroepiploic artery come from

A

gastroduodenal from common hepatic from coeliac trunk

207
Q

where does L gastroepiploic artery come from

A

splenic artery from coeliac trunk

208
Q

describe the lesser omentum

A

hangs off lesser curvature of the stomach

has a free edge and forms the lienorenal ligament

209
Q

what does the free edge of the lesser omentum contain

A

portal vein posteriolry
hepatic artery - left
bile duct right

210
Q

what does the lienorenal liagement carry

A

splenic vessels

211
Q

what os the gap between the lesser and greater omentum called

A

epiploic foramen

212
Q

what is the mesentery that attaches to the transverse colon and what artery does this carry

A

mesocolon - carries the marginal artery

213
Q

what artery and vein supply the foregut, where does the lymph go and where is pain referred

A 
artery = coeliac trunk T12
vein = portal vein 
lymph = coeliac nodes 
pain = epigastric
214
Q

what are the layers of the stomach

A

serosa
mscularis externa
submucosa
mucosa

215
Q

what are the regions of the stomach

A

fundus - right dome of diaphrgam
cardia - entry of oesophagus
pyloric antrum and pyloric valve - joining to duodenum

216
Q

what is the most superior level of the stomach

A

rib 5/6

217
Q

what level is the pyloric valve

A

L1

218
Q

what regions of the abdomen is the stomach in

A

left hypochondrium and epigastric

219
Q

what are the notches of the stomach

A

cardiac notech = entry of oesophagus

angular notch = lesser curvature

220
Q

what are the surfaces of the stomach like

A

smooth external

rugae in internal

221
Q

what is the arterial supply tot he stomach

A

lesser curvature = left gastric
fundus = short gastric
greater curvature = L and R gastroepiploic

222
Q

what is the venous drainage of the stomach

A

L and R gastric veins –> portal
L gastroepiploic and short gastric –> splenic
R gastroepiploic –> SMV

223
Q

what two veins unite to form the portal vei

A

splenic veins and SMV

224
Q

what nodes does the stomach drain to

A

coeliac at T12

225
Q

describe the duodenum

A

1st part = cap
2nd part = descending and entrance of bile duct
3rd part = transverse part
4th part = ascending to duodenum

226
Q

where does the bile duct enter the duodenum

A

2nd part at the major duodenal papilla with the sphincter of oddi controlling

227
Q

what makes the ampulla of vater

A

bile duct and pancreatic duct

228
Q

what forms the bile duct

A

cystic duct and hepatic duct

229
Q

what forms the common hepatic duct

A

right and left hepatic duct

230
Q

what vertebral levels does the duodenum lie at

A

L1 to L3

begins just above pyloric plane

231
Q

what parts of the duodenum are retorperitoneal

A

2nd and 3rd parts

232
Q

what are the folds in the duodenum called

A

plicae circulares

233
Q

what is the blood supply to the duodenum

A

pancreaticoduodenal arteries
proximal = superior
distal = inferior

234
Q

what is the venous drainage to the duodenum

A 
proximal = portal vein 
distal = SMV then portal vein
235
Q

what lymph nodes drain the duodenum

A

coeliac nodes T12 proximal

SM nodes L1 distal

236
Q

describe the ligaments on the liver

A

ligamentum teres = remnant of umbilical vein

falciform ligament = separates the L and R lobes

coronary liagment over R love

R and L triangular ligaments

237
Q

describe the lobes of the liver

A

R and L lobes
quadrate lobe ant by the bile dct
caudate lobe post by the IVC

238
Q

what is the highest point of the liver

A

rib 5/6

239
Q

what does porta hepatic contin

A

portal vein
bile duct
hepatic artery

240
Q

what regions of the abdomen is the liver in

A

right hypochondrium

epigastric

241
Q

what is the bare area

A

area on R lobe that has no peritoneum due to way peritonem reflexts on the diaphragm

242
Q

what is the blood supply tot he liver

A

hepatic artery = oxygen

portal vein = nurtients

243
Q

what is the venous drainage of the liver

A

hepatic veins to the IVC

244
Q

what is the lymphatic drainage of the liver

A

coeliac nodes T12

some via diaphragm and post mediastinum

245
Q

what are the areas of the gallbladder

A

fundus
neck
body

246
Q

what level is the gall bladder at

A

9th costal cartilage mid clavicular line

247
Q

when is bile needed

A

when eating fatty foods

248
Q

what causes bile to be released

A

cholecystokinin causes gallbladder to contract

249
Q

what colour are cholesterol stones

A

green or yellow/white

250
Q

what colour are bilirubin and calcium salts

A

small and dark

251
Q

what is the blood supply to the gallbladder

A

cystic artery

252
Q

what is the venous drainage of the gallbladder

A

cystic vein to the common hepatic

253
Q

what is the lymphatic drainage of the gallbladder

A

cystic nodes - hepatic nodes - coeliac nodes

254
Q

describe the parts of the pancreas

A

head
uncinate process (below head)
body
tail

255
Q

what is the arterial supply of the pancreas

A

pancreatic branches from the splenic artery

head supplied by sup and inf pancreaticoduodenal artery

256
Q

what is the venous drainage of the pancreas

A

splenic vein/SMV to the portal system

257
Q

what si the lymphatic drainage of the pancreas

A

SM nodes at L1

Coeliac nodes at T12

258
Q

what protects the spleen

A

ribs 9-11

259
Q

what ligament do the splenic vessels and tail of the pancreas travel in

A

lienorenal ligament

260
Q

what does the gastrosplenic ligament carry

A

short gastric and gastroepiploic vessles

261
Q

what is the arterial supply to the pancreas

A

pancreatic branches from splenic artery

262
Q

what is the venosu drainage of the pancreas

A

IMV to splenic to SMV to portal

263
Q

what is the lymphatic drainage of the pancreas

A

pancreaticosplenic nodes to coeliac

264
Q

what is more proximal and how much of the small intestine id the ileum and jejunum

A

jejunum first 2/5

ileum distal 3/5

265
Q

what are the arterial supplies to teh small intestine

A

ileal and jejunal branches from SMA

distal ileum = iliocolic

266
Q

what is the lymphatic drainage of the small intestine

A

L1 SMA nodes

267
Q

what artery and vein supply the midgut, where does the lymph go and where is pain referred

A

SMA L1
SMV
preaortic nodes at SMA L1
umbilical pain

268
Q

describe the large intestine

A

absorbs water and electrolytes
haustra
teniae coli
appendices epiplociae

269
Q

describe the blood supply to the caecum

A

caecal artery from iliocolic from SMA

270
Q

what is the venous drainage fromt the caecum

A

SMV

271
Q

what is the lymphatic drainage from the caecum

A

SM nodes at L1

272
Q

where is the appendix located

A

1/3 of the way between ASIS and umbilicus

273
Q

what is the arterieal supply to the appendix

A

appendicular artery from iliocolic from SMA

274
Q

what is the venous drainage of the appendix

A

small vein to the posterior caecal vein

275
Q

what is the lymphatic drainage of the appendix

A

SM nodes

276
Q

where is appendix pain reffered

A

T10 umbilicus

277
Q

what is the blood supply to the ascending colon

A

iliocolic and right colic from SMA

278
Q

what is the venosu drianage of the ascending colon

A

SMV

279
Q

what is the lymphatic drainage of the ascending colon

A

SM nodes at L1

280
Q

what gut regions is the transverse colon in

A 
midgut = proximal 2/3
hindgut = distal 1/3
281
Q

what is the bloody supply of the transverse colon

A 
prox = SMA
distal = IMA
282
Q

what is the venous drianage of the transverse colon

A 
prox = SMV 
distal = IMV
283
Q

what arteries joint to from the marginal artery and where is this artery found

A

middle and left colic

mesocolon

284
Q

what is the lymphatic drainage of the transverse colon

A

SMA L1 nodes proximal

IMA L3 nodes distal

285
Q

what artery and vein supply the hindgut, where does the lymph go and where is pain referred

A

IMA L3
IMV
preaortic at L3
suprapubic

286
Q

what is the arterial supply to the descending colon

A

left colic artery from IMA

sigmoid artery from IMA

287
Q

what is the drainage of the descending colon

A

IMV

288
Q

what is the lymphatic drainage of the descending colon

A

IM nodes at L3

289
Q

where is the sigmoid colon

A

ant to L external iliac artery to the 3rd sacral vertebra

290
Q

what is the arterial supply to the sigmoid colon

A

IMA

291
Q

what is the venous drainage of the sigmoid colon

A

IMV

292
Q

what is the lymphatic drainage of the sigmoid colon

A

IM nodes at L3

293
Q

what are the regions of the rectum

A 
sup = hindgut
inf = pelvic
294
Q

what is the blood supply to the rectum

A 
sup = superior rectal from IMA
mid = middle rectal from internal iliac
inf = inferior rectal from inferior pudendal
295
Q

what is the venous drainage of the rectum

A

sup rectal vein to IMV to portal

mid and inf to internal iliac and inf pudendal to common iliac to IVC

296
Q

what is the lymphatic drianage of the rectum

A 
sup = IM nodes at L3
inf = lower rectum to internal iliac nodes
297
Q

what are the primary retroperitoneal structrues

A

kidneys suprarenal glands

298
Q

what are the secondary retroperitoneal structures

A

duodenum, pancreas, ascending colon, descending colon, uper 2/3 rectum

299
Q

what are the layers covering the kidney

A

kidney –> capsule –> perirenal fat –> renal fascia –> pararenal fat

300
Q

what level is the hilum level

A

L1

301
Q

what is the level of the sup pole of the kidneys

A 
R = rib 12
L = rib 11 and 12
302
Q

what vertebral level is the kidney at

A

T12-L3

303
Q

what level are the renal arteries

A

L1

304
Q

what renal artery is longer

A

R renal artery

305
Q

where do the renal veins drain

A

IVC

306
Q

what drains into the L renal vein

A

left gonadal veins and left suprarenal vein

307
Q

what is the lymphatic drainage of the kidneys

A

Lateral aortic nodes at L1

308
Q

describe the course of the ureters

A

inf exit from renal pelvis and cross the bifurcation of the common ilia artery anterior to the SI joint

309
Q

what are the 3 main constrictions of the ureter

A

uteropelvic junction
pelvic brim
trigone of the bladder

310
Q

what is the blood supply to the ureters

A

renal arteries L1
gonadal artery
superior vesicular artery

311
Q

what is the venous drainage of the ureters

A

renal vein
gonadal vein
superior vesicular vein

312
Q

what is the lymphatic drainage of the ureters

A

lateral aortic nodes

iliac nodes

313
Q

where is ureter pain referred

A

inguinal region

314
Q

describe the right suprarenal gland

A

pyramid shape

315
Q

describe the left suprarenal gland

A

crescent shape

316
Q

what colour is the cortex and what does it produce

A

yellow and glucocorticoids and corticoids

317
Q

what colour is the medulla and what does it produce

A

brown and adrenaline and noradrenaline

318
Q

what is the arterial supply to the suprarenal glands

A

suprarenal branch of inf phrenic from coeliac trunk or aorta

319
Q

what is the venous drianage of the suprarenal glands

A 
right = suprarenal vein to IVC
left = suprarenal vein to left renal vein to IVC
320
Q

what is the lymphatic draiange of the suprarenal gland

A

lateral aortic nodes at L1

321
Q

what are the muscles of the posterior abdominal wall

A

quadratus laborum
iliacus
psoas

322
Q

describe the neurovascular supply to quadratus laborum

A

ant rami T12-L4

323
Q

describe the attachments of quadratus laborum

A

iliac cret to 12th rib and L1-4 transverse processes

324
Q

describe the neurovascular supply to iliacus

A

femoral nerve L2,3,4

325
Q

describe the attachments of iliacus

A

iliac fossa to join psoas to form iliopsoas inserting into lesser trochanter of femur

326
Q

describe the neurovascular supply to psoas

A

lumbar plexus branches L2-4

327
Q

describe the attachments of psoas

A

T12-L4 bodies and IV discs and L1-L5 to join iliacus as iliopsoas

328
Q

where does the left crus of the diaphragm insert

A

L1-3

329
Q

where does the right crus of the diaphragm insert

A

L1-2

330
Q

what level does the aorta bifurcate

A

L4

331
Q

what level does the IVC form

A

L5

332
Q

what continues down the midline after the bifurcation of the aorta

A

median sacral artery

333
Q

where does inferior epigastric artery originate

A

external iliac artery

334
Q

where do the lumbar veins drain

A

1 and 2 to ascending lumbar vein
3 and 4 to IVC
5 to iliolumbar vein and common iliac

335
Q

what is the level of the cisterna chyli

A

L1

336
Q

what nerve roots form the lumbar plexus

A

ant rami L1-L4

337
Q

where is the lumbar plexus located

A

below psoas

338
Q

what does the iliohypogastric nerve supply and what level does it arise

A

L1
sensory to lat gluteal and pubic skin
motor to internal oblique and transversus abdominis

339
Q

what does the ilioinguinal nerve supply and what level does it arise

A

L1
sensory to skin on medial thigh and root of penis/mons pubis
motor to internal oblique and transversus abdominis

340
Q

what does the genitofemoral nerve supply and what level does it arise

A

ant rami L1 and L2
sensory femoral = skin of upper ant thigh
sensory genital = scrotum or mons pubis
motor genital = cremasteric muscle

341
Q

what does the lateral femoral cutaneous nerve supply and what level does it arise

A

ant rami L2 and L3

skin on ant lat thigh

342
Q

what does the femoral nerve supply and what level does it arise

A

ant rami L2,3,4
sensory = skin on ant and lat thigh and medial thigh via saphenous branch
motor = pectineus, iliacus, ant compartment of thigh

343
Q

what does the obturator nerve supply and what level does it arise

A

ant rami L2,3,4
sensory = skin on medial thigh
motor = obturator externus, med compartment of thigh

344
Q

where is the superior hypogastric plexus

A

L4 bifurcation

345
Q

where is the inferior hypogastric plexus

A

lateral wall of pelvis

346
Q

where does the subcostal nerve lie

A

over 12th rib

347
Q

where does the genitofemoral nerve run

A

along ant surface of psoas

348
Q

where does the obturator nerve run

A

passes through obturator muscles and membrane of obturator formamen

BMSc Anatomy (2 decks)

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