Test 3 Flashcards

1
Q

Skeletal part of thorax

A

Bony enclosure formed by sternum, ribs and costal cartilages

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2
Q

Thoracic cage

A

Surrounds and protects organs in the thoracic cavity, provides support for upper limbs and plays a role in breathing

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3
Q

Superior thoracic aperture

A

Also known as thoracic inlet
Structures passing btwn the thoracic cavity and neck pass through it (trachea, esophagus etc.)

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4
Q

Inferior thoracic aperture

A

Also known as thoracic outlet
Structures passing btwn the thoracic cavity and abdominal cavity pass through it
12th Thoracic verterba

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5
Q

Bones of thoracic skeleton

A

Sternum and ribs

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6
Q

Sternum major regions and major surface features

A

a. manubrium (articulates with first and second ribs to form sternoclavicular joints)
b. body
c. xiphoid process
d. sternal angle
e. suprasternal (jugular) notch
f. clavicular notches (articulate with clavicles to form sternoclavicular joints)

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7
Q

True Ribs (vertebrosternal)

A

Pairs 1-7
Attach directly to sternum via costal cartilage

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8
Q

False ribs

A

Pairs 8-10
Attach indirectly to the sternum

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9
Q

Floating ribs

A

Pairs 11-12
Only attach posteriorly to the thoracic vertebrae, not sternum (no neck or tubercle)

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10
Q

Important surface features of the typical ribs

A
  • head
  • neck
  • tubercle: both articular and non-articular parts
  • body (shaft): costal angle and costal groove
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11
Q

Head of the ribs

A

Demifacets: superior and inferior
*TYPICAL RIB ONLY

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12
Q

Intercostal spaces

A

Spaces btwn neighbouring ribs

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13
Q

Typical ribs

A

3rd-9th

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14
Q

Atypical ribs

A

1st, 2nd, 10-12th
Single/complete costal facets
Absent transverse costal facets (11th-12th)

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15
Q

Function of the ribs

A

Provide attachment points to muscles of the back, thorax and proximal upper limb
Protect thoracic organs such as heart and lungs

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16
Q

Costovertebral joint articular surfaces

A

Costal demifacets on vertebrae T1-T9, full costal facets on vertebrae T1, T10, T11, T12; heads of ribs 1-12

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17
Q

Costotransverse joint articular surfaces

A

Tubercle and transverse costal facets on transverse processes of ribs 1-10

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18
Q

Ligaments of costovertebral joint

A

Fibrous capsule
Radiate ligament of head
Intra-articular ligaments (only joints 2-9)

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19
Q

Ligaments of costotransverse joint

A

Fibrous capsule
Medial costotransverse ligament
Superior costotransverse
Lateral costotransverse ligaments

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20
Q

Movements of costovertebral joints

A

Internal rotation and elevation of head of rib (gliding)

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21
Q

Movements of costotransverse joints 1-6

A

Internal rotation of neck of rib

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22
Q

Movements of costotransverse joints 7-10

A

Posteromedial translation of neck of rib

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23
Q

Neurovasculature of the thoracic cage

A

V: Intercostal veins (ant and post)
A: Intercostal arteries (ant and post)
N: Intercostal nerves

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24
Q

Internal thoracic artery

A

O: subclavian artery
Branches: Musculophrenic artery, superior epigastric artery, upper 6 anterior intercostal arteries

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25
Q

Anterior intercostal arteries

A

Origin: Internal thoracic artery (upper 6), musculophrenic artery (lower 3)

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26
Q

Posterior intercostal arteries

A

Origin: Supreme intercostal artery (upper 2), thoracic aorta (lower 10)

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27
Q

Subcostal artery

A

Origin: Thoracic aorta

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28
Q

Anterior intercostal veins

A

Drain into: Internal thoracic vein (which drains into the brachiocephalic veins) via the Venae Comitantes of the internal thoracic artery

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29
Q

Posterior intercostal veins

A

Supreme intercostal vein drains into: Brachiocephalic vein
Right 4th-11th drain into: Azygos vein
Left 4th-11th drain into: Hemiazygos veins

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30
Q

Subcostal vein

A

Drains into: Azygos vein

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31
Q

Thoracic Nerves

A

Anterior rami of spinal nerves T1-T11: Intercostal nerves
Anterior ramus of spinal nerve T12: Subcostal nerve

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32
Q

External intercostal muscles

A

*most superficial; fibres course inferomedially
O: Inferior border of one rib
I: superior border of immediate rib below
A: elevate the ribs during forced inspiration
N: anterior rami of spinal nerves T1-T11, i.e., the intercostal nerves of the corresponding intercostal space.

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33
Q

Internal intercostal muscles

A

*middle layer; fibres course inferolaterally
O: costal groove of one rib
I: superior border of immediate rib below
A: depress ribs during forced expiration
N: same as external

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34
Q

Innermost intercostal muscles

A

*deepest; fibres course inferomedially
O: costal groove of one rib, posterior to origin of internal intercostals
I: superior border of immediate rib below
A: depress the ribs during forced expiration.
N: same

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35
Q

Transverse thoracic muscle

A

O: Inferoposterior surface of body of sternum and xiphoid process; sternal ends of costal cartilages of ribs 4-7
I: internal surface of costal cartilages of ribs 2-6
A: depressor of the ribs during forced expiration; Supports intercostal spaces and thoracic cage

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36
Q

Diaphragm origin

A
  • Sternal part: xiphoid process
    -Costal part: lower costal cartilages and ribs 7-12
    -Lumbar part: Medial and lateral arcuate ligaments, bodies of vertebrae L1-L3, anterior longitudinal ligament
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37
Q

Diaphragm Insertion

A

Central tendon of diaphragm

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38
Q

Openings of diaphragm

A
  • Aortic hiatus
  • Esophageal hiatus
  • Caval foramen
  • Openings for greater & lesser splanchnic nerves, and superior epigastric vessels
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39
Q

What travels through the aortic hiatus?

A

Aorta, azygos vein, thoracic duct

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40
Q

What travels through the esophageal hiatus?

A

Esophagus, branches of the left gastric artery and vein, anterior and posterior vagal trunks

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41
Q

What travels through the caval foramen?

A

Inferior vena cava, branches of the right phrenic nerve

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42
Q

Recesses of diaphragm

A
  • Costo-diaphragmatic recess (posteromedial)
  • Costo-mediastinal recess (anteromedial)
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43
Q

Innervation of diaphragm

A
  • Phrenic nerves (C3-C5)
  • Sensory innervation of peripheries via 6th-11th intercostal nerves
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44
Q

Blood supply to diaphragm

A
  • lowest 5 intercostal arteries
  • Subcostal arteries
  • Superior phrenic arteries
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45
Q

Function of diaphragm

A
  • Main muscle responsible for respiration
  • Increases abdominal pressure during defecation, vomiting, and voiding
  • Applies pressure on the esophagus to prevent acid reflux
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46
Q

Abdominal surface of diaphragm parts

A
  • Skeletal muscle (sternal, costal, and lumbar parts)
  • Central tendon
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47
Q

Musculotendinous structures of abdominal surface of diaphragm

A
  • Right and left crus of the diaphragm
  • Median, medial and lateral arcuate ligaments
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48
Q

The heart

A

A hollow, cone-shaped organ that is about the size of a person’s closed fist

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49
Q

Location of the heart

A
  • Located between the lungs in the mediastinum
  • Two thirds of the heart’s mass lies to the left of the body’s midline.
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50
Q

Apex of the heart

A

Lower, pointed end (4th-5th intercostal space at midclavicular line)

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51
Q

Base of the heart

A

Broader, upper portion (2nd inercostal space and 2nd-6th costal cartilages to the right of the midline)

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52
Q

Surfaces of the heart

A

i. anterior surface (deep to sternum)
ii. inferior surface (resting on diaphragm)
iii. right surface (faces the right lung)
iv. left surface (faces the left lung).

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53
Q

Surface projection

A

outlining the dimensions of an organ on the surface of the body

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54
Q

Surface projection of the heart to the anterior surface of chest

A

i. superior right point
ii. superior left point
iii. inferior right point
**those are base
iv. inferior left point (apex)

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55
Q

Pericardium

A

Sac that surrounds and protects the heart

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56
Q

Portions of the pericardium

A
  1. Fibrous pericardium
  2. Serous pericardium
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57
Q

Fibrous pericardium

A

*superficial
Tough, inelastic dense irregular connective tissue prevents overstretching of the heart, provides protection, and anchors the heart in the mediastinum

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58
Q

Serous pericardium

A

*deep
Thin delicate mesothelial membrane

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59
Q

Layers of the serous pericardium

A
  1. Outer parietal layer lines the inside of the fibrous pericardium
  2. Inner visceral layer adheres to the heart’s surface
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60
Q

Pericardial cavity

A

Contains pericardial fluid, a lubricating fluid that reduces friction between the membranes as the heart moves.

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61
Q

Layers of the heart wall

A

a. Outer epicardium
b. Middle myocardium
c. Innermost endocardium

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62
Q

Outer epicaridum

A

Visceral layer of serous pericardium

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63
Q

Middle myocardium

A

Composed of thick cardiac muscle tissue

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64
Q

Innermost endocardium

A

Composed of connective tissue covered by endothelium that is continuous with the endothelium of the blood vessels

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65
Q

Upper/receiving chambers

A
  • Right and Left atria
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66
Q

Auricle

A

Anterior pouch-like structure in the atria that allows them to hold a larger volume of blood; receive blood from major systemic (superior & inferior venae cavae) veins (right atrium) and pulmonary veins (left atrium).

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67
Q

Lower/pumping chambers

A

Right and left ventricles
Pump blood into systemic (aorta; left ventricle) and pulmonary (right ventricle) arteries

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68
Q

Pulmonary pump

A

Right atrium and right ventricle
Pumps deoxygenated blood towards the lungs

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69
Q

Systemic pump

A

Left atrium and left ventricle
Pumps oxygenated blood towards rest of the body

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70
Q

Three major sulci on surface of the heart

A

i. coronary sulcus (atrioventricular (AV) sulcus)
ii. anterior interventricular sulcus
iii. posterior interventricular sulcus

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71
Q

Where does the right atrium receive deoxygenated blood from?

A

Three veins
i. superior vena cava (SVC)
ii. inferior vena cava (IVC)
iii. coronary sinus

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72
Q

Superior vena cava

A

Brings blood from most parts of the body superior to the heart

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73
Q

Inferior vena cava

A

Brings blood from all parts of the body inferior to the diaphragm

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74
Q

Pectinate muscles (musculi pectinate)

A

Internal parallel ridges on anterior and lateral walls of the right atrium

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75
Q

Crista terminalis

A
  • Smooth muscular ridge in the superior portion of the right atrium
  • Divides the musculi pectinati and the right atrial appendage from the smooth surface of the right atrium
  • Provides anatomical separation of the orifices of the IVC and the Coronary sinus
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76
Q

Interatrial septum

A

separates the atria
has an oval depression (fossa ovalis)
Part of right atrium

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77
Q

Right atrioventricular valve (tricuspid valve)

A

How blood flows from right atrium into right ventricle
Consists of three cusps (or leaflets)

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78
Q

Trabeculae carnae

A

Irregular surface of ridges on the internal surface of the right ventricle

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79
Q

Chordae tendineae and papillary muscles

A

Located in right ventricle
Ensure that the cusps of the tricuspid valve permit blood to flow into the right ventricle but prevent backflow of blood into the right atrium

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80
Q

Interventricular septum

A

Separates the two ventricles

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81
Q

Pulmonary valve

A

Allow the right ventricle to pump blood into pulmonary trunk which divides into the right and left pulmonary arteries which carry blood to the lungs

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82
Q

How does the left atrium receive oxygenated blood?

A

Four pulmonary veins; a pair of two pulmonary veins (one superior and one inferior) drain blood from each lung

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83
Q

Atrioventricular valve (bicuspid valve)

A

Allows blood flow from left atrium into left ventricle (2 cusps)

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84
Q

Left ventricle

A

Forms apex of heart
Also has trabeculae carneae, chordae tendineae and papillary muscles to ensure that the cusps of the bicuspid valve permit blood to flow into the left ventricle but prevent backflow of blood into the left atrium.

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85
Q

Aortic valve

A

Allows oxygenated blood flow from the left ventricle to the ascending aorta

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86
Q

Right and left coronary arteries

A

Arise from ascending aorta
Deliver blood to walls of heart

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87
Q

Ascending aorta

A

continuous with the arch of the aorta, which is followed by the descending aorta (which consists of the thoracic aorta and the abdominal aorta).
Branches of the aorta deliver blood throughout the systemic circulation

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88
Q

Ligamentum arteriosum

A

Fibrous remnant of the fetal ductus arteriosus vessel
Attached to the left pulmonary artery near its root and the inferior part of the aortic arch

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89
Q

Myocardial wall thickness and function

A

Atria: thin bc they pump low pressure blood into adjacent ventricles.
Ventricles: thick bc they pump higher pressure blood greater distances; the wall of the left ventricle is much thicker than that of the right ventricle

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90
Q

Fibrous skeleton of the heart

A

Consists primarily of four dense connective tissue rings that surround the four heart valves:
a. right atrioventricular fibrous ring
b. left atrioventricular fibrous ring
c. pulmonary fibrous ring
d. aortic fibrous ring

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91
Q

Function of fibrous skeleton of heart

A

provides a structural foundation for the heart valves, helps prevent overstretching of the valves, forms point of insertion for cardiac muscle bundles, and electrically insulates the atria and ventricles to ensure proper action potential propagation.

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92
Q

Heart valves

A

Open and close in response to pressure changes as the heart contracts and relaxes

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93
Q

Valves that prevent backflow of blood into the heart

A

Two atrioventricular valves: Right= tricuspid, Left= bicuspid
Two semilunar vales: pulmonary and aortic

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94
Q

Coronary (cardiac) circulation

A

Flow of blood through the blood vessels that penetrate the myocardium

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95
Q

Left coronary artery

A

Divides into the anterior interventricular branch (left anterior descending (LAD) artery) and circumflex branch

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96
Q

Right coronary artery

A

Divides into the posterior interventricular branch (posterior descending artery (PDA)) and the marginal branch

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97
Q

Coronary sinus

A

Where blood draining out of the myocardium travels
Empties into the right atrium

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98
Q

Principal tributaries of the coronary sinus

A

i. great cardiac vein (accompanies the LAD artery)
ii. middle cardiac vein (accompanies the PDA artery)
iii. small cardiac vein (runs parallel to the inferior margin of the right side of the coronary/AV sulcus)
iv. anterior cardiac veins (runs along the right inferior margin of the Rt ventricle)

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99
Q

Autorhythmic cells

A

Act as a natural pacemaker to set the rhythm for contraction of the entire heart
Form the cardiac conduction system to conduct action potentials throughout the myocardium, ensuring that the cardiac chambers contract in a coordination manner

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100
Q

Components of the cardiac conduction system

A

a. sinoatrial (SA) node which initiates each heartbeat and thus is the heart’s natural pacemaker
b. atrioventricular (AV) node
c. atrioventricular (AV) bundle or bundle of His
d. right and left bundle branches
e. Purkinje fibers

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101
Q

Nervous system and pace of contractions

A

NV can increase or decrease pace of contractions but not initiate contraction

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102
Q

Cardiac plexus

A

Sympathetic and parasympathetic nerves
Sympathetic: stimulate increased heart rate and cause dilation of coronary arteries
Parasympathetic: decreases heart rate

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103
Q

Systemic circulation

A
  1. Left side of heart receives oxygenated blood from the lungs and pumps blood into the aorta which branches into smaller systemic arteries that can carry blood to organs
  2. Arteries branch into arterioles, then into systemic capillaries where nutrients, wastes, gases, etc. are exchanged between the blood and the surrounding cells.
  3. Capillaries merge to deliver deoxygenated (oxygen-poor) blood into systemic venules which merge to form systemic veins that carry this blood to the right atrium of the heart
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104
Q

Pulmonary circulation

A
  1. Right side of the heart receives deoxygenated blood returning from the systemic circulation and pumps it into the pulmonary trunk which branches into pulmonary arteries that carry blood to the right and left lungs
  2. In the lungs, the pulmonary capillaries are the site of gas exchange, and the blood becomes oxygenated
  3. The oxygenated blood flows into pulmonary veins and returns to the left atrium
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105
Q

Mediastinum

A

Separates lungs into two distinct chambers

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106
Q

Pleural membrane and layers

A

Encloses and protects each lung
Two layers
1. Superficial parietal pleura: lines wall of thoracic cavity
2. Deeper visceral pleura: adheres to the lungs

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107
Q

Pleural cavity

A

Btwn the two pleurae
Contains a lubricating fluid secreted by the membranes

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108
Q

Lungs

A

Base: inferior portion
Apex: narrow superior portion

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109
Q

Surfaces of the lungs

A
  • Costal surface
  • Mediastinal (medial) surface
  • Diaphragmatic
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110
Q

Costal surface of the lungs

A

lies against the ribs

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111
Q

Mediastinal surface of the lungs

A

Contains the hilum through which bronchi, pulmonary blood vessels, lymphatic vessels, and nerves enter and exit the lung

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112
Q

Cardiac notch

A

Found on medial surface of left lung
Heart rest against it

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113
Q

Left lung lobes

A

Superior (upper) lobe and Inferior (lower) lobe
Separated by oblique fissure

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114
Q

Right lung lobes

A

Superior and inferior lobe separated by upper part of oblique fissure
Inferior lobe and middle lobe separated by lower part of oblique fissure
Middle lobe bordered superiorly by horizontal fissure

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115
Q

Right main bronchus

A

Divides into the superior, middle, and inferior lobar (secondary) bronchi
Supplies lobes of right lung

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116
Q

Left main bronchus

A

Divides into the superior and inferior lobar (secondary) bronchi
Supply lobes of left lung

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117
Q

Lobar bronchi

A

Secondary bronchi

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118
Q

Conducting zone

A

Trachea
Main bronchi
Lobar(secondary bronchi)
Segmental (tertiary bronchi)
Bronchioles

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119
Q

Respiratory zone

A

Respiratory bronchioles
Alveolar ducts
Alveolar saccules

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120
Q

Segmental (tertiary) bronchi

A

Lobar bronchi divide into these in each lung
They supply air to the bronchopulmonary segments of each lung.

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121
Q

Lobules

A

lung unit distal to the respiratory bronchioles
composed of alveolar ducts, alveolar saccules and pulmonary alveoli

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122
Q

Respiratory bronchiole

A

divides into several alveolar ducts

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123
Q

Alveolar ducts

A

Each one terminates in a cluster of about 100 numerous alveolar saccule and pulmonary alveoli.

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124
Q

Alveolar saccule

A

terminal dilation of an alveolar duct and is composed of about 20–30 outpouchings called pulmonary alveoli.

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125
Q

Pulmonary alveolus

A

cup-shaped outpouching lined by simple squamous epithelium and supported by a thin elastic basement membrane

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126
Q

Bronchopulmonary segment

A

Compartments of each lung (usually 10)
Each one is supplied by a tertiary/segmental bronchus

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127
Q

Blood supply to the lungs

A

Pulmonary arteries and bronchial arteries

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128
Q

Pulmonary arteries and veins

A

Pulmonary trunk splits into left and right pulmonary arteries which deliver deoxygenated blood to the lungs
Oxygenated blood is returned to the heart by four pulmonary veins (right and left superior and inferior pulmonary veins) which drain into the left atrium

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129
Q

Bronchial arteries

A

Branch from the aorta and deliver oxygenated blood to the bronchi and bronchioles

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130
Q

Innervation of the lungs

A

Pulmonary plexus formed by branches of vagus nerve and sympathetic trunks

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131
Q

Inhalation

A

Process of moving air into lungs
Occurs when alveolar pressure is lower than atmospheric pressure
Expanding lungs increases volume and decreases pressure

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132
Q

Muscles of inhalation

A
  1. Diaphragm (CONTRACTS DOWNWARDS)
  2. External intercostal muscles
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133
Q

Exhalation

A

Process of moving air out of lungs
Increased alveolar pressure due to decreased volume of thoracic cavity and lungs

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134
Q

Forced expiration (labored breathing)

A

involves the contractions of abdominal and internal intercostals muscles.

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135
Q

Mediastinum

A

A compartment of the thorax located in the midline of the body, that contains most of the thoracic viscera, apart from the lungs

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136
Q

Borders of the mediastinum

A

Superior: Thoracic inlet
Inferior: Diaphragm
Anterior: Sternum and costal cartilages of 1st-5th ribs
Posterior: Vertebral bodies of superior thoracic vertebrae
Lateral: Parietal pleura of each lung

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137
Q

The thoracic plane (of Ludwig)

A

Imaginary line extending from the sternal angle, anteriorly, to the T4-T5 intervertebral space, posteriorly
Divides the mediastinum into superior and inferior mediastinal divisions

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138
Q

Inferior division of mediastinum

A

further subdivided into anterior, middle, and posterior compartments by the pericardial sac

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139
Q

Anterior mediastinum

A

Posterior to the body of the sternum and anterior to the pericardium

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140
Q

Middle mediastinum

A

bounded by the pericardium, which encloses the heart and origins of the great vessels

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141
Q

Posterior mediastinum

A

posterior to the pericardium and anterior to the vertebrae

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142
Q

Pericardial sac

A

Structures located anterior to the pericardial sac belong to the anterior mediastinum
Structures located posterior to pericardial sac= posterior mediastinum.
Structures located in and around the pericardial sac= middle mediastinum

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143
Q

Structures that course longitudinally through the superior and inferior mediastinum

A

esophagus, azygos veins and vagus and phrenic nerves

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144
Q

Esophagus

A

courses longitudinally throughout the mediastinum, posterior to the trachea and main bronchi and anteromedial to the azygos vein.

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145
Q

Lymphatics of mediastinum

A

Most of the mediastinal organs drain into the thoracic duct
EXCEPT: the right side of the thorax with the right side of the head drains into the right lymphatic trunk

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146
Q

Contents of the superior mediastinum

A

Thymus, trachea, superior part of superior vena cava, aortic arch and its branches (brachiocephalic trunk, left common carotid artery and left subclavian artery), esophagus, vagus and phrenic nerves.

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147
Q

Contents of the anterior mediastinum

A

Remnants of the thymus

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148
Q

Contents of middle mediastinum

A

Pericardial sac and heart
Roots of superior and inferior vena cava
Pulmonary trunk, pulmonary arteries, and pulmonary veins
Root of aorta
Main bronchi
Phrenic nerves

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149
Q

Contents of posterior mediastinum

A
  • Descending thoracic aorta and its branches.
  • Azygos veins and hemiazygos venous systems
  • Esophagus and esophageal plexus
  • Thoracic duct & cisterna chyli
  • Vagus nerves (left & right)
  • Sympathetic trunk; greater and lesser splanchnic nerves
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150
Q

Function of abdominal wall

A
  • Protection of the internal abdominal organs
  • Stabilization and rotation of the trunk
  • Increase of intra-abdominal pressure (involved in coughing, defecating, vomiting)
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151
Q

Layers of the abdominal wall

A

From superficial to deep:
- Skin
- Superficial fascia
- Muscles
- Transversalis fascia
- Extraperitoneal fat (extraperitoneal fascia)
- Peritoneum

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152
Q

Two main sections of the abdominal wall

A

Anterolateral wall and posterior abdominal wall

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153
Q

Anterolateral abdominal wall main layers

A

Four main layers
1. Skin
2. Superficial fascia
3. Muscles and associated fascia
4. Parietal peritoneum

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154
Q

Posterior abdominal wall

A

Formed by the lumbar vertebrae, pelvic girdle, posterior abdominal muscles and their associated fascia

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155
Q

Muscles of the anterolateral abdominal wall

A
  1. Lateral flat muscle group: external oblique, internal oblique and transversus abdominis
  2. Anterior vertical muscles: rectus abdominus
156
Q

Muscles of the posterior abdominal wall

A

Psoas major and minor muscles
Iliacus muscle
Quadratus lumborum muscle

157
Q

External oblique

A

*outermost muscle; fibres run inferomedially
O: 5th-12th rib (connected w serratus ant and lats)
I: anterior layer of rectus sheath

158
Q

Internal oblique

A

*beneath external oblique; fibres run superomedially
O: thoracolumbar fascia, iliac crest and iliopectineal arch
I: lower costal cartilages and linea alba
*In men, caudal fibres extend to te spematic cord and merge to form the cremaster muscle

159
Q

Semilunar lines

A

Lateral margins of rectus abdominis muscle
Formed by divisions of internal oblique
Extend from the tip of the 9th costal cartilage to the pubic tubercle.

160
Q

External oblique aponeurosis

A

Extends medially to the linea alba and caudally to the iliac crest and the pubic bone
Its inferior margin forms the inguinal ligament

161
Q

Transverse abdominus

A

*deepest; fibres run horizontally
O: inner surface of the lower costal cartilages, thoracolumbar fascia, iliopectineal arch and iliac crest
I: Linea alba
*caudal fibers are also involved in the formation of the cremaster muscle

162
Q

Transversalis fascia

A

separates the anterior abdominal wall from the extraperitoneal fat
Posteriorly it is continuous with the thoracolumbar fascia

163
Q

Rectus sheath

A

Formed by the aponeurosis of the three lateral abdominal muscles
Divided into anterior and posterior layers

164
Q

Posterior layer of rectus sheath

A

Superior three quarters of the sheath
Inferior limit=arcuate line
Consists of aponeuroses of the internal oblique and transversus abdominis muscles

165
Q

Arcuate line

A

where the inferior epigastric artery and vein perforate the rectus abdominis

166
Q

Anterior layer of rectus sheath

A

Above arcuate line
Consists of the aponeuroses of the internal and external oblique,

167
Q

Rectus abdominus

A

Fibres run vertically, separated by linea alba
Consists of a string of four fleshy muscular bodies connected by three narrow bands of tendon (tendinous intersections) *six pack
O: Pubic symphysis, pubic crest
I: xiphoid process, costal cartilage of ribs 5-7

168
Q

Arteries of the anterolateral abdominal wall

A
  • Internal thoracic artery and its branches (musculophrenic artery, superior epigastric artery)
  • 10th and 11th posterior intercostal arteries and subcostal arteries
  • Inferior epigastric artery (branch of External Iliac artery)
  • Deep and superficial circumflex iliac arteries
169
Q

Arteries of the posterior abdominal wall

A
  • Abdominal aorta and its branches: subcostal artery, inferior phrenic artery and lumbar arteries
170
Q

Veins of the anterolateral abdominal wall

A
  • Superior and inferior epigastric veins
  • Thoracoepigastric vein
  • Subcostal vein
171
Q

Veins of the posterior abdominal wall

A
  • Inferior vena cava and its tributaries: inferior phrenic veins, lumbar veins, and common iliac veins
172
Q

Nerves of the anterolateral abdominal wall

A

Thoracoabdominal nerves
Lateral cutaneous branches of intercostal nerves 7-11, and subcostal nerves
Iliohypogastric and ilioinguinal nerve (L1)

173
Q

Innervation of the skin and peritoneum of the anterolateral wall

A

T7 to L1 spinal nerves

174
Q

Innervation of muscles of the anterior abdominal wall

A

Lower six thoracic nerves, the iliohypogastric nerve and the ilioinguinal nerve

175
Q

Nerves of the posterior abdominal wall

A

Aortic and periarterial nervous plexuses (Autonomic nervous plexsuses)

176
Q

What is the largest serous membrane in the body?

A

Peritoneum

177
Q

Two main layers of the peritoneum

A
  1. Parietal peritoneum: lines the wall of the abdominopelvic cavity
  2. Visceral peritoneum (serosa): covers some of the abdominal organs
178
Q

Peritoneal cavity

A

Located btwn the layers of the peritoneum
contains lubricating serous fluid

179
Q

Intraperitoneal

A

The structures that are almost completely enveloped by visceral peritoneum and attach to the abdominal walls by a mesentery

180
Q

Intraperitoneal structures

A

Liver (except at the bare area)
spleen
stomach
first part and fourth part of the duodenum
jejunum
ileum
cecum
vermiform appendix
transverse colon
sigmoid colon

181
Q

Retroperitoneal

A

Structures that lie between the parietal peritoneum and posterior abdominal wall
Not supported by a mesentery
Have a layer of parietal peritoneum resting on their anterior surface

182
Q

Retroperitoneal structures

A

2nd, 3rd parts of the duodenum
pancreas (except tail)
ascending colon and descending colon
suprarenal (adrenal) glands
kidneys
ureters
upper rectum
aorta and IVC

183
Q

Major folds of the peritoneum

A
  1. Greater omentum
  2. Falciform ligament
  3. Lesser omentum
  4. Mesentery
  5. Mesocolon
184
Q

Function of the major folds of the peritoneum

A

a. bind viscera of the gastrointestinal tract to each other and to the walls of the abdominal cavity
b. contain blood vessels, lymphatic vessels, and nerves that supply the abdominal organs

185
Q

Greater omentum

A

“fatty apron” in front of the abdominal viscera
extending from the greater curvature of the stomach and the duodenum downward anterior to the small intestine

186
Q

Falciform ligament

A

attaches the liver to the anterior abdominal wall and diaphragm

187
Q

Lesser omentum

A

Suspends the stomach and duodenum from the liver and is a pathway for blood vessels entering the liver

188
Q

Contents of the lesser omentum

A

Hepatic portal vein, common hepatic artery, and the common bile duct, along with some lymph nodes

189
Q

Mesentery

A

Largest peritoneal fold
Binds the jejunum and ileum of the small intestine to the posterior abdominal wall
Forms a double-layered structure at its origin
Between the two layers are blood vessels, lymphatic vessels, and lymph nodes associated with the jejunum and ileum

190
Q

Mesocolon

A

Two folds
1. Binds transverse colon to the posterior abdominal wall (transverse mesocolon)
2. Binds the sigmoid colon to the posterior abdominal wall (sigmoid mesocolon)

191
Q

Four main regions of the stomach

A
  1. Cardia; opening of the esophagus into the stomach
  2. Fundus
  3. Body
  4. Pyloric part
192
Q

Three main regions of the pyloric part of the stomach

A

a. pyloric antrum: connects to the stomach’s body
b. pyloric canal: leads to the pylorus
c. pylorus :leads to the duodenum

193
Q

Gastric folds (gastric rugae)

A

Folding of the stomach mucosa
Allow stomach to accommodate food

194
Q

Pyloric sphincter

A

Controls movement of chyme from stomach to duodenum

195
Q

Lesser curvature of the stomach

A

concave medial border

196
Q

Greater curvature of the stomach

A

convex lateral border

197
Q

Arterial supply of lesser curvature of stomach

A

Left gastric (branch of celiac)
Right gastric (branch of hepatic proper)

198
Q

Arterial supply of greater curvature of stomach

A

Left and right gastro-omental arteries
Left = branch of splenic artery
Right = branch of gastroduodenal artery

199
Q

Venous supply of stomach

A

All same names as arteries
Drain into hepatic portal vein

200
Q

Arterial supply of the fundus and body of the stomach

A

Short gastric and posterior gastric arteries (branches of splenic)

201
Q

Parasympathetic innervation of stomach

A

vagus

202
Q

Sympathetic innervation of stomach

A

celiac ganglia

203
Q

Small intestine

A

site of most digestion and almost all absorption of nutrients
extends from the pyloric sphincter to the large intestine.

204
Q

Three regions of small intestine

A
  1. Duodenum
  2. Jejunum
  3. Ileum
205
Q

Duodenum

A

C- shape tube that starts at pyloric sphincter of stomach and merges with the jejunum

206
Q

Parts of the duodenum

A
  • Superior limb: connects w pylorus of stomach; intraperitoneal
  • Descending limb: contains a major and minor duodenal papilla that receive the terminal ends of the main pancreatic duct and the common bile duct; retroperitoneal
  • Inferior limb: retroperitoneal
  • Ascending limb: empties into jejunum; retroperitoneal
207
Q

Jejunum and ileum

A

Jejunum= Left upper quadrant of the abdominal cavity
Ileum= right lower quadrant
Jejunum begins at the duodenojejunal flexure and ileum ends at the ileocecal junction
*no clear demarcation separating the two

208
Q

Arterial arcades

A

Anastomoses of the jejunal and ileal arteries which are branches of superior mesenteric artery.

209
Q

Vasta recta

A

Straight capillaries coming off from arcades

210
Q

Blood supply to jejunum and ileum

A

Superior mesenteric artery

211
Q

Vasta recta and arterial arcades of jejunum

A

Long vasa recta and single raw arterial arcades in its mesentary

212
Q

Vasta recta and arterial arcades of ileum

A

vasa recta that are short and arterial arcades that are numerous but very short

213
Q

Ileal orifice

A
  • Smooth muscle sphincter where ileum joins the large intestine
  • allows chyme from the ileum to enter the cecum
214
Q

Innervation of small intestine

A

Via superior mesenteric plexus
branches of the plexus contain postganglionic sympathetic fibers, preganglionic parasympathetic fibers, and sensory fibers (which are both vagal and of spinal nerves).

215
Q

Three principle regions of the large intestine

A
  1. Cecum
  2. Colon
  3. Rectum (terminates in anal canal)
216
Q

Cecum

A

small blind pouch in the lower right portion of the abdominal cavity; intraperitoneal (lacks mesentery)

217
Q

Appendix (vermiform appendix)

A

Attached to cecum

218
Q

Mesoappendix

A

attaches the appendix to the inferior part of the mesentery of the ileum

219
Q

Four segments of the colon

A
  1. Ascending colon
  2. Transverse colon
  3. Descending colon
  4. Sigmoid colon
220
Q

Ascending colon

A

Ascends on the right side of the abdominal cavity to the right colic (hepatic) flexure; retroperitoneal

221
Q

Transverse colon

A

Travels horizontally to the left colic (splenic) flexure; intraperitoneal

222
Q

Descending colon

A

Descends on the left side of the abdominal cavity to the level of the iliac crest; retroperitoneal

223
Q

Sigmoid colon

A

Travels medially from the left iliac crest to the level of the third sacral vertebra; intraperitoneal

224
Q

Rectum

A

Descends anterior to the sacrum and coccyx; terminates at anal canal

225
Q

Anus

A

Opening to the exterior

226
Q

Anal sphincters

A
  1. Internal anal sphincter: smooth muscle tissue (involuntary)
  2. external anal sphincter: skeletal muscle tissue (voluntary)
227
Q

Branches of the superior mesenteric artery

A

Right colic artery
Middle colic artery
Ileocolic artery

228
Q

Branches of the inferior mesenteric artery

A

Left colic artery
Sigmoid arteries
Superior rectal artery

229
Q

Blood supply to ascending colon

A

right colic and ileocolic arteries

230
Q

Blood supply to the transverse colon

A

middle colic artery

231
Q

Blood supply to the descending colon

A

the left colic artery

232
Q

Blood supply to the sigmoid colon

A

Sigmoid arteries

233
Q

Liver

A

Heaviest gland of the body and the largest internal organ of the body

234
Q

Location of the liver

A

Located under the diaphragm in the upper right quadrant of the abdominal cavity between vertebral levels T7-L2

235
Q

Surfaces of the liver

A

Diaphragmatic surface: convex
Visceral surface: flat concave

236
Q

Visceral surface of liver

A

Covered with visceral peritoneum except at the porta hepatis and gallbladder fossa

237
Q

Ligaments of the liver

A

Falciform ligament
Ligamentum teres
Coronary ligament

238
Q

Porta hepatis

A

passage for structures to pass to and from the liver
Structures are the Portal triad: the hepatic portal vein, hepatic arteries and common bile duct

239
Q

Gallbladder fossa

A

where the gallbladder rests against the liver

240
Q

Principal lobes of the liver

A

Right lobe (large)
Left lobe (small)

241
Q

Left lobe of liver

A

Inferior quadrate lobe
Posterior caudate lobe

242
Q

Falciform ligament

A

Separates right and left lobes of the liver

243
Q

Ligamentum teres

A

Free border of the falciform ligament
Extends from liver to the umbilicus (remnant of the umbilical vein)

244
Q

Common hepatic duct

A

Formed by the union of the right and left hepatic ducts
Carries bile from the liver

245
Q

Common bile duct

A

Formed by the merging of the common hepatic duct and the cystic duct from the gallbladder
Drains bile into the descending limb of the duodenum

246
Q

Hepatic artery

A

provides oxygenated blood to the hepatic sinusoids.

247
Q

Hepatic portal vein

A

delivers deoxygenated blood into the hepatic sinusoids

248
Q

Parasympathetic innervation of liver

A

vagus

249
Q

Sympathetic innervation of liver

A

Greater splanchnic nerves via celiac ganglia

250
Q

Gallbladder

A

Pear shaped sac in a depression of the inferior surface of the right lobe of the liver

251
Q

Parts of the gallbladder

A
  1. fundus
  2. body
  3. infundibulum
  4. neck
252
Q

Blood supply of gallbladder

A

cystic artery (arises from the right hepatic artery)
blood drains into cystic veins

253
Q

Innervation of gallbladder

A

branches from the celiac plexus and the vagus (X) nerves

254
Q

Pancreas

A

Located posterior to greater curvature of the stomach; retroperitoneal

255
Q

Four main regions of the pancreas

A
  1. Head: contains uncinate process
  2. Neck
  3. Body
  4. Tail
256
Q

Ducts formed by the pancreas

A
  1. Pancreatic duct: joins the bile duct from the liver and gallbladder to form the hepatopancreatic ampulla (ampulla of Vater)
  2. Accessory duct: empties into the duodenum
257
Q

Hepatopancreatic ampulla

A

Enters the duodenum at the major duodenal papilla (below the pyloric sphincter)

258
Q

Blood supply of pancreas

A

Superior and inferior pancreaticoduodenal arteries, splenic and superior mesenteric arteries
Blood drains into veins of the same name and eventually into the hepatic portal vein.

259
Q

Innervation of pancreas

A

Autonomic nerves from celiac and superior mesenteric plexuses; includes preganglionic vagal, postganglionic sympathetic, and sensory fibers

260
Q

Urinary system

A
  1. two kidneys
  2. two ureters
  3. One urinary bladder
  4. One urethra
261
Q

Location of the kidneys

A

Above the waist between the peritoneum and the posterior abdominal wall (retroperitoneal)
Btwn T12- L3, on the Left side
Btwn L1-L4 on right side (slightly lower)

262
Q

Hilum of the kidney (renal hilum)

A

Ureter, blood vessels, lymphatic vessels and nerves pass through it

263
Q

Three layers of protecting tissue around the kidney

A
  1. Inner renal capsule: dense irregular CT; protects kidney
  2. Intermediate perirenal fat capsule
  3. Outer renal fascia: dense irregular CT that anchors kidney to surrounding structures and to abdominal wall
264
Q

Two distinct regions of the kidney

A
  1. Outer light red layer (renal cortex)
  2. Inner dark red-brown region (renal medulla)
265
Q

Renal medulla

A
  • contains renal pyramids whose apexes are called renal papillae
266
Q

Renal columns

A

portions of the renal cortex that extend btwn the renal pyramids

267
Q

Renal lobe

A

portion of a kidney consisting of a renal pyramid and the renal cortex above it

268
Q

Nephrons

A

Functional units of the kidney that produce urine

269
Q

Path of filtrate

A
  1. Produced from nephron
  2. Drains into papillary ducts
  3. Drains into minor calyces
  4. Minor calyces merge to form major calyces
  5. Major calyces deliver urine to renal pelvis
  6. Urine exits kidney by flowing into a ureter
270
Q

Renal sinus

A

Cavity in the kidney that accommodates the renal pelvis, renal calyces, neurovasculature and fat

271
Q

Blood flow through kidneys

A
  1. Right and left renal arteries
  2. Right and left renal veins (each exits at the renal hilum)
272
Q

Innervation of kidney

A

Celiac and aorticorenal ganglia and renal plexus of the sympathetic part of the ANS
Parasympathetics have little to no effect on the kidney.

273
Q

Function of ureters

A

transport urine into the urinary bladder

274
Q

How is transport of urine into the bladder accomplished?

A

i. peristaltic waves
ii. hydrostatic pressure
iii. gravity

275
Q

How do the ureters attach to the bladder?

A

Enter the base of the urinary bladder medially at an oblique angle from the posterior aspect
Physiological valves prevent backflow of urine

276
Q

Blood supply to the ureters

A

renal arteries, testicular or ovarian arteries, common iliac artery, and inferior vesical arteries; blood drains into the corresponding veins

277
Q

Innervation of ureters

A

Renal plexus
- Sympathetic: lesser and lumbar splanchnic nerves
T10-L1

278
Q

Urinary bladder

A

a hollow, distensible muscular organ (held in place by folds of the peritoneum) located in the pelvic cavity posterior to the pubic symphysis

279
Q

Location of urinary bladder depending on gender

A

males: anterior to the rectum
females: anterior to the vagina and inferior to the uterus

280
Q

Trigone

A

Small triangular area on floor of bladder
Two posterior corners: ureteral openings
Anterior corner: the internal urethral orifice

281
Q

Layers of the wall of the urinary bladder

A
  1. Inner mucosa
  2. Intermediate detrusor muscle
  3. Outer layer
282
Q

Intermediate detrusor muscles of the bladder

A

a. inner longitudinal layer
b. middle circular layer
c. outer longitudinal layer

283
Q

Inner mucosa of the bladder

A

Urothelium lying over lamina propria; allows bladder to continually inflate and deflate to accommodate varied urine volumes

284
Q

Outer layer of bladder

A

Adventitia on posterior and inferior surfaces
Serosa on superior surface

285
Q

Urethral sphincters

A
  1. Internal urethral sphincter: opening of urethra in bladder
  2. External urethral sphincter: inferior
286
Q

Micturition (urination)

A

Stimulation of stretch receptors by urine initiates nerve impulses to micturition centre which in turn initiates a parasympathetic spinal micturition reflex

287
Q

Parasympathetic spinal micturition reflex

A

contraction of the detrusor muscle and relaxation of the internal urethral sphincter; simultaneous somatic relaxation of the external urethral sphincter occurs

288
Q

Blood supply of bladder

A

the superior, middle, and inferior vesical arteries; blood drains into the internal iliac vein.

289
Q

Innervation of urinary bladder

A

hypogastric sympathetic plexus and partly from the second and third sacral nerves (pelvic parasympathetic splanchnic nerve).

290
Q

Urethra

A

small tube leading from the internal urethral orifice in the floor of the urinary bladder to the exterior

291
Q

Location of urethra in females

A

posterior to the pubic symphysis and embedded in the anterior wall of the vagina; leads to the external urethral orifice, which is located between the clitoris and vaginal opening

292
Q

Layers of the wall of the female urethra

A
  1. Deep mucosa: epithelium and lamina propria
  2. Superficial muscular layer: continuous with that of the urinary bladder and consists of circularly arranged smooth muscle fibers; transports urine only
293
Q

Regions of the male urethra

A
  1. Prostatic urethra: passes through prostate
  2. Intermediate (membranous) urethra: passes through deep perineal muscles
  3. Spongy urethra: passes through penis
294
Q

Layers of the wall of the male urethra

A
  1. Deep mucosa: epithelium and lamina propria
  2. Superficial muscular layer
295
Q

The greater (false) pelvis

A

Extends from the ASIS to the pubic symphysis
Considered part of abdomen

296
Q

The lesser (true) pelvis

A

Between the pelvic inlet and the pelvic outlet (a plane between inferior aspect of pubic symphysis and tip of coccyx)
Bounded by the pelvic surfaces of the hip bones, sacrum and coccyx
Contains and supports elements of the urinary, GI and reproductive systems

297
Q

Pelvic inlet

A

Bounded by linea terminalis

298
Q

Linea terminalis

A

Formed by:
1. Pubic symphysis
2. Pubic crest
3. Pectineal line (superior ramus of pubis)
4. Arcuate line of ilium

299
Q

Posterior continuum of linea terminalis

A

Ala of the sacrum (anterior border)
Sacral promontory

300
Q

Pelvic inclination

A

The angle that the plane of the pelvic inlet forms with the horizontal plane

301
Q

Pelvic outlet

A

Bounded by:
- pubic symphysis (inferior margin)
- inferior rami of pubis and ischial tuberosities
- sacrotuberous ligaments
- tip of coccyx

302
Q

Pelvic diaphragm

A

Consists of levator ani and coccygeus muscles

303
Q

Levator ani muscles

A

O: pubic bone, the tendinous arch of the levator ani muscle, and the ischial spine
Fibres divide into:
i. The puborectalis muscle.
ii. The pubococcygeal (pubococcygeus) muscle.
iii. The iliococcygeal (iliococcygeus) muscle

304
Q

Openings of the pelvic diaphragm

A
  1. Urogenital hiatus: urethra and genital canal pass through
  2. Rectal hiatus: rectum passes through
305
Q

Insertion of Puborectalis

A

Some fibres form external anal sphincter
Some fibres form a retrorectal sling behind rectum

306
Q

Insertion of pubococcygeal and the iliococcygeal muscles

A

Either on anococcygeal ligament or directly onto the coccyx

307
Q

Coccygeus muscle

A

O: tendon from the ischial spine
I: Coccyx

308
Q

Function of levator ani

A

Resists intra-abdominal pressure
Bears weight of pelvic contents
Closure of rectum

309
Q

Innervation of pelvic diaphragm

A

The Sacral plexus (S2-S4) (via the pudendal nerve)

310
Q

Ligaments of the pelvic wall

A
  • sacrospinous
  • sacrotuberous
311
Q

Functions of the ligaments of the pelvic wall

A

they stabilize the sacrum on the pelvic bones by resisting the upward tilting of the inferior aspect of the sacrum

312
Q

Sacrospinous ligament

A

Apex: attached to the ischial spine
Base: sacrum and the coccyx

313
Q

Sacrotuberous ligament

A

Superficial to sacrospinous
Base: attached iliac spine, sacrum and coccyx
Apex: attached to ischial tuberosity

314
Q

Greater sciatic foramen

A

superior to the sacrospinous ligament and the ischial spine

315
Q

Lesser sciatic foramen

A

inferior to the ischial spine and sacrospinous ligament between the sacrospinous and sacrotuberous ligaments.

316
Q

Obturator canal

A

Bordered by obturator membrane, obturator muscles, and the superior pubic ramus
The obturator nerve and vessels pass from the pelvic cavity to the thigh through this

317
Q

Muscles of the pelvic wall

A

Lateral walls: Obturator internus and piriformis

318
Q

Hip bone

A
  1. Pubis
  2. Ilium
  3. Ischium
    *synostose in acetabular fossa
319
Q

Pubic bone

A
  1. Body
  2. Superior ramus
  3. Inferior ramus
320
Q

Illium

A
  1. Body
  2. Iliac wing
321
Q

Ischium

A
  1. Body
  2. Ramus
322
Q

Ischial spine

A

separates the greater sciatic notch from the lesser sciatic notch

323
Q

Perineum

A

diamond-shaped area that’s divided into the urogenital triangle anteriorly and the anal triangle posteriorly

324
Q

Urogenital triangle

A

Bounded posteriorly by the interischial line

325
Q

Perineal membrane

A

a sheet of fibrous tissue and has thickened attachments along the borders of the urogenital triangle; also known as inferior fascia of urogenital diaphragm

326
Q

Muscles contained within the perineal membrane

A
  1. the Bulbospongiosus (medially)
  2. the Ischiocavernosus (laterally)
  3. the Transversus perineal muscles (superficial & deep) (posteriorly)
327
Q

Innervation of the muscles within the perineal membrane

A

Pudendal nerves (sacral plexus)

328
Q

Anal triangle

A

Borders laterally on the ischiorectal fossa.

329
Q

Ischiorectal fossa

A

Located between the urogenital diaphragm and the pelvic diaphragm
Contains abdominal fat, pudendal artery, vein and nerve, and the inferior rectal nerve and artery

330
Q

Inferior rectal nerve and artery

A

Supply the anal canal and external anal sphincter

331
Q

Perineal body

A

Fibromuscular mass located in the middle of the interischial line, btwn the two triangles

332
Q

Muscles attached to the perineal body

A

i. The external anal sphincter
ii. Bulbospongiosus
iii. The transverse perineal muscles

333
Q

Testis

A

Paired, ellipsoid-shaped structure located in the scrotum for sperm production

334
Q

Epididymis

A

Firm, highly coiled tube attached to the posterior surface of each testis

335
Q

Parts of the epididymis

A
  1. Head
  2. Body
  3. Tail; continuous with ductus deferens (vas deferens)
336
Q

Function of epididymis

A

Facilitate the maturation of spermatozoa

337
Q

Spermatic cord

A

Formed by the ductus deferens and surrounding neurovasculature

338
Q

Ejaculatory duct

A

Formed by the ductus deferens and the duct of the seminal vesicles

339
Q

Male Urethra

A

Expels urine and sperm

340
Q

Three major accessory glands of the male reproductive system

A
  1. Seminal vesicles
  2. Prostate glands
  3. Bulbourethral glands
341
Q

Parts of the penis

A
  1. Root: conatins bulb of penis and the paired crus of penis
  2. Body: consists of three erectile tissues
  3. Glans
342
Q

Erectile tissues of the body of the penis

A
  • Unpaired corpus spongiosum
  • paired corpus cavernosa
343
Q

Location of the vagina

A

Extends from uterus to vulva
Posterior to urinary bladder
Anterior to rectum

344
Q

Upper end of vagina

A

Attached to cervix of uterus
Form a pouch (vaginal fornix)

345
Q

Lower end of the vagina

A

Vaginal orfice
Opens into the vaginal vestibule

346
Q

Blood supply of the vagina

A

Branches of the internal iliac artery; uterine, vaginal, and internal pudendal arteries.

347
Q

Innervation of the vagina

A

Inferior hypogastric plexus (Lesser splanchnic (T12-L1) and pelvic splanchnic nerves (S2-S4))

348
Q

Parts of the uterus

A
  1. Body
  2. Fundus
  3. Cervix
349
Q

Body of the uterus

A

Connected to the uterine (fallopian) tubes
Base is the fundus
Internal chamber is the uterine cavity

350
Q

Peritoneal pouches of the female pelvis

A
  1. Rectouterine pouch (of Douglas) ANT
  2. Vesicouterine pouch (uterovesical pouch) POST
351
Q

What covers the uterus?

A

Peritoneum

352
Q

Peritoneal ligaments of the uterus

A
  • Broad ligament (mesometrium and mesovarium)
  • Round ligament
353
Q

Blood supply of the uterus

A

Uterine artery which arises from the internal iliac artery

354
Q

Normal pelvic orientation of the uterus

A

Anteverted anteflexed posture

355
Q

Abnormal pelvic orientation

A

Retroverted retroflexed

356
Q

Anal coloumns

A

Series of longitudinal ridges on the superior portion of the rectum

357
Q

Anorectal junction

A

Border btwn rectum and anal canal
Formed by superior ends of anal columns

358
Q

Anal valves

A

Join the inferior ends of the anal columns

359
Q

Anal sinuses

A

Recesses superior to anal valves

360
Q

The pectinate (dentate) line

A

Indicates the junction of the superior part and inferior part of the anal canal

361
Q

Innervation of the internal anal sphincter

A

Autonomic fibres of the rectal plexus

362
Q

Innervation of external anal sphincter

A

Inferior rectal nerve (branch of pudenal)

363
Q

Blood supply of the rectum

A

Superior to pectinate line: superior rectal artery (branch of inferior mesenteric)
Inferior to pectinate line: inferior rectal artery

364
Q

Middle rectal artery

A

Forms an anastomosis with the superior and inferior rectal arteries resulting in redundant blood supply.

365
Q

Venous drainage origin of rectum

A

External rectal and internal rectal venous plexuses

366
Q

Venous drainage of rectum

A

Above the pectinate line: portal system
Below the pectinate line: caval system (IVC)

367
Q

Anal canal origin

A

Where the ampulla of the rectum narrows at the level of the U-shaped sling called the anorectal flexure

368
Q

Puborectalis muscle

A

Maintains the anorectal flexure in resting state and via active contraction

369
Q

Termination of anal canal

A

Anus

370
Q

Where does the internal iliac artery supply?

A

Pelvic wall and organs, gluteal region, and medial compartment of thigh

371
Q

Branches of the internal iliac artery

A
  • Parietal branches: Iliolumbar, superior and inferior gluteal arteries, lateral sacral arteries, obturator, and internal pudendal artery.
  • Visceral branches: superior and inferior vesical, uterine and middle rectal arteries.
372
Q

Where does the external iliac artery supply?

A

Lower limb, muscles, and skin of the lower abdominal wall

373
Q

Branches of the external iliac artery

A

Inferior epigastric, deep circumflex iliac arteries

374
Q

Veins of the pelvis

A

Most drain to internal iliac artery then to inferior vena cava
Exceptions:
Superior anorectal vein → inferior mesenteric vein
Right/left testicular (gonadal) veins → inferior vena cava/left renal vein

375
Q

Bronchopulmonary segment

A

Compartments of each lung (usually 10)
Each one is supplied by tertiary/segmental bronchi

376
Q

Compartments of female pelvis

A
  1. Anterior: urethra and bladder
  2. Middle: uterus and vagina
  3. Posterior: rectum, anal canal and anus
377
Q

What bronchi enter the hilum?

A

Primary bronchi

378
Q

Which bronchi have cartilage?

A

idk

379
Q

Which surface of the lungs faces the heart?

A

Mediastinal surface

380
Q

What way does the diaphragm move when contracting?

A

Inferiorly

381
Q

Sternal angle

A

Junction of manubrium and body of sternum

382
Q

Crista terminalis

A

Located in right atrium

383
Q

Fossa ovalis

A

Located in right atrium

384
Q

Where do the gonadal vessels run?

A

Alongside the abdominal part of ureter

385
Q

Retroperitoneal parts of duodenum

A

Inferior and descending

386
Q

Intraperitoneal parts of duodenum

A

Ascending and superior

387
Q

Innervation of anus

A

Lumbar splanchnic
Superior hypogastric
Inferior hypogastric