Thoracic and Urinary Anatomy

Question 1

The thoracic cage is made of?

Answer 1

Sternum anteriorly, 12 T vertebrae posteriorly, 12 pairs of ribs laterally

Question 2

Manubrium of the sternum articulates with?

Answer 2

Clavicles, 1st ribs, part of 2nd ribs, body of sternum

Question 3

Body of sternum articulates with what via what type of joint (x2)

Answer 3

Manubrium via symphyseal joint

2-6th ribs via synovial joints

Question 4

The xiphoid process articulates with what via what type of joint?

Answer 4

Body of sternum via symphyseal joint

Question 5

Which are true ribs and what makes them true?

Answer 5

Ribs 1-7 because they articulate with the sternum

Question 6

Which are false ribs and what makes them false?

Answer 6

Ribs 8-10 because they have cartilaginous ends and articulate with the cartilage of the rib above

Question 7

Which are floating ribs and what makes them floating?

Answer 7

Ribs 11-12 because their anterior ends aren’t connected

Question 8

Which are the typical ribs?

Answer 8

Ribs 3-9

Question 9

Features of typical ribs (3-9)?

Answer 9

Head w/2 articular demi-facets (art w/vertebra above and corresponding vertebra), neck btw head and tubercle, upper border of neck has crest for superior costotransverse ligament, tubercle with facet for articulation w/TVP of corresponding vertebra and rough part for lateral costotransverse ligament, angle btw tubercle and shaft, shaft has ext/int surfaces and sup (smooth/round)/inf (sharp, costal groove) borders, costal cartilage unossified ant end of rib and costal end articulate w/sternum via synovial joints

Question 10

Which are the atypical ribs?

Answer 10

1, 2, 10, 11, 12

Question 11

1st rib features?

Answer 11

shortest, most curvaceous, head has one articular facet, , rib has extra tubercle for anterior scalene attachement, rib has inner/outer borders and sup/inf surfaces, extra groove for subclavian A

Question 12

2nd rib is atypical because?

Answer 12

Large rough tuberosity for attachment of serratus ant

Question 13

10-12th rib is atypical because?

Answer 13

One facet on the head

Question 14

External intercostal muscle fibers run which directions?

Answer 14

Downward and medial (hands in pocket)

Question 15

Internal intercostal muscle fibers run which directions?

Answer 15

Upward and medial

Question 16

Innermost intercostal muscle fibers run which directions?

Answer 16

Upward and medial

Question 17

The neurovascular bundle in the intercostal spacs runs between what muscles?

Answer 17

Internal and innermost intercostals

Question 18

What is in the intercostal space’s neurovascular bundle from top to bottom?

Answer 18

Intercostal vein
Intercostal artery
Intercostal nerve

Question 19

The intercostal space is covered by what externally and internally?

Answer 19

Skin

parietal pleura

Question 20

The breast is a modified type of sweat gland, which one?

Answer 20

apocrine sweat gland

Question 21

The tail of spence is located under what and where?

Answer 21

deep fascia

Axilla

Question 22

The breast lies between which ribs?

Answer 22

Usually 2-6

Question 23

How many lobules are in the breast embedded in fat and fibrous tissue?

Answer 23

15-20

Question 24

The suspensory ligament of cooper attaches breast glandular tissue to what?

Answer 24

skin above pectoral fascia

Question 25

Glandular tissue of the breast opens into what ducts?

Answer 25

Lactiferous ducts

Question 26

Lactiferous ducts are dilated towards what sinuses before opening into the nipple?

Answer 26

lactiferous sinuses

Question 27

The nipple line lies in the center of what?

Answer 27

Areola

Question 28

The breast is supplied by what blood vessels?

Answer 28

Lateral thoracic, internal thoracic, 2-4th anterior intercostal, thoraco-acromial A

Question 29

What is the lymphatic drainage pathway of the breast?

Answer 29

75% to anterior (pectoral) group of axillary nodes, cntral group axillary nodes and apical group axillary nodes and rest drain to nodes along internal T A and a small amount drain to ant ab wall

Question 30

What landmarks separate the superior and inferior mediastinum?

Answer 30

Horizontal line btw manubriosternal joint (angle of Louis) and IVD of T4/5

Question 31

What is in the superior mediastinum?

Answer 31

Trachea, vagus and phrenic N, Arch of aorta and br, SVC, Thoracic duct, Esophagus, Remnant of Thymus gland

Question 32

What are the three compartments of the inferior mediastinum?

Answer 32

Middle, anterior (btw sternum and heart), posterior (btw heart and T vertebra)

Question 33

The anterior compartment of the inferior mediastinum contains?

Answer 33

Connective tissue, lymph nodes, remnants of thymus

Question 34

The middle compartment of the inferior mediastinum contains?

Answer 34

Heart, pericardium, roots of great vessels, phrenic N

Question 35

The posterior compartment of the inferior mediastinum contains?

Answer 35

Vagus, splanchnic N, sympathetic trunks, descending thoracic aorta and br (posterior intercostal A, esophageal br, bronchial A), azygos venous system, thoracic duct, esophagus

Question 36

The esophagus is lined by what type of epithelium?

Answer 36

Stratified squamous epithelium

Question 37

Where does the esophagus begin?

Answer 37

Circoid cartilage C6

Question 38

Where does th esophagus pass behind the trachea?

Answer 38

Lower part of the neck and superior mediastinum

Question 39

Where does the esophagus pass behind the left atrium of the heart?

Answer 39

Posterior mediastinum

Question 40

What level of the thoracics does the esophagus pass through the diaphragm?

Answer 40

T10

Question 41

What level of the thoracic does the esophagus join the stomach?

Answer 41

T11

Question 42

The esophagus has three layers what are they and what are the made of?

Answer 42

Inner: stratified non-keratinized squamous epithelium Middle: submucosa, epithelial glands Outer: outer longitudinal and inner circular layer of muscles

Question 43

The upper third of the esophagus: surrounded by? Supplied by what artery? Lymphatic drainage?

Answer 43

Skeletal muscle Inferior thyroid A Lower deep cervical lymph nodes

Question 44

The middle third of the esophagus: surrounded by? Supplied by what artery? Lymphatic drainage?

Answer 44

Skeletal and smooth muscle Thoracic aorta br mediastinal lymph nodes

Question 45

The lower third of the esophagus: surrounded by? Supplied by what artery? Lymphatic drainage?

Answer 45

Smooth muscle Left gastric A Left gastric lymph nodes

Question 46

The venous drainage for the esophagus are the?

Answer 46

Inferior thyroid, esophageal, L gastric V

Question 47

What are the three areas the esophagus narrows?

Answer 47

C6, T5 - X L bronchus, T10 pass through diaphragm

Question 48

The kidney develops in what embryological tissue?

Answer 48

Mesoderm

Question 49

From what embryological tissue does the nephron develop?

Answer 49

Metanephros

Question 50

The ureteric bud of the mesonephric duct develops into what?

Answer 50

Collecting tubules, minor/major calyces and he ureter

Question 51

The bladder arises from what embrylogical tissue except the trigone which comes from?

Answer 51

endodermurogenital sinus | Meoderm

Question 52

Why does the right kidney lie 1.5" lower than the left?

Answer 52

Larger right lobe of the lover

Question 53

What is inside the hilum of the kidney A-P?

Answer 53

Renal V, A, ureter

Question 54

What are the three coverings of the kidney from inside-out?

Answer 54

Thin fibrous capsule, peri-renal fat in renal fascia, surrounded by another layer of fat (extraperitoneal, para-renal fat)

Question 55

What four muscles are posterior to the kidney?

Answer 55

Diaphragm, QL, psoas major, Transversu abdominis

Question 56

What three nerves are posterior to the kidney?

Answer 56

Subcostal, iliohypogastric, ilioinguinal nerves

Question 57

what two vessels are posterior to the kidney?

Answer 57

Subcostal V and A

Question 58

What bone is posterior to kidney?

Answer 58

12th rib, and 11th rib on

Question 59

What structure is in the kidney medulla?

Answer 59

pyramids separated by columns

Question 60

What does the apex of the kidney medullary pyramid open into?

Answer 60

minor calyx

Question 61

What does the major calyx open into?

Answer 61

Renal pelvis

Question 62

The renal A is a branch of what?

Answer 62

Abdominal aorta @L1

Question 63

What are the five segmental branches of the renal A?

Answer 63

Interlobar, arcuate, interlobuar, afferent arterioles, glomerulus, efferent arterioles

Question 64

Renal veins drain into?

Answer 64

IVC

Question 65

Left renal vein receives what?

Answer 65

L adrenal V, L gonadal V

Question 66

The ureter is lined with what type of cell?

Answer 66

Transitional epithelium

Question 67

The ureter leaves the hilum of kidney behind what structure?

Answer 67

Renal A

Question 68

The ureter travels downward on what mucle?

Answer 68

psoas major

Question 69

At the level of the ischial spine the ureter turns medial and forward to enter what?

Answer 69

Base of bladder

Question 70

In the male the ureter passes under what structure? Female?

Answer 70

Ductus deferens | Uterine A

Question 71

What arteries supply the ureter?

Answer 71

Renal, gonadal, common and internal iliac arteries

Question 72

What nerves innervate the ureter?

Answer 72

T10-L1, S2-4

Question 73

What is the referred pain pattern for the ureter?

Answer 73

Loin-groin T10-L1 nerve distribution

Question 74

What shape is the bladder?

Answer 74

Tetrahedral

Question 75

The base of bladder is triangular and lies in what direction?

Answer 75

Posteriorly

Question 76

The neck of the bladder is the apex of the base and lies _______ to the prostate

Answer 76

superior

Question 77

The apex of the bladder lies just behind what structure?

Answer 77

symphysis pubis

Question 78

Where does the bladder lie in the female?

Answer 78

Anterior and inferior to the uterus

Question 79

The bladder is made of what tissue?

Answer 79

Detrusor and transitional epithelium

Question 80

The internal bladder sphincter is comprised of what? Innervated by?

Answer 80

smooth muscle Relax - Pelvic splanchnic N (S2-4) Contract: L1/2 sympathetic

Question 81

The external bladder sphincter is what type of muscle and innervated by?

Answer 81

``` Skeletal Pudendal N (S2-4) ```

Question 82

The prostate surrounds?

Answer 82

1st part of urethra

Question 83

What are the 5 lobes of the prostate?

Answer 83

Ant, post, R/L lateral, median btw ejaculatory ducts

Question 84

What are the 3 zones of the prostate?

Answer 84

Peripheral, central, transitional

Question 85

The prostate is covered by two capsules what are they?

Answer 85

True thin fibrous, false capsule (endopelvic fascia)

Question 86

Where is the prostatic venous plexus located?

Answer 86

Btw the true thin fibrous capsule and false capsule

Question 87

Why does prostate cancer spread so easily?

Answer 87

Prostatic venous plexus communicates w/external and internal vertebral venous plexues w/no valves (Batson) allows easy spread to Lumbar vertebra and basivertebral V

Question 88

How long is the urethra in males vs females

Answer 88

8" vs 1.75"

Question 89

Male urethra is divided into how many parts?

Answer 89

prostatic, membranous (shortest), penile parts

Question 90

The penile part of the urethra passes through what to open at the urethral orifice in the undersurface of the glans penis?

Answer 90

corpus spongiosum

Question 91

Where are the bulbourethral glands (of Cowper) located?

Answer 91

Urogenital diaphragm and drain into penile part of urethra

Question 92

Bulbourethral glands are the homologue to what?

Answer 92

Bartholin's glands

Question 93

Where does the female urethra open?

Answer 93

Between the clitoris and vaginal orifice