Thorax, Lungs, Heart, Abdomen Flashcards
1
Q
What is the anatomical name and the clinical name for the thoracic inlet?
A
Anatomical: Superior thoracic aperture
Clinical: thoracic outlet
2
Q
What 2 major structures are located at the thoracic outlet (aka inferior thoracic aperture)?
A
T11-T12 diaphragm closes off. Separation of thoracic cavity from abdominal cavity
T11-T12 gastro-esophageal junction
3
Q
What is the area called where the esophagus meets the greater curvature of the stomach?
A
Cardiac notch
4
Q
What kind of muscle is found in the esophagus?
A
Mix of smooth and striated muscle
5
Q
What is the mnemonic for the diaphragm of associated structures transmitted from superior to inferior, anterior to posterior?
A
“I 8 10 Eggs At 12”
IVC - T8
Esophagus - T10
Aorta - T12
6
Q
What are the muscles of expiration?
A
Internal intercostals
7
Q
What are the muscles of inspiration?
A
External intercostals
8
Q
What is the mnemonic used to remember which intercostals are inspiratory/expiratory?
A
“I goes with E”
Expiration - Internal
Inspiration - External
9
Q
What are the 3 ligaments of the diaphragm?
A
MediaN arcuate ligmament (Right crus = L1-L3, Left Crus = L1-L2)
MediaL arcuate ligament
Lateral arcuate ligament
10
Q
What are the medial and lateral arcuate ligaments of the diaphragm derived from?
A
Medial = derived from psoas fascia Lateral = derived from quadratus lumborum fascia
11
Q
What is the function of mesentery?
A
Connects organs to posterior abdominal wall
12
Q
What is the function of ligaments in the abdominal cavity?
A
Connects one organ to another
13
Q
What does the greater omentum connect?
A
Connects greater curvature of the stomach to the transverse colon
14
Q
What does the lesser omentum connect?
A
Connects lesser curvature of the stomach to the liver
15
Q
Where is the greater sac located?
A
Behind the greater omentum
16
Q
Where is the lesser sac located?
A
Behind the lesser omentum
17
Q
What is the epiploic foramen (aka foramen of Winslow)?
A
Opening between greater and lesser peritoneal sacs
18
Q
What are the borders of the epiploic foramen?
A
Inferior = duodenum Superior = caudate lobe of the liver Posterior = IVC Anterior = Common bile duct, portal vein, hepatic A.
19
Q
What are the 7 retroperitoneal organs?
A
Kidney Adrenals Pancreas Aorta Colon (ascending and descending) Duodenum (most) IVC
20
Q
Which lung hemisphere has arterial impressions, and which has venous impression?
A
Left lung: Arterial impressions
Right lung: Venous impressions (e.g. azygous V.)
21
Q
What are the contents of the left hilum from superior to inferior?
A
Pulmonary A.
Bronchus
Pulmonary V.
22
Q
What are the contents of the right hilum from superior to inferior?
A
Bronchus and pulmonary A. are both most superior,
Pulmonary V. is most inferior
23
Q
What lung has the lingula and where is it located?
A
Left lung, left upper lobe (homolog to R middle lobe)
24
Q
What does the lingula (left lung) contain?
A
Cardiac notch
25
what is the path of the respiratory system from trachea to secondary bronchus?
Trachea begins at C6 (inf margin of cricoid) and ends at T4 (sternal angle, aka angle of louis) where it bifurcates as the carinae into right and left primary (principal) brochus. Hyaline cartilage from trachea to secondary bronchus.
26
What are the cardinal bronchii?
Primary bronchus (principal)
Secondary bronchus (Lobar)
Tertiary bronchus (segmental)
27
What is the order of the tertiary bronchus?
```
Terminal bronchioles
Respiratory bronchioles
Alveolar ducts
Alveolar sacs
Alveoli (simple squamous)
```
28
Where does cartilage stop in the respiratory tract?
Secondary bronchus. NO cartilage in the tertiary bronchi.
29
How many lobar segments does each lung have?
Right lung: 3 lobar segments
| Left lung: 3 lobar segments
30
How many bronchopulmonary segments does each lung have?
R Lung: 10
| Left lung: 8
31
If there is fluid in the lungs where will it accumulate?
The costodiaphgragmatic recess
32
What is characteristic of the fissures of the left lung?
Oblique only (separates superior lobe from inferior lobe)
33
What is characteristic of the fissures of the right lung?
Horizontal (@ 4th rib anteriorly and T6 posteriorly)
Oblique (separates middle lobe from inferior lobe)
34
What are the 4 divisions of parietal pleura?
1. ) Mediastinal pleura
2. ) Diaphragmatic pleura
3. ) Costal pleura
4. ) Cervical pleura
35
What is the pulmonary ligament?
From mediastinal pleura, located inferior to root of lung
36
What is the cupola?
Apex of cervical pleura, above the clavicle
37
What are the divisions of the mediastinum?
Superior and Inferior
Inferior divided into: Anterior, middle, and posterior
38
What divides the superior and inferior mediastinum?
Sternal angle
39
What is contained in the anterior part of the inferior mediastinum?
Thymus
Areolar tissue
Lymph nodes
40
What is located in the superior mediastinum?
```
Thymus
Arch of aorta
Trachea
SVC
ESOPHAGUS
THORACIC DUCT
VAGUS NERVE
PHRENIC N.
Cardiac N.
Both recurrent laryngeal N.
```
41
What is located in the posterior part of the inferior mediastinum?
```
Thoracic & descending aorta
Carini & bronchi
Azygous & hemiazygous V
ESOPHAGUS
THORACIC DUCT
VAGUS NERVE
Splanchnic N.
```
42
What is found in the middle part of the inferior mediastinum?
```
Heart & pericardium
Ascending aorta
Pulmonary A & V
Lower 1/2 of SVC
Arch of azygous
PHRENIC N.
```
43
What 2 places receive blood drainage from the heart?
```
Coronary sinus (most veins of the heart)
Directly into the chambers of the heart (small veins)
```
44
What is the coronary sinus and what drains into it?
The main vein of the heart;
Great cardiac vein
Middle cardiac vein
Small cardiac vein
45
What does the coronary sinus open into?
Right atrium
46
What is the great cardiac vein and what is its pathway?
The main tributary of the coronary sinus;
(Wraps around left). It ascends into the anterior interventricular groove with the anterior interventricular A.
47
What is the pathway of the middle cardiac vein?
Ascends in the POSTerior interventricular groove with the posterior branch of the right coronary A.
48
What is the pathway of the small cardiac vein?
Runs in the coronary groove with the marginal A.
49
What 6 structures do you need to know for the right atrium?
AV node: @ opening of SVC)
Sinus venarum: Smooth space between openings of SVC & IVC)
Crista terminalis: In right atrium
Musculi pectinei: Muscular ridges in atria (AKA pectinate muscles)
Fossa Ovalis: Depression on intratrial septum. Remnant of foramen ovale
AV node: In interatrial septum
50
What are the AV valves made of?
Endocardium
51
What 6 structures do you need to know for the ventricles?
Left ventricle = thickest part of heart
Chordae tendinae: Tendinous strands attatched to papillary muscles and valve cusps (prevents eversion of AV valves)
Papillary muscles: come off muscular walls
Trabeculae carinae: muscular ridges in ventricles
Conus arteriosus: Conical prolongation of right ventrical from which coronary arteries emerge
Moderator band: right ventricle, contains right bundle branch (electrical stuff of right heart)
52
What is the mnemonic for the arteries of the heart?
Hearts LAC RPMMs
L: Left coronary
A: Anterior interventricular
C: Circumflex artery
R: Right coronary
P: Posterior inteventricular
M: Marginal
M: Muscular Branch (one of these also with Left coronary)
53
What structure does the left recurrent laryngeal nerve wrap around?
Think major vessel on LEFT and higher up: Arch of Aorta
54
What structure does the right recurrent laryngeal nerve wrap around?
Think major vessel on RIGHT and higher up: Right subclavian A.
55
How many regions does boards recognize for abdominal anatomy?
9
```
Epigastric
Umbilical (gastrium)
Pubic (aka hypograstric)
Right hypochondriac
Left hypochondriac
Right lumbar (right renal or 'lateral')
Left lumbar (left renal, or 'lateral')
Right Iliac (aka inguinal)
Left Iliac (aka inguinal)
```
56
Where is the fundic region?
Ontop
57
Where are the lesser and greater curvatures of the stomach located?
Lesser curvature on right side (smaller curve)
| Greater curvature on left sider (larger curvature)
58
Where is the gastric antrum?
In the pyloric region, before the pyloric sphincter
59
Which artery is associated with the lesser curvature of the stomach?
Left gastric A.
60
Which arteries are associated with the greater curvature of the stomach?
Left and right gastroepiploic arteries
61
What is the first major branch off of the abdominal aorta and what are it's 3 major branches?
Celiac trunk;
Left gastric
Splenic
Common hepatic
62
What is Stenson's duct and where is it located?
Parotid gland, opposite upper 2nd molar
63
Where is Wharton's duct?
Submandibular gland
64
Where is Bartholin's gland?
Sublingual
65
What is Wirsung's duct?
Main pancreatic duct
66
What is Santorini's duct?
Accessory pancreatic duct
67
Where is the L and R hepatic ducts from and what do they form?
From L and R lobe of the liver, forms Common Hepatic
68
Where is the Cystic duct from?
Gallbladder
69
What is the flow of bile and liver contents?
1. ) R and L hepatic ducts form common hepatic duct
2. ) Common hepatic + cystic duct = common bile duct
3. ) Common bile duct + Main pancreatic duct (Wirsung's) = hepatopancreatic ampulla (Vater)
4: Ampulla of Vater empties into 2nd part of duodenum @ the summit of the major duodenal papilla (Sphincter of Oddi)
70
What are the 3 major endocrine secretions of the pancreas?
Glucagon
Insulin
Somatostatin
71
What cells secrete each pancreatic endocrine product?
Glucagon: Alpha cells
Insulin: Beta cells
Somatostatin: (Delta cells)
72
What are the 5 exocrine (acinar) products of the pancreas?
```
Trypsinogen
Chymotrypsinogen
Lipase
Amalase
Bicarbonate
```
73
The head of the pancreas contacts what part of the duodenum?
2nd segment (descending) part of duodenum
74
Where is the uncinate process of the pancreas located?
Tongue-like projection inferior to the head of pancreas
75
What does the body and tail of the pancreas contact?
Body: Stomach and L kidney
Tail: spleen (the pancreas is licking the spleen)
76
What is the primary blood supplier for the pancreas?
Branches of the splenic artery (branch of celiac trunk)
77
What type of fibers is the spleen made up of?
Type III reticular fibers
78
Since the spleen is the filter of the body, what does the red pulp and white pulp filter respectively?
Red pulp = filters RBC
| White pulp = filter WBC
79
What separates the R and L lobes of the liver?
The falciform ligament
80
What separates the L lobe from the caudate lobe?
The ligamentum venosum
81
What is the remnant of the ductus venosus from fetal circulation?
The ligamentum venosum
82
What separates the quadrate lobe and the left lobe?
The round ligament (ligamentum teres)
83
What is the remnant of the left umbilical vein?
The round ligament (ligamentum teres)
84
What attatches the liver to the diaphragm?
The coronary ligament and the falciform ligament
85
What are the superior/lateral attachments of liver to diaphragm?
Triangular ligaments
86
Which lobe of the liver cannot be palpated?
The caudate lobe
87
What 3 ligaments attach the liver to the diaphragm?
Falciform ligament
Coronary ligament
Triangular ligament
88
On the inferior view of the liver, what separates the quadrate lobe from the right lobe?
The gallbladder
89
What is the pathway of venous blood flow into and out of the liver?
Superior mesenteric vein + splenic vein = portal vein. Portal vein empties into liver.
Liver sinusoids drain by central vein -> hepatic vein, hepatic vein drains into IVC.
90
What venous branch feeds into the splenic vein?
Inferior mesenteric vein
91
What forms the haustra?
Taeniae coli (3 longitudinal bands)
92
What connects the small intestine to the large intestine?
Ileo-cecal valve
93
At the transition found at the 2/3 transverse colon, what 3 major things change?
Midgut -> hindgut
Vagus N. -> Pelvic splanchnics (S2-S4)
Superior mesenteric A. -> Inferior mesenteric A.
94
What are the mucous secreting glands of the large intestine?
Goblet cells
95
What constitutes the foregut and what are its contents?
Oral cavity to 1st 1/3 of duodenum.
Contents: Oral cavity, pharynx, lower respiratory tract, stomach, duodenum, liver, pancreas, spleen
96
What is the blood supply to the foregut?
THORACIC AORTA
Bronchial A.
Esophageal and post intercostal AA
ABDOMINAL AORTA
All 3 branches of celiac trunk: Left gastric A, splenic A, and common hepatic A.
97
What is the innervation of the foregut?
Vagus N.
98
What constitutes the midgut and what are its contents?
Remaining 2/3 of duodenum -> 1st 2/3 transverse colon
Contains: Small intestine (except 1st 1/3 of duodenum), Large intestine: cecum, appendix, ascending, 1st 2/3 of transverse colon
99
What is the blood supply to the midgut?
Superior mesenteric A (right side of abdomen)
100
What constitutes the hindgut and what are it's contents?
Last 1/3 of transverse colon -> anus.
Contains: Last 1/3 of transverse colon, descending colon, sigmoid colon, rectum, anus
101
What is the blood supply to the hindgut?
Inferior mesenteric A. (left side of abdomen)
102
What is the innervation of the hindgut?
S2-S4 Pelvic splanchnic nerves
103
What is the blood supply of the bladder/urethra?
Internal iliac A
104
What is the blood supply to the genitalia?
Pudendal A.
105
What is the nerve supply to the bladder/urethra and genitalia?
Pudendal N.
106
Which two major veins empty into the SVC?
Azygous, hemiazygous VV
107
What does the azygous drain and where does it empty?
Drains right abdomen and empties into SVC. R & L intercostals & lumbars. Begins L1-L2
108
What does the hemiazygous drain and where does it empty?
Drains left abdomen. Begins L1-L2. Crosses over @ T8 to join azygous
109
What veins drain into the IVC?
External & internal iliac -> R & L common iliac v -> IVC
110
What does the common iliac V. drain?
Drains testicles or ovaries, phrenic vein, suprarenal, renal, hepatic vein
111
What are the 3 fetal blood bypasses?
Ductus venosus: Liver sinusoid
Ductus arteriosis: Lungs (between left pulmonary A and arch of aorta
Foramen ovale: Lungs
112
What is the remnant of the left umbilical vein?
Ligamentum teres (aka round ligament of liver)
113
What is the mnemonic for the thyrocervical trunk?
TIST
T: Thyrocervical trunk
I: Inferior thyroid A.
S: Suprascapular A.
T: Transverse cervical A.
114
What is the mnemonic for the suprahyoid muscles?
MSG and you Die
M: Mylohyoid
S: Stylohyoid
G: Geniohyoid
D: Digastric
115
What is the mnemonic for the infrahyoid muscles?
TOSS IN:
T:Thyrohyoid
O:Omohyoid
S:Sternohyoid,
S:Sternothyroid
116
What is the innervation for the stylohyoid muscle?
CN7
117
What is the innervation for the digastric muscle?
Anterior belly: CN V,
Post belly: CN VII
"Five comes before Seven"
118
What is the innervation for the mylohyoid muscle?
CN V
119
What is the innervation for the geniohyoid muscle?
C1 spinal nerve via CN XII
120
What is the innervation for the infrahyoid muscles?
All innervated by Ansa cervicalis, except for Thyrohyoid (C1 spinal nerve via CN XII)
121
What is plasma called when it passes into the lymph capillaries?
Lymph fluid
122
What side of the body does the thoracic duct drain?
The entire left side and everything below the ribs on both sides
123
Where does the thoracic duct empty?
Into the junction of the left internal jugular vein and the left subclavian vein.
124
What is the right lymphatic duct?
Drains lymph from the upper right side of the body and empties into the junction of the right internal jugular vein and right subclavian vein.
125
Where does the thoracic duct begin?
Begins as a dilation in front of L2 (cisterna chyli)
126
What other important structure terminates at the same level as the cisterna chyli?
Spinal cord
