Unit 2 high yield info Flashcards
Which way do the external intercostals run and what motion do they do
Fibers go down and forward (hands in front pockets)
- Raise ribs in inspiration
What replaces the external intercostals anteriorly
Internal intercostal membrane
Which way do internal intercostal muscles run and what do they do
Fibers pass down and backwards (hands in back pockets)
Interosseous part depresses ribs, interchondral part raises ribs
Innermost intercostal muscles run which way and do what?
Fibers pass down and back (same as internal intercostal)
- Depress ribs during exhalation
Layers of muscles on ribs
-Subcostal
- Innermost intercostal
- Internal intercostal
- External intercostal
Pec major innervation
Medial (C8-T1), and Lateral (C5-C7) Pectoral nerves
Pec Minor innervation
Medial pectoral Nerve ( C8, T1).
External oblique innervation
T7-T12
Rectus abdominus innervation
T7-T12
Serratus anterior innervation
Long thoracic nerve C5-C7
Which order are the Vein, Artery, and Nerve in in the intercostal space and what muscles are they inbetween
(superior)Rib(on top)–> Vein–>Artery–>Nerve
- Called the posterior intercostal V/A/N.
-Sit inbetween the Innermost intercostal and internal intercostal
- Want to be stabbed/poked with a needle right ABOVE every rib (Avoid VAN)
What is the second set of V/A/N that sit inbetween each rib
The collateral V/A/N
- These are better to hit (i.e.) better to hit right above a rib.
What neurotransmitter is associated with the sympathetic devision of the ANS?
Adrenergic (noradrenaline)
What neurotransmitter is associated with the parasympathetic nervous system
Cholinergic (AcH)
What levels of the spinal cord are white rami at vs grey rami
White: T1-L2
Grey: All levels from chain to spinal nerve
The middle and inverior cervical ganglion supply what
The heart, glands, eye
The white rami communicantes supply what
the lung
greater thoracic splanchnic nerve supplies what
the celiac ganglion, liver and gall bladder, stomach, spleen, adrenal gland/kidney, messenteric ganglion
The lesser thoracic splanchnic nerve supplies what
Large/Small intestine
The Lumbar splanchnic nerves supply what
- The inferior mesenteric ganglion (large intestine, rectum)
- The hypogastric ganglion (Uterus, vagina, penis, bladder)
What does the endothoracic fascia connect
Costal parietal plura to thoracic wall
What does parietal plura line and what are its parts
line the pulmonary cavity
Has cervical, costal, diaphragmatic, mediastinal parts
What does visceral plura cover
The surface of the lung
Where are visceral and parietal plura continuous
at the root of the lung/hilum
What is the pulmonary ligament
The sleeve of plura hanging down below the lung root
Where does the parietal plura extend and what recesses does it create
Extends over dome of diaphragm, creates costodiaphragmatic recesses
Where are costomediastinal recesses found? What side are they larger on?
posterior to sternum, larger on left side due to cardiac impression
What rib levels are the lungs/pleura at for the mid-clavicular line?
Rib 6, Rib 8
What rib levels are the lungs/pleura at for the mid-axillary line?
Rib 8, Rib 10
What rib levels are the lungs/pleura at for the scapular line?
Rib 10, rib 12
Which fissure is in the Right/Left lung
Both lungs have the oblique fissure (on the bottom)
R lung has the horizontal fissure (between superior and middle)
What are the surfaces of the lungs
costal, diaphragmatic, mediastinal surfaces
What vertebral level is the carina at
T4
What does the carina biforcate into
L and R main bronchus
Where do the vagus n. /phrenic n. pass in relation to the root of the lung?
Phrenic passes anterior
Vagus passes posterior
Phrenic comes first/passes first becuase P is before V in alphabet
What occurs at day 15, 21, 28, and 50 as the heart develops?
15: Cardiac crescent (heart field)
21: Heart tube
28: Pre-septated looped heart
50: Four-chambered heart
Autonomic innervation from the cardiac plexus goes where?
To the SA node
Vagus nerve does what to the heart?
Parasympathetic, intrensic ganglia, decrease heart rate and force of contraction, constrict coronary artery
Cervical and superior thoracic paravertebral ganglia do what to the heart
Sympathetic (T1-T6)
Increase HR, contraction, blood flow
Flow of current through the heat
SA–> AV–> Bundle of His–> Bundle branches–> Perkinje fibers–> Ventricles
Blood flow through the heart
(Azygous, R/L Brachiocephalic)–> Superior/ Inferior vena cava–> Right atrium –> (Tricuspid valve)–> R Ventricle–> (Pulmonary valve) –> Pulmonary artery–> (LUNGS) –> Pulmonary vein–> L Atrium–> (Mitral valve) –> L Ventricle –> (Aortic Valve) –> Aorta (R Brachiocephalic trunk, L CC, LSC)
What structure does the thymus lie behind
The manubrium
Where do the R/L vagus and R/L Laryngeal nerves wrap around the aorta and subclavians
R Vagus: Over the RSC
R Laryngeal: Under the RSC
L Vagus: Between the LSC and LCC
L Laryngeal: Under the Aortic arch
What tissue does the trachea have anteriorly vs posteriorly
Anteriorly: C-shapped cartilage
Posteriorly: Trachealis muscle
What are 2 smaller veins that come off the azygous vein?
The accessory hemiazygous, and hemiazygous vein
What opening do the sympathetic trunks pass through interiorly
Pass posteriorly to diaphragm through the R and L crus to enter the abdomen
Function of right crus
Longer and larger than L crus
Some of it sourrounds esophageal opening, acts as sphincter
Form arch across front of aorta with the L crus
L1-L3
Function of L Crus
Shorter than R crus
L1-L2
Layers of abdomen
Skin superficially–> Superficial fascia (camper)–> Superficial fascia (scarpa)–> External oblique–> Internal oblique–> Transversus abdominus–> Transversalis fascia–> Extraperitoneal fascia–> parietal peritinioum
What is significant about camper’s fascia?
What does it become in Males/Females?
- Fatty layer, goes over inguinal ligament and into thigh and perineum
Males: Continue as fascia of penis –> Fuse with superficial fascia to become dartos fascia of scrotum
Females: Continue as fascia to labia majora
What is the line where the rectus sheath goes from being above to being below the muscle
The arcuate line
(Below the line, the posterior rectus abdominis muscle is not covered by rectus sheath, but is direct contact w transversalis fascia)
What does the median umbilical fold cover and what is it a remnant of
Covers median umbilical ligament, remnant of fetal urachus
What does the medial umbilical fold cover and what is it the occluded portion of
Covers medial umbilical ligament, occluded portions of umbilical artery
What does the lateral umbilical fold cover
cover inferior epigastric vessels
What does the inguinal canal carry in males
Spermatic cord, ilioinguinal nerve, Genital branch of genitofemoral nerve
What does the inguinal canal carry in females
Round ligament of uterus, ilioinguinal nerve, Genital branch of genitofemoral nerve
What does the lesser omentum attach to
attaches to the lesser curvature of the stomach and duodenum
What occurs at the free edge of the lesser omentum
hepatic artery(L), bile duct (R), portal vein(posterior)
What is the foramen behind the portal triad and lesser omentum
the omental foramen
What is the foramen of winslow (epiploic foramen)
Connect greater and lesser peritoneal cavities
Contains: Hepatic artery, portal vein, common bile duct
Borders: Liver(S), IVC(P), duodenum(I), hepatoduodinal ligament (A)
What does the sphincter of oddi do
Control flow of pancreatic fluid and bile fluid into doudenum
What sourrounds the ampulla of vater
Hepato-pancreatic ampulla (it is called this)
- Union of common bile duct and pancreatic duct)
What does falciform ligament anchor
liver to diaphragm and anterior body wall
What do the coronary ligaments attach
attach liver to inferior surface of diaphragm
reflections of peritoneum around bare area of liver
What do the triangular ligaments attach
attach liver to inferior surface of diaphragm
which ligaments attach liver to inferior surface of diaphragm
Coronary ligaments, triangular ligaments
Which artery needs to be cut for an appendectomy
Appendiceal artery
Where is pain felt during appendicitis
Pain in umbilicus (T10)
What is the hepatic portal vein formed by
splenic and superior mesenteric vein
Where is the hepatic portal vein getting supply from
Spleen
pancreas
gall bladder
abdominal GI
Where does the hepatic portal vein travel to heart
Hepatic portal –> Hepatic v –> IVC
What hole does the IVC pass through in the diaphragm
Caval foramen / caval opening
What hole does the Esophagus pass through
Esophageal hiatus (T10)
What hole does the aorta pass through in the diaphgram
Aortic hiatus (T12)
What passes through the aortic hiatus
Aorta, thoracic duct, azygous vein
Where does urine flow at in the kidneys
Collecting ducts–> Minor Calyces–> –> Major calyces –> Renal pelvis–> Ureters –> bladder
What makes up the medulla in the kidney
Pyramids (darker)
Renal column (lighter)
Which kidney is closer to the aorta
The Left kidney- It has a direct artery to aorta
The Right kidney on the other hand has to pass under the inferior vena cava.
Which kidney sits higher in the body
The Left kidney(T12-L3)
The right kidney is pushed down by the liver
Is the right or left ureter longer
Left is longer- bc left kidney is higher
Which kidney has a branching line vs direct line to aorta
Left kidney is direct
Right kidney is branching
What is the remnant of the umbilical vein on the liver
ligamentum teres
Which nerve innervates the diaphragm
the phrenic nerve
What tendon does the diaphram move during inspiration
draws the central tendon down during inspiration (Central tendon is also insertion)
