Viscera Flashcards
Features of Right Lung
Apex Lobes - Superior - Middle - Inferior Fissures - Oblique (separates superior, inferior lobes and middle, inferior lobes) - Horizontal (separates superior, middle lobes)
Features of Left Lung
Apex Lobes - Superior - Inferior Fissures - Oblique (separates superior, inferior lobes) Lingula
Lingula
Tonguelike process on the superior lobe of the left lung that extends below the cardiac notch and slides in and out of the costomediastinal recess
Muscles forming rough walled portion of the right atrium
Pectinate muscles
Right atrioventricular valve
Tricuspid valve
Crista terminalis
ridge of tissue where the rough and smooth walled (interatrial septum) portions of the right atrium meet
SA node location
Where crista terminalis meets base of SVC
AV node location
Interatrial wall immediately superior to opening of coronary sinus
Trabeculae carnae
rounded or irregular muscular columns which project from the inner surface of the right and left ventricles of the heart
Difference b/w right and left bronchus
Right main bronchus bifurcates before entering the lung, left after entering the lung
Right main bronchus is wider and takes a more vertical course
Bronchopulmonary Segments
- Area of lung supplied by segmental bronchus and corresponding pulmonary arterial branch
- Smallest functionally independent region of lung
- Each lung has 10 BPS
Indentations in Right Lung
Rt subclavian artery and vein, esophagus, azygos vein, sup and inf vena cava
Indentations in Left Lung
Aortic arch, thoracic aorta, esophagus, lt subclavian artery and vein
Layers of Pericardium
- Fibrous pericardium
- Parietal layer of serous pericardium
- Visceral layer of serous pericardium
Coronary sulcus (Location, Contents)
- Separates atria from ventricles (deficient anteriorly where pulmonary trunk crosses)
- Posteriorly, contains coronary sinus
Semilunar Valves
- Aortic valve (b/w aorta, left ventricle)
- Pulmonary valve (b/w pulmonary trunk, right ventricle)
- Each with three cusps, prevent flow of blood back into heart
- Close passively when P(aorta/pulmonary trunk) > P(ventricle)
Atrioventricular valves
- Mitral/bicuspid valve (b/w left atrium, ventricle)
- Tricuspid valve (b/w right atrium, ventricle)
Auscultatory area for aortic valve
Between 2nd, 3rd right costal cartilages
Auscultatory area for pulmonary valve
Between 2nd, 3rd left costal cartilages
Auscultatory area for tricuspid valve
Between 4th and 5th left costal cartilages
Auscultatory area for mitral valve
Between 5th, 6th left rib shafts along midclavicular line
Effects of Parasympathetic Innervation of Heart
- Slows HR
- Reduce contractile force
- Constrict coronary arteries
Effects of Sympathetic Innervation of Heart
- Increase HR
- Increase contractile force
Features of Scrotum (Superficial to Deep)
- Raphe
- Septum
- Dartos muscle, fascia
Tunica vaginalis
- Parietal layer b/w internal spermatic fascia, visceral layer
- Visceral layer covering testis, epididymis
Tunica albuginea
- Tough outer surface of testes deep to visceral layer tunica vaginalis
- Fibrous septa divide testis into compartments
Efferent Ductules, Rete Testis
- Collect sperm from seminiferous tubules, delivers to head, body of epididymis
Epididymis (Location, Function, Divisions)
- Located on post side of testes
- Concentrates sperm before passage to ductus deferens
- Head (Lobules connected to efferent ductules)
- Body (Contains convoluted duct of epididymis)
- Tail (Continuous w/ ductus deferens)
Embryonic Origin of Mesentery
Splanchnic lateral plate mesoderm
Mesentery (Composition, Function)
- Double layer of visceral peritoneum
- Connects organ to body wall, conduit for neurovasculature
Omentum
- Double-layered extension of peritoneum passing from stomach, proximal duodenum to adj organs
- Greater Omentum: Greater curvature of stomach, proximal duodenum to transverse colon
- Lesser Omentum: Lesser curvature of stomach to liver
Important Peritoneal Ligaments (9)
- Falciform (Liver)
- Coronary (Liver)
- Hepatic triangular (Liver)
- Hepatogastric (Lesser Omentum)
- Hepatoduodenal (Lesser Omentum)
- Gastrophrenic (Greater Omentum)
- Gastrosplenic (Greater Omentum)
- Gastrocolic (Greater Omentum)
- Hepatorenal
- Splenorenal
- Phrenicolic
- Teres
Subdivisions of Peritoneal Cavity
- Greater Peritoneal Sac
- Lesser Peritoneal Sac/Omental Bursa
- Separated by Lesser, Greater Omentum, connected via epiploic foramen located b/w hepatogastric ligament and liver
Peritoneal Pouches
Women: Vesicouterine, Rectouterine
Men: Rectovesicle
Foregut Viscera
- Esophagus
- Stomach
- Liver
- Gallbladder
- Pancreas
- Spleen
- Duodenum (Prox. 1/2)
Midgut Viscera
- Duodenum (Dist. 1/2)
- Jejunum
- Ileum
- Cecum
- Appendix
- Ascending Colon
- Transverse Colon (Prox. 2/3)
Hindgut Viscera
- Transverse Colon (Dist. 1/3)
- Descending Colon
- Sigmoid Colon
- Rectum
Mnemonic for Retroperitoneal Organs
SADPUCKR S: Suprarenal glands A: Aorta/IVC [1] D: Duodenum (2nd, 3rd parts) [2] P: Pancreas (except tail) [2] U: Ureters [?] C: Colon (cecum, ascending, descending) [2] K: Kidneys [1] R: Rectum [2]
Esophageal Hiatus
- Gap in diaphragm through which the esophagus passes from the thoracic cavity into the abdominal cavity
- Occurs at level of T10 vertebra
Esophogastric junction / Z-line
- Where stratified squamous epithelium of esophagus transitions to simple columnar epithelium of stomach
- Occurs just above cardial orifice
Important Mesenteries
- Mesentery proper (surrounds branches of superior mesenteric vessels)
- Sigmoid mesocolon (surrounds branches of inferior mesenteric vessels)
- Transverse mesocolon (surrounds branches of middle colic vessels)
Duodenal Divisions
1) Superior (transitions from intra- to retroperitoneal)
2) Descending (where bile, pancreatic enzymes enter)
- Transition from foregut to midgut -
3) Inferior (superior mesenteric vessels pass anteriorly)
4) Ascending (suspensory muscle helps suspend, open up connection to jejunum)
Surfaces of Liver
- Diaphragmatic (Superior, Anterior, Posterior)
- Visceral (Inferior)
Falciform Ligament of Liver
- Connects liver to internal anterior abdominal wall
- Separates right and left lobes of liver
Coronary Ligament of Liver
- Anterior and posterior ligaments on the superior aspect of the liver
- Posterior ligaments derived from lesser omentum
- Attach liver to inferior aspect of diaphragm
Hepatic triangular ligaments
- Right and left
- Formed from the fusion of the anterior and posterior coronary ligaments
- Attach the liver to the diaphragm
Caval groove
- Groove on the left side of the bare area of the liver (located on the posterior surface) in which the inferior vena cava lies
Location, Borders of Quadrate Lobe of Liver
- Located on inferior aspect of liver
- Lateral (Left): Left lobe, round ligament of the liver
- Lateral (Right): Gallbladder
- Posterior: Porta hepatis/portal triad
Location, Borders of Caudate Lobe, Process
- Located on Postero-inferior surface of liver
- Bounded by inferior ivc, ligamentum venosum, porta hepatis
- Caudate process = stretch of liver b/w entrance of hepatic portal vein and inferior ivc
Portal Triad
- Hepatic portal vein
- Proper hepatic artery
- Bile duct
Blood Flow Through Liver
Hepatic portal vein -> sinusoids -> hepatic veins -> inferior vena cava
Formation of Bile Duct
- Rt, lt hepatic ducts join to form common hepatic duct
- Cystic duct (gallbladder) joins common hepatic duct to form bile duct which passes post to duodenum
Exocrine cells of pancreas, function
- Acinar cells
- Secrete digestive enzymes (pancreatic juice) into pancreatic ducts
Formation of major duodenal papilla
Union of pancreatic duct, bile duct to form hepatopancreatic ampulla -> sphincter of bile duct in duodenal wall -> major duodenal papilla
Pectinate Line of Rectum
- Demarcation between visceral and parietal/somatic tissues
Nerves, Lymphatics, Arteries, Veins Above Pectinate Line of Rectum
Nerves: Visceral motor (symp, parasymp)
Lymphatics: To int iliac nodes
Arteries: From inf mesenteric
Veins: To portal venous system
Nerves, Lymphatics, Arteries, Veins Below Pectinate Line of Rectum
Nerves: Somatic motor, sensory
Lymphatics: To sup inguinal nodes
Arteries: From int iliac artery
Veins: To caval venous system
Ductus deferens
- Muscular duct that travels from tail of epididymis to ejaculatory duct formed by union with the seminal vesicle
- Travels in spermatic cord with testicular artery, pampiniform plexus
Seminal Glands
- Produce fructose-rich fluid that nourish sperm
- Seminal vesicles join with ductus deferens to form ejaculatory ducts that dive into the prostate gland
Trigone
Triangle of tissue inside the bladder b/w the two uretal opening and the urethra that when it expands signal the brain of the bladder’s need to empty
Parts of the Urethra and Their Location
- Intramural (neck of bladder)
- Prostatic (prostate)
- Membranous (between prostate and perineal membrane)
- Penile/spongy (from root to glans of penis)
Prostate
- Produces prostatic fluid, slightly alkaline fluid, and secretes it into the prostatic urethra via the prostatic ducts
- The ejaculatory ducts also open into the prostatic urethra
Bulbourethral glands
- Upon arousal, release mucus-like substance into spongy urethra
- Located between prostate and perineal membrane lateral to the membranous urethra
Layers of Uterine Wall
- Perimetrium
- Myometrium (super stretchy layer of smooth muscle)
- Endometrium (heavily vascularized)
Parts of Uterus
- Body
- Fundus
- Isthmus
- Cervix
- Supravaginal part
- Vaginal part
- Internal os
- External os
Sections of Uterine Tubes
- Infundibulum
- Ampulla
- Isthmus
- Pars uterina
Broad Ligament of the Uterus and Divisions
- Peritoneal covering of female reproductive tract
- Mesovarium (covering ovary)
- Mesosalpinx (covering uterine tube)
- Mesometrium (remainder)
Suspensory Ligament
Peritoneal fold covering blood vessels supplying ovary
Typical Positioning of the Uterus
- Anteverted (referring to long axis of uterus relative to long axis of vagina)
- Anteflexed (axis of cervix relative to axis of body of uterus)
Supports of the Uterus
- Round ligament of the uterus
- Thickenings of Endopubic fascia
- Cardinal (transverse cervical) ligament
- Uterosacral ligament
Bulb of the vestibule
- aka clitoral bulbs
- Erectile tissue that is part of the internal parts of the clitoris deep and lateral to the labia minora
- Form body, glans of the clitoris
Greater Vestibular Glands
- Slightly posterior and to the left and right of the vaginal orifice
- Secrete mucus to lubricate the vagina
- Analogous to the male bulbourethral glands
Superficial Perineal Pouch (Borders, Contents)
Inferior: Superficial perineal fascia Superior: Perineal membrane Posterior: Ischial tuberosity - Ischicavernosus - Bulbospongeousus - Superficial transverse perineal - Crura of penis/clitoris - Bulb of penis/vestibular bulbs - Greater vestibular glands
Perineal Body
- Collection of collagen fibers, elastic fibers that serves as anchor for the urogenital triangle
Erectile Tissues and Their Origins, Contents
- Corpora cavernosa (derived from crura, contains deep artery of penis)
- Corpus spongiosum (derived from bulb, contains spongy urethra)
Innervation for Erection of Penis
- Smooth muscle in helicine artery must be relaxed
- Para S2-4 via cavernous nerve of prostatic plexus
Innervation for Emission of Penis
- Rhythmic contraction of ductus deferens, ejaculatory ducts
- Symp L1-2
Innervation for Ejaculation of Penis
- Contraction of internal urethral sphincters (Symp L1-2)
- Contraction of bulbospongiosus (perineal br of pudendal nerve S2-4)
Innervation of female perineum
- Engorgement of erectile tissues, erection of clitoris, increased vaginal secretions
- Para via cavernous nerve via uterovaginal plexus S2-4
Nerve Blocks in Female Perineum
- Pudendal mostly, if not sufficient, may also have to block ilioinguinal
Ischioanal Fossa
- Located on either side of the rectum
- Filled with fat, cushioning the rectum, allowing its expansion
- Rt, lt fossae connected posterior to rectum in the deep rectal space
- Also has anterior recesses that extend into the deep perineal pouch
