week 8 Flashcards
references a structure, such as an artery or a vein, by reference to an adjacent known or prominent structure
anatomical guide
a line drawn or visualized on the surface of the skin to represent the approximate location of some deeper lying structure
linear guide
the point of origin and point of termination of a structure in relation to adjacent structures
anatomical limit
boundaries for anterior cervical triangle (3)
- midline of the neck (tip of the mandible to the sternum)
- anterior border of the sternocleidomastoid (scm)
- lower margin of the body of the mandible
anatomical positioning of the anterior cervical triangle (3)
- platysma muscles alters the contour of the skin and the neck and covers most of the structures important for embalming
- carotid sheath lies posterior and parallel to the SCM; contains
- internal jugular vein (lateral and superficial)
- -partially overlaps the artery
- -lateral and superficial to the common carotid artery
- vagus nerve (between vein and artery)
- common carotid artery (medial and deep) - carotid sheath is crossed anteriorly by the central tendon of the omohyoid muscle
- external jugular is on the outer surface of the SCM
a line from a point over the respective sternoclavicular articulation to a point over the anterior surface of the base of the respective earlobes
linear guid of common carotid artery
artery is posterior to the medial border of the SCM (on each perceptive side)
anatomical guid for common carotid artery
right Sternoclavicular articulation to superior border of the thyroid cartilage
right side of the anatomical limit of the common carotid artery
second costal cartilage to the superior border of the thyroid cartilage
left side of the anatomical limit for the common carotid artery
terminal branch of the brachiocephalic artery
right origin of the common carotid artery
branch of the arch of the aorta
left origin of the common carotid artery
terminal bifurcation into right internal and right external carotid arteries
right branch of the common carotid artery
terminal bifurcation into right internal and right external carotid arteries
left branch of the common carotid artery
r/l external carotid branches (8)
- ascending pharyngeal
- superior thyroid
- lingual
- facial
- occipital
- posterior auricular
- maxillary
- superficial temporal
R/L internal carotid branches (5)
- ophtalmic
- anterior cerebral
- middle cerebral
- posterior communicating
- choroidal branches
axillary space boundaries (5)
- anterior wall; posterior wall; medial wall; lateral wall; apex; base
1. anterior wall; anterior axillary folds - pectoralis major and minor muscles
2. posterior wall; posterior axillary fold - latissimus dorsi, subscapularis, teres major muscles
3. medial walls; ribs 2-6 and corresponding intercostal muscles - covered by the serratus anterior muscle
4. lateral wall; shaft of the humerus, biceps brachii, coracobrachialis
5. apex; cervicoaxillary canal bound by - clavicle, scapula, first rib
6. base; fascia and skin where the axillary hair is found
a line from a point over or through the center of the base of the axillary space to appoint over or through the center of he lateral border of the base of the axillary space
linear guide of the axillary artery
behind the medial border of the coracobrachialis
anatomical guide of the axillary artery
from a point beginning at the lateral border of the first rib to the inferior border of the tendon of the teres major muscles
anatomical limit of the axillary artery
artery is a continuation of the subclavian artery
origin of the axillary artery
axillary artery branches (6)
- highest thoracic artery
- thoracromial artery
- lateral thoracic artery
- sub scapular artery
- anterior humeral circumflex artery
- posterior humeral circumflex artery
anatomical positioning of the axillary artery (2)
- axillary artery is lateral and deep to the axillary vein
2. incision is made along the anterior margin of the hairline of the axilla with the arm abducted
the center of the lateral border of the base of the axillary space to a point approximately 1 inch below and in front of the elbow joint
linear guide of the brachial artery
brachial artery lies in the bicipital groove at the posterior margin of the medial border of the belly of the biceps brachii muscle
anatomical guide of the brachial artery
from the inferior border of the tendon of the teres major muscles to a point inferior to the antecubital fossa
anatomical limit of the brachial artery
artery is a continuation of the axillary artery
origin of the brachial artery
anatomical positioning of the brachial artery (2)
- basilic vein is medial and superficial to the brachial artery
- incision is made along the upper one third of the linear guide (humerus to below the elbow)
distal forearm surface features; (7)
- styloid process of the radius
- tendon of the flexor carpi radialis muscle
- pronator teres, flexor carpi radialis, flexor carpi ulnaris, palmares longus - flexor disitorum superficialis
- deep muscles/tendons
- flexor digitorum - brachioradialis muscle
- antecubital fossa
a line from the center of the antecubital fossa to the center of the base of the index finger
linear guide of the radial artery
artery lies lateral to the tendon of the flexor carpiradlialis muscle and medial to the tendon of the brachioradialis muscle
anatomical guide of the radial artery
artery extends from 1 inch below and in front of the bend of the elbow to a point over the base of the thumb (thenar eminence)
anatomical limit of the radial artery
artery originates at the bifurcation of the brachial artery
origin of the radial artery
anatomical positioning of the radial artery (2)
- artery is on the lateral side of the forearm
2. two small veins lie on either side of the radial artery
a line from the center of the antecubirtal fossa on the forearm to a point between the fourth and fifth fingers
linear guide of the ulnar artery
artery lies lateral to the tendon of the flexor carpi ulnaris
anatomical guide of the ulnar artery
artery extends from 1 inch below and in front of the bend of the elbow to a point over the pisiform bone (hypothenar eminence)
anatomical limit of the ulnar artery
originates at the bifurcation of the brachial artery
origin of the ulnar artery
anatomical positioning of the ulnar artery (3)
- artery is on the medial side of the forearm
- artery lies between the tendons of the flexor carpi ulnaris and flexor digitorium superficialis
- two small veins lie on either side the ulnar artery
arteries of the body trunk (7)
- ascending aorta
- arch of the aorta
- right subclavian artery
- left subclavian artery
- descending thoracic aorta
- descending abdominal aorta
- external iliac artery
characteristics of the ascending aorta (4)
- originates at the the left ventricle
- branches - r coronary artery, L coronary artery
- may be used when embalming infants
- midsternal incision is used
arch of the aorta characteristics (2)
- center of arterial solution distribution
2 branches ; brachiocephalic artery, L cca , L subclavian artery
characteristics of the right subclavian artery (4)
- begins at the right sternoclavicular articulation
- extends to the lateral border of the first rib
- branches need to be clamped in the case of a complete autopsy
- branches; vertebral artery, internal thoracic artery, inferior thyroid artery
characteristics of the left subclavian artery (3)
- begins at the level of the second costal cartilage
- extends to the lateral border of the first rib
- branches; vertebral artery, internal thoracic artery, inferior thyroid artery
characteristics of the descending thoracic aorta (2)
- branches; nine pairs of thoracic intercostal arteries
2. may be used in the case of a partial autopsy in an adult or when visceral organs are donated
characteristics of abdominal aorta (6)
- begins at the diaphragm
- extends to the lower border of the fourth lumbar vertebra
- may be used when embalming infants
- incision from the diploid process downward toward the left of the midline is used
- may also be used in the case of partial autopsy in an adult or when visceral organs are donated
- branches include ; parietal, visceral (unpaired), visceral (paired)
parietal branches of the descending abdominal aorta (4)
- inferior phrenic
2 superior suprarenal - lumbar
- middle sacral
visceral (unpaired) branches of the descending abdominal aorta (3)
- celiac axis
- superior mesenteric
- inferior meseneteric
visceral (paired) branches of the descending abdominal aorta (5)
- middle suprarenals
- renals
- internal spermatic (male)
- ovarian (female)
- common iliacs (terminal branch)
characteristics of the external iliac artery (2)
- may be used in autopsy
- may be used in case of a very obese unautopsied case because the femoral vessels are located very deep
-originates at the common iliac artery
anatomical positioning of the external iliac artery (3)
- extends to a point under the center of the inguinal ligament
- artery lies exactly at this ligament lateral to the external iliac vein
- fairly superficial vessel
femoral triangle boundaries (6)
- medial border of the sartorius
- lateral border of the adductor longs
- base; inguinal ligament
- roof; dense sheet of fascia
- attaches firmly to the inguinal ligament and encircles the thigh - floor; iliopsoas and pectinous muscles
- apex; adductor canal
- femoral vessels enter through the canal
other structures of the femoral triangle (3)
- greater saphenous vein
- sits up on surface fascia lata
- runs up on medial aspect of the thigh from the foot - femoral sheath
- femoral artery, femoral vein, lymphatic vessels and nodes - femoral nerve lies lateral to the femoral sheath
a line from the center of the inguinal ligament to the center of the medial prominence of the knee (medial condyle of the femur)
linear guide of the femoral artery
artery passes through the center of the femoral triangle and is bounded laterally by the sartorius muscle and medially by the adductor longs muscle
anatomical guide of the femoral artery
artery extends from behind the center of the inguinal ligament to the opening in the adductor Magnus muscle
anatomical limit of the femoral artery
artery is a continuation of the external iliac artery
origin of the femoral artery
anatomical positioning of the femoral artery (1)
1 femoral artery is lateral and superficial to the femoral vein
posterior aspect of the knee in the shape of a trapezoid which is further divided into a femoral triangle and a lower tibial triangle
- lateral wall ; biceps femoris
- medial wall ; tendons of the semimembranosus + semitendinosus muscles
- floor; lower end of the femur and a portion of the capsule surrounding the knee joint
popliteal fossa
contents of the popliteal fossa )4)
- tibial and peroneal nerves
- popliteal vein (superficial to the artery)
- popliteal artery (deepest structure in the fossa)
- fat and lymphatic tissue
a line from the center of the superior border of the popliteal space parallel to the long axis of the lower extremity to the center of the inferior border of the popliteal space
linear guide of the popliteal artery
vessels are located between the popliteal surface of the femur and the oblique popliteal ligament
anatomical guide of the popliteal artery
artery extends from the opening of the adductor Magnus muscle to the lower border of the popliteus muscle
anatomical limit of the popliteal artery
artery is a continuation of the femoral artery
origin of the popliteal artery
five pairs of genicular arteries and five muscular branches
branches of the popliteal arteries
anatomical positioning of the popliteal artery (2)
- vein is posterior and medial to the artery
2. vein is superficial b/c were looking from posterior aspect of the body in anatomical position
a line from the lateral border of the patella to the anterior surface of the ankle joint
linear guide of the anterior tibial artery
vessels are in a groove located between the tibialis anterior muscle and the tendon of the extensor hallucis longus muscle
anatomical guide for the anterior tibial artery
extends from the inferior border of the popliteus muscle to a point in front of the middle of the ankle joint
anatomical limit of the anterior tibial artery
a line from the center of the popliteal space to a point midway between the medial malleolus and the calcaneus bone
linear guide for the posterior tibial artery
vessels are located between the posterior border of the tibia and the calcaneus tendon
anatomical guide of the posterior tibial artery
extends from the inferior border of the popliteus muscle to a point over and between the medial malleolus and the calcaneus of the respective foot
anatomical limit of the posterior tibial artery
a line from the anterior surface of the ankle joint to a point between the first and second toes
linear guide of the dorsals pedis artery
internal structures that should be preserved (4)
- cranium (brain and stem)
- thorax (lungs, heart)
- abdomen (stomach, small and large intestines, gallbladder, liver and pancreas)
- pelvis (bladder and kidneys)
- female (uterus, ovaries, uterine tubes, vag)
- male (prostate gland, seminal vesicles, urinary bladder, rectum)
nine region method
- two vertical lines upward from a point midway between the anterior superior iliac spine and the symphysis pubis
- one horizontal line between the costal margin
- one horizontal line at the level of the inferior margin of the tenth costal cartilage
Top ; R hypochondriac, Epigastric, L hypochondriac
Middle; R. lumbar, umbilical, L lumbar
Bottom; R inguinal (iliac), hypogastric, L inguinal (iliac)
- part of the liver
- part of the R kidney
- greater omentum
- coils of small intestine
- gallbladder
Right hypochondriac
- stomach
- part of the liver
- duodenum
- pancreas
- suprarenal glands
- part of the kidneys
- greater omentum
epigastric
- part of the liver
- stomach
- spleen
- tail of pancreas
- L colic splenic flexure
- L kidney
- greater omentum
Left hypochondriac
- lower liver
- ascending colon
- part of the right kidney
- coils of small intestine
- R hepatic flexure
Right lumbar
- transverse colon
- part of kidneys
- part of duodenum
- coils of small intestine
- greater omentum
- bifurcation of abdominal and inferior vena cava
umbilical
- part of left kidney
- descending colon
- coils of small intestine
- greater omentum
left lumbar
- cecum
- appendix
- part of ascending colon
- coils of small intestine
- greater omentum
Right inguinal (iliac)
- bladder in adults if distended
- uterus during pregnancy
- coils of small intestine
- greater omentum
hypogastric
- part of descending colon
- sigmoid colon
- coils of small intestine
- greater omentum
Left inguinal (iliac)
- horizontal line through the umbilicus
- vertical line down the midline of the body
quadrant method
trocar guides (7)
- right side of the heart
- stomach
- cecum
- urinary bladder
- thoracic cavity
- abdominal cavity
- male genitalia
trocar should intersect a line drawn from the left anterior; superior iliac spine and the right earlobe
right side of the heart for trocar guides
trocar should point towards the intersection the fifth intercostal space and the left midaxillary line
-line extending from the center of the medial base of the axillary space inferiorly along the rib cage
stomach tocar guides
trocar should be directed toward a point one-fourth of the distance from the right anterior ; superior iliac spine to the pubic symphysis
- trocar should be up near the abdominal wall until with in 4 inches of the right anterior ; super iliac spine
- trocar should dip 2 inches from here and be inserted forward into the colon
cecum of the trocar guides
- direct trocar to the median line of the pubic bone (symphysis pubis) until the point touches the bone
- retract slightly and insert trocar here
urinary bladder of the trocar guide
line running from the left anterior superior iliac spine to the lobe of the right ear
thoracic cavity of the trocar guide
line running along the left midaxillary line at about the level of the fifth intercostal space
abdominal cavity of the trocar guide
direct the point of the trocar to the most anterior portion of the symphysis pubis
-direct point over the top of the symphysis pubis into the scrotum
male genitalia of the trocar guide
considerations when selecting an artery (10)
- depth of location
- size of vessel
- proximity to the aorta
- surrounding structures
- effect on posing the body
- location regarding exposed areas
- practicality of drainage from vein
- likelihood of occlusion or obstruction
- pathology and disfigurement
- cause of death
- age, sex, weight, disfigurements, diseases, etc. edema, burns, growths, anasarca, trauma
- post mortem changes
factors to consider accessibility for vessel selection (7)
- superficial vs. deep
- surrounding structures
- proximity to the aorta
- size of the artery
- effect on posing the body
- location regarding the exposed areas
- practicality of drainage
factors to consider for vessel selection (10)
- arterial obstruction
- age, sex
- weight, weight distribution
- disfiguring pathologies
- edema
- trauma
- organ and tissue procurement
- invasive devices
- legal requirements
- cause and manner of death
process of blood clotting
- three major portions;
1. constrictions of the blood vessels
2. activity of platelets that help in blood clotting
3. actitivity of proteins found in blood that work with platelets to help the blood clot
hemostasis
results in the accumulation of platelets at the wound site and the formation of a fibrin clot which stems blood flow in order to limit the amount of blood lost.
-injury to blood vessel occurs exposing collagen that’s normally not exposed
coagulation cascade
allows for a weak platelet plug to form which provides temporary protection from hemorrhaging
primary hemostasis
process of primary hemostasis (4)
- vasoconstriction
- pressure helps to close any gaps in the vessel wall and to reduce blood flow
- collagen and von willebrand factor are exposed - platelet adhesion
- platelets begin to attach to the exposed collagen and bind with V.W factor - platelet activation
- change in shape from smooth to spiky
- secretes cytoplasmic granules
- activated by thrombin - platelet aggregation
- begins once the platelets are activated and receptors allow for adhesion to V.W factor and fibrogen
stabilizes the weak platelet plug
secondary hemostasis
process of secondary hemostasis (3)
- trigger activation of clotting factors
- come from damaged tissue cells and platelets
- form prothrombin activator and thromboplastin - conversion of prothrombin to thrombin
- triggered by thromboplasmic and prothrombin activator - conversion of fibrinogens to make this change
- intiated by factor VII
- vitamin K is vital to this process
types of blood vessels (6)
- arteries
- arterioles
- capillaries
- venules
- veins
- vasa vasorum
- large distribution vessels
- distributes blood from heart to capillaries via arterioles - progressively small arteries that lead into capillaries
- helps maintain arterial blood pressure by constricting and dilating - microscopic exchange vessels
- capillary bed is where the exchange of nutrients and respiratory gases occurs between blood and tissue fluid around the cells
- arteries
- arterioles
- capillaries
- vessels that collect blood from the capillaries
- vessels that carry blood toward the heart
- small blood vessels that comprise a vascular network supplying the walls of large blood vessels with blood
- venules
- veins
- vasa vasorum
blood vessel structure (3)
- tunica externa
- tunica mediA
- tunica intima
- outermost layer; made of connective tissue fibers so it doesn’t burst under pressure
- smooth muscle tissue in the middle layer of arteries and veins (thicker in arteries than veins
- inner layer of endothelial cells
- single layer of endothelium
- equipped with pockets that act as one way valves that prevent back flow of blood
- tunica externa
- tunica media
- tunica intima
other structures of vascular system (2)
- anastomoses
2. collateral circulation
- a connection between veins and arteries to transport blood around the body
- creates a backup pathway for blood flow if a vessel becomes blocked - a network of tiny blood vessels
- allows blood to flow around blocked blood vessels
- anastomoses
2. collateral circulation
- makes sure each cell is surrounded by fluid is constantly being replenished with oxygen, water, and nutrients necessary for cell function
- removes waste products from extracellular fluid as they are released from cells
- picks substances up from various parts of the body and delivers them to other
- allows body to move substances around in a way that helps to maintain a relative constancy of our internal environment
cardiovascular system function overview
- located between the lungs in the lower portion of the mediastinum
- 2/3 is on the left of the line
- 1/3 is on the right - triangular in shape
- roughly size of a closed fist
- apex; the blunt point of the lower edge
- lies on the diaphragm
- points to the left - positioned in the thoracic cavity between the sternum and thoracic vertebrae
structural anatomy of the heart
functional anatomy of the heart (4)
- hollow and a partition, or septum, divides it into right and left halves
- contains 4 hollow chambers (2 atria and 2 ventricles)
- pericardium is the hearts covering
- 2 set of valves L/R atrioventricular, pulmonary semilunar and aortic semilunar
heart chamber overview (7)
- each chamber is named according to its location R/L atria, R/L ventricles
- wall of each chamber is composed of cardiac muscle tissue (myocardium)
- septum between atrial chambers is called “interatrial septum”
- septum between ventricles are called “interventicular septum”
- each chamber is lined by a thin layer of very smooth tissue (endocardium)
- opening of the superior vena cava into the R atrium (superior vena canal orfice)
- opening of the inferior vena cava into the R atrium (inferior vena canal orfice)
features of the atria (upper chambers) (4)
- smaller than ventricles
- auricle ; ear like extension on both atria
- R atrial auricle collects deoxygenated blood from bloodstream
- L atrial auricle collects oxygenated blood as it leaves lungs - atria often Called “receiving chambers” because blood enters the heart through the veins that open into the atria
- fossa ovalis; depression in the R atrium
- thin fibrous sheet that covered the foramen oval during fetal development
- foramen ovale; small hole in septum between the 2 atria that helps the fetus get oxygenated rich blood - coronary sinus orifice
features of the ventricles (lower chambers) (3)
- pulmonary trunk originates at the R ventricle
- branches into R/L pulmonary arteries and lead to the lungs - common pulmonary orifice; opening between pulmonary trunk and R ventricle
- referred to as discharging chambers ; b/c blood is pumped from the ventricles and into the arteries
features of the pericardium (4)
- consists of 2 layers of fibrous tissue with a small space in between
- visceral pericardium (inner layer)
- parietal pericardium (outer layer)
- pericardial layers glide over each other smoothly and without friction when the heart beats
heart valves overflow (6)
- function is to control and direct blood flow
- Atrioventiricular valves separate the atrial chambers from the ventricles
- Atrio valves also prevent back flow of blood into the atria when ventricles contract
- semilunar valves separate each ventricular chamber and its associated artery
- ventricles contract together
- atria contract together
- R atrioventricular valve (tricuspid valve)
2. left atrioventricular valve (bicuspid valve or mitral valve)
atrioventricular valves
- pulmonary semilunar valve
- opens into the pulmonary artery - aortic semilunar valve
- opens to the aorta
- allows blood to flow out of the left ventricle up into the aorta
- prevents back flow
semilunar valve
blood flow to the heart muscle (3)
1 myocardium requires constant supply of blood
- coronary circulation; process of delivery of oxygen and nutrient rich arterial blood to cardiac muscle and return of oxygen poor blood from this tissue to the venous system
- R and L coronary arteries feed blood to the heart muscle
heart functions (5)
- a muscular pumping device for distributing blood to all parts of the body
- systole (contraction)
- diastole (relaxation)
- when heart beats, the atria contracts stimulataneously first
- ventricles then fill with blood and simultaneously contract
blood circulation systems (2)
- pulmonary circulation (flow of blood from the R ventricle to the lungs and back to the L atrium)
- systemic circulation (flow of blood from the L ventricle throughout the body and back to the R atrium
cardiac cycle (3)
- cardiac cycle ; each complete heartbeat
- includes systole and diastole of the atria and ventricles
- each cycle taks about 0.8 seconds to complete
- sinotrial node starts the firing that triggers a heart beat (pacemaker)
- atrioventricular node receives impulse from SA node
- av bundle and purkinje fibers cause the ventricles to contract
conduction system
- blood flows through vessels that are arranged in a complete circuit or circular pattern
- route of circulation
- system circulation (blood flow form the L ventricle of the heart through blood vessels to all parts of the body and back to the right atrium of the heart
- pulmonary circulation ; venous blood flow from the right atrium to the lung and then back to the left atrium
routes of circulation
- lymph vessels and blood capillaries are similar in that they are both microscopic and formed form sheets of the endothelium
- lymph from lymphatic capillaries moves into lymphatic venues and lymphatic veins
- cisterna chyli (temp holding area for lymph moving toward its point of entry into the veins
- lacteals ; lymphatic capillaries in the wall of the small intestine
- lymphatic organs
- lymph, lymph nodes, tonsils, spleen, thymus gland
lymph vascular system
- foramen ovale; between the atria
- dustus arteriosis; between the aorta and pulmonary artery
- ductus venosis; umbilical vein to inferior vena cava
- umbilical arteries ; deoxygenated blood from fetus to placenta
- umbilical veins; oxygenated blood from placenta to fetus
fetal circulation
- foramen ovale - fossa ovalis
- ductus arteriosis - ligamentum arteriosum
- ductus enosis to ligamentum venosum
- umbilical arteries to umbilical ligament
- umbilical veins to ligamentum teres
after birth
