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262 Cards in this Set

  • Front
  • Back
Smooth muscle
found in walls of luminal organs, vessels;
under control of the autonomic nervous system (ANS)
cardiac muscle
myocardium; under control of autonomic nervous system
skeletal muscle
voluntary
‘belly’
meaty part of muscle
tendons of origin
(connect ‘belly’ to bone) - closer to midline & less moveable
tendons of insertion
further from midline & more moveable
Collagen
primary protein in tendon
ligament
connect bone to bone
fulcrum
(F) The Joint functions as a FULCRUM (The fixed point around which the lever moves) and the Muscles provide the FORCE to move the Lever.
lever
(L) bar turning around a fixed point
Tendons are attached in such a way that they PULL on the Bones and make them work like LEVERS
Pull
(P) Force or power
Weight
(W)weight or resistance
Type 1 lever system
Pull---Fulcrum---Weight
Type 2 lever system
Fulcrum---Weight---Pull
Type 3 lever system
Fulcrum---Pull---Weight
Circulation System
Cardiovasular system
Lymphatic System
Lymphatic system
part of circulating system
return of interstitial fluid to cardiovascular system
interstitial fluid (lymph)
lymphatic capillary
lymphatic vessel
lymph node
lymphatic vessel
major lymphatic vessel
right lymphatic duct
receives lymph f/ right half of head, neck & face; upper right extremity & right thorax region
thoracic duct
receives lymph f/ everything else and left brachiocephalic vein
Functions of Lymphatic system
tonsils, thymus gland,
can produce WBC & antibodies; all lymphatic tissue, spleen
cancer can spread through lymphatic system
lymph nodes found superficial or deep & follow major arteries
Axial Skeleton
spine, skull, rib cage
Appendicular Skeleton
upper extremities
lower extremities
Function of Spine
protect spinal cord and spinal nerves
provides a rigid and flexible axis for trunk
provides a pivot for the head
articulation
posture and gate (walking)
Movements of spine
flex (forward bending)
extend (backward bending)
lateral bending
circumduction-all of the above (circles)
Curvatures of Spine
At birth, the thoracic and sacral curvatures are the only curvatures that exist- primary curvatures (posteriorly)
-As you develop, the cervical and lumbar curvatures form-secondary curvatures (anteriorly)
Curvature Disorders of Spine
Kyphosis-extreme thoracic curvature posteriorly (hump back)
Scoliosis-abnormal later curvature
Lordosis-exaggerated lumbar curvature
Vertebrae
33 total
Body - round, anterior
bodies articulate w/ intervertebral disc
function-to support weight of body
attached to anterior and posterior longitudinal ligaments
Vertebrae
Cervical - 7
Thoracic - 12
Lumbar - 5
Sacrum - 5 (fused)
Coccyx 3-5 (fused)
Smooth muscle
found in walls of luminal organs, vessels;
under control of the autonomic nervous system (ANS)
cardiac muscle
myocardium; under control of autonomic nervous system
skeletal muscle
voluntary
‘belly’
meaty part of muscle
tendons of origin
(connect ‘belly’ to bone) - closer to midline & less moveable
tendons of insertion
further from midline & more moveable
Collagen
primary protein in tendon
ligament
connect bone to bone
fulcrum
(F) The Joint functions as a FULCRUM (The fixed point around which the lever moves) and the Muscles provide the FORCE to move the Lever.
lever
(L) bar turning around a fixed point
Tendons are attached in such a way that they PULL on the Bones and make them work like LEVERS
Pull
(P) Force or power
Weight
(W)weight or resistance
Type 1 lever system
Pull---Fulcrum---Weight
Type 2 lever system
Fulcrum---Weight---Pull
Type 3 lever system
Fulcrum---Pull---Weight
Cervical Vertebrae
found in neck C1-C7
C1-atlas
articulates w/ occipital condyles (occipital bone) this forms that atlanto-occipital articulation
this joint allows had to nod.
has no spinous process, but does have a posterior arch
C2-axis
articulates w/atlas. Atlanto-axial articulation-allows head to rotate from side to side
dens (odontoid process)-part of anterior arch of axis; fused with atlas
C7-vertebral prominence
long, tapered spinous process
spinous process of cervical vertebrae is bifid; C7 is not bifid
transverse foramen-located in transverse process; only found in cervical vertebrae (all 7)
vertebral arteries-travel through transverse foramen of all transverse processes in cervical except C7.
Thoracic
12; T1-T12
costal facets-facilitate articulation w/ heads of ribs
-T1-T10-have facets on transverse processes; ‘transverse costal facet’-articulates w/ tubercle of rib
Lumbar
5; L1-L5
very thick & short spinous processes
bodies very large & thick
Sacrum
5; S1-S5
5 fused vertebrae gives support to pelvis; forms part of posterior wall of pelvis-articulates w/ 2 parts of hip bone
forms sacro-iliac joint
4 pair anterior and posterior sacral foramen
allows for passage of dorsal and ventral rami of spinal nerves
S1-sacral promontory (anterior side)
sacral hiatus (posterior side)
Coccyx
tail bone; 4 fused (3-5)
Intervertebral discs
located between pre-sacral vertebrae
-made f/ 2 types of tissue: fibrocartilaginous (1. fiber and 2. cartilage)
-function-absorb energy of axial skeleton
herniated disk
-when you have a herniated disk, the annulus fibrosis weakens. The nucleus pulposus intrudes outward. If you herniated posteriorly, you can get muscle weakness, abnormal sensations (b/c it is putting pressure on the spinal nerves) most of the time it is posterior herniation b/c the posterior ligament is weaker than the anterior ligaments.
disks dehydrate with time-so your spine shrinks.
Zygapophyseal Joints
(facet joints)-formed between the flat surfaces of the superior articulation processes of an inferior vertebrae and the inferior articulating processes of the superior vertebrae.
SPINAL CORD
begins at magnum foramen and ends about L2
-42-45 cm in length
-only occupies upper 2/3 of vertebral canal
-superiorly it continues on as the medulla oblongata in the brain
-located & protected by the vertebral canal
-protection
Spinal Cord
spinal cord is symmetrical except in two places
1)cervical enlargement-produces brachial plexus; brachial plexus produces nerves that supply the upper extremities
2)lumbar enlargement-produces lumbosacral plexus which form nerves that innervate lower extremities.
Spinal cord
3 meninges
cerebrospinal fluid (CSF)
ligament of vertebra
conus medularis
around L2 the spinal cord tapers
filum terminal
condensation of pia mater; it terminates at the 1st level of the coccyx.
contains no neurons
is associated with cauda equina
cauda equina
aka-horse’s tail)-a collection of dorsal & ventral rootlets-(make up lumbar & sacral spinal nerves)
located in subarachnoid space
surrounded by CSF
Meninges
dura mater
arachnoid mater
pia mater
dura mater
continuous w/ dura of brain; tough, thick, vascular membrane
-terminates at coccyx level
-superiorly it attaches to the magnum foramen; also attached (ventrally) to posterior longitudinal ligament (ventral surface of dura attached to posterior longitudinal ligament)
-extends laterally into intervertebral foramen; it covers spinal nerves and dorsal root ganglion
-spinal cord is suspended in dura mater by denticulate ligaments (about 21 pair-denticulate ligaments are not really ligaments, it is pia mater)
arachnoid mater
-(middle layer)-avascular; continuous with arachnoid mater of brain. Separated by dura mater in a potential space called subdural space
-between arachnoid & pia mater is the subarachnoid space. This is filled with cerebral spinal fluid.
-between L2 & L3-lumbar cistern
pia mater
innermost of 3 layers. Surrounds spinal cord & each dorsal & ventral rootlets. Vascular. Also continuous w/ pia mater of brain
filum terminal
condensation of pia mater; it terminates at the 1st level of the coccyx.
contains no neurons
is associated with cauda equina
cauda equina
aka-horse’s tail)-a collection of dorsal & ventral rootlets-(make up lumbar & sacral spinal nerves)
located in subarachnoid space
surrounded by CSF
Meninges
dura mater
arachnoid mater
pia mater
dura mater
continuous w/ dura of brain; tough, thick, vascular membrane
-terminates at coccyx level
-superiorly it attaches to the magnum foramen; also attached (ventrally) to posterior longitudinal ligament (ventral surface of dura attached to posterior longitudinal ligament)
-extends laterally into intervertebral foramen; it covers spinal nerves and dorsal root ganglion
-spinal cord is suspended in dura mater by denticulate ligaments (about 21 pair-denticulate ligaments are not really ligaments, it is pia mater)
arachnoid mater
-(middle layer)-avascular; continuous with arachnoid mater of brain. Separated by dura mater in a potential space called subdural space
-between arachnoid & pia mater is the subarachnoid space. This is filled with cerebral spinal fluid.
-between L2 & L3-lumbar cistern
pia mater
innermost of 3 layers. Surrounds spinal cord & each dorsal & ventral rootlets. Vascular. Also continuous w/ pia mater of brain
cross section of spinal cord
gray matter (H-shaped) it is gray b/c it contains cell bodies. Cell bodies are not myelinated. The cell axons of cellular processes of neurons are in the white area. They are myelinated and tend to be white
-CSF-cerebral spinal fluid
found in subarachnoid space around brain or spinal cord; also found in ventricular system of the brain.
-CSF-cerebral spinal fluid
functions
1)acts as a cushion-a protective layer
2)physiological activities of neurons
Cerebral Spinal Fluid
comes from choroid plexus of ventricular system
most is produced in lateral ventricles
clear, contains electrolytes. No protein should be in CSF
Blood Supply of Spinal Cord
3 sources
right & left posterior spinal arteries
anterior spinal artery
radicular arteries
Blood Supply to Spinal Cord
right & left posterior spinal arteries
both are branches of vertebral arteries, descend through magnum foramen. Serve upper 1/3 of the posterior side of spinal cord
Blood Supply to Spinal Cord
anterior spinal artery
comes off vertebral arteries
descends & serves upper 1/3 of anterior side
right and left posterior and anterior spinal arteries have an anastomal relationship- branches overlap
Blood Supply to spinal cord
radicular arteries
take care of distal 2/3 of spinal cord
branches off lumbar arteries
spinal nerves
31 spinal nerves
8 cervical
12 thoracic
5 lumbar
5 sacral
1 coccygeal
product of a fusing of a dorsal and ventral root (5-7 rootlets made a root)
ventral roots contain motor neurons
dorsal roots contain sensory neurons
dorsal & ventral rami-become named nerve of peripheral nervous system
most are products of ventral rami
Superficial Muscles of spine
muscles that are attached to upper extremity and is involved in moving it (aka extrinsic back muscles)
innervated by ventral rami
Intermediate Muscles of spine
muscles that are attached to the ribs and involved in respiration (aka extrinsic back muscles)
innervated by ventral rami
Deep Muscles of spine
attached to spine (aka intrinsic-move the spine)
innervated by dorsal rami
Thoracolumbar fascia
located in lumbar region
-very dense
-connective tissue that ‘sandwiches’ the erector spinae muscles
superficial fascia layer is thickest
function-add strength; serve as an origin or insertion for a tendon
trapezius Muscle
extrinsic, superficial, triangle shaped
O: superior nuchal line (skull)external occipital protuberance (skull)
ligamentum nuchal (cervical vertebrae)
spinous processes of C7-T12
I: spine of scapula acromion process of scapula
F: extends & draws head side to side (lateral bending)
adducts scapula
IN: accessory nerve (cranial nerve 11)
latisimus dorsi muscle
O: iliac crest, thoracolumbar fascia
lower 4 ribs spinous processes T7-T12
I: intertubercle groove of humerus
F: extends, rotates and adduct upper extremities
IN: thoracodorsal nerve
levator scapula
extrinsic & superficial
O: C1-C4
I: medial border of scapula
F: elevates scapula
IN: dorsal scapular nerve
rhomboid major & minor muscles
extrinsic & superficial
F: rotate & adduct scapula
IN: dorsal scapular nerve
serratus posterior superior muscle
F: pulls/elevates ribs respiratory muscle
IN: intercostal nerves (1-4)
serratus posterior inferior muscle
extrinsic & intermediate
F: pulls down on ribs, respiratory muscle
IN: intercostal nerves (10, 11 & 12)
splenius capitus & splenius cervicis muscles
intrinsic & deep
O: base of skull
F: extend head or neck, laterally bending head or neck
IN: dorsal rami of cervical spinal nerves
erector spinae muscle
aka sacrospinalis muscles)-intrinsic & deep
massive bilateral group of muscles that extend the full length of the back
spinalis-most medial
longissimus-intermediate
iliocostalis-lateral
F: extend spine; if only one side is working lateral bending
IN: dorsal rami of intercostal nerves
Thoracic cavity
cavity bound by thoracic wall & diaphragm
right and left pleura cavities
mediastinal pleura
divides cavities so one side can handle trauma
LUNGS
located in thoracic cavity-not pleura cavity
F: exchange carbon dioxide with oxygen
normal healthy lungs should be a pink color, but do get dark w/ time (particulate matter)
both lungs attached to trachea via right and left bronchi
pulmonary ligament
double fold of visceral pleura; inferior to root of lung-attaches lung to lateral side of pericardium
root of lung
where things go in and out
1 bronchus (right and left)
2 pulmonary veins
lymphatic vessels & lymph nodes
2 pulmonary arteries (RIGHT lung only)
1 pulmonary artery (LEFT lung only)
1 bronchial artery (RIGHT lung only)
2 bronchial arteries (LEFT lung only)
plexus of bronchial veins
in general, right lung is larger than left
LOBES
Right lung 3 lobes
Left lung 2 lobes
Right lung
3 lobes
1)upper / horizontal fissure / (2)middle / oblique fissure / (3)lower apex is most superior portion (actually resides in neck)
within lobes are broncho-pulmonary segments
upper right-3
middle right-2
lower right-5 total in right lung: 10
Left lung
2 lobes
(1)upper / oblique fissure / (2)lower
-broncho-pulmonary segments
upper left-4
lower left-5
total in left lung: 9
alveolar sacs
within broncho-pulmonary segments
venous drainage of lungs
bronchial plexus
right bronchial plexus
drains into azygous vein
left bronchial plexus of veins
drains into hemiazygous & accessory hemiazygous veins
bronchi Lengths
right bronchus is larger & shorter than left bronchus
Pleural cavities
space between visceral pleura & parietal pleura
parietal pleura-serous epithelial membrane that line the internal aspect of thoracic wall and superior surface of diaphragm
types of parietal:
diaphragmatic pleura (next to diaphragm)
cupola pleura (up top)
costal pleura (next to ribs)
visceral pleura
serous epithelial membrane that covers lungs
in pleura cavity you will find:
serous fluid--acting as a lubricant
pleuritis
-inflammation of pleura; excess fluid
dry pleurisy
membrane is diseased so fluid is not produced. Membranes rub-very painful.
Mediastinum Boundries
space
Boundaries
anterior-sternum
posterior-vertebral column
inferior-diaphragm
lateral-medial borders of the lungs
Mediastinum Categories
anterior mediastinum
superior mediastinum
middle mediastinum
posterior mediastinum
HEART
located in mediastinum
-a little left of center (mid-line)
-apex-tip-located in 5th intercostal space
-involuntary organ-controlled by intrinsic pacing system
-can be influenced by autonomic nervous system
Functions of heart
receive un-oxygenated blood
pump un-oxygenated blood to lung
intakes oxygenated blood f/ lungs
pumps oxygenated blood to systemic system (all tissue in body)
Layer of hearts
Pericardium
Myocardium
Endocardium
Pericardium
outermost layer, superficial to myocardium
fibroserous sac (3 layers)
1. fibrous layer--(thickest, outermost, densest)
allows pericardium to attach to vessels that enter or leave the heart
2. parietal serous layer-(adjacent to fibrous layer)
3. visceral serous layer-(in contact with myocardium)
space between 2 & 3 is called pericardial cavity. Serous fluid is in cavity. Allows serous membrane to slide with no friction
Myocardium
middle & thickest layer
cardiac muscle
intrinsic pacing system of heart is located here
thickness varies chamber to chamber
can produce specialized structures
1. papillary muscles-only found in ventricles. Attached to cusps of bicuspid and tricuspid valves via chordae tendonae.
-function of chordae tendonae is to prevent inversion of the valves
2. trabeculae-folds & bridges of myocardium
Endocardium
innermost, thinnest, comes in contact with blood.
lines chambers of heart & also vessels that enter & exit the heart.
Chambers of the Heart
Right atrium
Right ventricle
Right ventricle
Left Ventricle
Right ventricle
pumping chamber
Function: pumps unoxygenated blood to lungs
pulmonary artery takes oxygenated blood to lungs
receives venous blood from right atrium
shares septum w/ right atrium (right atrioventricular septum)
shares septum w/ left ventricle (left interventricular septum)
3 papillary muscles-attached to cusps via chordae tendonae
1)anterior papillary
2)posterior papillary
3)septal papillary
Right atrium
larger than left
walls are thinner than left atrium
receiving chamber-receives venous blood
superior & inferior vena cava & coronary sinus drain into right atrium
shares interatrial septum w/ left atrium
specialized structures
-fossa ovalis-flat depressed area on right side of interatrial septum. Represents foramen ovale (open during fetal circulation)
shares right atrioventricular septum w/ right ventricle
right auricle adds volume to heart
Left Atrium
receiving chamber
receives oxygenated blood f/ lungs
enters through 4 pulmonary veins
shares interatrial septum and left atrioventricular septum
has left auricle
Left Ventricle
largest chamber of the heart
receives oxygen blood f/ left atrium
primary function to pump (profuse) oxygenated blood to systemic system
2 papillary muscles attached to cusps via chordae tendonae
1)anterior papillary
2)posterior papillary
Valves of Heart
Right atrioventricular valve
Pulmonary valve
Left atrioventricular valve
Aortic valve
Right Atrioventricular valve
(aka tricuspid valve)
made of 3 triangular shaped cusps
attached to respective papillary muscles
names of cusps
1)anterior cusp
2)posterior cusp
3)septal cusp
Function: controls flow of blood f/ right atrium to right ventricle
located in right atrioventricular septum
open during diastole
closed during systole
Pulmonary valve (semilunar valve)
made of 3 semilunar cusps
1)anterior cusps
2)left cusps
3)right cusps
open during systole
closed during diastole
controls flow of blood f/ right ventricle to lungs
Left atrioventricular valve
(aka bicuspid or mitral valve)
located in left atrioventricular septum
made of 2 cusps
Function: controls flow of oxygenated blood between left atrium and left ventricle
open during diastole
closed during systole
Aortic valve (semilunar valve)
Made of 3 semilunar valve
1)right cusp
2)left cusp
3)non-coronary cusp
open during systole
closed during diastole
thicker, larger, & stronger than pulmonary valve
Superior vena cava
located in superior mediastinum
tributary of right atrium
1 major tributary-arch of azygous vein
formed by junction of 2 brachiocephalic veins
brachiocephalic veins
2 brachiocephalic veins (right and left) are a product of the fusion of subclavian vein & internal jugular vein
left brachiocephalic vein is longer than right
tributaries of brachiocephalic veins
internal thoracic veins
vertebral veins
inferior thyroid veins
Right Coronary Artery
Begins at right coronary cusp (at aortic valve)
Follows coronary sulcus (groove that correlates with atrioventricular septum)
Right Coronary Artery Branches
SA (sinoatrial) nodal branch
Marginal branch
Posterior interventricular branch
SA (sinoatrial) nodal branch
This artery goes to the SA node (SA node is part of the intrinsic pacing system)
Marginal branch
comes off inferior aspect of the heart; travels or course towards the apex
Posterior interventricular branch
continuation of right coronary artery
Largest branch
Found in posterior interventricular sulcus
Function: serves the right ventricle (sulcus correlates with interventricular septum)
Left Coronary Artery
Begins at left coronary cusps of aortic valve
Short- 1.5 inches in length
Bifurcates in 2 major branches
biforcation of Left Coronary Artery
anterior interventricular branch
circumflex
anterior interventricular branch of left coronary artery
descends into anterior interventricular sulcus (correlates with anterior interventricular septum)
terminates with apex
function: primarily serves left ventricle but does send branches to right ventricle. Serves interventricular septum.
It forms an anastomosis relationship with the posterior interventricular artery
Most heart attacks occur in anterior interventricular branch, this serves left ventricle which is vital
circumflex branch of Left Coronary Artery
courses posteriorly to left
ends up in posterior coronary sulcus
function: primarily serves left ventricle and two atrium
Venous Drainage of Heart
Coronary Sinus
main vein (receives directly or indirectly blood from all heart veins)
Tributary to right atrium
Located in posterior coronary sulcus
2 major tributaries of coronary sinus
major tributaries of coronary sinus
great coronary vein
middle cardiac vein
great coronary vein
located in anterior interventricular sulcus
coronary sinus is a continuation of great coronary sinus
middle cardiac vein
located in posterior interventricular sulcus
begins in apex region
Intrinsic Conduction System of the Heart
function: to initiate the normal rhythmic heartbeat and coordinate the contractions of the 4 chambers
may be overridden by the autonomic nervous system (ANS)
ANS
Sympathetic—speeds up heart rate
Parasympathetic—slows down heart rate
The heart has potential to beat on its own (without ANS). Cells in heart ‘want’ to contract
Sinoatrial node (SA node)
specialized area of modifies myocardial cells capable of initiating impulses. (responsible for initiating intrinsic cardiac cycle) (1 systole; 1 diastole)
Abnormalities with SA node
arrhythmia
SA Node
Located anterior and laterally at junction of superior vena cava and right atrium
SA Node
Innervated by ANS; both sympathetically and parasympathetically
SA Node
When SA node is activated it causes all myocardial cells in both atria to contract (blood goes from right atria to right ventricle and left atria to left ventricle)
Atrioventricular node (AV node)
Smaller than SA node
Located in the posterior, inferior aspect of the interatrial septum
Near orifice of coronary sinus
Receives input of myocardial cells of atria
Sends information into both ventricles via the atrioventricular bundle (AKA: bundle of HIS)
Atrioventricular Bundle (Bundle of HIS)
Located in the membranous (superior portion) part of the interventricular septum
Bifurcates into right and left bundle branches
Right bundle branch
Innervate myocardium of right ventricle
Left bundle branch
Innervate myocardium of left ventricle
Purkinje fibers
tell myocardium (ventricles) to contract
Phrenic Nerves
Bilateral
Originate from cervical spinal cord (ventral rami of C3, C4, C5)
Terminate with diaphragm
Innervates diaphragm
Located in posterior and superior mediastinum
As it passes by myocardial sac-attached to pericardial sac
Thymus Gland
 Located in superior mediastinum
 Inferior and deep to manubrium
 Lobated and large
 In young people it is pink; after puberty, it turns into fat (non-functioning in adults)
 Function: part of lymphatic system—immunity system. Processes T-lymphocytes (makes lymphocytes) and B-lymphocytes (makes antibodies)
Superior Vena Cava
Located in superior mediastinum
Formed by the right and left brachiocephalic veins and terminates at the right atrium of the heart.
Aortic Arch
Located in superior mediastinum
Continuation of ascending aorta
Becomes descending aorta at approximately T-4
3 major branches
innominate artery (aka: brachiocephalic artery trunk)
left common carotid
left subclavian
Brachiocephalic trunk
bifurcates and forms
right subclavian
right common carotid
Descending aorta
T-4 and diaphragm
pass through posterior mediastinum
passes through aortic foramen and enters abdomen
always to left of esophagus (and midline)
covered by parietal pleura
it descends posterior to root of left lung
Ligamentum Arteriosum
connection between arch of aorta and root of left pulmonary artery
located in superior mediastinum
in adult, it is ligamentous tissue
structure of fetal circulation
Vagus Nerves
bilateral structures
C-10
Enter thorax through superior thoracic aperture, then enters posterior mediastinum (after passing through superior mediastinum)
2 major branches
Right and left recurrent laryngeal nerves
Right and left recurrent laryngeal nerves
Recur or travel back in neck
Innervate larynx
Left arches under arch of aorta
Right goes back under right subclavian artery
Vagal nerves
branch and form vagal plexi and descend to posterior mediastinum
Plexi innervates lungs, heart and esophagus (all parasympathetically)
Plexi re-condense into anterior and posterior vagal trunks
These pass through esophageal foramen and enter abdomen. They branch and innervate structures in abdomen
Esophagus
Located in posterior mediastinum
Muscular tube that begins with oral pharynx
Terminates with esophageal sphincter
Function: tube to get food and fluid from mouth to stomach
Esophagus
Food is moved by peristalsis (rhythmic contractions of esophagus)
Peristalsis is under control of ANS
Divided into 1/3’s – upper, middle, and lower
Upper 1/3 – skeletal, voluntary
Middle 1/3 – transition, (mixture)
Lower/distal – smooth, involuntary
No digestion takes place in esophagus, because there are no digestive enzymes. There is mucus in the stomach for lubrication
Esophagus Arterial blood
Several pair of esophageal arteries (from thoracic aorta)
Several pair of esophageal veins—these are tributaries of the azygous vein
Esophagus
Always to the right of thoracic aorta
Posterior to trachea
Exits thoracic cavity through esophageal foramen (approximately at T-10 level)
Esophagus is anterior to vertebral column
Thoracic Duct
Located in posterior mediastinum
Located between thoracic aorta and esophagus
Largest lymphatic vessel in body
Begins in abdomen (approx. T-12)
Chyle Cisterna—where thoracic duct begins
Dilated sac
Enters thorax through aortic foramen
Ascends and terminates at junction of left subclavian vein & internal jugular vein [left brachiocephalic vein]
Abdomen
area between diaphragm and pelvis
Abdominal wall
Superior wall—diaphragm
Posterior wall
Anterior wall
Lateral wall (2)
Lateral wall muscles (3)
External abdominus oblique
Internal abdominus oblique
Transverses abdominus muscle
External abdominus oblique Muscle
O: Ribs 5-12
I: linea alba, pubic tubercle, and iliac crest
Medial limit—linea semilunaris
Fiber direction is inferior and oblique
Most superficial of 3 lateral wall muscles
Internal abdominus oblique Muscle
O: iliac crest, inguinal ligament, and thoracolumbar fascia
I: linea alba, ribs 10-12
Part of lateral wall
Medial limit—linea semilunaris
Fibers run inferior and oblique
Transverses abdominus muscle
deepest of 3 lateral muscles
inguinal ligament, iliac crest, thoracolumbar fascia, cartilage from ribs 5-10
I: linea alba, pubic crest, inguinal ligament, xyphoid process
Medial boundary—linea semilunaris
Fibers run perpendicular to rectus abdominus muscle
Anterior wall muscles
Rectus abdominus muscle Muscle
Rectus abdominus muscle Muscle
O: pubic symphysis and pubic crest
I: xyphoid process and costal cartilage from ribs 5, 6, & 7
Only muscle in anterior wall
Has 3 tendonous intersections
Function of Oblique and Transverse Abdominus Muscles
anteriorly flexing trunk
laterally bending trunk
rotation of trunk
Functions of
External abdominus oblique
Internal abdominus oblique
Transverses abdominus muscle
Rectus abdominus muscle
rectus abdominus - flexing trunk
all 4 muscles assist in respiration
during inspiration, (when the diaphragm goes down) the muscles have to relax
also pull down on ribs during forced expiration
all 4 muscles put pressure on visceral structures during visceral functions
vomiting
urination
defecation
birthing
Innervation of abdominal Wall
Intercostal nerves 6-12 and L-1 (bifurcates—iliohypogastric and ilioinguinal)
Skin and subcutaneous tissue are also innervated by these nerves
Arterial blood Supply to abdominal muscles
Superior epigastric artery
Inferior epigastric artery
Deep circumflex artery
Lower 2 posterior intercostals arteries
4 pair of lumbar arteries
lower anterior intercostals arteries
Superior epigastric artery
Terminal branch of internal thoracic artery
Enters the rectus abdominal muscle superiorly and descends to meet the inferior epigastric about 1/3 of the way. They form an anastomotic relationship
Inferior epigastric artery
Branch of external iliac artery
Ascends to rectus abdominus muscle; goes 2/3 of the way where it meets superior epigastric artery
Deep circumflex artery
Branch of external iliac artery
Serves inferior parts of anterior and lateral abdominal wall
Lower 2 posterior intercostals arteries
Branches of abdominal aorta; serve posterior abdominal wall
4 pair of lumbar arteries
serve posterior wall of abdominal wall
lower anterior intercostals arteries
serve anterior and lateral abdominal walls
branches of musculophrenic arteries
venous drainage of Abdominal wall
Superior epigastric vein
Inferior epigastric vein
Lumbar veins
Superior epigastric vein
Tributary to internal thoracic vein
Inferior epigastric vein
Tributary to external iliac vein, common iliac and inferior vena cava
Lumbar veins
Tributaries to inferior vena cava
Rectus Sheath
Long aponeurotic sheath which encloses the rectus abdominus muscle
Formed by aponeurosis of 3 lateral abdominal muscles
There is an anterior and posterior rectus sheath
External oblique goes over (becomes part of anterior rectus sheath)
Product of aponeurosis of internal oblique and transverses abdominus
Aponeurotic layers fuse at midline and form the linea alba
Fascia Transversalis
Layer of transparent fascia that lines all the abdominal cavity
Between muscle and aponeurosis and parietal peritoneum (lines abdominal cavity)
Incisions lateral to the linea semilunaris
Skin
Subcutaneous tissue
External abdominus oblique muscle
Internal abdominus oblique muscle
Transverses abdominus oblique muscle
Transverses fascia (extraperitoneal fat)
Peritoneum (parietal)
Peritoneal cavity
Peritoneum (visceral)
Organ of abdominal cavity
Peritoneum
Lines inner aspects of walls of abdomen and pelvis
May surround a visceral structure
Moist (b/c of serous fluid)
Function: allows sliding—reduction of friction between organs
Layers:
Parietal
Visceral
Parietal Peritoneum
Lines inner aspects of abdominal and pelvic wall
Visceral Peritoneum
Surrounds or is touching visceral organs
Peritoneal cavity
Space between parietal and visceral peritoneum
Special Structures of Peritoneum
Mesenteries
double sheet of peritoneum which attaches an organ to the abdominal wall
May contain a variable amount of fat
Types of mesentery
Greater omentum
Lesser omentum
The mesentery
Mesocolon
Greater omentum
attached to greater curvature of stomach and transverse colon; varies in size. AKA policeman of the stomach b/c it walls off infection
Lesser omentum
hangs off lesser curvature of stomach. Also attached to liver and proximal duodenum
The mesentery
attaches small intestine to posterior wall of abdomen. Important b/c it contains vessels involved in absorption of amino acids, simple sugars, and fatty acids into the blood stream.
Mesocolon
attaches colon (large intestine) to posterior abdominal wall
Digestion
Proteins>amino acids
Carbohydrates>simple sugars Fats>fatty acids
Peritoneal ligaments
double folds of peritoneum without the fat; extensive vessels function to stabilize structures with each other
Falciform ligament
attached liver to inferior portion of diaphragm
Peritoneal recesses
where peritoneum forms ‘blind’ pouches; where it reflects on itself.
Peritoneal Recesses
Omental bursa (lesser curvature of the stomach)
Epipoloic foramen—entrance to Omental Bursa (lesser sac)
Peritoneal cavity (greater sac)
Retro-peritoneal Structures
anterior (or ventral) surfaces are covered by parietal peritoneum
Anything behind parietal peritoneum
Inguinal ligament
Product of rolled under edge of the aponeurosis of the external oblique muscle. (it’s a tendon)
Extends between Anterior Superior Iliac Spine (ASIS) and pubic tubercle
Separation plane of tissue between abdomen and thigh
Inguinal canal
Passage for:
Male - spermatic cord
Female - round ligament of uterus
The canal is about 4.5 cm long
Runs inferiorly and medially
Begins with deep inguinal ring
Inguinal canal terminates with the superficial inguinal ring
The inguinal canal is less prominent in women It is a 360 degree structure
During fetal development, the gonads of the male travel down the inguinal canal to the scrotum. Also, the male has a higher risk of a inguinal hernia than a woman.
Deep inguinal ring
found in abdominal cavity
Superior to inguinal ligament
Just lateral to the branching of inferior epigastric artery
Spermatic Cord
Begins with vas deferens
Extends between testicle and urethra
Carries sperm and seminal fluids
Pampiniform plexus of veins
Testicular arteries
Cremaster muscle
Genitalfemoral nerve
Varying types of fascia
Sympathetic and parasympathetic nerves
Lymphatic vessels
Pampiniform plexus of veins
condense to form the testicular veins
Right testicular vein is a tributary to the inferior vena cava
Left testicular vein is a tributary to left renal vein
Testicular arteries
Right and left testicular arteries
Both branch off abdominal aorta; both come off just inferior to the renal arteries
Cremaster muscle
Fibers are parts of internal abdominus oblique muscles
Function: to force sperm from testicles to urethra
Innervated by genitalfemoral nerve
Testis
Surrounded by dense connective tissue
Referred to as tunica albuguinea (white tissue)
Function: produces sperm and hormone (ex: testosterone)
Sperm are produced in seminiferous tubules
Route of average spermatozoa
Seminiferous tubules of testicle
Rete testis
Efferent ductules
Head of epididymis
Vas deferens
Urethra
Outside world
Seminiferous tubules
Seminiferous tubules are connected to rete testis, rete testis are connected to about 20 efferent ductules; efferent ductules are attached to head of epididymis (kind of a storage) epididymis changes name to vas deferens
Epididymis
3 parts of Epididymis
1. head
2. body
3. Tail
Scrotum
single structure
Muscular sac made of smooth muscle
Dartos muscle—when exposed to cold, dartos contracts to keep testis warm (it pulls them closer to abdomen)
Function - Protect testicles
Keep testicles warm (sperm has to be a certain temperature to be viable)
Arteries in Abdominal Cavity
descending aorta(abdonminal aorta)
Inferior Phrenic Arteries
Lumbar Arteries
Testicular / Ovarian arteries
Adrenal Arteries
Inferior Phrenic Arteries
paired
Serve inferior surface of diaphragm
1st branches off the aorta
Lumbar Arteries
4 pairs
o Come off in lumbar region
o Serve primarily posterior abdominal wall, some extend and serve lateral wall
Testicular / Ovarian Arteries
Come off just inferior to renal arteries
Go to respective gonads
Adrenal Arteries
numerous, small, bilateral branches
Come off superior to renal arteries
Celiac Artery (aka celiac trunk)
not bilateral
Comes off about T12
Short, about 1 inch long
3 major branches
splenic artery
left gastric artery
common hepatic artery
splenic artery
goes to spleen (left)
left gastric artery
goes to lesser curvature of the stomach (left)
common hepatic artery
goes to right
branches serve liver, pancreas, gall bladder, duodenum and stomach
Superior Mesenteric Artery
not bilateral
Comes off about 1 inch below celiac artery
Extensive distribution pattern
Serves small intestine, cecum, appendix, ascending colon, part of transverse colon
Renal Arteries
bilateral; paired
Comes off about where superior mesenteric artery
Comes off about L1 or L2
Travel to kidneys
Left is shorter than right renal artery
Inferior Mesenteric Artery
not bilateral
Comes off inferior to renal arteries
Smaller than superior mesenteric artery
Serves transverse colon, descending colon, sigmoid colon & rectum
Inferior Vena Cava
Major vein in abdomen
Tributary of right atrium
Formed by fusion of 2 common iliac veins
Right of vertebral column
Retroperitoneal structure
Largest vessel in body in terms of diameter
Tributaries of IVC
Renal veins (from kidneys)
Hepatic veins (from liver)
Gonadal veins (right gonadal vein only)—(left gonadal vein is tributary of left renal vein)
Lumbar veins (from posterior abdominal wall)
Right adrenal vein (from right adrenal gland)—(left adrenal vein is a tributary of left renal vein)
All digestive organs do not drain directly into IVC. They drain into the portal system.
The portal system runs through the liver
Stomach
Large sac-like structure
Made primarily of smooth muscle
Smooth muscle runs horizontal and longitudinal. This means it facilitates peristalsis.
Digestive organ
Wall of the stomach
Chief cells
Parietal cells
Proteolytic enzymes
peristalsis
On average the stomach can hold 2-3 quarts of food.
Chief cells
Synthesize and secrete proteolytic enzymes
Enzymes digest proteins
Parietal cells
Produce and secrete hydrochloric acid
Proteolytic enzymes
activated by hydrochloric acid. They are activated by the low pH.
peristalsis
Stomach churns
chyme
Stomach contents
Greater curvature of the stomach
(always to left)
Lesser curvature of the stomach
(always to right)
Lower esophageal sphincter
where the esophagus meets the stomach (aka-cardiac valve
Anatomical sections of Stomach
Fundus
Cardiac notch
Cardiac orifice
Body
Pyloric antrum
Pyloric canal
Pyloric valve/sphincter
Duodenum
Internal Anatomy of Stomach
Lined with mucosal tissue
Protects stomach; also contains chief and parietal cells
Folds and ridges in lining called rugae
Stomach Location
Stomach touches diaphragm superiorly
Touches left lobe of liver to the right
Inferiorly the stomach lies on top of the pancreas
Inferiorly touches transverse colon
Arterial Blood Supply To Stomach
Celiac artery----left gastric artery
Celiac artery----splenic artery----left gastroepiploic artery
Celiac artery----common hepatic artery----gastroduodenal artery----right gastroepiploic artery
Celiac artery----common hepatic artery----right gastric artery OR celiac artery----common hepatic artery----gastroduodenal artery----right gastric artery
Splenic artery----4 or 5 short gastric branches
Celiac Artery—primary artery that takes blood to stomach
Left Gastric Artery
Branch of celiac artery
Goes to superior half of lesser curvature of stomach
Left Gastroepiploic Artery
Serves left half of greater curvature of stomach
Right Gastroepiploic Artery
Serves right half of greater curvature of stomach
Right and left gastroepiploic arteries form anastomosis relationship
Right Gastric Artery
Serves inferior half of lesser curvature of stomach
4 or 5 short gastric branches
comes off splenic artery
serves body of stomach
Venous Drainage System of stomach
Either drain directly or indirectly into portal system
Right and left gastric veins are tributaries of portal veins
Right gastroepiploic vein is a tributary to superior mesenteric vein
Left gastroepiploic vein is a tributary of the splenic vein
Short gastric veins are tributaries of splenic vein
Veins
4 or 5 short gastric veins
right gastric vein
right gastroepiploic vein
left gastroepiploic vein
Left Gastroepiploic vein
Left Gastric vein
Celiac vein
Innervation of stomach
Innervated by ANS, both sympathetically and parasympathetically
Sympathetically it is innervated by the splanchnic nerves
Parasympathetically it is innervated by the vagus nerve
[FYI: Normally, the sympathetic nervous system speeds up activity, and the parasympathetic nervous system slows down activity. In digestion, they do the opposite.]
Pancreas
the pancreas is a retroperitoneal structure
Function of Pancreas
Endocrine function—gland that produces hormones, but doesn’t have any ducts. (ductless system) The hormones go in vessels.
Isles of Langerhan
Produce insulin
About 1% of tissue is endocrine
Exocrine—glands that have ducts
99% of tissue
main pancreatic duct
ability to produce digestive enzymes that digest proteins, carbohydrates, and fats
Anatomy of pancreas
Head
Located in curve of duodenum
Deep (posterior) to stomach
Termination of main pancreatic duct
Neck
Between head and body
About 2 cm in length
Superior mesenteric vein and splenic vein fuse to form portal vein—this occurs posterior to neck
Body
Between tail and neck
Crosses abdominal aorta
Inferior and posterior to stomach
Tail
Terminates at hilum of spleen
Terminal part of pancreas
Celiac artery-->splenic artery-->10 short pancreatic arteries
Splenic artery
10 pancreatic arteries
primarily serve the tail and body
Aorta-->celiac artery-->common hepatic artery-->gastroduodenal artery-->superior pancreaticoduodenal artery
Serves head of pancreas
Aorta-->superior mesenteric artery-->inferior pancreaticoduodenal artery
Serves part of head of pancreas
Venous Drainage of pancreas
Veins have same name as arteries, just go backwards
Main vein that drains pancreas is the splenic vein (which is a tributary of superior mesenteric vein)
Innervation of pancreas
Sympathetically—splanchnic nerves
Parasympathetically—vagus nerves
LIVER
Weighs about 1500 grams
Largest organ in the body
Occupies upper right quadrant of abdominal cavity
Part of left lobe occupies upper left quadrant
2 major surfaces
diaphragmatic surface—in contact with inferior surface of diaphragm
visceral surface—in contact with different organs of abdomen
attached to inferior surface of diaphragm
right and left triangular ligaments
covered by visceral peritoneum
liver goes around IVC
lobes
right lobe—larger than left (two lesser lobes)
quadrate lobe—resides between gall bladder and falciform ligament
caudate lobe—adjacent or inferior to IVC
left lobe—has no subdivisions
both lobes are separated by falciform ligament
falciform ligament
double fold of visceral peritoneum
also attach liver to inferior surface of diaphragm
major metabolic functions of liver
biodegradation/breakdown of hemoglobin into bilirubin and bile
major detoxifying organ in body
stores glycogen (a polymer of glucose)
fat, protein, carbohydrates metabolism
major producer of lymphatic fluids
¼ - ½ of lymph received by thoracic duct comes from the liver; therefore, there are a lot of lymphatic vessels in the liver
porta hepatis
port of liver (where things go in and out of liver)
portal vein
receives all venous blood from digestive organs
formed by fusion of splenic v. and superior mesenteric v.
tributary of liver
portal venous system
venous system which directs all venous blood from digestive organs to pass through liver prior to returning to heart
portal system->capillaries of digestive organs->major veins-> superior mesenteric vein and splenic vein-> portal vein->liver-> sinusoids of liver->hepatic veins->IVC->right atrium
involves two capillary beds—atypical; most of the body only has one capillary bed
capillaries of digestive organs
capillaries of liver
arterial blood supply to liver
aorta-> celiac a. -> common hepatic a. -> hepatic a. proper
biliary tree
a. system of ducts which collect bile
b. hepatocytes—break down hemoglobin into bile.
c. Bile collected in canaliculi (which are tributaries of interlobular ducts) tributaries to right and left hepatic duct right and left hepatic ducts fuse to form common hepatic duct common hepatic duct fuses with cystic duct to form common bile duct common bile duct and main pancreatic duct form at hepatopancreatic ampulla
d. Choledochal sphincter (made of smooth muscle cells)
e. Sphincter of main pancreatic duct (made of smooth muscle cells)
f. Sphincter of Oddi—controls flow of bile or pancreatic secretions into duodenum