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293 Cards in this Set
- Front
- Back
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Three parts of the sternum
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manubrium, body, xiphoid process
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Where is the sternal angle located?
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at the junction of the manubrium with the body of the sternum
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What happens at the level of the sternal angle?
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* Trachea bifurcates into right and left primary bronchi
* Arch of aorta arises from ascending aorta and continues as descending aorta * Azygos vein drains into superior vena cava |
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How many pairs of ribs articulate posteriorly with the thoracic vertebrae?
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Twelve
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Which ribs are true ribs?
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1-7
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What defines a false rib?
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Costal cartilage articulates with the costal cartilage of a more superior rib
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Where do fractures of the rib most commonly occur?
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Just anterior to the angle of the rib
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Main components of the skeletal muscles of the thoracic wall:
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the diaphragm, the external and internal intercostal muscles, and the transversus thoracis muscles
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main muscle of inspiration
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the diaphragm
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What does the diaphragm do?
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Elevates the ribs and increases the anteroposterior, transverse, and vertical diameters of the thorax
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What nerves innervate the majority of the diaphragm?
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the phrenic nerves
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What make up the phrenic nerves?
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The ventral rami from the C3, C4, and C5 spinal cord segments
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What nerves innervate the periphery of the diphragm?
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Sensory fibers in the intercostal nerves (all motor innervation comes from phrenic nerves)
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What is possible cause of hiccups?
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Involuntary contractions of the diaphragm caused by an irritative lesion of a phrenic nerve
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What might be the result of a destructive lesion of a phrenic nerve?
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Paralysis and paradoxical movement of one half of the diaphragm
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What elevates the false ribs?
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The external intercostal muscles
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What is the purpose of the external intercostal muscles?
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Elevation of the false ribs (increasing transverse diameter of thorax) and of true ribs (increasing anteroposterior diameter of the thorax)
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What aids expiration?
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Passive elastic recoil of thorax is main mechanism of expiration. Also aided by internal intercostal and transversus thoracis muscles
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What is the purpose of the internal intercostal muscles?
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Aid in expiration
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What is the purpose of the transversus thoracis muscles?
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Aid in expiration
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What are considered the accessory muscles of inspiration?
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The sternocleidomastoid, scalene, and pectoralis major and minor muscles
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What muscles are used in forced expiration?
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Rectus abdominis, external oblique, and internal oblique
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What make up the intercostal nerves?
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Ventral rami of the T1 through T11 spinal nerves
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What makes up the subcostal nerve?
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The ventral ramus of the T12 spinal nerve
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What innervates the intercostal muscles and the skin of the thoracic wall?
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Intercostal nerves and subcostal nerve
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What arteries supply the thoracic wall?
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Branches of the anterior and posterior intercostal arteries and the descending aorta
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The internal thoracic artery is a branch of what larger artery?
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The subclavian artery
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What vein drains all blood from the thoracic walls?
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The azygos vein (fed by the hemiazygos vein)
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Where are the intercostal nerves, arteries, and veins located? What is the arrangement of the three vessels?
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The superior part of each intercostal space. They are protected by the costal margin of the overlying rib. The three vessels are organized in a "VAN" arrangement, with the vein lying superiorly and the nerve inferiorly.
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General classification of breasts?
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Modified sweat glands
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How are breasts divided for diagnostic purposes?
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Into four quadrants
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Where does most lymphatic drainage from the breast go?
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Axillary lymph nodes (parts of medial quadrants drain to parasternal lymph nodes)
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Where are most breast adenocarcinomas located?
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In lactiferous ducts; most commonly in upper lateral quadrant
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Symptoms of late stage adenocarcinomas of the breast?
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Retraction and fixation of the nipple and dimpling of the skin
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Where do breast adenocarcinomas metastasize?
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Mainly to axillary lymph nodes; also to parasternal nodes, opposite breast, and nodes of anterior abdominal wall
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What does a radical mastectomy consist of?
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Removal of breast, pectoralis major and minor muscles, axillary lymph nodes and vessles, and tributaries of the axillary vein.
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What nerves are likely to be damaged in a mastectomy procedure?
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Long thoracic nerve or thoracodorsal nerve
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How many tissue layers in the abdominal wall?
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Eight
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What could cause varicose superficial epigastric veins?
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Obstructions of either the inferior vena cava or the hepatic portal vein (both drain structures below the diaphragm)
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What forms the inguinal ligament?
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The folded posterior reion of the external oblique aponeurosis
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What marks the inferior border of the anterior abdominal wall?
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Inguinal ligament
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What forms the linea alba?
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Interdigitation of the aponeuroses of the external and internal oblique muscles and the transversus abdominis muscle
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What runs along the anterior midline in the abdomen?
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Linea alba
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What gives rise to the cremaster muscle?
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The internal oblique muscles
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What muscle covers the testis and spermatic cord?
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The cremaster muscle
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In what tissue layer do the ovaries and testes develop?
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Extraperitoneal fat
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Serious membrane that lines the walls of the abdominopelvic cavity?
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Peritoneum
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What is the peritoneal cavity?
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Potential space between the parietal and visceral layers of peritoneum
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What is the name for an accumulation of fluid in the peritoneal cavity? What could cause this?
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Ascites; could be caused by peritonitis or could result from convestion of the venous drainage of the abdomen
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What makes up a mesentary?
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Two layers of paritoneum
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Fetal purpose of the dorsal mesentery?
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Suspends gastrointestinal structures below the diaphragm
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Fetal purpose of the ventral mesentery
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Suspends gastrointestinal structures derived from fetal foregut and spleen
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What innervates the skin, fascia, and muscles of the anterolateral abdominal wall?
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Lower intercostal nerves, subcostal nerve, and iliohypogastric and ilioinguinal nerves
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What spinal segments do lower intercostal nerves come from?
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T7 through T11
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What spinal segments does the subcostal nerve come from?
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T12
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What wpinal segments do the iliohypogastric and ilioinguinal nerves come from?
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L1
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What is the arcuate line?
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Where the posterior wall of the rectus sheath disappears.
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What makes up the posterior wall of the rectus sheath?
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Above arcuate line: Aponeuroses of the internal oblique and transversus abdominis muscles
Below arcuate line: nothing |
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What makes up anterior wall of rectus sheath?
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Above arcuate line: Aponeuroses of external and internal oblique muscles
Below arcuate line: Aponeuroses of external and internal oblique and transversus abdominis muscles |
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What forms the blood supply for the rectus abdominis muscle?
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The inferior and superior epigastric arteries
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In what tissue layer is the deep inquinal ring formed?
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Transversalis fascia
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In what tissue layer is the superficial inguinal ring formed?
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Aponeurosis of the external oblique muscles
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What blood vessels are useful in locating the superficial inguinal ring?
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The inferior epigastric artery and vein (they are located just laterally to the superficial ring)
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What forms the conjoined tendon?
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Fibers of the transversus abdominis and internal oblique muscles
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What conveys sperm from epididymis to ejaculatory duct?
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Ductus deferens
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In what tissue layer is the deep inquinal ring formed?
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Transversalis fascia
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In what tissue layer is the superficial inguinal ring formed?
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Aponeurosis of the external oblique muscles
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What blood vessels are useful in locating the superficial inguinal ring?
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The inferior epigastric artery and vein (they are located just laterally to the superficial ring)
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What forms the conjoined tendon?
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Fibers of the transversus abdominis and internal oblique muscles
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What conveys sperm from epididymis to ejaculatory duct?
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Ductus deferens
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What is contained in the inguinal canal in females?
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Round ligament of teh uterus
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What process forms the inguinal canal?
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Gubernaculum
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Difference between direct and indirect hernias?
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Indirect: pass through abdominal wall lateral to inferiour epigastric artery and vein; they pass through the entire inguinal canal and are covered by peritoneum and the three fascial layers of the spermatic cord
Direct: protrude through wall of inguinal canal medial to inferior epigastric artery and vein; more likely to tear through transversalis and cremasteric fascia |
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Where does a femoral hernia occur?
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Pass through the femoral ring deep to the inguinal ligament, and then enter the anterior thigh
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How many bones in axial skeleton?
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80
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How many bones in appendicular skeleton?
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126
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Type of joint with little movement:
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Synarthrodial or solid joint; connective tissue occupies space between bony elements
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Type of joint with freedom of movement:
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Synovial or diarthrodial joint; space with synovial fluid separates articulating surface of opposed bones
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Three ways skeletal muscles can attach to bone:
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tendon, aponeurosis, fleshy attachment
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Depolarization of a skeletal motor neuron results in:
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contraction of all the muscle cells in the motor unit
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Structure of cardiac muscle:
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highly branched, striated fibers interconnected by intercalated disks
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Structure of smooth muscle:
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Single, nonstraited fibers
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Two major divisions of the nervous system:
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Central and Peripheral nervous systems (CNS and PNS)
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Anatomical structures (gross) that make up CNS
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Brain and spinal cord
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Anatomical structures (gross) that make up PNS
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Spinal nerves, cranial nerves, autonomic nerves, and their branches
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Typical structure of a neuron:
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Nerve cell body and two types of cytoplasmic processes (single axon and multiple, branched dendrites)
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Where can neuronal cell bodies be found?
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Ganglion or nucleus.
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What do you call a collection of neuron cell bodies situated in the PNS?
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Ganglion
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What do you call a collection of neuron cell bodies situated in the brain or spinal cord?
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Nucleus
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What do sensory ganglia contain?
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Cell bodies of sensory neurons.
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Do sensory ganglia have synapses?
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No.
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What do autonomic ganglia contain?
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Cell bodies of motor neurons.
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Do autonomic ganglia have synapses?
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Yes.
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In a synapse, what sends the signal and what receives it?
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Impulse is transmitted from axon of preganglionic autonomic neuron to the dendrites or cell body of a postganglionic neuron.
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What is the embryonic source of neurons in ganglia?
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Neural crest ectoderm
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What types of neurons are found in nuclei?
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Skeletal motor neurons and preganglionic autonomic neurons
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What is the embryonic source of neurons in nuclei?
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Neural tube
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What cells produce myelin for axons in the CNS?
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Oligodendrocytes (type of glial cells)
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What cells form myelin for axons or processes in the PNS?
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Schwann cells.
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Which type of myelin producing cells form it for multiple axons?
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Oligodendrocytes
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How many pairs of spinal nerves are there?
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31
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Division of spinal nerves (cranial to caudal):
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8 cervical, 12 thoracic, 5 lumbar, 5 sacral, 1 coccygeal
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All branches of spinal nerves contain:
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Both motor and sensory fibers
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Spinal nerves are formed by:
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The union of a dorsal root and ventral root of a nerve that emerge from the spinal cord
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What type of nerve fibers are found in the dorsal root of a nerve?
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Sensory neurons ("afferent")
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What type of nerve fibers are found in the ventral root of a nerve?
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Motor neurons ("efferent")
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Each spinal nerve splits into:
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Dorsal and ventral rami
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What do dorsal rami do?
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Carry both motor and sensory fibers that innervate the skin of the back, the deep muscles of the back, and the facet joints between articular processes of vertebrae.
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Named dorsal rami branches:
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Suboccipital nerve, greater occipital nerve, and the cluneal nerves that provide cutaneous innervation to the gluteal region.
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What do nerves in ventral rami do?
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Carry both motor and sensory fibers; Innervate skin, muscles, and joins in the ventrolateral aspects of the neck and trunk and all extremities
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What is a plexus?
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Grouping of nerve fibers that come from ventral rami; reorganization of fibers
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Which nerves running through ventral rami do NOT form plexuses of fibers?
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Those from the T2-11 spinal nerves.
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How do ventral rami communicate with the sympathetic chain of paravertebral (autonomic) ganglia?
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By white and gray communicating rami.
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What is a dermatome?
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The area of skin supplied by the branches of a single spinal nerve
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What is a myotome?
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The muscle mass supplied by the branches of a single spinal nerve.
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What are splanchnic branches?
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Branches of the ventral rami from T1-L2; carry autonomic and sensory fibers to organs in the thorax, abdomen, and pelvis
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How many cranial nerves are there?
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12 pairs
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Where does the vagus nerve originate?
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Cranial Nerve 10 (CN X)
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What does the vagus nerve innervate?
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Heart, lungs, and GI structures in the thorax and abdomen
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What innervates the heart and lungs?
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Vagus Nerve
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What innervates most of the GI tract?
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Vagus Nerve
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What does the name vagus derive from?
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Comes from latin for wanderer
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What are the two major divisions of the autonomic nervous system?
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Sympathetic and Parasympathetic
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What part of the nervous system ALWAYS uses two neurons in series?
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Autonomic Nerves
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What are preganglionic neurons, and where are their cell bodies found?
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First neurons in autonomic nerves; cell bodies found in CNS
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Where are the cell bodies for preganglionic sympathetic neurons found?
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Thoracic and upper lumbar segments of the spinal cord from T1 through L2
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Where do preganglionic sympathetic axons leave spinal cord?
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Through ventral roots and ventral rami of T1 through L2 spinal nerves
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What happens to preganglionic sympathetic axons after leaving spinal cord?
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Exit spinal nerves in "white rami communicantes" to synapse in a paravertebral ganglion in teh sympathetic trunk OR pass through trunk to synapse in prevertebral sympathetic ganglion
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What courses through gray rami?
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Postganglionic sympathetic axons from paravertebral ganglia
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What do grey rami allow the neurons inside to do?
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Rejoin spinal nerve branches to innervate smooth muscle in the walls of blood vessels and sweat glands (in body wall, extremities, and neck)
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What runs through splanchnic nerves and innervates smooth muscle and glands in the lungs, cardiac muscle, and conduction system of the heart?
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Postganglionic sympathetic axons from paravertebral ganglia
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Where in body are prevertebral ganglia found?
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Below the diaphragm; mainly situated around origins of branches of the abdominal aorta
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What do all preganglionic sympathetic axons use as a neurotransmitter??
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Acetylcholine
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What do (most) postganglionic sympathetic axons use as a neurotransmitter?
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Norepinephrine (except those innervating eccrine sweat glands and erectile tissues)
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Where do preganglionic parasympathetic neurons exit CNS?
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CN III, VII, IX, and X and S2-4
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Where do preganglionic parasympathetic axons in vagus nerve synapse?
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Terminal ganglia (near heart and lungs in thorax, and in walls of GI tract in foregut and midgut)
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What nerves carry the sacral preganglionic parasympathetic axons that will innervate the hindgut, bladder, and pelvis?
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Pelvic splanchnic nerves
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What do parasympathetic axons use as a neurotransmitter?
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Acetylcholine
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Where is most visceral pain referred to?
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T1 through L2 dermatomes
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What structures carry blood away from heart?
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Aorta and pulmonary trunk
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What are anastomoses?
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Communication between small arteries fed by different main arteries; permit collateral circulation in case of a blockage
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What do you call an artery that lacks collateral circulation? Examples?
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Called "anatomic end arteries". Examples: central artery of retina and interlobular arteries of kidney
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When does blood traverse two capillary beds before returning to heart?
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In "portal" circulation systems -- portal veins receive blood that has traversed 1 venous system and deliver it to a second capillary bed system;
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Two portal systems in body?
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Hepatic and hypophyseal (links the hypothalamus and the anterior pituitary)
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What structure bypasses capillary beds?
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Arteriovenous shunts.
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Where does lymph enter venous system?
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All lymph fluid enters venous system at junction of internal jugular vein and subclavian vein in neck
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Three thin, friction-reducing serous membranes:
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pleura, pericardium, peritoneum
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What friction-reducing membrane covers the thoracic wall?
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Parietal pleura
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What is the pleural cavity?
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Potential space between visceral pleura and parietal pleura (ie sac surrounding lungs)
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What innervates the costal parietal plaura?
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Intercostal nerves
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What innervates the mediastinal plaura?
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Phrenic nerve
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What innervates most of the diaphragmatic parietal pleura?
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Phrenic nerve
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Which pleuras are sensitive to pain?
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Parietal pleura, NOT visceral pleura
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Which lung is larger?
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Right.
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Lobes of right lung:
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Superior, middle, inferior
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Fissures of right lung:
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Oblique and horizontal
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Which lobes of right lung does the oblique fissure separate?
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Superior and middle lobes from inferior lobe
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What structures are in the root of each lung?
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(1) Main bronchus, (2) pulmonary artery and two pulmonary veins, (3) bronchial arteries that supply lung tissue, (4) autonomic and sensory nerves and lymphatic vessels
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Mnemonic for remembering positions of vessels in hilus of lungs:
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RALS gives position of pulmonary artery to bronchus:
Right: anterior; Left: superior |
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Branching of bronchi in lungs:
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In left: main bronchus divides into three lobar bronchi
In right: main bronchus dividesinto two lobar bronchi |
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Segmentation of lungs:
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In each lung, bronchi divide into 10 segmental bronchi that serve restricted segments of lung tissue
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What nerves are contained within each pulmonary plexus?
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1. preganglionic parasympathetic axons from the vagus nerves (CN X)
2. postganglionic parasympathetic axons from terminal ganglia in the plexus 3. postganglionic sympathetic axons from cervical and upper thoracic planchnic nerves 4. sensory fibers from baroreceptors in the trachea, bronchi, and lungs (note that lungs and visceral pleura are insensitive to pain) |
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What is result of sympathetic innervation of lungs?
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Relaxation of smooth muscle in bronchial tubes, causing dilation of tubes and allowing greater volume of respiration
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Three embryonic origins of abdominal structures:
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Foregut, midgut, hindgut
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What does "peritoneal" mean?
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Suspended by a deriavtive of a dorsal or ventral mesentery in postnatal life
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What does "secondarily retroperitoneal" mean?
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Structures that lost their meseneric suspension in postnatal life; These structures are only partially covered by peritoneum and lie of posterior wall of abdominopelvic cavity
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What does "primarily retroperitoneal" mean?
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Structures that were never suspended by a mesentery; These are partially covered by peritoneum and lie mainly on posterior wall of abdominopelvic cavity
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What names are given to postnatal derivatives of mesentery?
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Omentum or Ligament or "meso---"
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Where does blood supply for foregut originate?
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Celiac artery (from descending aorta)
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Where does blood supply for midgut originate?
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Superior mesenteric artery (from descending aorta)
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Where does blood supply for hindgut originate?
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Inferior mesenteric artery (from descending aorta)
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What is name given to nervous system of GI tract?
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Enteric nervous system
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Is parietal pertoneum sensitive to pain?
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Yes.
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What innervates parietal peritoneum?
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* Lower intercostal nerves (T7 - T11)
* Subcostal nerve (T12) * Iliohypogasric and ilioinguinal nerves (L1) * Branches of phrenic nerve (C3-5) |
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What structures are in the foregut?
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Pharynx, esophagus, stomach, duodenum up to entrance of bile duct, liver and pancreas
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What structure is NOT a foregut structure but uses its blood supply?
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Spleen
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What is the mesenteric relationship of foregut structures in postnatal life?
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Peritoneal except for pancreas
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Branches of the celiac artery:
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Splenic artery, common hepatic artery, left gastric artery
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What structures does the splenic artery supply?
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Spleen; neck, body, and tail of pancreas; left side of greater curvature of the stomach; fundus of stomach
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Branches of splenic artery?
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Short gastric arteries and left gastroepiploic artery
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What does the common hepatic artery branch into?
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Proper hepatic and gastroduodenal
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What does proper hepatic artery supply?
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Luver, gallbladder, lesser curvature of stomach
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Branching of proper hepatic:
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Right gastric artery, right and left hepatic arteries; Cystic artery comes off of right hepatic
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What does gastroduodenal artery supply?
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Foregut part of duodenum, superior part of head of pancreas, and right side of greater curvature of stomach
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Branching of gastroduodenal:
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Right gastroepiploic and anterior/posterior superior pancreaticoduodenal arteries
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What innervates the foregut?
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Vagus nerves and lower thoracic splanchnic nerves
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Where does esophagus pass through diaphragm?
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At T10 level
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What ligament extends from liver to ventral body wall, ending inferiorly at the umbilicus?
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Falciform ligament
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What are the anatomic lobes of the liver?
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Left, right, quadrate, caudate
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How does blood enter the liver?
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Through proper hepatic artery and portal vein
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What makes up the portal triad?
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Hepatic ducts, portal vein, and proper hepatic artery
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What forms the bile duct?
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The junction of the common hepatic duct (jxn of right and left hepatic) with cystic duct
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What is mesenteric structure of pancreas?
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Head, neck, and body are secondarily retroperitoneal; Tail is peritoneal
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What forms the portal vein?
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Junction of splenic vein and superior mesenteric vein
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What structures come from the midgut?
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Distal three fourths of duodenum; jejunum; ileum; cecum, appendix, and ascending colog; proximal two thirds of transverse colon
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What artery supplies the ascending colon?
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Right colic
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What artery supplies proximal two thirds of transverse colon?
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Middle colic
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What artery suppliesdistal part of ileum, appendix, cecum, and proximal part of ascending colon?
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Ileocolic artery
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Where does pain from the small intestine tend to be referred?
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T5-10 dermatomes in epigastric and umbilical region
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What is mesenteric relation of midgut part of duodenum?
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Secondarily retroperitoneal
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What marks the duodenojejunal junction?
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Ligament of Treitz
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What differentiates the ileum from the jejunum?
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Jejunum has thicker walls, a larger luminal diameter, more prominent plica circulares, and greater vascularity; ileum has more fat in its mesentery and contains peyer's patches in its wall
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What differentiates the colon from the small intestine?
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1. larger diameter
2. teniae coli (bands of smooth muscle) 3. haustrations 4. omental appendices (globules of fat) |
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What are the longitudinal bands of smooth muscle that run along the colon?
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Teniae coli
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What are the bulges of the colon called?
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Haustrations
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What are the hindgut structures?
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distal third of the transverse colon; descending colon; sigmoid colon; rectum; anal canal
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What supplies blood to the hindgut structures?
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Branches of the inferior mesenteric artery
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What is mesenteric relationship of sigmoid colon?
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Peritoneal (suspended by sigmoid mesocolon)
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What forms a brachiocephalic vein?
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Union of an internal jugular vein and a subclavian vein
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Three branches of the arch of the aorta:
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Brachiocephalic artery, left common carotid artery, left subclavian artery
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Where is teh ligamentum arteriosum found?
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Between the left pulmonary artery adn the arch of the aorta; remnant of fetal ductus arteriosus
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What structures pass OVER the right and left main bronchi?
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Arch of the aorta passes over left main bronchus; Azygos vein passes over the right main bronchus
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Four sites where the esophagus is constricted:
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Indentation on left by arch of aorta; indentation anteriorly by left main bronchus; origin of esophagus in neck; esophageal hiatus of diaphragm
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On what side does the thoracic duct enter the neck?
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Left
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Relation of vagus nerves to lung?
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Pass through superior mediastinum, enter posterior mediastinum and pass posterior to the root of the lung where they form an esophageal plexus
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Reslation between vagus nerve and arch of aorta?
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Left vagus nerve crosses arch of aorta nad gives off hte left recurrent laryngeal nerve
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Course of phrenic nerves through mediastinum?
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Left and right phrenic nerves pass through superior mediastinum, enter middle mediastinum and pass anterior to the root of the lung then descend to innervate the diaphragm
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What is located in the middle mediastinum?
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Pericardium, heart and adjacent great vessels, phrenic nerves, pericardiacophrenic vessels
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What covers the heart?
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Visceral layer of serous pericardium
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Where is the transverse pericardial sinus found?
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Between the ascending aorta and the pulmonary trunk and superior vena cava
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Where is the oblique sinus of the heart found?
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Inferior to the pulmonary veins and to the left of the inferior vena cava
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What makes up the walls of the heart?
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Epicardium, myocardium, fibrous skeleton, inner endocardium
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What forms the apex of the heart?
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The tip of the left ventricle
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What is contained within the rough-walled part of the right atrium?
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The pectinate muscle
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What is the post-natal remnant of the formen ovale, and where is it found?
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Fossa ovalis; found in the interatrial septum
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What delivers poorly oxygenated venous blood to the right atrium?
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1. superior vena cava
2. inferior vena cava 3. ostium of the coronary sinus 4. anterior cardiac veins |
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What is the valve between the right atrium and ventricle?
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Tricuspid valve
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What structures make sure the leaflets of the tricuspid valve stay closed?
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The papillary muscles and the chordae tendinae
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What separates the right and left ventricles?
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Interventricular septum
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What structures bring blood to the left atrium?
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The four pulmonary veins
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What valve leads from left atrium to ventricle?
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Mitral valve
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How many leaflets are in the mitral valve?
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Two
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How many leaflets are in the tricuspid valve?
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Three
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What connects the left ventricle to the aorta?
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The aortic vestibule
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What causes heart valve sounds?
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Closing of the mitral and tricuspid valves; Closing of the aortic and pulmonic valves
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What structures supply arterial blood to the heart and where do they branch from?
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The left and right coronary arteries arise from the aortic sinuses of the ascending aorta just before the aortic valve
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What does the right coronary artery supply?
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Right atrium and right ventricle (via marginal branch)
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Where does the posterior interventricular artery (or posterior descending artery) branch from?
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Usually: from right coronary artery
Sometimes: from circumflex coronary artery |
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What does the posterior interventricular artery supply?
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Right and left ventricles and posterior part of interventricular septum
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What does the left coronary artery branch into?
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Anterior interventricular artery and the circumflex artery
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What does the anterior interventricular artery supply?
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Right and left ventricles and two thirds of interventricular septum
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What does the circumflex artery supply?
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Left atrium and left ventricle (via marginal branch)
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Where can the coronary arteries establish collateral circulation with each other through anastomoses?
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1. between anterior and posterior interventricular arteries in a right dominant heart
2. between circumflex branch of left coronary artery and right coronary artery in posterior part of coronary sulcus |
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What is the coronary sulcus?
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Grooves that separate atria from ventricles
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What veins drain into the coronary sinus?
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Great, middle, and small cardiac veins
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What cardiac vein empties directly into the right atrium?
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The anterior cardiac veins
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Major components of cardiac conduction system:
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SA node, AVnode, atrioventricular bundle of His, Purkinje fibers
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What is the main pacemaker of the heart and why?
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SA node -- depolarizes faster than other cardiac muscle cells
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What is purpose of AV node?
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Delays wave of depolarization from passing to ventricles; allows both atria to fully contract first
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What is purpose of AV bundle of His?
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Causes papillary muscles in ventricles to contract to keep AV valves shut while ventricles contract
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What type of sensory receptors are present in the heart?
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Baroreceptors and chemoreceptors
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What branches from the descending aorta in the thorax?
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Posterior intercostal arteries, bronchial arteries, and esophageal arteries
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What is located in the anterior mediastinum?
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The thymus
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What does the inferior mesenteric vein empty into?
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Splenic vein (usually)
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Where do the left and right gastric veins empty?
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Directly into the portal vein
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What is course of hepatic veins?
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Drain blood from hepatic sinusoids and empty into inferior vena cava just below diaphragm
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Which kidney is superior?
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Left
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What muscles are in contact with the kidneys?
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Diaphragm, transversus abdominis, quadratus lumborum, psoas major
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Is renal vein or artery more anterior at the hilus of the kidney?
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Vein
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What areteries supply the ureters?
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Renal artery, common iliac artery, superior vesical artery
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Where does the abdominal aorta bifurcate, and what does it become?
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Splits into the common iliac arteries at the level of the L4 vertebrae
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What are the three unpaired arteries that branch off of the abdominal aorta, and where do they arise?
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1. celiac artery at T12
2. superior mesenteric at L1 3. inferior mesenteric at L3 |
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What are the paired arteries that branch off of the abdominal aorta, and where do they arise?
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1. renal arteries at L2
2. gonadal arteries between L2 and L3 3. other pairs: inferior phrenic supply the diaphragm; lumbar arteries supply the body wall |
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What forms the inferior vena cava and where is it located?
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Junction of the common iliac veins forms the inferior vena cava at L5 level; ascends just to the right of the midline
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What are differences between right and left venous circulation in the posterior abdomen?
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On right: renal, adrenal, and gonadal veins drain directly into inferior vena cava
On left: only left renal vein drains directly into IVC; left gonadal and adrenal veins drain into left renal |
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Where do the motor fibers that innervate the diaphragm run?
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In the phrenic nerves (ventral rami from C3, C4, C5)
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What are the three hiatuses through the diaphragm?
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Caval, esophageal, aortic
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With what other structure does the right phrenic nerve pass through the diaphragm?
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With the inferior vena cava
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With what other structure do the vagal trunks pass through the diaphragm?
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With the esophagus
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With what other structure does the azygos vein pass through the diaphragm?
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With the aorta
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With what other structure does the thoracic duct pass through the diaphragm?
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With the aorta
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What does the thoracic duct carry?
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Virtually all lymph from structures in the perineum, pelvis, and lower limbs; this all collects in the cisterna chyli just inferior to the aortic hiatus
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What doe the right and left crura of the diaphragm transmit?
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The splanchnic nerves
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What makes up a hip bone?
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Iliu, ischiu, and pubis bones
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Where are the three hip bones fused together?
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At the acetabulum
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What separates the greater and lesser pelvis?
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The pelvic inlet
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What forms the borders of the pelvic outlet?
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1. inferior aspect of the pubic symphysis
2. ischiopubic rami 3. ischial tuberosities 4. sacrospinous ligaments 5. tip of coccyx |
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What forms the subpubic angle?
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The union of the ischiopubic rami at the pubic symphysis
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What muscle forms the posterior third of the pelvic diaphragm?
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ischio coccygeus msucle
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What innervates the pelvic diaphragm?
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Ventral rami of the S2 and S3 spinal nerves and branches of the pudendal nerve
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What structure is on the inner posterior wall of the bladder?
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Trigone
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What muscles are present within the bladder?
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Detrusor and two sphincter muscles
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What are the three parts of the male urethra?
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Prostatic, membranous, penile
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Which part of the male urethra passes through the sphincter urethrae muscle?
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The membranous urethra
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What changes occur at the pectinate line?
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Above:
* anal canal is line by mucose * blood supply provided mainly by superior rectal artery * venous drainage goes eventually to inferior mesenteric vein via internal rectal venous plexus/superior rectal vein Below: * anal canal lined with skin * blood supply provided by inferior rectal artery (branch of internal pudendal) * venous drainage via inferior rectal vein to internal iliac |
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Difference between internal and external sphincter muscles of anal canal?
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* Internal anal sphincter consists of smooth muscle; under involuntary control
* External sphincter consists of skeletal muscle; under voluntary control |
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Course of ductus deferens:
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Arises from epididymis adjacent to testis; traverses inguinal canal and descends into pelvis to reach posterior aspect of urinary bladder
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What are the sections of the uterine tubes?
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Intramural, isthmus, ampulla, infundibulum
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What is the longest segment of the uterine tube?
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The ampulla
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The ovaries lie adjacent to what part of the uterine tube?
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Infundibulum
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What suspends the uterine tubes, ovaries, and part of the uterus?
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The broad ligament (fold of peritoneum)
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What is the mesometrium?
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The part of the broad ligament adjacent to the uterus
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What supplies arterial blood to the psoas major and minor and the quadratus lumborum muslces?
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The iliolumbar artery
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