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90 Cards in this Set
- Front
- Back
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phrenic n. of diaghragm
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in thoracic cavity, look alont lat. pericardial sac.
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expanding ribcage
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ribs elevated as external intercostals contract
- diaghragm moves inferiorly during contraction .. this is inspiration |
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compress the ribcage
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ribs depressed as external intercostals relax
- diaphragm moves superiorly as it relaxes. |
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serous fluid between visceral pleura and parietal pleura sticks lungs to thoracic wall
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so lungs move when ribcage moves.
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some muscles of inspiration expand the ribcage
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ext. intercostals
diaphragm - increases thoracic volume. note anchors on lumbar vertebrae |
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some mu. of expiration compress ribcage
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- innermost intercostals
- int. intercostals - most of - ext. oblique - int. oblique |
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some acc. muscles of breathing
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ventilation - when breathing is stronger than at rest.
- expand ribcage - SCM and SCALENES - compress the ribcage - abdominal wall m. important - push liver and other contens up, squeezing lungs. - rectus abdominus - transversus abdominus - ext. oblique - int. oblique |
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remaining ventilatory system
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trachea
- primary bronchus - mediastinum - middle space of cavities between lungs - parietal and visceral pleura - diaghragm |
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right lung and left lung lobes
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right has 3
-sup. lobe - middle lobe - inf. lobe - horizontal fissure seperates the sup. and middle lobe - oblique fissure seperates the middle and inf. lobe - left has 2 ( sup. and inf. lobe) - oblique fissure seperates these two and there is no horizontal fissure. |
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right lung hilum or root
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- where stuff goes in and out
- secondary or lobar bronchus - pulmonary artery - pulmonary vein to l. atrium - pulmonary artery from right ventricle. - pulmonary artery is directed towards the apex. |
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left lung root
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has the common carotid and subclavian artery running along the superior apex part.
- phrenic nerve - descending aorta and vagus nerve are also on this side |
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right lung root
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- phrenic nerve
- azygos arch - esophogus - azygous vein - vagus nerve |
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lung - lobar branching patterns
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- bronchioles --> alveoli
- trachea --> primary or main bronchus --> secondary or lobar bronchii --> tertiary or segmental bronchi. |
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vasculature of bronchioles
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- bronchioloe artery branches from aorta with variations
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thoracic cavity and pleura (serous membranes)
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- parietel pleura - wall membrane lines up. diaghragm, inner thoracic wall and mediastinum
- visceral pleura - "gut" membrane fused to lung surface - pleural cavity - a potential space with a film of serous fluid to stick lungs to thoracic wall; water adhesion is quite strong. - note, the lungs are surrounded by the pleural cavity, they are not in it. |
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pericardial sac
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- double layer of serous pericardium there is a visceral layer of serous pericardium
- analogy - if i push my fist into a baloon, is my hand inside the baloon - the layer touching my hand is the visceral serous layer, the outer layer is the parietal serous layer. |
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inf. view of the diaghram includes some openings
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- caval hiatus
- esophogeal hiatus - aortic hiatus (as aorta passes through it becomes the abdominal aorta) |
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mediastinum
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- median portion of thoracic cavity between the pleural sacs
- contains all thoracic cavity structures except lungs and pleurae - structures within covered loose c.t., lymph nodes and fat - 4 subdivisions - sup. great vessels, thymus - ant. not much - post. - esophagus, n. desc. aorta - middle - heart, pericardium asc. aorta, |
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superior mediastinum
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- sup. to other 3 subdivisions
- sup. to horizontal plane thru the sternal angle and inf. border of T4 - contains aortic arch, brachiocephalic artery, sup. vena cava, l. common carotid a., l. subclavian arter, inf. trachea, most of thymus gland; also sup. portions of vagus and phrenic n., esophogus and thoracic duct. |
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sup. mediastinum
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- thymus - lymphoid tissue
- greatly degenerates after childhood; in the aged mostly fatty tissue here - blood supply: inf. thyroid and int. thoracic artery - brachiocephalic v. - union of subclavian and int. jugular - right brachiocephalic v. (1/2 length of L) receives R lympatic duct) - L brachiocephalic vein receives the thoracic duct. - sup. vena cava - union of brachiocephalic v. drains thorax, upper extremities head and neck, IVC |
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sup. mediastinum
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aortic arches from R to L and ant. to post.
- continuation of ascending aorta of middle mediastinum - usually 3 main branches 1. brachiocephalic 2. l. common carotid a. 3. l subclavian a. brachiocephalic trunk forks into the common carotid and subclavian. |
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superior mediastinum
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vagus n. enters here deep to sternoclavicular joint. and brachiocephalic v.
- runs post. to lung root - locate recurrent laryngeal of vagus n. on l. side of looping under arch - phrenic nerve - enters between subclavian artery and start of brachiocephalic v. - runs ant. to lung root - motor innervation to C 3-4 and 5 keeps you alive. |
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Superior mediastinum R. lat. view
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- trachea: palpate - note c shaped cartilaginous ring
- sup. esophogus: deep to trachea and super. to vertebral bodies. |
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post. mediastinum
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- located inf. to T4, post. to pericardium and sup. to diaghragm.
- desc. aorta - branches: bronchial a., esophogeal artery, post. intercostal artery, and subcostal artery |
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desc. aorta branches
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- bronchial arteries
- esophogeal arteries - post. intercostal arteries - and subcostal arteries - celiac arteries |
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post. mediastinum thoracic duct
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- arises at abdomen expansion (called cisternae chyli)
- emptiew at or near the juncture of subclaviand and int. jugular v. - deep to esophogus and sup. to vertebral bodies. - recieves lymph drainage from 3/4 of body: l. thorax and l. head/ neck, L upper extremity, lower extremities, and abdominopelvic region. |
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post. mediastinum
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- azygos v. - eventually drains the r. and left post. intercostal v. and empties into SVC.
- some people have hemiazygous vein on the left side. - on the right side super. to vertebral bodies and then arches over right lung hilus to empty into SVC. |
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post. mediastinum
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esophogus - continuing from sup. mediastinum lies on vertebral bodies down to T10, then passes thru esophogeal hiatus of diaghram.
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post. mediastinum symp. trunk
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- along lateral vertebral bodies, strip away parietal pleura carefully.
- deep to parietal pleura, so technically not part of post. mediastinum, but convenient to mention here. |
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ant. mediastinum
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lies between fibrous pericardium, sternal body, diaphragm and sup. mediastinum
- has lymph vessels, part if internal thoracic vessels - also has inf. portion of thymus gland. |
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middle mediastinum
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- lies between diaphragm and sup. mediastinum
- contains pericardium, heart and roots of lungs, inf. portion of phrenic n., arch of azygos |
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abdominal cavity
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- between the trunk walls, inf. to domed diaphragm and sup. to the pelvic bowl of the plane defined by the pubic tubercles and sacral promontory (tops of pubis and sacrum)
- bony landmarks - sup. and ant. costal margins ribs 7-10 and xiphoid process - post. vertebrae and rib 12 - inf. - top of bony pelvis = iliac crests, ant. sup. iliac spines (ant. end of crest, pectineal lines of pubis and sup. pubic symphysis. |
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pelvic cavity
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- bounded by the bony pelvis; major contents include bladder, much of reproductive system and lower digestive tract.
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bony pelvis - right and left coxxal bones, sacrum, coccyx
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- inguinal ligament - runs from asis to pubic tubercle.
- pubic symphysis - humans don't fuse the pubes - amphiarthrotic symphysys joint - acetabulum - for the head of the femur - pectineal line of sup. pubic ramus |
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soft tissue landmarks of abdomen
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- lenea ablba - cartalige conn. tissues that connects the rectus abdominus muscle - goes in a sup. to inf. direction down the midline of the abdomene.
- linea semilunaris - rectus sheath edge - the edge of the rectus sheath. - umbilicus = belly button. |
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9 clinical abdominopelvic regions
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1. right hypochondriac upper right
2. epigstric region - upper middle 3. left hypochondriac upper left 4. right lumbar - middle right 5. umbilical middle middle 6. left lumbar - middle left 7. right iliac - (inguinal) lower right 8. hypogastric (pubic) - middle lower 9. left iliac (inguinal) - lower left |
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abdominopelvic arteriole supply
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- lumbar, sup. and inf. epigastric arteries
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rectus abdominus
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o- pubic crest and symphisys
i - ant. inf. ribcage action adn innervation - compresses abdomen and ribcage; flexes vertebral column and pelvis intercostal n. |
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transversus abdominus
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o - deep on costal cart. lat. 1/3 inguinal lig. and anteromedial iliac crest
i. - abdominal aponeurosis action and innerv. - rotate, flex and lat. flex vert. column; compress ribcage and abdominopelvic region intercostal nerve. |
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ext. oblique - fibers run like fingers in a pocket
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o - outer, anterolat. surface ribs 5-12
i. - ant. iliac crest and abd. aponeurosis - rotate, flex and lat. flex of vert. column ; compress ribcage and abdominopelvic region intercostal n. |
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int. oblique (these are the major trunk rotators)
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- o - thoracolumbar fascia, ant. 2/3 iliac crest and lat. 2/3 inguinal lig.
- i. - costal cart. of lower 4 ibs and abd. aponeurosis action andinnerv. - rotate flex and lat. flex vert. column; compress ribcage and abdominopelvic region intercostal ner. |
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cremaster
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i - loops ofinternal oblique gibers that start at top of inguinal canal
i - fibers run down with cord contents into scrotum and back up next to pubic tubercle action - elevate testis genitofemoral n. |
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ACETABULUM
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- coxal hip socket
- the 3 coxal bones - ilium, ischium and pubis fuse here. |
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In humans, no/little overlap of triple m. layer onto rectus abdominus
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this is what it says in the slide
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blood supply of rectus sheath area
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- musculophreinc artery of int. thoracic artery
- sup. epigastric artery of int. thoracic artery - internal thoracic artery is deep to these - inf. epigastric artery of ext. iliac artery. |
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rectus sheath region
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- post. rectus sheath - behing the rectus abdominus
- ant. rectus sheath area - infront of rectus abdominus - parietal pertoneum - wall is serous membrane - transversalis fascia - towards the outer wall but just superficial to the pariatel pertioneum aponeurosis - refers to asheetlike tendon or ligament. |
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inf. rectus sheath area
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- aponeurosis of the 3 muscles - - shift to ant. rectus sheath, no post. sheath inferiorly (where it ends is the arcuate line)
- still have transversalis fascia and parietal pertioneum |
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cremaster muscle
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- elevates testis and innervated by genitofemoral nerve
- it is in the spermatic cord |
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inguinal region
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- inguinal triangle bounded by rectus abd. medially, lat. by inf. epigastric artery ad inf. by inguinal canal
- inguinal ligament formed by infolding of external oblique aponeurosis, forming a gutter, runs from asis to pubic tubercel - inginal rings - ext. (or superficial) inginal rings - lies med. to femoral triangle - int. or deep inguinal rings - opening in transvresalis fascia of transversus abdominus; lies lat. to inf. epigastric artery. - inguinal canal - tunnel between inguinal rings, just sup. to med. inguinal lig. contains spermatic cord in males and round lig. in females. - illiolingual nerve of lumbar plexus passes thru ext. inguinal ring next to spermatic cord; genitofemoral n. joins inside spermatic cord at ext. ring. |
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inguinal canal
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- roog - inf. borders of oblique and transversus abdominus
- ant. wall - aponeurose of int. and ext. obliques - post. wall - transversalis fascia of deep side of transveruss abdominus - floor - mainly inguinal ligaments aponeurosis - |
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uterine round ligament
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- one of the structures that holds uterus in place; runs from uterus thru inguinal canal, continues to labium majores where its fibers spread and interdigitate with tissue of mons pubis .
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hernias
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- protrusion of organ/ tissue through an opening in its surroundings walls, esp. in the abd. region
- hiatal hernia, femoral hernia, semilunar(spigellan) hernia - strangulated hernia |
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spermatic cord contains
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testicular av, genitofemoral n. of lumbar plexus, ductus deferens and cremaster muscle.
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inguinal hernia
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- most common hernia in males; weakest spot in abd. wall, since testis went through here and spermatic cord stil does! inguinal canal is also larger in males.
- in females - femoral hernia most common; weak spot of femoral canal med. to femoral AV |
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direct vs. indirect inguinal hernias
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- indirect - bulges through testicular pathway of inguinal canal: improper closure of int. inguinal ring after testis descends; occur at any age
- direct - protrudes through weak abd. wall, rarely into scrotum - common in middle and elderly menas ewall weakesn with age |
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semilunar hernia
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- digestive tract thru aponeurosis between rectus abdominus and semilunar line
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inguinal canal
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- roof - inf. borders of int. oblique and transveruss abdominus
- ant. wall - aponeurosis of int. and ext. obliques. - post. wall - transversalis fascia of deep side of transversus abdominus - floor - mainly inguinal ligament . |
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ventral cavity arteriole supply
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- subclavian - internal thoracic artery
- musculophrenic artery - sup. epigastric artery - intercostal artery - - descending aorta - intercostal arteryis - pulmonary trunk and pulmonary arteries - trunk empties right ventricle ad arteries go to lungs. |
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abdominal blood supply
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- abdominal aorta (as soon as it passes through diaphrahim)
- lumbar artery - celiac trunk - sup. mesenteric artery - inf. mesenteric artery - adrenal artery - renal artery - ovarian/ testicular artery - common iliac artery - ext. iliar - inf. epigastric - int. iliac artery - sup. and inf. gluteal artery |
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cliac trunk of abdominal aorta
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think 3 branches 3 times.
- feeds the liver, spleen and stomach. - left gastric artery - splenic artery - branches just before it reaches the spleen and lets off the left gastroepiploic artery that rides down the greater curvature of the stomach - common hepatic artery - right gastric artery branches - gastroduodenal artery - right gastroepiploic artery - proper hepatic artery - right and left hepatic artery - cystic artery. |
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Hepatic portal system
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- The IVC is post. to the liver and hepatic v empty into it.
- the liver has special blood circulation. blood from digestive tract with nutrients passes thru 2 capillary beds before returning to the heart. - liver sinusoids - O2 rich blood from hepatic artery mix with hepatic porteal vein blood. - sometimes the gastric vein empties directly into the hepatic portal vein or at the splenic/ hepatic portal juncture. The inf. mesenteric v. also may empty at the juncture or into the splenic v. |
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abd. serous membranes
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- retroperitoneal - kidneys, adrenal glands, gonads and their vessels, ecum, parts of asc. and desc. colon, rectal colon, pancreas, abd. aorta, iliace vessels, IVC, urinary bladder, ureters
- visceral peritoneum - from both sides of the abdominal wall, the parietal peritoneum extends around much of the inner guts, now its visceral pertioneum - mesentary proper - double layer of peritoneum that connects the jejunm and ileum to post. abd. wall; encases lymph and blood vessels. - intestinal tract is long and highly coiled, which makes mesentary folding complex. |
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abd. serous membranes
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- lining wall - parietal peritoneum
- lining much of abdominal guts; visceral peritoneum - mesentaries double layer of serous membrane. - technically refers to layer that anchors jejunum and ileum to post. wall. - retroperitoneal - peritoneum only on ant. surface - intraperitoneal - covered all the way around. |
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greater omentum
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- loops from gr. curvature of stomach to transverse colon
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lesser omentum
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- lesser curvature of stomach to liver.
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esophogus
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- in adults 18- 25 cm muscular tube with cervical, thoracic and abd. parts.
- sup. 1/3 is skeletal mu and lower 1/3 is smooth muscle. - innervated by vagus nerve. - supplies by esophogeal artery of desc. aorta, and in abd. by esophogeal artery of l. gastric artery - esophogeal hiatus ant. to aortic hiatus, crossing midline, caval hiatus is lat. to the right and a little more ant. - acid reflux - lower esophogeal orifice does not close properly, allowing stomach HCL acid to back up into esophogus. |
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ahital hernia
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- stomach pokes through esophogeal hiatus into thorax; many exhibit no symptoms
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stomach regions
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- cardia
- fundus - hollow, top part of an organ, e. g. uterine fundys - body - pylorus - stomach curvatures - lesser curvature where lesser omentum attaches - greater curvature - where gr. omentum attaches openings - - cardiac orifice or lower esophogeal orifice - pyloric sphincter - exit into duodenum |
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celiac trunk
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- three branches three times
- abdominal aorta - - celiac trunk - feeds the liver, spleen and stomach - left gastric artery - splenic artery - left gastroepiploic artery - common hepatic artery - right gastric artery - gastroduodenal artery - right gastroepiploic artery - proper hepatic artery - r and l. hepatic artery - cystic artery |
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greater omentum
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- four layers of peritoneum - 2 layers from stomach greater curvature, traverses inferiorly - sometimes pelvic level - folds back to transverse colon.
- fed by r and l gastroepiploic artery - this apron called policaman of abdomen - has concentrations of macrophages - may help physically limit infections- often found wrapped around infections or injured regions. - fatty layer over intestines may insulate heat to increase chem. reactions. - lesser omentum - - runs from lesser curvatrue of stomach and prox. duodenum to liver. - encases the r and l gastric ar/v, common hepatic artery, common bile duct, hepatic portal v. and lymphatics - mainly fed by r and l gastric arteries. |
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sm. intestine
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duodenum- part of 3 divisions of sm. intestine. foregut duodenum, midgut jejunum and midgut ileum
-duodenum - retroperitioneal hepatopancreatic ampulla empties in here (papilla of vater) carries bile from common bile duct; and enzymes, water and bicarb from pancreatic duct |
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duodenum
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- retroperitoneal
- hepatopancreatic ampulla empties here papilla of vater - caries bile from common bile duct; and enzymes, water and bicarb from pancreatic duct - small intestines; most chemical digestion takes place (minor carb and lipid digestion in oral cavity and continues until food bolus parts contact stomach HCL: some proteins digested in the stomach. - fed by branches of gastroduodenal and sup. mesenteric artery. - from the gallbladder is the cystic duct and this combines with the other duct to form the common bile duct and this empties into the papillar of vater. |
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pancreas
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- its head nestles in the "sea of the duodenum" in the c shaped duodenum.
- retroperitoneal (except tail) - fed by branches of gastroduodenal, sup. mesenteric and splenic artery - major pancreatic duct empties digestive enzymes into shared hepatopancreatic ampulla to duodenum - islets make blood shugar regulation hormones. |
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liver
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- 4 well fused lobes; largest lobe is R, L other main lobe
- chemical factory of body: makes bile, triglycerides and cholesterol, cleans and filters blood. (stores glycogen, stores D,E, K A fat suluble vitamins, makes and recy les hormones, produces lots of heat, makes enzymes and clotting factors and blood osmotic proteins) - porta hepatis - doorway for vessles, n, bile ducts and lymphatics |
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liver
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biliary system transposts bile to duodenum and also backs up to store bile in a blind sac, the gall bladder
- bile emulsifies fat - for that cheeseburger with bacon and dressing; its a detergent that interferes mechanically to seperate big lipid drops onto small ones. |
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spleen
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- part of lymphatic system
- recycles erythrocytes and clans blood - sits in L hypochondriac region - fed by splenic artery |
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midgut small intestine
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- jejunum and ileum
- intestinal mesentary encases the blood and lymph vessels - many intestinal arteries branch from sup. mesenteric artery: intestinal artyer often more specifically called jejunal and ilial arteries - arcades are anastomoses of ileal ande jejunal arteries - jejunum - middle of sm. intestine - one set of arcades with long vasa recta - ileum - end of small intestine, empties into cecum of large intestine - a few stories of arcades with short vasa recta |
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large intestine
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- reabsorbs water and salt and a few nutrients
- prepares solid waste for elimination - some ext. features - taenia coli - 3 "racing stripes" of longitudinal muscle; on asc., transverse, desc, and sigmoid colon - haustra - compartments of large intestine produced by taenia coli - appendices eppicloae - dangling fat droplets - from cecum near ileocecal junction vermiform appendix normally dangles. |
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post. abdominal wall
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- bony landmarks
- T12 -L5 vertebrae - post. iliac crest - note that due to domed diaphragm, ribs 11-12 protect post. abd. wall - muscles - diaphragm, psoas major and minor, illiacus, quadratus, lumborum |
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diaphragm
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- diaphragm cura - anchored down lumbar vertebrae
- hiatuses include - caval, esophogeal and aortic - large central tendon and arcuate ligament |
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muscles of abdominopelvic wall
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- psoas major
- origin - transverse process, bodies and intervertebral discs of lumbar vertebrae insertion - lesser trochanter of femur - actions and innervations - flexes and int. rotates hip: flexes lumbar vertebrae, lumbar plexus |
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iliacus
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origin - rim of illiac fossa, sacral ala
insertion - lesser trochanter of femur, passes deep to inguinal ligament to lesser trochanter with p. major actions and innervations - flexes hip - femoral n. of lumbar plexus |
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quadratos lumborum
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origin - iliac crest and transverse processes of lower lumbar vertebrae
insertion - rib 12 and transverse processes of upper lumbar vertebrae actions and innervations - extends and lat. flexes lumbar vert. compress ribcage innervation is lumbar plexus |
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psoas minor (small strap like m. superf. to p. major, absent in some)
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- origin - pectineal line, iliopectineal eminence across from acetabulum
- insertion - bodies of T12-L1 and intervert. disc action and innerv. - flexes lumbar vert. - lumbar plexus |
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primary hip flexors
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- psoas major and iliacus
- deep to inguinal lig., psoas major and illicacus fuse and are reffered to as one muslce -illiopsoas of the femoral (thigh region |
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spinal cord segmentation
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- not that noticable in adult, but quite segmented like a good animal: besides ribs and vert., note the 31 spinal n. and their cord segments : c1-8, T1-12, L1-5, S1-5, Co1
- 8 cervical spinal cord segments but SEVEN cerv. vert. - someimes 3 coccygeal segments - spinal cord through vertebral column - 31 pairs of spinal n. pass thru intervertebral foramina or sacral foramina (except coccygeal) |
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spinal nerve roots and plexus
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- ventral rami of spinal roots from 5 plexus.
- spinal n. fork into post/ dorsal and ventral rami; plesus are ONLY formed from ventral rami; the dorsal rami of spinal n. innervate mid back skin and deep back muscles. - note a little ovelap in spinal cord segment plexus roots, e.g. lumbar plexus is T12-L4 and sacral L4- S4 - some use lumbosacral plexus for last 3 plexus; the sciatic nerve is formed from sacral and lumbar plexus. - lumbar plexus - T12, L1-4 - sacral plexus L4-S4 coccygeal or pudendal plexus - intercostal nerves - T1-11 no plexus here cervical plexus - C5-8 and T1 |
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sup. lumbar plexus
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- these 3 innervate muscles and integument of abd. wall
- subcostal n. (T12 ventral ramus, the "last intercostal n") - innervates skin over coxal region (and pyramidalis muscle in hypogastric region) - iliohypogastric n. - innervates skin of gluteal and hypogastric regions - iliolingual - pierces int. oblique, innervating part of it and accompanies spermatic cord thru superf. inguinal ring to innervate upper med. thigh and in male parts of genital region and in femal labium majus and mons pubis. |
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pemonic for lumbar plexus
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- some - subcostal (t12)
- india - iliohypogastric (l1) 0 inks - illiolingual (L1) - last - lateral cutaneous n. to thigh (L2-3) -For - femoral n. (L2-4) - innervates ant. thigh m. compartment - generations - genitofemoral (l1-2) - cutaneous branch to femoral triangle and part genital region, innervates cremaster muscle - or- obturator - (l2-l4) innervates med. thigh muscle compartment; the hip adductor m - longer- lumbosacral trunk (L4-5) - becomes 1/2 of sciatic n., which innervates pes(foot) crus(leg) and post. femur, thigh . |
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abdominal aorta
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- unparied visceral branches
- celiac trunk - sup. messenteric artery - inf. mesenteric artery - paired visceral brancher - adrenal artery - renal artery - ovarian or testicular artery - parietal branches: lumbar artery, median sacral artery on midline at fork of common iliac artery - terminal artery - and. aorta branchs into common iliac artery, in turn, fork into internal and external iliac artery -ext. iliac goes ouside abd. cavity; topographic name chage to femoreal artery deep to inguinal lig. - int. iliac - many branches to supply much of pelvic region and part terminates in pelvic bowl as fibrous cord. |
