What 3 vessels are contained in the hepatoduodenal ligament?

Common bile duct

hepatic artery

Portal vein

What structures form the anterior, posterior, inferior, and superior borders of the epiploic foramen?

Posterior : IVC

anterior: hepatoduodenal ligament

Superior : caudate lobe of liver

inferior: 1st part of duodenum

The portal vein is formed by the union of what 2 veins?

splenic  and superior mesenteric

The liver receives 70% of its blood from what vessel?

portal vein

What 3 arteries arise from the aorta and supply the GI tract?

celiac trunk (foregut)

superior mesenteric (midgut)

inferior mesenteric (hindgut)

From what vessel does the right gastric artery arise?

The left gastric?

Right gastric from hepatic artery

Left gastric from celiac trunk

What tissue is the deep inguinal ring located in?

The superficial ring?

deep inguinal ring - Transversalis fascia

superficial inguinal ring - External oblique aponeurosis

the pericardiophrenic ligament binds which two structures?

the fibrous pericardium around the heart and great vessels

and the central tendon of the diaphragm

What vessels form the anterior and posterior borders of the transverse pericardial sinus?

the transverse sinus is anterior to the SVC

it is posterior to the intrapericardial parts of the pulmonary trunk and ascending aorta

The ___ pericardial sinus can be entered inferiorly by several fingers. It is a blind cul de sac.

oblique pericardial sinus

The ___ artery parallels the phrenic nerve and supplies the pericardium.

What artery does it branch off from?

The pericardiacophrenic artery is a branch off the internal thoracic.

The apex of the adult heart lies posterior to which intercostal space?

the left 5th intercostal space

The ______ separates the smooth and rough parts of the internal right atrial wall.

crista terminalis

(externally by the sulcus terminalis)

The moderator band runs from the _____ to the ______ in the right ventricle. It carries part of the right bundle branch of the ______.

runs from septum to anterior papillary muscle

carries AV bundle branches

The ____ arteries supply the myocardium.

They arise from the _____.

Left and right coronary arteries arise from their corresponding aortic sinuses at begining of ascending aorta.

What ducts unite to form the common bile duct?

cystic duct (from the gall bladder)

and

common hepatic duct (from the liver)

This artery typically supplies the SA node (in 60% of people) and the AV node (in 80% of people), as well as the posterior third of the AV septum.

Right Coronary Artery

- also supplies Right Atrium

- most of Right Ventricle

- part of Left Ventricle

What structures form the 4 borders of the heart?

Right - right atrium

Left and Apex - left ventricle

Superior - R and L atria and auricles and vessels:

- SVC, ascending aorta, pulmonary trunk

Inferior - right ventricle

From what vein does the inferior mesenteric vein arise?

The superior mesenteric?

Inferior mesenteric splits off of the splenic vein.

Superior mesenteric is a continuation of the portal vein after the splenic splits off.

What are the three branches of the celiac trunk?

Which is the largest?

Hepatic artery, left gastric artery, splenic artery.

Splenic a. is the largest

What part of the heart is related posteriorly to the esophagus?

Left atrium

the pericardium is innervated by branches of what nerve?

phrenic

The adult Ligamentum _____ is the obliterated ductus ______, which bypasses the fetal liver.

The adult Ligamentum venosum represents the obliterated ductus venosus.

The fetal umbilical vein becomes the _____ in the adult.

Ligamentum teres (round ligament) of the liver

Which ribs are true ribs?

false ribs?

floating ribs?

1-7 are true

8-10 are false

11 & 12 are floating

Neurvasculature of the thoracic wall is located :

A. internal to the innermost intercostal muscles

B. between the innermost and internal intercostals

C. between the internal and external intercostals

D. external to the external intercostals

B. between the innermost and internal intercostals

Aspiration of foreign bodies is more likely in

A. the left bronchus

B. the right bronchus

Why?

B. right bronchus

- because is is shorter and wider than the left and runs more vertically

Where does internal respiration take place?

At the cellular level

What accessory respiratory muscles help during forced inspiration?

Anterior:

SCM

Scalenes

Serratus anterior

Pectoralis major and minor

Posterior:  

Trapezius

Rhomboid Major and Minor

Levator scapulae

The plane passing horizontally through the sternal angle meets which thoracic intervertebral disc?

IV disk between T4 and T5

- plane divides superior and inferior mediastinum

Which is not located in the superior mediastinum?

A. trachea

B. Right recurrent laryngeal nerve

C. thoracic duct

D. Cardiac plexus of nerves

E. Vagus nerve

B. Right recurrent laryngeal

- thymus gland is located in superior mediastinum in children

Which aren't located in the posterior mediastinum?

A. Azygous vein

B. Aorta

C. Splanchnic nerves

D. Sympathetic trunk

E. Thoracic duct

C. Splanchnic nerves &

D. Sympathetic trunk

nb: Azygoose, Vagoose, Esophagoose, thoracic duck

and aorta

What 2 veins form the superior vena cava?

 right and left brachiocephalic veins

 - the azygous vein drains into SVC just beneath their junction

The 12th rib protects what organ posteriorly?

kidney

What two layers of abdominal superficial fascia lie on top of the external oblique aponeurosis?

Scarpa's fascia (membranous)

Camper's fascia (fatty)

What forms the anterior rectus sheath above the arcuate line?

Aponeurosis of external oblique and

Aponeurosis of internal oblique (split)

- below arcuate line: Aponeurosae of all 3 flat abdominal muscles

From which spinal nerve(s) does the obdurator nerve arise?

Obdurator: L2-L4

From which spinal nerve(s) does the genitofemoral nerve arise?

Genitofemoral: L1, L2

From which spinal nerve does the Femoral nerve arise?

Femoral nerve: L2-L4

From which spinal nerve(s) does the subcostal nerve arise?

Subcostal: T12

What nerve lies on top of the Psoas major muscle?

From what spinal nerve(s) does it arise?

Genitofemoral : L1, L2

What nerve is found beneath and lateral to the Psoas major muscle, on top of the Iliacus muscle?

From what spinal nerve(s) does it arise?

Femoral nerve : L2 - L4

What muscle of the posterior thoracic wall is found above and continuous with the Iliacus muscle?

Quadratus lumborum

Both the inferior vena cava and the abdominal aorta split into the ______, which then splits into the ___ and _____.

L and R Common Iliac (artery and vein)

-->  External Iliac

-->  Internal Iliac

- occurs at ~L4-L5

What is the arterial supply to the pericardium?

From which artery do these arteries arise?

Pericardiophrenic (from internal thoracic)

Musculophrenic (terminal branch of internal thoracic)

The trachea bifurcates at the level of the sternal angle.

Remember that.

The intercostal nerves are the anterior rami of which spinal nerves?

T1 - T11

(T12 is subcostal)

The posterior intercostal arteries arise from the _____.

The anterior intercostal arteries arise from the _____.

Aorta --> posterior intercostals

 Internal thoracic a. --> anterior intercostals

(or from musculophrenic branch of int. thoracic)

True or False:

The pleural plexuses of the lung receive innervation from the phrenic nerve.

False

They receive sympathetic innervation from T2-T5

& parasympathetic innervation from the vagus.

- Branches of phrenic do innervate parietal pleura.

The thoracic duct originates at the cisterna chyli at T12, then ascends on the vertebral column between what two vessels?

The azygos vein and descending aorta

The Greater Splanchnic nerve is formed by fibers from which thoracic ganglia?

Lesser splanchnic?

Greater splanchnic: T5-T10

Lesser splanchnic: T10 & T11

From which artery does the inferior epigastric a. arise?

External Iliac

What forms the floor of the inguinal canal?

The roof?

Floor: inguinal ligament

Roof: arching fibers of internal oblique and transversus abdominus

What artery does the L. gastro-omental artery come off from?

The R. gastro-omental?

What do the gastro-omentals supply?

Splenic artery --> L. gastro-omental

Gastroduodenal --> R. gastro-omental

They supply the greater curve of the stomach

What organs does the celiac trunk supply?

liver

stomach

gall bladder

inferior esophagus

spleen

pancreas

duodenum

What are the 4 possible sites of portocaval anastomosis in the case of portal hypertension?

esophagus (esophageal varices)

umbilicus (caput medusae)

colon

rectum (hemorrhoids)

L. gonadal vein feeds into renal v.

L. Inferior mesenteric v. feeds into splenic v.

remember that!