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Coronary arteries:
right:
1) right marginal a.
2) posterior interventricular a.
left:
1) Anterior interventricular a. (LAD)
2) Circumflex artery
You look GREAT from the FRONT (anterior)
Great Cardiac Vein travels with the LAD and Becomes the Coronary sinus.
Middle cardiac vein travels with the Posterior interventricular a.
Small cardiac vein travels with right marginal a.
Both middle and small dump into the coronary sinus.
Deoxygenated blood gets to the right atrium via:
1) SVC
2) IVC
3) Coronary sinus
4) Anterior cardiac veins
Pericardium from Superficial to Deep: Fibrous pericardium - Parietal pericardium - Visceral pericardium (Epicardium)
Pleural sac is empty!
No pain in lung tissue
Quiet breathing:
inspiration - contraction of diaphragm
expiration - elastic recoil of the lungs and thoracic wall
Forced/Active breathing:
Inspiration - diaphragm, scalenes, external intercostals, SCM
expiration - internal intercostals, rectus abdominis, external and internal oblique, Transverse abdominis
Sigmoid Colon receives blood from Inferior Mesenteric Artery.
Erector Spinae muscles: spinalis, longissimus, iliocostalis
Openings in the thoracic diaphragm:
C - Caval opening T8
E - Esophageal opening T10
A - Aortic opening T12
Right main bronchus - shorter, wider, in line with trachea (foreign objects)
Right lung - 3 lobes - groove for SVC, trachea, arch of azygos
Left lung - 2 lobes - arch of aorta
RALS (pulmonary artery with respect to bronchus)
Innervation of lungs:
Sympathetic - T1-T5
Bronchodilation
Reduced secretion
Constricts Pulmonary vessels
SYMP impulses:
Increase heart rate, increase stroke volume, dilate coronary arteries
Parasympathetic - Vagus
Constrict bronchi
promote secretion
dilate pulmonary vessels
PS impulses:
Slow heart rate, decrease stroke volume, constrict coronary arteries
Transverse Thoracic Plane: Sternal Angle > 4th IV disk
Separates superior mediastinum from Anterior, Middle and Posterior
Anterior Mediastinum
1) lower remnants of thymus gland
2) fat and loose connective tissue
3) lymph nodes and vessels
4) deep branches of internal thoracic arteries and veins
Middle mediastinum - PHRAM
1) Pericardial sac
2) Heart
3) Roots of great vessels (SVC, IVC, Aorta)
4) Arch of Azygos vein
5) Main Bronchi
Posterior mediastinum
1)Thoracic aorta
2) Thoracic sympathetic trunks
3) Thoracic splanchnic nerves*
4) Thoracic duct*
5) Azygos and hemiazygos veins
6) Vagus nerve*
7) Esophagus* and esophageal plexus
8) lymph nodes and vessels
* in both superior and posterior
everything else, superior!
Abdomen:
Jejunum - deep red, thick wall, more vascular, long vasa recta, few arcades.
Ileum - pale pink, thinner wall
ileocecal junction > cecum > ascending colon > right colic flexure > transverse > left colic flexure > descending >
sigmoid > rectum
Liver produces bile.
Gallbladder stores bile.
Liver: 4 quadrants - Right, Left, Caudate (next to IVC) and Quadrate (next to gall bladder)
Mesentery - double layer of peritoneum
3 unpaired arteries on abdominal aorta:
1) Celiac trunk - supplies blood to the esophagus, stomach, liver, gallbladder, spleen,
and part of duodenum and pancreas.
Module 2
Tongue motor and/or sensory information: CN 5, 7, 9, 12
3977 COPS - Parasympathetic innervation
3 - Oculomotor - Ciliary ganglion - Constrictor pupillae & Ciliary muscles
9 - Glossopharyngeal - Otic ganglion- Parotid Gland
7 - Facial - Pterygopalatine Ganglion - Nasal mucosa and lacrimal gland
7 - Facial - Submandibular Ganglion - Submandibular and Sublingual gland
genioglossus protrude the tongue
hyoglossus and styloglossus retract the tongue
geniohyoid - pulls hyoid anteriorly
palatoglossus - elevates back of tongue and closes oropharynx
V3 inn. 4 muscles of mastication, tensor tympani, tensor veli palatini, mylohyoid and anterior belly digastric.
Great auricular nerve = cervical plexus (somatic sensory)
Auricotemporal nerve = branch of V3 Trigeminal (somatic sensory)
Posterior Auricular ARTERY = External Carotid Artery
Both upper and lower teeth blood supply come from maxillary artery. Innervation is different.
Auricotemporal nerve hugs the middle meningeal artery in infratemporal fossa.
Brachial plexus and subclavian artery = in between anterior and middle scalene.
anterior view: vagus nerve in between ICA and IJV
stylopharyngeus inn. by glossopharyngeal. goes in between superior and middle constrictor.
Torus tubarius - ridge over opening of auditory tube
Vagus = motor nerve of the pharynx. (except stylopharyngeus)
Choana - door from nasal cavity to nasopharynx
Nasal septum - primarily ethmoid, vomer .. and cartilage
Super and middle concha are part of ethmoid. Inferior concha is its own separate bone.
Below the conchas = meatus.
Superior meatus - posterior ethmoidal air cells
Middle Meatus - frontal sinus, maxillary sinus, anterior and middle ethmoidal air cells.
Inferior meatus - nasolacrimal canal
Sphenoid sinus drains into sphenoethmoidal recess.
V2 - upper lips/teeth
V3 - lower lips/teeth
vallate papillae - bumps on tongue.
palatine tonsil in between palatoglossal fold and palatopharyngeal fold
lingual tonsil - in back of tongue
tensor veli palatini hooks around hamulus on sphenoid
Tensors - V3
Palat- Vagus (except tensor veli palatini)
Glossus - Hypoglossal (except palatoglossus)
genioglossus - stick out tongue (protrude :p )
styloglossus - retract tongue
hyoglossus - retract tongue
palatoglossus - elevate back of tongue. close oropharynx
geniohyoid - pull hyoid anteriorly
Module 3
Muscles of the arm:
Upper arm:
anterior - 3
biceps brachii - supinator
coracobrachialis
brachialis - primary flexor of elbow
posterior - 1
triceps brachii - insert on olecranon process of ulna
Lower arm:
anterior
superficial - 4
pronator teres
flexor carpi radialis
palmaris longus
flexor carpi ulnaris
intermediate - 1
flexor digitorum superficialis
deep - 3
flexor digitorum profundus
pronator quadratus
flexor policis longus
posterior
superficial - 6
brachioradialis - inn by radial n and is an elbow flexor
extensor carpi radialis longus
extensor carpi radialis brevis
extensor digitorum
extensor digiti minimi
extensor carpi ulnaris
anconeus
deep abductor policis longus
extensor policis brevis
extensor policis longus
extensor indicis
supinator
Hand:
Thenar (A-F-O) - Inn. by Recurrent branch of Median n.
ABductor Policis Brevis
Flexor Policis Brevis
Opponens Policis
Hypothenar (A-F-O) - Inn. by Ulnar n.
ABductor digiti minimi
Flexor digiti minimi brevis
Opponens digiti minimi
ADductor pollicis - inn. by Ulnar n.
Name Changes:
Radial nerve:
superficial sensory branch
deep motor branch > posterior interosseous nerve after passing through supinator
3) Femoral Vein
4) Lymph
Popliteal Fossa (diamond shape)
Superior Boundaries:
Medially: semimembranosus, semitendinosus
Laterally: biceps femoris
Inferior Boundaries:
Medial and lateral heads of gastrocnemius
Roof:
Fascia lata and crural fascia
Contents:
Popliteal artery and vein
tibial nerve and common fibular nerve
small saphenous vein
Coming off Anterior Superior Iliac Spine:
1) Inguinal Ligament
2) Sartorius
3) Tensor Fasciae Latae
Coming off Anterior Inferior Iliac Spine:
1) Rectus Femoris
Coming off Pes Anserinus (Gooses Foot)
1) Sartorius
2) Gracilis
3) Semitendinosus
Abdominal Aorta
Common iliac
External iliac:
1) inferior epigastric a. (frequently pinned)
2) abberant obturator a. (sometimes)
* External Iliac > Femoral after passing the inguinal ligament.
Internal Iliac:
1) Superior gluteal a.
2) Inferior gluteal a
3) internal pudendal a.
4) uterine a. (female) / inferior vesical a. (male)
5) middle rectal a.
6) obturator a.
7) umbilical a.
Joints:
Foot:
Talocrural- dorsi/plantar flexion - talar and calcaneus
subtalar and midtarsal joint - eversion/inversion
Transverse tarsal - double joint - eversion/inversion
Fibularis - evertors
Tibialis anterior & posterior - invertors
Arch:
Ligaments - Calceneonavicular ligament, short plantar ligament, long plantar ligament,
Muscles - fibularis longus
Plantar aponeurosis - active support of the arch
Axis of foot - 2nd toe
Axis of hand - 3rd finger
Medial plantar nerve and lateral plantar nerve branch off Tibial nerve.
Medial plantar artery and lateral plantar artery branch off Posterior Tibial artery
Homologues:
Flexor digitorum profundus (in hand) = Flexor digitorum longus (in foot)
Plantar side of foot receives innervation from 5 nerves:
1) Medial plantar n. (3.5 toes)
2) Lateral plantar n. (1.5 toes)
3) Sural n. (lateral)
4) Saphenous n. (medial)
5) Tibial n. (heel)
medial collateral
medial meniscus
anterior cruciate ligament
Vastus Medialis obliqus (VMO) - helps prevent lateral tracking of patella. it pulls the patella medially.
Deltoid ligament - from medial malleolus of tibia to calcaneus, talus and navicular. restricts abduction and eversion.
Rotation of the foot takes place at the transverse tarsal and subtalar joints.
Superior gemellus
Obturator internus
Inferior gemellus
Quadrator femoris
hip ADductors
- gracilis
- adductor longus
- adductor magnus - pubofemoral
- obturator externus
Hip ABductors:
-
hamstrings
-originate on ischial tuberosity
-BI-ARTICULAR
semitendinosus and semimembranosus - medially rotate at flexed knee.
biceps femoris - laterally rotates at flexed knee
Innervation in foot:
Medial plantar n. - LAFF
Lumbrical 1
Abductor hallucis
Flexor hallicus brevis
Flexor digitorum brevis
*everything else, lateral plantar n.
*medial and lateral plantar n. coming off tibial n
Only three things in lesser sciatic foramen:
1) internal pudendal a.
2) pudendal n.
3) obturator internus m.
Gemelli, piriformis and obturator internus insert on GREATER trochanter
Sciatic nerve - L4-S3 ventral rami
Piriformis is innervated by direct branches of sacral ventral rami