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cranial nerves 12 on one side, 12 on the other side

There are around 20 bones.


Very hard to separate the bones
ANTERIOR VIEW OF SKULL

Supraorbital foramen
allow veins, arteries, nerves to go through Frontal Bone
forms the roof of the orbit

superior orbial fissure

optic canal
Nasal Bone!
Borders:!
lacrimal bone: Superior Zygomatic Bone
paired. Form
the medial Medial! 2 parts of the nasal septum: ethmoid, vomer
margns of the
orbits (NOT Lateral Nasal Septum!
LABELLED)
Perpendicular plate !
Inferior
of Ethmoid
Vomer
not fractures point. Surtures point

Maxilla
Infraorbital foramen!
concha
1) Superior
2) Medial
3) Inferior
superior and medial part of the ethmoid bone
Inferior concha, doesn’t belong to any bone
Mental foramen!
Mandible

The only movable bone is mandible


The middle meningeal artery is one of the major blood
vessels in the brain and its damage results in blood
accumulation, increased pressure on the brain that may
lead to death
LATERAL VIEW OF SKULL!
there is middle meningeal artery just behind the pteriorn. Fracture can break the bone and cut the arteries and bleed into the cranial cavity
And push the brain away. 24 hrs after, destroy the brain = Death! Treatment is to release the pressure

Frontal Bone! Pterion! Coronal suture!


where all the
sutures come
Parietal Bone!
together.
baby head, cartilage Thinniest part of
haven’t became bone the skull
yet Lambdoid suture!

Supraorbital !
Occipital Bone!
foramen! single bond, with a big magmum
tell if it is mail skull or not for the spinal cord

Greater Wing !
of Sphenoid! Temporal !
Bone!
for hearing (cochlea) and sensory appa
Nasal Bone!
External occipital protuberance

Zygomatic Bone! Zygomatic arch!


External !
Infraorbital ! auditory meatus!
foramen!
Mastoid process!
Maxilla!
Styloid process!
condyle Mandibular fossa: Paired. Located
Mental foramen!
Mandible! anterior to the external auditory
meatus. This is where the condyle of
coronoid process of mandible the mandible articulates. Part of the
temporal bone. (NOT LABELLED)
POSTERIOR VIEW OF SKULL!

Sagittal suture!

Parietal Bone!

lambdoit sutures

Occipital Bone!

Lambdoid suture! Temporal Bone!

External occipital !
Joins: Regions where bones come together. Divided
into 1) fibrous joints, 2) cartilaginous joints, 3)
protuberance!
synovial joints. (See course pack)
12 cranial nerves

FLOOR OF SKULL!

Sphenoid Bone:! Orbital plate of!


Lesser Wing! Frontal bone!
of Sphenoid! foramen spinosum- Paired. Direct
exit out of the skull. Carries the
middle meningeal artery
Greater Wing ! Ethmoid Bone:!
of Sphenoid! Crista Galli!
Cribriform Plate!
Anterior Clinoid! sella turcica holes allow the cranial nerves to go through
to the nasal cavity. I. Olfactory
process! superior orbital fissure
foramen ovale (leads to
II. optic canal infratemporal fossa. Direct exit
from the skull
foramen rotundum,
leads to pterygopalatine fossa Temporal Bone:!
foramen
Pituitary/! magnum Squamous
thin
part!
Hypophyseal Fossa! Petrous part!
(Sella Tursica)! The petrous part has a mountain shape
Rigid

internal auditory meatus/opening


(one of the cranial nerve to integrate hearing)
VII and VIII cranial nerve goes into this
Dorsum Sellae!
jugular foramen

Occipital Bone! Trigeminal Impression!


hypoglossal canal
FLOOR OF
sella SKULL!
Superior Orbital!
Frontal Sinus! Fissure!

Optic Canal!
Foramen Ovale!
Foramen Rotundum!
-pterygopalatine fossa!
Foramen Lacerum!

Foramen Spinosum!
-middle meningeal !
artery

Internal auditory !
meatus Jugular Foramen!

Foramen magnum!
Hypoglossal Canal!
The maxilla and the platine ar ebony hard palate
BASE OF SKULL!
Maxilla!
Palatine Process! Zygomatic Bone!
of Maxilla!
Zygomatic Arch!

Horizontal Plate of !
Palatine Bone! These are part of the spenoid
the palatine bone is paired
Hamulus!
Medial Pterygoid!
Plate!
Vomer!
Lateral Pterygoid!
mandibular fossa
Plate

Styloid Process!

Mastoid Process! Pharyngeal Tubercle!

Occipital Condyle!
External occipital protuberance hypoglossal canal (carries the XII cranial nerve)
BASE OF SKULL!
Choana!

Foramen Ovale!
foramen spinosum Foramen Spinosum!

zygomatic arch

Mandibular fossa!

Foramen Lacerum!
External Auditory!
Meatus

Carotid Canal!
carotid artery enters the brain
for blood supply Stylomastoid !
Foramen!

Jugular Foramen!
Foramen Magnum!
CORONAL SECTION OF NASAL CAVITY!

Cribriform Plate of Ethmoid!


There are holes
Perpendicular Plate of Ethmoid!

nasal septum (made out perpendicular plate of


ethmoid)

Superior Concha! Superior Meatus!


-drains Sphenoid and
Ethmoid Sinuses!

Middle Concha! Middle Meatus!


-drains Maxillary !
and Frontal Sinuses
Inferior Meatus!
Inferior Concha!

RIGHT LEFT

Maxilla!
Vomer! hard palate
SAGITTAL SECTION OF NASAL CAVITY!

Frontal Sinus!
superior concha and middle
concha belong to ethmoid Pituitary fossa!

Superior Concha!
Spenoidal Sinus!
individual bone (not part of
sphenoid nor any other
skull bone)
Middle Concha!

Inferior Concha!
inferior concha is not part of the ethmoid
Occipital Bone!

Paltine Process of Maxilla!


choana: these are posterior nasal openings
close to the middle but not exactly the middle

PARASAGITTAL SECTION OF HEAD & NECK!


Sinus: cavity inside. It is hollow
when you have a mucus in there during infection, it is painful
Frontal Bone! Sphenoid Boneconnects
! to the nasal cavity (passage ways to gain
Eustachian / and Sinus! and Sinus! acces to nasal cavity)

Auditory tube Cribri form plate, roof of the nose


this is why it feels Pituitary fossa!
weird during landing where pituitary gland hooks up to the brain
of plane pituitary tumor can chew the bone and
hard palate
grow into the sphenoid sinus Foramen Magnum!
soft palate
maxilla
palatine tonsils

Constrictor ! Occipital Bone!


Muscles! fuses with the sphenoid bone
they are the backwall of the spaces
Form the esophagus when it goes down
Cervical Vertebra (C1)!
Epiglottis!
prevents food from
going into the the Cervical Spine!
trachea

Vocal Cords!
thyroid cartilage
Vertebral Canal!
Oropharynx: Extends from tip of the
Esophagus! soft palate to the epiglottis

Laryngeal pharynx: Extends roughly from the


Tracheal Rings! epiglottis down to the sixth cervical vertebra
Hard palate: Separates the nasal cavity from
the oral cavity. Makes the roof of the oral cavity
Soft palate: Extension of soft tissue (muscles Trachea
windpipe
and fat) beyond the palatine bone. With the
hard palate, it separates the nasal cavity from
the oral cavity
Cranial cavity: Accommodates the brain

PARASAGITTAL SECTION OF HEAD & NECK!


maxillary sinus. Drains under the medial concha
Visible under the coronary section
pharyngeal tonsil (adenoid, when it is inflammed)

Soft Palate!
Concha:!
-Superior!
-Middle! nasopharynx Glossus (Tongue)!
glossus is latin for tongue
-Inferior! palatine tonsil

lingual tonsil

Maxilla!
Hyoid Bone (C3)!
oral pharyx
laryngeal pharyx
Palatine process! Thyroid !
Cartilage (C4-5)!
Palatine bone! This is the Adams Apple!

Mandible! Cricoid !
Cartilage (C6)!

this area is called larynx

Eustachian tube: Auditory tube that leads from the inner


ear to the nasopharynx. Provides a way to equalize the
pressure on both sides of the tympanic membrane
pharyngeal tubercle
ANTERIOR VIEW OF LARYNX!
23 muscles attached to hyoid
bone and it floats. Do not want to
Epiglottis! break this bone
HyoidTheBone:!
U shape, no posterior walls
Greater horn (Cornu)!
Thyrohyoid membrane! Lesser horn!
Body!
Thyroid cartilage is not a bone Thyroid Cartilage:!V shape
no posterior wall
Adams Apple
Superior horn!
Same thing as anterior protuberance
Anterior !
Protuberance

Lamina!
Cricothyroid membrane!
Inferior horn!

Trachea!
!
Tracheal Rings (C-shaped)! Cricoid Cartilage!
Fibroelastic Connective
Tissue!
LATERAL VIEW OF LARYNX!
Foramen for Internal Epiglottis!
Laryngeal Nerve!
Hyoid Bone (C3):!
Greater horn!
Thyroid Cartilage (C4-5):! Lesser horn!
Superior horn! Body!
Anterior Protuberance !
(Adam"s apple)!

Lamina!

Oblique line!

Inferior horn! Cricoid Cartilage (C6)!

Trachea!
3 muscles coming off the brain to go to
the orbit to control the eyeball. Voluntary
muscles

12 Cranial Nerves
1) Olfactory - Goes through crista galli
V1 Opthalamic
2) Optic - Goes through optic canal/orbit
V2 Maxillary
3) Oculomotor - Goes through the orbit
V3 Mandibular
4) Trochlear - Goes through the orbit
5) Trigeminal - Sits at the trigeminal impression. Receiving tons of info from the brain
6) Abducens - Goes through orbit
7) Facial - Goes through internal auditory meatus
8) Auditory
9) Glossopharyngeal
10) Vagus
11) Spinal Accessory
12) Hypoglossal - Goes through tongue
Vestibulocochlear - Goes through cochlea for hearing
and balance
BONE FRAMEWORK OF BODY!

ribs. bilaterally symmetricals


THORAX!

ABDOMEN! ribs are joined to the column via joints

PELVIS!

Alice’s note: heart apex extends to 5th intercostal space pushed to the left.
Sternum!
THORACIC RIB CAGE! 12 Paired Ribs!
12 Thoracic Vertebrae!
Clavicle!

Jugular Notch! (suprasternal)


just above manubrium
Sternum:!
the midline
Manubrium! Fibrous Joint!
(handle) at the 1st rib

Body!
Sternal Angle!
Xiphoid Process! make the position of the 2nd rib
(made of cartilage)

Intercostal Space!

Rib (Costa)!
costa is latin for ribs
Synovial Joint!
where there’s movement=
Costal Cartilage! where cartilage meets up
with sternum

Cartilaginous !
Joint!
Rib 1-7, Are directly associated with sternum with the edge of the sternum
Rib 8-9, Are indirectly associated with sternum above

11th and 12th ribs not shown ont he drawing. They are floating ribs
POSTERIOR VIEW OF STERNUM!

Jugular Notch!
(suprasternal notch)
Sternum:!
Manubrium! Fibrous Joint!

Body! Sternal Angle!


Xiphoid Process!
Costal Cartilage!

Rib (Costa)!

Synovial Joint!
cavity with fluid that allows for
movement

Cartilaginous !
Joint!
no cavity, no synovial fluid
10 facets of synovial joints for thoracic vertebra

VERTEBRAE!
7 cervical (C) vertebrae C1-C7 Foramen transversarium
12 thoracic (T) vertebrae: T1-T12
5 lumbar (L) vertebra L1-L5
Typical Arch:
C1 = Atlas
C2 = Axis Cervical Vertebra!
C7 = Prominens
Atlas has no body
Axis has a very big body

body and the arch for C1


ANT
Cervical
sup. facet lordosis
Vertebral foramen (for spinal cord)
T.P.
sup. surface

Thoracic Vertebra!
pedicle
Text
thoracic
transverse process inf. surface spine kyphosis
lamina
vertebral foramena
POST
spine thoracic process

body

Lumbar Vertebra!
Lumbar lordosis

T.P. = Transverse process


S.A.P. = Superior articular process
spine
- All vertebra foramen form spinal cord sacral kyphosis
- T4 = Sternal angle Sacral
lamina of vertebrae

scoliosis - abnormal lateral curvature of the spine. Compare with kyphosis and lordosis.
LATERAL VIEW OF THORACIC VERTEBRA!

Superior Articular Process! Transverse Process!

Costotransverse Joint!
/facet
superior surface

superior facet

pedicle
Body!
inferior vertebral notch
lamina
Spine!
inferior facet
inferior surface

Costovertebral Joint!

Inferior Articular Process!


THORACIC VERTEBRAE ARTICULATION!

Intervertebral Foramen!

Inferior Articular Process!


T4

Superior Articular Process!

T5

Intervertebral Disc!
POSTERIOR VIEW OF TYPICAL RIB !
Demifacets!
(Costovertebral Joints)! Head of Rib!
Superior Border!
(round)
(superior)
Neck of Rib!
body
External Surface!
costovertebral joints (interior)

Tubercle !
(Costotransverse Joint):! Body of Rib!
Articular Part!
Inferior Border!
Non-articular Part! (sharp)

Angle!

sternum
Internal Surface!

Subcostal Groove!
(runs posterior intercostal vein)
posterior intercostal artery
intercostal nerve
TYPICAL RIB ARTICULATION!
annulus fibrosus

Costovertebral Nucleus pulposus

Joints!
(Synovial)!
Sternal Angle!
(Cartilaginous)!
Costotransverse
Joint!
(Synovial)!

Sternocostal Joint!
(Synovial)!

Costochondral
Joint!
(Cartilaginous)!
Nucleus pulposus herniating into spinal canal
- Hurting the spinal cord/nerve !
TYPICAL RIB ARTICULATION!

Costovertebral
Costotransverse Joints!
(Synovial)!
Joints!
(Synovial)!
INTERCOSTAL MUSCLES!

External !
Intercostal!
Muscle!
dowwards and forwards
lifts the ribs to allow more volume to the lungs
sternum is going forward

Anterior Internal!
Intercostal Intercostal!
membrane! Muscle!
downwards and backwards
they are used for forced expiration

90 degree b/w external vs anterior intercostal muscle


BREATHING MOVEMENT!

Pump Handle -!
Ribs move upwards and outwards !
pushing sternum forward and up!
!
Increases ant to post diameter!

Bucket Handle -!
Ribs move up and out at the side!
!
Increases the side to side diameter !
DIAPHRAGM! liver is tucked under the diaphragm

Diaphragm!
Dome shaped. !
Separates thorax from abdomen!
!

!
Origin: back of xiphoid process,
inner aspect of lower 6 costal
cartilages, arcuate ligament,
crura!
!
Insertion: Central Tendon!
!
Nerve Supply: Phrenic N (C3-5)!
!
Function: Increases vertical
diameter of thorax!
!
diaphragm contracts = Can allow the bowel to release as well!
This increases the pressure in the abdominal
!
!
!
DIAPHRAGM!

Thoracic Cage!

Diaphragm!

Quadratus !
Lumborum!

Iliacus! Iliac!

Psoas Major!
INFERIOR VIEW OF DIAPHRAGM!

Central Tendon!
Inferior Vena Cava (T8)!

Esophagus (T10)!
!
! Abdominal Aorta (T12)! Right Crus (L1-3)!

Left Crus (L1-2)!

Posterior Abdominal Wall:!


illiac

Quadratus
Lumborum!
Psoas Major! Iliac Crest !
L3!
Iliacus

Hip bone!
L5!
INFERIOR VIEW OF DIAPHRAGM!

Xiphoid Process!
Central Tendon!

Inferior Vena Cava!


(T8)!
! Medial Arcuate!
! Esophagus! Ligament!
(T10)! cable or a liagament

Abdominal Aorta
(T12)!

Lateral Arcuate !
Ligament!
Right Crus (L1-3)!

Posterior !
Abdominal Wall:! Left Crus (L1-2)!
Quadratus !
Lumborum! !

Psoas Major!
SUBCOSTAL GROOVE!

Subcostal Groove:!

Posterior Intercostal Vein! Rib!


Posterior Intercostal Artery!
Intercostal Nerve!

Innermost Intercostal Muscle!

Internal Intercostal Muscle!


Deep Fascia!
External Intercostal Muscle!
Superficial Fascia!

injection, you would want to inject to the superior border of the rib
8 cervical spinal nerve
7 cervical vertebra

SPINAL NERVE FORMATION!


Dorsal Primary ! Dorsal Root!
Ramus!
Axons go to the ventral root = Motor efferent fibers

posterior primary ramus

anterior primary ramus Ventral Root!

Spinal Nerve!

Sensory Afferent Fibers!


Do go into the anterior and lateral cutaneous nerve

Motor Efferent Fibers!


they dont go into the anterior and lateral
Posterior ! cutaneous nerve. They dive into the muscles
Branch! Ventral Primary Ramus:! can cause them to contract

Lateral Cutaneous Branch!/nerve


goes out to the skin

Anterior ! Anterior Cutaneous Branch!/nerve


goes through the muscles
Branch!

Lateral Branch! Receptors picking up information and go to


different branches and go back to the dorsal root
Medial Branch! then spinal cord and then the brain!!

Common sensation: Touch, pressure, temperature, and pain


SPINAL NERVE FORMATION!
picking up information from the skin

Dorsal Primary !
Ramus! Spinal Nerve!

Ventral Primary Ramus:!


Posterior !
Branch! Lateral Cutaneous !
Branch!

Anterior Cutaneous !
Branch!
Anterior !
Branch!

Medial Branch!

Lateral Branch!

10th at the belly button


The green are the nerve
CROSS SECTION OF THORAX!
forms a thin membrane called
posterior intercoastal Dorsal Primary Ramus!
Subcostalis Muscle! membrane
Skin
Thoracic spinal nerve!
the skin can pick up what is going on
Post. Intercostal V.!
Azygous vein!
Post. Intercostal A.!
Thoracic Aorta!
Intercostal Nerve!
there are 12 of them.
One for every space Thoracic Duct!
Esophagus!
Lateral Cutaneous N.!
LUNG! Visceral Pleura!
Hilus of Lung!
External Intercostal! Parietal Pleura!
oriented down
Muscle! and forward Pleural Cavity!
contain pleura fluid, which is a lubricant
Internal Intercostal !
Muscle! they go down and
backwards
Ant. Intercostal A. and V.!

Innermost Intercostal! Internal Thoracic A. and V.!


Muscle!

Sternocostalis! Anterior Cutaneous N.!


anterior intercostal membrane
Muscle ! (continuation of external intercoastal
muscle next to the sternum)

Costalis are not that important compared the external and internal intercostal muscle
ANTERIOR VIEW OF LUNGS!
hyoid bone C3

thyroid cartilage C4-5


Cartilaginous ring!
Trachea!
cricoit cartilage C6
Apex of Lung! Bifurcation at T4!

Right Bronchus! Left Bronchus!

Upper Lobe! Anterior Border!

Horizontal Fissure! Upper Lobe!


(4th rib)!
Oblique Fissure
(6th rib)!
Middle Lobe!
Cardiac Notch!
Oblique Fissure!
(6th rib)! Lower Lobe!

Lower Lobe! Inferior Border!

Diaphragmatic Surface Lingula!


First division of trachea = primary bronchus —> Secondary bronchus —> Tertiary bronchus
Right lung is made of 3 lobes and the left lung is made of 2 lobe
MEDIAL SURFACE
right apex
OF LUNGS!
left apex

RIGHT LUNG! costal surface


LEFT LUNG!
H fissure

Upper Lobe! Upper Lobe!


oblique fissure

posterior border
Middle Lobe!
cardiac
posterior border notch
Lower Lobe!
Lower Lobe!
lingua

Inferior Border!
Posterior Border! Anterior Border!
Anterior Border!

mediastinal surface

Horizontal Fissure!
Oblique!
Oblique Fissure! inferior border inferior border Fissure!

diaphragmatic surface
MEDIAL SURFACE OF LUNGS!
RIGHT LUNG! LEFT LUNG!
Right Brachiocephalic Vein
trachea
Apex!
Anterior Border!
Anterior Border!
Hilus! Upper Lobe! Hilus!
superior
vena Posterior Border!
cava
Horizontal Fissure!
Esophagus groove

Root of Lung:!
Pulmonary A.!
Bronchus!
usually the most posterior
Pulmonary V.!

aortic groove

cardiac
Oblique Fissure! impression

Lower Lobe!

cardiac notch
cardiac impression Esophageal groove
Middle Lobe! (heart pushes
thoward the lung)
Diaphragmatic Surface! Lingula!
SURFACE IMPRESSIONS OF LEFT LUNG!
POSTERIOR! ANTERIOR!

Aortic Groove!

Cardiac
Impression
Esophageal !
Groove!
SURFACE IMPRESSIONS OF RIGHT LUNG!
ANTERIOR! POSTERIOR!

Right Brachiocephalic Vein!


Trachea!

Superior Vena Cava!

Esophageal !
Azygous Vein! Groove!

Cardiac Impression!
phrenic nerves run o the diaphragm. It is gonna run in front of the lungs.
Head to the supply the motor supplies of the diaphgram.
Between lungs and heart

PLEURAE!
Cervical !
Parietal Pleura!
Costal !
Parietal Pleura!
Mediastinal ! Hilus of Lung!
Parietal Pleura!

Pleural Cavity! Cardiac Notch!

Visceral Pleura!

Diaphragmatic!
Parietal Pleura! Costodiaphragmatic!
Diaphragm! Recess!
the lowest part of the lungs. When you
have bleedings, this is where the blood/
pus goes
CROSS SECTION OF THORAX!

Thoracic Vertebra!
Thoracic Wall!
Mediastinal !
Parietal Pleura!
face the mediastinal area

Visceral Pleura!

LUNG! LUNG!
Pleural Cavity!
Hilus! filled with pleural fluid, which
lubricate the lungs
HEART!
(Pericardial Sac)!
Costal Parietal!
Pleura!
up against the ribs

Sternum!
RIGHT PLEURAL SURFACE MARKINGS!

Visceral Pleura!
Midclavicular Line - 6th rib!
Midaxillary Line - 8th rib!
Paravertebral Line - 10th rib!

Parietal Pleura!
Midclavicular Line - 8th rib!
Midaxillary Line - 10th rib!
Paravertebral Line - 12th rib!
!
!
Apex of the Lung - 1-11/2” above the medial
! ! 1/3 of the clavicle!
ANTERIOR SURFACE MARKINGS!
surface making of lung = visceral pleura
Apex of the Lung - 1-11/2” above the medial 1/3 of the clavicle!
first point where TB is detected

Visceral Pleura! Parietal Pleura!


always gonna be 2 ribs lower!

Midclavicular Line ! Midclavicular Line !


6th rib! 8th rib!
!
Midaxillary Line !
Midaxillary Line!
8th rib! 10th rib!

(Paravertebral Line! (Paravertebral Line -


10th rib)! 12th rib)!
removes the heart, you see the vagus nerve
Vagus is always behind and heads to the throacic and divides on the surface of the esophagus
ANTERIOR VIEW OF THE HEART!
Common Carotid A.! L. Internal Jugular V.!
R. Internal Jugular V.! goes through the neck
run down the neck L. Subclavian A.!
L. Subclavian V.!
R. Subclavian A.!
goes to the limb L. Brachiocephalic V.!

R. Subclavian V.! Arch of Aorta!


right under the clavicle
Ligamentum arteriosum!
takes blood from right upper limb
R. Brachiocephalic V.!
joined vessel of R. jugular + subclavian artery
Pulmonary Artery!
Superior Vena Cava! Pulmonary trunk!
brings de-O2 from the upper body
pumps blood to right atrium
Left Atrium!
Ascending Aorta!
carries O2 blood from left ventricle
Left Coronary Artery!
Right Atrium!
Circumflex Artery!
Ant. Interventricular Artery!
Right Coronary!
Artery! Great Cardiac Vein!

Right Ventricle!
Left Ventricle!

Inferior Vena Cava!


BLOOD FLOW THROUGH HEART!
L. Common Carotid A.!
Brachiocephalic Trunk!
L. Subclavian A.!

Aortic Arch!
R. Pulmonary A.! Ligamentum Arteriosum!

R. Pulmonary V.! L. Pulmonary A.!


Carries O2 blood
Carries blood to the back of the
heart
L. Pulmonary V.!
(left atrium)
Ascending Aorta!
Superior Vena Cava!
head, neck, upper limb = deO2
Left Atrium!
Right Atrium!
pectinate muscle

Pulmonary Valve! Mitral or Bicuspid Valve!


Tricuspid Valve!
Aortic Valve!
OPENING OF CORONARY SINUS

Inferior Vena Cava! Left Ventricle!


apex = 5th intercostal space of
heart, 3 1/2’’ from midline
Right Ventricle! Interventricular septum!
rugged muscle
thoracic/descending aorta
trabeculae carneae
VALVES OF THE HEART!

Pulmonary Valve! Mitral or Bicuspid Valve!

Aortic Valve!

Tricuspid Valve!

Chordae tendineae! Papillary muscle!


opening of the right coronary
and the left coronary

Semilunar Cusp!
two of these "pockets" have the starting
point of the coronary artery (right and left)
ANTERIOR GROOVES OF THE HEART!

Anterior Atrioventricular Groove!


front

posterior A.V. = coronary sulcus groove


(anterior run to become posterior)

Anterior Interventricular Groove!


front

Posterior I.V. groove = runs along the diaphragmaic surface


DIAPHRAGMATIC SURFACE OF HEART!

Posterior Atrioventricular Groove (Sulcus)!

LA
RA!

Diaphragmatic surface of the heart

LV
RV
Posterior Interventricular Groove!
VENOUS DRAINAGE OF HEART!

Pulmonary Veins!
Superior Vena Cava!

Coronary sinus! Right Atrium!

Inferior Vena Cava!


LA!

Opening of Coronary
sinus into right atrium !

LV!
RV!

Middle Cardiac Vein!


Apex!
ARTERIAL SUPPLY OF HEART!

Ascending Aorta
Dark red = Anterior of the heart arteries
Light red = Posterior of the heart arteries

Right Coronary Artery! pulmonary trunk


- arrives at the beginning of ascending aorta
- Gives many branches to right ventricle and atrium
- Carries O2-blood to cardiac muscle Left Coronary Artery!
- comes from ascending aorta, but
from the posterior side
right coronary artery

LA
Anterior atrioventricular groove Circumflex Artery!
- runs posteriorly and anastomosis
RA w/ right coronary arteries
RV!
Ant.
Post. Interventricular! LV! Interventricular!
Artery! Artery
on the diaphragmatic surface of the heart

Site of
Marginal Artery! Anastomosis!
branch of R. coronary artery
site of anastomosis (site of merging)
VENOUS DRAINAGE OF HEART!
all the blood veins return blood to the right atrium

dark blue vein = anterior


light blue vein = posterior

Superior Vena Cava!

Coronary sinus!
big vein at coronary sulcus
Great Cardiac Vein!
run the anterior interventricular groove

Small Cardiac Vein! Middle Cardiac Vein!


run along posterior groove

Inferior Vena Cava!


Apex!
OPENED RIGHT VENTRICLE (ANTERIOR VIEW)!

Aortic Arch!

Superior Vena Cava!


Ascending Aorta!

Semilunar Cusp!
moderator band
goes from the septum to the papillary
muscle (ONLY IN RIGHT VENTRICLE)

Right Ventricle!
Left Ventricle!

Chordae tendineae!
Papillary muscle!
SURFACE MARKINGS OF HEART!

Hearing the Valves!


!
Pulmonary (P)!
2nd left intercostal space!
!
Mitral (M)!
5th left intercostal space !
3 #” from midline! T!
!
Aortic (A)!
2nd right intercostal space!
!
Tricuspid (T)!
5th right intercostal space!
ARTERIAL SUPPLY OF THORACIC WALL!
common carotid artery

Right Subclavian Artery!


bracheocephalic trunk

coarctation: when vessels become


Posterior Intercostal Artery! constricted of blood flow down to the
bottom

Internal Thoracic Artery!


Collateral Branch!

coronary artery

VAN!
Vein
Artery
Nerve

Anterior Intercostal Arteries!


INTERCOSTAL ARTERIAL SUPPLY!
Posterior Intercostal Artery!

Collateral Branch! Thoracic Aorta!

Internal Thoracic Artery!

Lateral Cutaneous
Branch !

Anterior Intercostal Arteries!


THORACIC VENUS DRAINAGE!
It is below the arteries!

Azygous Vein!
Posterior Intercostal Vein! on the right side !

Collateral Branch!

Internal Thoracic Vein!

Anterior Intercostal Veins!


ARTERIAL DRAINAGE OF THORAX!

R. Costocervical Trunk! Ascending Cervical A.!


Vertebral A.!
L. Subclavian A.!
Superior Intercostal A.!

R. Subclavian A.! 1st Posterior Intercostal A.!


2nd Rib!
R. Common Carotid A.!
2nd Posterior Intercostal A.!
Brachiocephalic Trunk!

Posterior Intercostal! L. Common Carotid A.!


Arteries!

Thoracic Aorta!
VENOUS DRAINAGE OF THORAX!
L. Internal jugular vein!
L. Subclavian Vein!
R. Brachiocephalic vein! L. Brachiocephalic vein!

Superior Vena Cava!


Posterior Intercostal !
Superior Intercostal Vein!
Veins!

Posterior Intercostal ! Hemiazygous vein!


Veins! the left side has hemiazygous
vein that will shunt the blood to
the azygous vein
Azygous Vein!
-drains tissues below! Collateral veins!
subcostal grooves of!
ribs 5-11!
autonomic nervous system
- We can’t change our heart rate
- The comes from the sympathetic nerve
and cardiac muscles

subcostal veins

Ascending lumbar vein! Ascending lumbar vein!

where is sympathetic trunk?


the nerve of the sympathetic trunk does all the action. We have no control over it
LYMPHATIC SYSTEM!
it is also a vascular channel

L. Internal Jugular V.!

L. Subclavian V.!

all lymphatic channels dump


fluids into the thoracic duct

lymph node gets rid of fluid


Fluid can accumulate when you get
rid of lymph node for cancer

Thoracic Duct!
lymphatic channel

except the brain, all systems have lymphatic systems


cancer cells can move along the lymphatic and can
move to the venous site, trouble!
Cisterna Chyli (L1)!
Can go to the heart! And could be in the lungs! And be
seen in the lungs. It may also move to the brain from
being in the heart!

lymphatic is crucial in the spread of cancer!


STRUCTURES BEHIND THE MANUBRIUM!
Right Common Carotid A.! esophagus Left Common Carotid A.!
Right Internal Jugular V.! Left Internal Jugular V.!
Left Subclavian A.!
Right Subclavian A.!
trachea
Left Subclavian V.!
Right Subclavian V.!
Left Vagus N.!
Right Vagus N.!
Right Recurrent Laryngeal N.! Left Brachiocephalic V.!
branch of the vagus. Recurrent = going back up
Aortic Arch!
Right Brachiocephalic V.!
Left Recurrent Laryngeal N.!
Superior Vena Cava!
enters the right atrium

Ascending Aorta! Ligamentum Arteriosum!

Right Bronchus! Left Pulmonary A.!

Pulmonary Trunk! Left Bronchus!


Right Vagus N.! Left Vagus N.!
carries only parasympathetic
Esophagus!
goes through the diaphragm T10 Descending Thoracic A.!
- vein in behind the upper half of manubrium
- lower half of manubrium = aortic arch - At T4, aortic arch becomes thoracic aorta
- esophagus = behind trachea - Brain: cranial nerves (12 pairs)
- Vagus nerve (origin in the brain)
THE MANDIBLE!
inferior dental nerve
1) One of the branches of V3 that heads through foramen ovale
Enter the canal inside the mandible that give more branches to the lower death
Opening of Mandibular ! - This is for common sensation to the lower teeth
Canal! - Where anesthetics are injected to freeze the nerve
Pterygoid fossa!
depression in the bone Condyle!
leads to the mental
foramen thru the inside
Mandibular !
of the mandible notch!
sublingual fossa
inferior dental nerve,
supplies sensory
Coronoid Process! located anteriorly above
information to teeth mylohyoid. For hte
sublingual salivary gland pterygoid fossa
attachement of th
inferior dental is a pterygomandibul
branch of (V3) raphe
mandibular nerve mandibular foramen
lingula of mandible
(trigeminal) Leads into the mandibular
cana.
Accomodates the inferior
Ramus! dental nerve
hold lower teeth

Genial ! medial surface

Spines!
(Upper and Lower)! Mylohyoid line!
Mental ! Angle of ! submandibular fossa
located anteriorly below mylohyoid. For the submandibular salivary gland
foramen! mandible!
Body!
missing digastric fossa

Digastric fossa is the origin of the anterior belly of digastric muscle


MUSCLES OF MASTICATION!
all of them innervated by V3

Masseter!
Comes from the zygomatic arch
very tough muscles
Origin: Lower edge of
zygomatic arch!

Insertion: Lateral
surface of angle of
mandible!
!
origin
Nerve Supply: V3!

Function: Raises
mandible. For grinding and
chewing food!
it brings the mandible up!

insertion
MUSCLES OF MASTICATION!

its on the temporal

Originates from the temporal lines from the lateral


surface of the skull
Temporalis!

Origin: Faint temporal


lines on parietal bone!

Insertion: Coronoid
process of mandible!

Nerve Supply: V3!

Function: Raises jaw!


MUSCLES OF MASTICATION!
Lateral Pterygoid!
Origin: Lateral surface of lateral pterygoid plate!
Insertion: Pterygoid fossa of mandible!
Nerve Supply: V3!
Function: Protraction of mandible!
!
!
Medial Pterygoid!
Origin: Medial surface of lateral pterygoid plate!
from the sphenoid bone
Insertion: Medial surface of angle of mandible!
Nerve Supply: V3!
Function: Raises mandible. Used for chewing!
!

Buccinator!
Origin: Ant. edge of pterygomandibular raphe!
Insertion: Skin of cheek and Orbicularis Oris!
Nerve Supply: VII (motor), V3 (Sensory)!
Function: Sucking and Blowing!
!
!
!
VII - Facial cranial nerve
- These are voluntary muscles

MUSCLES OF FACIAL EXPRESSION!


Frontalis!
Origin: Frontal bone!
Insertion: Area of skin
overlying forehead!
Nerve Supply: VII!
Function: Frowning muscle!

Occipitalus
Origin: Occipital bone!
Insertion: Area of skin of back of scalp!
Nerve Supply: VII!
Function: Moves skin of back!
of scalp!
Orbicularis Oculi!
Origin: Frontal bone and maxilla!
Insertion: Skin of eyelids !
Nerve Supply: VII!
Function: Opening and closing of !
the eyelids!
MUSCLES OF FACIAL EXPRESSION!
Buccinator!
Origin: Ant. border of pterygomandibular raphe!
Insertion: Skin of cheek and orbicularis oris!
Nerve Supply: VII/V3!
Function: Keeps food against teeth. !
Sucking and blowing. Trumpeters muscle.!

Orbicularis Oris:!
Origin: Maxilla and mandible!
Insertion: Area of skin around lips!
Nerve Supply: VII!
Function: “kissing muscle”!

Platysma!
Origin: Front of sternum and thorax!
Insertion: Skin and lower border of
mandible!
Nerve Supply: VII!
Function: Growling muscle. Moves
skin of neck!
TONGUE MUSCLES!
Stylohyoid!
tongue, voluntary muscles
Origin: Styloid process!
Insertion: Hyoid Bone!
Nerve Supply: VII! (facial)
Function: Raises Hyoid
(Swallowing, high notes)!
bifurcates and anchors itself to the hyoid bone
Glossus
(Tongue)! Styloglossus!
Origin: Styloid process!
Insertion: Undersurface of tongue!
Nerve Supply: XII!
Function: Draws tongue upward !
and backward!
This is how you can stick your tongue out or in

Hyoglossus!
Origin: Hyoid Bone!
Insertion: Undersurface of tongue!
Hyoid Bone!
Nerve Supply: XII!
Function: Depresses tongue!
Raises Hyoid Bone !
TONGUE MUSCLES!
Genioglossus!
Origin: Upper genial spine of mandible!
Insertion: Undersurface of tongue!
Nerve Supply: XII!
Function: Protrusion of tongue out!
of oral cavity!
involves in the depression of the tongue
Geniohyoid!
Origin: Lower genial spine!
Insertion: Hyoid bone!
Nerve Supply: Cervical Plexus (C1)!
Function: Elevates hyoid and/or !
depresses mandible!

Mylohyoid!
Origin: mylohyoid line of mandible!
Insertion: midline raphe!
Nerve Supply: V3!
Function: Forms floor of oral cavity,!
Depresses mandible!
TONGUE MUSCLES!

Posterior belly of !
Digastric muscle!
Origin: Mastoid Process!
Insertion: Common Tendon!
Nerve Supply: VII!
Function: Depresses Mandible!
hit down to hyloid
It is a muscle that suddenly forms a tendon

Anterior Belly of !
Digastric muscle!
Origin: Digastric Fossa!
Insertion: Common Tendon!
Splits the tongue into anterior (2/3) and posterior (1/3) Nerve Supply: V3!
Different nerves go there for different reasons
Anterior: Coming out is V3 (Lingual nerve). Coming out from ovale. Branches out in V3 Function: Depresses Mandible!
- Pick up common sensation (touch, temperature, pressure, pain…etc)
- Taste is important for the tongue as well! Comes from facial cranial nerve VII
- Goes to the anterior 2/3

Posterior: Cranial nerve IX. For the posterior third


- IX Glossalpharyngeal
FLOOR OF ORAL CAVITY!

Mylohyoid Muscle!
Mylohyoid line ! Origin: mylohyoid line!
(Medial surface of Mandible)! Insertion: midline raphe!
Nerve Supply: Mylohyoid branch of V3!
Function: Forms floor of oral cavity!

Anterior Belly of Digastric muscle!


Origin: digastric fossa!
Insertion: intermediate tendon!
Nerve Supply: Mylohyoid
branch of V3!
Function: Lowers mandible
and raises hyoid bone!

Posterior Belly of Digastric muscle!


Origin: medial surface of mastoid !
Midline Raphe! process!
Insertion: intermediate tendon!
Hyoid Bone! Nerve Supply: VII!
Connective !
Tissue Sling! Function: Depresses mandible !
and raises hyoid bone!
SUPRAHYOID MUSCLES!

Stylohyoid!

Posterior Belly of!


Digastric muscle!
Mylohyoid!

Hyoid Bone! Anterior Belly of !


Digastric muscle
STERNOCLEIDOMASTOID MUSCLE!

Sternocleidomastoid!
Origin: Anterior surface of
Sternum and adjacent
area of clavicle!

Insertion: Lateral surface


of mastoid process!
Nerve Supply: XI! spinal accessary

Function: flexion of neck,


accessory muscle of
respiration!
INFRAHYOID/STRAP MUSCLES!
superficial muscles deep muscles

Omohyoid! Thyrohyoid!
Origin: Scapula (inferior belly)! Origin: Oblique line of
and Hyoid (superior belly)! thyroid cartilage!
Insertion: hyoid bone
Insertion: intermediate tendon!
(lower border)!
Nerve Supply: Cervical plexus! Nerve Supply: Cervical plexus!
Function: Lowers hyoid bone ! Function: lowers hyoid!
(low notes)!

Sternohyoid! Sternothyroid!
hidden back the 1st rib
Origin: Post. surface of Sternum ! Origin: Post. surface of Sternum!
and adj. Area of clavicle! and adj. area of 1st rib!
Insertion: Hyoid bone ! Insertion: Oblique !
(lower border)! line of thyroid cartilage!
Nerve Supply: Cervical plexus! Nerve Supply: Cervical plexus!
Function: lowers hyoid bone! Function: lowers thyroid cartilage!

all innervated by the cervical plexus (C1,2,3,4)


vagus gives motor to constrictor muscles

MUSCLES OF THEthePHARYNX!
constrictors are U-shape. They have no anterior wall
pushing food to esophagus
They are voluntary muscles and all innervated by the X nerve
that comes out of the jugular foramen

Superior Constrictor!
Origin: posterior edge of
pterygomandibular raphe!
Hamulus!
Insertion: Attach into each other posteriorly in
a midline raphe!
Nerve Supply: X!
Buccinator! Function: Form back of nasopharynx!
Swallowing muscle!
superior laryngeal nerve

comes from hamulus to posterior end Middle Constrictor!


of the mandible on the medial side
Origin: Greater horn of hyoid bone!
Pterygomandibular!
Raphe! Insertion: midline raphe!
external laryngeal nerve
internal laryngeal nerve Nerve Supply: X!
takes care of the mucosa
above the vocal cords Hyoid Bone! Function: Forms back of oropharynx!
enters the thyro-hyoid
membrane
Thyroid Cartilage!
Inferior Constrictor!
Origin: oblique line of thyroid cartilage!
Cricoid Cartilage! Insertion: midline raphe!
Nerve Supply: X!
Trachea! Function: Forms back of laryngeal pharynx!
SCALENUS ANTERIOR MUSCLE!

Scalenus Anterior!

Origin: Transverse processes of


C3-5, sometimes C6!
Insertion: Scalene tubercle !
of 1st rib!
Nerve Supply: Cervical plexus !
(C1-4)!
Function: Accessory respiratory
muscle Flexes neck!

where phrenic starts

scalene tubercule
NERVES AND THYROID GLAND!

Lobe of Thyroid gland! Anterior protuberance!

Thyroid cartilage!

Cricoid cartilage!
Isthmus of Thyroid Gland -
crosses anterior to tracheal !
rings 2-4!
Tracheal rings!

Right Recurrent Laryngeal N.! Left Recurrent Laryngeal N.!

Left Vagus N.!


Right Vagus N.! Nerve X
Nerve X
The vagus is located between artery and vein
VAGUS NERVE!
motor goes to the larynx, sensory goes up to the brain, the rest goes to the parasympathetic (slowing down the heart)

Thyroid cartilage!

Thyroid gland!
Cricoid cartilage!
goes to muscle that moves vocal cords
(motor)

picks up information of the inner lining


of larynx BELOW vocal cords (sensory) Trachea!
in the groove between trachea and oesophagus

Right Vagus N.!


Left Vagus N.!
Automatic
parasympathetic nerves come from brain
and continue all the way down
(oesophagus, bronchus, heart)

goes behind the root of the lung (phrenic


nerve goes in front of the root)

root of the lung : broncus + pulmonary


vein + pulmonary artery

Right Recurrent Laryngeal N.! Left Recurrent Laryngeal N.!


under arch of aorta
BLOOD SUPPLY OF HEAD AND NECK!
Just need a very basic understanding of the blood supply!

Superficial Temporal Artery!

Maxillary Artery!
goes deep into the mandible
also gives into the middle mengenial artery
Also infraorbital alvelolar artery, superior
alveolar artery, buccal artery, infraorbital artery

Occipital Artery! Facial Artery!


foramen transversarium

External Carotid Artery! Lingual Artery!


Internal Carotid Artery!

Superior Thyroid Artery! Common Carotid Artery!


first major brain blood supply

Vertebral Artery!
Ascending Cervical!
Costocervical Trunk!
over apex of the lung (posteriorly)

Superior Intercostal Artery!


Subclavian Artery! Posterior Intercostal Arteries (1st and 2nd)!
3rd comes from thoracic aorta
CROSS SECTION OF NECK AT C6!
At C6 we can only visualize the 3 hyoid
istmus (2nd 3rd and 4th tracheal rings)

Esophagus! Platysma!

Recurrent Laryngeal N.! Sternocleidomastoid!


Sternohyoid!
Within Sheath! Sternothyroid!
Internal Jugular V.! Omohyoid!
Common Carotid A.!
Vagus (CN X) !
Thyroid gland!
secretes hormones to the blood
It is in front of trachea and esophagus

Phrenic nerve! Trachea!

foramen transversarium

Vertebral Artery!

Scalenus anterior!

Skin! Back muscle!


CRANIAL NERVES!
Supraorbital Nerve (V1)!
Supraorbital foramen!

Optic Canal! Optic (II)!

Superior Orbital ! Oculomotor (III)!


Fissure! Trochlear (IV)!
Abducens (VI)!
Opthalmic (V1)!

Infraorbital foramen!
Maxillary (V2)!

Mental foramen! Mandibular (V3)!


CRANIAL NERVES!
Olfactory (I)!
Optic canal!
Optic(II)!
Superior orbital! Oculomotor (III)!
fissure!
Trochlear (IV)!
Opthalmic (V1)!
Foramen Rotundum!
Abducens (VI)!
Foramen Ovale!
Maxillary (V2)!
Mandibular (V3)!
Internal auditory !
meatus!
Facial (VII)!
Auditory (VIII)!
Jugular Foramen!

Hypoglossal Canal! Glossopharyngeal (IX)!


Vagus (X)!
Spinal Accessory (XI)!

Hypoglossal (XII)!
CROSS SECTION ABOVE ORBIT – OPTHALMIC (V1)!

Supratrochlear N.!
Eye!
frontal sinus
Supraorbital N.!
lacrimal gland

Cribriform Plate! Lacrimal N.!

Frontal N.!

V1 ophthalmic (superior orbital fissure)


optic
sensory nerve!
nerve
Nerve II
V2!goes to rotundum
V3! goes to ovale

Trigeminal Ganglion!
pituitary fossa
V1!
resting on trigeminal impression
TRIGEMINAL NERVE (V2)!

V2 = Common sensation

Infraorbital !
Foramen! V1! Trigeminal !
Ganglion
V2!

V3!
Infraorbital N.!
picks up sensation from front
of face (nut cheek/chin) F. Ovale!

V2 maxillary br. trigeminal (totally


sensory)

Pterygopalatine Fossa!
entered by V2

Superior Dental N.! Palatine Nerve!


Lesser! goes to soft palate

Greater!
MANDIBULAR BRANCH OF TRIGEMINAL NERVE (V3)!

foramen ovale —> Infratemporal fossa

V Motor Branches of V3:!


V2! 1!
Temporalis muscle!
V3!
Med. and Lat. Pterygoid muscle!
Masseter Muscle!
Mylohyoid Muscle!

Sensory Branches of V3 :!
Long Buccal!(cheek)
Lingual! (CS 2/3 of the tongue)
Inferior Dental! (lower teeth)
Mental Nerve! (sensory to chin)

mental forama
INNERVATION OF THE TONGUE!

Facial Nerve VII! V3 - Lingual Nerve!


Taste for Ant. 2/3 of tongue! Sensory of Ant. 2/3 of Tongue!

Glossopharyngeal- IX!
Post. 1/3 sensory and taste
of tongue!

Hypoglossal Nerve- XII!


Motor Nerve of Tongue Muscles!
Hyoid Bone!
BRANCHES OF FACIAL NERVE(VII)!

Temporal Branch!

Occipital Branch!
Zygomatic Branch!

stylomastoid foramen

Buccal Branch! Parotid gland!

Cervical Branch!

Mandibular Branch! sublingual gland

submandibular gland
ANTERIOR ABDOMINAL WALL!

Exterior Oblique Muscle!

Tendinous Intersection!

Internal Oblique Muscle!

linea alba

Rectus Abdominus!
Transversus Abdominis!

external oblique muscle pieced by the spermatic chord goes to the testies
4th I.C.S.
Most anterior
ABDOMINAL ORGANS!
Liver! Stomach!
Spleen!
9th, 10th, 11th

Kidney!
Hepatic Flexure!
Splenic Flexure!

Transverse Colon!

Inferior Vena Cava!


Abdominal Aorta!

Ureter!

Ascending Colon! Descending Colon!

Cecum! Large Intestine!

Appendix!
Urinary Bladder!
POSTERIOR ABDOMINAL WALL!

Posterior Fibers of !
Diaphragm! Adrenal Gland!

Kidney!

Inferior Vena Cava! Quadratus Lumborum!

Abdominal Aorta!
Psoas Major!
Anterior Abdominal Wall:
Inguinal Canal:
- External oblique Iliacus!
- internal Oblique
- Transversus abdominis

-Aponeurosis Ureter!
-Linea alba

- Rectus abdominis
Iliopsoas!
Urinary Bladder!
Spermatic cord:
- Testicular artery
- Testicular vein
- Vas deferens
STOMACH AND SMALL INTESTINE!
Esophagus!
cardiac orifice Fundus of Stomach!
Cardia of Stomach!

Lesser Curvature!

Pylorus!
1st!
Greater Curvature!
2nd!
Ampulla of Vater!
The ampulla of Vater, also known as the
hepatopancreatic ampulla,or as
hepatopancreatic duct, is formed by the
union of the pancreatic duct and the 4th!
common bile duct. The ampulla is
specifically located at the major duodenal 3rd! Body of Stomach!
papilla.
Duodenum!
ABDOMINAL ORGANS (STOMACH REMOVED)!
stomach is more to the left Outline of Stomach!

Adrenal Gland!

Right Kidney! Body of Pancreas!

Left Kidney!

1st!
Tail of !
Pancreas!
2nd!
!

4th!

3rd!
Duodenum!
Head of Pancreas!
ANTERIOR VIEW OF LIVER!

Right Lobe! Left Lobe!

Falciform Ligament!

Fundus of Gall Bladder!


VISCERAL VIEW OF LIVER!
quadrate lobe
Inferior Vena Cava!
hepatic veins
inferior vena cava
Left Lobe! Right Lobe!
Groove for Stomach!

Common Bile!
Duct!
Porta Hepatis!
Portal Vein! Groove for
Right Kidney!
Hepatic Artery!

Hepatic Duct!

Cystic Duct!

caudate lobe
Fundus of Gall Bladder!
Right Colic Flexure!
(Hepatic Flexure)!
At the right colic flexure ascending colon comes up and turns 90 degree to become a transverse colon
ABDOMINAL ORGINS!
Gall Bladder! Spleen!
Right Hepatic Duct!
Left Hepatic Duct!

Common Hepatic Duct!

Common Bile Duct!


Cystic Duct!
1st!

Hilus of Spleen !
2nd!
Pancreas tail!
4th!

Ampulla of Vater! 3rd! Main


Pancreatic Duct!
piercing the posterior wall of the duodenum
at the center of the pancrease
- All the enzymes and all the other secretions
can ooze out of the duct to the duodenum

Duodenum! Pancreas head!


BRANCHES OF THE ABDOMINAL AORTA!
Fibers of Diaphragm!

PAIRED! UNPAIRED!
Beginning of L1

Inferior Phrenic A.! Celiac Trunk!


beginning of L2
Adrenal A.!
Renal A.! Superior Mesenteric A.!
beginning of L3

Gonadal A.! Abdominal Aorta!


beginning of L4
(Testicular or Ovarian)!

Common Iliac A.! Inferior Mesenteric A.!

Internal Iliac A.!


Go into bladder and other goodies
of the pelvis
External Iliac A.!
legs
I.V.C.

INFERIOR VENA CAVA BRANCHES!

Inferior Vena Cava!

Renal V.!
Renal V.!

Left Gonadal V.!


Right Gonadal V.!
(Testicular or Ovarian)!

Common Iliac V.! Common Iliac V.!

Internal Iliac V.!


Internal Iliac V.!
External Iliac V.!
External Iliac V.! At L5
ARTERIAL SUPPLY OF STOMACH AND SPLEEN!

Left Gastric A.!


Celiac Trunk!
Short Gastric!
this is also called the common hepatic Arteries!
Hepatic A.! Goes to the fundus of
goes to the liver the stomach

Right Gastric A.!


Goes along the lesser
curvature of the stomach and
meets up with left gastric A. Splenic A.!
going to the spleen

Behind the stomach

Left Gastroepiploic A.!


Along the greater curvature

Gastroduodenal A.!

Pancreaticoduodenal A.! Right Gastroepiploic A.!


ABDOMINAL ORGANS!

Adrenal Gland!
Inferior Vena Cava!

Left Kidney!

ureter is the most posterior


same with the kidney

Right Ureter! Abdominal Aorta!

Gonadal Veins!

Gonadal Arteries!
SURFACE MARKINGS OF KIDNEYS!
Right Kidney! Left Kidney!
Stomach!
Adrenal Gland!
Adrenal Gland!

Spleen!
Liver!

Right Colic !
Flexure! Splenic Flexure!

2nd Stage of ! Pancreas!


Duodenum! Small Intestine!
Small Intestine!
SURFACE MARKINGS OF KIDNEYS!
Left Kidney! Right Kidney!

Posterior Fibers of Diaphragm!


11th Rib!

12th Rib!
12th Rib!

Psoas Major!
Psoas Major!
Quadratus Lumborum!
WROOOONGGG Quadratus Lumborum!
Posterior Abdominal Wall! green: psoas major
red: quadratus lumborum
blue: transversus abdominus
Posterior Abdominal Wall!
LARGE INTESTINE!

Transverse Colon!

Ascending!
Colon! Descending !
Colon!

Cecum!

Sigmoid Colon!
Appendix!

Rectum!
ARTERIAL SUPPLY OF THE LARGE INTESTINE!
T.C.

Superior Mesenteric A.! Anastomosis with !


Left colic!

Middle Colic!
Abdominal Aorta!

Right Colic!
D.C.

A.C. Jejunum!

Ileocolic!

There are many branches that go


Arterial Arcade:!
on to feed the colons (ascending)
Jejunal Branches!
Ileal Branches!

Ileocolic Junction!
ileum
ARTERIAL SUPPLY OF LARGE INTESTINE!
Giving a lot of blood supplies to the sigmoidal colons

Abdominal Aorta! Ascending Branch!


(Anastomosis with
Middle Colic)!

Left Colic A.!


Superior Mesenteric A.!
If you block superior mescenteric A. Inferior
blooc can still be supplied to the
ascending branch Mesenteric !

Descending Branch!
Common Iliac A.! (Anastomosis with!
Sigmoidal A.)!
If the inferior mescenteric is blocked, the
blood can still be supplied by the superior
mescenteric a.
Sigmoidal Arteries!
Cecum!

Appendix!
Rectum! Superior Rectal A.!
PORTAL SYSTEM!
Gall Bladder!
Liver!
the splenic vein is analogous to splenic artery

Spleen!
Portal V.!
located behind the liver, pancreas Splenic V.!
and the 1st stage of the duodenum

Superior Mesenteric V.!


located behind the pancrease and
over the 3rd stage of duodenum
middle colic vein Inferior !
Mesenteric V.

Right Colic V.!


Left Colic V.!
Ileocolic V.!

Sigmoidal Veins!
Superior Mesenteric V.!

Ileal Branches! Superior Rectal V.!


BONY FRAMEWORK OF BODY!

THORAX!

ABDOMEN!

PELVIS!
illium

PELVIS!
Sacroiliac Joint! 5 sacrum vertebra
synovial joint
Sacrum!
rectum sits on the bone, right in the middle

Iliac Crest!

Coccyx!

Obturator Foramen!

Ischiopubic Ramus! Symphysis Pubis!


there is a membrane spanning across between the 2 ischiopubic ramus
called: Urogenital diaphragm
tube in the center where urethra go through
LATERAL VIEW OF RIGHT INNOMINATE BONE!
highlighted not on the exam
Iliac Crest!

Anterior Superior!
Iliac Spine!
Posterior Superior!
Iliac Spine!
illium

Gluteal Surface! Anterior Inferior!


Posterior Inferior! Iliac Spine!
Iliac Spine!

Acetabulum!
Greater Sciatic Notch! socket to hold the femur

Acetabular
Ischial Spine! Fossa!
Lesser Sciatic Notch! pubis bone

Ischial Tuberosity!
Ischiopubic Ramus!
Obturator Foramen! ischium
MEDIAL SURFACE OF RIGHT INNOMINATE BONE!

Iliac Crest!
L5

Sacrum!

Anterior Superior! Iliac !


Iliac Spine! Fossa!
Greater Sciatic!
Foramen!/notch
Anterior Inferior!
Iliac Spine! /notch
Sacrospinous!
Ligament!

Obturator Foramen! Sacrotuberous !


Ligament!

Symphysis! Lesser Sciatic Foramen!


Pubis!
Ischial Tuberosity!
MEDIAL SURFACE OF RIGHT INNOMINATE BONE!
Iliac Crest!

Sacrum!
Anterior Superior! Iliac !
Iliac Spine! Fossa!

Piriformis Muscle!
Anterior Inferior! going out to hit the femur
Iliac Spine!

Sacrospinous!
Ligament!

Obturator Internus!
anterior Sacrotuberous !
Ligament!

posterior
Symphysis Pubis! Lesser Sciatic!
covered by phasa
Very thick! Foramen!
White Line! Ischial Tuberosity!
white line, attachment point Inner aspect of pubis
of the pelvic diaphragm Thickening of the phasa
It goes to the ischial spine from the body of the pubis
SUPERIOR SURFACE OF PELVIS DIAPHRAGM!
Perineal Body! Symphysis Pubis!
Urethra!
Anal Canal!
Continuation of rectum White Line!

Obturator Internus! Obturator Internus!

Pelvic
! Diaphgram:!
Anococcygeal Body! Levator Ani Muscle!
O. Back of pubis!
All this forms a funnel shape and support pelvic organ White line!
Ischial spine!
ischiorectal fossa: A wedge-shaped area located
below and between the pelvic diaphragm and the Coccygeus Muscle!
obturator internus muscle and fascia. it is filled Obturator Foramen!
with fatty issue O. Ischial spine!
! I. Anococcygeal!
Symphysis Pubis! body!
Edge of sacrum!
Perineal Body!
Urogenital Diaphragm! F: Support pelvic !
organs

Urethra! Anterior View!


CHECK the diagram
Ischiopubic Ramus!
CORONAL SECTION PELVIN DIAPHRAGM
SAGITTAL SECTION OF MALE PELVIS!

Parietal Peritoneum! Rectum!

Urinary Bladder! Vas Deferens!


Peritoneal !
apex
Cavity! Seminal Vesicle!
Symphysis Pubis!

Prostate Gland!
Ejaculatory Duct!
Corpus Cavernosum! neck
anococcygeal body
Penile/Spongy Urethra! Membranous Urethra!

Corpus Spongiosum!
Anal Canal!
Scrotum!
(Testis)!
Urogenital Diaphragm!
Corpus ! superior layer of facia (connective tissue) over
Cavernosum! the diaphragm

inferior layer of facia under


Corpus Spongiosum!
Penile/Spongy Urethra! sphincter urethra (voluntary muscles)

connective tissue
perineal body
if the sperm accumulates and go into the blood = Can
create an autoimmune disease to destory testis

SAGITTAL SECTION OF MALE PELVIS!


vas deferens
inguinal canal
Superior surface of !
vas deferences come from the inguinal canal
Urinary Bladder!
Apex of Bladder!
Base of Bladder!
(Posterior Surface)!
posteror surface or base
Neck of Bladder!
infralateral surface Seminal Vesicle!
PAIRED (two)
but only one prostate
Ejaculatory Duct!

Urogenital Diaphragm:! Prostate Gland!


Superior! Prostatic Urethra!

Inferior! Membranous Urethra!


dorsal surface

Corpus Cavernosum! Cowper"s Gland!

ventral surface
Corpus Spongiosum!
Vas Deferens!

Epididymis!
Penile/Spongy sperms travel from the top of the epididymis to the
bottom to become motile and fertile
Urethra!
Testis!
sperm at the testis non-motile and infertile at epidiymis
Glans of Penis! Scrotum!
vasectomy, very good contraception, and you can reconnect the tube as well!
you will never stop sperm production
Macrophages will come in get rid of the extra sperms so your scrotum wouldn’t enlarge
ANTERIOR VIEW OF KIDNEYS!

Right Kidney!
Left Kidney!

Abdominal Aorta!

Ureters!
Common Iliac A.!

External Iliac A.! Internal Iliac A.!

Urinary Bladder!
BASE OF BLADDER!

Ureters!

ampulla of
Vas Deferens!

Seminal Vesicle! Ejaculatory Duct!

duct of seminal vesicles

Prostatic Urethra!
Prostate Gland!
Membranous Urethra!
Urogenital Diaphragm!
SAGITTAL SECTION OF FEMALE PELVIS!

Parietal Peritoneum!
Body of Uterus!

Fundus of Uterus! Peritoneal! Sacrum (S1-3)!


Cavity!
Uterovesical Pouch!
Rectouterine Pouch!
Cervix of Uterus!

Anterior Fornix!
Posterior Fornix!
Symphysis Pubis!
Rectum!
Urinary Bladder!
Anococcygeal Body!
Urethra!
Anal Canal!
Vagina! Perineal Body!
Urogenital Diaphragm!
don’t have to know it in the lab but in theory

ANTERIOR VIEW OF UTERUS!


Fallopian Tube! Ovaries!

Fundus!
!

Ovarian A.!

Body of Uterus! Uterine A.!


part of the internal iliac artery

Round Ligament
of Uterus!

Cervix of Uterus! Internal Iliac A.!


Vaginal A.!
Vagina!
The oocyte can floats at the peritoneal cavity
Sperm can come all the way there and fertilize the egg
The fertilized egg will be developed at the peritoneal
cavity then… CORONAL SECTION OF UTERUS!
Using the blood supply of surrounding tissues
Fertilization happens at the lateral third of the Fallopian tube

Ampulla! Fallopian Tube!


sometimes the implant can be at the wall of the fallopian tube
sperm meats egg (lateral 2/3) In a few weeks = Fallopian tube will burst —> Ectopic pregnancy

Fundus of Uterus!

infundibulum

ostium
Ovary!

Fimbriae!
Myometrium!
Isthmus! these cells become extremely elongated during pregnancy

Endometrium!
fertilized egg attaches

Uterine Cavity! Internal Os!


ostium is where the oocyte enters
into the Fallopian tube Cervical Canal!
External Os!
Vagina!

prolapse of the uterus (when it is not 90 degree angles)


SAGITTAL SECTION OF UTERUS!
uterus can REALLY expand
When it expands, it will push the bladder
= Always going to the bathroom

Ovary!

Anterior Fornix!

Fundus of Uterus!
Posterior Fornix!
round ligament that extends anteriorly of the uterus

Cervix!
Bladder Cavity!

Urinary Bladder! Vagina!