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Anatomy Exam 1

  1. What Cranial Nerves and Sacral Spinal Nerves make up the Parasympathetic System?
    • Cranial Nerves III, XII, IX, and X
    • Sacral Spinal Nerves S2, 3, 4
  2. What Spinal Nerves make up the Sympathetic System?
    Spinal Nerves T1 through L2 or L3
  3. What makes Cervical Nerve 1 stand out from the other Spinal Nerves?
    It has no Dorsal Root innervation, only has Motor/Ventral innervation
  4. What are the Root Nerve values for the Sciatic and Phrenic Nerve?
    • Sciatic - Ln4, Ln5, Sn1, Sn2, Sn3
    • Phrenic - Cn 3, 4, 5
  5. Where does the Vagus Nerve end?
    Left Colic Flexure
  6. Describe the Synapse Route for the following nerve bundles:

    T5-T9
    T10-T11
    T12
    L1-L2
    • T5-T9 = Greater Splanchnic = Celiac Ganglion
    • T10-T11 = Lesser Splanchnic = Superior Mesenteric Ganglion
    • T12 = Lowest/Least Splanchnic = Aortic-Renal Ganglion
    • L1-L2 = Lumbar Splanchnic = Inferior Mesenteric Ganglion
  7. List the corresponding Dermatome innervation
    a. Navel
    b. Nipple
    c. Hallux
    d. Pubic Bone
    e. Pinky Finger
    f. Digits 2, 3, 4
    g. Middle Finger
    h. Pinky Toe
    • a. Navel - T10
    • b. Nipple - T4
    • c. Hallux - L4
    • d. Pubic Bone - T12
    • e. Pinky Finger - C8
    • f. Digits 2, 3, 4 - L5
    • g. Middle Finger - C7
    • h. Pinky Toe - S1
  8. What is the Function of Flexure Lines? Where are they not found?
    • Function - allows the skin to move freely over Superficial Fascia 
    • They are not found on the Palms and Soles of Feet
  9. Tension Lines or Langers Lines are made of bundles of what type of fibers?
    Collagen Fibers
  10. Where are Friction Lines or Ridges found?
    The Palms and Soles of Feet (they give Finger and Foot Prints)
  11. Give a definition for a Dermatome
    An area of skin supplied by the Sensory Fiber of a Dorsal Root through the Dorsal and Ventral Rami of the Spinal Nerves
  12. What vessels give the Blood Supply to the Breast? From where do they branch from?
    • 1. Pectoral Branch of Thoracoacromial Artery - Axillary Artery
    • 2. Lateral Thoracic Artery - Axillary Artery
    • 3. Posterior Intercostal - Thoracic Aorta
    • 4. Anterior Perforating Branches of the Internal Thoracic artery - Subclavian
  13. What are the routes of Lymphatic Drainage for the breast?
    • 1. Axillary Nodes
    • 2. Opposite Breast
    • 3. Ligamentum Teres of the Liver
    • 4. Transpectoral
    • 5. Parasternal (Internal Thoracic Artery)
  14. What is removed in a Radical Mastectomy?
    • The Breast
    • The Opposite Breast
    • Axillary Nodes
    • Pec Major and Minor
    • Medial and Lateral Nerves
    • Medial and Lateral Arteries
    • Minor Arteries
  15. What makes up the Thoracic Inlet? What can be found within the Thoracic Inlet?
    • Thoracic Inlet is made of the 1st Rib, 1st Thoracic Vertebra, and Manubrium
    • Trachea, Esophagus, Phrenic and Vagus Nerve, and Apex of the Lung
  16. What makes up the Thoracic Outlet?
    The 12th Rib, Tv12, and Costal Margin
  17. At what level can the Xiphoid Process be found?
    Found at Tv10 or Tv11
  18. At what level can the Sternal Angle be found? What articulates at this joint?
    • Lower border of Tv4
    • Rib 2 articulates directly at the Sternal Angle
  19. List the following ribs:

    Typical
    Atypical
    True
    False
    Floating
    • Typical - Ribs 3 through 9
    • Atypical - Ribs 1, 2, 10 through 12
    • True - Ribs 1 through 7
    • False - Ribs 8 through 12
    • Floating - Ribs 11 and 12
  20. What are important distinctions for the First Rib?
    • Is short and broad
    • Boundary for the Thoracic Inlet
    • Groove for the Subclavian Artery and Vein
  21. What are the origins and insertions for the Serratus Anterior? Innervation?
    • Origin - Ribs 1-8
    • Attachment - Costal Surface of Scapula
    • Innervation - Long Thoracic Nerve
  22. What are the functions of the Serratus Anterior?
    • Rotates the Scapula
    • Aids in Respiration
    • Abductor of the arm
  23. For the External Intercostal Muscle:

    Where does it Attach
    What occurs to it at the Costochondral Joint
    Function
    Innervation
    • Where does it Attach -- lower borders of ribs 1-11 to upper borders of rib 2-12
    • What occurs to it at the Costochondral Joint -- it turns into External Intercostal Membrane
    • Function -- Inspiration
    • Innervation -- Intercostal Nerves
  24. For the Internal Intercostal:

    Where does it attach
    Function
    Innervation
    • Where does it attach -- lower margins of ribs, costal cartilages and grooves
    • Function -- Expiration
    • Innervation -- Intercostal Nerves
  25. For the Innermost Intercostal:

    What muscles is it made up of, and describe them
    • Innermost Intercostal per se
    • Subcostalis Muscle -- attach between ribs posteriorly, may cross 1 or 2 ribs and attach to 3rd
    • Sternocostalis/Transversus Thoracis -- attaches to back of Xiphoid Process and Sternum, inserts into costal cartilage; Function -- Expiration
  26. Where can the Posterior Intercostal Neurovascular Bundle be found?
    Between the Internal and Innermost Intercostal muscles
  27. What landmark describes the location of the Nipple?
    Intercostal Space 4
  28. What Arterial Blood Supply serves the Anterior Thoracic Aspect?
    Internal Thoracic Artery -- from the Subclavian Artery
  29. What Arterial Blood Supply serves the Posterior Thoracic Aspect?
    • (1) Highest Intercostal Artery -- Costocervical Trunk from Subclavian
    • (2-11) Posterior Intercostal -- Thoracic Aorta
    • (12) Subcostal -- Thoracic Aorta
  30. What Venous Blood Supply serves the Anterior Thoracic Aspect?
    Internal Thoracic Vein
  31. What Venous Blood Supply serves the Right Posterior Thoracic Aspect?
    • (1) Highest Intercostal -- Brachiocephalic 
    • (2-3) Higher Intercostal -- Azygous
    • (4-11) Intercostal -- Azygous
    • (12) Subcostal -- Azygous
  32. What Venous Blood Supply serves the Left Posterior Thoracic Aspect?
    • (1) Highest Intercostal -- Brachicephalic
    • (2-4) Higher Intercostal -- Accessory Hemiazygous
    • (5-11) Hemiazygous 
    • (12) Subcostal -- Hemiazygous
  33. What veins drain into the Azygous vein?
    • Accessory Hemiazygous (potentially, not always)
    • Hemiazygous 
    • Intercostal (right side)
    • Subcostal (right side)
  34. What veins drain into the Superior Vena Cava?
    Azygous
  35. What veins drain into the Brachiocephalic?
    • R+L Highest Intercostal
    • Internal Thoracic Vein
  36. What are the layers of penetration at the Mid-axillary line?
    • 1. Skin
    • 2. Superficial Fascia
    • 3. Deep Fascia
    • 4. Serratus Anterior
    • 5. External Intercostal Muscle
    • 6. Internal Intercostal Muscle
    • 7. Innermost Intercostal Muscle
    • 8. Endothoracic Fascia
    • 9. Parietal Pleura
    • 10. Plerual Cavity
    • 11. Visceral Pleura
    • 12. Lungs
  37. What is the function of Endothoracic Fascia?
    To prevent Parietal Pleura from rubbing against the Innermost Intercostal Muscles
  38. Where can Sibsons Fascia be found? What is it?
    • At the Apex of the Lungs
    • Thickening of Endothoracic Fascia
  39. What is the Cupola, and where is it found?
    Area of Parietal Pleura reflected on the apex of the lungs
  40. Where can you perform a Plural Cavity Tap?
    Intercostal Space 9
  41. What Arterial Blood supply serves the following Pleural Layers:

    Parietal
    Visceral
    • Parietal -- Intercostal Artery and ITA
    • Visceral -- Bronchial Artery
  42. What Nerve supply innervates the following Pleural Layers:

    Parietal
    Visceral
    • Parietal -- Intercostal Nerves T1-T11, Subcostal and Phrenic Nerves (it is HIGHLY sensitive to pain)
    • Visceral -- No sensory innervation
  43. What are the structures found within the Superior Mediastinum?
    • 1. Arch of Aorta (and branches)
    • 2. Brachiocephalic Vein(s)
    • 3. SVC
    • 4. Thymus
    • 5. Trachea
    • 6. Esophagus 
    • 7. Thoracic Duct
  44. What are the structures found within the Anterior Mediastinum? What landmarks define the location of the Anterior Mediastinum
    • 1. Fatty Tissue
    • 2. Thymus (infants)
    • 3. Lymph Nodes

    From the posterior surface of the Sternum to Anterior Surface of the Pericardial Sac
  45. What are the structures found within the Middle Mediastinum?
    • Heart
    • Pericardium
    • Main Bronchi
    • Great Vessels
  46. What are the structures found within the Posterior Mediastinum? What landmarks define the location of the Posterior Mediastinum?
    • Esophagus
    • Thoracic Aorta
    • Azygous System
    • Thoracic Duct
    • Vagus Nerve
    • Splanchnic Nerves

    From Pericardial Sac and Diaphramg and Anterior to the Lower 8 Thoracic Vertebra (5-12)
  47. Is all of the sympathetic chain found in the posterior mediastinum?
    No, just the Splanchnic Nerves
  48. What is a Mediastinoscopy?
    • Procedure done to remove tissue from the Anterior and Superior Mediastinum to examine the Lymph Nodes. Incision is made at the Jugular Notch/Suprasternal Notch
    • Performed to check metastasis if Bronchogenic Carcinoma is suspected
  49. What are the dimensions of the Trachea? Where does it begin, and where does it bifurcate?
    • 15-20 C Bars 
    • 9-15cm Long
    • 2.5cm Diameter

    Begins at Cv6, Bifurcates at Sternal Angle
  50. What structures are anterior to the Trachea?
    • Sternum
    • Thymus
    • Arch of Aorta
    • Origins of Brachiocephalic and Left Common Carotid Arteries
  51. What structures are posterior to the trachea:

    On the Right Side
    On the Left Side
    Posterior -- Esophagus

    Right Posterior -- Azygous, Right Vagus Nerve

    Left Posterior -- Arch of Aorta, Left Common Carotid, Let Subclavian, Left Vagus Nerve
  52. What Arteries give blood supply to the Trachea?
    • Superior Thyroid Artery
    • Inferior Thyroid Artery
    • Bronchial Arteries
    • Internal Thoracic Artery
  53. What nerves innervate the Trachea?
    • Vagus
    • Sympathetic
  54. Where is the Oblique Fissure of the Lung found?
    2 1/2 inches from the Apex of the lung and ends at Costal Cartilage 6
  55. Where is the Horizontal Fissure found?
    Costal Cartilage level 4
  56. What Arterial Blood Supply serves the Bronchopulmonary Segments?
    Brachial Artery from Thoracic Aorta
  57. What Venous Blood Supply serves the Bronchopulmonary Segments?
    Bronchial Veins which drain into Azygous Vein, and also the Pulmonary Veins
  58. What nerve groups give innervation to the Bronchopulmonary Segments? What does each grouping do?
    • Anterior/Posterior Plexus of Vagus Nerve -- Produces Bronchioconstriction, Vasodilation, and Increased Glandular Secretion
    • Sympathetic Trunk (Vasomotor from T2-T5) -- Produce Bronchodilation, Vasoconstriction, and Decreased Glandular Secretion
  59. What landmarks define the location of the Right and Left Dome of the Diaphragm?
    • Right -- Upper border of Rib 5
    • Left -- Lower Border of Rib 5
  60. What causes Hiccups?
    Spasmatic contraction of the diaphragm caused by irritation of the Phrenic Nerve
  61. Describe Cystic Fibrosis. How is it treated?
    • Condition where the lungs fill with fluid
    • Treated with Steroids
  62. Describe Congenital Diaphragmatic Hernia.
    Defect at the Pleuroperitoneal membrane. A large opening in the posterolateral region of the diaphragm. Abdominal contents may move up
  63. Where is the Caval Opening found, and what structures pass through it?
    • Found at Tv8
    • Contains -- Right Phrenic Nerve, IVC, and Lymphatics
  64. Where is the Esophageal Opening found, and what structures passes through it?
    Found at Tv10

    Contains -- Esophagus, Right and Left Vagus, and Esophageal Branches of the Gastric Artery and Vein
  65. Where is the Aortic Opening found, and what structures passes through it?
    Found at Tv12

    Contents -- Thoracic Aorta, Thoracic Duct, Greater Splanchnic Nerve, and Azygous Vein
  66. What nerves innervate the Diaphragm?
    • Phrenic (Cv3, 4, 5) -- Gives Motor supply; Left Phrenic supplies the Left dome and half of the Right
    • Intercostal Nerves -- supplies periphery of Diaphragm
  67. What Arteries give Blood Supply to the Diaphragm?
    • Musculophrenic from ITA
    • Superior Phrenic from Thoracic Aorta
    • Inferior Phrenic from Abdominal Aorta
    • Pericardiophrenic from ITA
    • Posterior Intercostal Arteries from Thoracic Aorta
  68. What different muscles are used during Normal versus Forced Expiration?
    • Normal -- Intercostals
    • Forced -- Serratus Anterior and Intercostals
  69. Where is the POSITION of the following
    Heart Valves: 

    Aortic Valve
    Pulmonary Valve
    Tricuspid Valve
    Bicuspid Valve
    • Aortic Valve: Left Half of the Sternum, opposite the 3rd Intercostal Space
    • Pulmonary Valve: Behind the medial end of the 3rd Left Intercostal Space
    • Tricuspid Valve: Behind the right 1/2 of Sternum, opposite the 4th Intercostal Space
    • Bicuspid Valve: Behind the left 1/2 of the Sternum opposite the 4th Intercostal Space
  70. Where is the location of Auscultation of the following Heart Valves:

    Aortic Valve
    Pulmonary Valve
    Tricuspid Valve
    Bicuspid Valve
    • Aortic Valve: Over the Right 2nd Intercostal Space
    • Pulmonary Valve: Over the Left 2nd Intercostal Space
    • Tricuspid Valve: Right 1/2 of Lower End of the Sternal Body
    • Bicuspid Valve: 6-7cm or more from the Median Plane, generally at the 4th or 5th Intercostal Space
  71. What connective attaches the Pericardium to the Sternum?
    The Sternopericardial Ligament
  72. What causes the LUB and DUB sound?
    • LUB: Contraction of Ventricles, Closure of the Tricuspid and Bicuspid
    • DUB: Closure of the Pulmonary and Aortic Valves
  73. Describe the layers of penetration of the Pericardial Layers from Outside Inwards
    • Pericardium
    • Fibrous Pericardium
    • Serous Sac--
    • Parietal Layer
    • Pericardial Cavity
    • Visceral Lay
    • Heart--
    • Epicardium (Visceral)
    • Myocardium
    • Endocardium
    • Chamber
  74. What two pericardial layers can the Phrenic Nerve be found in-between?
    Parietal Pleura and Fibrous Pericaridum
  75. Where can the Transverse and Oblique Sinuses of the Heart be found?
    • Transverse: Behind the Aorta and Pulmonary Trunk, and in front of the Left Atrium and SVC
    • Oblique: Between the Pulmonary Veins and IVC
  76. What Arteries/Branches give Blood Supply to the Pericardium?
    • Pericardiophrenic Branches of the ITA
    • Pericardial Branches from -- Bronchial, Esophageal, and Superior Phrenic Arteries
  77. What nerves innervate the Pericardium? Epicardium specifically?
    • Phrenic Nerve has Seonsory and Vasomotor Fibers
    • Epicardium -- supplied by Coronary Plexuses
  78. What landmark defines the location of the Apex of the Heart?
    Costal Cartilage 6
  79. What Artery accompanies the Phrenic Nerve?
    Pericardiophrenic Artery
  80. What structures can be found in the Right Atrium?
    • Fossa Ovalis
    • Limbus of Fossa Ovalis
    • Crista Terminalis
    • Opening of Tricuspid
    • Opening of SVC
    • Opening of IVC
    • Opening of Coronary Sinus
    • Opening of Anterior Cardiac Veins
  81. What structures can be found in the Right Ventricle?
    • Tricuspid Valve
    • Pulmonary Trunk
    • Papillary Muscles
    • Chorae Tendinaea 
    • Moderator Band/Septomarginal Band
  82. What structures can be found in the Left Atrium?
    • Pectinate Muscles
    • Opening of Pulmonary Veins
    • Opening of Bicuspid Valve
  83. What structures can be found in the Left Ventricle?
    • Bicuspid Valve
    • Opening of Ascending Aorta
    • Ticker Muscle
  84. What is the Purpose of Chordae Tendinea?
    • Prevent eversion of valves during ventricular contraction
    • Prevent backflow of blood into the Atrium
  85. In what chamber would the Lead of a Pacemaker be placed?
    Right Atrium
  86. What are the Branches of the Right Coronary Artery?
    • Sinoatrial Artery
    • Conal
    • Right Anterior Atrioventricular Branch
    • Marginal Artery
    • Right Posterior Atrioventricular Artery
    • Right Posterior Descending Interventricular Branch
  87. What are the Branches of the Left Coronary Artery?
    • Left Circumflex Artery
    • LAD Interventricular Artery (WIDOW MAKER)
    • Left Posterior Interventricular Ascending Artery
    • Branch to Left Atrium
  88. What Arteries give the Anastomoses of the Coronary Arteries?
    • Nodal
    • About the Conus Arteriosus
    • Circumflex
    • Interventricular Septum (Anterior)
    • Posterior Interventricular Septum
  89. Which Veins drain blood from the Anterior aspect of the Heart?
    • Anterior Cardiac Veins
    • Small Cardiac Veins
    • Great Cardiac Veins
  90. What Veins drain blood from the Posterior aspect of the Heart?
    • Middle Cardiac Vein
    • Oblique Vein of the Left Atrium
    • Coronary Sinus
  91. Where does the Anterior Cardiac Vein drain into?
    Directly into the Right Atrium
  92. Where does the Small Cardiac Vein drain into? From where does it drain? What artery does it Accompany?
    • Drains into the Coronary Sinus
    • Drains blood from the Right Ventricle
    • Accompanies the Marginal Artery
  93. What Artery does the Great Cardiac Vein accompany?
    LAD Interventricular Artery
  94. Where does the Coronary Sinus drain into?
    Into the Right Atrium
  95. What are the Tributaries of the Coronary Sinus?
    • Great Cardiac Vein
    • Small Cardiac Vein
    • Middle Cardiac Vein
    • Oblique Vein
  96. Give a description of the Cardiac Skeleton
    Fibrous tissue surround the Atrioventricular and Semilunar Valves. It fives attachment to the valves and muscular layers, and is continuous with the roots of Aorta and Pulmonary Trunk and with the membranous part of the Interventricular Septum.
  97. Describe the Coronary Bypass procedure
    • Obstruction of Coronary Circulation is treated by inserting a graph of the Saphernous Vein between the Ascending Aorta and Coronary Artery distal to the obstruction.
    • Can also us the ITA as a graph
  98. What 2 great vessels Leave the heart?
    • Ascending Aorta from Left Ventricle
    • Pulmonary Trunk from Right Ventricle
  99. What great vessels Enter the Heart?
    • Pulmonary Veins (left atrium)
    • SVC
    • IVC
    • Coronary Sinus
    • Anterior Cardiac Veins
  100. Where is the Ligamentum Arteriosum found? To what is it attached?
    • Located at the Sternal Angle
    • Attached from the Arch of the Aorta to the Pulmonary Trunk or Left Pulmonary Artery
  101. Where do the Left and Right Recurrent Laryngeal Nerves run, respectively?
    • Right: hooks under the Right Subclavian Artery
    • Left: hooks under the ligament at the Sternal Angle (Ligamentum Arteriosum)
  102. With respect to the SA Node, what does activation of the Sympathetic Fibers (T1-T3) versus Vagus Nerve result in?
    • Sympathetic Fibers (T1-T3): Results in Cardiac Acceleration, Dilation of Coronary Arteries
    • Vagus Nerve: Reduction of HR and Force of Contraction of both the Heart and Coronary Arteries
Author
Charlie581
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334296
Card Set
Anatomy Exam 1
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Anatomy Exam 1
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