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General Anatomy 1st
Gametogenisis to Abdominal wall
| Question | Answer |
|---|---|
| Bursa | is a closed sac of serous membrane located around the joints or muscle attachments to facilitate movement |
| Fascia | is a tough heavily innervated layer of connective tissue; the function of which is to compartmentalize the body |
| Fascia has three major subdivisions | Superficial (subcutaneous) Fascia Deep fascia Subserous fascia |
| Skin | is the largest organ of the body, It is a sturdy elastic, movable, envelop that covers the body blending with the mucous membranes of the mouth, nose, eyes, anal and urogenital openings |
| Functions of the Skin | Protection from environmental effects, such as fluid loss, invading microorganisms, mechanical abrasions, UV light, abrasionsContainment of the body structures and vital substances Heat regulation Sensation Synthesis and storage of vitamin D |
| Parts of a Muscle | Belly - the fleshy part Head - the origin or the proximal end of the muscle Tail - the insertion or the distal end of the muscle |
| Composite Muscle | A muscle having more than one innervation, ex adductor magnus, pectoralis major |
| Sperm Cell | • Small in size with very little cytoplasm • Motile • There are two kinds of normal sperm • Spermatogenesis begins at puberty |
| Oocyte | • Massive in size with an abundance of cytoplasm • Non-motile • There is only one kind of normal secondary oocyte • Oogenesis begins before birth (7M prenatally; 700K- 2M at birth; 400K at puberty; <500 gets ovulated |
| Alleles (gene pairs) | any two matched genes found on the same locus (location) on homologous chromosomes |
| Homozygous | when the two alleles controlling a trait are the same |
| Heterozygous | when the two alleles controlling a trait are different |
| Genotype | a person’s genetic makeup |
| Phenotype | the way the genotype is expressed in the body |
| Incomplete dominance | eg sickle cell |
| Multiple-Allele inheritance | eg ABO |
| Sex-linked inheritance | passed from mother to son X chromosome: 2500 genes Y chromosome: 78 genes SRY gene |
| Polygene inheritance | skin color (3 gene pairs), height (4 gene pairs), IQ |
| Nontraditional inheritance | – Genomic imprinting – epigenetic marks tagging genes as either maternal or paternal – Extrachromosomal (mitochondrial) inheritance |
| DOMINANT (traits) | • Tongue roller • Astigmatism • Freckles• Dimples in cheeks• Feet with normal arches• Widow’s peak• Broad lips• Polydactyly• Syndactyly• Huntington’s disease • Absence of CF• Absence of Tay-Sach’s disease• Achondroplasia |
| Mechanism of Gene Function | – genetic code is transmitted via genes – each mRNA molecule associates with a ribosome, translates the code to form a specific polypeptide molecule |
| Meiosis | • Produces gametes with a haploid number of chromosomes • When a sperm and ovum unite at conception, they form a zygote with 46 chromosomes |
| X chromosome | female chromosome; larger than Y chromosome; includes genes that determine female sexual characteristics, as well as nonsexual characteristics |
| Y chromosome | male chromosome; smaller that X chromosome; contains few genes other than male sexual characteristics |
| FERTILIZATION | • This is fusion of male and female gametes and usually occurs in the ampulla of the fallopian (uterine) tube |
| capacitation | to expose the acrosome of the sperm head(period of conditioning lasting for 7 hours), sperm becomes more motile |
| Phases of Fertilization | PHASE 1 - penetration of corona radiata, PHASE 2 - penetration of zona pellucida, PHASE 3 - fusion of oocyte and sperm cell membranes |
| Ectopic Pregnancies in order of occurrence | -- Tubal- fallopian tubes -- Abdominal - along intestines in mesentary -- Ovarian- in the ovary |
| Dominant | when one allele masks or suppresses the expression of its partner |
| Recessive | the trait of an allele that is masked or suppressed |
| Embryo | A developing human organism during the first eight weeks of growth |
| Fetus | After the eight weeks, which is from the ninth week to birth |
| What main events occur during the first week of development? | Fertilization, Implantation |
| Luteinizing hormone | Is responsible for Ovulation |
| prostaglandin | causes contraction of smooth muscles of uterus and fallopian tubes. This helps the egg move. |
| Mittelschmerz | Pain during mid cycles |
| Menstral Flow | Consists of blood, mucus, microsis of endometrium tissue |
| Ovulation | is extrusion of the oocyte from a mature Graafian follicle in the ovary. |
| Fertilization stimulates | secondary oocyte to complete its second meiotic division. |
| Syncytiotrophoblasts | is derived from trophoblasts; funct: will anchor itself to endometrium wall. |
| HCG | Takes the role of the LH; and will maintain the pregnancy of corpus luteum. HCG is what is detected by pregnancy tests. IF no HCG then results in low progesterone and abortion will occur. |
| Blastocyt | early stage of developing embryo |
| blastula | created when the zygote undergoes the cell division process known as cleavage;is preceded by the morula and is followed by the gastrula in the developmental sequence |
| Implantation | takers place on posterior wall of the uterus. |
| Hypoblast | consist of low cuboidal cells adjacent to the blastocyst, This layer contributes to the lining of the primitive yolk sac |
| Epiblast | tall columnar cells which separate from the cytotrophoblast to form the amniotic cavity |
| extra-embryonic mesoderm | proliferates and creates the chorionic cavity |
| Decidua reaction | endometrium cells swell up and gets ready for implantation. |
| Date of delivery | is calculated by the 1st day of the last day of menstral period. |
| GASTRULATION | begins with formation of the primitive streak on surface of epiblast, The epiblast, through the process of gastrulation, is the source of all germ layers in the embryo |
| GASTRULATION gives rise to | 3 germ layers ectoderm, mesoderm, and endoderm. |
| FORMATION OF NOTOCHORD | about day 16, cells of PS migrate rostrally toward the prechordal plate forming a tube-like notochordal process; the floor disintegrates leaving behind a grooved notochordal plate; this plate invaginates craniocaudally to form notochord |
| NEURAL TUBE FORMATION | the neural plate appears as a thickening of the embryonic ectoderm, cranial to the primitive node; a neural groove develops, which is flanked by neural folds; failure of the neural tube enclosure will result in part of the brain not developing. ex: spina |
| Neural crests of neural tube | gives rise to the sensory ganglia of cranial and spinal nerves and the adrenal medulla, the autonomic ganglia, sheaths of peripheral nerves, meningeal coverings of brain and spinal cord, etc. |
| SOMITE FORMATION | the mesoderm on each side of notochord thicken to form longitudinal columns of paraxial mesoderm; these columns then divide into pairs of somites beginning cranially by the end of the third week. |
| FORMATION OF ALLANTOIS | about day 16, the allantois forms as a diverticulum of the posterior wall of yolk sac extending into the connecting stalk; both allantois and yolk sac are responsible for early blood formation |
| TROPHOBLAST DEVELOPMENT | the extraembryonic mesoderm of the chorion invades the cytotrophoblastic core of the primary villi --> secondary villi; The core mesoderm of these villi organize into capillaries and make contact with the connecting stalk and chorion --> tertiary vi |
| Endoderm | Epithelium of GI tract,liver, pancreas, urinary bladder |
| Mesoderm | gives rise to the Head, Paraxial mesoderm, Intermediate mesoderm, and lateral mesoderm: splanchnic & somatic |
| paraxial mesoderm | muscles of head, skeletal muscles of trunk and limbs, dermis of skin and connective tissue |
| DERIVATIVES OF ECTODERM | • Neuroepithelium of sense organs • Epithelium of oral and nasal cavities, paranasal sinuses, salivary glands, anal canal • Epithelium of pineal gland, pituitary gland, and adrenal medulla |
| DERIVATIVES OF MESODERM | Dermis of skin, All skeletal, most smooth, and cardiac muscles, Cartilage, bone and other connective tissues, Blood, bone marrow, and lymphoid tissue |
| DERIVATIVES OF MESODERM | endothelium of blood and lymphatic vessels, Fibrous and vascular layer of eye, Middle ear, Mesothelium of ventral body cavities, Epithelium of kidneys, ureters, adrenal cortex, gonads |
| DERIVATIVES OF ENDODERM | • Epithelium of GI tract except oral cavity & anal canal • Epithelium of urinary bladder, liver, & gallbladder • Epithelium of pharynx, auditory tubes, tonsils, larynx, trachea, bronchi, & lungs |
| The primitive gut is divided into: | foregut, midgut, and hindgut;The gut is lined externally by lateral plate mesoderm - splanchnic portion |
| Cavity formed between the epiblast and cytotrophoblast | Amniotic cavity |
| what cells is the source of the three germ layers | Epiblast |
| Yolk Sac | is origin of the primordial germ cells, and part of it is incorporated into the body cavity to form the primitive gut. |
| Muscular System Development | each somites differentiate into a ventromedial sclerotome and a dorsolateral dermomyotome. The latter further differentiates into dermatome and myotome. |
| Sclerotome (“sclero” - hard) | - bones, cartilage, ligaments of the vertebral column and parts of the base of the skull |
| • Dermatome (“derma” - skin) | - dermis and hypodermis |
| • Myotome (“myo” - muscle) | - skeletal muscles |
| • Lateral plate mesoderm | splanchnic - most smooth muscles of visceral organs, cardiac muscle |
| Myotome cells (or myoblasts) | migrate ventrally to surround the intraembryonic coelom; Myoblasts become spindle-shaped and fuse to form multi-nucleated muscle fibers; Myofibrils appear in the cytoplasm and by the third month, cross striations appear |
| IVD in vertebrae | for shock absorption due to a high water content. |
| Epimere | forms deep back muscles; superfiscial, intermediate deep. "erectospinae" |
| Hypomere | forms anterior muscles, diaphragm, pectoralis major, minor, and abdominal, head, neck. |
| Muscles of the head | the extrinsic and intrinsic muscles of the tongue are derived from the occipital myotomes while extrinsic muscles of the eye are derived from the preoptic myotomes; The muscles of mastication, facial muscles of expression, muscles of pharynx and larynx ar |
| Limb muscles | in the seventh week, mesenchyme derived from the dermomyotome migrate into the limb bud; with elongation of the limb buds, the muscular tissue splits into flexor and extensor components |
| Smooth muscles of the iris | however, differentiate from the ectoderm of the optic cup |
| ectoderm gives rise to | Myoepithelial cells of the mammary glands and sweat glands |
| CARDIAC MUSCLE | • Develops from the splanchnic mesoderm surrounding the endothelial heart tube• The myoblasts adhere to one another by special attachments that later develop into intercalated discs |
| Skeletal System Development | Develops from mesodermal and neural crest cells – The paraxial mesoderm develop into segments called somites – The somites differentiate into sclerotome and dermomyotome |
| The sclerotomal cells form | the vertebrae and ribs |
| Congenital malformations | are gross structural defects present at birth (2-3% of live newborn infants show 1 or more anomalies at birth; another 2-3% are detected by 5 years of age)• time of exposure to factors is crucial |
| Teratology | study of birth defects and their causes |
| Teratogen | is any agent that can produce a congenital anomaly or raise the incidence of an anomaly in the population |
| critical periods of development | stage of embryonic development determines the susceptibility to teratogenic factors |
| genotype (genetic constitution) of embryo | underlying genetic susceptibilities |
| Critical Periods of Development | 1st two weeks are most vulnerable, 2-5 weeks is development of the central nervous system, 2,1/2- 5,1/2 is the heart |
| Hypoxia | due to cause of smoking, nicotine causes vasoconstriction and retardation. |
| low birth weight | <2000g, may cause prenatal death. |
| environmental chemicals | ex- mercury in river by eating fish may cause congenital malformations. |
| CHROMOSOMAL/GENETIC FACTORS | Numerical chromosomal abnormalities due to nondisjunction Turner syndrome (45, X); Klinefelter syndrome (47, XXY) Trisomy of autosomes (Trisomy 21; Trisomy of sex chromosomes; Mosaicism, Triploidy, Tetraploidy XYY - low mental capacity, and very aggress |
| Structural chromosome abnormality | caused by translocation or deletion; Ex: cri du chat syndrome (chr 5) |
| Angelman Syndrome | – Deletion of a segment of the maternal chromosome (more severe of mental retardation) 15 |
| • Prader-Willi Syndrome | – Deletion of a segment of the paternal chromosome 15 |
| Achondroplasia | results from a genetic mutation; It is an example of a dominantly inherited congenital anomaly |
| INFECTIOUS AGENTS • TORCH syndrome | – Toxoplasmosis - hydrocephalus, cerebral calcifications, MR – Rubella or German measles – Cytomegalovirus (CMV) - most common viral infection of the human fetus – Herpes simplex virus • varicella or chickenpox• HIV - not a major teratogen• syphilis |
| fetal alcohol syndrome (FAS) | most common cause of mental retardation; binge drinking can cause FAE |
| Ganglia (ganglion) | – Spinal ganglia (white matter), are cell bodies of sensory neurons. – Autonomic ganglia • Sympathetic ganglia • Parasympathetic ganglia |
| Cranial Nerves(Oh Oh Oh To Touch And Feel Very Green Vegetables Such Heaven!) | • Olfactory • Optic • Oculomotor • Trochlear • Trigeminal • Abducens • Facial • Vestibulocochlear • Glossopharyngeal • Vagus • Spinal accessory • Hypoglossal |
| Spinal Nerves | • Cervical (8) • Thoracic (12) • Lumbar (5) • Sacral (5)• Coccygeal (1) |
| Somatic fibers | – Sensory (general somatic afferent =GSA) Found in body wall. – Motor (general somatic efferent =GSE)ex diaphragm (going to or coming from skin, bone, cartilage, fascia, tendon, ligament, skeletal muscle. |
| Visceral fibers | – Sensory (general visceral afferent =GVA) ex heart attack pain; stomach, kidngey, ureter, bronchii, blood vessels. – Motor (general visceral efferent = GVE) ex vasoconstriction, • Presynaptic or preganglionic fiber • Postsynaptic or postganglionic fib |
| Dermatomes To Remember | • C 2 – back of the head; the “highest” dermatome of the body • C 4 – top part of the shoulder • C 6 – thumb • C7 – middle finger • C 8 – little finger • T 4 – level of the nipples • T 10 – level of the umbilicus • T 12/L 1 – the skin along the ingu |
| Dermatomes To Remember | • C 2 – back of the head; the “highest” dermatome of the body • C 4 – top part of the shoulder • C 6 – thumb • C7 – middle finger • C 8 – little finger • T 4 – level of the nipples • T 10 – level of the umbilicus |
| Dermatomes To Remember | • T 12/L 1 – the skin along the inguinal crease • L 4 – big toe • S 1 – little toe & sole of the foot • S 4/S 5/Cocc 1 – the skin around the anus |
| Somatic Nerve Plexus | It is a complex interwoven network of nerves formed by ventral rami of adjacent spinal nerves • Cervical plexus (C1-C4) • Brachial plexus (C5-T1) • Lumbar plexus (L1-L4) • Sacral plexus (L4-S4) |
| Special fibers | – Special somatic afferent =SSA ex optic and auditory. – Special visceral afferent =SVA receives taste and smell (IV, V, XII) – Special visceral efferent =SVE -supplies skeletal muscle of pharynx and larynx (X,V) (branchial motor) |
| Autonomic Nervous System Parasympathetic | • Craniosacral origin (brainstem, S2-S4) • Ganglia – Cranial – Intramural • Energy-conserving |
| ANS Sympathetic | • Thoracolumbar origin (T1-L2) • Ganglia – Paravertebral – Prevertebral • Energy-expending |
| Autonomic Nervous System | • Major function – to regulate heartbeat, smooth muscle contraction, and glandular secretions to maintain homeostasis • Many autonomic effectors are dually innervated, which allows remarkably precise control of effector |
| Referred pain | occurs when sensory information comes to the spinal cord, but is interpreted by the CNS as coming from another location innervated by the same spinal cord level |
| Referred pain Types: | – Viscero-somatic – Somato-somatic |
| ANS Distribution | Each pathway is made up of autonomic nerves, ganglia, and plexuses, which are made of efferent autonomic neurons • All autonomic neurons function in reflex arcs • Efferent autonomic regulation ultimately depends on feedback from sensory receptors • Rel |
| Neuron is composed of: | Axon, dendrites, and cell body. |
| dermatomes | strip of skin supplied by a single spinal nerve. |
| 4 cranial ganglion | Ciliary ganglion - next to the eye ball; Otic ganglion- near the ear; Pterygopalatine ganglion - deep to the ramus of the mandible; Submandibular ganglion - embedded in submandibular gland; NEVER FIND SYMPATHETIC FIBERS IN THE CRANIAL NERVES. |
| Thoracic Functions | • Breathing • Protection of vital organs • Conduit |
| Thoracic Components | • 12 thoracic vertebrae • Ribs & intercostal muscles • Sternum |
| Surface Landmarks of Thoracic | • jugular or suprasternal notch (T2 LEVEL) * manubrium (T3-T4) • sternal angle or angle of Louis (T4-T5) • xiphoid process (T10) • costal margin • infrasternal angle & xiphoidosternal angle (T9-T10) |
| Midclavicular line (MCL) | a vertical line that cuts through the middle of the clavicle. |
| Skeleton of the Thorax | 1st 10 ribs have corresponding costal cartiledge; superior and inferior thoracic apertures; Ribs (12 pairs) and costal cartilages |
| Ribs consists of | Head, Neck, tubercle (articular and nonarticlar part), costal angle, and body |
| Costochondritis | inflammation of costo chondroid junction |
| Tietze’s syndrome | inflammation of costal cartilage |
| Rib dislocation | costal cartilage separates from sternum |
| rib separation | separation occurs from costal cartilage |
| rachitic rosary | enlargement of node of costo cartilage junction |
| Cleidocranial Dysostosis | missing clavicle and shoulders are able to touch |
| Pectus Excavatum | lengthening of the ribs; depression of the sternum; if severe, can cause displacement of the heart, and difficulty in breathing |
| Pectus Carinatum | sternum is moved forward; "pigeon breats" |
| costoclavicular syndrome | narrowing of the space of the clavicle and 1st rib.(brachial plexus, subclavian blood vessels are structures that can be compromised) |
| The Breast - Location | – subcutaneous – overlies deep fascia covering the pectoralis major & serratus anterior – transversely extends from lateral border of sternum to MAL – vertically extends from 2nd through 6th ribs |
| The Breast - Structure | – axillary tail – retromammary space – suspensory ligaments (of Cooper) – 15-20 lactiferous ducts & sinuses – sebaceous glands (of Montgomery -lubes it up; tiny bumps to liberate nipple) – mammary glands -are modified sweat glands – nipple and areol |
| breast cancer | infiltration of the pectoralis major; muscle moves and breast moves along with it. will invade lymphatic vessels.Dimpling is caused by the retraction of the ligaments of cooper. |
| PAMS stands for: | Pericardialcophrenic Anterior intercostal artery Muscular phrenic (lateral) Superior epigastric (lateral) |
| The Breast – Blood Supply | – branches of the internal thoracic artery – lateral thoracic and thoracoacromial arteries – posterior intercostal arteries in the 2nd, 3rd, and 4th ICS Venous Drainage: – axillary vein and internal thoracic veins |
| The Breast – Lymphatic Drainage | – most lymph (75%), drains to the axillary lymph nodes(lateral quadrants) – most of the remaining lymph, particularly from the medial quadrants, drains to the parasternal nodes – lymph from the lower quadrants drain into the inferior phrenic nodes |
| polythelia | more than two nipples. |
| polymastia | more than two brests, usually no nipple present. |
| amastia | no breats or nipple. |
| gynecomastia | man boobs. |
| Abnormalities of the Breast | will occur on the mammary ridge (crest) |
| Pectoralis Major | • Origin: cartilages of ribs 2-6, body of sternum, inferior & medial portion of clavicle; • Insertion: lateral edge of inter-tubercle groove• Action: flexion, horizontal flexion, inward rotation, & adduction;• Nerve Supply: Pectoral nerves (C5-T1)• Blood |
| Pectoralis Minor | • Origin: • Insertion: • Action: • Nerve Supply: • Blood Supply |
| Serratus Anterior | • Origin: • Insertion: • Action: • Nerve Supply: • Blood Supply: |
| Subclavius | • Origin: 1st rib • Insertion: clavicle • Action: depresses and protracts shoulder • Nerve Supply: nerve to subclavius C5-C6 • Blood Supply: thoracocromial trunk |
| Forced inspiration | requires elevation of the ribs; external intercostal & internal intercostal muscles are involved. |
| Forced expiration | depression of the ribs occurs; internal (and innermost) intercostal muslces are involved. |
| Increased thoracic volume | will increase in side to side diameter, A-P diameter, and vertical length. (when diaphragm contracts will cause the lungs to expand) |
| Intercostal Nerves | • Derived from the thoracic spinal nerves • Ventral rami of T1-T11 form the intercostal nerves • Ventral ramus of T12 forms the subcostal nerve • Dermatomes - bandlike skin areas each supplied by a single spinal nerve |
| Thoracic Wall Arterial Supply | – thoracic aorta – subclavian artery – axillary artery |
| Thoracic Wall Venous Drainage | • posterior intercostal veins - drain mostly into the azygos venous system • anterior intercostal veins - drain into the internal thoracic vein • anterior and posterior intercostal veins anastomose with each other |
| Anastomose | is direct connection btw 2 arteries or veins; which provides collateral circulation ensuring continuous blood supply |
| • Superior Boundary of mediastinum | - plane connecting the cupola or the superior thoracic aperture |
| • Inferior Boundary of mediastinum | - diaphragm or inferior thoracic aperture |
| • Anterior Boundary of mediastinum | - sternum and costal cartilages |
| • Posterior Boundary of mediastinum | - T1 to T12 vertebrae and related ribs |
| Contents of Superior Mediastinum | – The lower ends of sternohyoid, sternothyroid and longus colli; Thymic remnants – Internal thoracic arteries and veins; Brachiocephalic veins and the upper half of the superior vena cava; Aortic arch, the brachiocephalic, left common carotid and subclav |
| Anterior Mediastinum - Contents | • Lymph nodes and vessels; Small portion of thymus; Mediastinal branches of the internal thoracic vessels; Sternopericardial ligaments; Fat |
| Middle Mediastinum - Contents | • It contains the Pericardium; The heart and the ascending aorta; Lower half of the superior vena cava receiving the azygos venous arch posteriorly; Tracheal bifurcation and both main bronchi; Pulmonary trunk and right and left pulmonary arteries and vein |
| Posterior Mediastinum - Contents | • Descending aorta & its branches • Posterior intercostal VAN • Azygos, hemiazygos, accessory hemiazygos veins • Sympathetic trunks and splanchnic nerves |
| Esophagus | • A muscular collapsible tube about 10 inches long; • Its abdominal portion is 1/2 inch long, enters stomach at its right side • Blood Supply: abdominal portion - left gastric a • Nerve Supply: vagus nerves;(located superior and posterior mediastinum) |
| Thymus Gland | Flattened bilobedstructure;Has a pink lobulated appearance • Site of development of T lymphocytes |
| Vagus Nerves | • Right vagus nerve enters thorax anterior to the right subclavian artery and gives off the recurrent laryngeal nerve; Left vagus nerve descends in the neck posterior to the left CCA; gives off the left recurrent laryngeal nerve |
| Both _____ breaks up into branches to form the pulmonary, cardiac, esophageal plexus. | Vagi |
| Phrenic Nerves | • Sole motor nerve supply to the diaphragm; Sensory to central portion of diaphragm; Arise from ventral primary rami of C3, C4, & C5 (motor branch of cervical plexus)• Descends down to superior and middle mediastinum |
| Thoracic Duct | • Largest lymphatic channel of the body: Returns all lymph and chyle from all of the body below the diaphragm & the left half of the body above the diaphragm • Arises as an occasional dilatation called the cisterna chyli at the level of L2 |
| The Intercostal Nerves | • First Thoracic Intercostal Nerve (T1) • Second Thoracic Intercostal Nerve (T2) • Typical Thoracic Intercostal Nerves (T3 -T6) • Thoracoabdominal Intercostal Nerves (T7 -T11) • Subcostal Nerve (T12) |
| abdominopelvic splanchnic nerves | are pre-gg sympathetic fibers arising from T5 to T12; Greater splanchnic nerves (T5-T9) – Lesser splanchnic nerve (T10-T11) – Least splanchnic nerve (T12) |
| Pericardium | • Located in the middle mediastinum, posterior to the body of the sternum, 2nd to 6th costal cartilages, and anterior to T5 to T8 vertebrae; Double-walled fibroserous sac which encloses the heart and the root of the great vessels; conical in shape; |
| Fibrous pericardium | outer tough fibrous layer made up of dense irregular connective tissue |
| Serous pericardium | parietal layer and visceral layer (= epicardium); cavity contains 5-30 ml of serous fluid |
| Pericarditis | condition in which the sac-like covering around the heart (pericardium) becomes inflamed |
| • Pericardial effusion | excess fluid around the heart |
| • Cardiac tamponade | compression of the heart that occurs when blood or fluid builds up in the space between the myocardium (heart muscle) and the pericardium (outer covering sac of the heart; symptoms include protruding neck veins and weak pulse. |
| • Pericardiocentesis | a procedure where fluid is aspirated from the pericardium (the sac enveloping the heart) |
| Borders of the Heart | • Superior border: is formed by the LA and RA and auricles • Inferior border: is formed by the RV and slightly by the LV • Left border: is formed mainly by LV and partly by the left auricle • Right border: is formed by RA and extends from SVC to IVC |
| Right atrium | crista terminalis, sinus venarum, pectinate muscles, venous openings, fossa ovalis, tricuspid orifice |
| • Left atrium | pulmonary vein openings, mitral orifice |
| • Right ventricle | conus arteriosus (infundibulum), papillary, trabeculae carneae, moderator band, chordae tendineae, tricuspid valve |
| • Left ventricle | thick muscular wall |
| Left coronary artery | - anterior interventricular - both ventricles and septum - circumflex - left atrium and left ventricle * SA nodal branch (40%) |
| • Right coronary artery | right atrium and ventricle - SA nodal artery (60%) - right marginal artery - AV nodal artery (80%) - posterior interventricular - both ventricles - marginal - right ventricle |
| Venous Drainage | • Coronary sinus - great cardiac vein, accompanied by the anterior interventricular artery Vena cordis minimi (smallest cardiac veins) – drain directly into the atria |
| Skeleton of the Heart | • Composed of fibrous or fibrocartilaginous tissue • Forms the central support of the heart Provide attachment to valves and prevent the outlets from becoming dilated |
| Cardiac Conduction System | • SA node • AV node (takes over if SA node is damaged) • Internodal fasciculi • AV bundle (of His) |
| • Purkinje fibers | |
| Nerve Supply of the Heart | Cardiac plexus of nerves contain: • Preganglionic parasympathetic fibers; (divided by vagus GVA chemoreceptors) will synapse with postganglionic PS within the wall of heart • Vagal afferent fibers - concerned with cardiac reflexes(monitors blood pH & CO |
| Nerve Supply of the Heart | • Postganglionic sympathetic fibers • Sympathetic afferent fibers - detects ischemic pain • NOT sensitive to touch, cutting, cold, or heat |
| Mapping Out the Heart | • Superior border - a line connecting the inferior margin of 2nd left costal cartilage and sup margin of 3rd right costal cartilage • Right border - line connecting 3rd right costal cartilage to 6th right costal cartilage |
| Mapping Out the Heart | • Inferior border - line connecting 6th right costal cartilage to apex beat area (3 |
| HEART SoundS Five auscultatory points | Pulmonic – 2nd left intercostal space lateral to sternum Aortic – 2nd right intercostal space lateral to sternum |
| HEART SoundS Five auscultatory points | Tricuspid - over lower portion of sternum Mitral – 5th left intercostal 1/2 inch medial to the midclavicular line; Erb’s point – left sternal border at 3rd ICS where S2 is best heard |
| LOWER RESPIRATORY TRACT contains | TRACHEA BRONCHI LUNGS |
| Trachea | A tube about 5 in long A fibroelastic wall with Ushaped bars of hyaline cartilage Begins at the level of C6 vertebra below the cricoid cartilage Ends at level of sternal angle (T4 vertebra); in deep inspiration, it descends down to T6 |
| Pleura | Each lung is invested by and enclosed in a serous pleural sac consisting of two continuous membranes: Visceral pleura- closest to the lung Parietal pleura - surrounds the lung Pleural cavity - contains a thin layer of serous fluid |
| The parietal pleura consists of four parts: | Costal pleura Mediastinal pleura Diaphragmatic pleura Cervical pleura (cupola or dome of the pleura) |
| chylothorax | (chyle) accumulating in the pleural cavity |
| pleuritis | inflammation of the pleura |
| pleurisy | is inflammation of the lining of the lungs and chest (the pleura) that leads to chest pain (usually sharp) when you take a breath or cough |
| hydrothorax | water in the cavity |
| Hemothorax | blood in cavity |
| pneuamathorax | air in the cavity, which pushes onto the lung resulting in atelectesis |
| parietal pleura topography | posteriorly - runs from T1 down to T11 laterally -rib 10 anteriorly - rib 7 |
| lung topography | posteriorly - runs from T1 down to T10 laterally -rib 8 anteriorly - rib 6 |
| oblique fissures of the lungs | SP's of T3-T4; RT lung begins SP of T4; in between ribs 5 & 6. |
| thoracocentesis | is an invasive procedure to remove fluid or air from the pleural |
| Lungs | Surfaces: Costal, Mediastinal, and diaphragmatic; Anterior border - fits into the mediastinal recess posterior border- fits into the paravertebral gutter |
| Contents of root & hilum: | A pulmonary artery Two pulmonary veins A main bronchus Bronchial vessels Nerves Lymphatics |
| pulmonary ligament | main funct: to allow arm to move freely up and down. |
| Sympathetic effects of lungs: | • Bronchodilation • Decreased bronchial gland secretion • Vasoconstriction |
| Parasympathetic effects of lungs: | • Bronchoconstriction • Increased bronchial gland secretion • Mild vasodilation or no effect |
| Diaphragm | • It forms the convex floor of the thoracic cavity and the concave roof of the abdominal cavity • It rises higher on the right side than on the left side due to the right lobe of the liver |
| Diaphragm – Origin & Insertion | O: • Sternal portion - back of the xiphoid process • Costal portion - inner surface of the lower six costal cartilages Ins: • Central tendon |
| Diaphragm - Openings APERTURES (Openings) | • Caval opening (T8) - inferior vena cava, terminal branches of right phrenic nerve • Esophageal opening (T10) -esophagus, vagal trunks,esophageal branches of left gastric vessels • Aortic opening (T12) - aorta, thoracic duct |
| Diaphragm Blood Supply | • Inferior phrenic artery – main source (1st branch of abdominable aorta) • Superior phrenic artery • Musculophrenic artery • Pericardiophrenic artery |
| Diaphragm Nerve Supply | • Phrenic nerve (C3-C4-C5) – provides motor supply for the entire diaphragm and sensory supply for central area of diaphragm • Lower intercostal nerves (T6-T12) – sensory supply to the peripheral part of the diaphragm |
| Umbilicus | Vertebra level of L3; dermatome level of T10 |
| Transpyloric plane | Vertebra level of L1; is the half way point of jugular notch and pubic symphysis |
| iliac crest level | vertebra of L4 |
| Subcostal plane | vertebra level of L3; and inferior edge of costal margin; |
| McBurney's Point | Inbetween umbillicus and RT ASIS; divide area into 3, upper 3rd will be the location of appendix. |
| Murphy's Point | RT MCL, and RT costal margin will be the location of the Gallbladder. |
| Anterior Abdominal wall layers superficial to deep | 1 skin; 2 Superficial fascia: fatty (camper's fascia) 3 membranous layer (scarpa's fascia) 4 linea alba; 5 transversalis fascia; 6 subserous fascia; 7 parietal peritoneum. |
Created by:
AAbraham
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