REGIONAL ANATOMY III
A Coggle Diagram about Heart
(2 heart sounds "lub dub." S1 sound is closure of tricuspid and mitral valves, S2 sound is closure of aortic and pulmonary valves.
- Aortic stenosis = sound heard between S1 and S2.
, Apex lies at the 5th intercostal space and is formed by the left ventricle.
, Comprised of 4 chambers - a right and left atria, as well as a right and left ventricle. Ventricles are on bottom and atria on top.
, Has two sections of pericardium - serous and fibrous. Serous is more deep to the heart and fibrous is more superficial to the heart.
, Left ventricle normally fails first (in regards to heart attack) because it has more work to do in pumping blood against gravity.
, The phrenic nerve and the cardiac plexus supply nerve innervation to the pericardium. Vagus nerve innervation to the heart. #
, Located in the middle mediastinum. #
, Base is mainly formed by left atrium, where all 4 pulmonary veins open.
- Right heart (RA and RV) pumps oxygen poor blood. The RA receives poorly oxygenated blood from whole body (including heart) via the SVC & IVC. Blood passes from RA to RV. RV pumps blood into pulmonary trunk, which carries blood to lungs for oxygenation.
- Left heart (LA and LV) pumps oxygen rich blood into the LA. The LA receives oxygenated blood from lungs via pulmonary veins. Blood passes from LA to LV. The LV pumps blood into aorta, which distributes oxygenated blood to all tissues and organs of body via its branches.
, SA Node = pacemaker of the heart.
, Everything drains into coronary sinus, which then drains into the right atrium.
, Arrhythmia = heart is beating on its own or off beat.
, The closer an obstruction/embolus/blockage happens to the coronary artery, the more likely someone is to die.
- atria receive blood from veins (SVC, IVC and coronary sinus drain into right atrium; 4 pulmonary veins drain into left atrium).
- ventricles pump blood into arteries (right ventricle pumps blood into pulmonary artery/trunk, left ventricle pumps blood into aorta).
formed on posterior wall of pelvis, just lateral to anterior sacral foramina, and anterior to piriformis
formed by lumbosacral trunk (ventral ramus of L5 + part of ventral ramus of L4) and ventral rami of S1 to S4 (roots of plexus). roots divide into anterior and posterior divisions.
branches are formed by anterior and/or posterior divisions of specific ventral rami
branches of sacral plexus supply muscles and part of skin of gluteal region, muscles and skin of posterior thigh, muscles and skin of entire leg and foot (except skin of medial aspect of leg and medial border of foot), and muscles and skin of perineum
branches are difficult to recognize in dissection of pelvis (they are identified more easily in lower limb)
, Pelvic Cavity
Short, curved canal whose anterior wall is shorter than posterior wall.
anterior wall is the pubic symphysis and bodies of pubic bones
posterior wall is the sacrum, coccyx and piriformis muscles
lateral wall is the hip bone inferior to pelvic brim, obturator membrane and obturator internus muscle
inferior wall (pelvic floor) is the pelvic diaphragm formed by levator ani and coccygeus muscles.
Begins anterior to S3, as a continuation of sigmoid colon. It passes inferiorly and anteriorly, following the curve of sacrum and coccyx and ends by piercing pelvic diaphragm to become continuous with anal canal.
Anorectal junction is angulated (perineal flexure/anorectal angle). The rectum passes inferiorly and anteriorly while the anal canal passes inferiorly and posteriorly. This angulation is caused by puborectalis part of levator ani.
Lower part of rectum is dilated and called the rectal ampulla.
, Ectoderm also makes skin and nerve system
Pectinate line = division between endoderm and ectoderm partsInjury in endoderm = stretch and pressure
Injury to ectoderm = lots of pain
, Arteries of the Pelvic CavityInternal iliac artery and its branches
Ovarian artery (females) is a paired visceral branch of abdominal aorta
Superior rectal artery is a terminal branch of inferior mesenteric artery.
Median sacral artery is an unpaired branch of abdominal aorta. #
2 hip bones form anterior and lateral walls
sacrum and coccyx form posterior wall
hip bones articulate with each other anteriorly at pubic symphysis
each hip bone articulates posteriorly with sacrum at sacroiliac joint
sacrum and coccyx articulate at sacrococcygeal joint.
and connection to skeletal anatomy and the fundamental function/comopnents of the entire pelvis.
), Female Repro
(Female Internal Reproductive Organs
•Ovary •Uterus •Fallopian Tubes •Vagina
• firm, almond-shaped organ attached to posterior layer of broad ligament by a very short mesentery (mesovarium)
• its surface is smooth until puberty. After puberty its surface becomes progressively scarred by degeneration of corpora lutea until menopause.
• it lies against lateral pelvic wall in a small depression (ovarian fossa) bounded by external iliac vessels superiorly and ureter posteriorly
• production of female germ cells (ova) • production of female sex hormones (estrogen and progesterone)
• pear-shaped, hollow organ with a thick muscular wall that encloses a slit-like cavity . The organ of gestation.
• Parts: fundus, body and cervix • fundus is a dome-shaped part that lies superior to entrance of uterine tubes
• cervix is more cylindrical, inferior part
• body forms majority of uterus & it is located inferior to entrance of uterine tubes and superior to cervix
, Uterine (Fallopian) Tube
• bilateral ducts that extend from uterus to ovary & communicate uterine cavity with peritoneal cavity
• lateral part of tube arches over ovary • it lies in upper border of broad ligament • mesosalpinx is the upper part of broad ligament, between uterine tube (superiorly)
and ovary and ovarian ligament (inferiorly) • functions: • receives ovum from ovary and it is the place where fertilization usually occurs • provides nourishment to fertilized ovum and carries it to uterine cavity
• female organ of copulation
• fibromuscular tube that extends from uterine cervix to vestibule (space between labia minora) Most of it lies in pelvic cavity while its lower end lies in perineum
• anterior and posterior walls are normally in apposition (lumen is H-shaped in cross-section)
• upper part of anterior wall is perforated by uterine cervix
• upper part of posterior wall is covered by peritoneum and related to rectouterine pouch (culdocentesis)
• vaginal fornix is the upper part of vaginal lumen that surrounds cervix. It is divided into anterior, posterior and lateral parts
• vaginal orifice in a virgin is partly closed by a mucosal fold (hymen) which is perforated in its center
• anteriorly is the base of urinary bladder and urethra
• posteriorly is the rectouterine pouch, rectum, perineal body and anal canal
• laterally is the ureter, levator ani muscle, and bulb of vestibule #
and ), Abdomen
(The gallbladder sits on the undersurface of the right lobe of the liver, its job is to store and concentrate bile.
, The stomach is the dilated part of alimentary canal between esophagus and small intestine.
, Liver is located in the upper right quadrant of the abdomen. Under cover of ribs and cartilage, divided into two unequal lobes, left and right. Division = falciform ligament.
, The superior boundary of the abdomen is the respiratory diaphragm.
, Blood supply to the liver comes from the hepatic artery and the portal vein.
and Blood supply of the abdomen:
- Foregut: celiac trunk (stomach)
- Midgut: Superior Mesenteric Artery (SI)
- Hindgut: Inferior Mesenteric Artery (LI)
(Right lung is larger than the left lobe and it's divided into 3 lobes - superior, middle, and inferior.
, Left lung is divided into two lobes - superior and inferior.
, Pneumonia is more likely to happen in the right lung than the left lung.
, Pneumonia = infection of the air sacs, brings fluid.
Bronchitis = infection of the bronchi, brings mucous.
and connection to Embryology and the development of the lungs
), Male Repro
thick-walled tube, about 45 cm long, that carries mature sperm from epididymis to ejaculatory duct
begins at tail of epididymis ascends within scrotum toward superficial inguinal ring & passes through inguinal canal ( as part of spermatic cord).
at deep inguinal ring it separates from testicular vessels and passes around lateral margin of inferior epigastric vessels to cross the pelvic brim and runs inferiorly on lateral pelvic wall. It passes superior to ureter and turns inferiorly and medially on posterior surface (base/fundus) of urinary bladder. #
fibromuscular and glandular organ that surrounds 2nd part of male urethra
it has a base directed superiorly and an apex directed inferiorly
ejaculatory ducts run through prostate to open into prostatic urethra
Superiorly the neck of urinary bladder
Inferiorly the sphincter urethrae muscle and perineal membrane
Anteriorly the retropubic fat pad and venous plexus, pubic symphysis
Posteriorly the rectum
Laterally the levator ani muscle
, Innervation of Internal Reproductive OrgansDuctus deferens, seminal glands, ejaculatory ducts, prostate
Presynaptic sympathetic fibers from T12 – L2 which enter the lumbar splanchnic nerves and hypogastric & pelvic plexus. Sympathetic stimulation during orgasm contracts the internal urethral sphincter preventing retrograde ejaculation as well as contraction of the vas and glandular smooth muscle required for secretion.
Presynaptic parasympathetic fibers from S2-S3 go to pelvic splanchnic nerves that go on to join the inferior hpogastric/pelvic plexuses. They form the cavernous nerves that pass to the erectile bodies of the penis.
and Male External GenitaliaDistal Urethra
), Urinary Bladder
(The adult empty bladder is located in pelvic cavity, immediately posterior to pubic bones and symphysis pubis. As it fills, its superior wall rises up into hypogastric region and elevates peritoneum of lower part of anterior abdominal wall.
during infancy and early childhood the pelvis is small & the empty bladder is largely above pelvic brim (it is an abdominal organ).
empty bladder is shaped like a three-sided pyramid. It has 3 parts: apex, base (fundus), body (with 1 superior and 2 inferolateral surfaces), and neck.
apex is directed anteriorly, and located posterior to upper margin of pubic symphysis & is connected to umbilicus by median umbilical ligament.
, Male urethra is about 20 cm long extends from internal urethral orifice (at neck of urinary bladder) to external urethral orifice (at tip of glans penis)
1st and 2nd parts are located in pelvic cavity, 3rd and 4th parts are located in perineum
, Female Urethra
short tube about 4 cm in length
extends from internal urethral orifice (at neck of urinary bladder) to external urethral orifice in vestibule (space between labia minora), anterior to vaginal orifice
runs inferiorly and anteriorly related anteriorly to pubic symphysis and retropubic fat pad and venous plexus related posteriorly to vagina
it is surrounded by sphincter urethrae (external urethral sphincter) muscle skeletal muscle, voluntary.
and Superior angles receive ureters, inferior angle gives rise to urethra.
in males it is related to rectum, seminal vesicles and ampullae of deferens ducts
in females it is related to vagina
Body forms most of bladder & it is located between apex and base. Superior surface is covered with peritoneum.
in males it is related to coils of ileum and sigmoid colon
in females it is related to uterus
inferolateral surfaces are related to obturator internus and levator ani muscles/urogenital diaphragm (same in both sexes) #
, Thick-walled muscular tube, with a small lumen, that carries urine from kidney to urinary bladder.
Begins in abdomen as a continuation of renal pelvis descends on psoas major muscle, posterior to peritoneum (retroperitoneal organ) It passes anterior to bifurcation of common iliac artery & descends on lateral wall of pelvis, anterior to internal iliac artery, to level of ischial spine & turns forward to reach base of urinary bladder.
, 2 surfaces: anterior and posterior
2 poles (extremities): superior and inferior
2 borders: medial and lateral
middle part of medial border is occupied by hilum, which leads into a renal sinus
structures at hilum (from anterior to posterior): renal vein, renal artery and renal pelvis (upper, expanded end of ureter)
lymph vessels and autonomic nerves also pass through hilum.
and anterior anatomic relations:
right kidney: liver, 2nd part of duodenum, right colic flexure, coils of small intestine
left kidney: spleen, stomach, pancreas, left colic flexure, coils of small intestine
posterior anatomic relations:
right kidney: psoas major, quadratus lumborum, transversus abdominis, diaphragm, 12th rib, subcostal, iliohypogastric and ilioinguinal nerves
left kidney: same + 11th rib (left kidney is higher than right)
upper pole of each kidney is related to corresponding suprarenal gland.
), Inferior Mediastinum
, Posterior Mediastinum
and Anterior Mediastinum
), Abdominal Wall
(Dermatomes of the Anterolateral Abdominal Wall
•T7 immediately inferior to tip of xiphoid process • T10 level of umbilicus • L1 just above inguinal ligament and pubic symphysis
, Layers of the Anterolateral Abdominal Wall (Superficial to Deep)
•skin • superficial fascia • muscles with their investing (deep) fasciae • transversalis fascia (part of endoabdominal fascia) • extraperitoneal fat • parietal peritoneum
and Nerves of the Anterolateral Abdominal Wall
7th to 11th intercostal and subcostal nerves pierce posterior wall of rectus sheath to supply rectus abdominis and pyramidalis (subcostal n. only) They terminate by piercing anterior wall of rectus sheath to supply skin (anterior cutaneous branches)
Iliohypogastric and ilioinguinal nerves do not enter rectus sheath Anteriorly they pierce internal oblique and run between this muscle and external oblique aponeurosis.
Terminal part of iliohypogastric nerve pierces external oblique aponeurosis above superficial inguinal ring to supply suprapubic skin.
Terminal part of ilioinguinal nerve emerges through superficial inguinal ring to supply skin of superomedial thigh and external genitalia.
), Small Intestine
(Composed of the duodenum, jejunum, and ileum.
and Responsible for absorption of food and nutrients.
), Large Intestine
(Mainly concerned with absorption of water and electrolytes and storage of undigested materials until they can be eliminated from body as feces.
and Large Intestine is comprised of the cecum with the vermiform appendix, ascending colon, transverse colon, descending colon, sigmoid colon, rectum, and anal canal.
), Inferior Mesenteric Artery
, Superior Mediastinum
(Comprised of SVC, brachiocephalic veins, aortic arch, brachiocephalic trunk, left common carotid artery, left subclavian artery.
), Superior Mesenteric Artery
(Airway to the lungs and begins at C6