PAC555 Exam 2 Golden Tickets

Costal Facets are located on which primary bones (include their bony landmarks if applicable)

Transverse Process of Thoracic Vertebrae; Manubrium of Sternum; Body of Sternum; Bodies of Thoracic Vertebrae (inferior and superior)

The clavicular facets to create the sternoclavicular joint are located where?

Manubrium of Sternum

Which surface anatomy line is located at the anterior border of the axillary fold

Anterior Axillary Line

Which surface anatomy line is bordered by the latissimus dorsi

Posterior Axillary Line

Which posterior surface anatomy line will run through the inferior angle of scapula

Scapular Line

Which surface anatomy line will run longitudinally down the mid-sternum?

Anterior Median Line

Which line runs longitudinally down the vertebral spinous process?

Mid-Vertebral Line

Which aperture is typically level with T1

Superior Thoracic Aperture

Which aperture will be closed off by the diaphragm at level T12

Inferior Thoracic Aperture

What type of joints are the costovertebral and costotransverse joints? What functions do they provide?

Synovial Gliding; Rib Elevation/Depression

Where does the costovertebral joint connect?

Costal facets of the bodies of the thoracic vertebrae

Where do True Ribs attach anteriorly? False? Floating?

True Ribs; Sternum via a single costal cartilage; False Ribs; Grouped costal cartilage; Floating Ribs; No anterior attachment

Can you describe the location of the intercostal neurovasculature (if dissecting provide the order at which these structures will be found)

VAN (Superior to Inferior): Vein, Artery, Nerve

What are the primary arteries that serve the intercostal area?

Anterior Intercostal A., Posterior Intercostal A., Subcostal A.

Where do the posterior intercostal arteries arise from

Thoracic Aorta

Where do the subcostal arteries arise from

Thoracic Aorta under T12

Where do the anterior intercostal arteries arise from

Internal Thoracic Artery from the Subclavian Artery

What are the additional branches of the internal thoracic A

Pericardiophrenic A., Medial Mammary A., Musculophrenic A.

Once the internal thoracic leaves the intercostal area it continues on as the…

Superior Epigastric Artery

Where will the Anterior Intercostal veins drain into

Internal Thoracic Vein

What will drain into the Azygos Vein?

Right Posterior Intercostal Veins, Accessory Hemiazygous Vein, Hemiazygous Vein

What will the Azygos V drain into?

Superior Vena Cava

What level does the Accessory Hemiazygos and Hemiazygos cross to drain into the Azygos

T8-T9

What is the function, innervation, and blood supply of the External Intercostal muscles

Elevate the ribs for inspiration; Intercostal N.; Anterior + Posterior Intercostal Arteries

What is the function, innervation, blood supply of the Internal Intercostal muscles

Depress the ribs during expiration; Intercostal N.; Anterior + Posterior Intercostal Arteries

Function of the Subcostalis muscles?

Depresses ribs during respiration

Function of the Transversus Thoracic?

Depresses ribs during expiration

What is a lab reference for your intercostal muscles?

External intercostals are closest to the vertebrae; Internal intercostals are closest to the sternum

Innermost intercostals are the most lateral and have VAN running under them

Innermost intercostals are the most lateral and have VAN running under them

What is the route of milk secretion from the breast tissue?

Mammary gland lobules → Lactiferous Ducts → Lactiferous Sinus → Nipple

Function of the areolar?

Lubricate the nipple; sebaceous/sweat gland

What structure will serve as a support for the mammary glands linking them to the pectoral fascia

Suspensory (Cooper) Ligaments

What structure will act similar to a bursa sac allowing movement of breast on chest?

Retromammary Space

What structure will extend the mammary tissue to the axilla and what is its importance

Axillary Tail of Spence

In terms of blood supply to the breast, what feeds the lateral mammary artery?

Lateral Thoracic A.

In terms of blood supply to the breast, what feeds the medial mammary artery?

Internal Thoracic A.

In terms of blood supply to the breast, which artery will branch from the thoracoacromial trunk to contribute?

Pectoral A.

What is the name of the plexus for which lymphatic drainage begins from the breast tissue

Areolar Plexus

The medial breast lymph will drain from the plexus to which vessel

Parasternal Lymph Nodes

Parasternal lymph nodes will empty into

Right or Left Bronchomediastinal Lymphatic Trunk

Right Bronchomediastinal Trunk drains into

Right Lymphatic Trunk

Right Lymphatic Duct to

Junction of Internal Jugular Vein → Right Subclavian Vein → Brachiocephalic Vein → Right Brachiocephalic Vein → Superior Vena Cava

The lateral areolar plexus will drain into which structures

Axillary Lymph Nodes: Pectoral, Humeral, Subscapular, Central, Apical

Axillary lymph nodes will drain into which additional nodes as lymph travels more proximal

Supraclavicular + Infraclavicular Lymph Nodes

The supra and infraclavicular nodes will drain into

Subclavian Lymphatic Trunk

The Right Subclavian Trunk will drain into

Right Lymphatic Duct → Brachiocephalic Vein → Superior Vena Cava

The Left Subclavian Trunk will drain into

Thoracic Duct → Brachiocephalic Vein → Superior Vena Cava

Which pleura layer is adhering the lung surface, including the fissures?

Visceral Pleura

Which pleura layer is lining the pleural cavity

Parietal Pleura

What are the subdivisions of the parietal pleural

Cervical, Mediastinal, Costal, Diaphragmatic

Which aspect of the thoracic cavity contains the heart, great vessels, trachea, esophagus, and lymph nodes and lies in between the lungs?

Mediastinum

Which fissure will divide each lung into left and right lobes (or superior, inferior depending on how you interpret)

Oblique Fissure

Which lung will have a horizontal fissure?

Right Lung → separates middle and superior lobes

Which lung will have a Lingula

Left Lung

Which lung will be shorter to accommodate the diaphragm

Right Lung

Which lung will have a cardiac notch for heart

Left Lung

What are the Hilums of the Lung

Region where pulmonary vein, pulmonary artery, and bronchi come together (PA RALS: Pulmonary Artery Right Anterior, Left Superior)

Which lung has the pulmonary artery hilums in between the bronchus and veins

Right Lung (PA RALS)

What are the three segments of the right upper lobe bronchus?

Apical, Anterior, Posterior

What is the shared airway that gives rise to the right middle lobe and right lower lobe bronchi?

Bronchus Intermedius

Which mainstem bronchus is straighter and more vertical?

Right Mainstem Bronchus

What is the inferior branch of the left upper lobe bronchus?

Lingular Branch

Which bronchial segment is usually not present in the left lower lobe?

Medial Basal Segment

What are the boundaries of the posterior inferior mediastinum

Posterior Pericardium, Vertebral Bodies, Sternal Angle (Superior Border), Diaphragm (Inferior Border)

Which Hiatus will be found at T10 and include Vagal trunks and the esophagus

Esophageal Hiatus

What level is the Caval opening found?

T8

Besides the Abdominal Aorta, what other structures run through the aortic hiatus?

Thoracic Duct + Splanchnic N.

What is the blood supply for the diaphragm and where do these arteries branch from

Musculophrenic (From internal thoracic), Pericardiophrenic (From internal thoracic), Superior Phrenic (From thoracic aorta), Inferior Phrenic (From abdominal aorta)

What is the nerve supply to the diaphragm

Phrenic Nerve (C3–C5)

Do you know the identifying characteristics of the Pericardial layers?

Fibrous Layer (tough outer shell), Parietal Layer (under fibrous), Visceral Layer (epicardium), Pericardial Cavity (between parietal and visceral)

What are the neurovasculature structures for the pericardium?

Pericardiophrenic A., Phrenic N., Vagus N., Sympathetic trunk

Do you know the characteristics of the heart layers?

Endocardium, Myocardium, Pericardium

Which structure will bind the Pulmonary trunk to the Aortic Arch?

Ligamentum Arteriosum

What two structures will help expand the blood filling capacity of the atria?

Auricles, Pectinate Muscles

Which opening of the right atrium will enable venous return from the coronary sinus?

Fossa to Coronary Sinus

Do you know the placement of the valves and how the valves work?

Right Atria → Tricuspid Valve, Right Ventricle → Pulmonary Valve, Left Atria → Bicuspid/Mitral Valve, Left Ventricle → Aortic Valve

What structure will add some turbulence to the blood movement in the ventricles

Trabeculae Carnae

What are the branches of the right coronary artery?

Acute Marginal Arteries, Posterior Interventricular A.

What are the branches of the Left coronary A

Left Anterior Descending A. → Diagonal Marginal Arteries, Circumflex A. → Obtuse Marginal Arteries

From where do the right and left coronary arteries begin

Base of Ascending Aorta

What structure collects most of the venous blood supplying the myocardium

Coronary Sinus

Which vein will ride with the Left Anterior Descending

Great Cardiac Vein

Which vein will ride with the Posterior Interventricular A

Middle Cardiac Vein

Which artery will the Small Cardiac V ride with

Right Coronary Artery

Sympathetic effect at heart

Increases heart rate via Norepinephrine/Epinephrine; Increases force of contraction (via cardiac plexus)

Parasympathetic effect?

Decreases heart rate via acetylcholine at SA and AV nodes (via cardiac plexus)

What is the general pathway for normal electroconductivity in the heart

SA node → AV node → AV bundle → Right + Left Bundle Branches → Purkinje Fibers

Which aortic valve cusp is adjacent to the interatrial septum

Non-coronary cusp

Which mitral valve leaflet is closest to the septum?

Anterior Leaflet

What are the boundaries of the triangle of Koch?

Tendon of Todara, Septal Leaflet of Tricuspid Valve, Coronary Sinus

What is the function of the right ventricle moderator band

Brings right bundle branch electroconductivity to the anterior papillary muscle

In terms of the abdominal quadrants, which plane passes horizontally through the umbilicus?

Transumbilical Plane

In terms of the abdominal quadrants, which plane passes vertically along the median line?

Median Plane

Generally, what are the NAMES of the 4 quadrants of the abdominal region?

Right Upper Quadrant, Right Lower Quadrant, Left Upper Quadrant, Left Lower Quadrant

Generally, what are the names of the 9 abdominopelvic regions?

Right Hypochondriac, Epigastric, Left Hypochondriac, Right Lumbar, Umbilical, Left Lumbar, Right Iliac/Inguinal, Hypogastric, Left Iliac/Inguinal

In terms of the abdominopelvic regions, which plane passes horizontally through the 10th rib

Subcostal Plane

In terms of the abdominopelvic regions, which plane passes horizontally through the iliac tubercles?

Transtubercular Plane

In terms of the abdominopelvic regions, which plane passes vertically through the mid clavicles to mid-inguinal

Midclavicular Plane

Can you provide the layers of the abdominal region starting at the skin?

Skin → Campers Fascia → Scarpas Fascia → External Oblique → Investing Fascia → Internal Oblique → Investing Fascia → Transversus Abdominus → Investing Fascia → Endoabdominal Fascia → Extraperitoneal Fat → Parietal Peritoneum → Peritoneal Cavity → Visceral Peritoneum

Which aspect of the peritoneum will line the walls of the abdominal cavity

Parietal Peritoneum