High yield module 2

Flashcards from lecture notes.

Heart (Referred Pain)

Pain fibers travel with sympathetics (T1–T4); referred to dermatomes.

Diaphragm (Referred Pain)

Irritated phrenic nerve (C3–C5) → referred to shoulder skin innervated by supraclavicular nerves.

Ureter (Referred Pain)

Pain travels along T11–L2 sympathetics; follows dermatomes from back to groin.

Appendix (Referred Pain)

Visceral afferents at T10 → somatic irritation of parietal peritoneum in RLQ.

Superior Mediastinum

Above sternal angle (T4–T5). Thymus, brachiocephalic veins, SVC, aortic arch & branches, trachea, esophagus, thoracic duct, phrenic & vagus nerves.

Inferior - Anterior Mediastinum

Below sternal angle, anterior to pericardium. Mostly fat, lymph nodes, remnants of thymus.

Inferior - Middle Mediastinum

Contains pericardium & heart. Heart, pericardium, roots of great vessels, phrenic nerves.

Inferior - Posterior Mediastinum

Posterior to pericardium. Esophagus, descending aorta, thoracic duct, azygos vein, sympathetic trunks.

Right Atrium (Surface Feature)

Right border.

Right Ventricle (Surface Feature)

Anterior surface.

Left Atrium (Surface Feature)

Base (posterior).

Left Ventricle (Surface Feature)

Apex & diaphragmatic surface.

Aortic Valve Auscultation

Right 2nd ICS, sternal border.

Pulmonary Valve Auscultation

Left 2nd ICS, sternal border.

Tricuspid Valve Auscultation

Left 4th or 5th ICS, sternal border.

Mitral Valve Auscultation

Left 5th ICS, midclavicular line.

SA Node

Right atrium near SVC. Pacemaker — initiates impulse.

AV Node

Interatrial septum near coronary sinus. Delays impulse to allow atrial emptying.

Bundle of His

Only electrical connection between atria & ventricles. Conducts signal through fibrous skeleton.

Right & Left Bundle Branches

Interventricular septum. Carry signals to ventricles.

Moderator Band

Right ventricle. Carries right bundle branch to anterior papillary muscle.

Purkinje Fibers

Subendocardial layer of ventricles. Rapid conduction to coordinate ventricular contraction.

Parasympathetic effect on Heart

Vagus nerve — slows HR, reduces force.

Sympathetic effect on Heart

T1–T4 — increases HR and force.

Foramen Ovale (Fetal Function)

RA → LA shunt.

Foramen Ovale (Adult Remnant)

Fossa ovalis.

Ductus Arteriosus (Fetal Function)

Pulmonary artery → aorta.

Ductus Arteriosus (Adult Remnant)

Ligamentum arteriosum.

Ductus Venosus (Fetal Function)

Umbilical vein → IVC (bypass liver).

Ductus Venosus (Adult Remnant)

Ligamentum venosum.

Right Lung Lobes

3: Superior, Middle, Inferior.

Left Lung Lobes

2: Superior, Inferior.

Right Lung Fissures

Oblique & Horizontal.

Left Lung Fissures

Oblique only.

Special features of Right Lung

Larger, more vertical bronchus.

Special features of Left Lung

Cardiac notch, lingula.

Inferior Limit of Lung (Midclavicular)

6th rib.

Inferior Limit of Pleura (Midclavicular)

8th rib.

Inferior Limit of Lung (Midaxillary)

8th rib.

Inferior Limit of Pleura (Midaxillary)

10th rib.

Inferior Limit of Lung (Scapular)

10th rib.

Inferior Limit of Pleura (Scapular)

12th rib.

Visceral Pleura

Covers lung surface, extends into fissures.

Parietal Pleura - Costal

Costal → intercostal nerves.

Parietal Pleura - Diaphragmatic & Mediastinal

Diaphragmatic & mediastinal → phrenic nerve.

Visceral Pleura Innervation

Visceral → autonomic innervation.

Costodiaphragmatic Recess

Gravity-dependent → fluid collects here when upright.

Costomediastinal Recess

Smaller, anterior near heart.

Intercostal Nerve (Fiber Types)

Somatic motor & sensory.

Intercostal Nerve (Cell Body Location)

Ventral horn & DRG.

Gray Ramus (Fiber Types)

Postganglionic sympathetic.

Gray Ramus (Cell Body Location)

Sympathetic ganglion.

White Ramus (Fiber Types)

Preganglionic sympathetic, visceral a erent.

White Ramus (Cell Body Location)

IML (T1–L2), DRG.

Greater Splanchnic (Fiber Types)

Preganglionic sympathetic.

Greater Splanchnic (Cell Body Location)

IML (T5–T9).

Cardiac Plexus (Fiber Types)

Mixed autonomic.

Cardiac Plexus (Cell Body Location)

Vagus & sympathetic trunks.

Vagus Nerve & Trunks (Fiber Types)

Preganglionic parasympathetic.

Vagus Nerve & Trunks (Cell Body Location)

Brainstem.

Phrenic Nerve (Fiber Types)

Somatic motor & sensory.

Phrenic Nerve (Cell Body Location)

C3–C5.

Celiac Plexus (Fiber Types)

Mixed autonomic.

Celiac Plexus (Cell Body Location)

Vagus & splanchnic nerves.

Lumbar Splanchnic (Fiber Types)

Preganglionic sympathetic.

Lumbar Splanchnic (Cell Body Location)

IML (L1–L2).

Pelvic Splanchnic (Fiber Types)

Preganglionic parasympathetic.

Sacral autonomic nucleus (Cell Body Location)

S2–S4 spinal cord.

Examples of Intraperitoneal Organs

Stomach, liver.

Examples of Retroperitoneal Organs

Kidneys, aorta.

Examples of Secondarily Retroperitoneal Organs

Pancreas (except tail), ascending & descending colon.

Foregut

Esophagus → 1st part duodenum, liver, pancreas.

Midgut

2nd–4th duodenum → 2/3 transverse colon.

Hindgut

Distal 1/3 transverse colon → rectum.

Foregut Parasympathetic Supply

Vagus.

Midgut Parasympathetic Supply

Vagus.

Hindgut Parasympathetic Supply

Pelvic splanchnic.

Portal Circulation

Gut → liver (via portal vein).

Caval Circulation

Systemic veins → IVC.

Portacaval Anastomosis

Esophagus, rectum, umbilicus.

Superficial Fascia (Colles') Description

Fatty & membranous.

Superficial Perineal Pouch Contents

External genitalia, muscles.

Deep Perineal Pouch Contents

Urethra, sphincter muscles.

Pelvic Diaphragm Components

Levator ani, coccygeus.

Male Superficial Perineal Pouch Contents

Penis root, scrotum muscles.

Female Superficial Perineal Pouch Contents

Clitoris, bulbs, Bartholin’s glands.

Male Deep Perineal Pouch Contents

Membranous urethra, Cowper’s glands.

Female Deep Perineal Pouch Contents

Urethra, compressor urethrae.

Pelvic Plexus

Autonomic; sympathetics (vasoconstrictor, contract sphincters), parasympathetics (stimulate bladder & erection); cell bodies in IML & S2–S4.

Pudendal Nerve

S2–S4; motor & sensory for perineum; cell bodies in ventral horn & DRG.

Greater (False) Pelvis Location

Above pelvic brim.

Lesser (True) Pelvis Location

Below brim.

Greater (False) Pelvis Contents

Lower abdominal organs.

Lesser (True) Pelvis Contents

Pelvic organs.

Urethral Injury - Spongy

Spongy urethra → superficial pouch.

Urethral Injury - Membranous

Membranous urethra → deep pouch.

Uterus Ligaments

Broad, round, uterosacral, cardinal.

Ovaries Ligaments

Suspensory, ovarian ligament.

Pectinate Line - Above: Epithelium

Columnar.

Pectinate Line - Below: Epithelium

Stratified squamous.