OMS1- Anatomy practical 3

sternoclavomastoid muslce

transversis thoracis muscle

• on inner side of ribcage

• fibers move from costal cartilage down 1 level below towards sternum

• most superficial when looking at the back of ribcage

• depressed ribs in forced expiration

internal thoracic artery

• can be seen through the thin muscles of ribcage

• runs on either side of the sternum

• veins are located to the side of the artery

• as it gets to the xyphoid process, it will branch into superior epigastric artery and musculophrenic artery

intercostal nerve

• runs on inner side of a rib

• anterior intercostal arteries and veins run with them

superior epigastric artery and musculophrenic artery

• superior epigastric will go straight down

• musculophrenic hugs intercostal margin, will move laterally

fiberous pericardium

visualized with lungs removed

• covers heart and ascending aorta+pulmonary trunk, sits directly on diaphram

• fiberous is most superficial layer

• on inner side, is shiny-er and called serous parietal pericardium

visceral pericardium

sits directly on heart under the fiberous/serious parietal pericardium. aka epicardium.

pulmonary trunk

• exits right ventrical, is the the anterior aspect of heart

• within pulmary trunk is the semilunar palmonic valve, had 3 cusps

right atrium of heart

ascending aorta

• within aorta is the semilunar aortic valve

superior vena cava

enters right atrium

left ventrical

forms left boarder of the heart

• forms apex of heart

left atrium

superior to left ventrical

transverse sinus

under ascending aorta and pulmonary trunk

inferior vena cava

• can be seen under apex of heart

oblique pericardial sinus

where hand is

• under apex of heart to just under pulmanary veins (where pericardial sac ends)

anterior interventricular artery

runs in anterior interventricular sulcus (between right and left ventricals on anterior aspect)

• aka left anterior descending artery

• the great cardiac vein runs with it before continuing with circumflex artery to coronary sinus.

left coronary artery

• first branch off aorta on left side

• has three branches: circumflex (right most); diagonal artery (middle); anterior interventricular artery (left most)

coronary sinus

• on posterior aspect of heart

• in artioventricular sulcus under left atrium

• drains into right atrium

right coronary artery

• first branch off aorta on right side

SA nodal artery

branch off right coronary artery

right marginal coronary artery

• branch off coronary artery

• small cardian vein runs with it, will drain into coronary sinus

posterior descending artery

can branch off right or left circumflex coronary artery. Or both. This picture is a right coronary artery branch

• right is called a right dominant heart and vise versa

• AV node artery will be a continuation of right coronary artery, diving between atriums

middle cardiac vein

drains into coronary sinus, where it drains forms the crux of the heart (where AV nodal artery dives too)

external intercostal muscles

directly below intercostal membrane, can be fused

• slope down to midline

• elevate ribs for breathing

• innervated by intercostal nerves, supplied by anterior/posterior intercostal arteries

internal and innermost intercostals

deep to external intercostals, fused. fibers run upwards towards midline

• depress ribs

• forced expiration

• between them sits the intercostal neurovasculatiue bundle

diaphragm

seperated thoracic and abdominal cavity

• primary respirator

pericardophrenic vessels with phrenic nerve

• one both sides of heart

hilum of right lung

• main bronchus

• pulmanary artery

• pulmanary veins

hilum of left lung

left lung will have an impression for the aortic arch

pectinate muscles of right atrium

Crista terminalis right atrium

• runs from the junction of SVC

• Area of SA node

fossa ovalis in right atrium

• 
  

tricuspid valve into right ventrical

Chordae tendinae

run between AV valves and papillary muscles

moderator band

• in right ventrical

• connects anterior papillary muscles to interventricular wall.

septal papillary msucle

right ventrical

left ventricals anterolateral papillary msucle

directly on lateral wall

• one other papillary muscle in left ventricals- posterior medial papillary muscle

left auricle of left atrium

• only part of atrium that is not smooth msucle

• has pectinae muscles

pericardiophrenic neurovasculatiue bundle

• contains phrenic nerve and pericardiophenic vessels

ascending aorta

• left to superior vena cava

• anterior to pulmonary trunk

• 3 brances of right to left: brachiocephalic trunk, left common carotid artery, left subclavian artery

pulmonary trunk

• most posterior of great vessels

ligamentum arteriosum

• connects aorta to pulmonary trunk

• on left side of pt

• near vagus nerve

L recurrent laryngeal, left vegus nerve

• Vagus nerve travels to esophagus behind lung root

esophageal plexus

• composed of right and left vagus nerve

descending thoracic aorta

left azygous system

• hemiazygous vein- on left side, startes inferior and will cross right to drain into azygous vein

• accessory hemizygous vein- more superior. Will cross to right side to drain into azygous vein

sympathetic chain

• ganglia are buldges

right azygous system

azygous vein- other veins drain into it

brachiocephalic veins

join to form superior vena cava

arch of azygous vein

• drains into superior vena cava

• wraps above right mrain bronchous (cut, posterior) and right pulmonary artery (cut, anterior)

right vagus nerve

• runs with trachea

• near the superior thoracic aperture, will give off right recurrent laryngeal nerve

platysma muscle

external jugular vein

posterior triangle

• Levator scapulae

• posterior scalene

• middle scalene

• inferirior omohyoid

spinal accessory nerve

runs between SCM and Trapezius

supraclavicular nn

transverse cervical nerve

great auricular nerve

superior belly omohyoid

anterior jugular vein

muscular triangle

• sternohyoid,

• sternothyroid

• thyrohyoid

cricothyroid muscle

deep in muscular triangle

thyroid gland

inferior to cricothyroid muscle

submandibular gland

facial artery wraps around this

digastric and stylohyoid msucle

intermediate digastric tendon prices stylohyoid muscle

mylohyoid muscle

• probe is touching hypoglossal nerve

• inferior to nerve is hyoglosis muscle

carotid aa

• hypoglassal nerve passes over both branches

• travels with internal jugular vein and vegus nerve in carotid sheath

ansa cervicalis

• originates where the the hypoglossal nerve does at the neck

• innervates omohyoid, sternohyoid, sternothyroid

carotid sheath (Carotid a, internal jugular v, vagus n)

• Carotid a

• internal jugular v

• vagus n

carotid body and sinus

• sinus is on the internal carotid artery

glossalpharyngeal nerve

on internal carotid artery

superior thyroid artery

first branch of extneral carotid artery

• superior larngeal branches off this and goes to larynx more superiorly

• thyroid artery will go inferiorly to supply thyroid

internal laryngeal nerve

a branch of superior laryngeal nerve

• runs with superior larngeal artery

external larengeal nerve

inferior to internal laryngeal nerve

• innervate cricothyroid muscle

lingual artery

• second branch off external carotid

• third branch, facial artery, is directly superior

ascending pharyngeal artery

between the external and internal branches of carotid artery