c
 

m| Inferior Vena Cava is formed by the joining of the two common iliac veins which do not go through liver
m| ©VC is formed by the left and right brachiocephalic veins, which are formed by the joining of subclavian and
jugular veins
p|  ygous vein also drains into the ©VC.
a| xight side:  ygous vein drains blood from right side posterior intercostals veins
a| ¦eft ©ide: Hemi ygous drains lower 2/3rd , and accessory drains upper 1/3rd , and they will join
together and come to a ygous as one, or come individual. This is also for posterior intercostals
veins
m| Thoracic ¦evels are going to be inervated by its own intercostals nerve
p| xegion of skin that nerve innervates is called ^

p| xegion of muscle that nerve innervates is called u 

Dermatone

1)| Top of shoulders £ C4

2)| Ñmbilicus £ T10
3)| Yipple £ T4
4)| ÿroin £ ¦1

   

 

     
   

 
  

£| Internal Thoracic rtery changes names into ©uperior Epiÿastric which is going to posterior rectus abdominus
and is going to meet up with Inferior Epiÿastric. The two meet at approximately the umbilicus.  meeting of
arteries is called anastomosis.

Inferior Epiÿastric artery came from the external Iliacs. Travels up posterior to rectus abdominus.

£| 24 Movable vertebrae within the column. ©acrum is made of 5 segments that are fused. Coccyx is 3-5.
m| IVD between the vertebrae, which is a ligament holding two vertebrae together
m| ¦¦ : xuns anterior vertebral bodies and disks through entire spinal column
p| ¦imits Extension
m| Φ¦: xuns posterior vertebral bodies and disks within the spinal canal
p| ©pinal cord sits posterior to Φ¦
p| Îin stuck in £ ¦¦£ Vertebral Body £ Φ¦ £ ©pinal Cord £ ¦igamentum Flavum which is within spinal canal
on back side of spinal cord vs. Φ¦ which is on front side of spinal cord
p| Φ¦ ¦imits Flexion
m| here does the parasympathetic innervations in majority of organs? Vagus which starts at Medulla, and travels
down, starts innervations at approximately oral pharynx down to as much as sigmoid colon
m| ©ympathetic innervations? By way of sympathetic trunk via spinal cord (T1-¦1 or 2) £ Fiber comes out of spinal
cord and enters trunk, synapting at either BOVE, BE¦O, or not synapse T ¦¦, entering the trunk and exiting
right away (ie: ©planchtic nerve)
ÿanglion will be surrounding around abdominal vessels:

1)| Celiac Trunk ÿanglion associated with Celiac Trunk vessel

2)| ©uperior Mesenteric ÿanglion associated with ©uperior Mesenteric vessel
3)| Inferior Mesenteric ÿanglion associated with Inferior mesenteric vessel

  

Celiac Trunk irrigates spleen, stomach, gallbladder, some of pancreas

©uperior Mesenteric rtery £ Entire ©mall Intestine & Îart of colon about midway transverse colon

xepeating pattern, rteries that come off ©M £ Jujenal or Ileual arteries which anestomose with each other
and form archs/loops forming rchae which have arteries coming off called vasa recta.

m| Middle Cholic £ Transverse Colo, Hepatic Flexure and part of ascending colon
m| xight Cholic£ Majority of scending Colon
m| IlioCholic£ Distal ileum (terminal part) & Cecum

Inferior Mesenteric rtery:

m| ¦eft Cholic £ Descending colon, and remainder of transverse colon, splenic flexure
m| ©igmoidal arteries £ ©igmoidal colon
m| ©uperior rectal artery£ xectum

m| Blood from abdominal circulation:

p| 1) ¦iver via Hepatic Îortal Vein which is formed by the ©plenic vein, and ©uperior mesenteric
p| 2) Hepatic Îortal Vein £ ¦iver £ Blood leaves liver via HEÎTIC VEIY which drain into IVC
a| Îroblems with circulation: Tumor growing outside hepatic portal vein so that its collapsing
hepatic portal vein Ox problem with heart which decreases ease of blood flow, and increases
resistance (Cirrohsis ʹ scarring of hepatocytes due to toxins or alcohol)
a| Îortal Hypertense
a| Blood make it back to heart via other paths ʹ Heart has problem getting blood through liver, so
blood backs up and reverses flow:
m| Caput Medussa ʹ Îeri umbilical
m| Esophageal varices
m| Hemmorhoidal veins

m| Does the HÎV receive blood from stomach circulation? YE© ͙

p| does it receive blood from the liver? YO
p| does it receive blood from duodenum? YO
p| what about blood from the leg? YO
p| what about heart? YO
 

m| here is bile formed? ¦iver

m| ¦eaves the liver via xight and ¦eft hepatic ducts which form the common hepatic duct
m| Bile is concentrated in ÿallbladder, where it will be released through cystic duct
m| Common bile joins main pancreatic duct to drain into duodenum via major duodenal papilla

]
  

m| ¦ower xight Quadrant: Cecum, pendix, scending Colon, xight Ovary and Fallopian Tube, xight Ñreter
m| ¦ower ¦eft Quadrant:
m| Ñpper ¦eft Quadrant : ©tomach, ©pleen, Îart of Îancreas
m| Ñpper xight Quadrant : ÿallbladder, ¦iver, Îart of Transverse Colon, Hepatic Flexure, Îart of scending Colon,
Duodenum, Îart of Îancreas

  

 


dduction (arm bringing close-er-er)
Innervated by ¦ateral and Medial Îectoral Yerves

 

 ©tabili ing and protraction of ©capular
Innervated by Îectoral Yerve
YO DIxECT EFFECT OY HÑMExOÑ©, since it doesn͛t cross the joint



 

©uperior Mesenteric rtery £ ©mall Intestine, ¦arge Intesitne (cecum, ascending colon, hepatic flexure, part of transverse
colon)

Celiac Trunk £ ©pleen, liver, stomach, gallbladder, part of duodenum, part of pancreas (these make the 


Inferior Mesenteric £ ©plenic Flexure, Descending colon, remainder of transverse colon, sigmoid colon, part of rectum

Y
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1)| ©tomach £ xugae

2)| ©mall Intestine £ Îilcae Circulares
3)| ¦arge Intestine £ Îilca semilunaris
m| "
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m| Between the Îlica ©emilunaris in the large intestine, between any two pilca is called the c
 
m| There are musculature associated with movement of ÿI tract
p| For ©tomach £ Oblique, ¦ogitudinal, Circular , respectively
p| For ©mall Intestine £ ¦ongitudinal, Circular
p| ¦arge Intestine £ ¦ogitudinal is stripped down to three stripes £ Tenea Cholae
p| 
m| 

   

 # $
p| Epiploic ppendages/ppendices
a| ©mall pouches of peritoneum filled with fat and situated along the colon and upper part of the
rectum
a| Chiefly appended to the transverse colon and sigmoid parts of colon
m| 
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p| i) ©pinalus, ¦ongissimus, Iliocastalis , medial to lateral respectively
p| ii) Involved in Voluntary Movement

m| 
 
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p| Muscle group is called 


 

a| 
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a| u  £&)(

 
   
a| &   £&(*

 
   

m| 

  
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p| Depends if it͛s one or both
a| ¦ateral Flexion if it͛s one
a| Extension if it͛s both Erector ©pinae
p| Contraction of the erector spinae will be responsible for anterior pelvic tilt, which is also associated with
the hip flexors (iliacus and rectus femoris) £ conjunction results in anterior pelvic tilt
 p| Îosterior Îelvic Tilt:
a| Hamstring and xectus abdominus work in conjunction and opposite to muscles trying to cause
anterior pelvic tilt

m| c((       
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p| Hilum: The connection at the lung, where the great vessels and bronchial tree meet (root of lung)
p| Hilum ¦ymph Yodes

m| x

  

 


     
 

 
  
p| xed Flags : non-movable, hard, tender lymph nodes

m| c((       
 
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p| Covers entire lung, except the hilum
p| The mediastinal part is not covered by visceral pleura
p| Îarietal Îleura covers entire area of thoracic cavity
a| xegion that lungs rest on is called diaphragmatic
a| xegion that is lateral most aspect of thoracic £ Costal
a| xegion around very top £ Cupola

m| c((     
 
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p| Covers the anterior and most of lateral region of cavity
p| DOE© YOT cover posterior of cavity - retroperotoneal (spleen, pancreas, kidneys, part of duodenum,
part of ascending & part of descending colon)


m| 
 
p| Mesentery: Tissue that is attached to intestines that holds it to posterior wall
p| Mesentery Îroper would hold small intestine to posterior wall
p| Mesocolon suspends the large intestine to posterior wall (Transverse mesocolon, sigmoid mesocolon)

m| ¦

p| 
¦

a| 3 ¦obes separated by hori ontal and oblique fissures

p| ¦ ¦

a| 2 ¦obes separated by oblique fissure

a| ¦ingula : Inferior most portion of superior lobe
p| 
 
a| Comes off as Trachea
 a| Bifurcation is called Carina (sp?)
a| Îrimary Bronchus £ ÿoing to the ¦ung
a| ©econdary Bronchii £ ¦obar (associated with number of lobes)
a| How many total Branching to get to alveoli? 23
p| ¦ungs receive blood from orta via Îosterior Intercostals rteries which will irrigate the actual tissues of
the lung (Y
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m| "

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p| xuns through superficial abdominal muscles (Internal, External & transverse obliques)
p| ©uperficial inguinal ring is formed mostly from external ring
p| Deep inguinal ring is formed by rectus abdominis
p| xound ¦igament travels through inguinal canal £ ¦abia Majora £ Female
p| ©permatic Cord travels through inguinal canal £ ©crotal ©ac £ Male
a| Contents of ©permatic Cord:
m| Cremaster muscle on the outside
p| hen stimulated causes elevation of the scrotum/testis
p| Temperature of Testis is modulated by cremaster muscle
a| The other muscle involved is the 
 muscle
p| Yerve innervations: ÿenital branch of ÿenito-femoral Yerve
m| Inside of ©permatic Cord:
p| Ductus Deferen
p| Testicular rtery
p| Îanpinifor Îlexus

m| 
 
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p| Oblique Muscles
a| External bdominal Oblique will work with Internal bdominal Oblique of other side

m| "

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m| 
 
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p| ¦eft coronary artery : 
a| Circumflex coronary artery travels through atrioventricular groove from front all the way
posterior which then anastomose with terminal branch of right coronary artery
a| nterior Interventricular rtery is drained by ÿreat Cardiac Vein
 m| ÿreat Cardiac Vein is going to travel with circumflex coronary artery, then connect to
the coronary sinus £ x
p| xight coronary artery:
a| Îosterior Interventricular rtery: Irrigates the interventricular septum posteriorly
m| Drained by Middle Cardiac Vein
p| ÿreat and middle cardiac veins
p| ¦eft Marginal Coronary rtery is drained by ¦eft Marginal Cardiac Vein
p| xight Marginal Coronary rtery is drained by ©mall Cardiac Vein

c


m| Trabeculae Carneae are associated with xight and ¦eft Ventricles

m| Mitral and Tricuspid Valves associated with Chordae Tendinae and papillary muscles
m| Îulmonary semilunar valve £ Îulmonary trunk £ ¦eft and right Îulmonary arteries
m| 
:
p| Îectinate Muscle
p| Fossa Ovalis
m| Three arteries of the ortic rch
p| xight Brachiocephalic Trunk :
a| xight common carotid
a| xight subclavian £ irrigates right upper extremities, internal thoracic arteries
p| ¦eft common carotid
p| ¦eft subclavian

   

)] *£Contraction of rectus abdomenis £ ssociated with posterior pelvic tilt

c] *£ssociated with anterior pelvic tilt

m| £xetraction of ©capula

p| ©erratus Îosterior ©uperior is just DEEÎ to xhomboid

m| 
 

   





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p| ¦EVTOx ©CÎѦ : you may have to recogni e origin/insertion as described by instructor.

m| 
  
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p| Vertebral rtery

m| 
  
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p| YOYE, there ain͛t no transverse processes in thoracic spine, foo!

m| © Y  &Y


 


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p| -dduction, also extension and internal rotation

m| 
 
 
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m| 
 
  
 
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p| 
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-| For every 2 degrees of rotation of humeral bduction, the scapula rotates 1 degrees
-| If the rhythm is off, then it can cause impingement syndrome which causes irritation of bursa, which is very
painful 6-120 degrees, but less painful at terminals
p| ©tarting when? 30 ʹ 60 degrees abduction






xCÎ major, xCÎ minor, Oblique Capitis superior, Oblique Capitis inferior

Oblique Capitis ©uperior -> C1 transverse process to skull

Oblique Capitis Inferior -> C2 spinous process to C1 transverse processe

p| 
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a| Vertebral artery and subocciptal nerve which innervates the muscles of the triangle

p| 
    
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a| ÿreater occipital nerve

p| ÿ
 
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a| ©emispinalis Capitis
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m| The order of progression from esophagus to
p| Esophagus
a| Bottom end connects to stomach through cardiac sphincter : the stomach is a bag that can be closed
off at two ends, upper ʹ cardiac sphincter, the bottom pyloric sphincter
p| Duodenum, C shaped wrapped around head of pancreas, last part of duodenum comes up and makes a
curve, apex of that curve is the end of duodenum and beginning of jujenum where the structure (ligament of
teret ) £ jujenum for a while, then connects to ileum and the dividing line between jujenum and ileum is not
clear but can be telled in lab by pleacae
p| Ileum will stick to cecum by ileocecal valve £ cecum £ appendix is connected to cecum which is posterior
aspect of cecum for most people £ Cecum is then continuous with ascending colon, which turns at hepatic
flexure £ transverse colon £ splenic flexure £ descending colon £ sigmoid colon £ rectum £ anus
m| The musculature around the gut tube is primarily two muscles:
p| ¦ogitudinal muscles £ all fibers side by side to make solid tube £ Îeristalsis
p| Circular muscles £ srruounded by longitudinal
a| BÑT in stomach there is oblique muscles © E¦¦, to help stomach move in a way that would mash
mix food, which is different £ Oblique is farthest out
p| ¦ongitudinal muscles are condensed into 3 stripes of longitudinal muscles £ tenea cholae
a| You would see tenea cholae only in the colon
a| Circular muscle all the way through
p| Colon has got, folds of tissue called £ Îlaeca semilunaris £ between two pleaca semilunaris the space is a
houstrum, or houstra.
p| Houstra are externally visible, tinea chola externally visible, epiploic appendages only at colon/large
intestine
a| lso, related to part of the large intestine £ greater omentum which attaches to transverse colon £
Transverse mesicolon where does greater omentum attaches?
m| ÿreater curvature of stomach and
p| Thoracic Cavity
a| The entire thoracic cavity is lined with parietal pleura, and entire surface pleura is covered by
visceral pleura except hilum, or mediastial portion
a| reas of the paeriatal pleura
m| Costal area, diaphragmatic, mediastinal, top area copular of parietal pleura
m| hat are the specific dividing lines that make up the mediastinum?
p| It͛s a region, no one structure is fully there, its imaginary medial 1/3rd
a| There are autonomic nervous system nerves that are going to innervate thoracic level structures,
sweat glands, blood vessels, etc͙
m| utonomic nerves start at spinal cord £ enter into the sympathetic trunk £ synapse either at
that level they came out of cord Ox some area above Ox some area below Ox enter trunk
and exit without synapsing heading down spinal colum to end up in enteric ganglion
p| Celiac ganglion £
p| Inferior mesenteric ganglion £ inferior mesenteric artery
a| utonomic nervous system is a two neuron pathway
m| 1) first neuron is the one that cell body at spinal cord and is going to exit the spinal cord and
enter the sympathetic trunk, the axons of that are myelinated, those are for pre-ganglionic
sympathetic, they͛re also known as white rami communicons
 m| 2) ÿray xami Communicon common from other side of sympathetic trunk after the xC
met there
m| ¦ateral horn is from T1-¦2
a| Vagus neve is going to synapse to ganglion that is close to target
m| ¦OYÿ perganglionic xC
m| ©HOxT postganglionic ÿxC

p| Transverse Foramina
a| hat ¦evels? CExVIC¦ OY¦Y
a| Vertebral artery goes through it
a| Vertebral artery that goes through that part is going to exit at C1 , turn and loop past a structure £
the structure is suboccipital triangle, vertebral artery passes right past it on its way to farmamen
magnum. £ also know suboccipital nerve which innerve the muscles of the triangle £ know the
muscles of the triangle
a| *now the origins and insertions for the muscles of the triangle
a| xCÎ minor £ C1 posterior tubercle to back of skull, and medial to xCÎ major
p| Îart of the vertebrae that supports the majority of the bodys weight of all the levels, is the vertebral body £
what part connects the body to spinous process £ Îedicle
p| ©pinous process
p| ¦amina unite posteriorly for spinous process
p| utonomic nerves
a| ©ympathetic innervations to heart would come from sympathic trunk T1-4
p| ©ympathetic to gut coming from thoracic segments
a| 1) nerve does not synampse at symp trunk, goes and synapses at ganglion in gut
m| ©planchnic Yerve
a| Thoracic autonomic/sympathetic nerves
p| Îarasympathetic to stomach £ vagus
p| The Heart
a| Heart is surrounded by pericardial sac: serous and fibrous pericardium make up parietal pericardium
a| Visceral pericardium £ Epicardium closely invested to surface of the myocardium
a| Take a pin from outside to in
p| Ventricular space is lined with musclular ridges that attach entire wall of ventricule £ tubercula carnae
p| Îappilary muscles are associated with valves via chordate tendenae
p| hat two valves are associated with papillar muscles
a| Mitral and tricuspid or atrioventricular valves
p| The valves that are associated with blood exiting the ventricules:
a| Îulmonary and aortic semilunar valves
p| Muscular ridges that line the right atrium £ pectinate muscle
p| tria also have a thin section called fossa ovalis
p| Blood supply to the heart
a| Coronary circulation
p| xight coronary artery £ long, wraps around posteriorly on its way back giving right marginal coronary artery,
p| Venous drainage:
a| ÿreat cardiac vein £ parallel to ¦D
a| ÿreat cardiac vein and circumflex artery travels around through atrio-ventricular groove
-| right marginal coronary artery £ small cardiac vein will drain blood from right marginal artery
 -| middle cardiac vein will drain blood from posterior interventricular artery

% "%-/

  " 

1) Top of pelvis, rectus abdomins (pubic bone to lower ribs) if it contracts thorax stays stationary it is the pelvis that͛s
gonna move, the pubic bone will go up, that is rolling the pelvis back £ posterior pelvic tilt

2) Hamstring are going to attach the lower extremities to ischael tuberosity, when they contract they pull the ischael
tubercosity down rolling the pelvis back (ref. top of iliac crest) the reference point will go back £ posterior pelvic tilt

  " 

1)| Hip flexores contract and the body is staying stationary £ nterior pelvic tilt, which is associated with increases
lumbar lordosis
2)| Hip flexores work in conjunction with muscles of back. Muscles of the back contraction also cause anterior pelvic tilt

m| 

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p| 1) xectus Femoris £ ssociated with Quadriceps
p| 2) Iliopsoas
m| Vagus comes from the Medulla; vagus travels close to carotid and enters thoracic cavity posterior to root of lung
p| ¦eft recurrent laryngeal travels around arch of aorta £ damage   
 

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p| xight recurrent laryngeal travels around right subclavian artery
m| If above C3 is damaged, Îhrenic is affected (anything above C5)

m| 

  
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p| Manubrium
p| ©ternal Body
p| Manubosternal ngle
p| Xiphoid
p| Jugular Yotch

m| 1-7 attached to sternum and spine (true)
m| †, 9, 10 atach to cartilage, which attach to cartilage, no bone attachment 
m| 11, 12 floating ribs £ Have only one attachment
m| 
 
*$c( 
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c 
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m| Costodiaphragmetic xecess £ hen is it relavent clinically.

m| aÎet Monkey £ what do the letters stand for?

a.| ortic £ 2nd intercostals space on the right along the sternum
b.| Îulmonic £ 2nd intercostals space ¦eft along the sternum
c.| Erbs point £ 3rd intercostals space along the sternum on the left
d.| Tricuspid £ 5th intercostals space on the left along the sternum
e.| Mitral £ ¦eft midclavicular line (5th intercostals space)