GROSS ANATOMY-Review Notes.pdf

8/16/2019 GROSS ANATOMY-Review Notes.pdf

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GROSS ANATOMY

Review Notes and Work Sheets

I. Cardiovascular System

A. Heart - organ reviewB. Arterial flow

C. Venous drainageD. Lymphatic flow

II. Digestive System

A. Position of GI tract and accessory organs and ductsB. Concepts of intra, retro, and extra peritoneal organs- views of mesenteries

C. Some embryo thoughts

D. Blood supply and innervation

III. Urogenital SystemA. Position of kidneys; male and female organsB. Contents of perineal pouches - definitions

C. Homologues

IV. Respiratory SystemA. Follow the airway - compare right and left lungs

B. Larynx and speech - function and innervation

V. Body Cavities, Walls, and Regions

A. Consider definitions and boundaries of compartments

B. TrianglesC. Inguinal canal and hernias

D. Cross sections

VI. Musculoskeletal System

A. Which bones form articulations?B. Skull and foramina

C. Muscle groups - common facts

D. Embryo thoughts

E. Limb muscles and functionsF. Nerve lesions - functional losses

VII. Nervous SystemA. Definitions - spinal nerves

B. Cranial nerves: foramen, function, lesions

C. Autonomic nervous system - origin and distribution

These drawings, charts, and lists were gathered to provide anatomical highlights of major

body systems, cavities, and regions for your review.


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ORGAN REVIEW

Name

Location

Shape

Coverings

Specializations

Arterial supply

Venous drainage

Innervation

Function

Anatomical relationships


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What vessels course together?1. LAD and great cardiac vein

2. Post. interventricular art. and middle cardiac vein

3. Right marginal artery and small cardiac vein

What opens into each chamber?What is lateral to the heart?

What chamber is at the base? right margin? diaphragmatic surface?


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CIRCULATION

ARTERIAL SYSTEM

Thoracic aorta

Ascending aortaRight coronary

Marginal

Post. intervent.

Left coronary arteryLAD

Circumflex

Arch of the aorta1. Brachiocephalic

2. L. com. carotid

3. Left subclavian

Descending aortaVisceral branches

Esophageal

Bronchial

Pericardial

MediastinalPerietal branches

P. intercostals

(3 to 11)Subcostal (T12)

Sup. phrenic

Common iliac artery

External iliacInferior epigastric

Deep circumflex iliac

Internal iliac

Parietal branchesIliolumbar

Lateral sacrals (2)

Superior gluteal

Inferior gluteal

ObturatorInternal pudendal

Visceral branches

Umbilical

Superior vesicalUterine

Inferior vesicalVaginal/prostatic

Middle rectal


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Label the major vessels

Axillary artery

1. Superior thoracic

2. Thoracoacromial

3. Lateral thoracic4. Subscapular

5. Anterior humeral circumflex

6. Posterior humeral circumflex

Brachial artery

7. Profunda brachii

Radial artery

8. Deep palmar arch

Ulnar artery9. Common interosseus

10. Superficial palmar arch

How does blood reach the fingers?


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Label the major blood vessels

Femoral Artery

1. Superficial epigastric

2. Superficial circumflex iliac

3. External pudendal4. Profunda femoris

5. Medial circumflex

femoral6. Lateral circumflex

femoral

7. Popliteal8. Anterior tibial

9. Dorsalis pedis

10. Posterior tibial

11. Peroneal

12. Lateral plantar13. Plantar arch

14. Medial plantar


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Which vessels run in which regions

of the lower extremity?

ThighPosterior

Anterior

Medial

Leg

Posterior

Anterior

Lateral


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Abdominal aorta

Visceral branches

Paired

CeliacSuperior mesenteric

Inferior mesenteric

pairedSuprarenals

Renals

Gonadals

Parietal branches

Paired

Inferior phrenics

Lumbars (4)Common iliac

UnpairedMiddle sacral


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Common carotid artery

Internal carotid artery

Ophthalamic

Anterior cerebral*

Middle cerebral**See in Neuroanatomy

External carotid artery1. Superior thyroid

2. Ascending pharyngeal

3. Lingual4. Facial

5. Occipital

6. Posterior auricular

7. Superficial

temporal8. Maxillary

Anastomoses

Thyroid Gld. – EC & Sub

through inf. & Sup Thyroid

Tongue – R to Left ECThrough lingual

Facial - - R-L EC

Brain - - Circle of Willis

Carotid/Subc

Subclavian artery

9. Internal thoracic

10. Vertebral11. Costocervical

12. Thyrocervical trunk

Transverse cervical

SuprascapularInferior thyroid


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VENOUS DRAINAGE

Generalization: Veins follow arterial pattern

Exceptions

1. Dural sinuses2. Hepatic portal vein

3. Diploic veins, emissary veins

4. Pulmonary veins5. Venous plexuses

6. Right-left inferior

Inferior Vena Cava

1. Inferior phrenics

2. Hepatics

3. Right renal4. Left renal

5. Left gonadal6. Left suprarenal

7. Right gonadal

8. Right suprarenal9. Lumbars


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DURAL SINUSES

1. Superior sagittal*

2. Inferior sagittal

3. Straight*

4. Transverse* (2) Identify 5. Sigmoid (2)

6. Cavernous (2) A. Falx cerebri

7. Superior petrosal (2) B. Tentorium cerebelli8. Occipital*

*Drain into the confluenceof sinuses located at the inion


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PORTAL HEPATIC SYSTEM

Portal vein

Splenic vein

Inferior mesenteric vein - enters in the area of the junction of the superior messenteric and

splenic veins

The portal vein also receives veins from the stomach.

Sites of anastomoses between the portal and caval systems.1. Umbilicus

2. Rectum

3. Esophagus

4. Retroperitoneal organs


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CIRCULATION

Venous System

Brachiocephalic veins (direct tributaries)Internal jugular

Subclavian

Vertebral

Left brachiocephalic vein (additional) Venous drainage of the heart

Left superior intercostal Right atrium

Inferior thyroid Superior and inferior vena cavaAnterior cardiac veins

Retromandibular vein Coronary sinus

Superficial temporal Great cardiac vein

Maxillary Middle cardiac vein


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LYMPHATICS

Generalization: follows venous pattern

Exceptions

1. Pelvis2. Head and neck

Thoracic duct versus right lymphatic duct

Shaded areas drain into the right lymphatic duct NOT the thoracic duct

Thoracic Duct

Rt HeadRt NeckRt Upper Ext.

Rt Upper Chest

↓DiaphragmEverythingdrains into

Thoracic duct


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LYMPHATICS


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GASTRO-INTESTINAL SYSTEM

Follow food through pathway:

What happens in the oral cavity?

What is characteristic (different) about each segment of the tract?

Think HISTOLOGY!

How does the system receive secretions?


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MESENTERY

Definition: a portion of the peritoneum that suspends a part of the GI tract from the body wall.

Allows for the passage of vessels, nerves, and lymphatics.

Intraperiotneal

Retroperiotneal

VENTRAL

Intraperitoneal and Retroperitoneal Organs

Intraperitoneal Retroperitoneal

StomachDuodenum - first part

Jejunum

IleumCecum

appendix

Transverse colong

Sigmoid colon

SpleenLiver and gall bladder

Blood and lymph vessels, nerves

contained in the mesenteries

Uterus and uterine tubesOvaries

Duodenum - parts 2, 3, & 4Ascending colon

Descending colon

Rectum

Kidneys and ureters

Suprarenal glands

Pancreas

AortaInferior vena cava


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Innervation of the GI Tract

Parasympathetic

Input Target

Sympathetic

Input Ganglia

Arterial supply of the GI tract

Celiac artery (supplies foregut derivatives)

EsophagusStomachDuodenum

Liver and gall bladder

Pancreas

NOTE: The spleen is also supplied by the celiac artery but it is NOT a foregutderivative, it is derived from mesoderm.

Superior mesenteric artery (supplies midgut derivatives)Duodenum

Jejunum

Ileum

Cecum

AppendixAscending colon

Transverse colon - right half

Inferior mesenteric artery (supplies hindgut derivatives)Transverse colon - left half

Descending colonSigmoid colon

Rectum - upper portion


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PERITONEAL CAVITY

Lesser omentum: a mesentery that consists of the

1. hepatoduodenal ligament2. hepatogastric ligament

What structures are found in #1?

Omental bursa = lesser peritoneal sac: a subdivision of the peritoneal cavity found posterior to the stomach, liver,and lesser omentum.

What are the lateral boundaries?

How do you enter this space?

Epiploic foramen of Winslow: opening into the omental bursa.

A finger in the epiploic foramen that pressesanteriorly touches:

posteriorly touches:


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ANATOMICAL RELATIONSHIPS

How does the bile duct

reach the duodenum?

What contacts the rightcolic flexure?

What contacts the

left colic flexure?

Through which foramen dothe ureters pass as they

enter the pelvis?

What is superior to

the liver?


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UROGENITAL SYSTEM

Urinary portion - position of kidneys and ureters

Pelvic

diaphragm

Levator ani musclesCoccygeus muscles

UG (urogenital) diaphragm

Deep transverse perinei muscles

Sphincter urethrae muscle


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Position of organs and peritoneum in the male

Urethra

1. Prostatic urethra2. Membranous urethra

- where sphincter is

3. Penile urethra

Recto vesicle

Pouch


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Position of organs and peritoneum in the female


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What view is this?

1. Broad ligament

a. Mesosalpinx

b. Mesovarium

c. Mesometrium2. Round ligament of the uterus

3. Ovarian ligament (proper lig. of the ovary)

4. Suspensory ligament of the ovary

Where is the ureter?

Review homolog list in the Embryology section


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Bartholin’s

glands

DEEP MUSCLES SCAN DIAGRAMS

Pelvic Diaphragm

Levator Ani

SUPERIOR FASCIA OF THE

UG DIAPHRAGM

THE UG DIAPHRAGM

Sphincter urethraeDeep Transversus perinei

PERINEAL MEMBRANE

(Inferior fascia)

STRUCTURES IN THE

SUPERIFICAL POUCH

MUSCLES IN THE

SUPERFICIAL POUCH

Ischiocavernosus

Bulbospongiosus

Superficial transversus perinei

Layers of the Perineum (Male and Female)


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SUPERFICIAL and DEEP PERINEAL POUCHES (SPACES)

Male and Female

SUPERFICIAL PERINEAL POUCH (SPACE)

BoundariesSuperficial perineal fascia = Colle's fascia

Inferior fascia of the urogenital diaphragm = perineal membrane

Male and Female

MusclesSuperficial transverse perineusBulbospongiosusIschiocavernosus

Arteries (branches of the internal pudendal artery)Perineal

Artery to the bulb (bulb of the penis or vestibular bulb)

Nerves (branches of the pudendal nerve)Perineal

Posterior scrotal or labialMuscular branches

Erective tissueMale Female

Corpora cavernosa Corpora cavernosaCorpus spongiosum Vestibular bulb

GlandsMale - none Female - greater vestibular gland

DEEP PERINEAL POUCH (SPACE)

BoundariesSuperior and inferior fascia of the urogenital diaphragm

Male and Female

OrgansMale - urethra Female - urethra and vagina

MusclesDeep transverse pernieusSphincter urethra

Arteries (branches of the internal pudendal artery)

Dorsal artery of the penis or clitorisDeep artery of the penis or clitoris

Nerves (branches of the pudendal nerve)Muscular branches of perineal nerveDorsal artery of the penis or clitoris

GlandsMale - bulbourethral glands Female - none


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RESPIRATORY SYSTEM

Follow airway - label the parts of the pharynx

1. Uvula

2. Epiglottis3. Vocal cords

4. Auditory tube opening

5. Esophagus6. Post. pharyngeal wall

7. Frontal sinus

8. Sphenoid sinus9. Nasal conchae


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At what level does the trachea bifurcate:

With what level is the apex of the lung associated?

Compare the right and left lungs.

Note: lobes, fissures, bronchopulmonary segments


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Larynx

Draw in two musclesPosterior cricoarytenoids

Cricothyroids


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BODY SPACES AND CAVITIES

MEDIASTINUM

What is found in each segment of the mediastinum?

Superior Posterior Anterior Middle

Thymus

TracheaEsophagus

Phrenic nerves

Azygos vein

Vagus nerves

Superior vena cava

Brachiocephalic veins

Left common carotid artery

Left subclavian arteryThoracic duct

Descending aorta

EsophagusThoracic duct

Azygos vein

Splanchnic nerves

Vagus nerves

Thymus, Fat

Ligaments

Pericardium & heart

Phrenic nervesAscending aorta

Superior vena cava

Inferior vena cava

Pulmonary arteries

Pulmonary veins

(roots of the lungs)

What structures are found in more than one part of the mediastium?


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Label the Triangles of the Neck

Anterior Triangle Posterior Triangle

A. Submandibular E. Occipital

B. Submental F. Subclavicular

C. CarotidD. Muscular


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BODY CAVITIES AND REGIONS

INGUINAL CANAL

Hernia - definition:

Types and locations of hernias

Inguinal, femoral, hiatal (diaphragmatic)

Classification of inguinal hernias

1. Direct: emerges through the posterior wall of canal medial to the inferior

epigastric vessels.2. Indirect: passes through the deep ring lateral to the inferior epigastric vessels,

courses through the inguinal canal.

Descent of the testis

Spermatic fascia - abdominal wall derivative

1. External spermatic fascia - external abdominal oblique

2. Cremasteric spermatic fascia - internal abdominal oblique

3. Internal spermatic fascia - transversalis fascia

What does the tunica vaginalis represent?


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Femoral Triangles

BoundariesSartorius

Adductor longus

Infuinal ligament

ContentsFemoral nerve, artery & vein

Femoral canal

Lymph nodesFemoral sheath

Suboccipital Triangle

Boundaries

Rectus capitus posterior majorObliquus capitis superior

Obliquus capitis inferior

ContentsSuboccipital nerve (CI)

Posterior atlanto-occipital membrane

Vertebral artery

Posterior arc of the atlas

Anal triangleBoundaries

Lines connecting the two ischial tuberosities and

the coccyx

ContentsAnus and associated muscles

Ischiorectal fossa and fat

Pudendal nerveinferior rectal nerves

Internal pudendal artery and vein

inferior rectal arteries and veins

Urogenital triangle

BoundariesLines connecting ischial tuberosities and the

pubic symphysis

ContentsSuperficial perineal space

Superficial perineal fascia

MusclesSuperficial transverse perineus

Bulbospongiosus

Ischiocavernosus

Erectile tissue

Crus of the penis clitorisBulb of the penis

Vestibular bulbBranches of the pudendal nerve and the internal

pudendal artery and veinFemale - greater vestabular gland

Anterior Triangle of the Neck

BoundariesSternocleidomastoid

Mandible

Anterior midline

SubtrianglesCarotid triangle

Boundaries

Superior belly of omobyoidPosterior belly of digastric

Sternocleidomastoid

Contents

Accessory nerveVagus nerve

Hypoglossal nerve

Ansa cervicalisCommon carotid artery

External and internal carotic aa.

Internal jugular vein

Submandibular triangle

BoundariesAnterior and posterior bellies of digastric

Mandible

Contents

Submandibular gland and ductFacial artery and vein

Stylohyoid muscle and ligament

Mylohyoid nerve (V3)Muscular triangle

Boundaries

Superior belly of omohyoid

Sternocleidomastoid

Anterior midlineContents

Infrahyoid (strap) muscles

Branches of ansa cervicalisThyroid gland

Thyroid and cricoid cartilages

First trachel ringPosterior triangle of the neck

Boundaries

Sternocleidomastoid

Trapezius

ClavicleContents

Accessory nerveBrachial plexus (roots, trunks, divisions)

Suprascapular nerveLong thoracic nerve

Dorsal scapular nervePhrenic nerve

Cutaneous nerves of cervical plexus

Inferior belly of omohyoid

Subclavian artery and vein

Scalene muscles


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Ischiorectal fossa Cranial fossae

Boundaries

Levator ani

Obturator internus and fascia

Skin of buttock region

Contents

Anal canal and anus associated musclesPudendal nerve

Inferior rectal nervesPerineal nerve

Dorsal nerve of penis/clitoris

Internal pudendal artery and vein

Inferior rectal art. & veinFat

Superficial perineal pouch (space)

Boundaries

Superficial perineal fasciaIschiopubic (conjoined) rami

Inferior fascia of the urogenital

Diaphragm (perineal membrane)

ContentsSee perineal triangle

Deep perineal pouch (space)

BoundariesSuperior and inferior fascia of the

urogenital diaphragm

Contents

Deep perineus muscles

Sphincter urethra muscleUrethra

MaleBulbourethral glands

Female

VaginaAdductor Canal

BoundariesSartorius

Vastus medialis

Adductor longus and magnus

ContentsFemoral artery and vein

Saphenous nerve

Popliteal fossaBoundaries

Lateral and medial head of gastrocnemius

Biceps femoris

Semimembranosus and semitendinosusContentsPopliteal artery and vein

Tibial nerve

Common peroneal nerve

Anterior cranial fossa

Boundaries

Frontal bone

Lesser wing or sphenoid bone

Contents

Frontal lobeOlfactory nerve

Middle cranial fossaBoundaries

Lesser wing of sphenoid bone

Superior ridge of temporal bone

ContentsTemporal lobe

Optic nerve

Oculomotor nerve

Trochlear nerveAbducens nerve

Trigeminal nerve and ganglion

Ophthalmic nerve

Maxillary nerveMandibular nerve

Lesser petrosal nerve

Greater petrosal nerveInternal carotid artery

Middle meningeal artery

Cavernous sinus

Hypophysis (pituitary)

Posterior cranial fossaBoundaries

Superior ridge of temporal boneOccipital bone

Contents

CerebellumBrainstem

Facial nerveVestibulocochlear nerve

Glossopharyngeal nerve

Vagus nerve

Accessory nerveHypoglossal nerve

Dural sinuses

OccipitalTransverse

Sigmoid

Vertebral and basilar arteries

Infratemporal fossaBoundariesRamus of mandible

Lateral pterygoid plate (sphenoid)

Maxilla

Temporal boneContents

Maxillary artery and veinLateral and medial pterygoid muscles

Otic ganglion


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CROSS SECTIONS

1. Look at the periphery of the sections or images. Landmarks: ribs, vertebrae, or pelvic

bones. Establish dorsal and ventral surfaces.

2. Look for solid or tubed organs.

Solid - like the liver, Tubed - like the trachea or heart

This establishes right and left sides in your mind.

3. Recall neighboring structures and walk from one to another.

Abdominal section Thoracic section

1. Liver - right lobe

2. Liver - left lope3. Inferior vena cava (IVC)

4. Hepatic veins

5. Ligamentum venosum6. Caudate lobe of liver

7. Coronary ligament

8. Pleural cavity9. Diaphragm

1. Pericardial sac

2. Right ventricle3. Right atrium

4. Superior vena cava (SVC)

5. Aortic valve6. Left atrium

7. Esophagus

8. Descending aorta9. Anterior mediastinum

10. Bronchus11. Right pulmonary vein

12. Lung - superior lobe

13. Lung - inferior lobe


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MUSCULOSKELETAL SYSTEM

Skeletal System

What bones articulate to form the joints listed below?

Shoulder

Elbow

Wrist

Where does supination and pronation take place?

Hip

Knee

Ankle

Where does eversion and inversion take place?

Vertebral column

Curvatures: primary = thoracic & sacral;

secondary = cervical & lumbarDisks: annulus fibrosus and nucleus pulposus

Notochord remnants?


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Skull: foramina - fossa

1. Cribriform plate

2. Optic canal

3. Foramen rotundum

4. Foramen ovale5. Foramen spinosum

6. Foramen lacerum

7. Internal auditory meatus8. Jugular foramen

9. Hypoglossal canal

10. Foramen magnum

Cranial fossa


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SKULL

Base of the skull

1. Stylomastoid foramen

2. Carotid canal

3. Jugular foramen4. Foramen ovale

5. Foramen spinosum

6. Foramen lacerum7. Foramen magnum

8. Greater palatine foramen

9. Lesser palatine foramen10. Incisive canal

Front of the skull

1. Supraorbital foramen (fissure)

2. Infraorbital foramen

3. Mental foramen4. Superior orbital fissure

5. Inferior orbital fissure


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MUSCULAR SYSTEM

Muscle Groups

Head

a. Face b. Mastication

c. Extraocular

d. Tongue

Neck

a. Lateral b. Infrahyoid

c. Suprahyoid

d. Anterior vertebral

BackSets

Thorax

a. Intercostal and diaphragm

b. Accessory muscles of respiration

Abdomen

a. Anterolateral b. Posterior

Pelvis

a. Diaphragm

b. Walls

Perineum

a. UG triangle

b. Anal triangle

Upper limb

Lower limb

Functional groupsa. Swallowing

b. Head turning

c. Speech

Branchial arch muscles

See Embryology


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Upper Limb Muscle Groups

Deltoid


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Lower Limb Muscle Groups


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Muscular System - Nerve Lesions

Reminder: Follow the clues in the question as to the location of the injury. An injury will

manifest in symptoms distal to the site of the injury.

Example: Radial nerve cut at the wrist. Sensory: loss on the dorsum of the hand

No muscular loss as these are already innervated above the sit of the nerve injury.

Thoughts on muscle-nerve lesions

1. Without specifically naming all the muscles assign a function to the variouscompartments of the limbs. Example: Posterior brachium = extension at the shoulderand the forearm.

2. List the nerve(s) that innervate those muscles or that area. Example: Posterior brachium = radial nerve.

3. You have: an area of the limb; a function of the muscles within that area; a nerveresponsible for the function.

Now you can damage a nerve and note what function is lost or weakened!

Upper extremity - lesions of the following nerves in the axilla

Radial nerve: Loss of extensors at the shoulder, elbow, wrist, and digits:weakened supination.

Median nerve: Loss of flexion of the digits; weakened wrist flexion; loss of

pronation; loss of thenar muscles.

Ulnar nerve; Weakened wrist flexion; loss of abduction and adduction of the

digits; loss of hypothenar muscles.

Musculocutaneous nerve: greatly weakened shoulder flexion; loss of flexion at the

elbow; very weakened supination.

Axillary nerve: Loss of abduction of the arm above the horizontal plane.

NOTE: What is the area of sensory loss with each nerve lesion?


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Lower extremity

Superior gluteal n.: loss of abduction of the limb; impairment of gait; patient

cannot keep pelvis level when standing on one leg.

Inferior gluteal n.: weakened hip extension; patient cannot rise from a sitting position or climb stairs.

Femoral nerve: greatly weakened hip flexion; loss of extension at the knee.

Obturator nerve: loss of adduction of the limb.

Sciatic nerve: loss of flexion of the knee; loss of function below the knee.

Tibial portion only: loss of flexion of the knee, and toes; loss of plantar

flexion; weakened inversion.

Common peroneal nerve:

Deep peroneal n.: weakened inversion; loss of extension of the toes

and dorsiflexion at the ankle.

Superficial peroneal n.: loss of eversion of the foot.


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NERVOUS SYSTEM - GROSS VIEW

Define a spinal nerve. Spinal nerve

What are the functions of ventral rami?

What are the functions of the dorsal rami?


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VENTRAL RAMI

What's missing?

Cervical plexus

Sensory toneck

scalp & ear

shoulder

Motor to

infrahyoids (ansa)

Brachial plexus

Sensory & motor toupper extremity

lateral chest

Lumbar plexus

Sensory & motor toabdominal wall

lower extremity

Lumbosacral plexus

Sensory & motor to

lower extremitygluteus

pelvis & perineum


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PARASYMPATHETIC SYSTEM

Compare and contrast the origin and distribution of these systems.

SYMPATHETIC TRUNK


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Label cranial nerves.

What's missing?


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CRANIAL NERVES - TYPES

Purely sensory cranial nerves

Olfactory

OpticVestibulocochlear

Purely motor cranial nerves

Oculomotor

TrochlearAbducens

Accessory

Hypoglossal

Mixed (sensory and motor) cranial nerves

TrigeminalFacial

Glossopharyngeal

Vagus

Cranial nerves that are autonomic

Oculomotor

FacialGlossopharyngeal

Vagus

Cranial nerve - autonomic ganglia

Oculomotor - ciliary ganglion

Facial - submandibular and pterygopalatine ganglia

Glossopharyngeal - otic ganglia

Vagus - terminal ganglia located near or within the walls of organs


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CRANIAL NERVE LESIONS

I. Olfactory nerve:

II Optic nerve:

III Oculomotor nerve:

IV Trochlear nerve:

V Trigeminal (Let's get specific!)

V1 - Ophthalmic nerve:

V2 - Maxillary nerve:

V3 - Mandibular nerve:

VI Abducens nerve:


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CRANIAL NERVE LESIONS

VII Facial nerve:

VIII Vestibulocochlear nerve:

IX Glossopharyngeal nerve

X Vagus nerve:

XI Accessory nerve:

XII Hypoglossal nerve:


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STUDY QUESTIONS GROSS

1. All of the following are branches of the axillary artery EXCEPT the

a. lateral throacic b. thyrocervical trunk

c. subscapulard. thoraco-acromial

e. highest thoracic

2. The inferior mesenteric artery supplies all of the following EXCEPT the

a. ascending colon

b. descending colon

c. sigmoid colon

d. distal transverse colon

e. upper rectum

3. All of the following drain to iliac nodes EXCEPT the

a. fundus of the uterus

b. superior rectum

c. cervix

d. upper vagina

e. bladder

4. All of the following are associated with a mesentery EXCEPT the

a. stomach

b. spleen

c. inferior mesenteric arteryd. ovaries

e. ureters

5. Access to the vertebral artery would be best accomplished by dissecting through the

a. carotid triangle

b. submandibular triangle

c. suboccipital triangle

d. posterior triangle

e. anal triangle

6. All of the following changes in circulation occur at birth, EXCEPT

a. closure of the ductus arteriosum

b. dilation of blood vessels of the lungs

c. enlargement of the right ventricle

d. closure of the foramen ovale

e. constriction of the umbilical arteries


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7. All of the following pass through the cavernous sinus EXCEPT the

a. optic nerve

b. trochlear nerve

c. occululomotor nerve

d. abducens nerve

e. internal carotid artery

8. Which of the following does NOT contribute blood into or receive blood from the

cavernous sinus

a. superior ophthalmic vein

b. inferior ophthalmic vein

c. internal carotid artery

d. superior petrosal sinus

e. inferior petrosal sinus

9. All of the following are derivatives of ventral mesogastrium EXCEPT the

a. hepatoduodenal ligament b. ligamentum teres

c. hepatogastric ligament

d. triangular ligamente. gastrosplenic ligament

10. All of the following are branches of the internal iliac artery EXCEPT the

a. umbilical

b. ovarian

c. obturatord. inferior gluteal

e. internal pudendal

11. The ulnar artery continues into the hand as the

a. princeps pollicis

b. common interosseuec. superficial palmar arch

d. digital branch to the index finger

e. deep palmar arch

12. Contents of the posterior triangle of the neck include all of the following structures,

EXCEPT the

a. scalene muscles

b. brachial plexusc. thyrocervical trunk

d. accessory nerve

e. subclavian vein


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13. Which of the following statements concerning the innervation of the heart is

INCORRECT?

a. The vagus nerves gives rise to preganglionic parasympathetic fibers.

b. The postganglionic sympathetic neurons are in the sympathetic chain.

c. The sympathetic system is responsible for decreasing the heart rate.d. The ganglia in the cardiac plexus are parasympathetic.

e. Pain afferents from the heart are carried by sympathetic nerves.

14. The "wrist drop" sign indicates damage to which nerve?

a. ulnar b. median

c. musculocutaneous

d. accessory

e. radial

15. Which of the following arteries is NOT a branch of the external carotid artery?

a. lingual

b. transverse cervical

c. faciald. superior thyroid

e. superficial temporal

16. Which of the following statements about the extrahepatic biliary system is

INCORRECT?a. The common bile duct empties into the second part of the duodenum.

b. The cystic duct contains a spiral valve.

c. The right and left hepatic ducts form the common hepatic duct.

d. The extrahepatic ducts have a simple squamous epithelium.e. The common bile duct passes through the pancreas.

Select the single best answer:

a. Femoral nerve f. Psoas major muscle

b. Obturator muscle g. Superior gluteal nervec. Posterior thigh muscles h. Popliteus muscle

d. Lateral compartment of leg muscles i. Common peroneal nerve

e. Inferior gluteal nerve j. Lateral plantar nerve

17. _____ Involved in the flexion of the leg at the knee.

18. _____ If injured, patient cannot rise from a sitting position.

19. _____ Provides sensory innervation to the dorsal surface of the great toe.


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Select the single best answer:

a. Gastrocolic ligament f. Suspensory ligament of the ovary

b. Gastrosplenic ligament g. Lienorenal ligament

c. Hepatic coronary ligament h. Medical umbilical ligaments

d. Hepatogastric ligament i. Falciform ligamente. Broad ligament j. Lateral umbilical ligaments

20. _____ Part of the ventral mesentery enclosing the bare area of the liver.

21. _____ Mesentery in which the short gastric arteries are found.

22. _____ Contains the obliterated umbilical arteries.

ANSWERS

EMBRYOLOGY GROSS

1. C2. B

3. C

4. C5. E

6. C7. E

8. B

9. C10. E

1. B2. A

3. B

4. E5. C

6. C

7. A8. C

9. E

10. B11. C

12. C13. C

14. E

15. B16. d

17. C18. E

19. I

20. C21. B

22. H

Documents

GROSS ANATOMY-Review Notes.pdf