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Relationships Unit 4

Terms in this set (62)

Liver palpation
below right costal margin
superior part of liver
4th right costal margin
inferior part of liver
finger's breadth below right costal margin
liver's left lobe extends...
just past midline into 5th intercostal space on the left
gallbladder lies in
fossa of the liver
gallbladder is ___ what costal cartilage?
behind 9th
superior part of stomach is in
5th intercostal space
inferior part of stomach is in
L1 vertebral body
superior duodenum
L1
descending duodenum
L1-3
transverse duodenum
L3
ascending duodenum
L3- L2
Pancreas sits in
C of duodenum
tail of pancreas extends to
left side of body and ends at spleen
cecum lies at
L5
vermiform appendix is found at
McBurney's pt
midpoint of line between umbilicus and ASIS
large intestine bends
right colic (hepatic) flexure- 9th rib
left colic (splenic) flexure- 8th rib
Right kidney is ___ than the left
lower to accommodate the liver
location of kidney
T11-L3
inferior border aka ___ location
costal margin
L2
iliac crest rises to level...
L4
Sternal angle of louis location
2nd rib/costal cartilage
xiphoid process at what vertebral level
T10
umbilicus at what vertebral level
L4
iliac crest at what vertebral level
L4
piercing diaphragm
aortic hiatus @ T12
esophageal hiatus @T10
caval hiatus @T8-9
I ate 10 eggs at noon
I (IVC in caval hiatus) ate (T8) 10 eggs (10 is esophageal hiatus) at noon (aortic canal at T12)
contents of aortic hiatus
thoracic (descending aorta)
thoracic duct
azygos vein
esophageal hiatus contents
esophagus, anterior and posterior vagal trunks
caval hiatus contents
IVC
locations of heart valves
pulmonic - 3rd cc
aortic - 3rd intercostal space
mitral - 4th cc
tricuspid - intercostal space
Heart valve auscultation points
pulmonic - 2nd intercostal space left of sternum
aortic- 2nd space right of sternum
mitral - 5th space at midclavicular line
tricuspid- slightly right of xiphoid process
describe the relationship between the testicular artery and the ductus (vas) deferens
Testicular artery lateral, ductus deferens medial ***important for vasectomy
describe course of ductus deferens after it leaves the deep inguinal ring
runs lateral to inferior epigastric artery, crosses external iliac vessels and the ureter, enters urethra

**ductus deferens crossing over ureter is water under the bridge
the IVC is located where in relation to the caudate lobe of the liver?
caudate lobe is left of the IVC
Important relationship between ureters and common iliac arteries
ureters cross over common iliac A's where they branch into int and ext iliac arteries
@ SI joint
proper hepatic artery, common bile duct, hepatic portal -- order left to right
proper hepatic A, hepatic portal V, common bile duct
left to right - right sympathetic trunk, Left sympathetic trunk, IVC, aorta
left sympathetic trunk, aorta, IVC, right sympathetic trunk
common iliac arteries run downward and laterally along medial border of ____ muscle
medial border of psoas muscle
what canal does the pudendal nerve and internal pudendal vessels run through
Alcock's/ pudendal canal
(lateral portion of ischiorectal fossa)
What nerve winds around the aortic arch and is closely applied to the ligamentum arteriosum?
left recurrent laryngeal
head of pancreas sits in the curve of the ___ and the tail projects to the ___
proximal duodenum; spleen (lays behind stomach, retroperitoneal)
What arteries straddle the pancreas head?
Superior anterior/posterior pancreaticoduodenal arteries anastomose with inferior anterior/posterior pancreaticoduodenal arteries.
Which lobe of the liver is immediately left of the gall bladder?
quadrate lobe
What is the cisterna chyli? -It overlies what?-It is behind what?
sac that gives rise to the thoracic duct
overlies the Ligament of Trietzand
sits behind the right crus of the diaphragm.
Where are the Ampulla of Vaterand the Sphincter of Oddi?
At the termination of the pancreatic duct and the common bile duct.
The Superior Mesenteric Artery "hooks" over what vein?
Left Renal Vein which lies in front of the Abdominal Aorta.
Left gonadal vein drains into the _________ and the right gonadal vein drains into the _________.
Left Renal Vein
right gonadal vein drains into the Inferior Vena Cava.
What makes Hesselbach'striangle so weak and susceptible to hernias?
covered only with the rectus sheath, making it a naturally weak region where hernias can occur.
Hesselbach'striangle is lateral or medial to the inferior epigastric artery? Borders?
medial to the inferior epigastric artery
borders:
free edge of rectus abdominis, inferior epigastric artery, inguinal ligament
Describe the difference between a direct and indirect inguinal hernias
direct inguinal hernia goes through Hesselbach's triangle. Same ratio in men and women.

An indirect inguinal hernia goes through the deep inguinal ring (lateral to the inferior epigastric artery) and into the inguinal canal. males- could go to the superficial ring and into the scrotum. - most common in males

In females, the canal has fat so that wouldn't happen.
What organ is immediately behind the pubic bone?
urinary bladder
What gland is embedded in the Urogenital diaphragm in males?
The Bulbourethral Gland (Cowper's)
The uterus is situated between which two pouches?
anterior to the rectouterine pouch of Douglas and posterior to the uterovesicalpouch & bladder.
The ovaries are attached to the broad ligament by _________ and are suspended in the pelvic cavity by ____________ .
mesovariumand are suspended in the pelvic cavity by suspensory ligament.
What is the female homologue to ductus deferens that runs through the deep inguinal ring to labia majora?
Round Ligament of the Uterus
Which of the 3 parts of the External Anal Sphincter attaches to the coccyx & perineal body?
Superficial
Name the boundaries, content, and purpose of the Ischiorectal Fossa
Boundaries
levator ani (med)
obturator internus & ischial tuberosity (lateral)
ischioanal absess

Fat, Pudendal/Alcock's canal with Internal Pudendal Vessels and Pudendal Nerve

Purpose: Allows for expansion during defecation
What is the attachment of the external anal sphincter, the bulbospongiosus, and the superficial transverse perineusin both sexes?
The perineal body/central tendon

**episiotomy for giving birth
Fundiform ligament is a specialization and thickening of _________.
scarpa's fascia
from linea alba around the penis like a sling
Suspensory ligament is attached to what bone?
pubic symphysis
holds penis close to pubic bone and supports an erection
The aortic arch bends in a posterior direction around the __________ as it forms the thoracic portion of the descending aorta posteriorly.
left mainstem bronchus
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