BUKHARI

Review for final examination of systemic anatomy (2010-2011)

1. The periosteum
The dense connective tissue covering the entire surface of a bone Except its auricular cartilage and serving as an attachment for muscles and tendons

2. The classification of skeletal muscle (4 types) external features.

Long Short Flat Orbicular

3. The bones of the trunk include (5)

vertebrae { Sacrum and Coccyx},sternum and ribs

4. The intervertebral disc

Central part nucleus pulpes Outer part annulus fibrosus Function: support vertebral body and decrease friction.
Symphsis between vertebral bodies (except between the first two) Sandwitched between plates of hyaline cartilage (between adjacent vertebral bodies) No disc between atlas and axis Consisting of fibro cartilaginous ring

5. The sternal angle

formed by the junction of the manubrium and the body of the sternum (obtuse angle) determine the forth thoracic vertebrae useful landmark indicating the level of second costal cartilage and order of ribs and intercostal space

6. The pterion
Area where the four bones(parietal,frontal,sphenoid and temperal)closely adjoint one another Landmark of great importance,overlying the anterior branch of middle miningeal artery Fracture at pterion cause hematomae

7. The cerebral cranium consists of , the facial cranium include .

CEREBRAL CRANIUM:

Paired: parietal, temporal Unpaired: frontal, sphenoid, ethmoid and occipital.

FACIAL CRANIUM:

Paired:maxillae,palatine,zygomatic,nasal,lacrimal,inferior nasal conchea. Unpaired: vomer,mandible,hyoid

8. The essential and accessory structures of synovial joint include

Articular Capsule:Composed of dense regular connective tissue. Articular Fluid:contained within Articular Cavity Synovial Membrane:Lines inside the Articular capsule. Articular Cartilage:A smooth Layer of hyaline Cartilage.

Articular disc:Fibrocartilaginous Pad Bursae:Flattened,pouchlike sac.are filled with synovial fluid Tendon Sheath:Modified bursa that surrounds and lubricantes the tendons of certain muscles.

9: The scalene fissure (form and contents)

---The triangle between scalene anterior and scalene medius and 1st rib ---brachial plexus and subclavian artery emerge (originate)from here.

10. The landmarks to indicate the order of the ribs and vertebrae
The second costal cartilage corresponding to the sternal angle is so readily found that it is used as a starting-point from which to count the ribs. Ileum crest and vertebrae prominence for verterbrae.

11: The elbow joint and knee joint comprise of

KNEE JOINTS:

Femur, tibia and pattela all together

ELBOW JOINTS:

Humerous, ulna and radius all together.

12. Please describe the paranasal sinuses.

Frontal sinuses:anterior part the middle nasal meatus of nasal cavity Ethmoidal sinuses:anterior and middle open into middle nasal meatus of nasal cavity.posterior open into superior nasal meatus.

Sphenoidal sinuses: open forward into sphenoethmoidal recess. Maxillary sinuses: opens into the middle nasal meatus of nasal cavity.

13. The splanchnology include (4 systems)

Alimentary system Respiratory system Urinary system Genital system

14. The superior and inferior digestive tube consists of

Superior digestive tube: mouth, pharynx, esophagus, stomach, duodenum Inferior digestive tube: jejunum, illium and large intestine

( cecum,appendix,colon,rectum and anal canal)

15. The papillae of the tongue are the

Fungiform papillae Foliate papillae Vallate papillae

16. The pharynx is divided into three parts, they are the

1. 2. 3.

nasal part of the pharynx (nasopharynx): lies between the base of the skull and level of the soft palate oral part of pharynx (oropharynx): extend from soft palate to superior border of the epiglottis laryngeal part of pharynx(laryngopharynx):located between superior border of epiglottis and cricoid cartilage.

17. The esophagus are three constrictions, they are

First at commencement,15cm from upper central incisor teeth. The second constriction is where the left bronchus crosses it anterior surface,25cm from the upper central incisor teeth. The third occurs where esophagus passes through the diaphragm into the stomach,40cm from the upper central incisor teeth.

18. The external shape and portions of stomach

SHAPE:

Two surfaces anterior and posterior Two curvatures greater and lesser Two orifices cardiac and pyloric Two notch- cardiac and ingular

PORTIONS: four regions

(cardia, fundus, body and pylorus)

19. The duodenum is divided into parts, in which the major duodenal papilla is the opening of
Superior part Descending part Horizontal part Ascending part

---major duodenal papilla is the opening of hepato pancreatic ampulla.

20. What is hilum of lung?

RIGHT:

Location- mediastanal surface of lungs. Vertical slit through which pulmonary vessels, bronchi, nerves and lymphatic vessels pass.

21. Please describe the difference of left and right principal bronchi.

Wider, shorter(2.5cm)more vertical in direction than the left Enter the lungs at fifth thoracic vertebra Divides into right superior, right inferior and middle bronchus lobe Less transverse course than left

LEFT:

Longer(5cm) Enter the lungs at the roof of sixth thoracic vertebra Divides into left superior and left inferior bronchus lobe

22. The parietal pleura is divided into. (4 parts)

1. 2. 3. 4.

Costal pleura Diaphragmatic pleura Midiastinal pleura Copula of pleura

23. The laryngeal cavity is divided into. (3 parts)

Extends from the laryngeal entrance to lower border cricoid cartilage

Portion above vocal folds = vestibule Portion below = infraglottic cavity Portion between = intermediate cavity

24. What is renal hilum? What is renal sinus?

RENAL HILUM:

Location- Depression along the medial border Structure- through which the renal blood vessels, nerves, lymphatic vessels and renal pelvis enter or exit.

RENAL SINUS:
Renal hilum is the door of renal sinus and renal sinus is the continuation of the renal hilum.

25. What is trigone of (urinary) bladder?

Function : Predilection site of tumor, tubercal and inflammation Location : triangular area in the base of bladder between two uretric orifice and internal urethral orifice.

26. What is spermatic cord?

---Extends from the testis to deep inguinal canal

Consist of ductus of deferens, the testicular artery and venous plexus

27. The ductus deferens can be divided into (4 parts)

Testicular part Funicular part Inguinal part Pelvic part

28. Please describe the portions and characteristics of the male urethra
Portions: there are 3 portions,they are
Prostatic part Membranous part Cavernous part

Characteristics:

Three construction part internal orifice, membranous part and external orifice Two curvatures- prepubic and subpubic curvatures. Three dilated places- prostetic part, bulb of urethra and nivicular fossa of urethra
Uterine part-wall of uterus Isthmus-place of tubosterilization ampulla- dilated portion for fertilization infundibulum-attached to the ovary

29. Please describe the four portions of uterine tube.

30. The ligaments of ovary include (2)

suspensory ligaments proper ligament

31. Describe the thoracic duct

Origination: lies in front of body of first lumber vertebrae to the right of the
abdominal aorta.

Course: receives left and right lumber trunks, intestinal trunk and small lymphatic
vessel drains abdominal part and lower part then passes through the aortic hiatus of diaphragm, ascent into thorax in front of vertebral column. Entering the neck, thoracic duct curves laterally to open in the left venous angle.

Termination: pair valves Origination: It begins in the abdomen at the cisterna chyli, which is the dilated

junction of the intestinal, lumbar, and descending inter-costal trunks.

Course: It Passes through the aortic opening of the diaphragm and ascends through the
posterior mediastinum between the aorta and the azygos vein.

Termination: It usually empties into the junction of the left internal jugular and
subclavian veins.

32. Please describe the shape, position of uterus, and the ligaments which support the normal position of uterus.
SHAPE: hollow thick walled muscular organ with the shape of an inverted pear. POSITION: considerable variation, depending chiefly on the condition of the bladder and rectum.

Antiversion (90 angle)between uterus and vagina. Antiflexion (170angle)between the body of the uterus and cervix. Ligaments- broad ligaments rounded utero sacral ligament and cardinal ligaments
Composed of 15-20 lobes Drainage pathway to lactiferous duct expands near the nipple to form lactiferous sinus Milk is stored in the lactiferous sinuses before draining at the tip of the nipple

33. Please describe the structure of the mamma.

34. The perineum can be divided into (2 regions)

urogenital region--anterior urogenital triangle anal region--posterior anal triangle

by transverse line drawing between the both Ischial tuberosities.

35. Please describe the lesser omentum?

--The lesser omentum (small omentum; gastrohepatic omentum; omentum minus) is the double layer of peritoneum that extends from the liver to thelesser curvature of the stomach and the start of the duodenum

heptogastric ligament- right and left gastric arteries hepto duodenal ligaments- bileduct, proper hepatic artery, portal hepatic vein

36. What are the limits of epiploic foramen?

-- The passage, below and behind the portal hepatis, connecting the two sacs of the peritoneum Anteriorly-- bounded anteriorly by the hepatoduodenal ligament Posteriorly-- posteriorly by a peritoneal fold over the inferior vena cava. Superior cudate lobe of liver Inferior- the first part of duodenum

37. Please describe the ligaments of the liver, stomach and spleen.
LIGAMENT OF THE LIVER:

1. falciform ligament: 2.

sickle-shaped saggital fold, connect to the diaphragm and the supraumbilical part of the

anterior abdominal wall.

ligamentum teres hepatis: extend from the umbilicus to the notch for the ligamentum teres hepatis of the
inferior border of the liver. coronary fold,formed by the reflexion of the peritoneum from diaphragm to the superior

3. coronary ligament:
surface of the liver.

4. right and left triangular ligaments: at the right and left sides of coronary ligament.
LIGAMENT OF THE SPLEEN:

1. gastrosplenic ligament: formed between fundus of the stomach and hilum of the spleen. 2. splenorenal ligament: contacts the left kidney and hilum of spleen.

3. phrenicosplenic ligament: small double fold of peritoneum between posterior extremity of spleen and diaphragm.
LIGAMENT OF THE STOMACH:

1. 2. 3. 4. 5.

gastrophrenic ligament: passes from the upper portion of the greater curvature of the stomach to the diaphragm. gastrosplenic ligament: formed between fundus of the stomach and hilum of the spleen. splenorenal ligament: contacts the left kidney and hilum of spleen. phrenicosplenic ligament: small double fold of peritoneum between posterior extremity of spleen and diaphragm. phrenicocolic ligament: the left colic flexure to the diaphragm opposite the 10th and 11th ribs

38. Please describe the external feature of the heart.

An apex ---- formed by the left ventricle Is conical in shape Is directed down, forwards and to the left. It is located at the fifth left intercostal space 1-2 cm medial to the midclavicular line.

A base ---- Formed by left atrium (mainly) and right atrium. It faces backward, upward and to the right. Two pulmonary veins on each side open into the left atrium. The superior and inferior vena cava open into the upper and lower parts of the right atrium.

Two surfaces ---The anterior surface (sternocostal surface) It faces anteriorly. Consists mostly of right atrium and right ventricle, a small portion of left atrium and left ventricle.

The posterior (diaphragmatic surface)

Is largely horizontal and sloping down, forwards. It is formed by two ventricles. It is separated from the anatomic base by the coronary groove and is traversed obliquely by the posterior interventricular groove.

Three borders--The right border--Corresponding to the right atrium The left border The inferior border

Four grooves-- Coronary groove Anterior and posterior

interventricular groove Interatrial groove

A crux

39. The right atrium is divided into (2 parts) by

1.

muscular and (atrium proper)

2. smooth walled parts of the right atrium (sinus vanarum cavarum) By Crista terminalis (internally) and by sulcus terminals(externally)

40. Please describe the internal structure of the right atrium of heart.
1. sinus Venarum: smooth walled portion that surrounds the opening of the superior and inferior

vena cava and the coronary sinus. a.This region is the embryological remanant of venous blood vessels that were absorbed into the formation of the right atrial wall
2. Openings of three vessels: 'a.'Superior Vena Cava 'b.'Inferior Vena Cava 'c.'Coronary Sinus 3. Pectinate muscles(musculi pectinati): muscular wall of the atria 4. Right auricle: pouch-like extension of the muscular part (pectinate muscles) of the right atrium 5. Crista terminalis: a ridge separating the muscular and smooth walled parts of the right atrium 6. Interatrial septum: separates right atrium from left atrium ' a.'Fossa Ovalis, represents the closure of an opening that was present within the interatrial septum of the fetal heart (normal) and was called the foramen ovale

i.Fossa ovalis, a depression that looks like "thumb print" within the interatrial wall

2. 41. The main branches of aortic arch?

CONVEX BORDER: brachiocephillic trunk, left common carotid artery, left subclavian artery.

42. The arteries that the pulsation can be felt.

Superficial temporal artery: direct in front of ear Facial artery: located on the mandible with the corners of the mouth Brachial artery: between biceps and triceps,medial side of the elbow cavity. Radial artery: in groove inside of the bone(radius)thumb side of the wrist. Femoral artery: located in the thigh,pulse can be felt at mid-inguinal point. Dorsal artery of foot: located on top of the foot
(dorsalis pedis artery)

43. The arteries supply to the stomach. (name and origin)

Left and right gastric artery-----left arise from celiac artery and right arise from hepatic artery. Left and right gastroepiploic artery----left arise from the splenic artery and right arise from the gastroduodenal branch of the hepatic artery. Short gastric artery: arise from the splenic artery.

44. The branches of axillary artery.

Divide into 3parts:

1. 2. 3.

first part give only one branch----upper thoracic artery second part gives 2 branches---- thoroacromial artery and lateral thoracic artery third part gives three branches---- subscapular artery, anterior circumflex humeral artery and posterior circumflex artery.

45. The entrances of the left and right atria?

RIGHT ATRIA: 3 entrances
1. 2. superior vena cava inferior vena cava

3.

coronary sinus

LEFT ATRIA: 4 entrances

1. 2. 3. 4.

left superior pulmonary vein left inferior pulmonary vein right superior pulmonary vein right inferior pulmonary vein

46. Describe the fibrous skeleton of the heart?

-Right & left fibrous trigone -4 fibrous rings -(Right sits among the annuli of bicuspid valve , the tricuspid valve and the aortic valve .the left sits among the annulus of bicuspid valve and the annulus of aortic valve left is smaller than right)

Right fibrous trigone Left fibrous trigone Four fibrous rings

47. The conduction system of the heart includes?

SA node (sinoatrial node) Internodal bundles AV node(Atrioventricular node) Atrioventricular bundle(bundle of HIS) Purkinje fibres

48. Define the systemic circulation.

Left ventricle pumps its contents into the aorta with each beat which distributes blood through branches to capillaries of whole body. Systemic circulation is the part of the cardiovascular system which carries oxygenated blood away from the heart to the body, and returns deoxygenated blood back to the heart. This physiologic theory of circulation was first described by William Harvey.

Systemic circulation is when blood leaves the heart, goes to every cell in the body and then re-enters the heart, blood leaves through the left ventricle to the aorta the bodies largest artery, the aorta leads to smaller arteries, arterioles, and finally capillaries, waste and carbon dioxide diffuse out of the cell into the blood and oxygen in the blood diffueses out of the blood and into the cell, blood then moves to venous capillaries, and then the superior vena cava, lower and then to the inferior vena cava, upper at the inferior vena cava the blood re-enters the heart at the right atrium.

49. The arterial supply of the thyroid gland include

Superior thyroid artery Inferior thyroid artery

50. The venous angle

The angle formed by junction of the internal jugular and subclavian veins behind the sternoclavicle joint Structure- thoracic duct join the left venous angle Structure- right lymphatic duct join right venous angle

51. Describe the hepatic portal vein and its tributaries.

HEPATIC PORTAL VEIN:

It is usually formed by the confluence of the superior mesenteric and splenic veinsand also receives blood from the inferior mesenteric, gastric, and cystic veins.

TRIBUTARIES:

Superior and inferior mesenteric vein Splenic vein, cystic veins, left and right gastric veins, paraumblical veins.

52. Describe the dangerous triangle of the face and the communications of the facial vein.
The root of the nose and two angles of the mouth , it is not the absence of venous valves but the
existence of communications between the facial vein and cavernous sinus and the direction of blood flow that is important in the spread of infection from the face. Most, but not all, people have valves in the veins of the face

53. The component of the lymphatic system

Lymphatic vessels Lymphatic tissues Lymphatic organs

The left and right lumber trunks The intestinal trunk Left and right jugular trunk Left and right subclavian trunk Left and right bronchomediastinal trunk

54. The lymphatic trunk include

55. The classification of bones (4 types)

Long bones Short bones Flat bones Irregular bones