Download [Type text]Anatomy Practical and Lecture Structure List[Type text

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Anatomy Practical and Lecture Structure List
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Mastoid process- absent or rudimentary in neonate skull; forms postnatally
as SCM pulls on it
Superior nuchal line- SCM and trapezius attach to it
Styloid Process- Stylohyoid lig., stylomandibular lig., stylohyoid m., and
stylopharyngeous m. attach to it
Hyoid bone- only distantly articulated to other bones by muscles or
ligaments. Provides attachment to the muscles of the floor of the mouth and
the tongue above, the larynx below, and the epiglottis and pharynx behind.
o Hyoid is ossified from six centers: two for the body and one for each
cornu. Commences in the greater cornua toward the end of fetal life,
body shortly after, and lesser cornua during the first or second year
after birth. Middle age before fibrous connection between the body
and greater cornu ossifies.
o Muscle attachments:
 Superior: middle pharyngeal constrictor muscle, hyoglossus,
digastric, stylohyoid, geniohyoid, mylohyoid
 Inferior: thyrohyoid, omohyoid, sternohyoid
o Body- second pharyngeal arch gives rise to superior part, while
cartilage of third pharyngeal arch forms the lower portion
o Greater Horn- projects backward from body; connect to the lateral
hyothyroid lig.; hyoglossus, constrictor, and digastric and stylohyoid
muscles
 Cartilage of the third pharyngeal arch
o Lesser Horn- stylohyoid lig. Attaches
 Derived from 2nd pharyngeal arch
Platysmao Insertion- base of mandible
o Artery- branches of submental and suprascapular
o Nerve- Cervical branch of CN VII
o Actions- Draws mouth downward, and draws skin of neck up when
teeth are clenched
Sternocleidomastoid (SCM)
o Origin- Medial portion of clavicle
o Insertion- Mastoid process and superior nuchal line
o Artery- Occipital and superior thyroid
o Nerve- motor- accessory nerve; sensory- cervical plexus
o Actions- rotationa and flexion unilaterally; forced inspiration assist
bilaterally
Stylohyoid
o Origin- styloid process
o Insertion- greater cornu of hyoid
o Nerve- CN VII
o Action- elevates the hyoid during swallowing
Mylohyoid
o Origin- mylohyoid line of mandible
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Anatomy Practical and Lecture Structure List
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o Insertion- body of hyoid bone and median raphe
o Artery- mylohyoid branch of inferior alveolar
o Nerve- mylohyoid nerve from inferior alveolar branch of V3
o Action- elevates hyoid and tongue; depresses mandible
Digastric
o Anterior belly
 Origin- digastric fossa (mandible)
 Insertion- intermediate tendon on hyoid
 Artery- submental branch of VII
 Nerve- V3 via mylohyoid nerve
 Action- Opens jaw when masseter and temporalis are relaxed
o Posterior Belly
 Origin- mastoid process
 Insertion- intermediate tendon
 Artery- occipital artery
 Nerve- CN VII
o Intermediate tendon- perforates the stylohyoid muscle and is held
in position by a loop of fibrous tissue between body and greater horn
of hyoid
Sternohyoid
o Origin- manubrium of sternum
o Insertion- hyoid
o Artery- superior thyroid
o Nerve- C1-C3 by branch of ansa cervicalis
o Action- depresses hyoid
Omohyoid
o Inferior Belly
 Originates at upper border of the scapula
o Superior Belly
 Lower border of the body of the hyoid lateral to the insertion
of sternohyoid
o Nerve- ansa cervicalis (C1-C3)
o Action- depresses the larynx and hyoid bone; also carries hyoid
backward and to the side
Sternothyroid
o Origin- manubrium
o Insertion- thyroid cartilage
o Artery- superior thyroid
o Nerve- ansa cervicalis
o Action- depresses thyroid cartilage
Thyrohyoid
o Origin- thyroid cartilage of larynx
o Insertion- hyoid bone
o Artery- superior thyroid
o Nerve- C1 via hypoglossal
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Anatomy Practical and Lecture Structure List
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o Actions- elevates thyroid, and depresses hyoid bone
Common Carotid artery- lies within the carotid sheath; bifurcates at level of
C4 into ICA and ECA
o Lies within the carotid triangle- Border muscles are SCM, stylohyoid
and posterior belly of digastric above, and superior belly of omohyoid
below
o It commonly gives off no branches prior to bifurcation
External Carotid Artery
o Superior thyroid- Originates at anterior border of SCM and runs
upward in the carotid triangle
 If artery is severed but not ligated during a thyroidectomy, it
will bleed profusely
o Ascending pharyngeal- one of the arteries that supplies the pharynx
(smallest branch of ECA)
o Lingual- arises from ECA between the superior thyroid artery and the
facial artery
 Runs toward greater cornu of hyoid, curves downward forming
a loop and passes beneath the digastric and stylohyoid, runs
beneath the hyoglossus, then to the tongue on its lower surface
o Facial artery- Arises in carotid triangle and lies on middle pharyngeal
constrictor
o Occipital artery- arises opposite the facial a.; supplies blood to back
of scalp and sterno-mastoid muscles
o Posterior auricular a.- arises from ECA above digastric and
stylohyoid; ascends beneath parotid gland and between the cartilage
of the ear and mastoid process (supplies blood to scalp post. to the ear
and ear)
Carotid sinus- place where atherosclerotic plaques form very often; where
numerous baroreceptors are located; baroreceptors are innervated by CN IX
Carotid body- small cluster of chemoreceptors located at the bifurcation of
the carotid artery; detects changes in PO2 and PCO2; also sensitive to temp.
and pH
Internal Carotid Artery- supplies the brain
Subclavian a- arises from aortic arch on the left and brachocephalic artery
on the right- supplies left and right arms respectively
Subclavian vein- joins with internal jugular vein and drains into
brachiocephalic vein- forming the venous angle
External Jugular vein- receives greater part of the blood from the exterior
of the head and deep parts of the face; used for venous access when no
peripheral vein is available in hospital settings; drains into the subclavian
vein lateral to the junction of the subclavian vein and the internal jugular
vein
Internal jugular vein- collecting blood from the brain, superficial parts of
face, and neck; superficial and susceptible to damage which can lead to lots of
blood loss and hypovolaemic shock and death if not treated. Cuts or
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Anatomy Practical and Lecture Structure List
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abrasions in the skin near the jugular vein will bleed longer and more
profusely (shaving)- since 95% of the body’s blood passes through this vein,
it takes on average about 30 minutes to fully stop a shaving abrasion on the
face.
Cervical Plexus- C1-C4: it anastomoses with the accessory and hypoglossal
nerves and sympathetic; has cutaneous branches and muscular branchesansa cervicalis, phrenic, and segmental branches
Ansa cervicalis- loop of nerves that are part of the cervical plexus and lies
superficial to the internal jugular vein in the carotid triangle; branches
innervate most of the infrahyoid muscles (sternothyroid, sternohyoid, and
omohyoid)
o Superior root- formed from C1 of the cervical plexus; goes around
the occipital artery and descends on the carotid sheath; branches sent
to superior belly of the omohyoid and upper parts of sterothyroid and
sternohyoid
o Inferior Root- formed from fibers of C2 and C3; branches to the
inferior belly of omohyoid and lower parts of sternothyroid and
sternohyoid
Phrenic nerve- C3-C5 and passes down between lung and heart to reach the
diaphragm; important for breathing (passes motor to diaphragm and
receives sensory from it); in the thorax it supplies mediastinal pleura and
pericardium
Hypoglossal nerve- innervates muscles of the tongue; General somatic
efferent (GSE); innervates genioglossus, hyoglossus, and styloglossus
muscles; can be transected to help connect to the facial nerve when it is
damaged so facial muscles work again but can cause some tongue weakness
Vagus nerve- right gives rise to recurrent laryngeal nerve that hooks around
the right subclavian artery- forms posterior vagal trunk at the lower part of
the esophagus and enters the diaphragm through the esophageal hiatus; left
vagus nerve enters the thorax between left common carotid artery and left
subclavian artery and descends on the aortic arch- gives rise to left recurrent
laryngeal nerve that hooks around the aortic arch to the left of the
ligamentum arteriosum.
Sympathetic chain- T1-L2; forms a plexus on the internal carotid artery
Superior cervical ganglion- only ganglion in the sympathetic nervous
system that innervates the head and neck (largest and most rostral of the
three cervical ganglia)
Gray ramus communicans- from the adjacent paravertebral ganglion of the
sympathetic trunk and contains both preganglionic and postganglionic nerve
fibers of the sympathetic nervous system
Other things to know
o Investing deep fascia- encloses SCM and Trapezius
o Prevertebral fascia- encloses vertebral region of neck
o Pretracheal fascia- encloses visceral region of neck
o Carotid sheath- encloses the vascular region of the neck
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Anatomy Practical and Lecture Structure List
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o Thyroid cartilage- from 4th and 6th branchial arch
 Lamina- 2 of them that fuse on the anterior side of the
cartilage to form a peak called the laryngeal prominence
o Submandibular gland-develops later than the parotid gland;
superficial and deep lobes are separated by the mylohyoid muscle;
receives blood supply from facial and lingual arteries
Naris- nostril
Nasal septum- composed of perpendicular plate of ethmoid bone, vomer
bone, cartilage of the septum, crest of the maxillary bone, and crest of the
palatine bone;
o Artery- anterior ethmoidal, posterior ethmoidal, sphenopalatine,
greater palatine, and branch of superior labia
o Nerve- anterior ethmoidal nasopalatine nerves
Hard palate
o Artery- greater palatine artery
o Nerve- greater palatine nerve and nasopalatine nerve
o Incisive canal- descending palatine artery and nasopalatine nerve go
through this
Sphenoethmoidal recess- small space in the nasal cavity that lies posterior
and superior to the superior concha into which the sphenoidal sinus opens
o Ostium of the sphenoidal sinus
Superior concha- part of the ethmoid bone; connected to the middle
turbinates by nerve-endings and serve to protect the olfactory bulb
o Superior meatus- lies between the superior concha and middle
concha; the sphenopalatine foramen opens into it behind and the
posterior ethmoidal cells in front
 Ostia of the ethmoidal air cells
Middle concha- project downward over the openings of the maxillary and
anterior and middle ethmoid sinuses, and act as buffers to protect the
sinuses from coming into contact with direct air
o Middle meatus- nasal opening or canal situated between the middle
and inferior conchae
 Ethmoidal bulla- caused by a bulging of the ethmoidal cells
which open on or immediately above it
o Ostia of ethmoidal air cells
 Hiatus semilunaris- crescent- shaped groove in the lateral
wall of the nasal cavity just inferior to the ethmoidal bulla
 Ostium of frontal sinus
 Ostia of ethmoidal air cells
 Ostium of nasolacrimal duct
Inferior concha- largest of the turbinates; responsible for the majority of
airflow direction, humidification, heating, and filtering of air inhaled through
the nose
o Inferior meatus- largest of the 3 meatuses; space between the
inferior concha and the floor of the nasal cavity
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Anatomy Practical and Lecture Structure List
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 Ostium of the nasolacrimal duct
Concha are made of pseudostratified columnar, ciliated respiratory
epithelium with a thick, vascular, and erectile glandular tissue layer
Frontal sinus- situated behind the brow ridges; opens into the anterior part
of the corresponding middle nasal meatus through the frontonasal duct ;
absent at birth
o Artery- supra-orbital and anterior ethmoidal
o Nerve- supraorbital nerve
Maxillary sinus- largest of the paranasal sinuses and drains into the middle
meatus of the nose; sinusitis; present at birth as air cells and develops
through childhood
o Artery- infraorbital artery and posterior superior alveolar artery
o Nerve- posterior superior alveolar nerve, middle superior alveolar
nerve, anterior superior alveolar nerve and infraorbital nerve
Sphenoidal sinus- present as very small cavities at birth, but main
development takes place after puberty; potential complication is cavernous
sinus thrombosis
o Nerve- posterior ethmoidal nerves, postganglionic parasympathetic
fibers of the facial nerve
Ethmoidal air cells- numerous thin-walled cavities situated in the ethmoidal
labyrinth
o Nerve- anterior and posterior ethmoidal nerves and orbital branches
of pterygopalatine ganglion
Mucoperiosteum (all sinuses)- compound structures consisting of mucous
membrane and periosteum; includes epithelium and lamina propria
Nasopalatine nerve- branch of pterygopalatine ganglion (V2)
Sphenopalatine artery- branch of the maxillary artery; artery responsible
for most serious posterior nosebleeds (epistaxis)
Nasal mucosa- produces the mucus in the nose
Mental symphysis- faint ridge on median line of mandible; origin for the
geniohyoid and genioglossus muscles
Genial tubercles- inferior and superior mental spines
o Inferior- origin of geniohyoid and suprahyoid muscles
o Superior- origin of genioglossus muscle
Mylohyoid line- line on the inside of the mandible ; mylohyoid muscle
originates from the anterior part of the line
Lingual frenulum- small fold of mucous membrane extending from the floor
of the mouth to the midline of the underside of the tongue
Sublingual foldLingual tonsil- rounded masses of lymphatic tissue that cover the posterior
region of the tongue
Palatoglossus muscle
o Origin- palatine aponeurosis
o Insertion- tongue
o Nerve- vagus (via pharyngeal branch to pharyngeal plexus
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Anatomy Practical and Lecture Structure List
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o Action- raising the back part of the tongue
Styloglossus muscle- shortest and smallest of the 2 styloid muscles
o Origin- styloid process
o Insertion- tip and sides of tongue
o Nerve- hypoglossal nerve
o Action- retraction and elevation of the tongue
Hyoglossus muscleo Origin- hyoid
o Insertion- side of the tongue
o Nerve- hypoglossal nerve
o Action- depresses and retracts the tongue
Genioglossus muscle- relaxation of this muscle can be implicated in
obstructive sleep apnea
o origin- superior part of the mental spine of the mandible
o insertion- dorsum of the tongue and body of the hyoid
o artery- lingual artery
o nerve- hypoglossal
o action- inferior protrude the tongue, middle depress, superior draw
the tip back and down
Geniohyoid
o Origin- inferior mental spine
o Insertion- hyoid
o Nerve- C1 via the hypoglossal nerve
o Action- carry hyoid bone and tongue upward during deglutition
Orbicularis oris
o Origin- maxilla and mandible
o Insertion- skin around the lips
o Artery- inferior labial artery and superior labial artery
o Nerve- CN VII- buccal branch
o Action- puckers the lips
Buccinator
o Origin- alveolar processes of the maxillary bone, mandible and TMJ
o Insertion- fibers of the orbicularis oris
o Artery- buccal artery
o Nerve- buccal branch of CN VII
o Actions- chewing, sucking, and holding food in
Hypoglossal nerve- CN XII
Lingual nerve- branch of V3 which supplies sensory innervation to the
tongue and also carries fibers from the facial nerve that return taste info
from the anterior two thirds of the tongue
Submandibular ganglion- one of the 4 parasympathetic ganglia of the head
and neck; innervates submandibular and sublingual glands
Lingual vein- begins at underside of tongue and drains to the internal
jugular vein
Parotid duct- route that the saliva takes from the parotid gland
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Anatomy Practical and Lecture Structure List
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Sublingual glando Artery- sublingual artery (branch of lingual artery of ECA)
o Nerve- submandibular ganglion
Submandibular duct- drains submandibular and sublingual glands
o Where spray of salivary fluid comes from preparing to take first bite
“gleeking”
Gingiva- gums (soft tissue lining the mouth)
Oral mucosa- mucous membrane lining the inside of the mouth
Longus collio Origin- transverse processes of C5-T3
o Insertion- anterior arch or the atlas
o Artery- ascending pharyngeal and vertebral arteries
o Nerve- C2-C6
o Action- flexes the neck and head
Longus capitis
o Origin- anterior tubercles of the transverse processes of 3, 4, 5, and 6
cervical vertebra
o Insertion- basilar part of the occipital bone
o Nerve- C1-C3/C4
o Action- flexion of the neck at the atlanto-occipital joint
Rectus Capitis anterior muscleo Origin- atlas
o Insertion- basilar part of the occipital bone
o Artery- ascending artery
o Nerve- ventral primary rami of spinal nerves C1-2
o Action- flexion of the neck at the atlanto-occipital joint
Rectus capitis lateralis
o Origin- upper surface of the transverse process of the atlas
o Insertion- under surface of the jugular process of the occipital bone
o Nerve- C1, C2
o Action- lateral flexion
Pharyngeal venous plexus- plexus of veins on the outer surface of the
pharynx that ends in the internal jugular vein
Superior thyroid artery- arises from the ECA just below the level of the
greater cornu of the hyoid bone and ends in the thyroid gland
Superior laryngeal artery- source is the superior thyroid artery and pierces
the hyothyroid membrane and supplies larynx
Vertebral artery- arises from the subclavian arteries and enter deep to the
transverse process of C6
Pharyngeal muscles
o Superior constrictor
 Origin- medial pterygoid plate, pterygomandibular raphe,
alveolar
 Insertion- pharyngeal raphe, pharyngeal tubercle
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Anatomy Practical and Lecture Structure List
Artery- ascending pharyngeal artery and tonsillar branch of
facial artery
 Nerve- pharyngeal plexus of vagus nerve
 Action- swallowing
o Middle constrictor
 Origin- hyoid bone
 Insertion- pharyngeal raphe
 Ascending pharyngeal artery
 Pharyngeal plexus of vagus nerve
 Action- swallowing
o Inferior constrictor
 Origin- cricoid and thyroid cartilage
 Insertion- pharyngeal raphe
 Nerve- pharyngeal plexus of vagus nerve
o Stylopharyngeus 3rd pharyngeal arch
 Origin- styloid process
 Insertion- thyroid cartilage
 Nerve- glossopharyngeal nerve
 Action- elevate the larynx and pharynx and swallowing
o Palatopharyngeus
 Origin- palatine aponeurosis and hard palate
 Insertion- upper border of thyroid cartilage
 Artery- facial artery
 Nerve- pharyngeal branch of vagus nerve
 Action- pulls pharynx and larynx upward
o Salpingopharyngeus
 Origin- lower part of the cartilage of the auditory tube
 Insertion- fibers pass down and blend with the
palatopharyngeus muscle to the upper border of the thyroid
cartilage
 Nerve- vagus
 Action- assists in elevating the pharynx and pulls on the torus
tubarius to pressure equalize the middle ear
Superior laryngeal nerve- branch of the vagus nerve and receives a branch
from the superior cervical ganglion of the sympathetic; palsy of this nerve
causes change in pitch of the voice and inability to make explosive sounds
due to paralysis of the cricothyroid muscle; bilateral palsy- tiring and hoarse
voice (injured during thyrectomy); 4th pharyngeal arch
Recurrent laryngeal nerve- branch of the vagus nerve and supplies all the
intrinsic muscles of the larynx with exception of the cricothyroid muscles;
also innervates the posterior cricoarytenoid muscles; 6th pharyngeal arch;
injury to the nerve can result in hoarseness or loss of voice (especially during
thyroid and parathyroid surgery)
Glossopharyngeal nerve- innervates the stylopharyngeus; general sensory
fibers from tonsils, pharynx, and posterior 1/3 of tongue; special sensory
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Anatomy Practical and Lecture Structure List
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(taste) from posterior 1/3 of tongue; visceral sensory fibers from carotid
bodies and sinus; supplies parasympathetic to parotid gland; if severed, will
cause loss of bitter and sour taste and impaired swallowing
Cricoid cartilage- only complete ring of cartilage around the trachea; when
intubating during general anesthesia, the cricoid cartilage is compressed to
compress the esophagus to prevent gastric reflux; cartilage used to locate
placement of emergent endotracheal intubation
o Lamina
o arch
Epiglottis- flap made of elastic cartilage tissue covered with a mucous
membrane and attached to the entrance of the larynx; 4th pharyngeal arch;
functions to protect the glottis during eating and drinking
o Epiglottic cartilageArytenoid cartilage- aid in vocal cord movement: tensed, relaxed, or
approximated; 4th and 6th branchial arches
Cricothyroid joint- joints connecting the cricoid and thyroid cartilages; aids
in changing of pitch of voice
Cricoarytenoid joint- joint connecting the cricoid and arytenoid cartilages
Cricothyroid muscle
o Origin- anterior and lateral cricoid cartilage
o Insertion- inferior cornu and lamina of the thyroid cartilage
o Nerve- external laryngeal branch of vagus
o Action- tension and elongation of the vocal folds
Posterior cricoarytenoid muscle
o Origin- posterior part of the cricoid
o Insertion- muscular process of the arytenoid cartilage
o Nerve- recurrent laryngeal branch of the vagus
o Action- abducts and laterally rotates the cartilage pulling the vocal
ligaments away from the midline, opening the rima glottidis
Lateral cricoarytenoid muscle
o Origin- lateral part of the arch of the cricoid
o Insertion- muscular process of the arytenoid cartilage
o Nerve- recurrent laryngeal branch of the vagus
o Action- adduct and medially rotate the cartilage pulling the vocal
ligaments towards the midline and backwards, closing the rima
glottidis
Arytenoid muscle
o Origin- arytenoid cartilage on one side
o Insertion- arytenoid cartilage on the other side
o Artery- superior laryngeal artery
o Nerve- recurrent laryngeal branch of the vagus
o Action- approximate the arytenoid cartilages (close the rima glottis)
Thyroarytenoid muscle
o Origin- inner surface of thyroid cartilage (anterior aspect)
o Insertion- anterior surface of arytenoid cartilage
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Anatomy Practical and Lecture Structure List
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o Nerve- recurrent laryngeal branch of the vagus
o Action- helps reduce tension on the vocal folds during speech to
decrease pitch
Vocalis muscle
o SAME AS THYROARYTENOID?
Median cricothyroid ligament- anterior part of the cricothyroid ligament;
connects thyroid and cricoid cartilages
Aryepiglottic fold- triangular opening at the entrance of the larynx that is
bound by the epiglottis and arytenoid cartilages and mucous membrane;
used in phonation for a growling sound
Vestibular fold- “false vocal cord”; play a large role in keeping food and
drink out of the airway, breathing, and phonation; used to produce a deep
sonorous tone in phonation; formed by the vestibular ligament extending
from lateral walls of epiglottis to arytenoid cartilage covered with mucous
membrane
Vestibule- portion of the cavity of the larynx above the vocal folds;
Vocal fold- upper free margin of conus elasticus which is covered by mucous
mucous membrane
o Vocal ligament- enclosed within the vocal folds; composed of
intermediate and deep layer of lamina propria
Glottis-“rima glottides”; vocal folds and the opening between them;
Piriform recess- bounded medially by the aryepiglottic fold, laterally by the
thyroid cartilage and thyrohyoid membrane; common place for food to be
trapped; recurrent laryngeal nerve as well as internal laryngeal nerve are
deep to this recess
Inferior laryngeal nerve- terminal branch of the recurrent laryngeal nerve
Superior thyroid artery- arises from ECA just below the level of the greater
cornu of the hyoid and ends in the thyroid gland; must be ligated at the
thyroid when conducting a thyroidectomy
Superior laryngeal artery- branches from the superior thyroid artery near
its bifurcation from the ECA and pierces the hythyroid membrane, and
supplies the muscles, mucous membrane, and glands of the larynx,
anastomosing with the branch from the opposite side
Inferior thyroid artery- arises from the thyrocervical trunk and passes
upward, in front of the vertebral artery and longus colli muscle and turns
medially behind the carotid sheath and its contents and also behind the
sympathetic trunk, the middle cervical ganglion resting upon the vessel; as it
reaches the lower border of the thyroid gland it divides into two branches,
which supply the postero-inferior parts of the gland, and anastomose with
the superior thyroid artery; relationship with RLN is highly variable so it can
be damaged during surgery
Inferior laryngeal artery- ascends on the trachea to the back part of the
larynx under cover of the inferior constrictor in company with the RLN and
supplies the muscles and mucous membrane of this part
Lung fissures
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o Oblique
o Horizontal (right only)
Lung Lobes
o Superior
o Lingula (left only)- part of the superior lobe
o Inferior
o Middle (Right only)
Primary bronchus- left and right branch from the trachea; *right is larger,
so things tend to get stuck there more often
Secondary bronchus- “lobar bronchi” arise from the primary bronchi with
each one serving as the airway to a specific lobe of the lung; 3 in right lung
and 2 in left lung
Tertiary bronchus- “segmental bronchi” arise from the secondary bronchi;
each of these serves a specific bronchopulmonary segment
o Bronchopulmonary segment- 10 in right lung and 8 in left lung;
each have their own artery, thus each bronchopulmonary segment is
supplied by a segmental bronchus and two arteries, a pulmonary
artery and a bronchial artery which run together through the center
of the segment; veins and lymphatic drain along the edges; each
segment is a discrete anatomical and functional unit and so each can
be surgically removed without affecting the function of the other
segments
Pulmonary artery- carries deoxygenated blood from the heart to the lungs;
begins at the base of the right ventricle and branches into two pulmonary
arteries (right and left); pulmonary hypertension and pulmonary embolism
are relevant clinically to this artery; embryology precursor is the truncus
arteriosus
o Secondary branch
o Tertiary branch
Pulmonary Vein- large blood vessel that receives oxygenated blood from the
lungs and drains into the left atrium of the heart; 4 in total (2 from each
lung); drains to the left atrium; sometimes the pulmonary veins drain into
the systemic circulation in whole or in part; this is clinically a problem
o Superior pulmonary vein
o Inferior pulmonary veinBronchial artery- supplies nutrition and oxygenated blood to the lungs;
usually there are 2 that run to the left lung and one to the right lung; left
bronchial arteries usually arise directly from the thoracic aorta; right can
arise from a few different locations; clinical relevance- typically enlarged and
tortuous in chronic pulmonary thromboembolic hypertension, usually not
reconnected following lung transplantation; aneurysms of the bronchial
artery may mimic aortic aneurysms
Cartilage rings of trachea- vary from 16-20 in number; each forming a
semicircular ring of hyaline cartilage which occupies the anterior two-thirds
or so of the circumference of the trachea
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Anatomy Practical and Lecture Structure List
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Trachealis muscle- smooth muscle that bridges the gap between the free
ends of the c-shaped cartilages at the posterior border of the trachea ad
o Nerve- vagus and upper thoracic spinal nerves
o Action- constricts the trachea
Carina- in line with the angle of Louis; lies to the left of midline and is
responsible for the bifurcation of trachea to right and left primary bronchi
Pleura
o Parietal pleura- innervated by intercostal nerves and phrenic
 Costal pleura- portion that lines the inner surfaces of the ribs
and intercostals
 Diaphragmatic pleura- lines the convex surface of the
diaphragm
 Mediastinal pleura- applied to the other thoracic viscera
 Cervical pleura- “pleural cupola” rises into the neck over the
apex of the lung
o Visceral pleura- attached directly to the lungs; derived from
mesoderm; nerve- pulmonary plexus
Pleural cavity- space between parietal and visceral pleura
o Costomediastinal recess- potential space at the border of the
mediastinal pleura and the costal pleura; helps lungs to expand during
deep inspiration
o Costodiaphragmatic recess- potential space in the pleural cavity at
junction of costal and diaphragmatic pleura; lungs expand into this
space during forced inspiration; *pleural effusions collect here when
standing; thoracocentesis is performed here
Hilus of the lung- structures from root of lung enter and leave
Bronchopulmonary lymph node
Pulmonary ligament- the parietal pleura surrounding the root of the lung
extends downward beyond the root of the lung as a fold called the pulmonary
ligament; retains the inferior part of the lung in position
Thoraco-abdominal diaphragm- (thoracic diaphragm)
o Artery- pericardiacophrenic artery; musculophrenic artery; inferior
phrenic arteries
o Vein- superior phrenic vein, inferior phrenic vein
o Nerve- phrenic and lower intercostal nerves
o Embryological precursor- septum transversum, pleuroperitoneal
folds
o Central tendon- thin but strong aponeurosis situated near the center
of the vault formed by the muscle, but somewhat closer to the front
than to the back of the thorax so that the posterior muscular fibers are
longer
o Caval opening- T8 (IVC and right phrenic nerve)
o Esophageal hiatus- T10 (esophagus and ant. And post. vagal trunks)
o Aortic hiatus- T12 (aorta, azygos vein, hemiazygos vein, and thoracic
duct