DOCSLIB.ORG

Clinical Anatomy Applied Anatomy for Students and Junior Doctors

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Clinical Anatomy Applied Anatomy for Students and Junior Doctors Clinical Anatomy Applied anatomy for students and junior doctors Harold Ellis ELEVENTH EDITION ECAPR 7/18/06 6:33 PM Page i Clinical Anatomy ECAPR 7/18/06 6:33 PM Page ii To my wife and late parents ECAPR 7/18/06 6:33 PM Page iii Clinical Anatomy A revision and applied anatomy for clinical students HAROLD◊ELLIS CBE, MA, DM, MCh, FRCS, FRCP, FRCOG, FACS (Hon) Clinical Anatomist, Guy’s, King’s and St Thomas’ School of Biomedical Sciences; Emeritus Professor of Surgery, Charing Cross and Westminster Medical School, London; Formerly Examiner in Anatomy, Primary FRCS (Eng) ELEVENTH EDITION ECAPR 7/18/06 6:33 PM Page iv © 2006 Harold Ellis Published by Blackwell Publishing Ltd Blackwell Publishing, Inc., 350 Main Street, Malden, Massachusetts 02148-5020, USA Blackwell Publishing Ltd, 9600 Garsington Road, Oxford OX4 2DQ, UK Blackwell Publishing Asia Pty Ltd, 550 Swanston Street, Carlton, Victoria 3053, Australia The right of the Author to be identified as the Author of this Work has been asserted in accordance with the Copyright, Designs and Patents Act 1988. All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, except as permitted by the UK Copyright, Designs and Patents Act 1988, without the prior permission of the publisher. First published 1960 Seventh edition 1983 Second edition 1962 Revised reprint 1986 Reprinted 1963 Eighth edition 1992 Third edition 1966 Ninth edition 1992 Fourth edition 1969 Reprinted 2000 Fifth edition 1971 Tenth edition 2002 Sixth edition 1977 Reprinted 2003, 2004 Reprinted 1978, 1980 Greek edition 1969 Eleventh edition 2006 1 2006 Library of Congress Cataloging-in-Publication Data Data available ISBN-13: 978-1-4051-3804-8 ISBN-10: 1-4051-3804-1 A catalogue record for this title is available from the British Library Set in 9/12 Palatino by SNP Best-set Typesetter Ltd., Hong Kong Printed and bound in India by Replika Press Pvt Ltd Commissioning Editor: Martin Sugden Editorial Assistant: Ellie Bonnett Development Editor: Mirjana Misina Production Controller: Kate Charman For further information on Blackwell Publishing, visit our website: http://www.blackwellpublishing.com The publisher’s policy is to use permanent paper from mills that operate a sustainable forestry policy, and which has been manufactured from pulp processed using acid-free and elementary chlorine-free practices. Furthermore, the publisher ensures that the text paper and cover board used have met acceptable environmental accreditation standards. Blackwell Publishing makes no representation, express or implied, that the drug dosages in this book are correct. Readers must therefore always check that any product mentioned in this publication is used in accordance with the prescribing information prepared by the manufacturers. The author and the publishers do not accept responsibility or legal liability for any errors in the text or for the misuse or misapplication of material in this book. ECAPR 7/18/06 6:34 PM Page v Contents Preface, xiii Acknowledgements, xiv Part 1:◊The Thorax Surface anatomy and surface markings, 3 ◊◊Surface markings of the more important thoracic contents, 3 The thoracic cage, 7 ◊◊The thoracic vertebrae, 7 ◊◊The ribs, 7 ◊◊The costal cartilages, 10 ◊◊The sternum, 11 ◊◊The intercostal spaces, 11 ◊◊The diaphragm, 14 ◊◊The pleurae, 18 The lower respiratory tract, 19 ◊◊The trachea, 19 ◊◊The bronchi, 23 ◊◊The lungs, 23 The mediastinum, 28 ◊◊The pericardium, 28 ◊◊The heart, 29 ◊◊The superior mediastinum, 42 ◊◊The oesophagus, 42 ◊◊The thoracic duct, 45 ◊◊The thoracic sympathetic trunk, 47 On the examination of a chest radiograph, 49 ◊◊Radiographic appearance of the heart, 50 Part 2:◊The Abdomen and Pelvis Surface anatomy and surface markings, 55 ◊◊Vertebral levels, 55 ◊◊Surface markings, 55 The fasciae and muscles of the abdominal wall, 58 ◊◊Fasciae of the abdominal wall, 58 ◊◊The muscles of the anterior abdominal wall, 58 ECAPR 7/18/06 6:34 PM Page vi vi Contents ◊◊The anatomy of abdominal incisions, 61 ◊◊The inguinal canal, 63 Peritoneal cavity, 65 ◊◊Intraperitoneal fossae, 68 ◊◊The subphrenic spaces, 69 The gastrointestinal tract, 70 ◊◊The stomach, 70 ◊◊The duodenum, 75 ◊◊Small intestine, 77 ◊◊Large intestine, 78 ◊◊The appendix, 79 ◊◊The rectum, 81 ◊◊Arterial supply of the intestine, 86 ◊◊The portal system of veins, 87 ◊◊Lymph drainage of the intestine, 88 ◊◊The structure of the alimentary canal, 88 ◊◊The development of the intestine and its congenital abnormalities, 90 The gastrointestinal adnexae: liver, gall-bladder and its ducts, pancreas and spleen, 93 ◊◊The liver, 93 ◊◊The biliary system, 98 ◊◊The gall-bladder, 99 ◊◊The pancreas, 101 ◊◊The spleen, 104 The urinary tract, 105 ◊◊The kidneys, 105 ◊◊The ureter, 109 ◊◊The embryology and congenital abnormalities of the kidney and ureter, 110 ◊◊The bladder, 112 ◊◊The urethra, 115 The male genital organs, 116 ◊◊The prostate, 116 ◊◊The scrotum, 119 ◊◊Testis and epididymis, 119 ◊◊Vas deferens (ductus deferens), 123 ◊◊The seminal vesicles, 124 The bony and ligamentous pelvis, 124 ◊◊The os innominatum, 124 ◊◊The sacrum, 125 ◊◊The coccyx, 126 ◊◊The functions of the pelvis, 126 ECAPR 7/18/06 6:34 PM Page vii Contents vii ◊◊Joints and ligamentous connections of the pelvis, 127 ◊◊Differences between the male and female pelvis, 128 ◊◊Obstetrical pelvic measurements, 128 ◊◊Variations of the pelvic shape, 130 The muscles of the pelvic floor and perineum, 132 ◊◊The anterior (urogenital) perineum, 133 ◊◊The posterior (anal) perineum, 134 The female genital organs, 136 ◊◊The vulva, 136 ◊◊The vagina, 137 ◊◊The uterus, 139 ◊◊The Fallopian tubes, 144 ◊◊The ovary, 145 ◊◊The endopelvic fascia and the pelvic ligaments, 146 ◊◊Vaginal examination, 147 ◊◊Embryology of the Fallopian tubes, uterus and vagina, 148 The posterior abdominal wall, 149 ◊◊The suprarenal glands, 151 ◊◊Abdominal aorta, 151 ◊◊Inferior vena cava, 153 ◊◊Lumbar sympathetic chain, 153 Part 3:◊The Upper Limb The female breast, 159 ◊◊Structure, 159 ◊◊Blood supply, 159 ◊◊Lymphatic drainage, 159 ◊◊Development, 161 Surface anatomy and surface markings of the upper limb, 162 ◊◊Bones and joints, 163 ◊◊Muscles and tendons, 164 ◊◊Vessels, 166 ◊◊Nerves, 167 The bones and joints of the upper limb, 168 ◊◊The scapula, 168 ◊◊The clavicle, 168 ◊◊The humerus, 169 ◊◊The radius and ulna, 171 ◊◊The bones of the hand, 174 ◊◊The shoulder, 176 ◊◊The elbow joints, 180 ECAPR 7/18/06 6:34 PM Page viii viii Contents ◊◊The wrist joint, 183 ◊◊The joints of the hand, 184 The arteries of the upper limb, 186 ◊◊The axillary artery, 186 ◊◊The brachial artery, 187 ◊◊The radial artery, 187 ◊◊The ulnar artery, 188 The brachial plexus, 189 ◊◊The segmental cutaneous supply of the upper limb, 191 The course and distribution of the principal nerves of the upper limb, 191 ◊◊The axillary nerve, 191 ◊◊The radial nerve, 192 ◊◊Branches, 194 ◊◊The musculocutaneous nerve, 194 ◊◊The ulnar nerve, 194 ◊◊The median nerve, 195 The anatomy of upper limb deformities, 197 The spaces of the hand, 200 ◊◊The superficial pulp space of the fingers, 200 ◊◊The ulnar and radial bursae and the synovial tendon sheaths of the fingers, 201 Part 4:◊The Lower Limb The anatomy and surface markings of the lower limb, 207 ◊◊Bones and joints, 207 ◊◊Bursae of the lower limb, 207 ◊◊Mensuration in the lower limb, 208 ◊◊Muscles and tendons, 211 ◊◊Vessels, 211 ◊◊Nerves, 214 The bones and joints of the lower limb, 216 ◊◊The os innominatum, 216 ◊◊The femur, 216 ◊◊The patella, 220 ◊◊The tibia, 223 ◊◊The fibula, 224 ◊◊A note on growing ends and nutrient foramina in the long bones, 225 ◊◊The bones of the foot, 225 ◊◊The hip, 226 ECAPR 7/18/06 6:34 PM Page ix Contents ix ◊◊The knee joint, 229 ◊◊The tibiofibular joints, 233 ◊◊The ankle, 233 ◊◊The joints of the foot, 234 ◊◊The arches of the foot, 235 ◊◊The anatomy of walking, 237 Three important zones of the lower limb— the femoral triangle, adductor canal and popliteal fossa, 237 ◊◊The femoral triangle, 237 ◊◊The fascia lata, 238 ◊◊The femoral sheath and femoral canal, 238 ◊◊Femoral hernia, 239 ◊◊The lymph nodes of the groin and the lymphatic drainage of the lower limb, 241 ◊◊The adductor canal (of Hunter) or subsartorial canal, 242 ◊◊The popliteal fossa, 242 The arteries of the lower limb, 244 ◊◊Femoral artery, 244 ◊◊Popliteal artery, 246 ◊◊Posterior tibial artery, 246 ◊◊Anterior tibial artery, 246 The veins of the lower limb, 247 ◊◊Clinical features, 249 The course and distribution of the principal nerves of the lower limb, 249 ◊◊The lumbar plexus, 250 ◊◊The sacral plexus, 251 ◊◊The sciatic nerve, 253 ◊◊The tibial nerve, 255 ◊◊The common peroneal (fibular) nerve, 255 ◊◊Segmental cutaneous supply of the lower limb, 256 Part 5:◊The Head and Neck The surface anatomy of the neck, 261 ◊◊The fascial compartments of the neck, 262 The thyroid gland, 264 ◊◊The parathyroid glands, 267 The palate, 270 ◊◊The development of the face, lips and palate with special reference to their congenital deformities, 270 ECAPR 7/18/06 6:34 PM Page x x Contents The tongue and floor of the mouth, 272 ◊◊The tongue, 272 ◊◊The floor of the mouth, 276 The pharynx, 277 ◊◊The nasopharynx, 277 ◊◊The oropharynx, 278 ◊◊The palatine tonsils, 279 ◊◊The laryngopharynx, 280 ◊◊The mechanism of deglutition, 282 The larynx, 284 ◊◊Blood supply, 287 ◊◊Lymph drainage, 287 ◊◊Nerve supply, 288 The salivary glands, 289 ◊◊The parotid gland, 289 ◊◊The submandibular gland, 292 ◊◊The sublingual gland, 293 The major arteries of the head and neck, 294 ◊◊The common carotid
Load more

Recommended publications
  • Te2, Part Iii
    TERMINOLOGIA EMBRYOLOGICA Second Edition International Embryological Terminology FIPAT The Federative International Programme for Anatomical Terminology A programme of the International Federation of Associations of Anatomists (IFAA) TE2, PART III Contents Caput V: Organogenesis Chapter 5: Organogenesis (continued) Systema respiratorium Respiratory system Systema urinarium Urinary system Systemata genitalia Genital systems Coeloma Coelom Glandulae endocrinae Endocrine glands Systema cardiovasculare Cardiovascular system Systema lymphoideum Lymphoid system Bibliographic Reference Citation: FIPAT. Terminologia Embryologica. 2nd ed. FIPAT.library.dal.ca. Federative International Programme for Anatomical Terminology, February 2017 Published pending approval by the General Assembly at the next Congress of IFAA (2019) Creative Commons License: The publication of Terminologia Embryologica is under a Creative Commons Attribution-NoDerivatives 4.0 International (CC BY-ND 4.0) license The individual terms in this terminology are within the public domain. Statements about terms being part of this international standard terminology should use the above bibliographic reference to cite this terminology. The unaltered PDF files of this terminology may be freely copied and distributed by users. IFAA member societies are authorized to publish translations of this terminology. Authors of other works that might be considered derivative should write to the Chair of FIPAT for permission to publish a derivative work. Caput V: ORGANOGENESIS Chapter 5: ORGANOGENESIS
    [Show full text]
  • Laparoscopic Extraperitoneal Salpingo-Oophorectomy in Women with Suspicious Ovarian Mass, a Way to Reduce the Risk of Spillage
    5 Surgical Technique Page 1 of 5 Laparoscopic extraperitoneal salpingo-oophorectomy in women with suspicious ovarian mass, a way to reduce the risk of spillage Giulio Sozzi, Giulia Zaccaria, Mariano Catello Di Donna, Giuseppina Lo Balbo, Stefania Cannarozzo, Vito Chiantera Department of Gynecologic Oncology, University of Palermo, Piazza Nicola Leotta, Palermo, Italy Correspondence to: Giulio Sozzi, MD. Department of Gynecologic Oncology, University of Palermo, Piazza Nicola Leotta 4, 90127 Palermo, Italy. Email: [email protected]. Abstract: The objective of the present paper is to provide a step by step description of the laparoscopic extraperitoneal salpingo-oophorectomy, a surgical technique useful to reduce the risk of spillage in women with suspected ovarian masses. The patient was a 52-year-old woman with sonographic diagnosis of a multilocular, 5 cm lesion, with Color Score 3 at right ovary. Computed tomography (CT) scan excluded any other localization of disease. Tumor markers were negative, except for Ca 19.9 that was 85 IU/mL. Preliminary diagnostic laparoscopy was performed and peritoneal carcinomatosis was excluded. In order to obtain a histological diagnosis, an extraperitoneal right salpingo-oophorectomy was performed. At frozen section analysis it was diagnosed an ovarian adenocarcinoma. Therefore, a laparoscopic complete surgical staging including total hysterectomy, controlateral salpingo-oophorectomy, infracolic omentectomy, multiple peritoneal biopsies, and pelvic and para-aortic lymphadenectomy, was performed. Operative time was 240 minutes and estimated blood loss was about 50 mL. No intra or post-operative complications were observed, and the patient was discharged 3 days after surgery. Final histology showed the presence of clear cell high grade carcinoma in both ovaries without fallopian tubes infiltration.
    [Show full text]
  • Chapter 28 *Lecture Powepoint
    Chapter 28 *Lecture PowePoint The Female Reproductive System *See separate FlexArt PowerPoint slides for all figures and tables preinserted into PowerPoint without notes. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Introduction • The female reproductive system is more complex than the male system because it serves more purposes – Produces and delivers gametes – Provides nutrition and safe harbor for fetal development – Gives birth – Nourishes infant • Female system is more cyclic, and the hormones are secreted in a more complex sequence than the relatively steady secretion in the male 28-2 Sexual Differentiation • The two sexes indistinguishable for first 8 to 10 weeks of development • Female reproductive tract develops from the paramesonephric ducts – Not because of the positive action of any hormone – Because of the absence of testosterone and müllerian-inhibiting factor (MIF) 28-3 Reproductive Anatomy • Expected Learning Outcomes – Describe the structure of the ovary – Trace the female reproductive tract and describe the gross anatomy and histology of each organ – Identify the ligaments that support the female reproductive organs – Describe the blood supply to the female reproductive tract – Identify the external genitalia of the female – Describe the structure of the nonlactating breast 28-4 Sexual Differentiation • Without testosterone: – Causes mesonephric ducts to degenerate – Genital tubercle becomes the glans clitoris – Urogenital folds become the labia minora – Labioscrotal folds
    [Show full text]
  • METHODICAL GUIDANCE for the Lecture Academic Subject Human
    Ministry of Public Health of Ukraine Ukrainian Medical Stomatological Academy "Approved" at the meeting of the Department of Human Anatomy «29» 08 2020 Minutes № Head of the Department Professor O.O. Sherstjuk ________________________ METHODICAL GUIDANCE for the lecture Academic subject Human Anatomy Module No 3 "The heart. Vessels and nerves of the head, the neck, the trunk, extremities" Lecture No 15 Review of the autonomic nervous system, its central departments. The principles of the autonomic innervation of the organs Year of study ІI Faculty Foreign students' training faculty, specialty «Medicine» Number of 2 academic hours Poltava – 2020 1. Educational basis of the topic The autonomic division of peripheral nervous system regulates physiological processes of the human organism like blood circulation, respiration, digestion, excretion and general metabolism; also, it regulates tissue trophic processes. The autonomic division acts relatively independently from the cerebral cortex and the organs supplied act involuntarily as well. It is quite clear that that distinguishing of the somatic and the autonomic compartments is conditional and exact delimitation is not possible. Such impossibility appears due to common regulatory centers for both divisions and tight morphological and functional associations featured by them. The somatic neurons and the interneurons of PNS like those of CNS feature topographical and synaptic associations so a reflex arc may comprise both somatic (e.g. afferent) and autonomic neurons. Summarizing the aforesaid, the term ’autonomic nervous system’ will be applied to a specific compartment of PNS but not for a separate nervous system. 2. Learning objectives of the lecture: . to familiarize students with the autonomic division of CNS; .
    [Show full text]
  • Human Physiology/The Male Reproductive System 1 Human Physiology/The Male Reproductive System
    Human Physiology/The male reproductive system 1 Human Physiology/The male reproductive system ← The endocrine system — Human Physiology — The female reproductive system → Homeostasis — Cells — Integumentary — Nervous — Senses — Muscular — Blood — Cardiovascular — Immune — Urinary — Respiratory — Gastrointestinal — Nutrition — Endocrine — Reproduction (male) — Reproduction (female) — Pregnancy — Genetics — Development — Answers Introduction In simple terms, reproduction is the process by which organisms create descendants. This miracle is a characteristic that all living things have in common and sets them apart from nonliving things. But even though the reproductive system is essential to keeping a species alive, it is not essential to keeping an individual alive. In human reproduction, two kinds of sex cells or gametes are involved. Sperm, the male gamete, and an egg or ovum, the female gamete must meet in the female reproductive system to create a new individual. For reproduction to occur, both the female and male reproductive systems are essential. While both the female and male reproductive systems are involved with producing, nourishing and transporting either the egg or sperm, they are different in shape and structure. The male has reproductive organs, or genitals, that are both inside and outside the pelvis, while the female has reproductive organs entirely within the pelvis. The male reproductive system consists of the testes and a series of ducts and glands. Sperm are produced in the testes and are transported through the reproductive ducts. These ducts include the epididymis, ductus deferens, ejaculatory duct and urethra. The reproductive glands produce secretions that become part of semen, the fluid that is ejaculated from the urethra. These glands include the seminal vesicles, prostate gland, and bulbourethral glands.
    [Show full text]
  • The Cyclist's Vulva
    The Cyclist’s Vulva Dr. Chimsom T. Oleka, MD FACOG Board Certified OBGYN Fellowship Trained Pediatric and Adolescent Gynecologist National Medical Network –USOPC Houston, TX DEPARTMENT NAME DISCLOSURES None [email protected] DEPARTMENT NAME PRONOUNS The use of “female” and “woman” in this talk, as well as in the highlighted studies refer to cis gender females with vulvas DEPARTMENT NAME GOALS To highlight an issue To discuss why this issue matters To inspire future research and exploration To normalize the conversation DEPARTMENT NAME The consensus is that when you first start cycling on your good‐as‐new, unbruised foof, it is going to hurt. After a “breaking‐in” period, the pain‐to‐numbness ratio becomes favourable. As long as you protect against infection, wear padded shorts with a generous layer of chamois cream, no underwear and make regular offerings to the ingrown hair goddess, things are manageable. This is wrong. Hannah Dines British T2 trike rider who competed at the 2016 Summer Paralympics DEPARTMENT NAME MY INTRODUCTION TO CYCLING Childhood Adolescence Adult Life DEPARTMENT NAME THE CYCLIST’S VULVA The Issue Vulva Anatomy Vulva Trauma Prevention DEPARTMENT NAME CYCLING HAS POSITIVE BENEFITS Popular Means of Exercise Has gained popularity among Ideal nonimpact women in the past aerobic exercise decade Increases Lowers all cause cardiorespiratory mortality risks fitness DEPARTMENT NAME Hermans TJN, Wijn RPWF, Winkens B, et al. Urogenital and Sexual complaints in female club cyclists‐a cross‐sectional study. J Sex Med 2016 CYCLING ALSO PREDISPOSES TO VULVAR TRAUMA • Significant decreases in pudendal nerve sensory function in women cyclists • Similar to men, women cyclists suffer from compression injuries that compromise normal function of the main neurovascular bundle of the vulva • Buller et al.
    [Show full text]
  • Gross Anatomy
    www.BookOfLinks.com THE BIG PICTURE GROSS ANATOMY www.BookOfLinks.com Notice Medicine is an ever-changing science. As new research and clinical experience broaden our knowledge, changes in treatment and drug therapy are required. The authors and the publisher of this work have checked with sources believed to be reliable in their efforts to provide information that is complete and generally in accord with the standards accepted at the time of publication. However, in view of the possibility of human error or changes in medical sciences, neither the authors nor the publisher nor any other party who has been involved in the preparation or publication of this work warrants that the information contained herein is in every respect accurate or complete, and they disclaim all responsibility for any errors or omissions or for the results obtained from use of the information contained in this work. Readers are encouraged to confirm the infor- mation contained herein with other sources. For example and in particular, readers are advised to check the product information sheet included in the package of each drug they plan to administer to be certain that the information contained in this work is accurate and that changes have not been made in the recommended dose or in the contraindications for administration. This recommendation is of particular importance in connection with new or infrequently used drugs. www.BookOfLinks.com THE BIG PICTURE GROSS ANATOMY David A. Morton, PhD Associate Professor Anatomy Director Department of Neurobiology and Anatomy University of Utah School of Medicine Salt Lake City, Utah K. Bo Foreman, PhD, PT Assistant Professor Anatomy Director University of Utah College of Health Salt Lake City, Utah Kurt H.
    [Show full text]
  • Autonomic Nervous System
    AUTONOMIC NERVOUS SYSTEM PAGE 1 AUTONOMIC NERVOUS SYSTEM PAGE 2 AUTONOMIC NERVOUS SYSTEM PAGE 3 AUTONOMIC NERVOUS SYSTEM PAGE 4 AUTONOMIC NERVOUS SYSTEM PAGE 5 AUTONOMIC NERVOUS SYSTEM PAGE 6 AUTONOMIC NERVOUS SYSTEM PAGE 7 AUTONOMIC NERVOUS SYSTEM PAGE 8 AUTONOMIC NERVOUS SYSTEM PAGE 9 REVIEW QUESTIONS 1. The autonomic nervous system controls the activity of _?_. (a) smooth muscle (b) cardiac muscle (c) glands (d) all of these (e) none of these 2. All preganglionic and postganglionic autonomic neurons are _?_ neurons. (a) somatic efferent (b) visceral efferent (c) somatic afferent (d) visceral afferent (e) association neurons 3. Which neurotransmitter is released at the synapses between preganglionic and postganglionic autonomic neurons ? (a) epinephrine (b) norepinephrine (c) acetylcholine (d) serotonin (e) oxytocin 4. All preganglionic sympathetic neurons are located in: (a) the lateral horn of the spinal cord of spinal cord segments T1-L2 (b) brainstem nuclei (c) intramural (terminal) ganglia (d) paravertebral ganglia of the sympathetic chains (e) prevertebral ganglia 5. All preganglionic parasympathetic neurons are located in _?_. (a) prevertebral ganglia (b) the lateral horn of spinal cord segments T1-L2 (c) sympathetic chain ganglia (d) intramural ganglia (e) brainstem nuclei and spinal cord segments S2-S4 6. Prevertebral and paravertebral ganglia contain _?_. (a) preganglionic sympathetic neurons (b) preganglionic parasympathetic neurons (c) postganglionic sympathetic neurons (d) postganglionic parasympathetic neurons (e) all of these 7. The otic, ciliary, submandibular and pterygopalatine ganglia are located in the head region and contain _?_. (a) preganglionic sympathetic neurons (b) preganglionic parasympathetic neurons (c) postganglionic sympathetic neurons (d) postganglionic parasympathetic neurons (e) none of these 8.
    [Show full text]
  • The Evolving Cardiac Lymphatic Vasculature in Development, Repair and Regeneration
    REVIEWS The evolving cardiac lymphatic vasculature in development, repair and regeneration Konstantinos Klaourakis 1,2, Joaquim M. Vieira 1,2,3 ✉ and Paul R. Riley 1,2,3 ✉ Abstract | The lymphatic vasculature has an essential role in maintaining normal fluid balance in tissues and modulating the inflammatory response to injury or pathogens. Disruption of normal development or function of lymphatic vessels can have severe consequences. In the heart, reduced lymphatic function can lead to myocardial oedema and persistent inflammation. Macrophages, which are phagocytic cells of the innate immune system, contribute to cardiac development and to fibrotic repair and regeneration of cardiac tissue after myocardial infarction. In this Review, we discuss the cardiac lymphatic vasculature with a focus on developments over the past 5 years arising from the study of mammalian and zebrafish model organisms. In addition, we examine the interplay between the cardiac lymphatics and macrophages during fibrotic repair and regeneration after myocardial infarction. Finally, we discuss the therapeutic potential of targeting the cardiac lymphatic network to regulate immune cell content and alleviate inflammation in patients with ischaemic heart disease. The circulatory system of vertebrates is composed of two after MI. In this Review, we summarize the current complementary vasculatures, the blood and lymphatic knowledge on the development, structure and function vascular systems1. The blood vasculature is a closed sys- of the cardiac lymphatic vasculature, with an emphasis tem responsible for transporting gases, fluids, nutrients, on breakthroughs over the past 5 years in the study of metabolites and cells to the tissues2. This extravasation of cardiac lymphatic heterogeneity in mice and zebrafish.
    [Show full text]
  • Female Perineum Doctors Notes Notes/Extra Explanation Please View Our Editing File Before Studying This Lecture to Check for Any Changes
    Color Code Important Female Perineum Doctors Notes Notes/Extra explanation Please view our Editing File before studying this lecture to check for any changes. Objectives At the end of the lecture, the student should be able to describe the: ✓ Boundaries of the perineum. ✓ Division of perineum into two triangles. ✓ Boundaries & Contents of anal & urogenital triangles. ✓ Lower part of Anal canal. ✓ Boundaries & contents of Ischiorectal fossa. ✓ Innervation, Blood supply and lymphatic drainage of perineum. Lecture Outline ‰ Introduction: • The trunk is divided into 4 main cavities: thoracic, abdominal, pelvic, and perineal. (see image 1) • The pelvis has an inlet and an outlet. (see image 2) The lowest part of the pelvic outlet is the perineum. • The perineum is separated from the pelvic cavity superiorly by the pelvic floor. • The pelvic floor or pelvic diaphragm is composed of muscle fibers of the levator ani, the coccygeus muscle, and associated connective tissue. (see image 3) We will talk about them more in the next lecture. Image (1) Image (2) Image (3) Note: this image is seen from ABOVE Perineum (In this lecture the boundaries and relations are important) o Perineum is the region of the body below the pelvic diaphragm (The outlet of the pelvis) o It is a diamond shaped area between the thighs. Boundaries: (these are the external or surface boundaries) Anteriorly Laterally Posteriorly Medial surfaces of Intergluteal folds Mons pubis the thighs or cleft Contents: 1. Lower ends of urethra, vagina & anal canal 2. External genitalia 3. Perineal body & Anococcygeal body Extra (we will now talk about these in the next slides) Perineum Extra explanation: The perineal body is an irregular Perineal body fibromuscular mass.
    [Show full text]
  • Scrotal Ultrasound
    Scrotal Ultrasound Bruce R. Gilbert, MD, PhD Associate Clinical Professor of Urology & Reproductive Medicine Weill Cornell Medical College Director, Reproductive and Sexual Medicine Smith Institute For Urology North Shore LIJ Health System 1 Developmental Anatomy" Testis and Kidney Hindgut Allantois In the 3-week-old embryo the Primordial primordial germ cells in the wall of germ cells the yolk sac close to the attachment of the allantois migrate along the Heart wall of the hindgut and the dorsal Genital Ridge mesentery into the genital ridge. Yolk Sac Hindgut At 5-weeks the two excretory organs the pronephros and mesonephros systems regress Primordial Pronephric system leaving only the mesonephric duct. germ cells (regressing) Mesonephric The metanephros (adult kidney) system forms from the metanephric (regressing) diverticulum (ureteric bud) and metanephric mass of mesoderm. The ureteric bud develops as a dorsal bud of the mesonephric duct Cloaca near its insertion into the cloaca. Mesonephric Duct Mesonephric Duct Ureteric Bud Ureteric Bud Metanephric system Metanephric system 2 Developmental Anatomy" Wolffian and Mullerian DuctMesonephric Duct Under the influence of SRY, cells in the primitive sex cords differentiate into Sertoli cells forming the testis cords during week 7. Gonads Mesonephros It is at puberty that these testis cords (in Paramesonephric association with germ cells) undergo (Mullerian) Duct canalization into seminiferous tubules. Mesonephric (Wolffian) Duct At 7 weeks the indifferent embryo also has two parallel pairs of genital ducts: the Mesonephric (Wolffian) and the Paramesonephric (Mullerian) ducts. Bladder Bladder Mullerian By week 8 the developing fetal testis tubercle produces at least two hormones: Metanephros 1. A glycoprotein (MIS) produced by the Ureter Uterovaginal fetal Sertoli cells (in response to SRY) primordium Rectum which suppresses unilateral development of the Paramesonephric (Mullerian) duct 2.
    [Show full text]
  • Head & Neck Surgery Course
    Head & Neck Surgery Course Parapharyngeal space: surgical anatomy Dr Pierfrancesco PELLICCIA Pr Benjamin LALLEMANT Service ORL et CMF CHU de Nîmes CH de Arles Introduction • Potential deep neck space • Shaped as an inverted pyramid • Base of the pyramid: skull base • Apex of the pyramid: greater cornu of the hyoid bone Introduction • 2 compartments – Prestyloid – Poststyloid Anatomy: boundaries • Superior: small portion of temporal bone • Inferior: junction of the posterior belly of the digastric and the hyoid bone Anatomy: boundaries Anatomy: boundaries • Posterior: deep fascia and paravertebral muscle • Anterior: pterygomandibular raphe and medial pterygoid muscle fascia Anatomy: boundaries • Medial: pharynx (pharyngobasilar fascia, pharyngeal wall, buccopharyngeal fascia) • Lateral: superficial layer of deep fascia • Medial pterygoid muscle fascia • Mandibular ramus • Retromandibular portion of the deep lobe of the parotid gland • Posterior belly of digastric muscle • 2 ligaments – Sphenomandibular ligament – Stylomandibular ligament Aponeurosis and ligaments Aponeurosis and ligaments • Stylopharyngeal aponeurosis: separates parapharyngeal spaces to two compartments: – Prestyloid – Poststyloid • Cloison sagittale: separates parapharyngeal and retropharyngeal space Aponeurosis and ligaments Stylopharyngeal aponeurosis Muscles stylohyoidien Stylopharyngeal , And styloglossus muscles Prestyloid compartment Contents: – Retromandibular portion of the deep lobe of the parotid gland – Minor or ectopic salivary gland – CN V branch to tensor
    [Show full text]