Muscles of Respiration INHALATION 10 diaphragm external intercostals think about expanding the space 20 SCM scalenes pecminor serratus anterior thoracic EXHALATION 10 none aidedbyphysics think about constricting 20 internalintercostals transversethoracis the thoracic space external internalobliquesrectusabdominis the diaphragm is the primary driver of respiration normal breathing depends only on the diaphragm forced breathingincludes accessory respiratory muscles AZYGOUS SYSTEM guy LYMPHATICS generally speaking most lymphatics are exceptions o right lymphaticductdrains Rhead Rupperlimb Inga É i l longinferior lobe RIL internaljugular and RIL subclavian as they join to form the RIL brachiocephalicAND are the site oflymphatic drainagefrom the rightlymphatic Rvenousangle Venousangles are formedby the and thoracic Lvenous angle ducts my Ty features aorticarch caringsternalangle TRACHEOBRONCHIALTREE ASPIRATION LEFT RIGHT 03x lobes 3 20bronchi 010bronchi n vertical y because of this aspirated substances tendtoendup in the rightlung because gravity of his nx o 2xlobes 2x 20bronchi o 10bronchi n horizontal ÉÉ Éff was upright more likely toaspirate into the R lowerlobe supine more likely to aspirate into the R upper lobe Innervations of the thoracic wall alongs AUTONOMICS SOMATOMOTOR n diaphragm intercostal nn e mm ofthoracic phrenic n cardidchnepostganglionic sympathetic fn bronchodilation vasomotorcontrol secretioninhibition cage vagusn t preganglionicparasympathetic fn bronchoconstriction secretionproduction Leftvagus n t Interiorpulmonaryplexus Rightvagusn Posteriorpulmonaryplexus É mediastinum.IM SUPERIORMEDIASTINUM superiorthymus superiorvenaCava suo LIRbrachiocephalicvu Heavenly brachiocephalictrunk commoncarotid a Lsubclavian a trachea esophagus LIRpericardiacophrenicaa LIRpericardiacophrenicur LIRphrenichn LIRVagusnn ORMEDIASTINUM inferiorthymus lymphnodes adipose Ilinarior gIii Eg MIDDLEMEDIASTINUM pericardium POSTERIORMEDIASTINUM heart LIRpericardiacophrenicaa esophagus LIRpericardiacophrenicvu 10bronchi thoracicaorta azygousv thoracicduct LIRuagusnn LIRthoracicsplanchnican LIRphrenicnn ascending aorta pulmonarytrunk ur pulmonary aa URpulmonaryVu superior inferiorvenacava recurrentlaryngeal n thoracicduct coronaryarteries coronaryveins ligamentumarteriosum arch ofazygous v AUTONOMICS PLEXUSES cardiac parasympathetic sympathetic cardiopulmonaryplexus pulmonary parasympatheticasympathetic esophageal parasympathetic sympathetic sunanse celiacganglion thoracic 1pYahThnicn t5 ta act on foregut snancmicnnTsFdhonnicn tio.t ganghsemiggregiorcervicalaanglion a sf9fhcnnicn t12Jsunanseaaorticorenaigangiion ct onvasculature of the kidney PERICARDIUM visceralpericardiumepicardium directlycovers the heart parietalserouspericardium secretesserousfluidfor lubrication fibrous parietal pericardium physicalprotection 9910 circulation É i i RU Body Body QUADRANTS OF ABDOMEN RUQ.eeobeofliver Klobeofliver spleen gallbladder quo stomach pylorusofstomach jejunum duodenum head pancreas proximalileum body tailofpancreas of rkidney Radrenalgland distalascending or transversecolon ileum cecum veriformappendix proximalascending kidney adrenalgland altransversetsuperior descendingcolon distaldescending sigmoidcolon Lureter Membranousfascia ofabdomen Scarpa's Abdominal muscles external oblique II abdominis proximalRueter UQ abdomen pelvic dartos penis scrotum male labium majus female Colles perineum transverses colon RLQ LV internally oblique Yfminis RECTUSSHEATH rectusabdominism internalobliquem ligament transversus abdominis m ligament IIEI.fi ABDOMEN arcuate line amiaem.iiaam.n transversal'sfascia aimaa susceptibletohernias SCROTUM S'd'Pposet membranous subcutaneoustissue external obliquemuscle fascia internalobliquemuscle µ s subcutaneoustissue Testiclesspermatic cord dartosfascia muscle externalspermatic 1mbar mphNodes fascia scrotum cremastermuscle t surfaces of internal GlansPenist clitoris 7 EEIIIT.tnoTe obliquemuscle transversesabdominis muscle transversalisfascia internalspermatic fascia tunicavaginalis spermaticcord peritoneum CLINICAL CORRELATES HERNIAS indirect lateralto inferiorepigastric a throughdeepinguinalving morecommon in younger people with testicles direct media toinferiorepigastric a morecommon in older people with testicles throughHesselbachistriangle femoral below inguinalligament through femoralcanat EPIPLOIC FORAMEN spacebetweengreater lessersacs morecommon in females Eigg Floor duodenum Posterior NO IIIineranaroamans g arterialsupply at proximal middle T.IEgrgtgIicagttanidaaiga ÉDÉ f É iasmatiathsitppinetiation thoracicduct F cisternachilli greatersplanchnicn celiac I commonhepatica I leftgastrica splenica 1 tyg parasympathetic innervation vagaltrunks AE'S S superior anteriorsuperior PANCREATICODUODENAL É 9 8É lymph is t iasmatiatingippinnisipiritinmetintricganannion superiormesenteric g parasympatheticinnervation vagaltrunks INERSE iiiiiii inferiormesenteric vascularsupply inferiormesenteric a si É ANUS g I outer longitudinal middle circular inner oblique s i i D é I PORTAL LAVAL ANASTOMOSES A esophagealvarices i J i impigastiffrummffaputmedusa perf gg priority hemorrhoids i anatmahithm.it Iiiesaaam sEREsaLAR'S EXTERNA III airxamin strosaharisexter E ht AtIMÉ f h Mi igfiigi.ie MAGNUM je HMM ileum erieatates remove.sn RETROPERITONEAL STRUCTURES INTRAPERITONEAL STRUCTURES majority of duodenum stomach rectum jejunum ileum ascendingcolon descendingcolon kidneys transversecolon sigmoidcolon ureters DIAPHRAGMATIC endsofduodenum anterior inferiorvena cava iOIIIIII posterior MAIL.lkfIIllKKl lateral arcuate arcuate ligament Mgdaindent 11 n leastsplanchnic 1111 4171 lymphvessels AORTICHIATUS thoracicduct azygousV ESOPHAGEALHIATUS esophagus esophageal brr of Lgastrica vagaltrunks anteriorposterior LATERALARNATE LIGAMENT quadratuslumborumm psuprarenal ADRENAL VASCULATURE middle suprarenala .is i I i M BRAHM LIRrenalUV BRANCHINGOFFLEFTRENAL IRlumbarUV I suprarenalV L gonadal u y gonadav Rsuprarenalv R gonadalv SOMATICNN vascularcompression Nutcrackersyndrome ÉSTAN TIL i ai i Medulla sympathetic zonaglomerulosa produces mineralocorticoid 00000 electrolyteregulation Isnt 15 SALT zonafasciculata 00000 produces glucocorticoids SUGAR cortisol glucoseregulation Zona reticulata 00000 É producesandrogens secondarysexhormones É i z Arenalpyramid renalcortex mmmm i SIX minorcalyces Majorcalyces Mureter THORACIC VISCERAL AUTONOMICS Preganglionic arise t th preganglionic sympathetic lateralhorns ganglionic arise cervicalganglia post sympathetic T1 typaravertebralganglia i e sympathetic trunk ateratforntiT4 fumpatheticthyeffector SYMPATHETICFUNITONS iheartrate postganglionic YagaFucleus parasympathetic ui 899nude organ cardiacNn sympathetic Fcontractilestrength parasympathetic Ganglia disceraldandieffector organ Vagalfibers parasympathetic PARASYMPATHETIC Functions theartrate bronchoconstriction Fbronchialsecretions pulmonaryplexi vasoconstriction mixed bronchodilation SPLANCHNICS 5 lumbar eatsiantitentialana jig amoiiatenaiaana.at Fessersmanennion leastsplanchnic n sacral Sacralsplanchnic Sympathetic kidney pelvic Pelvic PREGANGLIONIC greatersplanchnicn foregutadrenalgland lessersplanchnicn midgut least splanchnic n kidney lumbarsplanchnicnn hindgut hypogastricplexi hindgut apelvicviscera sacral splanchnic nn pelvicviscera postaanationic vagaltrunks heart visceralganglia all lungsforegutmidgut visceraof trunk a pelvic pet ganchnienn hindgut SYMPATHETIC TI Tu heartalongs inferiorhypogastricplexus PARASYMPATHETIC preganationic splanchnic Parasympathetic Y mesentericplexus inferior pttInIgasmap.eu exceptkidney postGANGLIONIC cardiac nn heart pulmonaryplexi hearts lungs celiacganglion foregut adrenalgland superiormesentericganglion aorticorenal ganglion midgut renalplexus kidney inferiormesenteric ganglion hindgut hypogastricplexi hindgut a pelvicviscera sacralsplanchnic nn pelvic viscera pelvic foramina pelvis obturator canal obturator n obturatora greatersciaticforamen superiorgluteal in superior topiriformism superiorgluteal a superiorglutealV w sciaticn inferiortopirifoumism inferiorgluteal n inferiorgluteala inferiorglutealu greatersciaticforamen tt KIMY e ii lessersciaticforamen pudendal n m internalpudendalV Pelvic Atteries i i i superficial i artery of vas Obturator Er i si 9 PELVIC SPACES FEMALE retracted Digg Xiong ÉÉÉÉ ÉÉ uterine tube ingamura É fimbriae HEHE io Einsteinatone.to iiiiiiieis centralzone 5 10 ofcancers anteriorfibro muscularzone LYMPHATICS OF THEPERINEUM superficialinguinallymphnodes superficial penislclitoris andscrotum labia majora deepinguinallymph nodes glanspenis glans clitoris labia minora lowervagina pubicsymphysis deepdorsalpenilev dorsalpenile a ROOT i i OF PENS i Bulbospongiosus m 2 MURA 1 BULB Bodyfoldingocessthat Organogenesis transforms the flat bilaminardiscto a tube within a tubestructure tailfolding 406469 layers deep oseptomtransversum DIAPHRAGMATICDEVELOPMENT transversum central tendon muscular pleuroperitoneal membrane bodywall FORLAG t dividebodycavities septum want para part peripheral splanchnopter paraxialmesoderm Dmostaxialbones allskeletalmm intermediate mesoderm Dkidneys lateralplatemesoderm somatopleuret skin appendicularbones splanchnopleuret internalorgans mesenchyme muscular part dorsalmesentery diaphragmatic crura of esophagus caudal É organlinings right atrium auricleisformedfrom Rprimitiveatrium sinusvenarum is formedfrom Rhorn of sinusvenous Priximiate.at vesselscoronamsinusisformedfromLhornof sinusvenosus I t distalleftventricle ÉI'iii I leftventricle auriclesof atria ysinousvenosus HOW left atrium auricle isformedfrom primitiveatrium atrial antrum isformedfrom common steps of CARDIACDEVELOPMENT heartlooping atrial septation ventricularseptation h0hoAt yMMtmayyK fffmumm Feltham v forgings membranous septum tf neuralcrestcells originates Ecc growstowardmuscular serum It muscular septum myocardium growstowardendocardialcushion ventricularseptaldefects common heartdefect Iighentin n'g cooccur with other Fetal Circulation Idf pulmonary bypass foramen ovalis Ratrium DL atrium ductosarteriosistpulmonamankt aorticarch aorta YWY http MM MMMM hepaticbypass ductusvenosuslumbilicalu Dive f BIRTH expansionoflungs w first breathrapidlydecreases pulmonaryvascularresistancewhich closes the rightventricle leftventricle foramenovalis andductus arteriosis FETALCIRCULATIONREMNANTS umbilical v oligamentumteresnepatis ductusvenous 1 ligamentumvenosum foramenovalistfossaovalis ductusarteriosis ligamentumarteriosis umbilicalarteries e medialumbilicalligaments digestive organogenesis dorsalmesogastrium gastro splenicligament 11115111mm ventral rotation1909 of thestomach overstretchesthedorsalmesogastrium Whichdrapesovertheintestines mesogastriumflesseromentumthepatogastrictigatingntoformthegreateromentom hepatoduodenal ligament primitive duodenum falciformligament gallbladder Y dorsalbud ofpancreas bodh tally biliarytree ventralbud ofpancreas headand uncinateprocess pantreas of Umbilicus cranial limb Samatalimb craniallimb distal 000 duodenum mostofileum vitelline 000 caudallimb distalileum duct 000 proximal213Of transversecolon pre rotation i 008,0800in iaoooooo60ca too idea 00000 1st rotation cloaca urogenital Ofgarogfuffff anorectalcanajarneym urinambladder reproductivetract hatins gonadsdevelopfrom the mesonephros Éfyfisinkpiros defaultprogramming median develop 1 I metanephros umbilical ovaries mesonephrieductresolves ligament cloaca paramesonephricducts femalegenitaliaforms malegenitaliaforms paramesonephricduct mesonephrieduct t mesoderm lower 13vagina endoderm KA th 11WKS spongyurethra TDF MIF present testsdevelop mesonephricductdifferentiates paramesonephricductforms paramesonephricductresolve inducesinovaginalbulbs upper'svagina FINAL 3rdrotation 2ndrotation urogenitalsinus 0000000000.0000 idea Wolffianduct Millerianduct at t it 12WKS 14WKS spongyurethra spongyurethra
