Visceral anatomy - Clinical Notes

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created 6 years ago by parn94
Clinical Notes from ANAT3007
updated 6 years ago by parn94
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Lecture 4 - The Heat

Artificial Cardiac Pacemakers

Used to correct heartbeat irregularities

  • tachycardia
  • bradycardia
  • irregular beat
  • long qt

Implanted between the skin and the pectoralis muscle just underneath the clavicle

Transmits low energy electrical pulses to correct to normal rhythm

Leads are threaded through R.subclavian to the heart


Lecture 5 - Arteries of the trunk

Coronary Artery Bypass Surgery

Occurs when a vein or artery from another region of the body is used to bypass a blocked coronary artery (when a stent is not an option)

  • commonly the internal thoracic, internal mammary artery, radial artery or greater or lesser saphenous veins
    • Veins are sutured in the opposite direction so the valves stay open

The original artery is left in place while the new artery is looped over the old

Collaterals can increase in size to take over the role of the internal thoracic when it has been removed

  • Lateral thoracic
  • Thoracoacromial
  • Intercostal

Lecture 6 - Veins of the trunk

Umbilical Vein

Umbilical vein carries nutrients and oxygenated blood from the placenta to the fetus

2x umbilical arteries return deoxygenated blood to the the placenta

Forms during 4-8th week of gestation

  • Week 5 - blood flow established
  • Week 6 - R.umbilical vein obliterated

Passes along falciform lig. to liver to communicate with L.hepatic vein which either goes into the liver of the ductus venosis --> IVC --> RA

Blood passes RA --> LA via foramen ovale

Blood pass L.pulmonary artery --> aorta via ductus arterioles


Lecture 1 - Anterolateral thoracic wall and breast

"Slipped disc" - Spinal disc herniation or prolapse

Tear occurs in the annulus fibrosis

  • Most commonly posterolaterally

The nucleus pulpous bulges our and can cause pressure on adjacent spinal nerves

Ages and trauma are the most common predisposing factors

Most likely to occur in the lumbar region > cervical > thoracic

Treatment: anti-inflammatory medications, exercise, spinal manipulation and surgery is possible


Lecture 3 - Posterior abdominal walls and Internal divisions of the trunk

Diaphragmatic hernias

Occur when a weakness, deficiency or injury results in protrusion of organs into the thoracic cavity

Hiatus hernia - terminal oesophagus, cardia and fundus protrusion

  • Results from heavy lifting, constant coughing, constipation as they increase abdominal pressure
  • May be symptomless or may cause reflux, digestive discomfort, oesophageal stricture, heart palpitations (due to effect on vagus)
  • Treatment: surgery

Congenital diaphragmatic hernia - Failure of diaphragm fusing to abdominal wall --> intestinal and liver protrusion into thoracic cavity

  • Failure of 1 of the 3 horizontal tissue folds to fuse
  • Improper lung development - pulmonary hypoplasia
  • Decreased blood flow through lungs - pulmonary hypertension
  • Treatment: surgery

Iatrogenic hernia - results from surgery


Lecture 7 - Lymphatic system

Vasa vasorum

Vaso vasorum can become congested in infection which leads to reddish streaks visible on the skin


Lecture 7 - Lymphatic system


Cause: protein retention in the CT (high molecular weight) when they are not readily absorbed into capillaries

Associated with long term inflammation, CT and immune changes

Treatment: compression garments, exercises, manual lymph drainage, liposuction, vascular lymph node transfer (transplanting some superficial inguinal lymph nodes to the axilla)


Lecture 7 - Lymphatic system

Additional connections of lymph vessels into the venous system

Extent and location is highly variable

Important if usual lymph channels are blocks and in the spread of malignancy or infection


Lecture 7 - Lymphatic system




Lecture 7 - Lymphatic system

Sentinal lymph nodes

Important in tumours as the sentinal node is the first location that it will likely spread to

Tumour cells are labelled with a coloured/radioactive dye before removal so as in a later examination the sentinal node can be examined to determine if spread has occurred


Lecture 8 - Respiratory system


Air in the pleural cavity from the lung collapsing

Causes: broken rib, surgery, blunt or penetrating chest injury, chronic obstructive pulmonary disease, cystic fibrosis, pneumonia

Symptom: chest pain and shortness of breath

Treatment: surgery, insertion of a chest tube, observation if minor


Lecture 9 - Alimentary 1


Pathological attachment of one organ or structure to another

  • Damage to mesothelium results in fibrin clot formation which can adhere to other surfaces
  • Clot should be broken down by fibrolysin
  • Can become a scaffold for vessels, cells and nerves to grow
  • Grater omentum involved in 90% of peritoneal adhesions

Lecture 10 - Alimentary 2

Ileal (Meckels) Diverticulum

Out pocketing of the distal ileum - congenital, embryonic remnant of yolk duct which passes from mid gut into umbilical cord

Antimesometrial side (opposite mesentary), may be free or attached to anterior wall

Symptoms: If inflamed it can mimmic appendicitis, if attached can result in torsion of the bowel


Lecture 10 - Alimentary 2

Phrenicocolic ligament

Directs fluid away from splenorenal recess


Lecture 10 - Alimentary 2

Umbilical hernia

Abdominal contents (SI or greater omentum) push through a weakness in the vicinity of the umbilicus