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    Anatomy & Radiology II – Practical – Labs 7,8,9

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    Costal pleura
    What is the highlighted structure?
    Costal pleura
    diaphragmatic pleura
    what is the arrow pointing to?
    diaphragmatic pleura
    #1 mediastinal pleura
#2 cervical pleura
    What is #1?

    What is #2?

    #1 mediastinal pleura
    #2 cervical pleura
    costodiaphragmatic recess
    Where is the probe extending into?
    costodiaphragmatic recess
    pulmonary ligament
    Pinned structure?
    pulmonary ligament
    costal surface of the lung
    What is the probe touching?
    costal surface of the lung
    mediastinal surface of the lung
    What surface of the lung is visualized?
    mediastinal surface of the lung
    apex of the lungs
    The arrows are pointing to the ______
    apex of the lungs
    superior lobe of right lung
    what is the probe pointing to?
    superior lobe of right lung
    middle lobe of right lung
    highlighted structure?
    middle lobe of right lung
    inferior lobe of right lung
    highlighted structure?
    inferior lobe of right lung
    oblique fissure of the right lung = orange line

horizontal fissure of the right lung = red line
    orange line?

    red line?

    oblique fissure of the right lung = orange line

    horizontal fissure of the right lung = red line

    oblique fissure of left lung
    what are the blue arrows pointing to?
    oblique fissure of left lung
    #1-superior lobe of left lung
#2-inferior lobe of left lung
    what are #1 and #2 respectively?
    #1-superior lobe of left lung
    #2-inferior lobe of left lung
    pericardium
    What is the probe touching?
    pericardium
    Which nerve runs anterior to the root of the lung?

    which vessels run anterior to the root of the lung?

    phrenic nerve

    pericardiacophrenic vessels

    phrenic nerves 

innervate diaphragm
    nerves pointed to?
    phrenic nerves

    innervate diaphragm

    pericardiacophrenic vessels
    red arrows are pointing to?
    pericardiacophrenic vessels
    pericardiacophrenic vessels
    red arrows are pointing to?
    pericardiacophrenic vessels
    green line = anterior border of the right lung
red line = inferior border of right lung
blue line = posterior border of right lung
    green line?
    red line?
    blue line?
    green line = anterior border of the right lung
    red line = inferior border of right lung
    blue line = posterior border of right lung
    blue line = anterior border of left lung
red line = inferior border of left lung
green line = posterior border of left lung
    blue line?
    red line?
    green line?
    blue line = anterior border of left lung
    red line = inferior border of left lung
    green line = posterior border of left lung
    cardiac impression of left lung
    blue box?
    cardiac impression of left lung
    cardiac notch of left lung
    highlighted structure?
    cardiac notch of left lung
    cardiac impression of right lung

    key: look for the apex of the lung–> identify impressions from there

    impression for SVC on right lung 
key: look for apex of the lung, identify impressions from there
    blue lines point to?
    impression for SVC on right lung
    key: look for apex of the lung, identify impressions from there
    arch of azygoes vein impression on right lung
    green arrows point to?
    arch of azygoes vein impression on right lung
    lingula of lung
    green circle is around?
    lingula of lung
    green line = posterior border of the left lung
red line = inferior border of the left lung
blue line = anterior border of the left lung
    green line?
    blue line?
    red line?
    green line = posterior border of the left lung
    red line = inferior border of the left lung
    blue line = anterior border of the left lung
    #1- aortic arch impression on left lung

#2- thoracic aorta impression on left lung
    #1?

    #2?

    #1- aortic arch impression on left lung

    #2- thoracic aorta impression on left lung

    primary (main) bronchus
    green?
    primary (main) bronchus
    primary (main) bronchus
    green circle is around?
    primary (main) bronchus
    primary (main) bronchus
    structure?
    primary (main) bronchus
    lobar bronchus (secondary) 

NOTE: be specific about location- superior, middle and inferior bronchus on right lung and superior and inferior bronchus on left lung. they go to the respective lobe
    structures?
    lobar bronchus (secondary)

    NOTE: be specific about location- superior, middle and inferior bronchus on right lung and superior and inferior bronchus on left lung. they go to the respective lobe

    segmental bronchi
    structures?
    segmental bronchi
    red circles = pulmonary arteries; superior and posterior to veins

blue circles = pulmonary veins; inferior and anterior to arteries
    red circles?
    blue circle?
    red circles = pulmonary arteries; superior and posterior to veins

    blue circles = pulmonary veins; inferior and anterior to arteries

    bronchial artery
    orange circle?
    bronchial artery
    blue box = serous pericardium (breaking down the other two boxes)
green box = parietal layer of serous pericardium 
red box = visceral layer of serous pericardium
    blue box?
    green box?
    red box?
    blue box = serous pericardium (breaking down the other two boxes)
    green box = parietal layer of serous pericardium
    red box = visceral layer of serous pericardium
    transverse pericardial sinus
    space where green straw is going through?
    transverse pericardial sinus
    oblique pericardial sinus
    space where fingers are going?
    oblique pericardial sinus
    ascending aorta
    structure?
    ascending aorta
    pulmonary trunk
    structure?
    pulmonary trunk
    SVC
    structure?
    SVC
    IVC
    structure?
    IVC
    brachiocephalic trunk
    structure?
    brachiocephalic trunk
    left brachiocephalic vein
    structure?
    left brachiocephalic vein
    yellow = left brachiocephalic vein
green = right brachiocephalic vein 
purple = SVC
    yellow circle?
    green circle?
    purple circle?
    yellow = left brachiocephalic vein
    green = right brachiocephalic vein
    purple = SVC
    l. and r. IJV = black circles

l. and r. brachiocephalic veins = red circles
    black circles?
    red circles?
    l. and r. IJV = black circles

    l. and r. brachiocephalic veins = red circles

    l. and r. subclavian veins
    green circles?
    l. and r. subclavian veins
    arch of the aorta
    structure?
    arch of the aorta
    yellow box = brachiocephalic trunk
blue box = right common carotid artery
orange box = r. subclavian artery
    yellow box?
    blue box?
    orange box?
    yellow box = brachiocephalic trunk
    blue box = right common carotid artery
    orange box = r. subclavian artery
    ligamentum arteriosum
    structure?
    ligamentum arteriosum
    phrenic nerves
pericardiacophrenic vessels
    nerve structure in this area?
    vessel structure in this area?
    phrenic nerves
    pericardiacophrenic vessels
    left vagus nerve (wraps around aortic arch *anteriorly*; l. recurrent laryngeal emerges posteriorly behind the arch); right vagus nerve simply wraps around subclavian artery
    structure?
    left vagus nerve (wraps around aortic arch *anteriorly*; l. recurrent laryngeal emerges posteriorly behind the arch); right vagus nerve simply wraps around subclavian artery
    left phrenic nerve
    nerve?
    left phrenic nerve
    freebie- left and right recurrent laryngeal nerves
    trachea
    structure?
    trachea
    left primary bronchus
    structure?
    left primary bronchus
    tracheobronchial lymph nodes
    structure on probe tip?
    tracheobronchial lymph nodes
    carina; bifurcation of trachea into left and right primary bronchi
    blue structure?
    carina; bifurcation of trachea into left and right primary bronchi
    orange circle = thoracic aorta
green circle = esophagus
    orange circle?
    green circle?
    orange circle = thoracic aorta
    green circle = esophagus
    anterior esophageal plexus
    structure?
    anterior esophageal plexus
    freebie- anterior vagal trunk, posterior vagal trunk and esophageal plexus
    azygos vein
    structure?
    azygos vein
    thoracic duct
    structure?
    thoracic duct
    accessory hemiazygos
    structure?
    accessory hemiazygos
    orange circle = accessory hemiazygos vein
red circle = hemiazygos vein
    orange circle?
    red circle?
    orange circle = accessory hemiazygos vein
    red circle = hemiazygos vein
    esophageal artery
    artery blue arrow is pointing to?
    esophageal artery
    esophageal arteries
    arteries?
    esophageal arteries
    posterior intercostal arteries
    arteries?
    posterior intercostal arteries
    freebie: right and left bronchial arteries; my guess is more likely to see at hilum of the lung view
    posterior intercostal arteries
    arteries under probe?
    posterior intercostal arteries
    posterior intercostal vein, artery and nerve (VAN) mnemonic
    from superior to inferior you call out the neurovasculature under the probe:
    posterior intercostal vein, artery and nerve (VAN) mnemonic
    greater splanchic nerve
    nerve?
    greater splanchic nerve
    thoracic sympathetic *ganglia* (
    structure?
    thoracic sympathetic *ganglia* (“bulb” of thoracic sympathetic trunk)
    white and gray communicating rami
    structures?
    white and gray communicating rami
    greater splanchnic nerve - formed by contributions from T5-T9 sympathetic ganglia, is the largest and most medial of these three

lesser splanchnic nerve - arises from T10-T11 sympathetic ganglia, is moderate in size and intermediate in position

least splanchnic nerve - arises from the T12 sympathetic ganglion, is the smallest and most lateral of these three
    structures?
    greater splanchnic nerve – formed by contributions from T5-T9 sympathetic ganglia, is the largest and most medial of these three

    lesser splanchnic nerve – arises from T10-T11 sympathetic ganglia, is moderate in size and intermediate in position

    least splanchnic nerve – arises from the T12 sympathetic ganglion, is the smallest and most lateral of these three

    crista terminalis
    pinned structure?
    crista terminalis
    right atrium
    structure?
    right atrium
    left border of the heart
    border?
    left border of the heart
    right border of the heart
    border?
    right border of the heart
    freebie: left, right and inferior borders of the heart
    .
    #1-right ventricle
#2-left ventricle
    grey box/#1?

    white box/#2?

    #1-right ventricle
    #2-left ventricle
    left auricle
    structure?
    left auricle
    right pulmonary surface of the heart = purple
left pulmonary surface of the heart = green
    purple arrow points to?

    green arrow points to?

    right pulmonary surface of the heart = purple
    left pulmonary surface of the heart = green
    left pulmonary artery
(right pulmonary artery passes inferior to aortic arch)
    structure?
    left pulmonary artery
    (right pulmonary artery passes inferior to aortic arch)
    opening of the IVC
    structure?
    opening of the IVC
    right ventricle
    structure?
    right ventricle
    right pulmonary veins 
(indicate superior/inferior)
    structures?
    right pulmonary veins
    (indicate superior/inferior)
    left pulmonary veins 
(indicate superior/inferior)
    structures?
    left pulmonary veins
    (indicate superior/inferior)
    opening of the IVC
    structure?
    opening of the IVC
    coronary sinus
    structure?
    coronary sinus
    anterior inter ventricular septum
    structure?
    anterior inter ventricular septum
    apex of the heart
    structure?
    apex of the heart
    coronary sulcus
    structure?
    coronary sulcus
    ligamentum arteriosum
    structure?
    ligamentum arteriosum
    posterior interventricular sulcus 
between left and right ventricles on diaphragmatic surface
    structure?
    posterior interventricular sulcus
    between left and right ventricles on diaphragmatic surface
    right auricle of the heart
    structure?
    right auricle of the heart
    great cardiac vein
    vein?
    great cardiac vein
    middle cardiac vein in 
in posterior interventricular sulcus
    vein?
    middle cardiac vein in
    in posterior interventricular sulcus
    small cardiac vein
    vein?
    small cardiac vein
    RCA
    artery?
    RCA
    freebie – sinoatrial nodal artery and right marginal artery
    posteiror interventricular artery = red
small cardiac vein = yellow
middle cardiac vein = green
    red? (artery)
    yellow? (vein)
    green? (vein)
    posteiror interventricular artery = red
    small cardiac vein = yellow
    middle cardiac vein = green
    freebie:
    left anterior descending
    artery?
    left anterior descending
    diagonal branch of LAD
    artery?
    diagonal branch of LAD
    circumflex artery
    artery?
    circumflex artery
    posterior interventricular artery
    artery?
    posterior interventricular artery
    left marginal artery
    artery?
    left marginal artery
    crista terminalis of right atrium
    structure hidden by box?
    crista terminalis of right atrium
    freebie: opening of SVC
    opening of IVC
    pectinate muscles
    pinned structure?
    pectinate muscles
    freebie: you see a flap of tissue over the opening of the IVC. structure?
    valve of the IVC
    opening of the coronary sinus;
it is anterior and adjacent to opening of the IVC
    white box covers?
    opening of the coronary sinus;
    it is anterior and adjacent to opening of the IVC
    interatrial septum
    tag?
    interatrial septum
    white box = fossa ovalis

green arrows = limbus fossa ovalis
    what structure is concealed by the white box? What are the arrows pointing to (two answers)
    white box = fossa ovalis

    green arrows = limbus fossa ovalis

    *muscular* interventricular septum
    tag?
    *muscular* interventricular septum
    conus arteriosus of right ventricle
    tag?
    conus arteriosus of right ventricle
    anterior and posterior pulmonary cusps
    tag?
    anterior and posterior pulmonary cusps
    *muscular* interventricular septum
    structure?
    *muscular* interventricular septum
    *membranous* interventricular septum
    structure in green circle?
    *membranous* interventricular septum
    trabeculae carneae of the left ventricle
    structures of left ventricle?
    trabeculae carneae of the left ventricle
    moderator band of right ventricle
    structure?
    moderator band of right ventricle
    phrenic nerve, pericardiacophrenic artery and vein
    what nerve would you expect to find here?
    what artery and vein would you expect to find here?
    phrenic nerve, pericardiacophrenic artery and vein
    opening of the inferior vena cava
    what is found at the location outlined in red?
    opening of the inferior vena cava
    diaphragmatic surface of the heart-
    must see in lab
    base of the heart
    what view of the heart are we visualizing?
    base of the heart
    sternocostal surface of the heart
    Which surface of the heart are we primarily visualizing?
    sternocostal surface of the heart
    blue circle = right pulmonary artery
red circle = left pulmonary artery
    blue circle?
    red circle?
    blue circle = right pulmonary artery
    red circle = left pulmonary artery
    #1-posterior cardiac vein
#2- middle cardiac vein
    #1?
    #2?
    #1-posterior cardiac vein
    #2- middle cardiac vein
    right marginal artery
    ?
    right marginal artery
    posterior descending artery (posterior interventricular artery), middle cardiac vein
    artery here?
    vein here?
    posterior descending artery (posterior interventricular artery), middle cardiac vein
    #1- left coronary artery
#2- left marginal artery
    #1
    #2
    #1- left coronary artery
    #2- left marginal artery
    #1-right superior pulmonary vein
#2-right inferior pulmonary vein
#3-left superior pulmonary vein
#4-left inferior pulmonary vein
    #1
    #2
    #3
    #4
    #1-right superior pulmonary vein
    #2-right inferior pulmonary vein
    #3-left superior pulmonary vein
    #4-left inferior pulmonary vein
    SVC opening anterior to aorta; use that as landmark

#1- SVC
#2- aorta
#3- pulmonary trunk
    #1
    #2
    #3
    SVC opening anterior to aorta; use that as landmark

    #1- SVC
    #2- aorta
    #3- pulmonary trunk

    opening and valve of coronary sinus
    #1?
    opening and valve of coronary sinus
    anterior cusp of tricuspid valve-must see in lab; anterior chorda tendinae – must see in lab
    anterior papillary muscle – must see in lab
    septal cusp of tricuspid valve – must see in lab
    septal chordae tendinae – must see in lab
    septal papillary muscle – must see in lab
    posterior cusp of tricuspid valve – must see in lab
    posterior chordae tendinae – must see in lab
    posterior papillary muscle – must see in lab
    trabeculae carnae of right ventricle
    probe is touching?
    trabeculae carnae of right ventricle
    conus arteriosus of right ventricle
    #1?
    conus arteriosus of right ventricle
    pulmonary valve of:
    – anterior cusp of pulmonary semilunar valve
    >nodule of anterior cusp of pulmonary semilunar valve
    >lunule of anterior cusp of pulmonary semilunar valve

    -right/left cusp of pulmonary semilunar valve
    >nodule of right/left cusp of pulmonary semilunar valve
    >lunule of right/left cusp of pulmonary semilunar valve

    nodule of anterior cusp of pulmonary semilunar valve
    lunule of anterior cusp of pulmonary semilunar valve
    -valve of foramen ovale>must see on cadaver
    pectinate muscles of left ventricle
    >must see on cadaver
    anterior cusp of mitral valve
    > anterior cordae tendinae of mitral valve
    >anterior papillary muscle of mitral valve
    posterior cusp of mitral valve
    >posterior chordae tendinae of mitral valve
    >posterior papillary muscle of mitral valve
    trabeculae carnae of the left ventricle
    >rough inner surface of left ventricular wall
    >must see on cadaver
    -posterior cusp of aortic semilunar valve
    >nodule of posterior cusp of aortic semilunar valve
    >lunule of..
    sinus of..
    – right/left cusp of aortic semilunar valve
    >nodule of..
    lunule of..
    sinus of..

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