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the fibers of the external oblique muscle run downward and forward (as in inserting a hand in a pocket),
whereas those of the internal oblique muscle go upward and forward
5-4 The superficial inguinal ring is a
divergence of fibers (crura) of the external oblique aponeurosis. It
lies about 1 cm above and lateral to the pubic tubercle and can be
palpated by invaginating the scrotal skin upward along the spermatic
cord. An inguinal hernia, especially when indirect (i.e., traversing
the inguinal canal), may present through the superficial inguinal ring.
he inguinal triangle is bounded by
the inferior epigastric artery, the lateral border of the rectus, and
the inguinal ligament. A direct inguinal hernia enters the inguinal
canal through the inguinal triangle. Excess fluid within the peritoneal
cavity (ascites) may be removed (tapped), after the bladder has been
emptied, by inserting a cannula immediately lateral to the rectus well
above (and hence lateral to the termination of) the inferior epigastric
artery (see fig. 25-9).
21-3 The right main bronchus is shorter,
wider, and more nearly vertical than the left, and it is more likely to
receive foreign objects.
The cupola is the cervical parietal
pleura superior to the apex of the lung.
In inspiration, the diaphragm
contracts, descends, increases the volume and decreases the pressure
within the thorax, and increases the abdominal pressure. The diaphragm
is lower when a subject is in the sitting posture than when in the
erect posture, and patients with difficulty in breathing are more
comfortable when sitting.
20-2 What is the vertebrocostal trigone?
20-2 The vertebrocostal trigone is a
variable interval between the costal and lumbar parts of the diaphragm.
The pleura may then be in close relationship to the suprarenal gland
he serous membranes line the body
cavities and are reflected over protruding organs as their serous coat.
The serous membranes are the pleura, pericardium, and peritoneum. The
tunica vaginalis testis is a (usually) detached extension of the
peritoneum. Serous membranes consist of mesothelium and connective
tissue, and they secrete a film of serous exudate.
Pneumothorax is the presence of air in
the pleural cavity. Air may enter from the lung (e.g., from ruptured
alveoli) or through the chest wall (e.g., from a perforating injury).
The lung then collapses.
The right lung is usually heavier,
shorter, and wider than the left lung, and it generally has three
rather than two lobes.
What is the inferior limit of the
lung and pleura?
22-5 The lung and pleura are generally said
to cross rib 6 in the midclavicular line and ribs 8 and 10,
respectively, in the midaxillary line and then to proceed toward the
spinous processes of T10 and T12 vertebrae, respectively.
What is a bronchopulmonary segment?
22-7 A bronchopulmonary segment is the
portion of lung supplied by a third-order bronchus.
What are the classic methods of
22-9 The classic methods of physical
examination are inspection, palpation, percussion, and auscultation.
The stethoscope was invented for auscultation by Laennec in 1816.
What is the transverse sinus of the
23-1 The transverse sinus of the
pericardium is a passage between the venous end (left atrium and
superior vena cava) of the heart behind and the arterial end (aorta and
pulmonary trunk) in front
In which direction does blood flow
from the atria to the ventricles?
23-3 Blood flows from the atria to the
ventricles almost horizontally forward (see fig. 23-3) and
to the left, especially in the "right heart."
What is the main component of the
sternocostal surface of the heart?
23-4 The sternocostal surface of the heart
is formed mainly by the right ventricle. The chamber least visible from
the front is the left atrium, of which only the left auricle can be
what is the outflowing part of (a)
the right ventricle and (b) the left ventricle termed?
23-7 The conus arteriosus (or infundibulum)
is the outflowing part of the right ventricle. The left ventricle ends
in the aortic vestibule.
Which important structure is situated
at the lower border of the membranous part of the interventricular
23-8 The atrioventricular bundle is
situated at the lower border of the membranous part of the
interventricular septum. The bundle divides, and its limbs straddle the
muscular part of the septum.
he right free border of the lesser omentum
contains the bile duct, portal vein, and hepatic artery.
How is the liver divided into right
and left anatomical lobes?
28-1 The liver is divided into right and
left anatomical lobes along the left limb of the "H" formed at the
porta (see fig. 28-2) and, anteriorly, along the falciform
ligament. The much larger right lobe includes the caudate and quadrate
lobes. The porta is the "gate" of the liver, and the "vein of the gate"
is termed portal.
here is the portal vein formed?
28-10 The portal vein is formed posterior
to the neck of the pancreas by the union of the splenic and superior
mesenteric veins (see fig. 28-8). Portal hypertension (caused by obstruction)
results in dilation of portal-systemic anastomoses, e.g., at the lower
end of the esophagus. Uncontrolled hemorrhage from esophageal varices
can be treated by a portal-systemic shunt, e.g., by anastomosing the
portal vein with the inferior vena cava (portacaval anastomosis).