I. Ya.
Human
Anatomy Department
Methodical Instructions
for student of the medical faculty
to practical classes on human
anatomy
(Vessels and nerves of
trunk and extremities)
according to the credit-module system
Module 5
of
trunk and extremities
Ternopil
2009
Methodical instructions have been prepared by:
Assoc. Prof. Reminetskyy B.Y.
Theme. Lymphatic
vessels and nodes of abdomen and pelvis. Lumbar part
of sympathetic trunk and abdominal division of vagus. Autonomic
plexus of abdomen. Pelvic part of sympathetic trunk.
Pelvic division of the parasympathetic nervous system. Autonomic plexus of pelvis.
Practical
skills ‘anatomy of vessels and nerves of trunk’
Purpose: To learn the structures of the lymphatics of abdominal region and
pelvis. To learn lumbar part of sympathetic trunk and
abdominal division of vagus, innervation of organs. To
learn peripheral structures of AUTONOMIC NERVOUS SYSTEM, what responsible at
innervation of pelvic viscera.
Professional orientation of students. Knowledge the structure of pelvic sympathetic
and parasympathetic divisions of
the autonomic nervous system is the base for understanding of neurophysiology
and neuropathology of various prlvic organs. Anatomical peculiarities of the
location of central and peripheral parts is necessary for therapeutical and
surgical treatment of pelvic viscera and walls.
Knowledge the structure of lumbar sympathetic
division of the autonomic nervous system is the base for
understanding of neurophysiology and neuropathology. Anatomical peculiarities of the location of central and peripheral
parts is necessary for therapeutical and surgical treatment of abdominal
viscera (oesophagus, lungs and heart) and walls.
The knowledge of regional abdominal
and pelvic lymphatic nodes is important for two reasons:
first is the possibility of forecasting the probability of spreading from
certain lymphatic nodes in case when a tumour or infectious center
are known. And on the contrary, the knowledge of regional lymphatic
nodes allows to find out a unknown place of
localization in case when pathologically changed lymphatic node or group of
nodes have been detected.
Base level of knowledges and abilities.
Latin terminology.
2.
Common data about lymphatic of system.
3.
Location and structure of abdominal and pelvic organs.
I.
Practical
studies – 9:00-11:15 am (3 hours)
Program of self-preparation.
I. Learn the ‘Lymphatics
of abdomen and pelvis” in references and find the plates in ‘Atlas of Human
Anatomy’.
²². Create the graphic charts.
²²². Answer the questions.
Illustrative material.
Demonstration corpse with
dissected retroperitoneal space.
2. Educational corpse.
Method of implementation of practical work.
Work 1. Finding and demonstration
of lymphatic nodes of
the separate groups on the
demonstrative and studying corpses.
Work
2. Dissection of abdominal cavity by method of “ apron".
The lateral cut
on anterior axillary
lines,continue to anterior spina of left and right. Maximum pulling anteriorly
chest wall, cut off sternal and costal parts of diaphragm and round ligament of
liver from it, where up on anterior paries of trunk turn away forward and down,
widely open thoracic and abdominal cavities.
Work
3. Dissection of retroperitoneal space.
Drawing
off a liver upwards and stomach a little down
and to the left, dissect a lesser omentum, dissect a left gastric artery in
gastropancreatic ligament. Find a common
hepatic artery in the hepaticduodenal ligament and dissect its branches.
Dissect gastrocolic ligament. A stomach draw for greate curvature upwards
and dissect splenic artery and vein on the superior edge of pancreas.
Work
4. Dissection of celiac plexus.
Drawing off a liver upwards and stomach a little down and
to the left, dissect a lesser omentum, dissect a left gastric artery in
gastropancreatic ligament. Find a celiac
trunk and celiac plexus in the hepatogastric ligament.
Work
5. Dissection of superior and inferior mesenteric plexuses.
Heave up greater omentum and turn away by its free edge
upwards, opening a middle storey of the peritoneal cavity. Exfoliating and
ablating parietal peritoneum, open abdominal part of aorta and initial parts
of the superior and inferior mesenteric
arteries and same name nervous plexus.
II. Seminar discussion of
practical work 11:45 am – 13:15 pm (2 hours)
List of questions:
1. Where and how is thoracic duct
formed, peculiarities of its topography?
2. What lymphatic trunks fall into thoracic duct?
3. From what sites of a body does thoracic duct collect
lymph?
4. What parietal lymphatic nodes are located in abdomen?
5. What visceral lymphatic nodes are located in abdomen?
6. What group of lymphatic nodes is biggest?
7. Describe location of mesenteric lymphatic nodes?
8. What parietal lymphatic nodes are located in pelvis?
9. What visceral lymphatic nodes are located in pelvis?
10. What vessels and nodes drain the stomach?
11. What vessels and nodes drain the esophagus?
12. What vessels and nodes drain the pancreas?
13. What vessels and nodes drain the jejunum and ileum?
14. What vessels and nodes drain the kidneys?
15. What vessels and nodes drain the liver?
16. What vessels and nodes drain the uterus?
17. What vessels and nodes drain the rectum?
18. Describe lumbar sympathetic ganglia and their
branches.
19. Describe plexuses of abdominal cavity.
20. Where is located and how is formed celiac plexus?
21. What does celiac plexus innervate?
22. What does plexus of abdominal aorta innervate?
23. What do white communicating rami connect?
24. What do grey communicating rami connect?
25. What does pelvic plexuses
innervate?
26. Describe plexuses of pelvic cavity.
27. Describe autonomic innervation of abdominal
organs.
28. Describe autonomic innervation of pelvic organs.
29. What divisions does vagus nerve have?
30. Describe topography of left and right vagus
trunks.
31. What do the branches of vagus form in an abdominal
region?
32. What do the branches of vagus innervate in an
abdominal region?
33. What physiological effect of vagus innervating?
34.
Describe pelvic sympathetic
ganglia and their branches.
35.
What do grey communicating
rami connect?
36.
Describe plexuses of
abdominal cavity.
37.
Where is located and how is
formed celiac plexus?
38.
What does celiac plexus
innervate?
39.
What does superior
mesenteric plexus innervate?
40.
What does abdominal aortal
plexus innervate?
41.
What does inferior
mesenteric plexus innervate?
42.
What do pelvic splanchnic
nerves innervate?
43.
Describe plexuses of pelvic
cavity.
44.
What does inferior
hypogastric plexus innervate?
45.
Describe autonomic innervation
of pelvic organs.
46.
Describe autonomic
innervation of stomach.
47.
Describe autonomic
innervation of small intestine.
48.
Describe autonomic
innervation of large intestine.
49.
Describe autonomic
innervation of large intestine.
²²². Òest
control – 14:15 – 15:00 pm (1 hour)
References: 1. Gray`s Anatomy. Lawrence H.Bannister, MartinM.Berry,
Patricia Collins and others. Churchhill Livingstone, - 1999.
2092 p. 2. W. Kahle, H. Leonhardt, W. Platzer. Colour
atlas and Textbook of Human Anatomy. –