I. General questions of meteorology. History of Medicine.

1. The subject of anatomy, its place in a number of biological disciplines.

The importance of anatomy for medicine.
Human anatomy is the science of the origin and development, forms and structure of the human body.
Anatomy studies the external forms and proportions of the human body and its parts, individual
organs, instructions, microscopic structure. The tasks of anatomy include the study of the main
stages of human development in the process of evolution, the characteristics of the structure of the
body and individual organs at different age periods, the formation of the human body in the external
environment.

Modern science examines the structure of the human body from the standpoint of dialectical
materialism. Human anatomy should be studied taking into account the functions of each organ and
organ system. "Form and function are mutually conditional." The features of the shape, structure of
the human body cannot be understood without analyzing the functions, just as it is impossible to
imagine the features of the function of any organ without understanding its structure. The human
body consists of a large number of organs of a huge number of cells, but this is not the sum of
separate parts, but a unit of a folded living organism. Therefore, it is impossible to consider organs
without interconnection with each other, without the unifying role of the nervous and vascular systems.

The importance of anatomy in the system of medical education is undeniable. Professor of Moscow
University E.O. Mukhin (1766-1850) wrote that "a doctor who is not an anatomist is not only not useful,
but also harmful." Having poor knowledge of the structure of the human body, the doctor, instead of
benefit, can harm the patient. That is why, before starting to comprehend clinical disciplines, it is
necessary to study anatomy. Anatomy and physiology are the foundation of medical education,
medical science. “ Without anatomy, there is no therapy or surgery, but only signs and prejudices” -
wrote the famous obstetrician A.P. Gubarev (1855-1931)

2.Methods of anatomical research

The main methods of anatomical research are observation, examination of the body, dissection, as
well as observation, study of an individual organ or a group of organs (macroscopic anatomy), their
internal structure (microscopic anatomy).

Macroscopic anatomy (from the Greek makros - large) studies the structure of the body, individual
organs and their parts at levels accessible to the naked eye, or with the help of devices that give a
small increase (magnifying glass). Microscopic anatomy (from the Greek mikros-small) studies the
structure of organs using a microscope. With the advent of microscopes, histology (from the Greek
HistosTissue) - the study of tissues and cytology (from the Greek Kytos - cell) - the science of the
structure and functions of the cell, stood out from anatomy.

Anatomy makes extensive use of modern technical research tools. The structure of the skeleton,
internal organs, the location and appearance of blood and lymphatic vessels is learned using X-rays.

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The internal integuments of many hollow organs are examined (in the clinic) by endoscopy methods.
Anthropometric methods are used to study the external forms and proportions of the human body.

3. The contribution of Abuali ibni Sino to the development of medicine.

One of the contributions of Abuali ibn Sino is his work entitled "The Canon of Medicine." This book is
an encyclopedia of medical knowledge. This book consists of several parts in which it is written about
the introduction of anatomy and physiology, causes of diseases, symptoms of diseases, diet,
preventive medicine, about simple and complex medicines, diseases of the head, neck, eyes, larynx
and certain other organs, diagnosis and treatment, about surgery. dislocations, fractures, tumors,
purulent inflammation, etc.

4. Stages of human ontogenesis.

Ontogenesis is the development of the human body from the moment of fertilization to death.
Ontogenesis is divided into 2 periods:
1. intrauterine period (from the Latin word prenatal) ontogenesis is the development of the human
body from the moment of fertilization to birth. This period is divided into 9 months. Prenatal
ontogenesis is divided into 2 periods:
a) the development of the embryo (embryonic development) up to 3 months, ie the development of
the embryo-embryo b) the development of the fetus from 3 months to 9 months.
2. Extrauterine (from the Latin word postnatal) ontogenesis is the development of the human body
from the moment of birth to death.

5. Constitutional types. Body types.

The human constitution is a set of individual morphological and functional characteristics of an
organism, which have developed on the basis of hereditary and acquired properties and determine its
reactivity. Human bodies are divided in shape into 3 types of physique:
1.Dolichomorphic body type (from Lat. Dolichos-long), that is, these people have a narrow and long
chest, short shoulders, upper and lower limbs are long. This type is called the asthenic type.
2. Brachymorphic type (from Lat. Brachius - short) that is, these people have a short and wide chest,
broad shoulders, and short upper and lower limbs. They are called hypersthenics.
3. Mesamorphic body type (from Lat. Mezo - medium), ie these people have a medium chest, medium
shoulders, upper and lower limbs are medium - they are called normosthenics.

6. Areas of the abdomen

Holotopy is the location of organs in relation to the abdominal region or in relation to the abdominal
cavities. The abdominal cavity is conventionally divided into 9 areas. These areas are conditionally
formed due to 4 lines that are drawn along the front wall of the abdomen: 1.the upper horizontal line -
10 ribs are drawn

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2. lower horizontal line - drawn along the anterior upper iliac spines (spina iliaca anterior superior).
Two horizontal lines of the abdominal cavity are divided into 3 large areas: a) epigastric (region
epigastrum)
b) celiac (regio mesogastrium)
c) hypogastric (region hypogastrium)
Two conditional vertical lines (right and left) Drawn along the lateral edges of the rectus abdominis
muscles (musculus rectus abdominis) These three areas are divided into 9 areas: 1.the right
hypochondrica region (region hypochondrica dextra) the liver is located here
2. Own epigastric region (region epigastrum propria) There is a stomach
3.the left hypochondric region (region hypochondrica sinistra) the spleen is located here
4. The right mesogastric region (region mesogastrium dextra) here is the ascending colonic intestine
5. The umbilical region (region umblicalis) is the small intestine, on the upper part of the transverse
colon and pancreas.
6.Left mesagastric region (region mesogasrium sinistra) Here is the descending rimocum 7.Right
inguinal region (region inguinalis dextra) here is the cecum and appendix
8. The pubic region (region pubis) is where the bladder, uterus and rectum are located.
9.Left inguinal region (region inguinalis sinistra) is the sigmoid colon.

7.General structure of the skeleton

The skeleton (skeleton) forms a solid base of the body. Its composition includes about 208-210 bones,
of which 33-34 are unpaired, and the rest are paired: 29 bones form the skull, 26-vertebral column,
25-ribs and sternum, 64-form skeleton of the upper and 62-skeleton of the lower limbs. The mass of
the dry skeleton is 5-6 kg, which is 8-10% of the total body weight. The human skeleton is classified:
1.skeleton of the head - refers to the bones of the skull
2.skeleton of the trunk - vertebrae, ribs, sternum
3.skeleton of the shoulder-girdle include the scapula and clavicle
4.skeleton of the free upper limb - include the humerus and radius, ulna and bones of the hand
5.the bones of the pelvic girdle - include the bones of the pelvis and sacrum
6. Bones of the free lower limb - include the femur, small and tibia and foot bones.

8.The concept of skeletotopy, syntopy and holotopy

Skeletotopy - This is the location of internal organs in relation to the skeleton. For example: The
kidneys are located along the lateral surfaces of the spinal column at the level of the XII thoracic - III
lumbar vertebrae.
Syntopy is the location of internal organs in relation to neighboring organs. For example: stomach
syntopy: the liver is on the right, the spleen is on the left, the diaphragm is on top, and the pancreas is
below. Holotopy is the relationship of the internal organs in relation to the abdomen. Eg: holotopy of
the liver - the liver is located in the right hypochondrium.

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 II.Anatomy of the musculoskeletal system
1. Bones: classification, structure and function.
Bone (os) Refers to bone tissue. The collection of over 200 different bones forms the skeleton.

Classification: bones are divided into 6 groups in shape:

1.tubular bones: divided into long and short-humerus, radius, ulna, hand, femur, small and tibia and foot bones

2.flat bones-bones of the skull roof, scapula, pelvic bone

3.spongy bones: long-sternum, ribs, clavicle and short-bones of the wrist and bones of the foot

4.Air bones - which have a cavity called sinuses that communicate with the cavity of the nose and participate
in the act of breathing

5.Mixed bone-vertebrae

6.sosomoid bones - which develop inside the tendon and muscle (patella and pisiform bone, calyx)

Structure.The bone of an adult person is met with a compact (forms the diaphysis of tubular bones, in the
form of a thin plate covers the outside and the epiphyses) and a spongy substance (built of bone plates
with cells between them)

Function: protective, supporting, depot of mineral salts and vitamins

2. The structure of tubular and flat bones. Periosteum

The structure of the tubular bones: the tubular bone has a body called the diaphysis and has 2 ends called the
pineal gland. Between the diaphysis and the pineal gland there is a metaphysis due to which the bone
develops in length. Therefore, the metaphysis is called the bone growth zone. Tubular bones also consist of 2
substances: external solid and internal cancellous substances.

The structure of flat bones: flat bones have a double structure, i.e. they have 2 layers of solid, an outer and an
inner solid. Between them, a spongy substance is found, compared to the outside, thin fragile ones often
break.

The periosteum (periosteum) is a connective tissue membrane that is tightly fused with the bone due to
connective tissue fibers penetrating deep into the bone.

3 chemical composition of bones

The living bone of an adult contains 50% water, 15.75% fat, 12.4% ossein (collagen fibers), 21.85% inorganic
substances. Inorganic substances are represented by various salts. Most of all contains lime phosphate -
60%, lime carbonate - 5.9%, magnesium sulfate - 1.4%. In addition, the bones contain representatives of all
earthly elements. Mineral salts dissolve easily in a weak solution of hydrochloric or nitric acid. This process is
called decalcification. After such processing, only organic matter remains in the bones, which retains the
shape of the bone. It is porous and elastic like a sponge. When organic matter is removed by burning, the

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bone also retains its original shape, but becomes fragile and easily crumbles. Only the combination of organic
and inorganic substances makes the bone firm and elastic.

4. Vertebrae: their structure in different parts of the spine

Vertebrae (vertebre) - number 33-34. All these vertebrae are connected to each other to form a vertebral
column (columna vertebralis). The vertebral column is divided into 5 parts:

1. cervical part (pars cervicalis) - 7 cervical vertebrae

2. chest (pars thoracica) - 12 thoracic vertebrae 3. lumbar part

(Pars lumbalis) - 5 lumbar vertebrae

4.sacral part (Pars sacralis) - 5 sacral vertebrae.

5.coccygeal part (pars coccygeus) - 3-5 coccygeal vertebrae

Structure: Each vertebra, except for the first cervical, has a body, arches and processes. The cervical
vertebrae have a body, 2 transverse, 1 -spinous, 2costal processes. The second cervical vertebra has a tooth.
The thoracic vertebrae have a body, transverse and spinous processes. The lumbar vertebrae have an
accessory process. The sacrum consists of 5 fused bones. The coccyx is formed by the fusion of 2-4
coccygeal vertebrae.

5. Rib, sternum, collarbone and scapula

Ribs(costae) 1-12 / seven pairs of upper ribs (1-7) are connected with cartilaginous parts to the sternum.
These ribs are called true (costae verae). Cartilage 8,9,10 pairs of ribs are connected not with the sternum, but
with the cartilage of the overlying rib. Therefore, these ribs are called false ribs (costae spuriae), 11-12 ribs
have short cartilaginous parts that end in the muscles of the abdominal wall. Each rib has a head (caput), an
articular surface (facies articularis), a neck (collum), a body (corpus)

Sternum(sternum) - This is a flat bone to which the ribs are attached to the left and right. The sternum
consists of three parts. Its upper part is the handle of the sternum, the middle part is the body, the lower part
is the xiphoid process. In adults, all these three bones are fused into a single bone.

Sternum handle (manubrium sterni) - the widest, especially from above, toast part of the hudin. On the upper
edge of it there is a shallow jugular notch (incisura jugularis). On the sides of the notch there is a clavicular
notch (Incisura clavicularis) for connection with the clavicle.

Sternum body (corpus sterni) - the longest part of the sternum, in the middle and lower parts of the body of
the sternum is wider than at the top. On the front surface of the body, rough lines are noticeable (places of
fusion of bone segments), on the edges of the body there are costal incisions (incisura costalis) to form
connections with the cartilage of the true ribs.

Xiphoid process(processus xiphoideus), can have a different shape, sometimes it is bifurcated from top to
bottom or has a hole.

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Scapula (scapula) a flat triangular bone. The scapula has a lower, lateral, upper angle (angulus) and three
edges: medial, lateral, upper. There is a notch of the scapula at the upper edge. The rib surface forms a
subscapular fossa (fossa subcapularis) /

Collarbone (clavicula) curved tubular bone, which is located between the acromion of the scapula and the
clavicular notch of the sternum. Allocate the body (corpus), acromial and sternal ends (extremitas acromialis
et extremitas sternalis)

6 upper limb bones

The bones of the upper limb (ossa membri superioris) are subdivided into the bones of the girdle of the upper
limbs, which is connected to the skeleton of the trunk, and the free part of the upper limb.

Upper Limb Belt (cingulu embri superioris) consists of the clavicle and scapula.

The free part of the upper limb (pars libera membri superioris) has three sections:

1.proximalhumerus (humerus)

2.medium bones of the forearm: radius (radius) and ulnar (ulna)

3.distalbones of the hand: bones of the wrist (ossa carpi), metacarpus (ossa metacarpi), phalanges of the
fingers (Phalanges digitorium) The humerus is a long tubular bone. The body of the humerus and two ends:
the upper and lower ends. The upper end forms the head of the humerus (caput humeri) .Anatomical neck
(collum anatomicum) runs along the edge of the head. Immediately behind the anatomical neck, there are
two large and small tubercles. The narrowest place between the head of the humerus and its body is called
the collum chirurgicum. The humerus has three surfaces: posterior, medial anterior, lateral anterior.

Elbow bone- its proximal end is thickened and has a block-shaped notch (incisura trochlearis) facing forward
for connection with the humerus block and it is bounded from below by the coronoid process (processus
coronoideus) from above to the olecranon process (olecranon) .Side this notch there is a radial notch
(incisura radialis) , the junction with the head of the radius. Below the coronoid process, a tuberosity is
located in front.

Radius- at its proskal end there is a head, with a flat articular fossa (fovea articularis) for articulation with the
head of the condyle of the humerus, and the surface articulating with the treatment notch of the ulna is called
the articular circle. The head below passes into the neck, and below the neck there is tuberosity. On the
medial side of the distal end of the radius there is an ulnar notch, and on the lateral side there is a styloid
process (processus styloideus).

Ossa manus hand bones- subdivided into the bones of the wrist, metacarpus and phalanges of the fingers.

Wrist - has 8 short bones arranged in two rows: 1 row (scaphoid (os scaphoideum), lunar (lunatum), triangular
(triquetrum), pea-shaped (risiforme)). 2 row (bone-trapezium-os trapezium, trapezoidal (trapezoideum)
(capitatum), hook-shaped (hamatum)).

Pastern- consists of five short tubular bones, each of which contains a head, base, and body. Bones of the
fingers of the hand - at the hand, the shortest and thickest thumb (digitus primus), the index finger (index),

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middle finger (digitus medius), unnamed finger (digitus annularis), little finger (dig.minimus). IN
composition of all fingers Besides the first distinguish three phalanges:
proximal, middle, distal. Each of the phalanges contains a body, base, and head.

7 pelvic bone
The os coxae pelvic bone is formed after the fusion of three bones: the iliac, pubic, sedation.

The bodies of these three bones form the acetabulum for the femoral head.

The ilium (os ilium) has a body and wing (alla ossis ilei). The wing at the top forms a wide iliac crest (crista
iliaca). On the iliac crest it has three lines (lips): outer, inner and intermediate line (linea intermedia). the
muscles of the abdomen stick to the lips. This bone, thanks to the ear-shaped surface (facies auricularis),
connects to the sacrum.

The pubic bone (os pubis) It has a body and two branches. The body of the pubic bone forms the anterior part
of the acetabulum. The upper branch of the pubic bone (ramus superior) extends from the body forward and
from below this branch passes into the lower branch. The ischium (os ischii) has a body that forms the lower
part of the acetabulum. The branch of the ischium, connecting with the lower branch of the pubic bone, limits
the obturator opening
(foramen obturatum)

8 lower limb bones

In the lower extremities, the bones of the girdle of the lower extremities (pelvic girdle) and the free part of the
lower limb are distinguished. The pelvic girdle is formed by paired pelvic bones that are connected in front
with each other, behind with the sacrum.

The free part has three sections: the proximal-femur (os femoris), the middle-tibia and fibula (tibia et fibula),
the distal-bone of the foot.

The femur has an elongated body and two thickened ends. The proximal end forms a head to connect with
the acetabulum of the pelvic bone. The head below passes into the neck. At the border of the neck and the
body of the femur there are two protrusions of the greater and lesser trochanters. The distal end forms two
rounded protrusion - medial and lateral condylus

The tibia is the tubular bone of the tibia. At the proxial end it contains the medial and lateral condyle. The
upper part of both condyles form the upper articular surface for articulation with the femur. Laterally and
below the lateral condyle is the peroneal articular surface for connection with the head of the fibula.

The fibula-proximal end forms the head. The lower distal end of the fibula forms the lateral malleolus
(malleolus lateralis) in which there is an articular surface of the ankle to connect to the talus of the foot.

Foot- (pes) is divided into tarsus (tarsus), metatarsus (metatarsus), phalanges of fingers (phalanges
digitorum)

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 Tarsus: prox. Row (ram-talus, calcaneal bone-calcaneus), dist. row (scaphoid-
naviculare, cuboid-cuboideum, medial, intermediate, lateral sphenoid-cuneiformia) Metatarsal bones: five
short tubular bones. Each of these bones contains a body, head and base.

Bones of the toes: In each of the fingers, except for the first, there are: middle, proximal, distal phalanx. Each
of the phalanges has a body, a head and a base.

9.Bones of the roof of the skull (frontal, parietal and occipital)

The frontal bone (os frontale) is involved in the formation of the anterior part of the cranial vault, the anterior
cranial fossa and the orbit. The frontal bone includes the frontal scales (sguama frontalis), the orbital and
nasal parts (pars orbitales et pars nasalis)

Occipital bone (os occipital) - Located and the back-lower part of the cerebral section of the skull. At the
occipital bone, the basilar part (pars basilaris), two lateral parts and the occipital scales (squama occipitalis),
which surround the foramen magnum, are distinguished.

The parietal bone (os parietale) is paired, wide forms the upper-lateral parts of the cranial vault. The dark
bone has four edges: the frontal (bordered by the posterior edge of the frontal scales), occipital (connected to
the occipital scales), sagittal (with the help of its two parietal bones are connected to each other friend), scaly
(connect with the scales of the temporal bone). The parietal bone has
4 corners: frontal, occipital, wedge-shaped (sphenoidalis), mastoideus (mastoideus).

10 sphenoid and ethmoid bone

The sphenoid bone (os sphenoidale) occupies a central position at the base of the skull. The sphenoid bone
consists of a body, pterygoid processes (processus pterigoideus), large and small wings. The body of the
sphenoid bone has 6 surfaces: upper, lower, back, anterior and two lateral. The small wing has the visual
canal (canalis opticus). The large wing has 4 surfaces: cerebral (cerebralis), orbital (orbitalis), temporal
(temporalis) and maxillary.

The ethmoid bone (os ethmoidale) is involved in the formation of the anterior part of the base of the skull.
This bone together with other bones forms the walls of the nasal cavity and orbits. The upper part of the bone
is the ethmoid plate (lamina cribrosa). This plate contains numerous openings for the olfactory nerves. the
plate goes down into the nasal cavity perpendicular plate (lamina perpendicularis), involved in the formation
of the nasal septum. Above, to the edges of the ethmoid plate on the right and left, an ethmoidal labyrinth
(labyrinthus etmoidalis) is attached, which is formed by bony ethmoidal cells (cellulae) filled with air. the
maze is smooth. It participates in the formation of the medial wall of the orbit and is called the orbital plate
(Lamina orbitalis).

11. Upper and lower jaw. Small bones of the facial region.
Maxillary bone(maxilla) - a steam room, has a body and 4 processes: frontal, alveolar, palatine, zygomatic.
The body of the bone has 4 surfaces: anterior, orbital, infratemporal (facies infratempiralis), and nasal. The

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orbital surface is involved in the formation of the lower wall of the orbit. There are alveolar canals in the
infratemporal surface. The nasal surface is involved in the formation of the lateral wall of the nasal cavity.
From the body of the maxillary bone, the frontal process departs to meet the nasal part of the frontal bone.
The alveolar process also departs, which is involved in the formation of the alveolar arch, the palatine process
(palatinus) departs from the medial side of the body to meet the same process of the other bone, the
zygomatic process departs from the upper-lateral part of the body towards the zygomatic bone.

Mandibular bone (mandibula) -is the only movable bone of the skull. Unpaired, has a body and two branches.
The branch of the lower jaw is paired, and goes posterior to the body of the lower jaw. The corner of the lower
jaw is located at the transition point between the body and the branch. It has two processes: the coronary
(coronoideus) and the muscular process (condylaris). Palatine bone- (os palatinum), the steam room
participates in the formation of the hard palate, orbit, pterygo-palatine fossa. This bone has two plates -
vertical and horizontal. The perpendicular plate is involved in the formation of the lateral wall of the nasal
cavity. The palatine bone has three processes: the orbital ( orbitalis), wedge-shaped (sphenoidalis), pyramidal
(pyramidalis).

Inferior turbinate-concha nasalis inferior- paired, thin curved plate. It has a body and three processes:
lacrimal (lacrimalis), maxillary and ethmoidalis (ethmoidalis).

Coulter-vomer is unpaired, participates in the formation of the bony septum of the nasal cavity.

Nasal boneos nasale - paired, quadrangular plate, participates in the formation of the bone stalk of the nose.

Lacrimal boneos lacrimale-steam room, forms the anterior part of the medial wall of the orbit.

Cheekbone-os zygomaticus is a steam room, connects the frontal, temporal and maxillary bones. The
zygomatic bone is distinguished: the lateral, temporal and orbital surfaces and 2 processes - the temporal
and ilobic. The hyoid bone (os hyoideum) is located in the front of the neck. With the help of muscles and
ligaments, the bone is suspended from the skull under the lower jaw and connected to the larynx. This bone
has a body and two processes: small and large horns (cornu)

12. Temporal bone, its parts, canals.

The temporal bone (os temporale) is a steam room, which is part of the base and lateral wall of the skull.
Inside the temporal bone are the organs of hearing and balance. As part of the temporal bone, there is a
pyramid or stony part (pars petrosa), tympanic (tympanica), scaly part (pars sguamosa). Inside the pyramid
of the temporal bone there is a tympanic cavity. This cavity has 6 walls: upper, lateral, lower, posterior,
anterior, medial.

Temporal bone canals:

1.sleep channel (caroticus) - begins with the external carotid opening on the lower surface of the pyramid.
This canal ends with the internal carotid opening at the apex of the temporal bone pyramid. Through this
canal the internal carotid artery and the non-internal carotid plexus pass into the cranial cavity.

2.Three carotid tubules (canaliculi caroticotympanici) go from the carotid canal to the tympanic cavity
through which the thin arteries and nerves of the same name pass.

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3.muscular-tubal canal (musculotubarius) - It starts at the apex of the temporal bone pyramid, and opens
into the tympanic cavity.

4.facial canal (facialis) begins in the internal auditory canal and ends with the stylo-mastoid opening. The
facial nerve runs in this channel.

5.drum string channel ( canaliculus chordae tympani) departs from the facial canal in its terminal section,
opens into the tympanic cavity on its posterior wall, where the tympanic string is a branch of the facial nerve.

6.drum tubule (tympanicus) begins in a stony dimple and opens into the tympanic cavity on its lower wall.
The tympanic nerve passes through this channel.

7.mastoid tubule ( mastoideus) begins with the hole of the same name on the anterior wall of the jarine fossa,
and ends in the tympanic-mastoid fissure. The ear branch of the vagus nerve passes through the tubule.

13.Eye socket, walls and posts.

Eye socket (orbita) has the shape of a four-sided pyramid, open anteriorly. In the orbit is the eyeball and the
auxiliary apparatus of the eye: muscles, lacrimal gland, as well as vessels, nerves. The orbit has 4 walls: upper,
lower, medial and lateral. The medial wall is formed by the frontal process of the maxillary bone, the lacrimal
bone, the orbital plate of the ethmoid bone, the body of the sphenoid bone. The upper wall is formed by the
orbital part of the frontal bone, and behind - by the small wing of the sphenoid bone. The lower wall is formed
by the orbital surface of the maxillary bone, the zygomatic bone, and the orbital The lateral wall is formed by
the orbital surface of the great wing of the sphenoid bone and the frontal process of the bone.

Between the lateral and upper walls is the lower orbital fissure (fissure orbitalis inferior) - it connects the orbit
with the pterygo-palatine and infratemporal fossa. On the lateral wall of the orbit, in the region of the orbital
surface of the zygomatic bone, there is the zygomatic-orbital foramen. It leads to the zygomatic-facial
foramen on the lateral the surface of the zygomatic bone and the zygomatic-temporal opening opening on
the temporal surface of the same bone.

14.Nasal cavity, walls and posts.

The nasal cavity (ccavum nasi) consists of the right and left halves, separated by a septum of the nose. The
bony septum of the nose is formed by a perpendicular plate of the ethmoid bone connected to the vomer. In
front, the nasal cavity has a pear-shaped aperture (aperture piriformis). The posterior opening of the nasal
cavity (choanae) leads into the nasal part of the pharynx. The nasal cavity has an upper, lower and lateral wall.
The upper wall is formed by the nasal bones, the nasal part of the frontal bone, the ethmoid plate of the
ethmoid bone and the lower surface of the sphenoid bone body. The lower wall is formed by the palatine
processes of the maxillary bones, connected by horizontal plates of the palatine bones. The lateral wall is
formed by the nasal surface of the body and the frontal process of the maxillary bone, the lacrimal bone.

The upper nasal passage (meatus nasi superior) is located in the posterior parts of the nasal cavity. It is short,
bounded by the upper and middle turbinates. In the upper nasal passage through the sphenoid-ethmoidal
depression 9recessus sphenoethmoidalis), the posterior ethmoid cells and the sphenoid sinus open.

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The middle nasal passage (medius) is located under the middle turbinate and above the inferior turbinate. In
this nasal passage through the ethmoid funnel, the anterior and middle cells of the ethmoid bone, the frontal
sinus and the maxillary sinus open through the semilunar cleft. Behind the middle nasal concha is the
foramen-sphenopalatinum, which communicates the middle nasal passage with the pterygo-palatine fossa.

The lower nasal passage is located between the inferior turbinate at the top and the bottom of the nasal
cavity below. The opening of the nasolacrimal canal (nasolacrimalis) opens into this nasal passage.

15.temporal, infratemporal and pterygopalatine fossa

The temporal bone is bounded from above by the lower temporal line, from below by the infratemporal ridge
of the greater wing of the sphenoid bone. The infratemporal ridge separates the temporal fossa from the
infratemporal fossa.

The infratemporal fossa: the upper wall is the lower surface of the greater wing of the sphenoid bone and the
infratemporal crest. The medial wall is formed by the lateral plate of the pterygoid process of this bone. The
anterior wall is formed by the tubercle of the maxillary bone and partly the zygomatic bone. The infratemporal
fossa has no lateral and inferior walls.

The pterygoid palatine fossa (Fossa pterygopalatina) is bounded in front by the tubercle of the maxillary bone.
The base of the pterygoid process of the sphenoid bone serves as the posterior wall of the fossa, the medial
wall is the perpendicular plate of the palatine bone. There is no lateral wall.

16. Inner base of the skull

The inner base of the skull (basis cranii interna) has a concave surface. It is divided into three extensive
cranial fossa: anterior, middle, posterior, in the depth of which there are holes.

The anterior cranial fossa (fossa crania anterior) is formed by the ocular parts of the frontal bone and the
ethmoid plate of the ethmoid bone. The border between the anterior and middle cranial fossa is the posterior
edge of the lesser wings of the sphenoid bone. In the central part of the anterior cranial fossa, there is a blind
hole.

The middle cranial fossa is formed by the body and large wings of the sphenoid bone, as well as by the
anterior surface of the temporal bone pyramids. This fossa is separated from the posterior cranial fossa by
the upper edge of the pyramids of the temporal bones and the dorsum of the sella turcica. There is a pituitary
fossa in the central part of the fossa.

The cranial fossa is formed by the occipital bone, the posterior surface of the temporal bone pyramids. As
well as the posterior side of the body of the wedge bone Central position in the posterior fossa is occupied by
the large occipital foramen.

17.Outer base of the skull.

11
The outer base of the skull (basis crania externa) in front is formed by the bones of the facial section: palatine,
maxillary, zygomatic. The posterior part is formed by the surfaces of the temporal, sphenoid and occipital
bones. In the center of this area is the foramen magnum. The anterior part of the outer base of the skull is a
hard palate, which is the bone basis of the upper wall of the oral cavity and the lower wall of the nasal cavity.
On the outer base of the skull there are an incisal foramen (foramen incisivum), an oval foramen (foramen
ovale), an external auditory foramen (porus acusticus externus), a carotid canal, a styloid foramen (foramen
stylomastoideum), a torn foramen (foramen lacerum), a spinous foramen (Foramen spinosum ), palatine
opening (foramen foramen palatinum major). Through the hole,

18.Classification of bone connection.

There are three types of bone joints:

1. Continuous connections - in which there is a layer of connective tissue or cartilage between the bones.
There is no shell or cavity between the connecting bones. Continuous joints include fibrous (sutures,
syndesmosis, dentoalveolar joints-hammering)), cartilaginous (with the help of cartilaginous tissue) and bone
joints

2. Continuous joints or joints (synovial joints), characterized by the presence of a cavity between the bones
and the sonovial membrane lining the joint capsule from the inside. Also contains synovial fluid.

3. The symphysis or semi-joints, in the cartilaginous layer between the bones, have a narrow slit-like cavity.

19. Continuous connections.

Fibrous.Sutures (suturae) are joints in the form of a thin connecting layer between the bones of the skull.
Distinguish between flat (between the bones of the facial region), dentate (between the bones of the brain),
scaly sutures (joints of the temporal bone scales with the parietal bone)

Syndesmoses (sundesmoses) - joints of bones through ligaments (in the form of thick bundles of fibrous
connective tissue connects adjacent bones) and interosseous membranes (stretched between the diaphysis
of the tubular bones).

Dental alveolar joints (hammering) (gomphosis) are the junction of the tooth root with the walls of the dental
alvola, between which there is a thin connective tissue layer.

Cartilage joints or synchondrosis (synchondroses) are called joints of bones with the help of cartilaginous
tissue. This type of connection is very strong and elastic. There are permanent and temporary synchondrosis.

Bone joints are formed as a result of replacement of temporary synchondrosis with bone tissue.

20. Structure and classification of joints.

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The joints are characterized by the presence of articular surfaces covered with cartilage, an articular capsule,
an articular cavity and synovial fluid in it. Some joints additionally have formations in the form of articular
discs, mineski or articular lip.

Anatomical and biomechanical classification of joints is distinguished.

Anatomical classification: according to this classification, joints are divided into simple (formed by two
articulating bones) and complex (formed by three or more bones (wrist, ulnar)).

Biomechanical classification: uniaxial (they have one axis of rotation around which flexion-extension or
abduction-adduction occurs): there are cylindrical and block-shaped, biaxial (have two axes of rotation:
flexion and extension or abduction and adduction): ellipsoidal, condyle, saddle and polyaxial (shoulder, hip)
have a spherical shape.

21. Connections of the vertebrae. Spinal column: bends.

The bodies of the adjacent vertebrae are connected by intervertebral discs (disci intervertebrales), and the
arches and processes by the joints and ligaments. Each intervertebral disc consists of a central and
peripheral part. The joints of the vertebral bodies are reinforced by the anterior and posterior longitudinal
ligaments. The arches of the adjacent vertebrae are connected by yellow ligaments (ligament flava). The
spinous processes of the vertebrae are interconnected with the help of interspinous and supraspinous
ligaments. Between the transverse processes there are intertransverse ligaments.

The vertebral column (columna vertebralis) is formed by vertebrae interconnected by intervertebral discs,
joints, ligaments and membranes. The vertebral column performs a supporting function, is a flexible axis of
the trunk. The spine forms bends in the sagittal and frontal planes. Bending of the spinal column with a bulge
backwards is called a kyphoid bulge anterior lordosis, lateral scoliosis. The following physiological curves of
the spine are distinguished: cervical and lumbar lordosis, thoracic and sacral kyphosis.

22. Connections of the vertebrae to the skull.

The first cervical vertebra is connected to the skull, its occipital bone. These connections are strong, mobile
and complex in structure. The joints of the spinal column to the skull include the atlantooccipital, middle and
lateral atlanto-axial joints.

Atlanto-occipital joint(articulation atlantooccipitalis) is formed by two condyles of the occipital bone,

connected to the glenoid fossa of the atlas. Each of these joints has its own joint capsule. The anterior
atlanto-occipital membrane is stretched between the basilar part of the occipital bone and the anterior arch
of the atlas. The posterior atlanto-occipital membrane is riveted to the posterior semicircle of the foramen
magnum and the posterior arch of the atlas.

Mid-atlanto-occipital joint(articulation atlantoaxialis) is formed by the anterior and posterior articular

surfaces of the tooth of the axial vertebra. The tooth in front is connected to the fossa of the tooth on the
posterior surface of the anterior arch of the atlas. This joint is a cylindrical uniaxial joint.

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Lateral atlanto-axial joint(articulation atlantoaxialis lateralis) paired, formed by the glenoid fossa on the
lateral mass of the altant and the upper articular surface on the body of the axial vertebra.

23. Connections of the bones of the skull.

The bones of the skull are connected together with sutures. The exception is the temporomandibular joint.
The adjacent bones of the skull roof are connected using serrated sutures. The medial edges of the two
parietal bones are connected by a dentate sagittal suture, the frontal and parietal-dentate coronal sutures, the
parietal and occipital-dentate lambdoid sutures. The bones of the facial region are connected using flat
seams. Temporo-mandibular joint (articulation temporo-mandibularis) Formed by the articular head of the
lower jaw and the mandibular fossa, the articular tubercle of the temporal bone, covered with fibrous cartilage.
This joint is strengthened by capsular and extracapsular ligaments. The joint is paired, complex, combined
and ellipsoid. Due to this joint, the mouth opens and closes.

24. Connections of the ribs with the vertebra and with the sternum.
Ribs connect to vertebrae with the help of costal-vertebral joints (articulations costovertebrales), which
include the joints of the rib head (formed by the upper and lower costal fossa of two adjacent thoracic
vertebrae and the rib head which starts on the anterior surface of the rib head, fan-shaped and riveted to the
bodies of adjacent vertebrae and the intervertebral disc ) and rib-transverse joints (formed by the tubercle of
the rib and the costal fossa on the transverse process of 2-10 thoracic vertebrae.

Ribs connect to the sternum with the help of joints and synchondrosis. The cartilage of the 1st rib fuses with
the sternum (synchondrosis). Cartilage of the 2-7 ribs, joining with the sternum, form the sterno-costal joints
(articulations sterno-costales). The front ends 8-10 are not directly connected to the sternum. The cartilages
of these ribs are connected to each other, and the cartilage of the 8 ribs is connected with the cartilage of the
7 ribs lying above.

25 rib cage in general

The thorax (compages thoracis) is a bone-cartilaginous formation, consisting of 12 thoracic vertebrae, 12
pairs of ribs and a sternum, connected to each other. 4 walls of the chest are distinguished: anterior, posterior
and two lateral, as well as two holes (aperture) : upper and lower. The anterior wall is formed by the sternum,
costal cartilages, the posterior wall is formed by the thoracic vertebrae and the posterior ends of the ribs, the
lateral ribs. The adjacent ribs are separated from each other by the intercostal space. The upper opening is
limited by 1 thoracic vertebra in the back, the inner edges of the first ribs from the sides and the upper edge of
the sternum handle in front. The lower opening is bounded behind by the body of the 12th thoracic vertebra, in
front by the xiphoid process of the sternum, and on the sides by the lower ribs. The antero-lateral edge of the
lower aperture, formed by the joints of 7-10 ribs, is called the costal arch.

26.Junction of the bones of the shoulder girdle. Shoulder joint.

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The joints of the girdle bones of the upper limb and its free part are distinguished.

The joints of the girdle of the upper extremities (articulations cinguli membri superioris) connect the clavicle
with the scapula and sternum.

Sternoclavicular joint(sternoclavicularis) is formed by the thoracic end of the clavicle and the clavicular notch
of the sternum. The articular surfaces are saddle-like. There is an articular disc between the articular surfaces,
which fuses with the joint capsule along the periphery. The articular campus is strengthened by the anterior
and posterior sternoclavicular ligaments. In this joint, such movements are possible as: raising and lowering
the clavicle around the sagittal axis, moving the acromial end of the clavicle (together with the scapula)
forward and backward relative to the vertical axis, and circular motion.

Acromioclavicular joint (art.acromoiclavicularis) is formed by the acromial end of the clavicle and the
articular surface of the acromion. The capsule is attached along the edges of the articular surfaces. From
above, it is strengthened by the acromioclavicular ligament, which consists of two parts. In this joint,
movements with respect to three axes are possible. The shoulder joint (art. Humer) is formed by the articular
cavity of the scapula and the head of the humerus. The articular surface of the spherical head is almost three
times the flat surface of the glenoid cavity of the scapula. The glenoid cavity is supplemented along the
edges with a cartilaginous glenoid lip, which increases the capacity of the glenoid fossa. The articular
capsule is attached to the outer surface of the articular lip of the scapula, as well as to the anatomical neck of
the humerus. From above, the articular capsule is reinforced with the coracohumeral ligament. The joint is
spherical in shape. Flexion and extension, abduction and adduction, supination and pronation are performed.
Also circular motions.

27. Elbow joint. Connections of the bones of the forearm.

Elbow joint (art.cubiti) formed by three bones: humerus, radius and ulna. The humerus and forearm bones
form three joints, enclosed in a common joint capsule. The humeral joint (art.humeroulnaris), block-shaped, is
formed by the connection of the humerus block with the block-shaped notch of the ulna. The humeroradial
joint (art.humeroradialis), spherical, is formed by the junction of the head of the humerus and the articular
cavity of the radius. The proximal radioulnar joint (art.radioulnaris proximalis), cylindrical in shape, is formed
by the articular circumference of the radius and the radial notch of the ulna. The elbow joint can be extended
and flexed.

Forearm bones connected by discontinuous and continuous connections. A continuous connection is the
interosseous membrane of the forearm (membrana interossea antebrachii). It is a strong connective tissue
plate stretched between the mobility edges of the radius and ulna. The discontinuous joints of the forearm
bones include the proximal and distal radioulnar joints, and the joints of the hand.

28 hand bone joints

Wrist joint (art.radoicarpea) formed by the carpal articular surface of the radius and the articular disc, as well
as the proximal row of the wrist bones. In this joint there is the radial collateral ligament of the wrist
(lig.collatlaterale carpi radiale), the ulnar collateral ligament of the wrist (Lig. Collatlaterale carpi ulnare), the
palmar radiocarpal ligament (lig.radiocarpeum palmare), the dorsal ligament of the wrist (Lig.

Mid-carpal joint (atr.mediocarpea) formed by the articular surfaces of the first and second row of the wrist
bones.

15
Intercarpal joints (art.intercarpeae) formed by the articular surfaces of the adjacent wrist bones.

Carpometacarpal joints (art.carpometacarpeae) formed by the articular surfaces of the bones of the second
row of the wrist and the bases of the metacarpal bones.

Metacarpophalangeal joints (art.metacarpophalangeae) formed by the bases of the proximal phalanges of

the fingers and the articular surfaces of the heads of the metacarpal bones.

Interphalangeal joints (art.interphalanges manus) formed by the heads and bases of the adjacent phalanges
of the fingers of the hand.

29 Joints of the pelvic bones

The joints of the girdle of the lower extremities (art.cinguli membri inferioris) are formed by connecting the
pelvic bones with the sacrum. The posterior end of each pelvic bone is articulated with the sacrum by the
sacroiliac joint, and in front, the pelvic bones form the pelvic symphysis.

Sacroiliac joint, right and left (art.sarcoiliaca) is formed by the auricular articular surfaces of the pelvic bone
and sacrum. The articular capsule is strongly stretched and very strong, it grows together with the periosteum
of the sacrum and pelvic bone and with the ligaments. Anteriorly, the capsule is strengthened by the anterior
sacroiliac ligaments (lig.sacroiliaca anteriora). On the back of the joint there are interosseous sacroiliac
ligaments (interosseous iliac ligaments) which are interosseous ligaments (interosseous The posterior
sacroiliac ligaments (lig.sacroiliaca posteriora) are located behind the interosseous ligaments.

Pubic symphysis (symphysis pubica) connects the symphysial surfaces of the two pubic bones, between
which the fibrocartilaginous interpubic disc is located. The pubic symphysis is reinforced with ligaments. The
superior pubic ligament (lig.pubicum superior) goes transversely upward from the symphysis and connects
both pubic bones. The arcuate ligament of the pubis (lig.arcuatum pubis) is adjacent to the symphysis below.

30 pelvis as a whole
The pelvis (pelvis) is formed by the connecting pelvic bones and the sacrum. The pelvis is divided into two
sections: the large and small pelvis. The large pelvis from the small one is limited by the boundary line (linea
terminalis).

The large pelvis (pelvis major) is bounded behind by the body of the 5th lumbar vertebra and the base of the
sacrum, with the lateral wings of the iliac bones. In front, the large pelvis has no bone wall.

The small pelvis (pelvis minor) is bounded behind by the pelvic surface of the sacrum and the anterior surface
of the coccyx, laterally by the inner surface of the pelvic bones. The anterior wall of the small pelvis is the
upper and lower branches of the pubic bones, the pubic symphysis. The small basin has an inlet and outlet.
The pelvis in women is wider and shorter than in men.

31. Hip and knee joints.

Hip joint (art.coxae) is formed by the acetabulum of the pelvic bone and the head of the femur. The articular
surface of the pelvic bone is increased by the labrum acetabulare. The joint capsule of the hip joint is
attached along the edges of the acetabulum. The joint capsule is firmly reinforced with five powerful

16
ligaments. In the thickness of the fibrous membrane of the hip joint there is a thick ligament - a circular zone
(zona orbicularis), covering the neck of the femur in the form of a loop. This ligament attaches to the ilium
under the inferior anterior iliac spine. Also in this joint are the ilio-femoral ligament, pubic-femoral ligament,
ischio-femoral ligament. The hip joint is spherical in shape.

Knee joint (art.genus) formed by the femur, tibia and patella. The articular surfaces of both condyles of the
femur are articulated with the superior articular surface of the tibia and with the patella. There is a medial and
lateral meniscus inside the joint. The knee joint is strengthened by several strong ligaments: the peroneal
collateral ligament, the tibial collateral ligament, the oblique popliteal ligament, the arcuate popliteal ligament,
the patellar ligaments.

32. Joints of the shin bones. Ankle joint.

The shin bones are connected using the peroneal joint and syndesmosis.

Peroneal joint (art.tibiofibularis) formed by the surface of the fibula head with the fibular articular surface of
the tibia. Both articular surfaces are flat, along their edge a tightly stretched articular capsule is attached.
There is no movement in this joint.

Peroneal syndesmosis (sundesmosis tibiofibularis)formed by the peroneal notch of the distal epiphysis of
the tibia and the articular surface of the lateral scapula. Anteriorly and posteriorly, these joints are reinforced
by the anterior and posterior tibiofibular ligaments.

Ankle joint (art.talocruralis) is a blocky joint. It is formed by the articular surfaces of both bones of the leg
and talus. On the tibia, it is the inferior articular surface articulating with the talus block, and the articular
surface of the medial malleolus articulating with the medial malleolus surface of the talus block. On the fibula,
it is the articular surface of the lateral malleolus articulating with the lateral malleolus surface of the talus.
Ligaments that strengthen the joint, are located on the lateral surfaces of the joint: the medial ligament, which
has four parts (tibial-navicular, tibial-calcaneal, anterior tibial-talus and posterior tibial-talus). Flexion and
extension occurs.

33. Connections of the bones of the foot.

Talocalcaneonavicular joint (art.talocalcaneonavicularis) formed by two joints having an independent
capsule and a separate articular cavity. The first of them is formed by the articulation of the posterior
calcaneal articular surface, located on the underside of the talus, and the posterior talus articular surface,
located on the upper side of the calcaneus (subtalar joint (art.subtalaris)). The second joint is formed by the
articulation of the head of the talus with the scaphoid from below. The talocalcaneal joint is supported by
several ligaments (interosseous talocalcaneal ligament, talnophase ligament). This joint is spherical in shape.

Heel-cuboid joint (art.calcaneocuboidea)saddle-shaped, formed by the articular surfaces of the calcaneus

and cuboid bones facing each other. Ligaments: plantar heel-cuboid, long plantar, calcaneo-cuboid ligament.

Wedge-navicular joint (art.cuvneonavicularis)flat in shape, connects three sphenoid bones to the scaphoid.
The joint is strengthened by the dorsal and plantar wedge-navicular ligaments.

Tarsometatarsal joints (art.tarsometatarsales), flat in shape, formed by cuboid and sphenoid bones in the
back and the bases of the metatarsal bones in front. These are three joints isolated from each other. One of
them is the junction of the medial sphenoid bone with the first metatarsal bone. The other joint is formed by

17
the 2nd and 3rd metatarsal bones in front, intermediate and lateral sphenoid bones in the back. The third joint
is formed by the cuboid bone in the back and the 4-5th metatarsal bones in the front. The joint capsules are
reinforced with the dorsal and plantar tarsometatarsal ligaments.

Intermetatarsal joints (art.intermetatarsales) formed by the surfaces of the bases of the metatarsal bones
facing each other. The articular capsules of these joints are reinforced by the dorsal and plantar metatarsal
ligaments, which are located transversely. There is no movement here.

Metatarsophalangeal joints (art.metatarsophalangeales) close to spherical in shape, formed by the heads of

the metatarsal bones in the back and the bases of the proximal phalanges in the front. On the lateral and
medial sides, these joints are reinforced by collateral ligaments. From below, the joints strengthen the plantar
ligaments (lig.plantaria)

Interphalangeal joints (art.interphalangeales pedis) belong to blocky joints. These joints are laterally
reinforced with collateral ligaments and also have plantar ligaments.

34. The structure and shape of the muscles. Their auxiliary devices.
There are 400 muscles in the body that contract voluntarily, in accordance with the will of the person. The
structural elements of skeletal muscle are striated muscle fibers capable of contracting and relaxing. Muscle
fibers have a connective tissue sheath-endomysium. The bundles of fibers inside the muscles are delimited
from each other by connective tissue layers-internal perimysium internum. Outside, each muscle has a thin
connective tissue sheath epimysium. Muscle fibers form the fleshy part of the muscle, which passes into the
abdomen
tendon (tendo)

Muscles are broad (flat), fusiform, single-pinnate, two-pinnate, ribbon-like, circular muscle in shape. Muscle
accessory devices are fascia (fascia), which are connective tissue cases for muscles that delimit muscles
from each other, create support for muscles when they contract, serve as the starting point for a number of
muscles. Fascia in pathology can limit the spread of pus and blood during hemorrhage. The auxiliary
apparatus also includes fibrous canals, tendon sheaths, bursae (reduce friction and facilitate muscle sliding)
and blocks (the block changes the direction of the tendon, being its support, and increases the angle of
attachment of the tendon to the bone.

35 Muscles and fascia of the chest.

Superficial chest muscles:

1.The pectoralis major muscle (m.pectoralis major)has three parts: sternocostal, clavicular, abdominal part.
F-I: the raised hand lowers, penetrates and leads to the body, participates in the expansion of the chest. 2.
The small pectoral muscle (m.pectoralis minor) is located behind the pectoralis major muscle. It originates at
the front ends of 3-5 ribs and attaches to the coracoid process of the scapula. F-I: tilts the scapula anteriorly,
raises the ribs.

3.Subclavius muscle (m.subclavius) - located between the clavicle and the 1st rib. F-I: shifts the clavicle
forward and downward. 4. Anterior serratus muscle (m.serratus anterior) - located on the anterior-lateral
surface of the chest. It originates from the 8-9 upper ribs, attaches to the medial edge and lower corner of the
scapula. F-I: pulls the scapula forward and laterally.

18
Own chest muscles:

one.External intercostal muscles (m.intercostales externi) are located in the intercostal spaces. Fya: raise the
ribs.

2.Internal intercostal muscles (m.intercostales interni) are located inside from the external intercostal
muscles. F-I: lower the ribs.

3. The transverse muscle of the chest (m.transversus thoracis) lies on the inner surface of the anterior chest.
This muscle begins on the xiphoid process and is attached to the cartilage of 2-6 ribs. F-I: pulls the costal
cartilage down, lowers the ribs.

4.Subcostal muscles (m.subcostales) are located in the lower part of the posterior part of the inner surface of
the chest. They originate from 10-12 ribs. F-I: lower the ribs

5The muscles that lift the ribs (m.levatores costarum) are short and long. F-I: raise the ribs. Fascia: The
superficial fascia of the chest (fascia superficialis) is poorly developed. The pectoral fascia (fascia
pectoralis) has a superficial (covers the front of the pectoralis major muscle) and deep plates (located above
the pectoralis major muscle, it separates the pectoralis major from the pectoralis minor)

36 Muscles and fascia of the back

The muscles of the back (m.dorsi) are paired, arranged in layers. These muscles are subdivided into
superficial and deep.

Superficial muscles of the back are attached to the bones of the shoulder girdle and humerus. They are
located in two layers: the first layer is the trapezius and broadest muscles of the back, the second layer is the
large and small rhomboid muscles, the levator scapula muscle, the posterior upper and posterior lower
dentate muscles. The trapezius muscle (m.trapezius) is flat, triangular in shape. It begins on the external
occipital protuberance of the occipital bone, spinous processes of the 7th cervical vertebra and all thoracic
vertebrae and attaches to the lateral third of the clavicle, acromion and spine of the scapula. F-I: brings the
scapula closer to the spine, raises the scapula.

Latissimus dorsi (m.latissimus dorsi) flat,, triangular. It begins on the spinous processes of the lower six
thoracic, all lumbar vertebrae and the lower 3-4 ribs and attaches to the crest of the lesser tubercle of the
humerus. F-I: brings the hand to the body, turns it inward, unbends the shoulder, lowers the raised arm.

Muscle lifting the scapula (m.levator scapulae)begins on the transverse processes of 3-4 upper cervical
vertebrae and attaches to the upper medial edge of the scapula. F-I: raises the scapula, brings it closer to the
spine.

Small rhomboid muscle (m.rhomboideus minor) - start at the remaining line. 7 cervical and 1 thoracic
vertebrae and is attached to the upper part of the medial edge of the scapula.

Large rhomboid muscle -beginning at 2-5 thoracic vertebrae, ending at the medial edge of the scapula. F-I:
bring the scapula closer to the spine, pulls it medially and up

The posterior superior dentate muscle (m.serratus posterior superior) thin, flat, begins on 5-7 cervical and 12
thoracic vertebrae and attaches to the back surface of 3-5 ribs.

19
Posterior dentate muscle - flat, thin beginning at the end of the process of 11-12 thoracic and 1-2 lumbar
vertebrae, attached to the four lower ribs. F-I: lowers the ribs

Deep back muscles - lie in three layers: the first layer (the belt muscle of the head, the belt muscle of the neck
and the straightening muscle of the spine, the second layer (transverse spinous muscle), the third layer
(interspinous and suboccipital muscle).

Belt muscle of the head(m.splenius capitis) begins at the rest of the process of the 7th cervical vertebra and
the upper 3-4 thoracic vertebrae and is attached to the mastoid process of the temporal bone.

Back fascia: Superficial fascia of the back, covering the trapezius, the broadest muscle of the back, is poorly
expressed. The lumbar-thoracic fascia (Fas.thoracolumbalis) belonging to the deep muscles of the back is
well developed, most developed in the lumbar region.

37 Muscles and fascia of the abdomen

The abdominal muscles are divided into anterior, posterior, and lateral. The muscles that form the anterior
and lateral walls of the abdomen include the external and internal oblique, transverse, rectus abdominis
muscle, and also the pyramidal muscle. The external oblique muscle (m.obliquus externus abdominis) begins
on the lateral surface of the 8-9 lower ribs and goes forward. Muscle bundles are directed downward and
medially, passing into a wide flat aponeurosis. F-I: lowers the ribs and bends the spine, turns the torso

Internal oblique muscle of the abdomen -naya-Xia on the lateral two-thirds of the inguinal ligament, on the
lumbar fascia. F-I: lowers the ribs, bends the spine.

Transverse abdominal muscle (m.transversus abdominis) begins on the inner surface of the 6 lower ribs, on
the lateral part of the inguinal ligament. The lower bundles are part of the spermatic cord. F-I: pulls the lower
ribs forward and down, reduces the size of the abdominal cavity. The rectus abdominis muscle (m.rectus
abdominis) is a steam room, located on the sides of the anterior midline. It is separated from the muscle of
the same name on the opposite side by the white line of the abdomen. It begins on the pubic crest and pubic
symphysis, attaches to the anterior surface of the xiphoid process and the outer surface of the cartilage 5-7
ribs. F-I: pulls the ribs down, lowers the chest.

Pyramidal muscle (m.pyramidalis) steam room, triangular. It begins on the pubic crest, woven into the white
line of the abdomen. F-I: pulls the white line of the abdomen.

Muscles of the back wall of the abdominal cavity: in the formation of the posterior abdominal wall, the paired
square muscle of the posnitsa, the large and small psoas muscles, located on the sides of the spinal column,
are involved.

Fascia of the abdomen:superficial fascia (fas.superficialis) Is a continuation of the superficial fascia of the
chest. Own fascia (fascia propria) in the area of the superficial ring of the inguinal canal forms
interpeduncular fibers. The fibers of this fascia in men passes to the spermatic cord in the form of the fascia
of the muscle that lifts the testicle. The transverse fascia (f.transversalis) covers the transverse abdominal
muscle from the inside and participates in the formation of the posterior wall of the sheath of the rectus
abdominis muscle.

20
38. The vagina of the rectus abdominis muscle. White line of the abdomen.
Inguinal canal.
White line of the abdomen (linea alba)a dense connecting plate running along the anterior midline of the
abdomen from the xiphoid process to the pubic symphysis. A white line is formed by intersecting fibers of the
aponeurosis of the broad muscles of the abdomen on the right and left sides.

The vagina of the rectus abdominis muscle (vagina m.recti abdominis) located on either side of the white
line and is a receptacle for each of these muscles and the adjacent pyramidal muscles. The sheath of the
rectus abdominis muscle is formed by the aponeuroses of the oblique and transverse abdominal muscles
and has anterior and posterior walls.

Inguinal canal (canalis inguinalis) paired formation, located on the right and left above the medial half of the
inguinal ligament, lateral to the lower sheath of the rectus abdominis muscle. It passes through the anterior
abdominal wall obliquely from top to bottom to the surface of the inguinal ring. The spermatic cord passes
through the inguinal canal in men, and the round ligament of the uterus in women. The inguinal canal has 4
walls: the anterior (formed by the aponeurosis of the external oblique abdominal muscle), the posterior
(transverse fascia), the upper (lower edge of the internal oblique and transverse abdominal muscles) and the
lower (inguinal ligament).

39. Diaphragm: structure, parts and function.

Diaphragm (diafragma) -a thin, wide musculo-tendinous septum separating the chest and abdominal cavities.
The concave side faces the chest cavity, and the concave side faces the abdominal cavity. The diaphragm
has 3 parts: lumbar, costal and sternal. Muscle bundles of the diaphragm are located on the periphery,
converge towards the center, forming a tendon center (centrum tendinum). The diaphragm has weak points in
which muscle fibers are absent. These places include the lumbar-costal triangle and the sternocostal triangle.
Diaphragmatic hernias may develop in these areas. Ph-I: with contraction, the diaphragm falls, flattens. The
diaphragm helps to increase intraperitoneal pressure

40 Muscles of the neck. Their functions

The superficial and deep muscles of the neck are distinguished. Superficial group (subcutaneous muscle,
sternoclavicular-mastoid muscle, suprahyoid group (maxillary-hyoid, digastric, stylohyoid and sublingual),
subhyoid group (sternohyoid, sternothyroid, thyroid-hyoid and scapular) muscles) The deep muscles are
divided into the medial prevertebral muscle (longus muscle of the head, longus neck muscle, lateral rectus
muscle of the head, anterior rectus muscle of the head) and lateral (anterior, middle and posterior scalene
muscles) Subcutaneous muscle of the neck (m.platysma) very thin and flat mimic muscle ... It begins on the
superficial plate of the pectoral fascia and is woven into the chewing fascia, into the muscle that lowers the
lower lip, and the muscle that lowers the corner of the mouth. Ph-I: lifts the skin of the neck, protects
superficial veins from compression. The sternocleidomastoideus muscle (m.sternocleidomastoideus) begins
on the front surface of the sternum handle and the medial end of the clavicle. Attaches to the mastoid
process of the temporal bone. Fya: throws his head back, tilts his head to his side and turns his face in the
opposite direction.

Stylohyoideus muscle (m.stylohyoideus) originates on the styloid process of the temporal bone, attaches to
the body of the hyoid bone. F-I: pulls the hyoid bone back.

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41. Fascia and topography of the neck.
The subcutaneous muscle of the neck has its own fascia. There are three plates of the cervical fascia or three
cervical fascia. The superficial fascia is located behind the subcutaneous muscle, covering the neck from all
sides. The middle fascia forms the connective tissue sheaths for the muscles located below the hyoid bone.
The deep fascia is located behind the pharynx and esophagus, covers the anterior scalene, long muscles of
the head and neck, anterior and lateral rectus muscles of the head. Three regions are distinguished on the
neck: anterior, sterno-nodular-mastoid (right and left), lateral (right and left). The anterior region of the neck or
the anterior triangle of the neck, laterally bounded by the sternocleidomastoid muscles. At the top, the base of
the triangle corresponds to the lower edge of the lower jaw. .The anterior region of the neck is also divided
into the suprahyoid (distinguish between the submental, submandibular and lingual triangles) and subhyoid
region (distinguish between the sleepy and muscular triangle). In the lateral region of the neck,
scapular-clavicular and scapular-trapezoidal triangles are distinguished.

42. Mimic muscles. Their function.

Facial or facial muscles (m.faciales) located under the skin, do not have fascia. The mimic muscles originate
from the surface of the bones and attach to the skin. All facial muscles are subdivided into: muscles of the
cranial vault (occipital-frontal muscle, muscle of the proud), muscles surrounding the palpebral fissure
(circular muscle of the eye, muscle puckering eyebrow), muscles surrounding the nostrils (nasal muscle,
muscle lowering the septum of the nose), muscles surrounding the oral opening (circular muscle of the
mouth, muscle lowering the corner of the mouth, muscle lowering the lower lip, chin muscle, buccal muscle,
muscle lifting the upper lip, large zygomatic muscle, muscle lifting the angle of the mouth, muscle of
laughter), muscles of the auricle (anterior ear muscle, upper ear muscle , posterior ear muscle)

Occipitofrontal muscle (m.occipitofrontalis) covers the roof of the skull has an occipital and frontal abdomen.
F-I: the occipital abdomen pulls the scalp posteriorly, when the frontal abdomen contracts, the forehead skin
forms transverse folds, the eyebrows rise.

Muscle of the proud (m.procerus) originates on the outer surface of the nasal bone, ends in the thickness of
the forehead skin. Ph-I: forms transverse folds at the root of the nose.

Orbicular muscle of the eye (m.orbicularis oculi) located around the circumference of the orbit, in the
thickness of the eyelids. The muscle is distinguished by the secular, orbital, and lacrimal parts. F-I: the secular
part closes the eye, closes its eyes, the lacrimal part expands the lacrimal sac.

Anterior, upper and posterior ear muscles pulling the auricle back and forth.

43. Chewing muscles. Their functions

In the group of masticatory muscles, the masticatory muscle, the temporal muscle, the lateral and medial
pterygoid muscles are distinguished.

Chewing muscle (m.masseter) has a superficial and deep part. The superficial part begins on the zygomatic
process of the maxillary bone and the anterior part of the zygomatic arch. The deep part of the pasr profunda
begins at the back of the lower edge and the inner surface of the zygomatic arch. Both parts are attached by
the chewing tuberosity of the lower jaw. F-I: raises the lower jaw.

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The temporal muscle (m.temporalis) begins on the temporal fossa, the inner surface of the temporal fascia
and attaches to the coronoid process of the lower jaw. F-I: raises the lower jaw. The posterior bundles pull the
lower jaw posteriorly.

Medial pterygoid muscle (m.pterygoideus medialis) begin in the pterygoid fossa of the pterygoid process of
the sphenoid bone and are attached to the pterygoid tuberosity on the inner surface of the lower jaw. F-I:
raises the lower jaw.

Lateral pterygoid muscle has two heads: upper and lower. The upper one begins on the maxillary surface, the
lower outer surface of the lateral plate of the pterygoid process. F-I: with bilateral contraction, the lower jaw
pushes forward.

44. Muscles and fascia of the shoulder girdle and shoulder.

The muscles of the shoulder girdle begin at the clavicle and scapula, attach to the humerus and act on the
shoulder joint.

Muscles of the shoulder girdle: Deltoid muscle (m.deltoideus) beginning at the anterior edge of the

acromion, the spine of the scapula and attaches to the deltoid tuberosity of the humerus. F-I: with the
contraction of the entire muscle, the hand is retracted to 70 degrees, the hand withdraws, lowers it, the
shoulder bends.

Supraspinatus muscle (m.supraspinatus) begins on the posterior surface of the scapula and attaches to the
lower part of the greater tubercle of the humerus. F-I: removes the shoulder, pulls the capsule of the shoulder
joint.

Infraspinalis muscle (m.infraspinalis) begins on the back surface of the scapula below the spine of the
scapula and attaches to the large tubercle of the humerus. F-I: turns the shoulder outward, pulls the joint
capsule.

There is also a small round muscle (m.teres minor), a large round muscle and a subscapularis muscle
(m.subscapularis).

Shoulder muscles:

The muscles of the shoulder are divided into two groups: anterior (coracohumeral, biceps and brachial
muscles), posterior (triceps brachii and ulnar muscles).

Coracobrachial muscle (m.coracobrachialis) beginning at the apex of the coracoid process and attached
below the crest of the lesser tubercle to the humerus. Ph-I: flexes the shoulder at the shoulder joint and brings
it to the body.

Biceps brachii (m.biceps brachii) has two heads: short and long. The short head begins at the apex of the
coracoid process of the scapula, and the long head begins at the supra-articular tubercle of the scapula and
is attached to the tuberosity of the radius. Ph-I: flexes the shoulder at the shoulder joint.

Fascia:

Deltoid fascia covers the deltoid muscle and its connective tissue septa divide this muscle into separate
bundles. In front, the deltoid fascia continues into the thoracic fascia. The supraspinatus and subscapularis

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fasciae are poorly developed. The shoulder fascia surrounds the shoulder muscles in the form of a sheath,
extends proximally into the deltoid and axillary fascia, distally passes into the forearm fascia.

45 Muscles and fascia of the forearm and hand

The muscles of the forearm are subdivided into the anterior (flexors) and posterior (extensors) groups. The
anterior group is arranged in four layers: the first layer (brachialis muscle, pronator circular, radial wrist flexor,
palmaris longus, flexor ulnar of the wrist), the second layer (superficial flexor of the fingers), the third layer
(deep flexor of the fingers and long flexor of the thumb), fourth layer (square pronator).

Back group are divided into two layers: superficial (long radial extensor of the wrist, short radial extensor of
the wrist, extensor of the fingers, extensor of the little finger, ulnar extensor of the wrist. The deep layer (instep
support, long muscle abducting the thumb of the hand, short extensor of the thumb, long extensor of the
thumb) , the extensor of the index finger.

Muscles of the hand are divided into three groups: muscles of the thumb (short muscle, abductor thumb,
muscle opposing thumb, flexor muscle of the thumb, muscle adductor thumb of the hand), muscles of the
little finger (short palmar muscle, muscle opposing the little finger, short flexor of the little finger) , middle
group (vermiform muscles, interosseous muscles, palmar interosseous muscles, dorsal interosseous
muscles).

Fascia of the forearm (f.antebrahii) in the form of a dense case, it covers the muscle of the forearm. In the
area of the wrist, the fascia of the forearm thickens strongly, forming on the palmar and dorsal sides the
so-called flexor and extensor retainers, which strengthen the muscle tendons that go from the forearm to the
hand and to the fingers.

Fascia of the hand... On the palmar side of the hand, the fascia is more pronounced than on the back of the
hand. The dorsal fascia of the hand consists of two plates: superficial and deep.

46. Axillary fossa and upper limb topography.

Axillary fossa (fossa axillaris) located between the lateral surface of the chest and the medial surface of the
proximal shoulder. In front, it is bounded by a fold of skin corresponding to the lower edge of the pectoralis
major muscle. Behind, the axillary fossa is limited by a skin fold that covers the lower edge of the latissimus
dorsi muscle and the major round muscle.

Axillary cavity is deeper. Has the shape of a four-sided pyramid. The cavity has 4 walls: anterior (formed by
the pectoralis major and minor), posterior (latissimus dorsi), medial (serratus anterior) and lateral (biceps
brachii and coracobrachial muscle). The anterior wall is subdivided into three triangles: clavicular-thoracic,
thoracic, and sub-chest. There are two holes on the back wall: three-sided and four-sided.

The canal of the radial nerve or brachomuscular canal (canalis nervi radialis) located on the back of the
shoulder, between the bone and the triceps brachii

47. Muscles and fascia of the pelvic girdle

The pelvic muscles are divided into two groups: internal (iliopsoas, psoas minor, internal obturator, gemini
and piriformis), external (gluteus maximus, gluteus maximus, and minimus muscle, fascia lata tensor, square
femoris muscle and external obturator muscle).

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Iliopsoas muscle (m.iliopsoas) consists of two large muscles: the large lumbar and iliac muscles. F-I: flexes
the hip at the hip joint, tilts the pelvis along with the body forward.

Psoas minor muscle (m.psoas minor) begins on the intervertebral disc of the 1st lumbar vertebra and
attaches to the arcuate line of the ilium. F-I: pulls the iliac fascia.

Superior twin muscle (m.gemellus superior) beginning on the ischial spine. F-I: turns the hip outward.

Fascia: lumbar fascia covers the psoas major muscle. The iliac fascia attaches to the inner lip of the iliac
crest along its entire length and to the arcuate iliac line. The gluteal fascia begins on the dorsal surface of the
sacrum and covers the outside of the gluteus maximus muscle. A deep leaf of this fascia separates the
gluteus maximus muscle from the median muscle, and the tendon muscles of the fascia lata.

48 Muscles and fascia of the thigh.

The muscles of the thigh are divided into three groups: anterior (sartorius muscle, quadriceps muscle),
posterior (biceps femoris, semitendinosus muscle, semimembranosus) and medial (fine muscle, comb
muscle, long adductor muscle, short adductor muscle, large adductor muscle)

Tailor muscle (m.sartorius) beginning on the upper anterior iliac spine, attached to the tendon, to the
tuberosity of the tibia and the fascia of the leg. F-I: flexes the thigh and lower leg, also participates in turning
the thigh outward.

Quadriceps femoris muscle (m.quadriceps) consists of four muscles: rectus, lateral, medial, and
intermediate. Ph-I: this muscle is a powerful extensor of the lower leg in the knee joint.

Biceps muscle (m.biceps femoris) has two heads: long and short. F-I: extends the thigh, flexes the lower leg.
Semitendinosus muscle (m. semitendinosis) begins on the sciatic tubercle. At the level of the middle third of
the thigh, it passes into a long tendon and attaches to the medial surface of the upper part of the tibia. F-I:
extends the thigh, flexes the lower leg.

Wide fascia (f.lata) thick, has a tendon structure. In the form of a tight sheath, it covers the muscles of the
thigh from all sides.

49 Muscles and fascia of the lower leg and foot

Calf muscles:

Distinguish between the anterior (tibialis anterior muscle, extensor longus of the toes, long extensor of the big
toe), posterior (triceps muscle of the lower leg, gastrocnemius muscle, soleus muscle, plantar muscle,
popliteal muscle, long flexor of the fingers, long flexor of the big toe, posterior tibial muscle and lateral (long
peroneal muscle, short peroneal muscle).

Muscles of the foot: muscles of the back of the foot (the short extensor of the toes, the short extensor of the
big toe), the muscles of the sole of the foot (the medial is the abductor muscle of the big toe, the short flexor
of the big toe, the muscle of the adductor big toe, the lateral is the muscle, the abductor of the little toe, the
short flexor of the little toe, the muscle opposing little finger, middle - short flexor of the fingers, square sole
muscle, interosseous muscles, plantar interosseous muscles, dorsal interosseous muscles)

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Leg fascia (f.cruris) grows together with the periosteum of the anterior edge and the medial surface of the
tibia, covers the outside of the anterior and posterior muscle groups of the lower leg in the form of a dense
case. The dorsal fascia of the foot (f.dorsalis pedis) is poorly developed.

50. Topography of the pelvic girdle and lower limb.

Locking channel (can.obturatorius) located at the top edge of the hole of the same name. Formed by the
obturator groove of the pubic bone and the upper edge of the internal obturator muscle.

Muscle lacuna (lacuna musculorum) bounded in front and above by the inguinal ligament, posteriorly by the
iliac-combed arch.

Vascular lacuna (lac.vasorum) located medially from the iliac-comb arch, posteriorly and inferiorly, the comb
ligament, on the lateral side, the iliac-comb arch, and medially, the lacunar ligament.

Femoral triangle (trigonum femorale) bounded from above by the inguinal ligament, from the lateral side by
the sartorius muscle, the medial long adductor muscle. The femoral canal is formed in the region of the
femoral triangle during the development of a femoral hernia.

III.Anatomy of internal organs.

1.The structure of the wall of the alimentary canal
The wall of the alimentary canal consists of:

Mucous membrane (tunica mucosa) it distinguishes between the epithelial cover and the lamina propria of
the mucous membrane. The epithelium covers the inner surface of the mucous membrane. It can be
multi-layer flat, transitional, single-layer cylindrical, prismatic. Under the epithelium is the proper lamina of
the mucous membrane (lamina propria mucosae). It is formed by the RVST, in which the blood and lymph
vessels are located.

Submucosa (tela submucosa) located outside of the mucous membrane, consists of RVST. It contains blood,
lymph vessels, and multicellular glands.

Muscular membrane (tunica muscularis) built of smooth muscle cells, myocytes, which form two layers: the
inner - circular, and the outer - longitudinal.

Outer sheath (adventitia) RVST was formed.

2. Anatomy of the oral cavity. Developmental defects.

Oral cavity (cavitas oris),is the beginning of the digestive system. From the sides, the oral cavity is limited
by the cheeks, in front of the lips, and from the back it communicates with the pharynx through a wide
opening, the mouth (fauces). In the oral cavity, the vestibule of the mouth (vestibulum oris) and the oral
cavity itself (cavitas oris propria) are isolated. The vestibule of the mouth is limited from the outside by the

26
lips and cheeks, and from the inside by the teeth and gums. The entrance to the oral cavity, more precisely,
in its vestibule - the mouth gap (rima oris) is limited by the lips.

Upper lip and lower lip (labium superius et inferius) represent musculocutaneous folds.

Cheeks (buccae) right and left, limit the oral cavity on the sides. The buccal muscle is located in the thickness
of the cheek.

Sky (palatum), in which a hard palate and a soft palate are distinguished, forms the upper wall of the oral
cavity. The hard palate (palatum durum) occupies the front two-thirds of the palate. The soft palate
(palatum molle) or palatine curtain (velum palatinum) is located posterior to the hard palate.

3. Anatomy of the tongue and salivary glands

Language (lingua) is a muscular organ that takes part in mixing food in the mouth, as well as swallowing,
articulating speech. The front of the tongue forms the top of the tongue (apex linguae). The back is the root
of the tongue (radix linguae). Between the apex and the root of the tongue is the body of the tongue (corpus
linguae). On the sides, right and left, is the edge of the tongue. The mucous membrane of the tongue forms
papillae of the tongue (papillae linguales) of various sizes and shapes (filamentous, cone-shaped,
mushroom-shaped, grooved, leaf-shaped). The tongue has its own muscles that begin and end in the
thickness of the tongue (upper and lower longitudinal, transverse and vertical) and skeletal muscles that
begin on the bones of the head (chin-lingual, hyoid-lingual and styloid).

The glands of the mouth include the small and large salivary glands, the ducts of which open into the oral
cavity. Small salivary glands are located in the thickness of the mucous membrane or submucosa of the
walls of the oral cavity. These include the labial glands, cheek glands, molar glands, palatine glands, lingual
glands.

Large salivary glands paired, located outside the mouth. These include the parotid, submandibular and
sublingual.

4.General anatomy of teeth

Teeth (dentes), whose function is to grab and grind food. Each tooth consists of a crown, neck, and root.
The substance of the tooth consists of dentin, enamel and cement. The crown of the tooth (corona dentis)
protrudes above the gum. In the crowns of all teeth, several sides, or surfaces, are distinguished (lingual,
vestibular, contact, anterior and posterior). The root of the tooth (radix dentis) is cone-shaped, located in the
dental alveolus. Each tooth has one to three roots. The cervix dentis is a short section between the crown
and the root of the tooth. Teeth are milk and permanent. The total number of teeth is 32. Full dental formula:
2123 (2 incisors, 1 canine, 2 small and 3 large molars).

5 anatomy of the pharynx

Pharynx (pharynx) located in the head and neck region, it is part of the digestive and respiratory systems. In
the pharynx there is an intersection of the digestive and respiratory tract. The pharynx is a funnel-shaped
tube. Above, the pharynx is attached to the base of the skull. At the level of 6-7 cervical vertebrae, the
pharynx passes into the esophagus. The length of the pharynx is 12-14 cm. The pharynx has anterior,
posterior, and lateral walls. It also has an upper wall that forms the vault of the pharynx. The posterior wall

27
of the pharynx faces the spinal column. There are three parts of the pharynx: nasal, oral and laryngeal. The
nasal part of the pharynx is at the level of the choanas and constitutes the upper part of the pharynx. The
mouth of the pharynx is at the level of the pharynx. The laryngeal part of the pharynx is the lower part of the
pharynx.

The walls of the pharynx formed by the mucosa, submucosa, muscular membrane and adventitia.

Muscles of the pharynx form the constrictors of the pharynx - constrictors (upper, middle and lower) and
longitudinal muscles - the lifters of the pharynx (stylopharyngeal and tubopharyngeal muscles).

6. Anatomy of the esophagus.

Esophagus (oesophagus) It is a tube 25-30 cm long. It begins at the level of the 6-7 cervical vertebra and
ends in the abdominal cavity with the confluence into the stomach to the left of the 10-11 thoracic vertebra.
The esophagus is divided into three parts: cervical, thoracic and abdominal. The cervical part and the
thoracic part are adjacent to the spinal column. At the level of the 9th thoracic vertebra, the esophagus
departs from the spinal column. The esophagus is narrowed in three places. The first narrowing is at the
level of 6-7 cervical vertebrae, in the place where the pharynx passes into the esophagus. The second
narrowing is at the level of 4-5 thoracic vertebrae, and the third is at the level of the passage of the
esophagus through the diaphragm. Adventitia was formed by the RVST. The mucous membrane is covered
with stratified squamous epithelium. The submucosa is thick and gathers in longitudinal folds.

7.Anatomy of the stomach.

Stomach (ventriculus) a saccular enlargement of the digestive tract located between the esophagus and
the small intestine. In the stomach, the anterior wall (paries anterior) and the posterior wall are distinguished.
At the edges, where the anterior and posterior walls converge, a small and large curvature (curvature
ventriculi) is formed. The stomach is located in the upper abdominal cavity, under the diaphragm and liver.
The stomach is covered with peritoneum on all sides. The muscular membrane, submucosa and mucous
membrane are involved in the formation of the walls of the stomach. The muscular membrane is well
developed and is represented by three layers: the outer longitudinal, middle circular, inner layer of oblique
fibers. The submucosa is thick, which contributes to the formation of folds of the mucous membrane. The
mucous membrane forms numerous folds of the stomach.

8. Small intestine: sections, wall structure. The small intestine (intestinum

tenue) is the longest section of the digestive system. The small intestine
is located in the middle region of the abdomen, downward from the
stomach and transverse colon. In the small intestine, it secretes the
duodenum, the jejunum and the ileum.

Duodenum (duodenum) being the initial section of the small intestine. This intestine is divided into four
parts: upper, descending, horizontal and ascending. The upper part starts from the pylorus of the stomach,
goes to the right, turns sharply downward and forms the upper bend of the 12 intestine.

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Jejunum located immediately after the 12 intestine, its loops lie in the upper left part of the abdominal
cavity. The ileum (ileum) occupies the right lower part of the abdominal cavity and flows into the cecum in
the region of the right iliac fossa. This intestine has a muscular layer: it contains a longitudinal outer layer
and an inner circular layer. The submucosa is rather thick. It consists of RVST. The mucous membrane
forms circular folds.

9. Large intestine: sections, wall structure

Large intestine (intestinum crassum) is the final section of the digestive system. In the large intestine, the
cecum, the ascending colon, the transverse colon, the descending colon, and the sigmoid colon are
distinguished. The large intestine is located in the abdominal cavity, in the pelvic cavity. The large intestine
has a mesenteric tape (taenia mesocolica), an omental tape (taenia omentalis), a loose tape (taenia libera).
Between the ribbons, the wall of the colon forms saccular protrusions - haustrae coli

The cecum (caecum) beginning of the colon. This intestine is located in the right iliac fossa on the iliac and
psoas major muscles.

Ascending colon (colon ascendens) is a continuation of the cecum upward in the right lateral region of the
abdominal cavity. Behind this intestine is adjacent to the square muscle of the lower back and the
transverse muscle of the abdomen, the anterior surface of the right kidney.

Transverse colon (colon transversum) lies in the abdominal cavity transversely, extending from the right
flexure of the colon to the left flexure of the colon (flexura coli sinistra), where this intestine passes into the
descending colon. The transverse colon is covered by the peritoneum on all sides. The descending colon
(colon desendens) starts from the left bend of the colon, goes down and at the level of the crest of the left
iliac bone passes into the sigmoid colon. With its posterior surface, this intestine is adjacent to the square
muscle of the lower back, the lower pole of the left kidney and the iliac muscle. The peritoneum covers the
descending colon anteriorly and laterally.

Sigmoid colon (colon sigmoideum) located in the left iliac fossa. Covered by the peritoneum on all sides.

Colon outside it is covered with a serous membrane, under which the muscular membrane is located. The
submucosa and mucous membrane are well developed. Does not form villi. There are only semi-lunar folds.

10 liver anatomy
Liver (hepar) being the largest gland, it participates in the processes of digestion. Weight 1500 g. It is
located in the area of the right hypochondrium and epigastric region. The upper border is at the level of
the fourth intercostal space. From this point, the upper border descends steeply to the right down to the
tenth intercostal space. Here, the lower and upper borders of the liver converge, forming the lower edge of
the right lobe of the liver. Two surfaces are distinguished in the liver: diaphragmatic (convex, adjacent to the
lower surface of the diaphragm) and visceral (directed downward and posteriorly)

Diaphragmatic surface: from the diaphragm to this surface is the sickle ligament of the liver (lig.falsiforme
hepatis), and divides it into the right and left lobes. At the back, the falciform ligament connects to the
lig.coronarium. The right and left edges of the coronary ligament expand to form triangles to form the right
and left triangular ligaments. On this surface there is a cardiac depression (impressio cardiaca).

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Visceral surface:on this surface, there are three grooves - two sagittal, and one frontal. On this surface of
the right lobe of the liver, a square lobe (lobus quadratus) and a caudate lobe (lobus caudatus) are
distinguished. On this surface there is a gastric depression, an esophageal depression, a renal depression.

The liver is outside covered with a serous membrane (tunica serosa). The morphofunctional unit of the liver is
a lobule of the liver (lobulus hepatis). In the human liver there are about 500 thousand such lobules.

11. Path of bile (diagram). Liver function.

Bile performs a whole complex of various

functions, most of which are associated with digestion, providing a change from gastric digestion to
intestinal, eliminating the action pepsin, dangerous for enzymes pancreas, and creating favorable
conditions for them.

Bile acids contained in bile, emulsify fats and participate in micelle formation, intensify small intestine
motility, stimulates production slime and gastrointensive hormones: cholecystokinin and secretina, prevent
the adhesion of bacteria and protein aggregates.

Bile is also involved in the performance of the excretory function. Cholesterol, bilirubin and a number of
other substances cannot be filtered kidneys and their excretion from the body occurs through the bile.
Excreted fromfeces 70% cholesterol in the bile (30% is reabsorbed by the intestines), bilirubin, as well as
the above metals, steroids, glutathione[5]...

Bile activates kinazogen, converting it into enteropeptidase, which in turn activates trypsinogen, converting
it into trypsin, that is, it activates the enzymes needed to digest proteins.

12.Gallbladder, excretory ducts of the gallbladder and liver.

Gallbladder (vesica biliaris) being a reservoir in which bile accumulates. It is located in the fossa of the gallbladder on the
visceral surface of the liver, has a pear-shaped shape. The bottom of the gallbladder (fundus vesicae biliaris) - comes out
from under the lower edge of the liver at the level of the cartilage junction of the 8th and 9th right ribs. The narrower end of
the bladder, directed to the gate of the liver, is the neck of the gallbladder (collum vesicae biliaris). Between the bottom

30
and the neck is the body of the gallbladder. The neck of the bladder continues into the cystic duct merging with the
common hepatic duct.

The underside of the gallbladder is covered with a peritoneum, passing onto it from the visceral surface of the liver. In
those places where the peritoneum is absent, the outer membrane is formed by adventitia. The muscular layer is
composed of smooth muscle cells. The mucous membrane forms sweet.

Common bile duct (ductus choledochus biliaris) located between the sheets of the hepato-duodenal ligament. The duct
goes down, first behind the upper part of the duodenum, and then between its descending part of the head of the pancreas,
medially pierces the wall of the descending part of the duodenum and opens at the apex of the large papilla of the
duodenum, connecting with the pancreatic duct.

13. Anatomy of the pancreas.

Pancreas (pancreas) is a digestive gland, as well as an endocrine gland. Lies behind the stomach. Covered with a thin
connecting capsule. This gland has a head (located at the level of 1-3 lumbar vertebrae), a body (crosses from right to left
the body of 1 lumbar vertebra) and a tail (reaches the gate of the spleen). Three surfaces are distinguished on the gland:
anterior, posterior, and lower.

Excretory duct of the pancreas (ductus pancreatus) begins in the region of the tail of the gland, passes through the body
and head of the organ from left to right, takes on smaller ducts. The excretory duct flows into the descending part of the
duodenum on its large papilla.

14. Anatomy of the peritoneum.

Peritoneum (peritoneum) is the serous membrane that lines the abdominal cavity and covers the internal organs located
in this cavity. The peritoneum is formed by its own lamina of the serous membrane and a single-layer squamous
epithelium - mesothelium. The peritoneum, which lines the walls of the abdominal cavity, is called the parietal peritoneum
(peritoneum parietale). The peritoneum that covers the organs is called the visceral peritoneum (peritoneum viscerale).
The peritoneum is a continuous leaf that passes from the walls of the abdominal cavity to the organs and from the organs
to its walls. Some organs are covered by the peritoneum only on one side (pancreas, kidneys, adrenal glands -
extraperitoneally), other organs on three sides (mesoperitoneally ascending and descending colon), others are covered on
all sides (intraperitoneally - stomach, jejunum and ileum,

15. Anatomy of the nasal cavity.

Nasal cavity (cavum nasi) divided by the septum of the nose into the right and left halves. Behind, through the choanae,
the nasal cavity communicates with the nasopharynx. In each half of the nose, the anterior part is distinguished, the
vestibule and the nasal cavity itself, located behind. On each side wall of the nasal cavity there are three protruding
elevations - nasal conchas - protruding into the nasal cavity. Under the upper, middle and lower nasal concha (concha
nasalis superior), there are longitudinal depressions: the upper, lower and middle nasal passages. A common nasal
passage is located between the septum of the nose with the medial surfaces of the turbinates on each side. The olfactory
and respiratory regions are distinguished from the nasal cavity. The epithelium of the nasal mucosa contains a large
number of goblet cells that secrete mucus.

16. Anatomy of the larynx.

Larynx (larynx) performs respiratory and voice-forming functions. The upper border is at the level of the lower edge of the
5th cervical vertebra, the lower one is at the lower edge of the 6th cervical vertebra. The larynx is located on the front of
the neck. At the top, the larynx is attached to the hyoid bone, at the bottom, it continues into the trachea. In front, the larynx

31
is covered with the superficial and pretracheal plates of the cervical fascia and the subhyoid muscles of the neck. At the
larynx, the vestibule, the interventricular region and the sub-vocal cavity are distinguished. The basis of the larynx is
formed by cartilage, paired and unpaired. To unpaired ot-sya thyroid, cricoid cartilage and epiglottis. Paired cartilages
include arytenoid, horn-shaped, wedge-shaped and non-permanent granular cartilages of the larynx. The muscle of the
larynx is subdivided into dilators of the glottis (posterior cricoid muscle), constrictors of the glottis (lateral cricoid muscle,
thyroidal muscle) and muscles that strain the vocal cords (cricothyroid muscle, vocal muscle). The mucous membrane of
the larynx is lined with multi-row ciliated epithelium. The submucosa forms the fibro-elastic membrane of the larynx.

17. Anatomy of the trachea and bronchi.

Tracheaa hollow tubular organ that carries air into and out of the lungs. It begins at the level of the lower edge of the 6th
cervical vertebra, ends at the level of the 5th thoracic vertebra. In the trachea, the cervical and thoracic parts are
distinguished. The esophagus is adjacent to the trachea. On the sides are the common carotid artery, the internal jugular
vein and the vagus nerve. At the level of the 5th thoracic vertebra, the trachea is divided into the right and left main bronchi
(bronchii principales). The wall of the trachea consists of a mucous membrane covered with multilayer columnar
epithelium, submucosa, fibrocartilaginous and adventitious membranes. Outside, the trachea is covered with an adventitia
membrane.

18. Lung anatomy

Lungs (pulmones) right and left, each located in its own half of the chest cavity. The lungs have three surfaces:
diaphragmatic (concave, facing the diaphragm), costal (convex, adjacent to the inner surface of the chest wall), medial
(adjacent to the mediastinum). Each lung has an apex and a base. In the lung, a front edge and a lower edge are
distinguished. Each lung is subdivided into lobes with the help of deep slits. The right lung has three lobes (upper, middle,
lower), the left has two (upper and lower). The apex of the right and left lung protrudes 2 cm above the clavicle in front,
and 3-4 cm above 1 rib. Behind the apex of the lung at the level of the spinous process of the 7th cervical vertebra. The
lower border of the right lung ends at the 11th rib. The lower border of the left lung is located somewhat lower.

19. Anatomy of the pleura.

Pleura (pleura) is a serous membrane, covers both lungs, enters the cracks between their lobes, and also lines the walls of
the chest cavity. Allocate the visceral (pulmonary) and parietal (parietal) pleura. In the parietal pleura, costal, mediastinal
and diaphragmatic parts are distinguished. The costal pleura covers the inside of the inner surface of the ribs and
intercostal spaces. The mediastinal pleura is laterally limited by the mediastinal organs, fused with the pericardium. The
diaphragmatic pleura covers the top of the diaphragm. The anterior and posterior borders of the pleura correspond to the
borders of the right and left lungs.

In the places of transition of the costal pleura into the mediastinal and diaphragmatic pleura, the pleural cavity has
depressions) - pleural sinuses (sinus pleurales). Costal-phrenic sinus (sinus costodiaphragmaticus) is located at the
junction of the costal pleura into the diaphragmatic one. The diaphragmatic-mediastinal sinus (sinus
pherenicomedistinalis) is located at the junction of the mediastinal pleura into the diaphragmatic one. The
costomediastinal sinus (sinus costomediastinalis) is located at the transition of the anterior rib pleura into the mediastinal
pleura.

20. Mediastinum: borders, divisions and organs of the mediastinum

Mediastinum (mediastinum) is a complex of internal organs bounded by the sternum in the front and back by the spine, by
the right and left mediastinal pleura from the sides. The upper border of the mediastinum corresponds to the upper
aperture of the chest, the lower one is limited by the diaphragm. The mediastinum is divided into upper and lower sections.
In the upper section are the thymus, right and left brachiocephalic veins, the initial section of the superior vena cava, the

32
aortic arch and the beginning of the brachiocephalic trunk, vagus and phrenic nerves. The lower section is subdivided into
three parts: anterior (located between the body of the sternum and the anterior surface of the pericardium - internal
thoracic arteries and veins, perihoracic and pre-pericardial lymph nodes), middle (located the heart, pericardium, initial
sections of the aorta, pulmonary trunk, the final part of the upper and lower hollow veins, main bronchi,

21. Kidney anatomy

Kidney (ren) paired bean-shaped organ. In the kidney, the anterior surface and the posterior surface, the upper and lower
pole are distinguished. The right and left kidney are located on either side of the spinal column. The left kidney is located
higher than the right one. The square muscle of the lower back, the transverse abdominal muscle and the psoas major
muscle form the bed for the kidney.

The kidney has several membranes. A fibrous capsule is attached to the renal tissue. Outside the fibrous capsule is
adipose tissue, which is better expressed on the back of the kidney.

The kidney consists of cortex and medulla.

Renal cortex (cortex renalis) consists of alternating lighter and darker areas. In the light areas there are straight kidney
tubules, the initial sections of the collecting ducts. In the dark areas are renal corpuscles, proximal and distal sections of
the convoluted renal tubules.

Kidney medulla (medulla renalis) does not form a continuous layer. It consists of renal pyramids. The structural and
functional unit of the kidney is the nephron.

22. Anatomy of the ureter and bladder.

Ureter (ureter) beginning from the renal pelvis and zak-Xia confluence into the bladder. A tube-shaped ureter with a length
of 30-35 cm. Drain urine from their kidneys into the bladder. There is a narrowing of the ureter in the bladder. He spills the
abdominal, pelvic and intramural parts.

Bladder (vesica urinaria) is a hollow organ, a reservoir for urine. The bladder is located in the pelvic cavity behind the pubic
symphysis. The mucous membrane of the empty bladder forms folds.
The muscular membrane in the area of the inner opening of the urethra forms the bladder constrictor.

23. Testicle, epididymis: their structure and function

Testicle (testis) is a paired male sex gland that performs exocrine (the formation of male germ cells) and endocrine
function (synthesizes testosterone). The testicles are located in the scrotum. The testicles are surrounded by membranes
and are separated from each other by a septum. The surface of the testicle is smooth. In the testicle, a lateral and medial
surface is distinguished, as well as an anterior margin and a posterior margin. The epididymis is adjacent to the posterior
edge. At the testicle, the upper and lower ends are distinguished. Outside, the testicle is covered with a fibrous tunica
albuginea, under which we find the testicular parenchyma.

Epididymis (epididymis) having an elongated shape, located along the posterior edge of the testicle. In the epididymis, the
head of the epididymis is distinguished, which passes downward into a narrower part, the body of the appendage. The
body narrows and the tail of the epididymis continues.

24. The spermatic cord, its components

Seed cord (funiculus spermaticus) is a rounded strand 15-20 cm long, located between the upper end of the testicle and
the deep inguinal ring. The spermatic cord includes the vas deferens, testicular artery, vas deferens artery, venous plexus,

33
lymphatic vessels of the testis and epididymis, nerves. The spermatic cord is surrounded by membranes that continue into
the membranes of the scrotum. The outer sheath of the spermatic cord is the outer spermatic fascia. Under it, we find the
muscle that lifts the testicle and the internal seminal fascia.

25. Male urethra and penis.

Urethra (urethra) is a tubular organ, starting from the bladder with the inner opening of the urethra and ending on the
head of the male penis with the outer opening of the urethra. In the male urethra, the prostate, membranous and spongy
parts are distinguished. The prostate (pars prostatica) passes through the prostate gland. The membranous part (pars
membranacea) goes from the apex of the prostate to the bulb of the penis. The spongy part (pars spongiosa) passes
through the thickness of the spongy body of the penis.

Penis (penis) serves to remove urine and introduce sperm into the female genital tract. As part of the penis, a distinction is
made between the head, body and root. The crown of the head (corona glandis) and the neck of the head (collum glandis)
are distinguished at the head. The penis is formed by the right and left cavernous bodies and the corpus spongiosum.

26. Anatomy of the vas deferens and seminal vesicles.

The vas deferens (ductus deferens) paired tubular organ, designed for sperm removal. It begins from the duct of the
epididymis and ends by fusion with the excretory duct of the seminal vesicle. In the vas deferens, testicular (nah-Xia in the
scrotum behind the testicle), cord, inguinal (nah-Xia in the inguinal canal) and the pelvic part are isolated. The wall of the
vas deferens is formed by mucous, muscular and adventitious membranes.

Seminal vesicle (vesicula seminalis) is a paired organ that secretes liquid components of sperm. Located in the pelvic
cavity., Up from the prostate gland. In the seminal vesicle, an expanded middle part (body) and a lower one, passing into
the excretory duct, are distinguished. The mucus ob-ka forms folds, the muscular ob-ka is well developed, the adventitia of
the ob-ka is formed by dense connective tissue.

27. Prostate and bulbourethral glands.

Prostate gland (prostata) is an unpaired muscular-glandular organ, the secret of which is part of the sperm. Located under
the bladder. The gland has anterior, posterior, and inferior-lateral surfaces. Has a right and left lobe. The urethra passes
through the prostate gland. The excretory ducts of the prostatic glands open into the prostatic urethra.

Bulbourethral gland (glandula bulbourethralis) paired organ, the secret of which neutralizes the acidity of urine, and also
protects the mucous membrane of the urethra. These glands are located in the depth of the deep transverse muscle of the
perineum, behind the membranous part of the urethra.

28. Testicular membranes (scrotum)

Scrotum (scrotum) being a receptacle for the testicles, it is formed from the protrusion of the anterior abdominal wall. Nah-
Xia down and back from the root of the penis, in the perineum. In the scrotum, 7 membranes are distinguished: skin, dartos,
external seminal fascia, muscle lifting the testicle, with its fascia. The skin of the scrotum is thin, pigmented, covered with
hair, and contains numerous sweat and sebaceous glands.

29. Anatomy of the ovary and fallopian tubes

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Ovary (ovarium) is a paired female reproductive gland, performs exo (formation of eggs) and endocrine functions
(produces female sex hormones). The ovary is located in the pelvic cavity, lateral to the uterus, under the fallopian tube. In
the ovary, medial (facing the pelvic cavity) and lateral (facing the walls of the pelvis) surfaces are distinguished. The ovary
has two ends: the tubal (facing the fallopian tube) and the uterine (attached to the uterus). The ovary is covered from the
outside with a single-layer cubic epithelium, under which the connective tissue tunica is located, under it is the
parenchyma, which has cortical and medulla.

Fallopian tube (tuba uterine) - steam room, about 10-12 cm long, serves to carry the egg from the ovary into the uterine
cavity. The fallopian tube lies in the thickness of the upper part of the wide ligament of the uterus and opens into the
abdominal cavity with the abdominal opening of the fallopian tube. In the fallopian tube, a laterally located funnel, ampulla,
isthmus and uterine part are distinguished. The walls of the fallopian tube are formed by mucous membranes, muscular
and serous membranes. The mucous membrane forms longitudinal tube folds.

30. Anatomy of the uterus.

Uterus (uterus) - is an unpaired hollow muscular organ in which a fetus is carried during pregnancy. The uterus is located
in the pelvic cavity between the bladder in front and the rectum in the back. The widened upper part of the uterine uterus
(fundus uteri), from top to bottom, passes into the cone-shaped body of the uterus, continuing into the narrow rounded
cervix (cervix uteri). Between the body and the cervix is the isthmus of the uterus. The uterine cavity has a triangular
shape. In the uterus, two surfaces are distinguished: the anterior vesical surface (facies vesicalis) and the posterior
intestinal surface (facies interstinalis). The uterus is covered with a serous membrane outside, which is called perimetry.
In the area of the cervix and on the sides of the uterus, there is a PCT-parameter. The muscular membrane is
myometrium, thick consists of complexly intertwined smooth muscle bundles.

31. Vagina and external female genital organs.

Vagina located in the pelvic cavity, connects the genital slit and the uterus. In its upper part, it surrounds the cervix,

forms the vaginal vault (formix vaginae). The walls of the vagina are formed by the mucosa, muscular and adventitious
membranes. The upper third of the anterior wall is adjacent to the bottom of the bladder. The external female genital
organs (organa genitalia femininae externae) include the female genital area and clitoris. The female genital area
includes the pubis, large and small labia, the vestibule of the vagina.

Loboc (mons pubis) covered with hair, separated from the thighs by the hip grooves, from the abdomen by the pubic
groove.

Large labia (labium majus pudenda) paired skin fold that limits the genital cleft (rima pudenda). The right and left labia
are connected in front by the anterior commissure of the lips (commissura labiorum anterior), and behind by a
narrower posterior commissure of the lips. The labia minus (labium minus pudenda) is a paired longitudinal thin skin
fold. The labia minora are located inwardly from the labia majora and limit the entrance to the vestibule of the vagina.
The anterior end of each labia minora is divided into two legs, which are directed towards the clitoris.

Clitoris ((clitoris) has a body 2.5-3.5 cm long, a head and two legs. The clitoral legs are attached to the lower branches of
the pubic bones.

The vestibule of the vagina (vestibulum vaginae) is a depression bounded by the medial surface of the labia minora. In
the depths of the vestibule, the opening of the vagina (ostium vaginae) is located. Between the opening of the vagina and
the clitoris, the external opening of the urethra opens. In the thickness of the walls of the vestibule, there are small glands
of the vestibule. Their excretory ducts open on the eve of the vagina.

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32. Anatomy of the perineum.
Perineum (perineum) is a complex of soft tissues that close the exit from the small pelvis. The perineum is
rhombus-shaped, bounded in front by the lower edge of the pubic symphysis, behind by the apex of the coccyx, on the
sides by the lower branches of the pubic bones, by the branches of the ischial bones and by the ischial tubercles. Dark
stripes of the perineum (raphe perinealis) run along the midline of the perineum. A transverse line drawn between the
ischial tubercles divides the perineum into two triangular parts. The front part is the genitourinary area. The back part
forms the pelvic diaphragm. The urethra passes through the urogenital diaphragm, in women, the urethra and vagina.

The muscles of the urogenital diaphragm are subdivided into superficial (superficial transverse muscle of the perineum,
sciatic-cavernous and bulbous-spongy muscles) and deep (deep transverse muscle of the perineum and sphincter of the
urethra.

IV.Anatomy of the circulatory system.

1. General characteristics of the vascular system.
In the human body, the cardiovascular system is isolated, which ensures the transport of blood, the supply of
organs and tissues with nutrients and energy, and removes metabolic products.

The cardiovascular system includes the heart and blood vessels. The heart is central to this system. Blood
vessels are arteries that carry blood from the heart and veins that carry blood to the heart. The microcircular
bed also belongs to the blood vessels, at the level of which metabolic processes take place between the blood
and adjacent tissues. Blood vessels are found in all organs and tissues, except for the epithelial lining of the
skin, mucous membranes, hair, nails, the cornea of the eye and articular cartilage.

2. Anatomy of arteries and veins. Microcircular bed.

Arteries - the blood vessels going from the heart to the organs and carrying blood to them are called
arteries (aeg - air, tereo - I contain; on corpses, the arteries are empty, which is why in the old days they
were considered air tubes).

The wall of the arteries consists of three sheaths. The inner membrane, tunica intima, is lined from the side
of the vessel lumen by the endothelium, under which the subendothelium and the inner elastic membrane
lie; middle, tunica media, is built of fibers of unstated muscle tissue, myocytes, alternating with elastic
fibers; the outer shell, tunica externa, contains connective tissue fibers.

Veins(Latin vena, Greek phlebs; hence phlebitis - inflammation of the veins) carry blood in the opposite
direction to the arteries, from the organs to the heart. Their walls are arranged according to the same plan
as the walls of the arteries, but they are much thinner and there is less elastic and muscle tissue in them,
due to which the empty veins collapse, the lumen of the arteries gapes in the cross section; veins, merging
with each other, form large venous trunks - veins flowing into the heart. Veins widely anastomose among
themselves, forming venous plexuses.

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The beginning of the microcircular bed is arteriole - precapillary - capillary - postcappelar venules - venules.
The microcircular bed also includes the vessels connecting the arteriole and the venule - arteriolo-venular
anastomoses.

3. Anatomy of the heart.

Heart (cor) - located in the lower part of the middle mediastinum, between the right and left lungs. The
heart is shaped like a cone. At the heart, there are sternocostal, diaphragmatic and two pulmonary
surfaces. The heart consists of 4 chambers: the right atrium (atrium dextrum) resembles a cube in shape.
It has an additional cavity - the right ear. The enlarged posterior section of the right atrium, into which the
superior and inferior vena cava flow, is called the vena cava sinus. The right atrium is separated from the
left by means of the atrial septum (septum interatriale).

Right ventricle (ventriculum dexter) resembles a triangular pyramid in shape. The lower wall is flattened,
adjacent to the tendon center of the diaphragm, the anterior wall is convex. The medial wall is formed by
the interventricular septum. The upper part of the right ventricle has 2 openings: the atrioventricular
opening and the opening of the pulmonary trunk. The right atrioventricular opening has a right
atrio-ventricularis dextra, which has three cusps. The left atrium (atrium sinistrum) has an irregular cuboid
shape, it is separated from the right atrium by the interatrial septum. The anterior-lateral wall of the atrium
has a cone-shaped protrusion - the left ear. Above and behind, four openings of the pulmonary veins open
into the left atrium.

Left ventricle (ventriculum sinister) has a conical shape. The upper part of the ventricle has two openings:
the atrioventricular opening and the opening of the aorta. The left atrioventricular opening has anterior and
posterior cusps belonging to the left atrioventricular valve.

At the walls of the atrium and ventricles, three layers are distinguished: the endocardium (lining the inside
of the heart cavity), the epicardium (covering the outside of the myocardium and endocardium),
myocardium (formed by the cardiac, striated muscle tissue, which consists of the outer, middle and inner
layers.).

4. Vessels supplying the heart.

Arteries of the heartdepart from the very beginning of the aorta, at the level of its valve. Distinguish
between the right (a.coronaria dextra- goes to the right under the auricle of the right atrium, passes in the
coronary groove. Then it goes around the right surface of the heart, goes along its posterior surface to the
left) and the left (starts from the aortic bulb, is immediately divided into the anterior interventricular sulcus
of the heart in the direction of its apex) and the bending branch (anastomoses with the right coronary
artery) coronary arteries.

Veins of the heartare collected in a common venous vascular sinus (sinus coronaries). The large, middle
and small veins of the heart, the posterior vein of the left ventricle, and the oblique vein of the left atrium
flow into the coronary sinus. The large vein of the heart (v. Cordis magna) starts anteriorly from the apex
of the heart, goes up the anterior interventricular groove. At the level of the coronary sulcus, this vein turns
to the left, lies in the coronary sulcus on the back of the heart and flows into the coronary sinus.

37
Middle vein of the heart begins on the posterior surface of the apex of the heart, rises up the posterior
interventricular groove and flows into the coronary sinus.

Small vein of the heart (v. Cordis parva) begins on the right side of the right ventricle, goes up, lies in the
coronary groove and flows into the coronary sinus.

5. Anatomy of the pericardium.

Pericardium (pericardium) or a pericardial sac, has the form of a closed sac surrounding the heart, as well
as the initial sections of the aorta, pulmonary trunk and the terminal parts of the vena cava. The
pericardium is fused at the bottom with the tendon center of the diaphragm, on the sides, with the
mediastinal pleura, in front, with the sternum and costal cartilages. Behind, the pericardium is adjacent to
the esophagus, thoracic part of the aorta, azygos and semi-unpaired veins. At the pericardium, fibrous
(outer) and serous (inner) layers are distinguished. The fibrous pericardium at the base of the heart is
fused with the adventitia of large vessels (aorta, pulmonary trunk, hollow and pulmonary veins). The
serous pericardium has two plates: parietal and visceral. Between these two plates there is a pericardial
cavity (cavitas pericardialis)

6. Circles of blood circulation. Scheme.

In humans, a large (beginning in the left ventricle and ending in the right atrium) and small (beginning on the
right ventricle and turning in the left atrium) circles of blood circulation are distinguished.

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7.Aorta and its departments. Branches of the aortic arch.
Aorta (aorta) -the largest arterial vessel of the human body, it has an ascending part, an arc and a descending
part. The ascending part of the aorta (pars ascendens aortae), leaving the left ventricle, forms an expansion -
the aortic bulb. At the level of the aortic bulb, the right and left coronary arteries depart from it. At the level of
the 2nd right costal cartilage, it passes into the aortic arch.

Aortic arch (arcus aortae) forms a bend to the left and posterior to the left side of the body of the 4th thoracic
vertebra, where it passes into the descending part of the aorta.

The descending part of the aorta (pars descendens aortae) it is subdivided into the thoracic (beginning at the
level of the 4th thoracic vertebra - the parietal and visceral branches depart from it) and the abdominal part
(beginning after passing it through the diaphragm and the division of the aorta into two common iliac atreria at
the level of 4- th lumbar vertebra.

39
The branches of the aortic arch are the brachiocephalic trunk, the left common carotid and left subclavian
arteries.

Brachiocephalic trunk (truncus brachiocephalicus) departs from the aortic arch at the level of the 2nd costal
cartilage, goes up and to the right. At the level of the right sternoclavicular joint, the brachiocephalic trunk is
divided into the right common carotid artery and the right subclavian artery. The left common carotid artery
extends directly from the aortic arch.

8. External carotid artery.

External carotid artery (a.caroticus externa) departs from the common carotid artery in the lower parts of the
carotid triangle. Located under the skin. In the thickness of the parotid salivary gland, it is divided into its
terminal branches: the superficial temporal and maxillary artery. Within the carotid triangle, the arteries give off
three groups of branches:

Front branches:

goes to the thyroid gland. It supplies blood to the thyroid gland, larynx,
hyoid bone and muscles, sternocleidomastoid muscle.

departs at the level of the large horn of the hyoid bone into the thickness of the tongue.
It supplies blood to the tongue, mucous membrane of the floor of the mouth, palatine tonsil and submandibular
salivary glands. 3. Facial art (a.facialis) - departs at the angle of the lower jaw, just above the lingual art. Blood
is: facial muscles and facial skin, nasal septum, soft palate, palatine tonsil, auditory tube, lacrimal sac,
stylohyoid, styloid and stylopharyngeal muscles.

Rear branches: departs next to the facial art, lies in the occipital groove of the
temporal bone. Zak-Xia in the skin of the occiput by the occipital branches. Bleeding: the skin of the occiput

40
 and parietal region, the auricle, the hard medulla of the posterior cranial fossa. Muscles: sternocleidomastoid,
posterior abdomen of the digastric muscle, muscles of the posterior region of the neck.

departs above the upper edge of the posterior abdomen of the

digastric muscle, goes posteriorly and upward. Hemorrhage: auricle, mucous membrane of the tympanic cavity,
hard shell of the brain in the region of the posterior cranial fossa. Muscles: digastric, stylohyoid, styloid.

Medial branches:

End branches: 1. goes up in the thickness of the parotid

salivary gland, between the external auditory canal and the articular process of the lower jaw and goes to the
temporal region. Bleeding: skin of the temporal, frontal and parietal areas, external auditory canal, ear ravokina,
temporomandibular joint, parotid salivary gland, circular muscle of the eye, muscles of the auricle, tendon helmet,
temporal muscle.
2. from the place of origin, it goes forward to the infratemporal, and then to the
pterygo-palatine fossa, where it splits into terminal branches. Bleeding: skin and muscles of the chin, lower
eyelid, upper and lower lips, external auditory canal, auditory tube, eardrum. The dura mater of the middle
cranial fossa, the temporomandibular joint, the teeth of the upper and lower jaws.

9. Internal carotid artery.

Internal sleepy art (a.carotis interna) supplies the organ of vision and the brain. In this art. Allocate the cervical,
stony, cavernous and cerebral parts. This artery departs at the level of the upper edge of the thyroid cartilage
from the common carotid art. At the inner edge of the anterior process of the sphenoid bone, the inner son. Art.
is divided into its terminal branches - the anterior and middle cerebral art. Ocular art. (A.ophthalmica) goes into
the orbit through the optic canal together with the optic nerve. Bleeding: the eyeball, its muscles, the lacrimal
gland, the lacrimal sac, the eyelids, the mucous membrane of the anterior part of the nasal cavity, ethmoid cells
and the sphenoid sinus.

Anterior cerebral art (a.cerebri anterior) departs from the inner sleep. art is just above the beginning of the eye
art and is directed forward and at the level of the optic chiasm is connected to the opposite one of the same
atp using the front connecting art. Bleeding: medial parts of the frontal, parietal, occipital lobes, corpus
callosum, olfactory bulb.

Medium brain art rises up and lies in the lateral groove of the large brain. Gives off cortical and central
branches. Hemorrhage: upper-lateral parts of the frontal, parietal and temporal lobes, islet

Anterior villous art (a.choroidea anterior) departs from the posterior semicircle of the inner son.art, goes
posteriorly along the outer surface of the brain stem.

Back connecting art. (A.communicanc posterior) departs from the inner son.art posteriorly and medially and
flows into the posterior cerebral artery, which is one of the terminal branches of the basilar part.

10. Subclavian artery

41
Subclavian artery (a.subclavia) is a branch of the brachiocephalic trunk (right) and aortic arch (left). It leaves
the chest cavity through the superior aperture, passes under the clavicle to the 1st rib and penetrates into the
interscalene space. On the 1st rib art. Located in the groove of the subclavian art.

Vertebral artery (a.vertebralis) departs from the upper semicircle of the connection art. immediately upon
leaving the chest cavity. Located behind the common sleepy art. Bleeding: cerebellum, medulla oblongata,
spinal cord, roots of the cervical spinal nerves, meninges, deep muscles of the neck.

Basilar artery (a.basilaris) formed at the junction of the right and left vertebrates art., is located in the basilar
sulcus of the pons. Bleeding: pons, cerebellum, medulla oblongata, diencephalon, occipital lobe of the cerebral
hemisphere, inner ear.

Internal thoracic artery (a.thoracica interna) departs from the bottom. The surface of the subclavian artery
goes down behind the subclavian vein, then descends along the edge of the sternum along the posterior
surface of the cartilaginous part of 1-7 ribs. Bleeding: anterior chest and abdominal walls, sternum, diaphragm,
thymus. Pleura, pericardium, mammary gland, rectus abdominis muscle, lower trachea, main bronchi.

Thyroid trunk (truncus thyrocervicalis) moves away from the upper surface of the connection art. at the point
of its entry into the interstellar space. Blood-ets: thyroid gland, larynx, laryngeal pharynx, cervical esophagus
and trachea.

Costal-cervical trunk (truncus costocervicalis) departs upward and posteriorly from the subkey art in the
interstellar space and immediately divides into deep cervical and highest intercostal art. Bleeding: deep
muscles of the neck, spinal cord in the cervical region and yoke of the membrane, muscles and skin of the
region of 1-2 intercostal spaces.

Transverse neck artery (a.transversa colli) departs after leaving the interstitial space, goes laterally and
posteriorly. Goes to the top of the scapula. Bleeding: muscles - subcutaneous neck, large and small rhomboid,
lifting the scapula, trapezoidal, anterior dentate.

11 axillary artery
Axillary artery (a.axillaris) is the continuation of the connection art. in the axillary cavity (below 1 rib).

Branches:

1.shoracromial artery (a. Thoracoacromialis) beginning at the upper edge of the pectoralis minor muscle,

pierces the clavicular-pectoral fascia. 2.the superior thoracic artery (a.thoracica superior) begins at the upper
edge of the clavicle, goes down medially, the pectoralis major and minor, the muscles of the first and second
intercostal spaces, and the serratus anterior are bleeding.

3.lateral thoracic artery (a.thoracica lateralis) departs at the level of the pectoral triangle, goes along the outer
surface of the serratus anterior muscle.

4.Subscapular artery (a. Subcapulares) departs at the level of the clavicothoracic triangle.

5. Anterior and posterior artery, bending around the humerus. (A.circumflexa humeri anterior et posterior)

42
The anterior one runs laterally under the clavicular-humeral muscle, bends around the surgical neck of the
humerus. The posterior one goes through the quadrangular opening to the deltoid muscle, supplying blood to
the shoulder joint and adjacent muscles.

12.Brachial artery. Formation of the ulnar arterial network.

Brachial artery (a.brachialis) begins at the level of the lower edge of the pectoralis major muscle, being a
continuation of the axillary artery. The superior collateral ulnar artery (a.collateralis ulnaris superior) starts from
the brachial artery in the middle of the shoulder. Together with the ulnar nerve, this artery passes in the
posterior medial ulnar groove, at the level of the elbow joint it gives off branches to its capsule and
anastomoses with the posterior branch of the ulnar recurrent artery.

Inferior collateral ulnar artery departs from the brachial artery just above the medial epicondyle of the humerus,
goes to the elbow joint and forms an anastomosis with the anterior branch of the ulnar recurrent artery.

13.Arteries of the forearm.

Ulnar artery (a.ulnaris) naya-Xia from shoulder art. At the level of the neck of the radius, it goes under the round
pronator, gradually deviates to the ulnar side, giving off muscle branches along the way.

departs from the initial part of the elbow art. And is divided into front
and back branches.

) in the form of a short trunk departs from the beginning

of the ulnar artery. Divided into front and back branches.

departs from the elbow art. Near the pisiform bone, it penetrates into
the rear of the hand, participates in the formation of the dorsal arterial network of the wrist.

departs from the ulnar artery at the level of the pisiform bone or
slightly distal.

The ulnar artery supplies blood to the skin and muscles of the forearm and hand, the ulna, ulna, wrist joint, and
hand joints.

Radial artery (a.radialis) goes down first between the round pronator medially and the brachioradialis laterally.
Has muscular branches.

departs from the radial artery in the ulnar fossa, is directed laterally
and upward between the brachial and brachioradial muscles.

) beginning from the radial artery at the level of the base of the
styloid process of the radial bone.

start from ray art on the back of the hand.

departs within the hand from the radial artery.

43
The radial artery supplies blood to the skin and muscles of the forearm, hand, radius, elbow, wrist, and hand
joints.

14. Arteries of the hand. Palmar arterial arches.

In the palm of the hand, the ulnar artery turns to the lateral side and nastomoses with the superficial palmar
branch of the radial artery. As a result, the ulnar artery forms a superficial palmar arch (arcus Palmaris
superficialis), which is located under the palmar aponeurosis on the tendons of the superficial flexor of the
fingers. The deep palmar arch (arcus Palmaris profundus) is located at the level of the bases of 2-5 metacarpal
bones, under the tendons of the superficial and deep flexors of the fingers, under the beginning of the flexor
muscle of the thumb and its adductor muscle.

From beam art. The first dorsal metacarpal artery, which gives off branches to the adjacent sides of the 1st and
2nd fingers, and the artery of the thumb. This artery departs from the radial artery either in the thickness of the
first interosseous muscle, or at the exit from it and gives off its own three palmar digital arteries (a.digitales
palmares propriae).

15. Branches of the thoracic aorta. Areas of blood supply.

The thoracic part of the aorta is a section that extends from the aortic arch above to the aortic opening of the
diaphragm below. Distinguish between parietal (blood supply to the walls of the chest cavity) and its visceral
branches (go to the organs located in the chest cavity).

The parietal branches include paired posterior intercostal arteries and superior phrenic arteries. The posterior
intercostal arteries (a.intercostales posterior) are paired, in the amount of ten they extend laterally into the
intercostal spaces from 3 to 12. Each intercostal artery is located at the lower edge of the overlying rib (at its
groove), together with the vein and nerve of the same name, between the external and internal intercostal
muscles. From the 4th, 5th, and 6th posterior intercostal arteries, the medial and lateral branches of the
mammary gland (r.mammarii mediales et lateralis) depart. Bleeding: muscles and skin of the chest, vertebrae
and ribs, spinal cord, its membranes, diaphragm. The superior phrenic artery (a.phrenica superior) It departs
from the thoracic part of the aorta directly above the diaphragm, goes to the lumbar part and the pleura
covering the diaphragm. Blood supply to the back of the diaphragm.

Visceral branches the chest part of the aorta is the bronchial branches (r.bronchiales) - it supplies the trachea,
bronchi, and lungs, the esophageal branches (r.oesophageales) - the thoracic esophagus bleeds, the pericardial
branches (r.pericardiaci) - the pericardium, lymph nodes the posterior mediastinum, mediastinal branches
(r.mediastinales) - the pericardium is bleeding, the lymph nodes of the posterior mediastinum.

16. Unpaired visceral branches abdominal aorta. Areas of

blood supply.
Into the unpaired visceral branches of the abdominal aorta includes the celiac trunk, superior and inferior
mesenteric arteries. The celiac trunk (truncus coeliacus) is a short vessel (1.5-2 cm long), which starts from the
anterior semicircle of the aorta at the level of the 12th thoracic vertebra. Above the upper edge of the body of
the pancreas, the celiac trunk is subdivided into the left gastric, common hepatic, and splenic arteries. Bleeding:
abdominal esophagus, stomach, duodenum, pancreas, liver, gallbladder, spleen. The superior mesenteric
artery (a.mesenterica superior) departs from the anterior surface of the aorta at the level of 12 thoracic-1

44
lumbar vertebrae. The artery goes down between the lower part of the 12 duodenum in the back with the head
of the pancreas in front. It has the jejunal, ileal, ileal, colonic, right and middle colon arteries. Blood supply to:
pancreas,

Lower mesenteric artery (a.mesenterica inferior) starting from the left semicircle of the abdominal part of the
aorta at the level of the lower edge of the 3rd lumbar vertebra, goes down and to the left along the anterior
surface of the large muscle, behind the parietal peritoneum. From the inferior mesenteric artery, the left colonic,
sigmoid, superior rectal arteries depart. Bleeding: descending, sigmoid colon, left side of the transverse colon,
upper part of the rectum.

17. Paired visceral branches of the abdominal aorta. Areas of blood supply.
Paired visceral branches of the abdominal aorta are middle adrenal, renal, testicular (ovarian) arteries that
supply blood to paired internal organs located in the abdominal cavity and outside it (sex glands).

Middle adrenal artery (a.suprarenalis media) departs from the aorta at the level of 1 lumbar vertebra and goes
to the adrenal gland.

Renal artery (a.renalis) departs from the aorta at the level of 1-2 lumbar vertebrae, 1-2 cm below the beginning
of the superior mesenteric artery. Renal art. Goes to the gate of the kidney and is divided into anterior and
posterior branches, extending into the renal parenchyma. Blood supplies: kidney, adrenal gland, upper ureter,
kidney capsule. Testicular (Ovarian) artery (a.testicularis, ovarium) is a thin vessel extending from the aorta
downward at an acute angle at the level of 2 lumbar vertebra. The artery is directed downward and laterally.
Blood supply: testicle, its epididymis, vas deferens, ureter, testicular membranes (ovary, fallopian tube, ureter)

18. Parietal branches of the abdominal aorta, Areas of blood supply.

The parietal branches of the abdominal aorta include the lumbar arteries and the lower phrenic artery, which
supply blood to the walls of the abdominal cavity.

Lumbar arteries (a.lumbalis) in the amount of 4 pairs depart from the posterior semicircle of the abdominal
part of the aorta at the level of 1-4 lumbar vertebrae. Its branches are located between the transverse and
internal oblique muscles of the abdomen, giving branches to them. It supplies blood to the spinal cord, its
membranes, muscles of the back and abdominal wall. The lower phrenic artery (a. Phrenica inferior) departs
from the aorta under the diaphragm at the level of the 12th thoracic vertebra, supplying blood to the diaphragm
and the peritoneum covering it. It gives from 1 to 24 upper adrenal arteries.

19. Branches of the external and internal iliac arteries. Areas of blood
supply
Common iliac arteries (a.iliaca communis), right and left, are formed at the level of the 4th lumbar vertebra as a
result of the division of the abdominal part of the aorta. Anterior to the sacroiliac joint, each common iliac
artery divides into an internal iliac artery and a thicker external iliac artery.

Internal iliac artery (a.iliaca interna) goes down the back wall of the pelvis. At the upper edge of the large
sciatic foramen, it is divided into anterior and posterior branches.

45
 departs from the initial part of the internal iliac arth., at the level of the
sacroiliac joint it goes up [and laterally. Bleeding: muscles - psoas major, iliac, quadratus lumbar muscle,
transverse abdominal muscle, iliac bone, spinal nerve roots, spinal cord membranes.

departs at the level of the 3 pelvic sacral foramen and goes down the
pelvic surface of the sacrum. Bleeding: sacrum, spinal cord membranes, levator ani muscle, piriformis muscle.

goes down the lateral wall of the pelvis to the obturator canal. Bleeding: pubic
symphysis, iliac bone, hip joint, iliopsoas muscles, square femoris muscle, levator ani muscle, obturator,
adductor thigh muscles. 4. The superior gluteal artery (a.glutea superior) leaves the pelvic cavity through the
supra-piriform opening and is divided into superficial and deep branches. Bleeding: the hip joint, the skin of the
gluteal region, the muscles of the small and middle gluteal muscles, straining the broad fascia of the thigh. 5.
The inferior gluteal artery (a.glutea inferior) leaves the pelvic cavity through the piriform opening.
Bleeding: gluteus maximus muscle, square muscle of the thigh, hip joint, skin of the gluteal region. 6. The
umbilical artery (a.umbilicalis) departs from the anterior semicircle of the internal subvascular artery, goes to
the inner surface of the anterior abdominal wall. Bleeding: the bladder, the lower gives off the ureter, the vas
deferens (in men)

goes to the bottom of the bladder. Bleeding: bladder, prostate gland.

located between the leaves of the broad ligament of the uterus. Bleeding: uterus,
vagina, fallopian tube, ovary.

External iliac artery (a.iliaca externa) being a continuation of the trunk of the common iliac artery, through the
vascular lacuna it leaves the pelvic cavity continuing into the femoral artery.

departs at the level of the inguinal ligament, goes forward and

upward along the inner surface of the anterior abdominal wall. Bleeding: spermatic cord, levator testicle
muscle (in men), round ligament of the uterus (in women). Abdominal muscles: straight, transverse, oblique,
pyramidal.

departs at the level of the beginning of the lower

epigastric art and goes into the pelvic cavity along the inner surface. inguinal ligament. Bleeding: abdominal
muscles - transverse, oblique, iliac muscles, tensioner of the wide fascia of the thigh, tailor.

20. Femoral artery: branches and areas of blood supply.

Femoral artery (a. Femoralis) located on the front of the thigh, goes obliquely from top to bottom and medially.

nap-Xia laterally and upward under the

inguinal ligament in the direction of the anterior superior iliac spine.
forms superficial and deep branches. Superficial branches in the
skin of the pubic region. Deep branches pierce the fascia and extend under the skin of the comb muscle.

46
 departs from the back surface 3-5 cm below the inguinal ligament.
Located between the vastus medialis and the adductors of the thigh.
departs from the femoral artery in the adductor canal,
goes to the front surface of the thigh.
Bleeding: the anterior abdominal wall, the skin and muscles of the thigh, the hip and knee joints, the external
genitalia, the muscles of the back of the thigh.

21.Popliteal artery. Formation of the arterial network of the knee joint.

Popliteal artery (a. Poplitea)being a continuation of the femoral artery after its exit from the adduction canal, it
is located together with the popliteal vein in the popliteal fossa. The popliteal artery is divided into the anterior
and posterior tibial arteries. From the popliteal artery, the medial upper and lower knee arteries, the middle
knee artery, and the lateral upper and lower knee arteries depart. All these arteries are involved in the formation
of the arterial network of the knee articular network (rete articulare genus).
Lateral superior knee artery (a.superior lateralis genus) -depart over the lateral condyle of the femur, bends
around it and supply blood to the lateral vastus muscle and the biceps femoris muscle. The medial superior
knee artery (a. Superior medialis genus) bends around the medial condyle of the femur from above, supplies
blood to the medial broad muscle of the thigh.
Middle artery of the knee (a.genus media) strains to the posterior surface of the capsule of the knee joint, and
supplies it with blood.

22. Artery of the leg and foot.

Anterior tibial artery (a. Tibialis anterior) departs from the popliteal artery in the popliteal fossa and
immediately enters the ankle-popliteal canal. In the lower part of the leg, the anterior tibial artery passes
between the long muscle, the extensor big toe and the anterior tibial muscle, and continues to the foot as the
dorsal artery of the foot. Bleeding: skin and muscles of the anterior leg, knee and ankle joints.
Dorsal artery of the foot (a.dorsalis pedis) is a continuation of the anterior tibial artery on the foot. The dorsal
artery of the foot runs along the front surface of the ankle joint, between the long extensor tendon of the big toe
medially and the short extensor of this toe laterally. Bleeding: bones, joints of the foot, skin of the rear, medial
and lateral edges of the foot, muscles of the rear of the foot. Fingers, interosseous muscles.
Posterior tibial artery (a.tibialis posterior) being a continuation of the popliteal artery, it passes under the
tendinous arch of the soleus muscle into the ankle-popliteal joint. Further, the posterior tibial artery goes down
the posterior side of the long flexor of the fingers, gradually shifting towards the medial side. Bleeding: knee
joint, tibia and fibula, ankle, skin and muscles of the back of the leg.
Medial plantar artery (a.plantaris medialis) on the foot, first it goes under the muscle that abducts the thumb,
then lies between this muscle medially and the flexor of the fingers laterally. Bleeding: code of the medial part
of the sole, the muscles of the eminence of the big toe.
Lateral plantar artery (a.plantaris lateralis) the larger one, goes along the lateral groove of the sole to the base
of the fifth metatarsal bone, where it forms a bend in the medial direction - the plantar arch. Bleeding: the skin
of the lateral part of the sole, muscles of the eminence of the little toe, middle group, joints of the foot.

23. Anastomoses between the branches of the arteries of the lower

extremity.
1. The superficial artery enveloping the ilium anastomoses with the deep artery enveloping the ilium and the
ascending branch of the lateral artery enveloping the femur.

47
2. The medial artery, which bends around the femur, anastomoses with the branches of the obturator artery,
which bends around the femur and the first perforating artery.
3. The perforating arteries anastomose among themselves.
4. The posterior tibial recurrent artery anastomoses with the medial inferior knee artery.
5. The lateral anterior ankle artery anastomoses with the lateral ankle branches of the peroneal artery.
6. The medial anterior ankle artery anastomoses with the medial ankle branches.

24. Veins of the head and neck.

Internal jugular vein (v. Jugularis interna) collects blood from organs and tissues of the head and neck, the
brain and its membranes, organs of vision and hearing. This vein is formed in the region of the jugular foramen,
where the sigmoid sinus passes into it.
Diploic veins (v. Diplocae) collect blood from the bones of the skull. These veins are located in the spongy
substance of the bones of the cranial vault, communicate with the sinuses of the dura mater and superficial
veins of the head - the frontal diploic vein (v. anterior) - flows into the wedge-parietal sinus.
Emissary veins connects the saphenous veins of the head and the sinuses of the dura mater. The mastoid
emissary vein (v. Emissaria mastoidea) is located in the mastoid tubule of the temporal bone. The condylar
emissary vein (v. Emissaria condylaris) passes through the condylar canal of the occipital bone.
Eye veins carry out the outflow of blood from the eye sockets. The lower eye vein (v.ophtalmica inferior) is
located on the lower wall of the orbit, the veins of the ciliary body, eye muscles, veins located in the canals of
the zygomatic bone flow into it. The superior ocular vein (v.ophthalmica superior) takes the lacrimal vein,
anterior and posterior ethmoid veins, nasolabial veins.
In the neck area, the pharyngeal, lingual, upper thyroid, facial, mandibular and other veins flow into the internal
jugular vein.
The external jugular vein (v. Jugularis externa) collects blood from the posterior parotid and occipital regions,
the deep temporal region of the face. The external jugular vein is formed from the anterior and posterior
tributaries connecting at the anterior edge of the sternocleidomastoid muscle.
Anterior jugular vein (v. jugularis anterior) formed from small veins in the chin region. The anterior jugular vein
flows into the external jugular, subclavian or brachiocephalic vein directly. The subclavian vein (v.subclavia) is
a continuation of the axillary vein. The subclavian vein lies 1 rib in front of the attachment of the anterior
scalene muscle.

25. Veins of the upper limb.

Distinguish between superficial and deep veins of the upper extremity, which are connected by numerous
anastomoses.
Superficial veins of the upper limb originate from the veins of the dorsal venous network of the hand (rete
venosum dorsal manus), which is located under the skin on the back of the fingers, metacarpus and wrist. This
network is formed by the dorsal metacarpal veins (v.metacarpales dorsales) that anastomose together.
The superficial veins are the lateral and medial saphenous veins of the arm.
) beginning from the lateral part of the dorsal venous network of
the hand, being a continuation of the first dorsal metacarpal vein. Goes up to the axillary vein and flows into it.
beginning from the medial part of the dorsal venous network of
the hand, being a continuation of the fourth dorsal metacarpal vein. The medial saphenous vein of the hand
passes from the back of the hand to the elbow of the front of the forearm.
Deep veins of the upper limb.

48
 paired, starting from a deep venous arch accompanying the
arterial arch of the same name. Deep veins also receive blood from the surfaces of the venous palmar arch and
superficial veins through numerous anastomoses of the veins of the upper limb. Merging, these veins form two
brachial veins (v. Brachiales), which rise upward, join into a single trunk, passing at the level of the lower edge
of the latissimus dorsi tendon into the axillary vein. Axillary vein (v.axillaaris) continues to the level of the lateral
edge of 1 ribs, where it goes into the subclavian vein.

26. Veins of the chest cavity and their tributaries.

Unpaired Vienna (v.azygos) collects blood from the posterior walls of the chest and abdominal cavities, as
well as from the organs of the posterior mediastinum. The unpaired vein on the posterior wall of the abdominal
cavity begins from the ascending right lumbar vein. The ascending right lumbar vein (v. Lumbalis ascendens
dextra), being the beginning of the azygos vein, is formed from the anterior sacral veins. In the thoracic cavity,
this vein takes the name of the azygos vein, which follows upward in the posterior mediastinum, to the right of
the thoracic aorta and thoracic lymphatic duct. Eight (4-11) posterior right intercostal veins (v.intercostales
posteriors) and the right superior intercostal vein (v. Intercostalis superior dextra), formed from the three upper
right intercostal veins, flow into the azygos vein. The esophageal, bronchial, pericardial and mediastinal veins
also flow into the azygos vein.
Semi-unpaired Vienna (v. Hemiazygos) start from the left ascending lumbar vein, originating in the small
pelvis from the anterior sacral veins. The left ascending lumbar vein (v. Lumbalis ascendens sinistra) behind
the psoas major muscle forms an anastomosis with 4-5 left lumbar veins.
Posterior intercostal veins (v.intercostales posteriores) pass along with the arteries of the same name. Each
posterior intercostal vein anastomoses with the anterior intercostal veins.

27. Portal vein formation: tributaries and features.

Portal vein of the liver (v.portae) collects blood from all unpaired abdominal organs. A portal vein is formed
behind the head of the pancreas, their superior and inferior mesenteric and splenic veins. The portal vein runs
obliquely up and to the right between the descending part of the duodenum and the head of the pancreas.
Having entered the liver, the portal vein is divided into right and left branches.
They flow into the portal vein gastric, pre-pituitary, biliary and peri-umbilical veins.
Superior mesenteric vein (v. Mesenterica superior) nah-Xia to the right of the artery of the same name, it
collects blood from the walls of the mesenteric part of the small intestine, cecum and appendix, ascending and
transverse colon, stomach, greater omentum, duodenum 12 and pancreas. The veins of the jejunum and ileum
flow into this vein, the ileo-colon vein, the right colon vein, the middle colon vein.
Splenic vein (v. Lienalis) goes behind the body of the pancreas, located slightly below the splenic arteries. It
receives from the stomach short gastric veins, pancreatic veins, and the left gastroepiploic vein.
Lower mesenteric vein (v. Mesenterica inferior) ob-Xia in the left iliac region as a result of the fusion of the
superior rectal vein and veins of the sigmoid colon.

28. Inferior vena cava.

Inferior vena cava (v.cava inferior) collects blood from the abdominal and pelvic organs, the walls of these
cavities and the lower extremities. This vein is at the level of the intervertebral disc between the 4-5 lumbar
vertebrae at the junction of the right and left common iliac veins. The inferior vena cava lies on the lumbar
spine. The inferior vena cava has parietal (parietal) and visceral (internal) tributaries. The parietal tributaries of
the inferior vena cava are paired diaphragmatic and lumbar veins. The visceral tributaries of the inferior vena
cava are paired testicular (ovarian), renal, adrenal veins.

49
 29. Porto-caval anastomoses. Scheme.
30. Kava-caval anastomoses. Scheme
The roots of the portal vein are anastomosed with the roots of the veins belonging to the systems of the
superior and inferior vena cava, forming the so-called portocaval anastomoses. If we compare the abdominal
cavity with a cube, then these anastomoses will be located on all its sides, namely:
1. Above, in the pars abdominalis of the esophagus, between the roots of v. gastricae sinistrae, which flows
into the portal vein, and
vv. esophageae flowing into vv. azygos et hemyazygos and further in v. cava superior.

2. Below, in the lower part of the rectum, between v. rectalis superior, flowing through v. mesenteria inferior in
the portal vein, and vv. rectales media (tributary v. iliaca interna) et inferior (tributary v. pudenda interna)
flowing into v. iliaca interna, and further v. iliaca communis - from system v. cava inferior.

3. In front, in the navel area, where vv is anastomosed with their tributaries. paraumbilicales, going through the
lig. teres hepatis to the portal vein, v. epigastrica superior from v. cava superior (v. thoracica interna, v.
brachiocephalica) and v. epigastrica inferior from the v. cava inferior (v. iliaca externa, v. iliaca communis).
Portocaval and cavo-caval anastomoses are obtained, which have the significance of a roundabout way of
blood outflow from the portal vein system when there are obstacles for it in the liver (cirrhosis). In these
cases, the veins around the navel dilate and acquire a characteristic appearance ("jellyfish head").
Portocaval and cavo-caval anastomoses.

4. Behind, in the lumbar region, between the roots of the veins of the mesoperitoneal colon (from the
portal vein) and parietal vv. lumbales (from v. cava inferior system).

5. In addition, there is a cavo-caval anastomosis between the roots of vv on the posterior abdominal wall.
lumbales (from the v. cava inferior system), which are associated with the pair v. lumbalis ascendens, which
is the beginning of vv. azygos (right) et hemiazygos (left) (from v. cava superior system).

6. Cavo-caval anastomosis between vv. lumbales and intervertebral veins, which in the neck are the roots of
the superior vena cava.

31. Veins of the small pelvis.

In the pelvic cavity, the largest venous vessels are the right and left common iliac veins (v. Iliacae
communes), which are connected at the level of the intervertebral disc of 4-5 lumbar vertebrae and form
the inferior vena cava. The right common iliac vein is shorter than the left. The median sacral vein
(v.sacralis mediana) flows into the left. At the level of the sacroiliac joint, each common iliac vein forms at
the junction of the external and internal iliac veins.
Internal iliac vein (v.iliaca interna) located on the lateral surface of the small pelvis, has parietal
(ilio-lumbar vein, lateral sacral, obturator veins, superior and inferior gluteal veins) and visceral (internal
genital vein, urinary veins, middle rectal veins, prostatic veins) inflows.
External iliac vein (v.iliaca externa) being a continuation of the femoral vein in the pelvic cavity, it receives
blood from the lower extremities and partly from the walls of the pelvis. The inflows are the inferior
epigastric vein, the deep vein enveloping the iliac bone.

32. Veins of the lower limb

50
On the lower limb, superficial and deep veins are distinguished, anastomosing with each other. Popliteal
vein (v. Poplitea) is broken up between the tibial nerve and the popliteal artery. The small saphenous vein
of the leg, the veins of the knee, and the calf veins flow into it.
Femoral vein (v.femoralis) decay behind the femoral artery, and then takes a medial position. At the level of
the inguinal ligament, it passes into the vascular lacuna and continues into the external iliac vein.

33. Features of fetal blood circulation

Oxygen and nutrients are delivered to the fetus from the mother's blood through the placenta - the
placental circulation. It happens as follows. Arterial blood, enriched with oxygen and nutrients, flows from
the mother's placenta into the umbilical vein, which enters the fetal body at the navel and goes up to the
liver, lying in its left longitudinal sulcus. At the level of the gate of the liver v. umbilicalis is divided into two
branches, one of which immediately flows into the portal vein, and the other, called the ductus venosus,
runs along the lower surface of the liver to its posterior edge, where it flows into the trunk of the inferior
vena cava.
The fact that one of the branches of the umbilical vein delivers pure arterial blood to the liver through the
portal vein determines the relatively large size of the liver; the latter circumstance is associated with the
function of hematopoiesis of the liver, which is necessary for the developing organism, which
predominates in the fetus and decreases after birth. Having passed through the liver, blood flows through
the hepatic veins into the inferior vena cava.
Thus, all blood from v. umbilicalis, either directly (through the ductus venosus), or indirectly (through the
liver) enters the inferior vena cava, where it mixes with the venous blood flowing through the vena cava
inferior from the lower half of the fetal body.
Mixed (arterial and venous) blood flows through the inferior vena cava into the right atrium. From the right
atrium, it is directed by the valve of the inferior vena cava, valvula venae cavae inferioris, through the
foramen ovale (located in the atrial septum) into the left atrium. From the left atrium, mixed blood enters
the left ventricle, then into the aorta, bypassing the pulmonary circulation that is still not functioning.

In addition to the inferior vena cava, the superior vena cava and the venous (coronary) sinus of the heart
also flow into the right atrium. Venous blood entering the superior vena cava from the upper half of the
body then enters the right ventricle, and from the latter into the pulmonary trunk. However, due to the fact
that the lungs do not yet function as a respiratory organ, only a small part of the blood enters the
parenchyma of the lungs and from there through the pulmonary veins into the left atrium. Most of the blood
from the pulmonary trunk along the ductus arteriosus passes into the descending aorta and from there to
the viscera and lower extremities. Thus, despite the fact that in general, mixed blood flows through the
vessels of the fetus (with the exception of v. Umbilicalis and ductus venosus before it flows into the inferior
vena cava), its quality below the place of confluence of the ductus arteriosus significantly deteriorates.
Hence, the upper body (head) receives blood richer in oxygen and nutrients. The lower half of the body eats
worse than the upper one, and lags behind
in its development. This explains the relatively small size of the pelvis and lower limbs of the newborn.

V. Anatomy of the lymphatic system.

1. Anatomy of the lymphatic system.

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The lymphatic system is part of the cardiovascular system and complements the venous system, takes part
in metabolism, cleanses cells and tissues. It consists of lymphatic pathways that perform transport
functions, and organs of the immune system that perform the functions of immune and biological
protection. Lymph nodes, lymphatic capillaries and blood vessels, ducts and trunks through which lymph
(tissue fluid) flows, are united under the general name of the lymphatic system ( systema lymphaticum).

2. The mechanism of lymph movement. Pathways for the outflow of lymph

into the venous bed.
From the lower extremities and the pelvis, lymph passes along the right and left lumbar trunks (truncus
lumbalis dexter et sinister), and from the abdominal organs - along the intestinal trunk (truncus
intestinalis). At level II of the lumbar vertebra, the trunks are combined into the thoracic duct (ductus
thoracicus) (Fig. 215). At the very beginning of the thoracic duct, the length of which can vary from 20 to
40 cm, there is a small expansion called the cisterna chyli. The thoracic duct itself through the aortic
opening of the diaphragm enters from the abdominal cavity into the chest, where at the level of V-III of the
thoracic vertebrae it turns to the left, penetrating into the neck, and forms an arc. Then the thoracic duct
flows into the left venous angle formed by the left subclavian vein and the left jugular vein.

Lymph from the left half of the organs and walls of the chest is collected by the left broncho-mediastinal
trunk (truncus bronchomediastinalis), from the left side of the head and neck - by the left jugular trunk
(truncus jugularis sinister), and from the left hand - by the left subclavian trunk (truncus subclavius
sinister). They all flow into the cervical part of the thoracic duct. They correspond to three right trunks of
the same name, collecting lymph from the organs and walls of the right half of the chest, the right side of
the head and neck and the right arm. The right lymphatic trunks flow into the right lymphatic duct (ductus
lymphaticus dexter), which, in turn, flows into the right venous angle. The length of the right lymphatic duct
is no more than 1-1.5 cm.

3. Lymphatic vessels and nodes. Structure.

Lymphatic vessels (vasa lymphatica) formed when the lymphatic capillaries merge. The walls of the
lymphatic vessels are thicker, they consist of three layers. Outside the endothelium (inner tunica intima) is
the middle tunic (tunica media), which is covered by the outer membrane
(tunica externa).

Lymph. The vessels have valves, the presence of which gives them a characteristic clear-cut appearance.
The valves of the lymphatic vessels, formed by the folds of the inner membrane, are located in such a way
that they can pass lymph in only one direction: from the place of its formation in the capillaries towards
the lymph nodes, lymphatic trunks and ducts.

Through the lymphatic vessels, lymph from organs and parts of the body is directed to the lymph nodes.
From the lymph nodes through their outflowing lymphatic vessels, lymph flows either to the next lymph
nodes, or to the collector vessels - the lymphatic trunks and lymphatic ducts. Through these vessels,
lymph flows to the lower parts of the neck, towards the so-called venous angle, formed on the right and left
when the internal jugular and subclavian veins merge.

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4.Lymphatic vessels and nodes of the chest, abdominal cavity and small
pelvis.

Parietal nodes of the chest cavityconstitute the peri-pectoral, or paramammary, nodes, periosternal, or
parasteral (nodi lymphatici parasternales), prevertebral upper diaphragmatic (nodi lymphatici phrenici
posteriores) and intercostal lymph nodes (nodi lymphatici intercostales). The visceral includes pulmonary
(nodi lymphatici pulmonales), bronchopulmonary (nodi lymphatici bronchopulmonales), tracheobronchial
(nodi lymphatici tracheobronchiales), tracheal (nodi lymphatici tracheales), juxtapoesophageal lymphatic and
medial pericardial lymph nodes, prepericardial posteriores).

In the peri-sternal, intercostal and upper diaphragmatic lymph nodes, lymph is collected from the walls of
the chest cavity and parietal pleura. From the lungs, lymph enters the pulmonary, juxtapesophageal lymph
nodes, and from them, through the outflowing vessels, enters the tracheobronchial lymph nodes. Individual
lymphatic vessels of the lungs carry lymph to the anterior and posterior mediastinal nodes. The lymphatic
vessels of the peritracheal nodes merge into the broncho-mediastinal trunk, which flows into the thoracic
duct on the left, and into the right lymphatic duct on the right, which are the main lymphatic vessels. In the
anterior mediastinal, tracheobronchial, peri-tracheal, pre-pericardial and lateral pericardial lymph nodes,
lymph flows from the heart. From the medial parts of the mammary gland, lymph is directed to the
peri-sternal lymph nodes, from the lateral to the axillary nodes. From the upper sections of the mammary
gland, lymph flows into the upper group of axillary (subclavian) nodes and into deep cervical
(supraclavicular) nodes (nodi lymphatici cervicales profundi), and from the lower sections into the upper
epigastric lymph nodes.

Lymph nodes of the abdominal cavity are also subdivided into parietal and visceral.

Parietal nodes are concentrated in the lumbar region. Among them, there are left lumbar lymph nodes
(nodi lymphatici lumbales sinistri), which include lateral aortic, preaortic and postaortic nodes,
intermediate lumbar nodes located between the portal and inferior vena cava, and right lumbar nodes
(nodi lymphatici lumbales dextri) self lateral caval, precaval and postcaval lymph nodes. The classification
is carried out depending on the position of the nodes in relation to the aorta and inferior vena cava.

Internal nodes are arranged in several rows. Some of them are located on the path of the lymph from the
organs along the large intra-neural vessels and their branches, the rest are collected in the area of the
gates of the parenchymal organs and near the hollow organs. Lymph from the stomach enters the left
gastric nodes (nodi lymphatici gastrici sinistri), located in the lesser curvature of the stomach, left and
right gastroepiploic nodes (nodi lymphatici gastroomentales sinistri et dextri), lying in the area of the
greater curvature of the stomach, hepatic nodes (lymphatic hepatici), following along the hepatic vessels,
pancreatic and splenic nodes located in the gate of the spleen, pyloric nodes, heading along the
gastro-duodenal artery, and into the cardiac nodes that form the lymphatic ring of the cardia. From the
duodenum and pancreas, lymph flows into the pancreatoduodenal nodes along the vessels of the same
name, and part of the lymph from the pancreas is sent to the pancreas-splenic lymph nodes (nodi
lymphatici pancreaticolienales). Lymph from the jejunum and ileum enters the superior mesenteric nodes
(nodi lymphatici mesenterici superiores). The outflowing vessels of the upper mesenteric nodes carry
lymph to the lumbar and celiac nodes (nodi lymphatici coeliaci). Lymph from the colon, down to the

53
descending colon, is directed to the ileo-colonic nodes (nodi lymphatici ileocolici), the left, middle and right
colonic nodes, and to the left and right gastroepiploic nodes. Of these nodes, the outflowing vessels
supply lymph to the superior mesenteric and lumbar nodes. Lymph from the descending and colon and the
sigmoid colon is taken by the left colon-intestinal nodes, and the efferent vessels carry it further, to the
lower mesenteric and lumbar nodes. From the liver, lymph is collected mainly in the hepatic, celiac, pyloric
and right gastric nodes. Then it enters the lower and upper diaphragmatic nodes (nodi lymphatici phrenici
inferiores et superiores), and from there - to the nodes of the mediastinum (nodi lymphatici mediastinales).
Lymph from the kidneys is sent to the renal nodes, from where the efferent vessels carry it to the lumbar
nodes. Then it enters the lower and upper diaphragmatic nodes (nodi lymphatici phrenici inferiores et
superiores), and from there - to the nodes of the mediastinum (nodi lymphatici mediastinales). Lymph
from the kidneys is sent to the renal nodes, from where the efferent vessels carry it to the lumbar nodes.
Then it enters the lower and upper phrenic nodes (nodi lymphatici phrenici inferiores et superiores), and
from there - to the nodes of the mediastinum (nodi lymphatici mediastinales). Lymph from the kidneys is
sent to the renal nodes, from where the efferent vessels carry it to the lumbar nodes.

Pelvic lymph nodes make up two large groups: parietal, or parietal, nodes and visceral, or visceral, nodes.

Parietal nodes collect lymph from the walls of the pelvis and include external, internal and common iliac
nodes (nodi lymphatici iliaci externi, interni et communi)

The internal nodes serve the internal organs and are subdivided into peri-rectal, peri-vesical, perivaginal
and peri-ocular. The lymphatic vessels, heading from the bladder, carry lymph to the external and internal
iliac, lumbar (nodi lymphatici lumbales) and sacral (nodi lymphatici sacrales) lymph nodes. Lymph from
the vagina and uterus collects in the lumbar nodes, superficial inguinal nodes, external and internal sacral
and iliac lymph nodes. From the testicle and prostate, lymph enters the lumbar nodes, external and internal
iliac lymph nodes. Superficial inguinal lymph nodes receive lymph from the external genitalia.

The outflowing vessels of the external and internal iliac nodes are directed to the common iliac lymph nodes,
from which lymph enters the lumbar nodes.

5.Lymphatic vessels and nodes of the upper and lower extremities.

In the area of the lower limb, superficial and deep lymphatic vessels are distinguished. The former
collect lymph from the skin and subcutaneous tissue, the latter remove it from bones, joints, ligaments,
tendons, muscles and fascia. The lymph nodes of the lower extremity are divided into inguinal (nodi
lymphatici inguinales) and popliteal (nodi lymphatici poplitei), which are also divided into deep and
superficial.

Superficial vessels include those of the medial group and those of the posterolateral group. Vessels of the
medial group accompany the great saphenous vein and collect lymph from the medial surfaces of the foot,
lower leg and thigh. They start from the capillary lymphatic networks of the skin, flow into the large
lymphatic vessels, and then into the superficial inguinal lymph nodes (nodi lymphatici inguinales
superficiales which are located below the inguinal ligament. Lymph from the external genital organs,
perineum, lower half of the anterior abdominal walls, the lower back, some organs of the pelvic cavity.The
posterolateral vessels accompany the small saphenous vein and provide lymph outflow from the lateral
surfaces of the foot and lower leg.Gathering, the vessels flow into the popliteal lymph nodes.

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Deep lymphatic vessels begin from the capillaries of the lymphatic network of the bone marrow,
periosteum, joints, muscles and fascia. They collect lymph from the foot, lower leg and knee joint, flowing
into the popliteal nodes.

From the tissues of the thigh, lymph is sent to the deep inguinal lymph nodes (nodi lymphatici inguinales
profundi) from where the outflowing vessels deliver it to the external iliac lymph nodes of the pelvis
(nodi lymphatici iliaci externi).

In the upper limb are the axillary (nodi lymphatici axillares) and ulnar lymph nodes (nodi lymphatici
cubitales). Both groups are divided into superficial and deep lymph nodes. The medial surface of the
forearm and hand is served by the medial superficial lymphatic vessels, some of which flow into the
superficial axillary nodes, and the other part into the superficial ulnar nodes. The outflowing vessels of the
latter carry lymph to the central superficial lymph nodes (nodi lymphatici centralis superficiales). Lymph
from the lateral surface of the shoulder, forearm and hand goes along the lateral vessels, which supply it to
the deep axillary lymph nodes. Deep lymphatic vessels accompany deep arteries and veins and carry
lymph from the hand and forearm to the ulnar lymph nodes, from where it enters the deep axillary nodes. In
the deep axillary nodes, lymph is also collected from the upper parts of the anterior abdominal wall, the
walls of the chest cavity and the lateral part of the mammary gland. The outflowing vessels of the axillary
nodes form the subclavian trunk (trancus subclavius), the left side of which flows into the thoracic duct,
and the right into the right lymphatic duct.

6. Lymphatic vessels and nodes of the head and neck

Head lymph nodes include parotid nodes (nodi lymphatici parotidei) (which are subdivided into superficial
and deep, occipital (nodi lymphatici occipitales) mastoid (nodi lymphatici mastoidei) submandibular (nodi
lymphatici lymphatici lymphatic nodes lymphatic nodi) chin

The lymphatic vessels in the occipital region carry lymph to the occipital nodes. From the auricle and the
posterior parts of the parietal and occipital regions, the lymphatic vessels of the head are directed to the
mastoid nodes. Lymph from the forehead, the anterior parietal and temporal regions, the tympanic
membrane, the external auditory canal, part of the auricle and part of the eyelids enters the parotid lymph
nodes. From these nodes, the efferent vessels transmit lymph to the lymph nodes of the neck. In the
submandibular nodes, lymph is collected from the bones and soft tissues of the face. Lymph drainage
from the lower lip and chin is carried out to the chin nodes.

Neck lymph nodessubdivided into anterior and lateral groups. Each of the groups, in turn, is divided into
superficial and deep lymph nodes of the neck (nodi lymphatici cervicales superficiales et profundi). The
anterior superficial lymph nodes of the neck are located next to the anterior jugular vein and are
concentrated on the superficial fascia. The anterior deep nodes are located next to the organs from which
they collect lymph, and have the same names (for example, prelaryngeal, pretracheal, thyroid, etc.). The
group of deep lateral nodes consists of supraclavicular and retropharyngeal lymph nodes (nodi lymphatici
retropharyngei), as well as anterior and lateral jugular nodes located near the internal jugular vein.

Deep nodes in the neck receive lymph from the nasal cavity, mouth, part of the pharynx and middle ear,
which previously passes through the occipital nodes. The lymphatic vessels of the tongue end in the

55
 lingual lymph nodes (nodi lymphatici linguales). From the lingual nodes, lymph enters the submandibular
and chin nodes, and from there - into the pharyngeal and deep cervical nodes. From the deep cervical
nodes, lymphatic vessels begin, passing on each side and accompanying the internal jugular vein. These
vessels form the right and left jugular trunks (tranci jugulares dexter et sinister). The left one flows into the
thoracic duct, and the right one into the right lymphatic duct.

7. Right and thoracic lymphatic ducts: formation, places of confluence into

the bloodstream
Right lymphatic duct (ductus lymphaicus dexter) is a short vessel 10-20 mm long, into which the right
broncho-mediastinal trunk flows. The right subclavian and jugular trunks sometimes flow into the right
lymphatic duct, the short ones usually follow independently to the right venous angle or the end sections
of the venous subclavian or internal jugular that form it. The thoracic duct (ductus thoracicus) is formed in
the retroperitoneal tissue at the level of 12 thoracic - 2 lumbar vertebrae, when the right lumbar trunk and
the left lumbar trunk merge.

Vi. Anatomy of the hematopoietic organs and the immune system

1. Organs of the immune system, their classification.

The immune system provides the body's immune defense through the cellular elements of the immune
system, which are lymphocytes and plasma cells.

The immune system is made up of lymph nodes, spleen, bone marrow, thymus gland, or thymus, as well as
lymphoid tissue of the walls of the respiratory and digestive systems, which include the tonsils, group
lymphoid nodules of the appendix, group and single lymphoid nodules of the ileum.

2. Bone marrow, thymus gland, their structure, functions.

Bone marrow(medulla ossium) is the main organ of hematopoiesis. In newborns, it fills all bone marrow
cavities and is characterized by a red color (medulla ossium rubra). Upon reaching 4-5 years in the diaphysis
of tubular bones, the red bone marrow is replaced by adipose tissue and acquires a yellow tint (medulla
ossium flava). In an adult, red bone marrow is preserved in the epiphyses of long bones, short and flat bones.
Its total mass reaches 1.5 kg. Red bone marrow is formed by myeloid tissue, which contains hematopoietic
stem cells. These cells are the ancestors of all blood cells and, with its flow, enter the organs of the immune
system, where they are differentiated. Some of the stem cells enter the thymus gland, where they differentiate
as T-lymphocytes, that is, thymus-dependent. Later they spread to certain areas, called thymus-dependent
areas of the lymph nodes and spleen. T-lymphocytes destroy obsolete or malignant cells, and also destroy
foreign cells, that is, they provide cellular and tissue immunity.

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The rest of the stem cells enter other organs of the immune system, where they differentiate as cells that take
part in the humoral reactions of the immune system, that is, B-lymphocytes, or bursose-dependent. The name
of these cells comes from the name of the Fabritius bursa present in birds, which is an accumulation of
lymphatic tissue in the wall of the cloaca. It is assumed that in humans, such a bag can either be located in
the bone marrow, or it is represented by group lymphoid nodules of the ileum and the appendix.
B-lymphocytes are the ancestors of cells that produce antibodies, or immunoglobulins, and settle in
bursos-dependent areas of the peripheral organs of the immune system.

Thymus(thymus) (Fig. 244, 248) performs an immunological function, a function of hematopoiesis and
carries out endocrine activity. The latter fact allows it to be ranked not only among the organs of the immune
system, but also among the organs of internal secretion.

In the thymus gland, differentiation of stem cells of the red bone marrow takes place, falling into the
subcapsular zone of the subcortical substance. Therefore, it is the source of T-lymphocytes, that is, the
central organ of the immune system. In relation to it, the lymph nodes and spleen are peripheral organs.

The thymus gland is located in the upper mediastinum, lying in front of the pericardial sac, the aortic arch, the
superior vena cava and brachiocephalic veins. Its anterior surface is in contact with the handle and the body
of the sternum, and areas of the lung tissue and the mediastinal pleura are adjacent to the lateral surfaces. In
the thymus gland, the right and left lobes are distinguished, the location of which determined the name of the
organ. Both lobes are covered with a capsule (capsula) formed by connective tissue. From the capsule deep
into the organ, there are processes that separate it into small lobules (lobulus thymi) and are called
interlobular septa (septum interlobulare). The lobules are formed by the cortex, located along the periphery
and characterized by high functional activity, and the medulla (mebulla) lying in the center. Thymus cells
include lymphocytes (thymocytes), macrophages, granulocytes, and plasma cells. The medulla is formed by
specific layered bodies, consisting of flattened epithelial cells called Gassal's little bodies.

3. Peripheral organs of the immune system: their structure, function.

The accumulation of lymphoid tissue containing follicles against the background of diffusely located
cellular elements, which are a denser (nodular) accumulation of cells, is called tonsillae. The tonsils,
located in the initial sections of the respiratory and digestive tubes, are represented by the lingual,
pharyngeal and palatine tonsils. The tonsils located in the area of the mouth of the auditory tube are
called tubal.

Palatine tonsil (tonsilla palatina) steam room. It is located in the amygdala, which is a small depression
between the palatine-laryngeal and palatal-lingual folds of the oral cavity, and is attached to it with its
lateral edge. On the free medial surface there are up to 20 crypts, which are depressions in the mucous
membrane. The working tissue of the tonsil contains lymphoid nodules. Lymphocytes freely move from
the thickness of the amygdala to its mucous membrane and to the free surface. The shape of the palatine
tonsil determined the very name of the organ, as it resembles an almond.

The lingual tonsil (tonsilla lingualis) is located under the epithelium of the mucous membrane of the root
of the tongue. Lymphoid nodules of the lingual tonsil have light centers and form about 80-90 tubercles on
the surface of the tongue root, lifting its mucous membrane. Crypts are located between the tubercles, into
which the excretory ducts of the mucous glands of the tongue open.

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Pharyngeal tonsil (tonsilla pharyngealis), also called adenoid, lies in the upper part of the back of the
pharynx and in the region of the fornix of the pharynx. The mucous membrane covering the pharyngeal
tonsil forms multiple transverse folds, into the grooves between which the excretory ducts of the
pharyngeal glands open. Under the epithelium of the mucous membrane, lymphoid nodules are
concentrated in the diffuse lymphoid tissue.

Tubal tonsil (tonsilla tubaria) steam room. It is located behind the mouth of the pharyngeal opening of the
auditory tube in the mucous membrane of the nasal part of the pharynx. In the place of its occurrence, a
pipe bead is formed. The number of lymphoid nodules in the lymphoid tissue of the tonsil is insignificant.

Group lymphoid nodules of the appendix (noduli lymphatici aggregati appendicis vermiformis) are located
in the mucous membrane and submucosa of the appendix wall and form an almost single layer. Group
lymphoid nodules consist of single lymphoid nodules, usually located in 2-3 rows. The total number of
single nodules reaches 500. At the age of 16-18 years, the number of nodules decreases, which is
explained by age-related changes, and after 60 years, the nodules become single. Group lymphoid nodules
of the ileum (noduli lymphatici aggregati) are located on the antimesenteric side of the ileum, in the
mucous membrane and submucosa. Their number varies from 30 to 40 pieces, and the length is from 0.5
to 8 cm. They have a flattened elongated shape, are located along the longitudinal axis along the axis of
the intestine and form bulges, lifting the mucous membrane. For this reason, the rectal mucosa covering
the group lymphoid nodules is devoid of folds and is characterized by a lighter color. The lymphoid tissue
of group nodules is formed by single lymphoid nodules. With age, the number of group lymphoid nodules
and their size decrease, and the bulges they form become less distinct. By old age, the lymphoid tissue of
group lymphoid nodules acquires a diffuse character. With age, the number of group lymphoid nodules
and their size decrease, and the bulges they form become less distinct. By old age, the lymphoid tissue of
group lymphoid nodules acquires a diffuse character. With age, the number of group lymphoid nodules
and their size decrease, and the bulges they form become less distinct. By old age, the lymphoid tissue of
group lymphoid nodules acquires a diffuse character.

Solitary lymphoid nodules of the ileum (noduli lymphatici solitarii) are located in the mucous membrane
and submucosa of the walls of the respiratory tube (larynx, trachea, bronchi), digestive tube (pharynx,
esophagus, stomach, small and large intestine) and in the gallbladder. Solitary lymphoid nodules are
surrounded by reticular fibers that separate them from adjacent tissues.

4. Spleen. Structure, functions.

The spleen (splen) is the largest organ of the immune system, the length of which reaches 12 cm, and the
weight is 150-200 g. It is located in the left hypochondrium, projecting with a wide end onto the chest
between the IX and XI ribs, has a characteristic brownish-red tint. flattened elongated shape and soft
consistency. The spleen is fixed in a certain position with the help of the phrenic-splenic ligament (lig.
Phrenicolienale) and the gastro-splenic ligament (lig. Gastrolienale). Above it is covered with a fibrous
membrane (tunica fibrosa) fused with the serous membrane (peritoneum).

The convex outer surface of the spleen is called the fasies diaphragmatica because it touches the diaphragm,
and the concave inner surface, called the fasies visceralis, faces the stomach, splenic flexure of the colon, tail
of the pancreas, left kidney and left adrenal. The departments of the internal surface are named by the name
of the organs adjacent to them. In addition, the gate of the spleen (hilus lienis) is located on it, through which

58
 vessels and nerves penetrate into the parenchyma. The surfaces are separated from each other by a blunt
lower edge (margo inferior) and a sharp upper edge (margo superior) In addition, in the spleen, the posterior
end (extremitas posterior) and the anterior end (extremitas anterior) facing forward and downward are
distinguished.

Vii. Central nervous system anatomy

1. The nervous system, its importance in the body. Classification of the

nervous system (according to the topophgraphic principle)
The nervous system controls the activity of various organs, systems and apparatuses, it regulates the functions
of movement, digestion, respiration, blood supply, metabolic processes, etc. The nervous system establishes
the relationship of the body with the external environment, unites all its parts into a single whole. According to
the topographic principle, the nervous system is divided into central and peripheral. The central part of the
nervous system includes the spinal and cephalic spinal cord.
To the peripheral part include the spinal and cranial nerves with roots and branches, nerve plexuses, nerve
nodes, nerve endings.

2.Classification of the nervous system (according to the functional

principle).
According to the functional principle, the nervous system is divided into somatic (innervates the organs of the
body, striated muscles, skin, tongue, larynx, pharynx - the actions of the nervous system under the
consciousness of a person) and vegetative (innervates the viscera, glands, smooth muscles of organs and skin,
blood vessels and the heart , regulates metabolic processes in tissues).
The entire nervous system is built from nerve tissue. Nervous tissue consists of neurons and nyroglia. A
neuron is a structural and functional unit of the nervous system. Neuroglia provides the existence and specific
functions of neurons, performs supporting, trophic, demarcating and protective functions.

3. Types of receptors. Simple reflex arc.

There are several classifications of receptors:

By position in the body

o Exteroceptors (exteroceptors) - located on or near the surface of the body and perceive external stimuli
(signals from the environment)
o Interoreceptors (interoceptors) - located in internal organs and perceive internal stimuli (for example,
information about the state of the internal environment of the body)
Proprioceptors (proprioceptors) - receptors of the musculoskeletal system, allowing you to determine, for
example, the tension and degree of stretching of muscles and tendons. They are a type of interoreceptor.

By adequate stimulus:

• Chemoreceptors - Perceive the effects of dissolved or volatile chemicals.

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• Osmoreceptors - perceive changes osmotic concentration liquids (usually the internal environment).
• Mechanoreceptors - perceive mechanical stimuli (touch, pressure, stretching, vibrations of water or air, etc.)
• Photoreceptors - perceive visible and ultraviolet light
• Thermoreceptors - perceive a decrease (cold) or increase (heat) temperatures

Reflex arc (nerve arch) - the path traversed by nerve impulses during exercise reflex...

The reflex arc consists of:

• receptor - a nerve link that perceives irritation;

• afferent link - centripetal nerve fiber - processes of receptor neurons that transmit impulses from sensitive
nerve endings to the central nervous system;
• central link - the nerve center (optional element, for example, for axon-reflex); efferent link - transfer
from the nerve center to the effector.
• effector - an executive body whose activity changes as a result of a reflex.
• executive organ - activates the body

4. Spinal cord anatomy.

Spinal cord (medulla spinalis) an elongated cord located in the spinal canal. The length for men is 45cm, for
women is 41-42cm, weight is 30g. Beginning at the level of the foramen magnum, the lower border
corresponds to the level of the 2nd lumbar vertebra. Below this level is the filum terminale. On the anterior and
posterior sides of the spinal cord, the anterior median and posterior median sulcus runs from top to bottom.
The spinal cord consists of white and gray matter. Gray matter (substantia grisea) is located in the central
parts of the spinal cord, white matter - along the periphery. On a transverse section of the spinal cord, in place
of the gray pillars, paired anterior, posterior and lateral horns of the gray matter are distinguished.

The gray matter, the posterior and anterior roots of the spinal nerves, their own bundles of white matter form
the segmental apparatus of the spinal cord.

The white matter is formed by nerve fibers running in an upward and downward direction.

5. Spinal cord membranes.

The spinal cord has three membranes:

Hard shell (dura mater spinalis) It is a blind sac, inside which is the spinal cord, the anterior and posterior roots
of the spinal nerves. In the spinal canal, the hard membrane is strengthened by its processes, which form the
sheaths of the spinal nerves.

Spider web (arachnoidea mater spinalis) is a thin translucent connective tissue plate located medially from the
hard ob-ki. The hard and arachnoid membranes grow together only in the area of the intervertebral
foramen. Between the arachnoid and pia mater are thin bundles of collagen and elastic fibers that connect the
arachnoid to the pia mater and spinal cord. The soft (vascular) membrane (pia mater spinalis) is tightly
attached to the surface of the spinal cord. Connective tissue fibers, extending from the soft membrane,
accompany the blood vessels and enter together in them into the tissue of the spinal cord.

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6. Brain bladders and their derivatives
In 4-week-old embryos, the head section of the neural tube consists of cerebral vesicles: anterior -
proencephalon, middle - mesencephalon, posterior - metencephalon, separated from each other by small
narrowings. At the end of the 4th week, the first signs of the division of the anterior bladder into two
appear, of which the telencephalon and diencephalon will arise. At the beginning of the 5th week, the
posterior vesicle is divided to form the posterior and medulla oblongata. The midbrain is formed from the
unpaired middle bladder.

7.General characteristics of the brain

Brain (encephalon) together with the surrounding membranes, we are in the cavity of the cerebral section
of the skull. The convex surface of the brain corresponds in shape to the inner concave surface of the
cranial vault. The lower surface of the brain is in contact with the inner base of the skull and repeats its
complex relief, corresponding to the shape of the cranial fossa. Weight g - 1100-2000g. The brain has five
divisions: the telencephalon, diencephalon, middle
brain, hindbrain and medulla oblongata. The largest parts of the brain are the cerebral hemisphere
(terminal) brain, brain stem and cerebellum. The brain stem is formed by the diencephalon, midbrain, pons
and medulla oblongata.

8. Exit of 12 pairs of cranial nerves from the base of the brain.

Cranial nerves (nervi craniales) are called the 12 pairs of nerves that leave the brainstem. Each nerve has its
own name.
1.Olfactory nerves (n.olfactorii)
2. Optic nerve (n.opticus)
3.oculomotor nerve (n.oculomotorius)
4.bloc nerve (n.trochearis)
5.tronic nerve (n.trigeminus)
6. abducens nerve (n.abducens)
7.facial nerve (n.facialis)
8.predoor-cochlear nerve (n.vestibulocochlearis)
9.Lingopharyngeal nerve (n.glossopharyngeus)
10. vagus nerve (n.vagus)
11. accessory nerve (n.accessorius)
12.hypoglossal nerve (n.hypoglossus)

VIII. Peripheral nervous system

1. The olfactory nerve. Pathways of the olfactory analyzer. Scheme.

Olfactory nerves (I, n.olfactorii) formed by axons of olfactory cells located in the mucous membrane of the
olfactory region of the nasal cavity. The olfactory nerve fibers do not form a single nerve trunk, they are
collected in 15-20 thin olfactory nerves, which pass through the openings of the ethmoid plastic of the

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ethmoid bone and go to the olfactory bulb of the brain, where they form synapses with the dendrites of the
neurons of the olfactory bulb.
The pathways of the olfactory analyzer consist of two parts — peripheral and central. The olfactory nerve
belongs to the peripheral part, the peripheral and central pathways are closed in the olfactory bulb.
The olfactory nerve originates in the olfactory region of the nasal cavity. This area is characterized by the
presence of special olfactory cells located among the epithelial cells of the nasal mucosa; the peripheral
processes of these cells are very short and end in expansion on the free surface of the mucous membrane.
The central processes are collected in large trunks, about 20 in number, which penetrate through the ethmoid
plate of the ethmoid bone into the cranial cavity and end in the olfactory bulb, in the layer of the olfactory
glomeruli.
The olfactory bulb lies at the base of the brain at the anterior end of the olfactory groove.

2. The optic nerve. Pathways of the visual analyzer. Scheme.

Optic nerve (II, n.opticus) -is a thick nerve trunk, which consists of the axons of the ganglionic neurocytes of
the retina of the eyeball. The optic nerve in the region of the blind spot of the retina, passes through the
choroid and sclera of the eyeball. Coming out of the eyeball, it goes to the visual canal. The intracal portion of
the optic nerve passes through the optic canal. Coming out of the optic canal into the middle cranial fossa,
both optic nerves come closer to each other and form a cross (chiasm). Posteriorly, the chiasm passes into
the right and left optic tracts, heading towards the lateral geniculate bodies.

3. III, IV and VI pairs of cranial nerves.

Oculomotor nerve (III, n.oculomotorius) contains motor, autonomic and sensory fibers, 10-15 roots emerge
from the medial surface of the brain stem. Through the orbital fissure it enters the orbit. Before entering the
eye socket, it is divided into upper and lower. The superior branch runs to the side of the optic nerve,
innervates the muscle that lifts the upper eyelid, and the superior rectus muscle of the eye. The lower branch
innervates the lower and medial rectus muscles of the eye, the lower oblique muscle of the eye.
Block nerve (IV, n.trochlearis) -thin, emerges from the midbrain behind the plate of the quadruple. Then the
nerve bends around the lateral leg of the brain, passes between it and the temporal lobe of the hemisphere.
The nerve passes through the block wall of the cavernous sinus and enters the orbit through the superior
orbital fissure. It innervates the oblique muscle of the eye.
Abducens nerve (VI, n.abducens) leaves the brain at the posterior edge of the bridge, between it and the
pyramid of the medulla oblongata. Why does the nerve pass on the side of the internal carotid artery in the
cavernous sinus and through the superior orbital fissure penetrates the orbit to the lateral rectus muscle of
the eye, which it innervates.

4. Trigeminal nerve.
Trigeminal nerve (V, n. Trigeminus) innervates the skin of the face, the mucous membrane of the nose and
its sinuses, oral cavity, anterior 2/3 of the tongue, teeth, conjunctiva, chewing muscles, muscles of the floor of
the oral cavity, muscles straining the eardrum and palatine curtain. The trigeminal nerve has motor and three
sensory nuclei: midbrain, bridge, spinal. Three large branches of the trigeminal nerve branch off: the optic
nerve, the maxillary nerve, and the mandibular nerve. The optic and maxillary nerves contain only sensory
fibers, the mandibular nerve - both sensory and motor. The optic nerve (n.ophthalmicus) passes through the
lateral wall of the cavernous sinus and goes to the superior orbital fissure. Entering the orbit, the optic nerve is
divided into the frontal (passes under the upper wall of the orbit), the nasociliary (n.

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Maxillary nerve out their cranial cavity through a round opening into the pterygo-palatine fossa, having
previously given the meningeal branch into the cranial cavity to the hard shell of the brain. In the
pterygoopalatine fossa, the nerve is divided into the zygomatic and infraorbital nerves.
Mandibular nerve leaves through the foramen ovale from the cranial cavity, and immediately divides into its
motor and sensory branches.

5. Facial nerve.
Facial nerve (VII, n.facialis) contains motor (starting from the cells of the motor nucleus), sensitive (ending
on the neurons of the nucleus of a single pathway) and autonomic parasympathetic fibers (originating from
the upper salivary nucleus). The facial nerve exits at the posterior edge of the bridge, goes into the internal
auditory canal, then goes into the canal of the facial nerve of the temporal bone, leaves it through the styloid
opening and goes to the facial muscles. In the canal of the facial nerve, a large, deep stony nerve departs
from it. After leaving the styloid opening, the posterior ear nerve gives off. In the thickness of the parotid
salivary gland, the facial nerve forms the parotid plexus. The facial nerve and its branches innervate the ear
muscles, the frontal abdomen of the supracranial muscle, the circular muscle of the eye, the puckering
eyebrow muscle, and the facial muscles.

6. Predoor-cochlear nerve
The vestibular cochlear nerve(VIII,
n.vestibulocochlearis) is formed by sensitive
nerve fibers coming from the hearing organs. The nerve exits behind the
bridge, lateral to the facial nerve. It goes into the internal auditory canal
where it is divided into the vestibule (located at the bottom of the internal
auditory canal) and the cochlear part (nah-sya in the cochlear canal) The
anterior part of its branches ends in the walls of the membranous labyrinth.
7. Glossopharyngeal nerve
Glossopharyngeal nerve (IX.N.glossopharyngeus) contains sensitive (terminate on the neurons of the
nucleus of a single pathway), motor (exit from the double nucleus) and secretory fibers (exit from the lower
salivary nucleus). This nerve leaves the medulla oblongata with 4-5 roots behind the olive, goes to the jugular
foramen .. Here it forms the superior node. After exiting the jugular foramen, the nerve passes to the lateral
surface of the internal carotid artery. Heading towards the root of the tongue. From this nerve, the tympanic
nerve, containing sensory and secretory fibers, departs from the lower node of the glossopharyngeal nerve
into the petrosal fossa and the tympanic tubule of the temporal bone. Sensory fibers innervate the mucous
membrane of the tympanic cavity and the cells of the mastoid process of the auditory tube. The pharyngeal
branches in the amount of 2-3 enter the pharyngeal wall from the lateral side. A branch of the stylopharyngeal
muscle (r.

8. Nervus vagus
Vagus nerve (X. n.vagus) innervates the lining of the brain, organs of the neck, chest cavity, most of the
abdominal organs. Its impulses slow down the heartbeat, narrow the bronchi, increase peristalsis and relax
the sphincters of the intestine, increase the secretion of glands. As part of the nerve, there are sensory (being
the central processes of pseudo-unipolar neurons of the superior and inferior node of the vagus nerve), motor
(starting from the double nucleus) and secretory fibers (originating from the posterior nucleus). The vagus

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nerve leaves the medulla oblongata with 10-18 roots behind the olive, exits through the jugular foramen, on
the neck it passes between the internal vein and the internal carotid artery, and below between the same vein
and the common carotid artery. The vagus nerve distinguishes between the head, cervical, thoracic and
abdominal regions.
The meningeal branch extends from the head section - it goes to the hard shell of the brain in the region of the
posterior cranial fossa, the auricular branch - passes in the mastoid canal of the temporal bone, innervates
the skin of the posterior wall of the external auditory canal and the outer surface of the auricle.
The pharyngeal branches branch off from the cervical spine - they go to the walls of the pharynx, innervates
the muscles-constrictors of the pharynx, the muscle that lifts the soft palate, the muscle of the uvula, the
palatine and palatopharyngeal muscles, mucous membranes of the pharynx
In the thoracic region, branches branch off to the internal organs: chest cardiac branches, bronchial branches,
esophageal branches.

9. Accessory nerve
Accessory nerve (XI, n.accessorius) , formed by the processes of motor nuclei located in the lining of the
medulla oblongata and the spinal cord. The cranial roots emerge from the posterior lateral groove of the
medulla oblongata, behind the olive, the spinal roots, from the posterolateral groove of the spinal cord. The
roots are combined in the cranial cavity into one trunk, which exits the cranial cavity through the jugular
foramen. At the exit from the jugular foramen, the nerve gives int. and outside. branches. The outer branch
innervates the sternocleidomastoid muscle, trapezius muscle, digastric muscle.

10 hypoglossal nerve
Hypoglossal nerve (XII, n.hypoglossus), formed by fibers of the motor nucleus, innervates the muscles of the
tongue and some muscles of the neck. From the brain, the nerve leaves in the groove between the pyramid
and the olive, is directed forward and laterally into the canal of the hyoid nerve of the occipital bone. The
hypoglossal nerve gives off the lingual branches. It innervates the scapular-hyoid, sterno-hyoid, sterno-thyroid
and thyroid-hyoid muscles.

11. Spinal nerves: formation, exit, branches.

Spinal nerves (nervi spinals), 31-33 pairs, their branches provide innervation to almost all organs and parts of
the body. There are 8 pairs of cervical, 12 pairs of thoracic, 5 pairs of lumbar, 5 pairs of sacral, 1-3 pairs of
coccygeal, respectively 31-33 segments of the spinal cord. Each spinal nerve, after leaving the intervertebral
foramen, is divided into anterior, posterior, and meningeal branches.
Meningeal branches (r. Meningeales) spinal nerves in the form of thin trunks penetrate through the
corresponding intervertebral foramen into the spinal canal, where its walls, the membranes of the spinal cord
innervate
Posterior branches of the spinal nerves (r.dorsales, s.posteriores) innervate the muscles of the back, the
muscles of the occiput and the skin of the back of the head and trunk, give lateral and medial branches to
them. Having separated from the trunks of the spinal nerves, the posterior branches go posteriorly between
the transverse processes of the vertebrae. The posterior branches of the sacral spinal nerves exit through the
darsal sacral foramen. The posterior branch of the I spinal nerve is called the suboccipital nerve
(n.suboocipitalis). It goes posteriorly between the occipital bone and the atlas, innervates the superior and
lower oblique muscles of the head, as well as the joints formed by the atlas and the axial vertebra.
The posterior branches of the thoracic spinal nerves branch out into the muscles and skin of the back, which
they innervate.

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The posterior branches of the lumbar spinal nerves innervate the deep muscles of the back and the skin of
the lumbar region.
Anterior branches of the spinal nerves (r.anteriores, s.ventrales) innervate the muscles and skin of the
anterior and lateral regions of the neck, chest, abdomen, and limbs.

12. Cervical plexus

The cervical plexus (plexus cervicalis) is formed by the anterior branches of the four superior cervical spinal
nerves. Located between the anterior scalene muscle and the longus neck muscle (medially), the middle
scalene muscle and the muscle that lifts the scapula, laterally. Muscular branches leave the cervical plexus,
which innervate the long muscles of the neck and head, the anterior, middle and posterior scalene muscles,
laterally and the anterior rectus muscles of the head.
The sensory branches of the cervical plexus are the greater auricular, small occipital nerves, the transverse
nerve of the neck and the supraclavicular nerves.
Large ear nerve goes vertically upward and innervates the skin of the posterior and lateral surfaces of the
auricle, the skin of the earlobe and the external auditory canal, as well as the skin of the face in the parotid
gland.
Small occipital nerve innervates the skin behind and above the auricle.
Transverse nerve of the neck innervates the skin of the front of the neck.
Supraclavicular nerves medial, intermediate and lateral innervate the skin of the front of the neck.

13. Brachial plexus: its formation, short branches.

Brachial plexus (plexus brachialis) formed by the anterior branches of the four lower cervical spinal nerves.
Short branches:
goes along the front surface of the muscle that lifts the scapula.
Further, the nerve passes between the middle and posterior scalene muscles and branches into the large and
small rhomboid muscles and the muscle lifting the scapula.
goes posterior to the brachial plexus, located between the
subscapularis and the anterior dentate muscles, innervates the anterior dentate muscle.
goes down the outer edge of the anterior scalene muscle to the subclavian
muscle.
First, it passes under the trapezius muscle and the lower abdomen
of the scapular-hyoid muscle. The nerve passes into the infraspinatus fossa and innervates the supraspinatus
and infraspinatus muscles and the capsule of the shoulder joint.
goes along the anterior surface of the subscapularis muscle, innervates
the subscapularis and large round muscles

14. Brachial plexus: its formation, long branches.

The long branches of the brachial plexus innervate the bones and joints, muscles and skin of the free part of
the upper limb.
pierces the coracobrachial muscle and gives it muscle
branches. It innervates the brachial and biceps muscles of the shoulder, the skin up to the eminence of the
thumb.
branches in the skin of the medial surface
of the shoulder to the medial epicondyle of the humerus and the olecranon of the ulna.

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 gives the dorsal branch, palmar branch (r.palmaris), deep branch (r.profundus) - goes
under the distal portions of the flexor tendons of the fingers in the lateral direction (innervates all the muscles
of the little finger elevation, the dorsal and palmar interosseous muscles, as well as the adductor muscle of
the thumb and the deep head of the short flexor of the thumb, the third and fourth worm-like muscles, bones,
joints and ligaments of the hand.

15. Anterior branches of the thoracic spinal nerves.

The anterior branches of the thoracic spinal nerves form the intercostal nerves that innervate all the muscles
and skin of the lateral and anterior chest and abdominal walls, the parietal pleura and peritoneum, and the
mammary gland.
Intercostal nerves (n.intercostales) , 11 pairs are directed laterally and anteriorly in the intercostal spaces.
Each intercostal nerve runs at the lower edge of the corresponding rib under the artery and vein of the same
name, between the external and internal intercostal muscles. Six pairs of lower intercostal nerves pass
through the costal part of the diaphragm, then go obliquely forward and downward between the internal
oblique and transverse abdominal muscles, giving branches to them. The muscular branches of the
intercostal nerves innervate the external and internal intercostal muscles, subcostal muscles, muscles lifting
the ribs, transverse muscle of the chest, posterior superior serratus muscles.
Each intercostal nerve gives off anterior and lateral cutaneous branches. The lateral cutaneous branches of
the III-IV intercostal nerves are involved in the innervation of the mammary gland.
The anterior branches of the II-III intercostal nerves in women give off branches to the mammary gland.
The branches of the intercostal nerves innervate the costal and phrenic parts of the pleura, the parietal
peritoneum of the anterior-lateral wall of the abdominal cavity and the diaphragm.

16. Lumbar plexus: formation, branches

Lumbar plexus (plexus lumbalis) formed by the anterior branches of the three upper lumbar, part of the
anterior branch of the XII thoracic and anterior branch of the 4th lumbar spinal nerves. The plexus is located
anterior to the transverse processes of the lumbar vertebrae and on the anterior surface of the quadratus
lumbar muscle, in the thickness of the psoas major muscle. It innervates part of the muscles and skin of the
abdominal wall, the skin of the external genital organs, the skin and muscles of the anterior-medial side of the
thigh, the skin of the medial side of the leg and foot.
Muscular branches (r.musculares) goes to the square muscle of the lower back, the small and large lumbar
muscles, the intertransverse lateral muscles of the lower back.
The iliohypogastric nerve (n.iliohypogastricus) pierces the psoas major muscle, passes behind the kidney
along the front surface of the square muscle of the lower back. Further, the nerve goes forward and down,
pierces the transverse abdominal muscle and is located between this muscle and the internal oblique muscle
of the abdomen, giving them its branches.
Ilio-inguinal nerve (n.ilioguinalis) located between the transverse and internal oblique muscles of the
abdomen, innervates them. Further, the nerve goes into the inguinal canal and branches in the skin of the
pubis, the scrotum in men, or the labia majora in women.
Femoral nerve (n.femoralis) goes from top to bottom between the large lumbar and iliac muscles gives up
muscle (innervate the iliac muscle, quadriceps muscle, capsule of the hip joint) and cutaneous branches
(innervate the skin of the anterior side of the thigh to the level of the patella.

17. Sacral plexus: formation, short branches.

Sacral plexus (plexus sacralis) formed by part of the anterior branches of the 4-5 lumbar and anterior
branches of the 1-3 sacral spinal nerves. The plexus is located in the pelvic cavity. Short branches:

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 leaves the pelvic cavity through the epigastric opening. It innervates the gluteus
minimus, gluteus medius muscles.
from the pelvic cavity through the piriform opening. It innervates the gluteus maximus
muscle.
from the pelvic cavity comes out through the piriform opening. Through the small
sciatic foramen it goes into the ischio-anal fossa. Gives the lower rectal branches, perineal nerves, dorsal
nerve of the penis. It innervates the external sphincter of the anus, the skin of the anal region, the muscles and
skin of the perineum and scrotum in men or the labia majora.

18. Sacral plexus: formation, long branches.

Posterior cutaneous nerve of the thigh (n.cutaneus femoris posterior) comes out of the pelvic cavity through
the piriform opening and goes down next to the sciatic nerve. Gives the lower nerves of the buttocks, perineal
nerves. It innervates the skin of the lower gluteal region, perineal skin.
Sciatic nerve (n.ishiadicus) leaves the pelvic cavity through the sub-pyriform opening, then the nerve goes
down between the sciatic tubercle and the greater trochanter of the femur along the back side of the twin
muscles, the internal obturator and square muscles of the thigh.

IX. The autonomic nervous system

1. Anatomy of the autonomic nervous system. Reflex arc VNS

Autonomic nervous system (systema nervosum autonomicum) is a part of the nervous system that controls
the functions of internal organs, glands, blood vessels, carries out adaptive and trophic influence on all
human organs. This system maintains the constancy of the organism - homeostasis. The veg. System is
divided into central and peripheral sections. The central section includes the parasympathetic nuclei 3,7,9
and 10 of the cranial nerves, parasympathetic sacral nuclei, the autonomic nucleus located in the lateral
intermediate column.

The peripheral section includes autonomic nerves, branches and nerve fibers emerging from the brain and
spinal cord, the sympathetic trunk ...

Spinal cord - pre-nodular nerve fibers - node of the autonomic plexus - efferent first endings.

2. The parasympathetic part of the ANS.

The parasympathetic part of the ANS is subdivided into the head (autonomic nuclei and parasympathetic
fibers of the oculomotor, facial, glossopharyngeal and vagus nerves, as well as the ciliary, pterygopalatine,
submandibular, sublingual, ear and other nodes and their branches) and sacral (formed by the sacral nuclei 2,
3 4 sacral segments of the spinal cord, internal pelvic nerves, parasympathetic pelvic nodes) divisions.
Generally innervates the ciliary muscle, the sphincter of the pupil, glands of the mucous membrane of the
nasal cavity, palate and pharynx, smooth muscles and glands in the walls of the hollow internal organs, chest
and abdomen.

3.The sympathetic part of the ANS

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The sympathetic part includes the lateral intermediate gray matter in the lateral columns of the spinal cord
from the 8th cervical segment to the 2nd lumbar segment, nerve fibers and nerves going from the cells of the
lateral intermediate substance to the nodes of the sympathetic trunk and autonomic plexuses of the
abdominal cavity and pelvis, the right and left sympathetic trunks, connecting branches, nodes of vegetative
plexuses, located anteriorly to the spine in the abdominal cavity and the pelvic cavity and the nerves
accompanying the blood vessels, nerves going from these plexuses to the organs, sympathetic fibers that go
as part of the somatic nerves to organs and tissues.

4.Sacral part of the parasympathetic part of the ANS: formation, branches

and areas of innervation
The sacral region is formed by sacral parasympathetic nuclei located in the lateral intermediate substance of
the 2-4 sacral segments of the spinal cord, as well as by the pelvic parasympathetic nodes and processes of
the cells lying in them. The axons of the sacral parasympathetic nuclei exit the spinal cord as part of the
anterior roots, then go as part of the anterior branches of the sacral spinal nerves, which form the pelvic
visceral nerves. These nerves approach the parasympathetic nodes of the lower hypogastric plexus and the
nodes of the autonomic plexus located near the internal organs located in the pelvic cavity. On the cells of
these nodes, the preganglionic fibers of the pelvic intrinsic nerves end. The processes of the cells of the
pelvic nodes are postganglionic parasympathetic fibers,

5. Vegetative innervation of the head and neck organs.

The cervical section of the sympathetic trunk is represented by three nodes and the inter-nodal branches
connecting them, which are located on the deep muscles of the neck behind the prevertebral plates of the
cervical fascia. The preganglionic fibers approach the cervical nodes along the inter-nodal branches of the
thoracic part of the sympathetic trunk, where they come from the autonomic nuclei of the lateral intermediate
substance 8 of the cervical and 6-7 upper thoracic segments of the spinal cord.

The upper cervical node (ganglion cervical superius) is located in front of the transverse processes of the
upper cervical vertebrae.

The middle cervical node is located anterior to the transverse process of the 6th cervical vertebra. From this
node, connecting branches depart in the 5th and 6th cervical spinal nerves, as well as the middle cervical
cardiac nerve. The cervicothoracic node (g.cervicothoracicum) is located behind the subclavian artery, at the
place where the vertebral artery leaves it. The knot is formed by the fusion of the lower cervical knot with the
first thoracic knot.

6. Vegetative innervation of the chest cavity organs

Includes 9-12 thoracic nodes located on the lateral surface of the vertebral bodies behind the intrathoracic
fascia and parietal pleura. The thoracic-cardiac nerves (n.cardiaci thoracici) extend from 2-5 thoracic nodes
forward and medially and participate in the formation of the cardiac plexus. From the thoracic nodes of the
sympathetic trunk, thin sympathetic nerves (pulmonary, esophageal, aortic) depart, which together in the
branches of the vagus nerve form the pulmonary plexus, esophageal plexus, and aortic plexus.

7. Vegetative innervation of the pelvic organs.

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The hypogastric plexus is divided into the right and left hypogastric plexus, which descend into the pelvic
cavity. The lower hypogastric plexus (plexus hypogasricus inferior) is formed by branches extending from the
superior hypogastric plexus, the nodes of the sacral sympathetic trunks, and the fibers of the sacral visceral
nerves. The right and left lower hypogastric plexuses are located on the posterior wall of the pelvis, right and
left of the rectum. This plexus in men continues to the bladder and prostate gland in the form of the urinary,
prostate, middle and lower rectal and other organ plexuses. In women, it forms the uterovaginal plexus.

8. Sympathetic trunk
Sympathetic trunk (truncus sympathicus)paired formation, located on the sides of the spine, consists of
20-25 nodes connected by inter-nodal branches. The nodes of the sympathetic trunk are spindle-shaped,
ovoid and irregular. White connecting branches approach the sympathetic trunk, diverting from all the
thoracic and upper two lumbar spinal nerves. Gray connecting branches emerge from the sympathetic trunk,
as well as nerves to the internal organs, blood vessels and large plexuses of the abdominal cavity and pelvis.

9 vegetative innervation of the abdominal organs

One of the largest autonomic plexuses of the abdominal cavity is the abdominal aortic plexus (plexus
aorticus abdominis), located on the aorta and continuing on its branches. The largest and most important in
the composition of the abdominal aortic plexus is the celiac plexus (plexus coeliacus), which is located on
the anterior surface of the abdominal aorta, around the celiac trunk. The celiac plexus consists of several
large nodes. It consists of two celiac nodes located to the right and left of the celiac trunk, two aortorenal
nodes (g.aortorenalia), each of which is located at the origin of the corresponding renal artery from the aorta.
Numerous branches go to the celiac trunk and its branches, forming plexuses around the common hepatic,
splenic, left gastric arteries.

10. Parasympathetic parts of the facial and glossopharyngeal nerves

Parasympathetic part of the facial nerve consists of the upper salivary nucleus, pterygopalatine,
submandibular and sublingual nodes and parasympathetic nerve fibers. The axons of the cells of the upper
salivary nucleus, which lies in the pontine cover in the form of preganglionic fibers, pass through the facial
nerve. In the area of the knee of the facial nerve, part of the parasympathetic fibers is separated in the
form of a large petrosal nerve and leaves the facial nerve. The large petrosal nerve goes into the pterygoid
canal, with the sympathetic deep petrosal nerve forms the nerve of the pterygoid canal, this nerve goes into
the pterygopalatine fossa and goes to the pterygopalatine node.

Parasympathetic glossopharyngeal nerve formed by the lower salivary nucleus, ear node and processes of
the cells lying in them. The axons of the lower salivary nucleus, located in the medulla oblongata, are part of
the glossopharyngeal nerve, then at the level of the lower edge of the jugular foramen it branches off as part
of the tympanic nerve (n.tympanicum), which penetrates into the tympanic cavity and participates in the
formation of the tympanic plexus. This nerve leaves the cranial cavity, the cartilage of the laceration opening,
approaches the ear node.

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 XI. Endocrine glands.

1.Classification of endocrine glands.

The endocrine glands are divided into dependent and independent of the functions of the pituitary gland.
The glands dependent on the pituitary gland include the thyroid gland, the adrenal cortex, and the sex
glands. The parathyroid glands, pancreatic islets (islets of Langerhans of the pancreas), the adrenal
medulla, paraganglia do not depend on the pituitary gland. The endocrine glands also include the pineal
gland (pineal gland) and single hormone-forming cells (diffuse endocrine system).

2.Thyroid gland: structure, hormones and functions

Thyroid gland (g.thyroidea) located in the front of the neck, anteriorly and to the sides of the larynx and
upper tracheal cartilage. Anterior to the thyroid gland, we find the sterno-thyroid, sternohyoid and
scapular-hyoid muscles. In the thyroid gland, the right lobe and the left lobe are divided, connected by the
isthmus of the thyroid gland (isthmus g. Thyroidei). The longitudinal size of the gland in an adult is 5-8 cm,
the transverse size is 5-6 cm, the thickness of the isthmus is 2.5 cm.The mass of the thyroid gland is 16-18
g. Outside, the shield is covered with a connective tissue capsule, from which thin trabeculae extend
inward ... The parenchyma of the gland consists of follicles, the walls of which

formed by one layer of cubic thyrocytes. Thyrocytes synthesize hormones: triiodothyronine These
hormones regulate the metabolism of fats, proteins and carbohydrates, the function of the cardiovascular
system, gastrointestinal tract, mental and sexual activity. and tetraiodothyronine, parafollicular cells
secrete thyrocalcitonin. It is involved in the regulation of calcium levels in the body. Calcium is essential for
building bones, as well as for conducting impulses in nerve and muscle tissue.

3. Parathyroid and thymus glands: their structure, hormones and functions

Parathyroid glands (g.parathyroideae) located on the back surface of the thyroid lobes. There are paired
upper and lower parathyroid glands. The size of each gland is 4-8 mm, the mass is 0.2-0.35 g. The glands
are covered with a thin capsule outside, from which trabeculae extend deep into the parenchyma, dividing
the parenchyma into incomplete lobules. The parenchyma of the gland is formed by parathyrocytes, which
form intertwining epithelial overlaps. Parathyrocytes secrete parathyroid hormone, which regulates the
metabolism of calcium and phosphorus.

The thymus gland is a small organ of pinkish-gray color, soft consistency, its surface is lobular. In
newborns, its dimensions are on average 5 cm in length, 4 cm in width and 6 cm in thickness, weight -
about 15 grams. The growth of the organ continues until the onset of puberty (at this time its size is
maximum - up to 7.5-16 cm in length, and the mass reaches 20-37 grams). With age, the thymus
undergoes atrophy and in old age is hardly distinguishable from the surrounding adipose tissue of the
mediastinum; at 75 years old, the average weight of the thymus is only 6 grams. Asinvolution it loses its
white color and due to an increase in its share stroma and the fat cells become more yellow. The thymus
is located in the upper part of the chest, just behind the sternum (uppermediastinum)... In front of it is the
handle and the body of the sternum to the level of IV costal cartilage; behind - the upper part of the
pericardium, covering the initial sectionsaorta and pulmonary trunk,aortic arch, left brachiocephalic vein;
from the sides - mediastinalpleura...In humans, the thymus consists of two lobes, which can be

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spliced or simply fit snugly together. The lower part of each lobe is wide and the upper part is narrow;
thus, the upper pole may resemble a two-pronged fork (hence the name).

The organ is covered with a capsule of dense connective tissue, from which the bridges extend into the
depths, dividing it into lobules. Produces hormones: thymosin, thymalin,thymopoietin,insulin-like growth
factor-1 (IGF-1), thymic humoral factor - they are all proteins (polypeptides). With hypofunction of the
thymus, immunity decreases, as the number of T-lymphocytes in the blood decreases

4.Endocrine part of the gonads (testicle, ovary): location, hormones and

functions
The endocrine part of the sex glands.The sex glands produce sex hormones. In the female gonads - the
ovaries - cells of the follicular epithelium produce folliculin (estrogens), the corpus luteum - progesterone.
In the male gonads - in the testes - special cells called interstitial endocrinocytes (Leydig cells) synthesize
testosterone (androgen).

Under the influence of sex hormones, the development of the reproductive apparatus, secondary sexual
characteristics occurs, and sexual reflexes arise. Female sex hormones also contribute to changes in the
endometrium during the menstrual cycle, as well as the implantation of a fertilized egg and the
development of the fetus. Located next to the genitals (in men - in the scrotum, in women - inside the
pelvic cavity).

5. Adrenal gland: structure, hormones and functions

Adrenallocated above the upper pole of the kidney. This is a paired organ. The mass of one adrenal gland
in an adult is about 12-13 g. Being an anatomically single organ, the adrenal gland essentially consists of
two glands, represented by the cortex and medulla. In the adrenal cortex, three zones are distinguished by
structure and function: glomerular, bundle and reticular. The cells of each zone synthesize their own
specific hormones. The cells of the glomerular zone produce mineralocorticoids that regulate mineral
metabolism (the level of Na + and K + in the blood plasma. In the bundle zone, glucocorticoids are
synthesized, which affect carbohydrate, protein and fat metabolism. In the reticular zone, sex hormones
are produced.

The adrenal medulla is formed by clusters of large rounded or polygonal cells. The cells of the medulla
produce the hormones adrenaline and norepinephrine, which are involved in carbohydrate metabolism,
affecting cardiovascular activity.

6. Pituitary gland and pineal gland (pineal gland): structure, hormones and
functions

PituitaryIs a small gland. Its dimensions reach 10 - 15 mm, weight - 0.5 - 0.7 g. The pituitary gland is
located in the pituitary fossa of the Turkish saddle of the sphenoid bone. The funnel connects the pituitary
gland to the hypothalamus. The pituitary gland is a very important endocrine gland. She coordinates the

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functions of many other endocrine organs. In addition, the pituitary gland is both anatomically and
functionally closely related to the hypothalamus, which regulates many vital functions.

Being anatomically unified, the pituitary gland is divided into three lobes - anterior, middle (intermediate)
and posterior, which have different origins and structures. The anterior and middle lobes are united under
the general name "adenohypophysis".

formed by epithelial tissue. A number of hormones are produced here: somatotropin,

thyrotropin, prolactin, follitropin, lutropin and adrenocorticotropic hormone, which stimulate many
processes in the body. Growth hormone has a wide spectrum of action - it stimulates bone growth,
regulates metabolic processes in the body. Tyrotropin controls the function of the thyroid gland. Prolactin
affects the growth of mammary glands and milk secretion. Follitropin and lutropin regulate the functions
of the gonads, stimulate the release of sex hormones. Adrenocorticotropic hormone regulates the function
of the adrenal cortex, the release of steroid hormones.

narrow, built of epithelial tissue. The cells of the middle lobe secrete the
hormones melanocytotropin, which regulates the synthesis of the pigment melanin, and lipotropin, which
activates fat metabolism.

(neuro-pituitary gland) is formed by nerve tissue. She does not synthesize

hormones. Biologically active substances oxytocin and vasopressin, produced by the nuclei of the
hypothalamus, are transported to the posterior lobe of the pituitary gland, where they accumulate and are
released into the blood. Oxytocin increases the tone of smooth muscles of internal organs, vasopressin
increases blood pressure, delays the release of water from the body.

Given the close morphofunctional relationship of the pituitary gland with the hypothalamus, it is customary
to distinguish the hypothalamic-pituitary system. The fact is that the neurosecretory cells of the
hypothalamus secrete biologically active substances that enter the pituitary gland and affect its functions.
The neurosecretions of the small cell nuclei of the medial region of the hypothalamus (gray eminence)
enter the anterior and intermediate lobes of the pituitary gland through small venous vessels, where they
control the hormone-forming function of the adenohypophysis. The neurosecrets of the large cell nuclei of
the hypothalamus along the axons of these cells reach the posterior lobe of the pituitary gland, from where
they are carried with the blood to the periphery.

The pineal gland, or pineal gland, located in the groove between the upper hillocks of the quadruple of the
midbrain. The pineal gland has a rounded shape, weighs about 0.2 g. Neurosecretory cells of the pineal
gland - pinealocytes produce and release melatonin and a number of other biologically active substances
into the blood that act directly on the working organs, have a regulatory effect on the pituitary gland,
thyroid, parathyroid and gonads, on the pancreatic islets and adrenal glands, and also inhibit puberty and
increase the level of potassium in the blood.

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