Term
| What is at the level of the sternal angle? |
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Definition
-Disk b/t TV4 and TV5
-Horizontal line separates sup. and inf. mediastinum
-Arch of the aorta
-Bifurcation of trachea
-Termination of azygos |
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Term
| True, false, and floating? |
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Definition
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Term
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Definition
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Term
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Definition
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Term
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Definition
| -Trying to exhale against closed airway (as in popping ones ears) |
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Term
| In terms of the azygous system, what gets the left and right and where do they drain? |
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Definition
-The azygous gets the right and bridges the gap between the vena cavae.
-The hemiazygous gets the left bottom four
-The accessory hemiazygous get the left middle four
(the top left four are from branches of the brachiocephalic v., mostly the left superior intercostal v.) |
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Term
| Arrangement of neurovascular bundle under ribs? |
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Definition
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Term
| How can adenocarcinomas metastasize? |
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Definition
| -To axillary lymph nodes or also to the opposite breast via the parasternal nodes. |
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Term
| Where does the lung vs. the parietal pleura end? |
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Definition
Lung;
-6, 8, & 10 for front, side, and back
Pleura;
-8, 10, & 12
Thoracentesis;
-7, 9, & 11 |
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Term
| Innervation of parietal vs. visceral pleura of lung? |
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Definition
Parietal;
-Intercostal (costal pleura) and phrenic nerves (the rest)
-Sensitive to pain
Visceral;
-sensory nerves that course with autonomics
-insensitive to pain |
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Term
| Pleuritis/pleurisy and pain? |
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Definition
-Parietal pleura becomes inflamed and may fuse
- If it's on the costa surface, the pain will be localized and at its highest intensity during inspiration
-If the pleuritis is anywhere else, the pain may be referred to the C3-C5 dermatomes (arms & neck, don't think ear) |
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Term
| What is it called when we sample the fluid in the pleural cavity, and where do we do it? |
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Definition
-Thoracentesis
-We tap into the costodiaphragmatic recess at the level of C7, C9, or C11 for front, side, and middle. |
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Term
| Difference between open and tension pneumothorax? |
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Definition
OPEN;
-Wound from the outside (such as stab wound)
-The lung collapses under increased intrapleural pressure, and the mediastinal contents are pushed opposite
-However, when the patient exhales, air is able to pass out of the wound
TENSION;
-Also from a penetrating wound
-Same thing happens, but now the wound acts like a valve and the air has no escape once it is inside the pleural cavity
-The mediastinal contents are displaced to a greater extent, often compromising cardiac output |
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Term
| What do we call an accumulation of fluid in the pleural cavity? |
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Definition
-Pleural effusion
-Can result from blockage of veins or lymphatics |
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Term
| Where do the lung fissures happen in relation to the ribs? |
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Definition
-Oblique fissures; 5th intercostal space
-Horizontal; Straight line across chest from 4th costal cartilage |
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Term
| Most common site of foreign body aspiration? |
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Definition
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Term
| Spontaneous pneumothorax. |
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Definition
-Happens when an emphysematous bleb spontaneously ruptures and air is able to flow into pleural cavity from lung
-Most common in the superior lobe
-Symptoms will be basically the same as with a tension pneumothorax |
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Term
| Lymphatic drainage lungs? |
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Definition
Bronchopulmonary nodes --> tracheobronchial nodes --> bronchomediastinal trunk --> lymphatic duct --> junction of subclavian and internal jugular
-note; left lower lobe goes to right side via the inferior group of tracheobronchial nodes |
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Term
| Thoracic outlet syndrome? Caused by? |
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Definition
-Can result from a PANCOAST TUMOR (tumor of apex)
Results in compression of nerves and vessels;
-Stellate ganglion; Horner's
-Subclavian a.; decreased radial pulse
-Recurrent laryngeal; hoarseness
-Ventral rami of lower brachial plexus; paresthesia and weakness of forearm and hand |
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Term
| Components of cardiac plexus and characterization of contributing nerves? |
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Definition
Components;
-R&L pulmonary (R pulmonary derives most the rest)
-R&L atrial
-R&L coronary
-Plexus on arch of Aorta
Characterization of cardiac branches;
-Cervical - bottom of CV6 and higher
-Cervicothoracic - bottom of CV6 to bottom of TV1
-Thoracic - bottom of TV1 and lower |
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Term
| What is the top border of the mediastinum? |
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Definition
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Term
| Which mediastinal compartments are the phrenic and vagus located in and how are they transmitted through the diaphragm? |
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Definition
Phrenic;
-superior and middle mediastinum through caval hiatus
Vagus;
-superior and posterior mediastinum through esophageal hiatus |
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Term
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Definition
| -Tumor of the thymus that may result in myasthenia gravis (ACh receptors are autoimmune targets causing fatigability) |
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Term
| Coarctation of the aorta? Collateral path? |
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Definition
-Partial constriction of aorta that occurs near ligamentum/ductus arteriosum (infantile type is proximal, while adult type is distal).
-Causes raised blood pressure in head neck and upper limbs, and lowered blood pressure in lower limbs
-Collateral circulation is provided by anastamoses between ant. and post. intercostal arteries with blood flowing in retrograde direction through the post.
-Growth of these vessels can cause rib erosion |
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Term
| Left vagus hooks recurrent laryngeal around what, and primarily forms which vagal trunk? |
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Definition
| -Left vagus sends the recurrent laryngeal around the arch of the aorta and forms mostly forms the anterior vagal trunk. |
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Term
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Definition
-Space between viceral and parietal layers of serous pericardium
-Parietal layer is fused with fibrous pericardium layer
-Site of cardiac tamponade |
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Term
| Cardiac tamponade? Treatment? |
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Definition
-Accumulation of fluid in pericardial cavity causing compression of the heart
-Often presents with distention of veins of the neck during inspiration (Kussmaul's sign)
-Use pericardiocentesis to aspirate blood from the cavity at the site of the left xiphocostal angle |
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Term
Chamber that corresponds to surface;
Posterior
Apex
Right surface
Left surface
Anterior surface
Inferior surface |
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Definition
-Posterior - left atrium
-Apex - tip of left ventricle
-Right surface - right atrium
-Left surface - left ventricle
-Anterior surface - right ventricle
-Inferior surface - both ventricles |
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Term
| -Names of valves for inf. vena cava and coronary sinus. |
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Definition
| -Eustachian and Thebesian |
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Term
| Other name for the conus arteriosus? |
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Definition
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Term
Where to listen to valves;
Tricuspid
Mitral
Aortic
Pulmonic |
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Definition
-Tricuspid - 5th intercostal space to left of sternum (to right works as well)
-Mitral - 5th space in midclavicular line (apex)
-Aortic - 2nd space to right of sternum
-Pulmonic - 2nd space to left of sternum |
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Term
When and where would you here stenosis of the aortic valve?
Stenosis for mitral valve?
When and why would you be most likely to hear a strong mumur in the 5th intercostal space on the right? On the left? |
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Definition
-During systole while listening at the aorta?
-During diastole while listening at the apex?
-Mitral incompetence during systole (back-flow). Either mitral stenosis (too tight) or aortic incompetence (back-flow), both during diastole. |
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Term
| Heart vessel anastomoses? |
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Definition
-b/t ant. and post. interventricular aa.
-b/t circumflex and right coronary aa.
-both on posterior aspect of heart |
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Term
| Referred pain in from heart? |
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Definition
-Pain from heart is called angina and is caused by ischemia
-Thoracic wall, arm, shoulder, sometimes the ear (cardiac otalgia)
-From thoracic splanchnics |
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Term
| Most common site of myocardial infarction? |
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Definition
| Anterior interventricular artery. |
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Term
What do the following travel with and drain into?
Great cardiac vein
Middle cardiac vein
Small cardiac vein
Anterior cardiac veins |
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Definition
-Great; anterior interventricular a.
-Middle; posterior interventricular a.
-Small; right coronary a. & marginal br.
(all drain into coronary sinus)
-Anterior; dont run with anything but drain right ventricle and empty into right atrium directly |
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Term
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Definition
-AV node has trouble conducting impulses from the SA node and the atria and ventricles may beat out of concert
-The atria will beat normally at about 70 beats/min, but the ventricles will slow down to 40ish |
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Term
| What structures cause constriction points of the esophagus? |
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Definition
-Left main bronchus
-Arch of the aorta (aneurism)
-Esophageal hiatus
-At it's origin |
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Term
| Branches of descending aorta in thorax? |
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Definition
-Intercostal
-Sup. and Inf. left bronchial
-Esophageal
(right bronchial is from 3rd intercostal) |
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Term
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Definition
| -Puss in an anatomical cavity (whereas an abbess is in a newly formed one) |
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