Term
| What are dermatomes slanted in some areas of the body and horizontal in others? |
|
Definition
| due to embryology and development |
|
|
Term
| Which spinal nerves are associated with the intercostal nerves? Where are the intercostal nerves located? |
|
Definition
-anterior rami of spinal nerves T1-T11
-they lie in the intercostal space between the ribs |
|
|
Term
| Is the innervation to the muscles of the thoracic wall somatic or visceral? |
|
Definition
|
|
Term
| Which spinal nerve supplies to dermatome at the level of the clavicles and immediately below? |
|
Definition
|
|
Term
| Give some characteristics of shingles |
|
Definition
-reactivation of chicken pox virus
-Follows the dermatome levels of the spinal ganglia for which it effects
-skin area involved is red and vesicular eruptions appear
-mostly sensory, but sometimes muscle weakness can occur |
|
|
Term
| At what spinal level is the thymus located? |
|
Definition
|
|
Term
| When is the thymus largest? |
|
Definition
|
|
Term
| Which type of immune cells mature in the thymus? |
|
Definition
|
|
Term
| What is special about the tissue of the thymus? |
|
Definition
| It is hematopoietic tissue, blood can be produced there |
|
|
Term
| Which nerve is the esophageal plexus formed from? |
|
Definition
|
|
Term
| Esophageal varicose develop due to elevated pressure in which vein? |
|
Definition
|
|
Term
| How many ribs are there? Which are true? false? floating? Which ribs are the "typical" ribs? |
|
Definition
|
|
Term
| Each vertebrae articulates with how many ribs? How many vertebrae does each rib articulate with? |
|
Definition
|
|
Term
| What is unique about rib 1? |
|
Definition
| It has a single facet on its head for articulation with only T1. it also has an attachment for the scalene muscle |
|
|
Term
| What is unique about rib 2? |
|
Definition
| it has a tuberosity for the serratus anterior |
|
|
Term
| What is unique about ribs 10-12? What is even more unique about 11 and 12? |
|
Definition
-10-12: only have one facet and articulate with a single vertebrae
-11&12: have no neck or tubercle |
|
|
Term
| How are the intercostal spaces named? |
|
Definition
| According to the rib forming the superior border |
|
|
Term
| At what vertebral level is the sternal angle? |
|
Definition
|
|
Term
| What is the xyphoid process a point of attachment for? |
|
Definition
|
|
Term
| Rib 1 is rarely fractured, but if it is broken injury to which to structures will likely occur? |
|
Definition
-brachial plexus
-subclavian arteries |
|
|
Term
| Flail chest results from what? |
|
Definition
|
|
Term
| What is a pneumothorax? What is the difference between an open and a tension pneumothorax? |
|
Definition
-Air enters the pleural cavity, takes up space, and restricts lung expansion
-Tension: air enters pleural cavity through wound in inhalation, but cannot leave on exhalation
-Open: air enters pleural cavity through the wound on inhalation and exits on inhalation |
|
|
Term
| What is usually the cause of a spontaneous pneumothorax? |
|
Definition
A bulla ruptures
*a bulla is when little alveoli group into larger air sacs (like in emphysema) and turn into a blister like growth on the lung |
|
|
Term
| What are some consequences of an extra cervical rib? |
|
Definition
-may interfere with neurovascular structures resulting in thoracic outlet syndrome
-can put stresses on lower part of the brachial plexus |
|
|
Term
| Where are the three places on the vertebrae that a rib articulates? |
|
Definition
-On the body at the superior and inferior costal facets of the superior vertebrae and the vertebrae of the same number
-transverse process of the vertebrae of same number |
|
|
Term
| Which rib articulates with the sternal angle? |
|
Definition
|
|
Term
| What significance does the T4/T5 level have with the aorta? |
|
Definition
| It is where the aorta transitions from ascending to arch then to descending |
|
|
Term
| About at what level of the vertebrae does the aorta pierce the diaphragm? |
|
Definition
|
|
Term
| About at what level of the vertebrae does the esophagus pierce the diaphragm? |
|
Definition
|
|
Term
| About at what level of the vertebrae does the vena cavae? |
|
Definition
|
|
Term
| What vertebral level does the diaphragm posteriorly descend to? |
|
Definition
|
|
Term
| What is the action of the diaphragm when you inspire? expire? |
|
Definition
-contracts (flattens)--> induces pressure change which results in air being drawn into the lungs
-relaxes |
|
|
Term
| What are three arteries that supply blood to the diaphragm? |
|
Definition
-inferior phrenic- which branch directly from abdominal aorta
-superior phrenic- which branch from lower thoracic aorta
-branches of the internal thoracic arteries from above |
|
|
Term
| In terms of alveolar and atmospheric pressure, list these actions in order of greatest to least pressure: expiration, inspiration, at rest |
|
Definition
-expiration
-at rest
-inspiration |
|
|
Term
| Which nerves supply the diaphragm? |
|
Definition
| C3, C4, and C5, the phrenic nerves |
|
|
Term
| Do the parietal and visceral pleura move together during inspiration and expiration? Describe the pleural cavity. |
|
Definition
-yes
-it is between the visceral and parietal pleura. a potential space, never a real space unless there is some pathology (i.e. pneumothorax |
|
|
Term
| The two pleural cavities of the thorax are separately enclosed spaces except for at the ________ through which the airways and blood vessels enter and leave. |
|
Definition
|
|
Term
| What is the difference between the parietal and visceral pleura? |
|
Definition
Parietal lines the walls of the pleural cavities
visceral lines the surface of the lung |
|
|
Term
| Name 6 significant things about vertebral level TIV/TV |
|
Definition
-passes through sternal angle anteriorly
-separates superior mediastinum from the inferior superior limit of the pericardium
-arch of aorta
-superior vena cava penetrates the pericardium to enter heart
-trachea bifurcates into right and left primary bronchi
-superior limit of pulmonary trunk |
|
|
Term
| The thoracic aorta branches into the internal thoracic arteries which then branch into what that pass laterally around the thoracic wall? |
|
Definition
| posterior and anterior intercostal vessels |
|
|
Term
| Intercostal nerves are from the anterior/posterior (?) rami of which spinal nerves? |
|
Definition
| anterior rami of thoracic spinal nerves |
|
|
Term
| Which two veins converge to form the superior vena cava? |
|
Definition
| the right and left brachicephalic veins |
|
|
Term
| Superiorly, what are the 4 major branches of the aorta? |
|
Definition
| Right and left common carotid artery and right and left subclavian artery |
|
|
Term
| Does the head of the rib articulate with the vertebrae or the sternum? |
|
Definition
|
|
Term
| Which ribs articulate with the sternum? What types of joints do they form? |
|
Definition
| 1-7, synovial joints except for Rib 1 |
|
|
Term
| Where do intercostal nerves and major arteries and veins lie? |
|
Definition
| in the costal groove along the inferior margin of the superior rib and pass between the inner two layers of muscle |
|
|
Term
| What is the order of the arteries, nerves and veins in each intercostal space? |
|
Definition
| Vein is most superior, then artery, and then nerve (VAN) |
|
|
Term
| Which way do the fibers of the external intercostal muscles run? what is the O and I? what do they function in? |
|
Definition
-like hands going into pockets
-O: inferior aspect of rib above
-I; superior aspect of rib below
-function in inspiration |
|
|
Term
| Which way do the fibers of the internal intercostals run? What is the O and I? what do they function in? |
|
Definition
-like hands under suspenders
-O: rib below
-I; rib above
-function in expiration |
|
|
Term
| The innermost intercostal muscles are the same as which other intercostal muscles? |
|
Definition
|
|
Term
| Which nerve innervates the intercostal muscles? |
|
Definition
|
|
Term
| What is the O,I, and A of the diaphragm muscle? |
|
Definition
O- typhoid process of sternum
I- costal margin of the thoracic wall, vertebrae of lumbar region
A- aids in inspiration, recoils with expiration |
|
|
Term
| What supplies blood to the anterior thoracic wall? Which artery do these arteries arise from? Which arteries do these arteries give rise to? |
|
Definition
-internal thoracic arteries
-arise from the subclavian arteries
-give rise to the anterior intercostal arteries |
|
|
Term
| At the level of the 6th intercostal space each internal thoracic artery divides into two branches. what are these branches? |
|
Definition
-superior epigastric which supplies the anterior abdominal wall
-musculophrenic which goes through the diaphragm |
|
|
Term
| What delivers the blood supply to the posterior thoracic wall? |
|
Definition
| Descending aorta which gives rise to the posterior intercostal arteries |
|
|
Term
| Blood is returned from the anterior thoracic wall by the anterior intercostal veins which carry blood to the internal thoracic veins which empty into what? |
|
Definition
| the right and left brachicephalic veins |
|
|
Term
| The posterior wall is drained by the posterior intercostal veins which empty into the bayous venous system. The ________ vein dumps into the posterior aspect of the ______/______/______ |
|
Definition
-azygous
-superior vena cava |
|
|
Term
| How many lobes does the left lung have? the right? |
|
Definition
|
|
Term
| What comprises the root of the lung? |
|
Definition
| primary bronchi, pulmonary arteries, and pulmonary veins |
|
|
Term
| At what vertebral level does the trachea split into the R and L bronchi? Which primary bronchi do aspirated objects end up in usually? |
|
Definition
-4th thoracic vertebral level
-right because it continues nearly vertically while the left veers laterally |
|
|
Term
| What is the depression on the L lung? |
|
Definition
|
|
Term
| The tertiary (segmental) bronchi supply segments of lung tissue called what? |
|
Definition
| bronchopulmonary segments |
|
|
Term
| Each bronchopulmonary segment consists of many small compartments called what? What are these compartments composed of? |
|
Definition
-Lobules
-lymphatics, arterioles, venules, terminal bronchioles, respiratory bronchioles, alveolar ducts, alveolar sacs, alveoli |
|
|
Term
| What do type 1 pneumocytes do? |
|
Definition
| they are macrophages in the alveoli |
|
|
Term
| what do type 2 pneumocytes do? |
|
Definition
| produce surfactant that reduces the surface tension in the alveoli and prevents the alveoli from collapsing at the end of expiration |
|
|
Term
| What are the three layers of the trachea? |
|
Definition
| mucosa, submucosa, and hyaline cartilage |
|
|
Term
|
Definition
| the internal ridge on the last ring of cartilage of the trachea. it is where the bronchi bifurcate |
|
|
Term
| T of F: each bronchopulmonary segment is independently supplied by a tertiary branch of the pulmonary artery. |
|
Definition
|
|
Term
| Terminal bronchioles give rise to what? |
|
Definition
|
|
Term
| Respiratory bronchioles divide in to 2-11 what? which give rise to what? |
|
Definition
-alveolar ducts
-alveolar sacs (basic unit of gas exchange) |
|
|
Term
| When a blood clot is stationary in that body it is called what? when it breaks free and travels it is call what? |
|
Definition
|
|
Term
| What do the pulmonary arteries do? Where does bifurcation of the pulmonary trunk occur? Which one R or L is longer? |
|
Definition
-carry deoxygenated blood to the lungs
-T4/T5
-R is longer |
|
|
Term
| What do pulmonary veins do? |
|
Definition
| carry oxygenated blood from the lungs back to the heart |
|
|
Term
| How do the bronchial veins return to the heart? |
|
Definition
|
|
Term
| Bronchial arteries originate from what? |
|
Definition
|
|
Term
| The superficial and deep lymphatic plexuses both drain into what? |
|
Definition
| deep veins in the base of the neck or they may drain into the R lymphatic trunk or thoracic duct |
|
|
Term
| where is the deep lymphatic plexus located in the lung? |
|
Definition
|
|
Term
| Mammary glands are modified _______ glands |
|
Definition
|
|
Term
| What is the circular pigmented area of skin surrounding the nipple called? |
|
Definition
|
|
Term
| Innervation of breast is via anterior and lateral cutaneous branches of the ____-_____ intercostal nerves |
|
Definition
|
|
Term
| 75% of the lymphatic drainage from the breasts drains into which nodes? |
|
Definition
|
|
Term
| What is significant about the suspensory ligaments in the breast? |
|
Definition
| if you have a lesion that causes fibrosis, it can tug on the suspensory ligaments and cause dimpling of the skin of the breast |
|
|
Term
| What is important about the fascia that lies beneath the breast and over the pectoral muscle? |
|
Definition
| Lesions will track along the path of least resistance and most likely follow the fascia downward following gravity |
|
|
Term
| Divide the breast into _______ to conduct examinations |
|
Definition
|
|
Term
| Branching of the ________ ducts occur in breast tissues during menstrual periods and pregnancy |
|
Definition
|
|
Term
| What is the name of the white to yellowish pre milk fluid that secretes from the nipples during the last trimester of pregnancy? What is significant about it? |
|
Definition
-colostrum
-it is rich in proteins, immune agents and growth factors affecting the infant's intestines |
|
|
Term
| Which two veins drain the posterior and lateral parts of the left thoracic wall? Which vein do they flow into? |
|
Definition
-hemiazygos and accessory hemiazygos veins
-drain into the azygous vein |
|
|
Term
| Where does the remaining 25% of lymphatic drainage that does not drain via that axillary nodes go? These nodes drain into what? |
|
Definition
-parasternal nodes
-bronchomediastinal trunk |
|
|
Term
| Why are the supraclavicular lymph nodes nicknamed "sister mary's lymph nodes"? |
|
Definition
| Sister mary, a nurse and nun, was the first to make the observation that many women with metastasis had hard supraclavicular lymph nodes, meaning that the cancer had metastasized to the supraclavicular lymph nodes |
|
|
Term
| The parasympathetic fibers from the vagus nerve innervate what three areas of the lungs? |
|
Definition
-motor to the smooth muscle of the bronchial tree (bronchoconstrictor)
-inhibitory to the pulmonary vessels (vasodilator)
-secretory to the glands of the bronchial tree (secretomotor) |
|
|
Term
| The central part of the diaphragmatic pleura and mediastinal pleura are supplied by what nerves? |
|
Definition
|
|
Term
| Horizontal plane passing through which two structures separates the mediastinum into superior and inferior parts? |
|
Definition
-sternal angle
-intervertebral disc between T4/T5 |
|
|
Term
| the inferior mediastinum is subdivided by the ________ |
|
Definition
|
|
Term
| The fibrous _______ is the tough CT outer layer that defines the boundaries of the middle mediastinum |
|
Definition
|
|
Term
| The _______ pericardium is thin and has two parts. what are the two parts? |
|
Definition
-serous
-parietal: lines inner surface of the fibrous pericardium
-visceral: adheres to the heart and forms the outer layer or epicardium |
|
|
Term
| Between the parietal and visceral layers of the serous pericardium is what? |
|
Definition
| A potential space filled with pericardial fluid that reduces the friction between the two membranes |
|
|
Term
| Bleeding into the pericardial cavity compresses the heart and is potentially lethal. What is the name for this? |
|
Definition
|
|
Term
| Which nerves pass through the serous pericardium? |
|
Definition
| the phrenic nerves, C3-C5 |
|
|
Term
| What are three major vessels that are included in the middle mediastinum? |
|
Definition
-superior and inferior vena cava
-pulmonary trunk (R and L pulmonary arteries)
-ascending aorta |
|
|
Term
| What are the vertebral levels of the thoracic aorta? |
|
Definition
| Begins at T4 and ends at T12 |
|
|
Term
| The heart has two surfaces and two borders, what are they? |
|
Definition
-anterior and inferior
-right and left |
|
|
Term
Where is the auscultation position for:
-the aortic valve
-the mitral valve
-the tricuspid valve
-the pulmonary valve |
|
Definition
-right of the sternum at the 2nd intercostal space
-at the apex, usually midclavicular around the 5th intercostal space
-just left of sternum at 5th intercostal space
-just left of sternum at 2nd intercostal space |
|
|
Term
| What are the sulci of the heart? |
|
Definition
| grooves on the surface of the heart containing coronary blood vessels and fat |
|
|
Term
| Which sulcus encircles the heart and marks the boundary between the atria and the ventricles? |
|
Definition
|
|
Term
| from what three sources does the right atrium receive blood? |
|
Definition
-superior vena cava
-inferior vena cava
-coronary sinus |
|
|
Term
| Where is the tricuspid valve located? |
|
Definition
| Between the right atria and the right ventricle |
|
|
Term
| Which part of the heart forms most of the anterior surface of the heart? |
|
Definition
|
|
Term
| Where is the pulmonary semilunar valve located? |
|
Definition
| in-between the right ventricle and the pulmonary trunk |
|
|
Term
| What are chordae tendinae? |
|
Definition
| cords between valve cusps and papillary muscles |
|
|
Term
| Which part of the heart forms most of the base of the heart? |
|
Definition
|
|
Term
| Where is the bicuspid valve located? What are some other names for this valve? |
|
Definition
-in between the left atrium and ventricle
-LAMB: left atrioventricular, mitral, bicuspid |
|
|
Term
| Which part of the heart receives blood from the lungs? How many pulmonary veins are there? |
|
Definition
Left atrium
-4 veins, 2 left and 2 right |
|
|
Term
| Which part of the heart forms the apex? |
|
Definition
|
|
Term
| Where is the aortic semilunar valve located? |
|
Definition
| in-between left ventricle and ascending aorta |
|
|
Term
| What lie just above the aortic semilunar valve? |
|
Definition
| openings to the coronary arteries |
|
|
Term
| What is the moderator band? |
|
Definition
| a single specialized trabeculum that forms a bridge between the lower portion of the inter ventricular septum and the base of the anterior papillary muscle. It carries a portion of the cardiac conduction system, the right bundle of the AV bundle, to the anterior wall of the right ventricle |
|
|
Term
| Dense ________/________ rings surround the valves of the heart, fuse and merge with the _________/_________ |
|
Definition
-connective tissue
-interventricular septum |
|
|
Term
| What is a function of the fibrous skeleton of the heart regarding conduction of impulses? |
|
Definition
| it acts as an electrical insulator between the atria and ventricles, preventing direct propagation of AP's to ventricles |
|
|
Term
| When the atrioventricular valves are open are the chordae tendinae and papillary muscles relaxed or contracted? |
|
Definition
|
|
Term
| What is mitral valve insufficiency aka mitral valve prolapse? |
|
Definition
| blood regurgitates into the left atrium when the left ventricle contracts |
|
|
Term
| What is pulmonary valve stenosis? |
|
Definition
| valve cusps are fused, restriction of right ventricular outflow, right ventricle hypertrophies |
|
|
Term
| What is pulmonary valve incompetence? |
|
Definition
| back rush of blood under high pressure into the R ventricle during diastole |
|
|
Term
| What is aortic valve stenosis commonly caused by? |
|
Definition
| rheumatic fever (left ventricle hypertrophies) |
|
|
Term
| What is aortic valve insufficiency? |
|
Definition
| aortic regurgitation into the L ventricle |
|
|
Term
| What is coarctation of the aorta? |
|
Definition
| narrow segment of the aorta. depending on where the narrowing is it can be more or less serious |
|
|
Term
| What is patent ductus arteriosus? |
|
Definition
| The ductus arterioles remains open |
|
|
Term
| What is atrial septal defect? |
|
Definition
| Foramen ovale fails to close and blood will have to shunt from L to R and puts increased load on the R side of the heart |
|
|
Term
| What is a ventricular septal defect? |
|
Definition
| Opening in the inter ventricular septum. blood will shunt from L to R |
|
|
Term
| What is teratology of Fallot? |
|
Definition
| Aorta and pulmonary trunk are emerging from the wrong places. Aorta emerges from both ventricles: enlarged right ventricle, inter ventricular septal defect, stenosed pulmonary valve |
|
|
Term
| What is the end diastolic volume (EDV)? |
|
Definition
| volume in the ventricle at the end of diastole |
|
|
Term
| What is the end systolic volume (ESV)? |
|
Definition
| volume in the ventricle at the end of systole |
|
|
Term
| What is the stroke volume? |
|
Definition
| the volume ejected per beat from each ventricle |
|
|
Term
|
Definition
|
|
Term
| What is the coronary circulation? |
|
Definition
| blood supply to the heart muscle |
|
|
Term
| What specifically do the L and R coronary arteries supply? |
|
Definition
L: both ventricles and inter ventricular septum
R: supplies the R atrium and ventricle, SA and AV nodes, the interatrial septum, part of left atrium, and part of left ventricle |
|
|
Term
| What is the sequence of the internal conduction system of the heart? |
|
Definition
| SA-AV-bundle of HIS-purkinje fibers |
|
|
Term
| What are the three most common sites of coronary artery occlusion? |
|
Definition
-anterior LAD branch of the LCA
-RCA
-circumflex branch of the LCA |
|
|
Term
|
Definition
-great CV
-middle CV
-small CV
-posterior CV |
|
|
Term
| Where is the SA node located? |
|
Definition
|
|
Term
| Where is the AV node located? |
|
Definition
| in atrial septum, transmits to bundle of his |
|
|
Term
| What is the AV bundle of his? |
|
Definition
-the connection between the atria and ventricles
-divides into bundle branches and purkinje fivers |
|
|
Term
| The autonomic NS is responsible for regulation of what three aspects of the heart? |
|
Definition
-heart rate
-force of contraction
-cardiac output |
|
|
Term
|
Definition
| congestive heart failure: chronic or acute state that results when the heart is not capable of supplying the oxygen demands of the body |
|
|
Term
| Where does blood back up in left sided heart failure? |
|
Definition
| into the lungs as pulmonary edema |
|
|
Term
| where does blood back up in right side heart failure? |
|
Definition
| the tissues as peripheral edema |
|
|
Term
| Contrast the effects of unilateral and bilateral damage to the recurrent laryngeal nerves? |
|
Definition
-unilateral= voice changes (hoarseness)
-bilateral= breathing difficulties and aphonia (inability to speak) |
|
|
Term
| Which veins drain blood from the body wall and move it to empty into the superior vena cava? |
|
Definition
| Azygos veins (azygos, hemiazygos, and accessory hemiazygos) |
|
|
Term
| Where does the greater splanchnic nerve, the lesser splanchnic nerve, and the least splanchnic nerve arise from? |
|
Definition
-greater= 5-10th thoracic ganglia
-less=10-11 thoracic ganglia
-least= 12 thoracic ganglion |
|
|
Term
| What are the sounds heard for air filled, fluid filled, and solid tissue upon auscultation? |
|
Definition
-air filled= resonant sound
-fluid filled= dull sound
-solid= flat sound |
|
|
