| Term 
 | Definition 
 | 
        |  | 
        
        | Term 
 | Definition 
 | 
        |  | 
        
        | Term 
 | Definition 
 
        | 8-10 attach at 7th cost cart |  | 
        |  | 
        
        | Term 
 | Definition 
 | 
        |  | 
        
        | Term 
 
        | typical ribs what
 how typical
 
 aypical means what
 |  | Definition 
 
        | 3-9 or 2-10 - may vary two costal attachments at vertebra
 1 at transverse process
 
 attach at 1 vertebral costal facet
 |  | 
        |  | 
        
        | Term 
 
        | 5th rib attaches to which verts superior costal articulating facet? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | pect major has two innervations 
 pect minor one
 |  | Definition 
 
        | lateral/medial pectoral 
 medial pectoral
 |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | clavipectoral fascia 
 medial/sup to CP fascia neurovas bundle of thoracoacromial a/v and lateral pectoral pierce
 |  | 
        |  | 
        
        | Term 
 
        | breast located in what fascia |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | mammallary crease. where 
 nipple, males ?
 |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | suspense ligs of cooper attach to what, but not what |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | retromam space, bet what? |  | Definition 
 
        | deep fascia of pect major and breast |  | 
        |  | 
        
        | Term 
 
        | cause of dimples vs retraction 
 small dimples?
 |  | Definition 
 
        | dimples: invasion of suspens ligs 
 nipple retraction: of lact ducts
 
 lymphedema
 |  | 
        |  | 
        
        | Term 
 
        | how breast ca spread to brain/verts? |  | Definition 
 
        | ax nodes - posterior intercostal veins - azygos/hemi or
 - vert. venous plexuses surrounding spinal cord system to verts or brain
 
 azy runs along spine
 |  | 
        |  | 
        
        | Term 
 
        | how know if cancer in pect major fram breast? |  | Definition 
 
        | when pect contracts, boob elevates |  | 
        |  | 
        
        | Term 
 
        | ax and parasternal nodes drain to what nodes |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | what intercostal muscle can you see from costal cart to sternum? |  | Definition 
 
        | inner intercostal. 
 external laterally to costal cart then stop
 |  | 
        |  | 
        
        | Term 
 
        | external intecost, direction |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | which in from axillar v/a? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | transverus thoracis given rise by what muscle
 do what
 |  | Definition 
 
        | innermost intercost hold down internal thoracic
 |  | 
        |  | 
        
        | Term 
 
        | intercostal n between which intercost muscles? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | limits of thoracic cavity
 mediastinum
 |  | Definition 
 
        | diaphragm to ribs 
 lungs/diaphram
 |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | afferent visceral, afferent motor converge at same levels of spinal cord |  | 
        |  | 
        
        | Term 
 
        | problems with mediastinum, or any pushing on diaphram results in pain where? 
 ex. pain in mediastinum/diaphragm
 ex. pain in stomach/pancreas/spleen/liver/Q
 |  | Definition 
 
        | shoulder, neck (PHRENIC) 
 between shoulder blades (SPLANCHNIC, T5,6)
 
 phrenic nerve motor/sensory to diaphragm but also SENSORY TO MEDIASTINAL PLEURA
 
 if blow up cavity with air for study, shoulders will hurt after
 |  | 
        |  | 
        
        | Term 
 
        | parietal pleuras pain, nerve
 
 visceral pleura
 pain nerves
 |  | Definition 
 
        | localized, sensitive (can be referred) somatic 
 poorly localized, insensitive autonomic
 
 disease wont really hurt until invades parietal layer
 |  | 
        |  | 
        
        | Term 
 | Definition 
 | 
        |  | 
        
        | Term 
 
        | cardiac notch at what rib space |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | if at 1st rib what is the space below called? |  | Definition 
 
        | 1st space! 
 spaces take name of rib ABOVE
 |  | 
        |  | 
        
        | Term 
 
        | mid clavicular lungs
 pleura
 |  | Definition 
 | 
        |  | 
        
        | Term 
 | Definition 
 | 
        |  | 
        
        | Term 
 
        | scapular (inf angle( lung
 pleura
 |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | why only one fissure on left |  | Definition 
 
        | no room for 3 lobes, heart there |  | 
        |  | 
        
        | Term 
 
        | pulmonary ligament function
 what is it
 |  | Definition 
 
        | connection between visceral/parietal pleura 
 at hilum, visceral pleura of lung becomes parietal  (think of fist in baloon... has to become parietal at some point
 |  | 
        |  | 
        
        | Term 
 | Definition 
 | 
        |  | 
        
        | Term 
 
        | leading cause of maternal death |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | bronchus branches a what topographical struct |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | bronchus intermedius  what side  where  how diff from left main bronchus |  | Definition 
 
        | right side. right below right upper lobe bronchus  wider and more vertical then left main bronch   [image] |  | 
        |  | 
        
        | Term 
 
        | if something aspirated, where likely to get stuck |  | Definition 
 
        | right main bronchus. wider and more vertically in line with trachea
 |  | 
        |  | 
        
        | Term 
 
        | bronchial arteries/veins function
 |  | Definition 
 
        | feed, drain visceral pleura/tissue of lungs. do not function in gas exchange
 |  | 
        |  | 
        
        | Term 
 
        | bronchial branching 
 right side has how many lobes?
 left?
 
 about how many segments on each side?
 |  | Definition 
 
        | main (prim) -> lobes (secondary) -> segments (tertiary) 
 Right: 3
 Left: 2 (not enough room for 3!)
 
 about 10 on each side
 |  | 
        |  | 
        
        | Term 
 
        | bronchus bronchiole
 avioli
 
 compostion?
 when does cartilage stop?
 |  | Definition 
 
        | bronchus - cart bronchiole - smooth m, elastic fiber
 avioli - elastic fiber
 
 cart stops at about 1mm diameter
 |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | vasodilates systemic vessles (decrease heart rate, BP, stroke v)
 increase mucous, less exchange
 constricts bronchiole lumen, slower oxygenation
 constricts coronoary arts
 |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | constrict systemic vessels decrease mucous
 dilate bronchioles
 dilate cornary art (increase BF to <3)
 |  | 
        |  | 
        
        | Term 
 
        | diaphragm flattens upon inspiration why? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | inspiration: what intercostal muscle contracts why
 |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | expiration what m contracts?
 why?
 |  | Definition 
 
        | inner intercostal 
 bring ribcage down
 |  | 
        |  | 
        
        | Term 
 
        | pneumothorax (open) what?
 |  | Definition 
 
        | air getting into pleural cavity, pressure rises and lung collapses |  | 
        |  | 
        
        | Term 
 
        | pneumothorax (closed) what happens
 
 affect on venous return?
 |  | Definition 
 
        | inspiration air into pleural cavity (puncture) causing ipsilateral lung to collapse.
 mediastinum shifts to opposite side
 
 expiration
 open wound closes from pressure inside, air cannot get out, mediastinum pushes to other side
 
 increased pressure impairs venous return
 |  | 
        |  | 
        
        | Term 
 | Definition 
 | 
        |  | 
        
        | Term 
 
        | hemothorax hydrothorax
 pyothorax
 chylothorax
 |  | Definition 
 
        | blood (usual injury to intercostal vess) watery stuff (maybe from effusion into pcavity)
 pus
 lymph
 |  | 
        |  | 
        
        | Term 
 
        | 2 ways stuff could get into pleural space? |  | Definition 
 
        | opening in parietal pleural 
 leakage through visceral pleura
 |  | 
        |  | 
        
        | Term 
 
        | thoracentisis where?
 where in this place?
 |  | Definition 
 
        | 2nd/3rd intercost space 
 above upper boarder of ribso dont hit intercostal vessels/nerves
 |  | 
        |  | 
        
        | Term 
 
        | why does lung collapse when air in PC |  | Definition 
 
        | surface tension between pleura broken. collapses due to inherent elasticity (recoil)
 |  | 
        |  | 
        
        | Term 
 
        | percussion sounds dull
 resonant
 flat
 |  | Definition 
 
        | dull: fluid resonant: air
 flat: solid
 |  | 
        |  | 
        
        | Term 
 | Definition 
 | 
        |  | 
        
        | Term 
 
        | heart, how many beats/min 
 average age
 |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | pericardium layers, layers
 
 outer layer continuous with?
 |  | Definition 
 
        | fibrous & serous 
 serous: parietal and visceral
 
 fibrous layer continuous with central tendon of diaphrahm
 |  | 
        |  | 
        
        | Term 
 
        | cardiac tamponade what
 result - which causes
 end result
 how treat?
 |  | Definition 
 
        | compression of heart 
 due to fluid accumulation in pericardium, increased pericard pressure on heart. cant fill up!!
 
 decreased vent filling/StrokeV
 vents get bigger to compensate (cardiomeglay)
 
 usually shock or death
 
 pericardiocentesis (remove liquid from pericard sac)
 |  | 
        |  | 
        
        | Term 
 
        | pericardiocenteisis where put needle in? space?
 drain?
 |  | Definition 
 
        | xiphoid/costal margin, 5th space 
 cardiac notch allows easy drainage that doesnt affect L lung
 |  | 
        |  | 
        
        | Term 
 
        | what could cause heart compression |  | Definition 
 
        | liquid in peri sac but stab wound (blood), perforated heart wall after Hattack) |  | 
        |  | 
        
        | Term 
 
        | mediastinum structs anatomically lower when lying or standing |  | Definition 
 
        | standing. gravity pulls down |  | 
        |  | 
        
        | Term 
 
        | what sulcus separates A/V |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | percussion of heart sounds normally dull where?
 |  | Definition 
 
        | 4th, 5th, 6th intercost spaces 6 cm to left |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | only right ventricle where  pul art starts
 |  | 
        |  | 
        
        | Term 
 
        | tricuspid valve how many papillary m, where
 |  | Definition 
 
        | 3 papillary muscles attached to cordae tendinae 
 ant/post/septal
 |  | 
        |  | 
        
        | Term 
 
        | ductus arteriosis function
 becomes what
 where
 |  | Definition 
 
        | bt aorta to pul trunk/artery 
 shunts blood from pul artery to aorta
 LIGAMENTUM ARTERIOUS
 |  | 
        |  | 
        
        | Term 
 
        | pap muscles contract/relax during systole |  | Definition 
 
        | contract, close valve so no backflow, respond to pressure |  | 
        |  | 
        
        | Term 
 
        | interventricular septum what is made of?
 |  | Definition 
 | 
        |  | 
        
        | Term 
 | Definition 
 
        | due to certain types of heart disease, detach and occlude stff |  | 
        |  | 
        
        | Term 
 
        | septomarginal trabecular also called
 funtion
 |  | Definition 
 
        | moderator band (R vent) part of electrical conduction system
 |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | R has more, L has only in auricle. from embryonic atrium
 |  | 
        |  | 
        
        | Term 
 
        | what of L atrium is anterior |  | Definition 
 | 
        |  | 
        
        | Term 
 | Definition 
 | 
        |  | 
        
        | Term 
 
        | RCA branches
 prx - distal
 
 LCA
 |  | Definition 
 
        | AV branch marginal (supplies r boarder)
 Post IV (right post descending)
 
 ant IV (LAntDescending)
 circumflex
 |  | 
        |  | 
        
        | Term 
 
        | Dominance % R, % left
 
 what means
 
 
 why is having left dominant dangerous
 |  | Definition 
 
        | R, 70 L, 10
 
 SOURCE of posterior descending artery
 
 LCA easily occulded
 |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | corn art bypass graft 
 internal thoracic artery (divert)
 or
 great saphenous vein
 or radial artery
 |  | 
        |  | 
        
        | Term 
 
        | most common sites of embolism resulting in infarct |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | ischemic heart diease cause
 |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | typical place of myocardio referred pain |  | Definition 
 
        | medial aspect of left upper arm |  | 
        |  | 
        
        | Term 
 
        | CAD / electric system SA/AV nodes supplied by?
 AV bundle supplied by?
 |  | Definition 
 
        | SA/AV -RCA AV bundle -LCA
 
 NOTE: av bundle runs down AV septum
 |  | 
        |  | 
        
        | Term 
 
        | heart block damage to what?
 
 bundle block
 damage to what
 |  | Definition 
 
        | damage to AV node vents contract but much slower
 
 AV bundle
 normal systole in one branch only (asnychronus contraction)
 |  | 
        |  | 
        
        | Term 
 
        | Cardiac veins drain where
 branches?
 |  | Definition 
 
        | drain to Csinus 
 great vein follows LAD
 middle follows post IV
 small follows marginal
 |  | 
        |  | 
        
        | Term 
 
        | listening to valves: aortic
 pulmonic
 tricuspid
 mitrial
 |  | Definition 
 
        | 2nd space/sternum right 2nd space/sternum left
 5th space/sternum left
 5th space/mid-clavicular (apex of heart), where costal cart ends
 |  | 
        |  | 
        
        | Term 
 | Definition 
 | 
        |  | 
        
        | Term 
 
        | apex contracts? (direction) 
 atria contracts?
 |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | topographic borders of mediastinum ant
 post
 
 sup mediastinum
 
 inferior mediastinum
 |  | Definition 
 
        | sternal angle to xiph-sternal joint 
 T5-T9
 
 sternal angle to sup thoracic aperature
 
 sternal angle to diaphragm
 |  | 
        |  | 
        
        | Term 
 
        | orientation of vessels in mediastinum |  | Definition 
 
        | Veins - ant arteries - poster
 nerves - most post
 |  | 
        |  | 
        
        | Term 
 
        | embryonic origin of thymus |  | Definition 
 
        | endoderm 3rd laryngeal pouch
 |  | 
        |  | 
        
        | Term 
 
        | blood path when IVC/SVC obstructed? |  | Definition 
 
        | IVC: through azygos to SVC SVC: drain into abdominal walls then up azygos
 |  | 
        |  | 
        
        | Term 
 
        | AAA pain manifests where?
 other sympts
 |  | Definition 
 
        | back dyspnea, AAA may compress trachea/esophagus/Recurrent laryngeal n (difficulty breath/swallow)
 |  | 
        |  | 
        
        | Term 
 
        | branches of brachiocephalic vein (L/R) 
 BCv dumps into
 |  | Definition 
 
        | internal jugular v. + subclavian 
 SVC
 |  | 
        |  | 
        
        | Term 
 
        | branches of aortic arch 
 med to lateral
 |  | Definition 
 
        | brachiocephalic trunk (r. common carotid, r sub)
 
 L common carotid
 L subclavian
 |  | 
        |  | 
        
        | Term 
 
        | Bovine Arch % people
 what
 |  | Definition 
 
        | L common carotid comes off brachiocephalic artery L carrot can come off at prox/distal trunk
 
 12%
 
 so now BC artery would have 3 branches, r sub, r carrot, l carrot
 |  | 
        |  | 
        
        | Term 
 
        | Bowline Arch what?
 % people
 |  | Definition 
 
        | two brachiocephalic trunks 1.2%
 |  | 
        |  | 
        
        | Term 
 
        | L vertebral artery comes off aorta (instead of L subclavian) 
 %?
 |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | collateral blood with aortic coarctation |  | Definition 
 
        | less blood to inferior body. due to narrowing of lumen of aorta. prox/dis to ligamentum arteriosis 
 so blood goes from posterior intercostals moves anterior and inferior.
 |  | 
        |  | 
        
        | Term 
 
        | landmark for left recurrent laryngeal nerve? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Patent Ductus Arteriosis problem after birth?
 common in?
 #/1000?
 female or male?
 how treat non invasively?
 |  | Definition 
 
        | pressure drives blood from aorta through DA to pulmonary trunk/arteries. 
 more blood to lungs increases pul pressure (-> pul edema)
 
 decreased systemic flow,
 LV compensates and pumps more (hypertrophy)
 
 more in females,
 8/1000
 give anti-inflammatorys.
 |  | 
        |  | 
        
        | Term 
 
        | Wwhat keeps ductus arterious open? |  | Definition 
 
        | prostangladins AKA INFLAMMATION |  | 
        |  | 
        
        | Term 
 
        | inflamm of bronchi or aorta will cause what nerve to get compressed |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | left recurr laryngeal n. under what? 
 right RLn. under what?
 |  | Definition 
 
        | aorta/ligamentum arteriosis 
 R subclavian
 |  | 
        |  | 
        
        | Term 
 
        | cardiac plexus originiates from what?
 supplies what?
 controls what?
 where sits?
 |  | Definition 
 
        | vagus nerves/sympathetic trunk heart
 constriction of coronary a, heart rate
 aortic arch
 |  | 
        |  | 
        
        | Term 
 
        | pulmonary plexus originates from?
 controls
 sits?
 |  | Definition 
 
        | vagus nerves/sympathetic trunk bronchiole constriction
 pul trunk
 |  | 
        |  | 
        
        | Term 
 
        | bifurcation of trachea at vert lvl? (carina) |  | Definition 
 
        | T4, sternal angle (2nd rib) |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | thymus, lymph nodes, fat, connective tissue |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | pericardium, heart, root of great vessels, arch of azygos, main bronchi |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | largest region, T5-T12, esophagus, aorta, azygos & hemizygos, thoracic duct, vagus nerves, sympathetic trunks, splanchnic nerves |  | 
        |  | 
        
        | Term 
 
        | esophagus deviates to become anterior to aorta at what vert lvl |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | azygos, thoracic duct, aorta right to left
 |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | laceration fo Thoracic duct result
 |  | Definition 
 
        | chylothorax - accumulation of chyle in pleura |  | 
        |  | 
        
        | Term 
 
        | azygos joins SVC at what vert lvl 
 drains blood from where?
 |  | Definition 
 
        | T4 (sternal angle) 
 post walls of abdomen and thorax
 |  | 
        |  | 
        
        | Term 
 
        | hemiazygos arises from where?
 crosses verts to join azygos where?
 |  | Definition 
 
        | post renal vein 
 T6/7 (post to Tduct/aorta)
 |  | 
        |  | 
        
        | Term 
 
        | accessory hemiazygos where crosses over?
 drains blood from where?
 |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Splanchnic Nerves innervate what?
 |  | Definition 
 
        | supply viscera inferior to diaphragm 
 Greater, lesser, least (T5-12)
 medial to sympathetic trunk
 |  | 
        |  | 
        
        | Term 
 
        | what vert level, aortic arch |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | anterior cardiac vein drains where? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | normal, quiet expiration lying down  is acheived by contraction of what? |  | Definition 
 
        | elastic tissue of lungs/thoracic wall. EXPIRATION IS PASSIVE |  | 
        |  | 
        
        | Term 
 
        | CIRCUMFLEX BRANCh supplies what? |  | Definition 
 
        | left atrium, left ventricle |  | 
        |  | 
        
        | Term 
 
        | posterior intercostal arteries 3-12 supplied by? 
 what supplies upper 6 intercost arteries?
 |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | thorocentesis where preformed preferrably?
 |  | Definition 
 
        | 1-2 spaces below the fluid, not below the 9th. mix axillary line |  | 
        |  | 
        
        | Term 
 
        | apex of heart receives blood form what coronary artery generally? |  | Definition 
 
        | LAD (goes all the way down) |  | 
        |  | 
        
        | Term 
 
        | major muscles upon active expiration? |  | Definition 
 
        | abdominal (not diaphragm) |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | diaphragm, external intercostal, levator, |  | 
        |  | 
        
        | Term 
 
        | what vein passes over root of r lung? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | venous drainage - intercostals |  | Definition 
 
        | 2-4 intercost veins form SUPERIOR IC vein wich drains into (L) brachiocephalic, R (azygos) |  | 
        |  | 
        
        | Term 
 
        | internal thoracic vein drains into what? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | coronary arteries at max blood flow at? systole/diastole
 |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | LUB DUB what closes during lub?
 dub?
 |  | Definition 
 
        | tricuspid/mitrial 
 aortic/pulmonary
 |  | 
        |  | 
        
        | Term 
 
        | septum primum = character? septum secondum =
 |  | Definition 
 
        | SP = thin, membranous SS = musccular thick
 |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | atrium in back, ventricle in front endocardial cushions  begin to grow into ridges of tissue on opposite sides (crossing each other) of trucus arteriorsis (superior to vent) making a spiral. forming AORTICOPILMONARY SEPTUM
 
 muscular vent septum grows from floor, partially dividing ventricles. when aorticopulmonary septum and intervent septum meet, aorta and pul trunk are formed.
 |  | 
        |  | 
        
        | Term 
 
        | VSD main development cause?
 
 blood goes where?
 |  | Definition 
 
        | often associated with irregular partitioning of conotruncal region - failure of ridges to fuse and descend. 
 blood from left V to right vent and to pulmonary trunk (higher P to lower P) - leading to pul edema
 |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | Dacron patch or reduce flow to pulmonary trunk. |  | 
        |  | 
        
        | Term 
 
        | tetrology of Fallot most frequent abnormality of conotruncal region
 what?
 
 4 things associated
 
 presents as?
 |  | Definition 
 
        | unequal division of conus, produces 4 alterations: 
 Intervent septal defect
 Hypertrophy of Right V
 Overriding aorta
 Pulmonary stenosis (small pul trunk)
 
 body cyanosis
 |  | 
        |  | 
        
        | Term 
 
        | persistant truncus arteriosis |  | Definition 
 
        | contruncal ridges fail to fuse, blood from R/L vents move into aorta/pul trunk fused and mix |  | 
        |  | 
        
        | Term 
 
        | 4th pharangeal arch 6th
 3rd
 all become what
 |  | Definition 
 
        | 4th subbclavian/aorta 6th pulmonary artery (6P)
 3rd thymus
 |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | oxy blood (placenta) - umbilical vein - ductus venosus (bypass liver) - IFC - RA - foramen ovale - LA - LV - aorta - body - umbilical artery - placenta 
 or
 
 RA - RV - PT - DArteriosis - Aorta - body - umbilical artery - placenta
 |  | 
        |  |