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55 Cards in this Set

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Which ribs are True, False, and floating?
Which rib connects to the sternal angle?
True = 1-7
False = 8-10
Floating =11 -12

Rib 2 connects at sternal angle
What are the 3 types of joints associated with ribcage?
Costovertebral joints: synovial joints between ribs and vertebra

Sternocostal Joints: synovial joints between costal cartilages of true ribs and the sternum

Costochondral joints: synchondroses between distal ends of ribs and costal cartilage
Which sternocostal joint is the only one that is not a synovial joint, and what kind is it?
Sternocostal joint of 1st rib

it is a synchondrosis
Vertebral level of the: Jugular notch, manubrium, bifurcation of the trachea (also sternal angle)
Jug notch - T2

Manubrium - T3-T4

Sternal angle (bifurc of trachea) - T4-T5
Vertebral level of xiphoid process?

This is the midline marker for what?
T10

midline marker for upper limit of liver, central tendon of diaphragm, inferior border of heart
Definition of ribs that are:
dislocated, separated, fractured
Dislocated - displaced at the sternocostal joint

Separated - rib torn from the costal cartilage

Fracture - break in the rib , often occurs at angle of the rib.
What type of connective tissue surrounds the mammary glands?
Dense irregular
What is the pathway of travel for milk out the breast?
Alveoli > intralobular ducts > interlobular ducts > lactiferous sinuses > lactiferous duct
What is the DUAL mode of secretion for milk in the breast?
Merocrine - proteins and carbs secreted by exocytosis

Apocrine (portion of cell leaves) - Milk fats secreted in large lipid-type droplets
From birth to about 3-4 days afterwards, what is the mammary gland secreting?

5 days after birth, secreting what?
Colostrum (birth to 3 days): very HIGH in protein and antibodies.
LOW in fat and carbs

Milk (5 days after birth): LOW in protein + antibodies, HIGH in fat and carbs
During pregnancy, prolactin production is suppressed by _________ and _______.
estrogen and progesterone
After pregnancy, temporary decrease in estrogen and progesterone allows secretion of what?
Prolactin, which stimulates milk production.
Suckling sends impulses to _______ which in turn activates ________.
hypothalamus

adenohypophysis
Oxytocin stimulates ______ cells to contract and eject milk.
myoepithelial
Drainage from the cysterna chyli goes to where?
Thoracic duct
Thoracic duct drains into the venous system where?
at jxn of internal jug veain and the subclavian vein
What area of the body drains to the right lymphatic duct?
Upper right
What area of the body drains to the thoracic duct?
Upper left, lower left, lower right.
Most of the drainage of the upper limb initially travels to the _______ nodes and then to the _______ nodes.
Lateral nodes

then to apical nodes
Main Breast lymphatic drainage pattern.
Breast > axillary nodes (pectoral, subscapular, apical) > inra/supraclavicular nodes > sublavian nodes > jxn of brachiocephalic + jugular veins
What is the origin, insertion, primary actions, secondary actions, innervation of
PECTORALIS MAJOR?
origin - clavicle, anterior sternum, upper 6 costal cartilages, aponeurosis of external oblique

insertion - lateral aspect of intertubercular groove (bicipital groove) of humerus.

Primary actions - adduction and medial rotation of humerus

secondary - forced inspiration

Innervation - lateral and medial pectoral nerves
What is the origin, insertion, primary actions, secondary actions, innervation of
PECTORALIS MINOR?
Origin - 3rd-5th ribs

Insertion - coracoid process

Primary action - pull scapular inferiorly, scapular protrusion

2ndary action - forced inspiration

Innervation - medial pectoral nerve
What is the origin, insertion, primary actions, secondary actions, innervation of
SERRATUS ANTERIOR?
origin - ribs 1-8

insertion - anterior surface of medial border of scapula

Primary actions - protrusion and inferior rotation of scapula

2ndary - forced inspiration

Innervation - long thoracic nerve (runs on it's surface)
The inercostal veins, arteries and nerves run between what 2 layers of intercostal muscles?
internal and innermost intercostal muscles
External intercostal muscles are innervated by what?

And are most active during (inspiration or respiration)
innervated by branches of thoracic VPR

Active during inspiration
Internal intercostal muscles are active during (inspiration or respiration)
respiration
What are the costal muscles that DEPRESS the ribs?
Subcostal muscles

On internal surface of ribs
What nerve and vessel run on the surface of the serratus anterior?
Long thoracic nerve and lateral thoracic artery
Borders of superior thoracic aperture?
Posterior - body of vertebra T1

Sides - medial margin of rib 1

anterior - manubrium
What are the borders of the Axillary Inlet?
Posterior border - superior margin of scapula

Anterior border - clavicle

Lateral margin - medial aspect of 1st rib

Apex - medial margin of the coracoid process

Base - lateral margin of rib 1
Excessive connective tissue growth in the axillary inlet leads to what?
weakness of the upper limb
Which bronchus is wider, right or left?
right
The right lung has __ lobes and the left lung has __ lobes.
Right = 3 lobes
Left = 2 lobes
What are the divisions of the parietal pleura?
Costal Pleura
Diaphragmatic pleura
mediastinal pleura
cervical pleura
What artery, vein, and nerve runs thru the axillary inlet?
Subclavian artery + vein

Brachial plexus
What are the pleural recesses?
Costodiaphragmatic recess

Costomediastinal recess
What are the parietal and visceral pleura innervated by?
Parietal is innervated by phrenic and intercostal nerves

Visceral is innervated by autonomic plexi but has NO pain endings
The base of the lungs rests on what?
diaphragm
With regards to the lungs, what is are the oblique and horizontal fissures?
Oblique fissures separte each lung into upper and lower lobes

Horizontal fissure is only found in the RIGHT lung which results in a middle lobe
In which lung is the pulmonary artery most superior?
Left lung
Where are the azygos and hemiazygos veins located, and what drains into them?
Azygos - right of vertebral column
Hemiazygos - left of vertebral column

The lungs drain into these
What type of blood does the pulmonary artery carry?
DEoxygenated
The lungs receive parasympathetic fibers from where?
Sympathetic fibers from where?
Para - vagus nerve

Sympathetic - sympathetic trunks
Lymphatic drainage from the lungs and pleura all ends up where?
Bronchomediastinal trunk.

Everything goes towards the midline
What are the 3 diaphragmatic apertures and what levels are they at?
Caval - between T8 and T9

Esophageal - At T10

Aortic - posterior to diaphragm at T12
What travels through the Caval aperture?
Inferior vena cava, right phrenic nerve and lymphatic vessels
What travels through the Esophageal aperture?
Esophagus, sympathetic fiber, esophageal branches of left gastric vessels, ant and post vagal trunks, lymphatic vessels
What travels through the Aortic aperture?
Aorta, thoracic duct and sometimes the azygos vein
What keeps the diaphragm "alive"
C3, C4, C5
Visceral pain (indirect pain) from the diaphragm goes back via the ______.
phrenic nerve
During normal inspiration, what muscles contract?
Diaphragm, intercostals
During FORCED inspiration, what muscles contract?
Diaphragm, intercostals
scalenes, sternomastoid, pectoralis major and minor, serratus anterior
During normal expiration, what muscles contract?
none

it is passive
During forced expiration, what muscles contract?
external and internal obliques
transversus thoracis and abdominus
Rectus abdominus
What is Atelectasis?
The collapse of part or all of a lung.

Caused by blockage of the air passages or by pressure on the lung