Anatomy Block 2

Front 1

two measures of cardiac performance

Back 1

flow rate
blood pressure

Front 2

Flow rate

Back 2

Cardiac output Q is in L/min

5L/min

Front 3

Blood pressure fun facts

Back 3

Biggest delta P is in the arterioles because resistance has increased
systemic has more pressure than pulmonary
normal is 120/80
P=QR

Front 4

Electrical events of a heartbeat

Back 4

1. sinoatrial node depolarizes
2. atria contract
3. atrioventricular node depolarizes
4. conduction through fiber bundles
5. ventricles contract

Front 5

ECG bumps

Back 5

P- atrial depolarization
QRS- ventricular depolarization
T- ventrical repolarization

Front 6

Control of heart rate

Back 6

SA node pacemaker function + 80 bpm autorhythmic
Parasympathetic input decreases HR to about 60-70 bpm
Sympathetic input increases HR
temperature, drugs

(AV node autorhythm is ~50bpm)

Front 7

Sinus Rhythm

Back 7

Paced by SA node and under parasympathetic and sympathetic control

Front 8

Arythmias can result from

Back 8

pacing -- SA node too slow; AV node too fast
conduction-- heart block; poor or no AV conduction
repolarization
ectopic foci -- rogue pacemaker

Front 9

Lub and Dub sounds are caused by

Back 9

Mitral AV valve closes LUB
Aortic Valve closes DUB

Front 10

Diastole and systole

Back 10

filling of the ventricles is diastole
ejection is systole

Front 11

diastolic heart failure

Back 11

stiffened ventricle
poor filling

Front 12

asymptomatic atrial fibrillation

Back 12

OK, since 70% of filling is w/o atrial contraction

Front 13

aortic valve stenosis

Back 13

narrowed valve restricts flow

Front 14

blood flow, volume and pressure are regulated by

Back 14

-baroreceptors
-para and sympathetic nervous input
-in response to other regulatory mechanisms (e.g., thermoregulation, exercise).
-by the renin-angiotensin II -aldosterone system (long term).
-regionally, depending on tissue demands for nutrients, oxygen.

Front 15

Lung develops from

Back 15

central outpouching of foregut
endodermal lining and splanchnic LPM smooth muscle

Front 16

Diaphragm forms from the _____

Back 16

septum transversum -- somatic LPM, no muscle

striated skeletal muscle migrates from somites C3, 4, 5 (myotome, hypomere)

innervated from C3,4,5 keeps the diaphragm alive

Front 17

Chambers of the Fetal Heart

Back 17

Truncus Arteriosus: forms the great vessels
Bulbus Cordis: forms the righst ventricle
Primitive Ventricle: forms left ventricle
Primitive Atrium: forms the trabeculated right atrium and left atrium
Sinus Venosus: forms the smooth right atrium, the SA node and the venae cavae

Front 18

Septation

Back 18

formation of atrial septum, ventricular septum, and truncoconal septum

endocardial cushions form AV septa

spiral truncoconal septum separates the arteriosus into aorta and pulmonary trunk

Front 19

Three important fetal structures that change circulation

Back 19

1. Ductus venosus (umbilical vein bringing Oxygenated blood into the system

2. Foramen Ovale connects the right and left atriums

3. Ductus Arteriousus connects the pulmonary trunk to the aorta

Front 20

what happens after birth that changes fetal to adult circulation path?

Back 20

After birth:
1. Lungs expand
2. blood flows through the pulmonary arteries
3. blood flows back from the lungs
3 foramen ovale closes
4. ductus arteriosus will close

Front 21

Persistent trucus arteriosus

Back 21

occurs when the aorticopulmonary septal ridges fail to form. conal ridges also fail to form normally-\
Oxygenated and Deoxygenated blood mix in the outflow tract. cyanotic defect

Front 22

three disorders that involve the abnormal location of the truncal and conal septa

Back 22

1. tetralogy of fallot (pulmonary stenosis, large VSD, overriding aorta and hypertrophy of the right ventricle dues to higher pressures on right side)

2. transposition of the great vessels. (most of blood reaching brain is deoxygenated)

3. Double outlet right ventricle. another cyanotic defect in which the aorta overrides both ventricles

Front 23

semilunar valvular atresia or stenosis

Back 23

can be either the pulmonary or the aorta
lack of flow

Front 24

Lung volumes

Back 24

Total lung capacity= 5900ml
Tidal volume (TV) = 500 ml = air moved in, and then out, in one breathing cycle
Functional residual capacity (FRC) = 2400 ml = amount of air in lungs at end of typical exhalation
Residual volume (RV) =1200 ml = amount of air that cannot be exhaled from the lungs
Vital capacity (VC) = 4700 ml = maximum amount of air that can be forcibly ventilated in one breath

Front 25

process of inspriation

Back 25

1. Diaphragm is the primary inspiratory muscle in humans
2. Intercostal muscles and accessory respiratory muscles (e.g. serratus anterior,
sternocleidomastoid) generally contribute less than diaphragm to normal inspiration
3. Intercostal and accessory muscles become more important for labored breathing

Front 26

Expiration process

Back 26

1. At rest is passive (no muscle action); is caused by elastic recoil of lungs, surface tension
within alveoli, and some elastic recoil of chest wall
2. During labored breathing is driven primarily by abdominal muscles (external and internal
oblique and transverse abdominal) with small contributions from intercostal muscles
• contraction of abdominal muscles squeezes liver up toward the thorax, thereby
lengthening the muscle fibers of the diaphragm

Front 27

intercostal and oblique fiber directions

Back 27

External: hands in pockets

internal: hands over heart

Front 28

Lymphatic drainage of breast

Back 28

Breast cancer typically spreads by means of lymphatic vessels.

cells lodge in nodes producing tumors
pathways along axillary, cervical, and parasternal nodes may also cause cancer to develop in the supraclavicular lymph nodes, opposite breast, or the abdomen

Front 29

lymphedema

Back 29

cancer causes edema in the subcuntaneous tissue.

may result in deviation of the nipple and leathery, thickened appearance of the breast skin.

puffy skin around pores resembles orange peel.

larger dimples caused by invasion of the suspensory ligaments

Front 30

advanced breast cancer

Back 30

cancer can spread by contiguity (invasion of adjacent tissue) to invade the pectoral fascia or metastasize to the interpectoral nodes. breast elevates when the muscle contracts

Front 31

Winged scapula

Back 31

when serratus anterior is paralyzed because of injury to the long thoracic nerve, the medial border of the scupla moves laterally and posteriorly, away from thoracic wall. arm cannot be adbucted above horizontal.

Front 32

where do you insert intercostal needles so as not to injure the nerves and vessels?

Back 32

superior to the inferior rib

Front 33

what can cause widening of the mediastinum

Back 33

1. hemorrhage to great vessels from trauma
2. malignant lymphoma
3. enlargement of the heart with congestive heart failure

Front 34

hemothorax and pneumothorax

Back 34

pleural space fills with blood and air respectively

Front 35

cardiac tamponade

Back 35

is due to critically increased volume of fluid outside the heart but inside the pericardial cavity (due to stab wound or perforation of a weakened area after heart attack)

Front 36

innervation of lungs

Back 36

visceral pleura is insensitive to pain because its innervation is autonomic

parietal pleura is sensitive to pain because it is richly supplied by branches of the somatic intercostal and phrenic nerves. local pain is referred to areas sharing the same segments of cord

Front 37

diaphragm refers pain where?

Back 37

local and referred from the costal and peripheral parts of diaphragm being irritated go to thoracic and abdominal walls

irritation of mediastinal and central diaphragmatic areas refer to root of neck and over shoulder

Front 38

Azygous system veins problem

Back 38

Azygous and hemiazygous drain from thorax and abdomen when IVC is obstructed.

some people get all the blood from inferior to diaphragm except that from digestive tract

SVC obstruction superior to azygous can allow drainage to run below to abdomen and then back up through azygous and IVC

Front 39

rotator cuff problem

Back 39

injury or disease may damage the rotator cuff, producing instability of the glenohumeral joint.

Rupture or tear of the supraspinatus tendon is the most common injury of the rotator cuff

degenerative tendinitis of the rotator cuff is common esp. in older people

Front 40

Dorsal Scapular and subdeltoid region problems

Back 40

axillary nerve may be injured when the glenhumeral joint dislocates because its close relation to the inferior part of the joint capsule of this joint.

displacement of head of humerous into quadrangular space damages the axillary nerve.
axillary nerve injury is indicated by paralysis of the deltoid

Front 41

suprascapular region problems

Back 41

several arteries join to form anastomoses

when a subclavian or axillary artery is ligated, the direction of blood flow in the subscapular artery is then reversed to provide blood to the third part of the axillary artery