Anatomy Exam 1

Front 1

gross anatomy- why is it gross

Back 1

b/c studying th large bits-visible to the naked eye

Front 2

morphology

Back 2

the study of shapes

Front 3

the examination of surface geastures and how they are related to the deeper structures in the body

Back 3

surface anatomy

Front 4

biomechanics

Back 4

the study of functions, related to morphology, structural morphology or the study of how shapes are related to function

Front 5

the study of the small bits, parts invisible to the naked eye

Back 5

microscopic anatomy

Front 6

histology

Back 6

the study of tissue types and their construction

Front 7

cell biology

Back 7

the study of cellular anatomy i/e/ the parts of the cell

Front 8

pathology

Back 8

the study of when good structures go bad, usually studies at the microscopic level but can have a gross component

Front 9

neuroanatomy

Back 9

combines gross and microscopic anatomy but focuses on the CNS

Front 10

embryology

Back 10

includes neuro, microscopic and gross anat. but fucuses on how they dvp

Front 11

developmental embryology

Back 11

incles general embryology but focuses on genetics more

Front 12

auxology

Back 12

the study of growth from birth onward

Front 13

comparative anatomy

Back 13

includes all subfields of anat( neuro, embryology, microscopic and gross) but focuses on how animals are ontogenetically and phylogenetically related

Front 14

the frankfurt horizontal plane

Back 14

a plane used to describe the skull-close to how it is in anatomical position but not quite. the three points used are usually the two superior points of the external acoustic meati, and the inferior point of the right orbit

Front 15

towards the direction which you are going/ came from

Back 15

anterior/posterior

Front 16

toward teh belly and toward teh back- ( in anat. it can refer to adult anatomical position and also developmental origins)

Back 16

ventral/ dorsal

Front 17

toward the top/bottom

Back 17

superior/inferior

Front 18

what aspect of the brain is at the top of the brain? (ventral/dorsal)

Back 18

dorsal

Front 19

toward the head/tail

Back 19

cranial/caudal

Front 20

toward the head

Back 20

rostral-used more often in emryology because the head might not have developed yet so don't say cranial

Front 21

cephalic/caudad

Back 21

mean exactly the same as cranial/caudal- toward head/tail but more often used in british english

Front 22

toward the surface/away from the surface

Back 22

superficial/ deep

Front 23

toward the middle/ toward the side

Back 23

medial/lateral also clinicians sometimes use internal/external but this pair is also sometimes used synnonomously with superficial and deep-here it's most likely to use the latin internus and externus

Front 24

median vs. medial

Back 24

median is a structre that is directly in the midline-there's only one of them e.g. nose, mouth, sternum, liver, etc. medial structures are paired.

Front 25

central

Back 25

a synonym for median- most often used by clinicians

Front 26

referring to postition along alimb: closer to the trunk and farther from the trunk

Back 26

proximal/distal

Front 27

refers to relationships along the ceolomic wall: anything that pertains to the structures that protrude into the ceolom vs. anything that pertains to the outer layer of the ceolom-usually the body wall.

Back 27

visceral/parietal or splanchnic/somatic- synonymous but when use one word use it's pair!! never mix the two.
think of a foot with a shoe. the foot is the viscera, the sock is the visceral linging, the space bet. the sock and the shoe is the ceolomic cavity, the shoe lining is the parietal lining

Front 28

same side of the body/opposite side of the body-usually used to describe nerve pathways or locations of pathologies

Back 28

ipsilateral/contralateral

Front 29

plane that divides body into left and right parts-also what it's called when the division is directly down the middle and when the left and right parts aren't even

Back 29

sagittal: median and midsagittal vs. parasagittal

Front 30

divides body into front and back (vent and dorsal parts).

Back 30

coronal or frontal

Front 31

divides the body into cranial and caudal parts

Back 31

transverse plane or horizontal plane. (a transverse section of the brain follows teh body's tranxverse plane but not the brains b/c it splits the brain into dorsal and ventral

Front 32

to bend or fold a limb, ideally so that a ventral surface will fold onto another ventral surface

Back 32

flexion

Front 33

to straighten a limb or bend it in such a way that a dorsal surface will fold onto another dorsal surface

Back 33

extension

Front 34

to nod or make a motion similar to putting your chin on your chest. mostly happens at the sacroiliac joint of the sacrum in pathological conditions

Back 34

nutation- it's also like flexion of the neck

Front 35

to un-nod- or lift head off of chest

Back 35

counter nutation- opposite of nutation

Front 36

to bend to the side

Back 36

lateral flexion- no word for the opposite action

Front 37

when the twisting of a limb about its longitudinal axis causes the anterior surface of that limb to point medially vs. pointing laterally

Back 37

medial vs. lateral rotation or internal vs. external rotation

Front 38

any combo of mvmts that will cause a body segment or limb to describe a circle- cna include rotation but doesn't have to

Back 38

circumduction

Front 39

describing mvmts of the ankle.- when toes pointing downward vs. upward

Back 39

plantarflexion vs. dorsiflexion

Front 40

an inward vs. outward twist of the foot

Back 40

inversion vs. eversion- no actual precise def.

Front 41

either mvt. of radius relative to the ulna that has palm facing the anterior vs. the posterior, also in the lower limb it's used to describe teh twist of a foot- no precise def. exists

Back 41

supination vs. pronation

Front 42

when glenoid of the scapula faces more cranially vs. facing more caudally

Back 42

upward rotation vs downward rotation

Front 43

jaw mvt where it is projected farther out from the body vs. in towards to body

Back 43

protraction and retraction

Front 44

motion describing the sliding of one bone relative to another, usually restricted to detailed descriptions ofjoint movements rather than limb movements

Back 44

translation

Front 45

bent or twisted inward vs. outward

Back 45

varus vs. valgus

Front 46

bent forward or bent backward

Back 46

anteflexed, retroflexed

Front 47

shifted forward or shifted backward

Back 47

anteverted, retroverted

Front 48

a convex curve of the vertebral column when viewed from the side- normal in the adult thoracid and sacrococcygeal regions

Back 48

kyphosis

Front 49

a concave curve of the vert. column when viewed from the side, normal in the adult cervical and lumbar regions

Back 49

lordosis

Front 50

a lateral curve of the vert. column- common but not always significant

Back 50

scoliosis

Front 51

prefix meaning flat

Back 51

platy

Front 52

prefix meaning thin or light

Back 52

lepto

Front 53

means short

Back 53

brachy

Front 54

means long/short

Back 54

longus/brevis

Front 55

a thin plate or layer

Back 55

lamina

Front 56

pedicle

Back 56

literally foot, it usually bridges on part of the structure with another

Front 57

isthmus vs ampula

Back 57

a narrowing of a structure tube or passageway, vs. ampula- a widening

Front 58

uncus

Back 58

hook like

Front 59

epiphysis

Back 59

end of a long bone, usually assd. with a joint

Front 60

metaphysis

Back 60

the growth plate of a long bone, usually located near but not on on or both ends

Front 61

diaphysis

Back 61

the shaft of a long bone

Front 62

corpus

Back 62

body, usually the central or most solid part of a structure

Front 63

fossa

Back 63

a shallow depression

Front 64

protuberance

Back 64

a swelling or knoblike outgrowth, usually assd. with a bone

Front 65

process

Back 65

a projection or outgrowth usually froma bone

Front 66

tubercle

Back 66

a rounded nodule, usually la bump on a bone

Front 67

tuberosity

Back 67

a large tubercle

Front 68

trochanter

Back 68

the very large bumpos on the proximal end of the femur, unique from other bone bumps because the trochanters have indpndt osseous dvpt centers

Front 69

haeckel's law

Back 69

ontogeny (growth) recapitulates phylogeny (evolut. dvpt)
Wrong

Front 70

Von Baer's Law

Back 70

each stage of embryological dvpt respembles teh embryos of phylogenetically related species.- more correct than haeckels' law

Front 71

Which germ layer gives rise to most of the things we think about when we think about anatomy e.g. nerves, skin, teeth, gut, etc.

Back 71

mesoderm

Front 72

dermatome

Back 72

the sensory component o fthe skin, a sensory pattern that can be assd. with a specific spinal level

Front 73

myotome

Back 73

gives rise to most of the voluntary (skeletal) musculature of teh body. a motor prob. that can be assd. with a specific spinal level.

Front 74

what are the two types of bone formation

Back 74

membranous ossification
endochondral ossification

Front 75

membranous ossification

Back 75

-starts with mesenchymal (unspecialized connective tissue) model that transforms directly into bone
-more common in flat bones
-creates very dense bone
-adult mech. of bone repair after fracture

Front 76

endochondral ossification

Back 76

-mesenchymal model to cartilage (usually hyaline) model to finished bone.
-assd more with long bones
-normal consequence of vascularization of cart.
-can be pathological-bone spurs

Front 77

3 types of cartilage, most common, and what each is made of

Back 77

1. hyaline-most comon- non visible fibers
2. fibrocartilage-large collagen fibers, important structural cart.
3.elastic- lots of elastin, stretchy and maintains shape still

Front 78

outside lining of bone

Back 78

periosteum

Front 79

solid structure assd. with the shaft ends, typically remodeled with haversion systems (growin part of the bone)

Back 79

compact bone, or lamellar or cortical

Front 80

young bone, typically not yet dvpd haversion systems yet, assd with greater amts of collagen

Back 80

woven bone or nonlamellar

Front 81

series of bony beams found near the ends of bones

Back 81

trabecular bone (or cancellous or spongy)q

Front 82

the inside lining of the bone

Back 82

endosteum

Front 83

the inside space of bone containing the marrow

Back 83

medullary cavity

Front 84

covers the ends of bones and participates in joints

Back 84

articular cartilage

Front 85

the growth plate

Back 85

metaphysis

Front 86

joints

Back 86

the bringing together of two bony elements, can include cart. a joint can favor structural stability, mvt, or a compromise bet. the two

Front 87

the two types of arthroses

Back 87

1.synarthroses (solid joints)
2.diarthroses-cavitated joints

Front 88

the three types of synarthroses and e/g.s of each

Back 88

1.osseous joints- go thru synostosis (2 bones merge together) e.g. skull bones eventually go thru this.
2.fibrous joints-e.g. skull ankle, jaw
3. cartilaginous joints=e.g. growth plates, pubic symphysis, intervertebral disks

Front 89

fibrous joints-what type of arthroses are they and what are the three types with e.g.s

Back 89

it's a synarthroses (solid joint)
1.suture-e.g. skull
2. syndesmosis-e.g. ankle joint
3. gomphosis-e.g. peg joint like jaw and teeth

Front 90

cartilaginous joints, what type of arthroses is it and the two types it has with e.g.

Back 90

it's a synarthroses
1.synchondrosis-e.g. metaphysis
2.symphysis-bone to cart to bone. e.g. pubic symph., intervertebral disk

Front 91

the 7 synovial joints and what type of arthroses they are

Back 91

they're diarthroses:
1. planar-translational mvt
2.ginglymus-hinge-like, flexion/ext.
3.trochoid-assd. w/ a pivoting action so rotation
4.condyloid-combing translation with 2 of the spin moves
5.ellipsoid-combing two spin mvts-usually flex/ext and add/abduction
6.sellar-combo two spin mvts but allow only 1 at a time
7.spheroidal-combo all three spin mvts.

Front 92

is the ant. part of thigh ventral or dorsal

Back 92

dorsal

Front 93

endo rotation is synonymous with which other two types of rotation

Back 93

inward and medial

Front 94

what are the three germ layers formed from the epiblast-use the house analogy
1.aluminum siding/wiring
2.pipes
3.paint

Back 94

1.ectoderm=everything you can see=teeth, skin, eyes and nerves
2.mesoderm=muscle, bone and blood
3.endoderm, absorptive surfaces of lungs/GI syst.

Front 95

the two types of mvts humans can do

Back 95

squeeze and ooze/secrete

Front 96

do myotomes correspond to dermatomes

Back 96

no

Front 97

do vertebrae correspond with the segmental patterning of the body

Back 97

no they are a half step off from it

Front 98

what phylum are we in and why

Back 98

chordata b/c we had a notochord as embryos-but became spinal cord

Front 99

how many growth centers do each vertebrae have and how many ossification centers are there

Back 99

5 growth, 3 ossification

Front 100

mesenchyme

Back 100

connective tissue in our body

Front 101

haversian systems

Back 101

osteons in cortical bones

Front 102

three types of bone cells and fcn

Back 102

osteocytes-reg. cells
osteoblasts-make new cells
osteoclasts-dissolve away old bone

Front 103

number of synovial joints assd. w/ typical thoracic vert
total number of joints assd with typical thoracic vert

Back 103

10, 12

Front 104

which one has a costo transverse facet T10 or t11

Back 104

t10

Front 105

which cervical vert has scalene tubercle

Back 105

c1

Front 106

disk herniation:
-what happens, where is it thinnest
-where is herniation likely to go and what does this cause

Back 106

the nucleus pulposus bulges thru the annulus fibrosis, which is the thinnest in the posterior next to the spinal cord, but that is reinforced by the posterior longitudinal ligament so herniation is likely to go dorso laterally.
this encroaches upon the dorsal root ganglion or mixed spinal nerve creating dermatomal pain pattern.

Front 107

what pathology results from herniated disks, and is it always pathogenic

Back 107

-dermatome/myatome pain patterns if herniation goes dorso-laterally and impiges upon the mixed spinal nerve, but not pathogenic if goes anteriorly b/c just squirts into gut usually

Front 108

what does pelvic girdle consist of

Back 108

the R and L hip bones which are each made up of ilium, ischium, and pubis that fuse by age 16. all come together at acetabulum.

Front 109

bone you sit on

Back 109

ischium

Front 110

what forms the sides of the greater (or false) pelvic basin, the lateral walls of the lesser (or true) pelvic basen and the enterior walls of the lesser pelvic basin

Back 110

greater=ilium
lat walls of lesser=ischium
-ant walls of lesser=pubis

Front 111

where do the pubes from l and r sides join

Back 111

pubic symphysis

Front 112

lg hole bet. pubis and ischium

Back 112

obturator foramen

Front 113

number of elements in vert column and number bones adult typically has in it

Back 113

33 and 26

Front 114

what forms the sides of the greater (or false) pelvic basin, the lateral walls of the lesser (or true) pelvic basen and the enterior walls of the lesser pelvic basin

Back 114

greater=ilium
lat walls of lesser=ischium
-ant walls of lesser=pubis

Front 115

when all vert forames put together forms

Back 115

neural canal

Front 116

opening spinal nerves pass thru

Back 116

intervertebral foramena

Front 117

type of joint the intervert disk is

Back 117

a symphysis or fibrocartilaginous joint

Front 118

how many segs does coccyx typically have

Back 118

4

Front 119

which lig links the cornu of sacrum with cornu of the coccyx

Back 119

intercornual ligament

Front 120

what two bones comprise the pectoral girdle

Back 120

clavicle and scapula

Front 121

though there are exceptions, how are the skin and muscles of the back usually innervated

Back 121

segmental innervation by the dorsal rami of the segmental mixed spinal nerve. ( though sometimes vent. rami can-i.e. intercostal nerves in the thorax).

Front 122

what rami of the mixed spinal nerve has names and which usually doesn't

Back 122

vent rami does and dorsal usually doesn't sans a few

Front 123

does the typical dorsal ramus join with other neres to form a plexus

Back 123

no

Front 124

which is usually bigger, dorsal or vent rami

Back 124

ventral

Front 125

what do the dorsal rami split into

Back 125

a medial and lateral branch

Front 126

both the medial and lateral branch of the dorsal ramus always innervate the epaxial muscles, but take turns innervating the skin, when do they switch and which is which and why

Back 126

medial supplies skin above T6, and lateral supplies skin below T6. this is b/c of the scapula in the way so the medial branch has to take over for the lateral

Front 127

though most dorsal rami don't have names there are nine that do, what nerves are they a part of

Back 127

suboccipital (C1 dorsal ramus)
-greater occipital nerve- medial branch of C2
3rd occipital nerve-medial branch of C3
-superior cluneal nerves-lateral branches of L1-L3
-middle cluneal nerves-lateral branches of the S1-S3 dorsal rami

Front 128

C1 dorsal ramus

Back 128

suboccipital nerve

Front 129

medial branch of the c2 dorsal ramus

Back 129

greater occipital nerve

Front 130

medial branch of teh c3 dorsal ramus

Back 130

third occipital nerve

Front 131

lateral branches of the L1-L3 dorsal rami

Back 131

superior cluneal nerves

Front 132

lateral branches of the S1-S3 dorsal rami

Back 132

middle cluneal nerves

Front 133

which dorsal rami do not split into medial and lateral branches (5)

Back 133

-suboccipital nerve C1
-dorsal ramus of:
S4, S5 and CX1 and CX2

Front 134

dorsal rami that usually lack cutaneous branches are (4)

Back 134

-suboccipital nerve-C1
-C6
-C7
-C8

Front 135

what is special about the dorsal ramus of C1

Back 135

it is usually larger than the ventral ramus!

Front 136

what is special about the dorsal ramus of C2 that is similar to C1

Back 136

it is usually larger than the verntral ramus

Front 137

what is the largest dorsal ramus nerve

Back 137

C2- the greater occipital nerve

Front 138

where are two places where the dorsal rami might link up and form a plexus

Back 138

-the lateral branches of C2 and C3 (so muscles only), and the S4, S5, and CX1 levels

Front 139

what is the only hypaxial muscle that sometimes receives innervation from dorsal rami and how does that happen

Back 139

the trapezius muscle b/c the medial branch of C3 pierces it and may thereby provide some innervation to the muscle.

Front 140

what is the only hypaxial muscle that sometimes receives innervation from dorsal rami and how does that happen

Back 140

the trapezius muscle b/c the medial branch of C3 pierces it and may thereby provide some innervation to the muscle.

Front 141

what is the muscle group primarily responsible for stabilizing the vertebrae and where does this group receive it's innervation from

Back 141

epaxial- segmental innervation from the dorsal rami

Front 142

why are most hypaxial muscles only secondarily dorsal

Back 142

b/c they're muscles of the upper limb

Front 143

why are the superficeal back muscles not really considered true back muscles

Back 143

b/c they have migrated over the back during dvpt

Front 144

thoracolumbar fascia, lumbodorsal fascia, thoracolumbar aponeurosis:
-what is it a subdivision of
-what muscles uses this as part of its attmt

Back 144

it's a subdivision of the vert. fascia surrounding the intrinsinc musclesof teh back and neck and it serves as tendon of origin for lats

Front 145

what is the thoracolumbar fasica continuous with and describe it's physical properties

Back 145

continuous with the fascia nuchae surrounding the splenius group of intrinsic muscles.
it's thin and transparent in the thoracic region, thick and strong in the lumbar region. it blends laterally with the aponeurosis of the transversus abdominus muscle in the lumbar region

Front 146

the three intrinsic layers

Back 146

superficial intrnisic muscles- only in neck
-middle/indermediate-erectorspinae group
-deep- transversospinalis group and related muscles

Front 147

what is the highest vert w/ spinous process

Back 147

axis

Front 148

where do most m's of the suboccipital reg. seem to point to

Back 148

spinous process of c2

Front 149

explain the ascent of the spinal cord

Back 149

it doesn't actually ascend, the cord fills most of the neural canal at birth (skull to coccyx) bot does not grow much more, so the vert. column continues to lengthen/grow and the spinal cord statys pretty much the same. the net effect is that the end of teh psinal cord will be assd with increasingly higher vert levels as the person matures. by adulthood the typical spinal cord will end at the level of the l1/l2 disk

Front 150

explain the pathway of the voluntary motor nerves

Back 150

-cell body is in the ventral horn of teh spinal cord
-passes out the vent. root
-joins mixed spinal nerve
-travels in either of 2 ways
-dorsal ramus to epaxial musc
-vent ramus to hypaxial musc.

Front 151

pathway of the general sensory nerves

Back 151

-starts at target sensation depending :
most of body=goes thru vent. ramus
back=thru dorsal ramus
viscera=travels in concert with the autonomic nerve pathways

then:
-passes thru mixed spinal nerve
-passes into dorsal root
-joings its cell body in dorsal root ganglion
-continues thru dorsal root to dorsal hrn of the spinal cord

Front 152

sympathetic autonomic motor system pathway

Back 152

cell body in vernt. horn of the spinal cord
-passes out vent. root
-mixed spinal nerve
-thru vent. ramus
-thru white ramus communicantes
-enters paravertebral sympathetic ganglion
-most synapse here
-some travel up, or down, to synapse in another paravertebral ganglion
-other fibers will travel out a splanchnic nerve to synapse in one of the ganglions of the gut system


-then pathways that synapsed in paravertebral will send postganglionic fibers out the gray ramus communicantes
-pathway to most of the body is via the ventral ramus
-pathway to the back is via the dorsal ramus

then pathways that synampse in the ganglion of the gut system will join the enteric NS to supply the gut

Front 153

parasympathetic autonomic nervous system pathway

Back 153

-some specialized parasympathetic innerv. in the head that will be studied later
-innervation of most of the body, down to the left colic flexure, is supplied by the vagus nerve
-innerv for the rest of the body originates ni the S2-S4 spinal levels

-preganglionic fibers travel top their target organ
-synapse at or very near target organ
-postganglionic fibers supply organ

Front 154

what structures make up the thorax

Back 154

thoracic vet, ribs, costal cart, sternum

Front 155

what is the vein that is prominent in skinny women with lg. breasts

Back 155

thoracoepigastric v

Front 156

what type of joint is the costo chondral joint

Back 156

synnovial

Front 157

if somebody pokes you in the nipple, what nerve does it stimulate for ppl

Back 157

T4

Front 158

what level is the nipple at in m's vs. f's

Back 158

m's=4th intercostal space
typical f at 5th intercostal space b'c of droop but feel it as part of you t4 dermatome/nerve

Front 159

what type of joint is the costochondral joint

Back 159

synnovial

Front 160

what are the individ bone seg's that fuse in the sternum

Back 160

sternebrae

Front 161

why do some old people sometimes feel a bump mid-chest that they never felt before

Back 161

b/c the xyphoid process (joint?) hardens/ossifies and it no longer pushes in anymore

Front 162

where are interchondral joints located

Back 162

on cart. coming off of sternum

Front 163

do all ribs have a costochondral joint

Back 163

yes even on the false ribs

Front 164

# pr's of ribs we have

Back 164

12 pairs

Front 165

what are the three groups of ribs and which ones do each include

Back 165

1-7 = true ribs- costal element articulates directly with the sternum
8-10= false ribs--costal element articulate with eachother (interchondral joints) before articulating with sternum
-11-12-floating ribs: costal elements do not articulate with the transverse process nor with the sternum

Front 166

what is the mammary gland a modification of

Back 166

the apocrine gland/ or the sudoriferous (sweat) gland

Front 167

the darker pigmented area directly around the nipple

Back 167

areola

Front 168

a potential space bet. the breast tissue and the deep fascia of the pectoral musculature

Back 168

retromammary space

Front 169

literally means small nipple, is the opening for milk flow in the nipple. there are usually 10-15 of these per nipple

Back 169

papilla

Front 170

collection site for the three or more ducts that then channel milk through the papilla

Back 170

lactiferous sinus

Front 171

tubes that connect the glandular tissue to the sinus of the nipple

Back 171

lactiferous ducts

Front 172

extra thick layers of connective tissue that support the breast tissue and provide some level of functional segmentation

Back 172

suspensory ligaments

Front 173

pathway of milk starting at the glandular tissue

Back 173

gland. tiss to lactiferous duct, to lactiferous sinus, to papilla

Front 174

women need a lot of lymph nodes in their breast so thye don't pass stuff to their baby but this can also lead to increased chance of breast cancer. where does the lymph drain to and what does this mean medically

Back 174

most (75%) goes to axillary lymph nodes, which is why women who've had masectomy's have big knot of scar tiss. that presses on the brachial plesus there so end up not using arm which has major consequences.
the rest (25%) drains to the parasternal lymph nodes, which are common to both breasts so it is often a mech. for cancer transmission from one breast to the other

Front 175

what suppliles blood to the breast

Back 175

internal thoracic artery (aka mammary artery) -breaks off into medial mammary arteries

lateral thoracic artery- breaks off into lateral mammary arteries

Front 176

what suppliles blood to the breast

Back 176

internal thoracic artery (aka mammary artery) -breaks off into medial mammary arteries

lateral thoracic artery- breaks off into lateral mammary arteries

Front 177

what are the two extra muscles that lie at the same layer as the innermost intercostal muscle

Back 177

post-near the ver is the subcostalis muscles
ant, by the sternum are the transverse thoracic muscles

Front 178

how is the ant. body wall innervated

Back 178

entirely by thoracic nerves

Front 179

what's responsible for the innervation of the entire abdominal wall

Back 179

thoracic nerves

Front 180

what innervates the muscles of the thoracic wall

Back 180

ventral rami of t1 -t11

Front 181

which thoracic nerve has a special name and what nerves does it act just like

Back 181

T12, called subcostal N but acts just like the intercostal nerves

Front 182

what supplies innervation for the sensory components to the body wall of the thorax

Back 182

cutaneus branches (note that there is no t1 dermatome on the thorax in the adult

Front 183

which nerves supply the uppermost thorax

Back 183

C3 and C4, the supraclavicular N's

Front 184

what are ventral rami of the thoracic reg usually called

Back 184

intercostal nerves with t12 being the subcostal N

Front 185

which has an anterior and posterior portion, is it the intercostal nerves or blood vessels?

Back 185

intercostal blood vessels have ant. post and nerves do not!

Front 186

what do the intercostal n's break off into on the sides of the thorax and what do those further breakinto

Back 186

lateral cutaneous branches which further split within the skin to curve dorsally to partially overlap with the cutaneous nerves of the dorsal rami, and ventrally to partially overlap with the anterior cutaneous branches

Front 187

just lateral to the midline near the sternocosal joints, intercostal nerves give off what branches and what do they split into

Back 187

anterior cutaneous branches which split with in the skin to curve laterally to partially overlap with the lateral cutaneous branches and medially to partailly overlap with the anterior cutaneous branches from the other side

Front 188

what nerves eventually supply the skin and muscles of the anterior abdominal wall

Back 188

intercostal nerves 8-11

Front 189

what happens to the upper ribs (1-7) during breathing, i.e. what happens to the joints/facets, which direction do the anterior end of the ribs move and what is the result

Back 189

-costotransverse facets are more cup shaped allowing for little translational movement
-rotational mvt dominates at costovertebral, costotransverse, and sternocostal joints.
-ant ends of the ribs move sup, and inf.
result is a change in the anterior posterior diameter of the thorax

Front 190

which ribs arent' really involved in breathin

Back 190

11 and 12

Front 191

WHAT HAPPENS in the lower ribs
(1-8)during breathing i/e/ to the facets/ joints , which dir. do they move and what is the result-is it diff than in the upper ribs

Back 191

-costotransverse facets are planar allowing for more translational mvts
-translational mvt dominates at costotransverse joints. slight rotational movenemnts at costovertebral, sternocostal and intercostal joints (vs onlly rotational mvt for the upper ribs)
-the rib twists so that the superior border of the rib moves superiourly and inferiorly (vs. the anterior end of the rib that moves for upper ribs)
-result is a change in the medial-lateral diameter of the thorax (vs. the ant.post/ diameter for upper)

Front 192

T/F: the lung resides within the pleural cavity

Back 192

false, it protrudes into but does not reside within the pleural cavity (pleural cavity is a division of the coelomb so there is still nothing that resides within it)

Front 193

which lung tends to be larger and why

Back 193

right because of heart tilting left

Front 194

the lung receives and expels air thru the ___________

Back 194

bronchial tubes

Front 195

what is analagous to vaccuum hose

Back 195

bronchial tubes

Front 196

the lung receives blood to process thru the____________ but they receive blood for nourishment from the________

Back 196

-pulmonary vessels
-bronchial vessels

Front 197

what does teh lung dvp from

Back 197

an offshoot of the gut tube- it has pretty much the same concept -bringing in molec's and dropping some off.

Front 198

lung is to gut tube as heart is to___________

Back 198

diaphragm

Front 199

b/c this system is an outgrowth of the gut tube dvpt, it has close dvptal phylogenetic and functionaly ties to the digestive system

Back 199

resp. system

Front 200

what does the resp system start as after it buds off the developing foregut, and what grows to separate it from the gut tube/esophogas

Back 200

larynogotracheal diverticulum, then grows the tracheoesophageal septum

Front 201

b/c the resp system is derived from the gut tube it's functional survfaces are derivatives of which germ layer, and then what is reswponsible for forming the mucle cartilage and other connective tissues assd with the trachea and bronchial tubes

Back 201

endoderm, then mesenchyme from the mesoderm

Front 202

what lies deep to the innermost intercostal muscle layer. it is a very thin and whispy fascia that is analagous to the fascia transversalis of the abdomen. it is described as the glue that connects the pleura to the body wall.
- and what is the thickening part of it called at the superior aspect of the thorax and what is it's function

Back 202

the endothoracic fascia
thickened part at sup. aspect of thorax=suprapleural membrane, and it serves to protect the top of the lungs and keep the lungs from bulging into the neck

Front 203

what are the three main regions of the thorax

Back 203

right and left pleural cavity and mediastinum

Front 204

what four regions is the mediastiunum divided into

Back 204

superior, anterior, posterior and middle

Front 205

define pleura

Back 205

a thin serous membrane in mammals that envelops each lung and folds back to make a lining for the chest cavity

Front 206

what are the four named regional parts of the parietal pleura

Back 206

-mediastinal parietal pleura
-diaphragmatic
-costal
-cupola

Front 207

what is the dome shaped top of the pleural cavity, part of the parietal pleura that's made of the suprapleural membranE

Back 207

cupola

Front 208

what is the meeting of the viscerlan and parietal pleura at the root of the lung called that allows passage of teh blood vessels and air tubes

Back 208

pulmonary ligament

Front 209

what is pleuracy

Back 209

-when you have some adhesion bet. visceral and parietal pleura. you get friction and nast stuff fills up in your lungs like pneumonia

Front 210

sensory innervation of parietal pleura reflects dvpt origin of each region. the parietal pleura develops from the somatic layer of the lateral mesoderm, therefore the parietal pleura is innervated by __________.
specifically
costal parietal pleura=
diaphragmatic and mediastinal parietal pleura=
conversely, the visceral pleura is innervated by the?

Back 210

parietal pleura=somatic nerves/ventral rami

-costal parietal pleura=intercostal nerves
-diaphragmatic and mediastinal parietal pleura i=phrenic nerve (C3C4C5 keep the diaphragm alive)
-visc pleura =autonomic innervation by the vagus nerve (innervates all parasymp NS in the thorax)

Front 211

where is referred pain from parietal pleura felt
what about visceral referred pain?

Back 211

parietal pleura is felt on body wall or the dermatomes of the phrenic nerve-on the shoulder

visceral-trick-not sensitive to pain and temp so it isn't assd with a referral pattern

Front 212

connects the medial survace of the lungto the mediastinum and is formed by the structures/tubes that pass into the lung

Back 212

root of the lung/pulmonary root

Front 213

hilum vs root of lung

Back 213

hilum=region of the lung where structures that form the root eneter and root is the collection of structures entering

Front 214

what are the typical lobes of the R and L lung/and their names

Back 214

R=3, upper (sup), middle, and lower (inf)
L=2, lower and upper
lingula=bottom part of the upper lobe, roughly corresponds to the middle lobe of the right lung

but these are highly highly variable so never det. lung by this

Front 215

bottom part of the upper lobe in the left lung that rougly corresponds to the middl elobe of the right lung

Back 215

lingula

Front 216

what separates the upper lobe from the lower lobe in the lungs and what is typically found only in the rightlung that separates the middle lobe from the upper lobe and joins the first separation

Back 216

-oblique fissure
-horizontal fissure

Front 217

draw out the pathway from the air coming in the mouth until where gas exchange occurs

Back 217

-pharynx-combo food and air
-trachea-just air
-two primary bronchi
-primary bronchus=air tube to the lung
-lobar (secondary) bronchi -typically 3 for R and 2 for L
-10 segmental (tertiary) bronchi
-bronchioles
-alveolar ducts
-alveolar sacs=where gas exchange occurs (alveolus is a group of the sacs)

Front 218

do pulmonary arteries typically enter the lung superior or inferior to the principle bronchus

Back 218

superir

Front 219

what is the lobar bronchus that is typically superior to the pulmonary artery in the right lung called

Back 219

eparterial bronchus

Front 220

where does the bronchial artery typically arise from

Back 220

the dexcending aorta near the level of the tracheal bifurcation

Front 221

what does the bronchial vein drain into

Back 221

the azygous system

Front 222

the lymphatic drainage of the lung, name all of the structures at each level (going in order), also say which two are assd with the lungs
1.in lung
2.at hilum
3.bifurcation of trachea
4.common to all thoracic structures:
5. common to almost all the body
then on to the venous system

Back 222

1.in lung: pulmonary nodes
2.at hilum: bronchopulmonary nodes
3.bifurcation of trachea :trachoebronchial nodes
4.common to all thoracic structures: bronchomediastinal nodes
5. common to almost all the body: thoracic duct
then on to the venous system

**the 2: bronchopulmonary nodes and the tracheobronchail nodes

Front 223

what might become obvious as hardened nodule in someone with lung cancer

Back 223

pulmonary nodes- located within the lung

Front 224

-what are the three types of innervation that the lung receives and where do they arise from?

what is the gathering of these nerve fibers called (they gather around the bronchi after they had gathered around the bifurcation of the trachea to form the cardiac plexus.

Back 224

1. parasympathetic efferent (motor) vagus N (#X)
2.sympathetic efferent (motor)-thoracic sympathetic ganglia
3. visceral afferent (sensory)-vagus N (#X)

pulmonary plexus

Front 225

what are the nerve fibers that gather near the bifurcation of the trachea called, and what are they then called as they branch off and follow the bronchi to the hilum of the lung

Back 225

cardiac plexus and pulmonary plexus

Front 226

what is the fcn of stretch receptors (afferent fibers) in respiration and where are they located

Back 226

located in the smooth musc layer of the bronchioles, they are excited by press increase so as the lung inflates they inhibit inspiration and promote expiration

Front 227

where are irritant receptors found and what do they do when they're stimulated e.g. by noxious gases
what about cough receptors

Back 227

irritant: in bronchioles, cause increase ventilation
cough in larger bronchi and trachea, stim by dus and noxious gases and cause cough and some bronchoconstriction

Front 228

what does teh diaphragm dvp from

Back 228

primarily from the septum transversum with some contrib from the pleuroperitoneal membranes and the lateral body wall

Front 229

very early on in dvpmt, a bridge of mesoderm which event. turns into the septum transversum and tehn the diaphragm, joins the developing heart with the cranium, where are these two things (primitive heart and diaphragm) in relation the the developing brain/

Back 229

superior!

Front 230

at what point is the true diaphragm actually formed in dvpt

Back 230

around 4th week when the embryo begins to fold in craniocaudal direction, which brings the hearta nd septum where it can unite with the pleuroperitoneal membrane and therefore effectively divide the ceolom into the pleural cavity above and the peritoneal cavity below

Front 231

why is it that the diaphragm is innervated clear up by the C345 cervical levels?

Back 231

b/c the muscle of the diaph originates from the myotomes that differentiated from the 3rd,4th, and 5th cervical somites when it was transverse to them during dvpt

Front 232

what is a congenital diaphragmatic hernia

Back 232

when parts of the gut go into the thorax and usually compromise lung function/dvpt.

Front 233

what are they attmt's of the diaphragm-ant/post/and lateral

Back 233

anteriorly to the xiphoid process and costal cartilages, laterally to the bone and cart of ribs 7-12, posteriourly and distally, it has two insertion tendons (crura) that go to body of L2 (left) and L3 (right)

Front 234

what is the hole in the diaphragm that passes thru the muscular part and what passes trhough it, what about the hole that passes thru the central tendon part and what passes thru it

Back 234

-caval hiatus goes thru the central tendon part, where the inferior vena cava passes thru
-esophageal hiatus is the one passing thru the muscular part where the esophagus passes thru

Front 235

what is the hole in the diaphragm that passes thru the muscular part and what passes trhough it, what about the hole that passes thru the central tendon part and what passes thru it

Back 235

-caval hiatus goes thru the central tendon part, where the inferior vena cava passes thru
-esophageal hiatus is the one passing thru the muscular part where the esophagus passes thru

Front 236

how does the esophageal hiatus assist the esophagus during inspiration

Back 236

contraction of the diaphragm during inspiration increases internal pressure within the abcominal cavity, and squeezes the esophagus closed to prevent gastric contents from esxaping up the esophagus

Front 237

how does the caval hiatus assist in pumping the blood

Back 237

during inspiration when the diaphragm contracts, the central tendon dilates the cava hiatus so that both the increased diameter of the vena cava and the increased abdominal pressure help to push/pump blood up the vena cava toward the heart

Front 238

what does the median arcuate lig allow passage of and what was it formed by

Back 238

it allows passage of the aorta, the sympathetic splanchnic N's, and the thoracic duct, it was formed from thetwo crura of the diaphragm (L and R)

Front 239

what are the gaps on either side of the vertebral bodies at the level of the diaph. created by and what do they allow passage for

Back 239

they were created by the medial arcuate ligamentsand they allow for passage of the psoas major musc and the sympathetic trunk

Front 240

which lig is in close assn with the 12th rib and what does it allow passage of (at the level of the diaphragm)

Back 240

the lateral arcuate lig and it allows passage of the quadratus lumborum musc and any lumbar contrib's to the azygous system

Front 241

what are the 5 branches off the aorta and where do they go to

Back 241

single unpaired ventral branch to the gut tube and derivitaves
-paired lateral branches to the urogenital system and derivatives
-paired dorsal branches to the body wall and limbs a.k.a. posterior intercostal A's

Front 242

main function of the azygous vein

Back 242

drains the thoracic wall

Front 243

blood exits heart thru

Back 243

ascending aorta

Front 244

the three arteries that typically arise from the aortic arch from right to left and where they go

Back 244

brachiocephalic trunk-splits into r subclavian and R. common carotid
-left common carotid- goes to head and throat
-left subclavian- goes to the left upper limb

Front 245

the paired arteries given off by the descending aorta in the thorax

Back 245

posterior intercostal arteries

Front 246

what branches does the aorta give off below the diaphragm

Back 246

-unpaired ventral to the gut tube
-paired lateral to the urogenital system
-paired dorsal to the body wall

Front 247

around where does the aorta end and what does it split into, and what do those split into and what do those last branches supply

Back 247

ends around L4 and splits into 2 common iliac arteries which split into internal and external iliac arteries with the internal supplying the pelvis and the external supplying the lower limb

Front 248

where does blood from the head mostly drain into

Back 248

internal jugular vein

Front 249

blood from the upper limbs mostly drain into the ____

Back 249

subclavian vein

Front 250

what two veins unite to form the brachiocephalic vein

Back 250

internal jugular and subclavian veins

Front 251

which of the 2 brachiocephalic veins is longer and why

Back 251

left brachiocephalic vein is longer b/c it must cross the midline of the body since the vena cava's are on the right side

Front 252

what two veins unite to form the sup. vena cava

Back 252

brachiocephalic veins r and l

Front 253

what vein drains the pelvic organs and what vein drains the lower limb

Back 253

pelvic=internal iliac V
lower limb=external iliac v

Front 254

what two veins unite to form the common iliac vein

Back 254

external and internal iliac veins

Front 255

what two veins unite to form the inferior vena cava and where do they unite at typically

Back 255

the R and L common iliac veins unite at around L5

Front 256

where does blood from the digestive system drain into?

Back 256

a single large portal vein which sends blood to the liver for processing

Front 257

where does blood from the liver drain

Back 257

into the inf vena cava just below the diaphragm

Front 258

where does blood from the thracic body wall drain into

Back 258

they azygos system

Front 259

where does the azygos vein drain into

Back 259

the superior vena cava

Front 260

where does blood that has fed the heart muscle drain into and where does that go

Back 260

inot the coronary sinus which drains into the RA

Front 261

how many pulmonary veins does each lung have- name them

Back 261

2- superior and inferior

Front 262

how many pulmonary veins does each lung have- name them

Back 262

2- superior and inferior

Front 263

How do blood vessels form and how does the blood get in there?

Back 263

1.blood islands form out of collections of angioblasts that have differentiated from the mesenchyme cells of the mesoderm
2. blood cells differentiate within the blood islands as they grown and start touching eachother
3. blood islands fuse as ther walls break down and create a vessel that already contains the blood cells!

Front 264

How does circulation start out in early dvpt

Back 264

As two separate loops, each with its own heart tube. The tubes migrate toward eachother and fuse at the heart tubes.
The two circulatory loops joined at the heart can now fcn as the 2 parallel circ tubes: A’s and V’s

Front 265

What are the 2 inefficiencies of developing circulation?

Back 265

The best blood that we give our body is diluted- not much O2 but it’s the best blood we have. Also we send this same diluted blood back to mom so that means it’s not fully de-O2’d yet so we’re also throwing our best blood out. This is b/c we don’t require as much…

Front 266

How many aortic arches dvp

Back 266

6

Front 267

What did the 6 pairs of aortic arches link, what did they arch over, and what did they represent

Back 267

They linked the vent and dorsal aorta, they arched over the developing pharynx and represented the initial chordate body plan mech for filter feeding and later for aquatic respiration but since we don’t’ use these functions, they are transformed into other structures.

Front 268

What are the aortic arches made up of

Back 268

Mesoderm with event turns into blood and blood vessels and a shell of neural crest mesenchyme

Front 269

What does blood flow out of in the early heart that the aortic arches stem off of?

Back 269

Truncus arteriosus

Front 270

What’s the deal with the recurrent laryngeal N- where does it come off of, why does it come way down and back up, and which is longer, left or right

Back 270

Comes off of vagus N to supply bottom of the larynx which embryologically was a straight shot across, lying inferior to the 6th aortic arch artery. As embryo ctd to dvp. The R 5th and 6th aortic arteries degenerated and so the right recurrent laryngeal nerve hooks around the R subclavian A (from 4th arch) however the left 6th aortic artery remains as the ductus arteriosus and the L recurrent laryng. N is stuck under it so as the embryo dvp’s it gets pulled down into the thorax so that in the adult it loops around what is now the ligamentum arteriosum. This makes the left much longer than the right.

Front 271

What does the 3rd aortic arch turn into

Back 271

Common carotid artery and internal carotid artery

Front 272

What does the common carotid A and internal carotid A come from

Back 272

3rd aortic arch

Front 273

What does the 4th aortic arch transform into

Back 273

Left side: arch of the aorta
R side: depends on who you believe:
1. degenerates
2. brachiocephalic A and some of the R subclavian A

Front 274

Where does the arch of the aorta come from

Back 274

4th aortic arch- L side

Front 275

Where do some ppl think the brachiocephalic A and some of the R subclavian A come from?

Back 275

Right side of the 4th aortic arch but some believe that 4th just degenerated

Front 276

What does the 6th aortic arch transform into?

Back 276

L side=ductus arteriosus –ligamentum arteriosum
R side=degenerates

Front 277

Where does the ductus arteriosus/ ligamentum arteriosum dvp from/

Back 277

The left side of the 6th aortic arch

Front 278

What happens to the 1st, 2nd, and 5th aortic arches?

Back 278

Mostly degenerate- 5 completely does

Front 279

Where does the descending and abdominal aorta dvp from

Back 279

Dorsal aorta

Front 280

What does the dorsal aorta turn into

Back 280

Descending and abdominal aorta

Front 281

What does the ventral aorta turn into

Back 281

Truncus arteriosus/ ascending aorta and pulmonary trunk

Front 282

What does the pulmonary trunk and truncus arteriosus/ascending aorta dvp from?

Back 282

Ventral aorta

Front 283

What does the unbilical artery dvp into

Back 283

Sup. Vexical artery and medial umbilical lig

Front 284

Where do the sup. Vesical A and medial umbilical ligament dvp from?

Back 284

Umbilical A

Front 285

Q
What do the cardinal V’s turn into i.e. common, anterior, and posterior

Back 285

Common=sup vena cava
Ant=brachiocephalic v
Post=azygos v

Front 286

What does the sinus venosus turn into

Back 286

R=smooth area of RA and Inf vena cava
L=coronay sinus

Front 287

Where does gas exchange occur in the mammalian fetus and why isn’t it the gills or the lungs?

Back 287

In the placenta, not the gills b/c they’ve already transformed into air breathing roles and not the lungs b/c they can’t fcn yet since the fetus lives in a watery enviro of amniotic fluid.

Front 288

is BP higher in the RA or the LA during embryonic dvpt, and how does it switch when you're born

Back 288

RA has higher BP than LA, keeping the foramen ovale open so blood can go directly into LA, then it switches on 1st breath, forcing the foramen ovale closed so that it eventually grows into a fossa ovalis.

Front 289

since in the fetus the lungs, kidneys and gi tract don't need as much blood, what are the three shunts that bypass these systems called

Back 289

ductus venosus
ductus arteriosus
foramen ovale

Front 290

what are the 2 shunts in place to bypass the lungs during embryonic dvpt

Back 290

ductus arteriosus and foramen ovale

Front 291

what happens with the first breath of air

Back 291

pulmonary resistance in the lungs is dramatically reduced due to inglation of the lungs so that blood will now follow that path of least resistance (adult)

Front 292

the first breath triggers the release of hormones that cause what

Back 292

-closing of the ductus arteriosus
closing of the umbilical A's
-uterine contractions that squeeze that last bit of blood into the baby
-eventually the lack of blood flow from the placenta causes the collapse of the umbilical vein and ductus arteriosus

Front 293

in an embryo where is the highest O2

Back 293

umbilical vein then to the inf vena cava

Front 294

lungs protrude into the pleural cavity the same way the heart protrudes into__________

Back 294

periccardial sac

Front 295

at the very beginning of dvpt, which starts dvping more superior, the dvping heart or brain

Back 295

developing heart is more superior

Front 296

why is it that many of the cardia N's originate in the cervical ganglia

Back 296

b/c of folding of the embryo that brinsg the heart down to a vental body posititon that is just opposite the cervical somitse

Front 297

what prevents back flow into the RV

Back 297

pulmonary valve

Front 298

thre three heart layers:
-muscle layer
-serous pericardium covering the external surface
-lining of the heart chambers

Back 298

myocardium
-epicardium
endocardium

Front 299

all of the great vessels of the heart are assd with which surface feature/part of it

Back 299

the base- posterior/superior surface

Front 300

the apex of the heart is formed mostly by what

Back 300

LV

Front 301

inferior sufrace of the heart where it sits on the diaphragm, formed mostly by the LV

Back 301

diaphragmatic surface

Front 302

groove around the heart that separates the upper atria from the lower vent's

Back 302

atrioventricular (coronary) sulcus

Front 303

groove that separates teh vents on the diaphragmatic surface of the heart

Back 303

posterior interventricular sulcus

Front 304

groove that separates the vent's on the ant surface of the heart

Back 304

anterior interventricular sulcus

Front 305

The smooth walled part of the RA is called

Back 305

sinus venarum

Front 306

what is comprised of fibrous rings surroundingg and supporting the aortic pulmonary and R atriovent and L atriovent orifices that serve as anchors for the valve cusps of each orifice, sometimes solidifying into cart.

Back 306

skeleton of the heart

Front 307

the fossa ovalis is directly opposite of which vena cava and why

Back 307

inferior b/c when it was foramen ovale blood from placenta that was O2nated came from inf directly thru the foramen ovale

Front 308

what does the single ventricle drain into which then transitions into the truncus arteriosus (common trunk of the aortic arches)

Back 308

bulbous cordis

Front 309

where is a common place for an interventricular septal defect

Back 309

the conotruncal ride needs to meet the interventricular septum and at this location the septum is very thin therefore a common place for a defect

Front 310

what are the only arteries that have blood pumped into them during the resting phase of the heart beat cycle and how does that happend

Back 310

coronary arteries, blood surging back towards the LV from the aorta after the LV contracts is stopped by the closing of the L atrioventricular valve and so then surges into the aortic sinuses which act like funnels so that the right sinus directs blood into the right coronary artery and the left into the left

Front 311

the anterior atrial coronary artery supplies the

Back 311

wall of RA

Front 312

the sinuatrial nodal A supplies the

Back 312

RA and the sinuatrial node

Front 313

the atrioventricular nodal artery supplies the

Back 313

RA and ventricle and the atrioventricular Node

Front 314

the RA is supplied blood by which arteries

Back 314

anterior atrial, sinuatrial nodal artery, and atrioventricular nodal artery

Front 315

the right marginal artery supplies the

Back 315

wall of the RV

Front 316

the posterior interventricular artery dupplird yhr

Back 316

R and L vent's

Front 317

where do the coronary arteries arise from

Back 317

the aortic sinuses

Front 318

which coronary artery is longer left of right

Back 318

right

Front 319

what are the 2 branches off of the L coronary artery and what do they supply

Back 319

anterior interventricular (aka LAD) located in the ant intervent sulcus an dit supplies the right and left vent's
-Circumflex artery in the posterior part of the atrioventricular sulcus

Front 320

what supplies the wall of the LV and where does it come from

Back 320

Left marginal artery off of the circumflex artery

Front 321

what does it mean to have a right or left dominated heart and which one is more common

Back 321

most people -80%, have a right dominant heart where the posterior interventricular artery comes off of the RIGHT CORONARY ARTERY. but in Left dominant heart people the post intervent A comes off of the CIRCUMFLEX A

Front 322

anterior cardiac veins drain the

Back 322

RV directly into the RA

Front 323

least cardiac V's drain the

Back 323

heart wall and go directly into the nearest heart chamber, they are most numberous on the R side of the heart but can be anywhere

Front 324

coronary sinus

Back 324

most of the veins assd with the heart wall drain into the coronary sinus, this sinus differs from a vein b/c you can't life it up off the heart, located in the posterior aspect of the atrioventricular sulcus aka coronary sulcus and drains directly into the RA

Front 325

which vein found in the ant. interventricular sulcus and the atrioventriculasr sulcus bet the lefft auricle and left vent- continuous with the coronary sinus

Back 325

great cardiac vein

Front 326

found in the posterior interventricular sulcus= which vein?

Back 326

middle cardiac

Front 327

which coronary artery is foun in assn with the cardiac sinus

Back 327

circumflex A

Front 328

great cardiac V mostly assd with

Back 328

anterior interventricular artery

Front 329

middle cardiac vein mostly assd with

Back 329

posterior intervenntricular artery

Front 330

small cardiac vein mostly assd with

Back 330

the right marginal artery

Front 331

what does sympathetic NS do in briefly to the heart

Back 331

speeds things up
increases HR
ups contractile force of hear
dilates the arteries- increases fuel to the hear

Front 332

what does parasym NS do in gerneral a few things to the heart

Back 332

slows things down
decreases the rate of pumping and the force of pumping and constricts the arteries, decreases fuel to the heart
-everything comes from the vagus nerve pretty much

Front 333

where does sympathetic innervation of the heart come from

Back 333

the cervical sypathetic ganglia to create the superior middle and inferior cardiac N's
also some contrib from upper thoracic ganglia to create the thoracic cardiac N's

Front 334

where does parasympathetic innervation of the heart come from

Back 334

the vagus nerve duh

Front 335

where does sensory innervation of the heart come from

Back 335

they accompany both sympathetic and parasympathetic N's, much of the pain sensors accompany the middle cardiac N which is why herat attacks refer pain to the upper limb

Front 336

why do heart attacks refer pain to the upper limb

Back 336

b'c much of the pain sensors in the heart accompany the middle cardiac Nerve

Front 337

where do nerves from the cardiac plexus which is a bundle of nerve fibers around the arch of the aorta and bifurcation of the trachea

Back 337

travels to both the heart and the lungs

Front 338

where does the heart beat initiate at

Back 338

the sinuatrial node

Front 339

what does the bundle of his split into towards the apex

Back 339

purkinje fibers or R and L bundle branches

Front 340

what is evidence of the conduction pathway from the left and right bundle branches to the papillary muscles so thta they contract simultaneously with the ventricles contracting

Back 340

the moderator band aka septomarginal trabecula

Front 341

go through the conductino system of the heart starting at the sinuatrial node

Back 341

impulses conducted through atrial septum to the AV (atrioventricular) node,
-bundle of his -conducts thru intervent septum towards apex
-splits into R and left bundle branches aka purkinje fibers which initiate heart beat in ventricles and also travel to papillary muscles to cooridnate their contractions (evidenced by the septomarginal trabecula) of the RV.
-heart beat propagates as a coordinated contractile wave that starts at the apex and moves up ending with the contraction of the atria

Front 342

what's the lub and what's the dub

Back 342

lub=closing of the AV valves assd with the contraction of the ventricles
dup=closing of the aortic and pulmonary valves assd with the relaxation of the vent's

Front 343

when listening with a stethoscope, where would you put it to listen to the pulmonary valve

Back 343

by the third sternocostal joing in the left second intercostal space

Front 344

where would you put the stethoscope to listen to the aortic valve

Back 344

near the 4th sternocostal joint heard best in the right second intercostal space

Front 345

where would you put the stethoscope to listen for the right AV valve

Back 345

under the sternum near the left 5th and 6th sternocostal joints heard best near the lower left border of the sternum

Front 346

where would you put the stethoscope to listen for the mitral valve aka left atrioventricular valve

Back 346

located under the 4th costal cartilage, heard best in the left fifth intercostal space about half way across the thorax

Front 347

what is the central space of the thorax between the two pleural cavities

Back 347

the mediastinum- divided into 4 divisions

Front 348

the 4 divisions of the mediastinum

Back 348

superior, anterior, posterior and middle

Front 349

what is the central top of the thorax down to a line that connects the sternal angle with the intervertebral disk bet. t4 and t5 called

Back 349

superior mediastinum

Front 350

what are the boundaries of the anterior mediastinum

Back 350

from the line that connects the sternal angle with the intervertebral disk bet t4 and t5 to the bottom of the thorax (diaphragm) and anterior to the pericardial sac

Front 351

what are the boundaries of the middle mediastinum

Back 351

the space that contains teh pericardial sac and the heart

Front 352

what are the boundaries of the posterior mediastinum

Back 352

from the line that connects the sternal angle with the intervertebral disk bet t4 and t5 to the bottom of the thorax/diaphragm and posterior to the pericardial sac

Front 353

anterior mediastinum contents

Back 353

thymus gland
fatty remnants f it
sternopericardial lig connects the sternum to the pericardial sac- appreciate it before lifting up rib cage

Front 354

middle mediastinum contents

Back 354

pericardial sac adn teh heart
-phrenic N
pericardiacophrenic A and V
- root of lung

Front 355

posterior mediastinum contents

Back 355

esophagus-
-vagal esophageal plexus
descending aorta and its branches
veins of teh azygos syst
*thoracic duct
the sympathetic splanchnic Nerves

Front 356

how does the esophagus travel down the thorax

Back 356

starts midline but migrastes a little left and anterior which is the opposite of the descending aorta

Front 357

the thymus

Back 357

lymph organ that produces t-cells that important in extablishing the body's immune system. dvps from endoderm assd with the third pharyngeal pouch and starts degenerating at the onset of puberty. remnants in adult are usually recognized as a fatty pad in the anterior thorax

Front 358

the phrenic nerve

Back 358

primary motor and sensory nerve to diaphragm- vent rami of c345 keeps it alive
-lateral to the vagus N in the superior mediastinum
then travels thru middle mediastinum anterior to the root of the lung where it's accompanied by the pericardiacophrenic artery and vein

Front 359

is the sypathetic trunk in the mediastinum

Back 359

not really but it's nearby and so frequently grouped with this region

Front 360

what suspends the sympathetic ganglia off the ventral rami (intercostal nerves)

Back 360

white and gray rami communicans

Front 361

what is teh sympathetic trunk

Back 361

teh connection bet. adjacent ganglia

Front 362

describe the sympathetic trunk

Back 362

N travels from base of skull to coccyx, and has ganglia in thorax at every spinal level (paraverteral ganglion)- nerve and ganglia are located near th eheads of the ribs behind the costal pleura which means technically symp. trunk isn't really in the mediastinum at all

Front 363

what are the three preganglionic N's that come off of the sympathetic trunk in the thorax and go to the abdominal viscera called

Back 363

greater lesser and least splanchnic N's

Front 364

the descending aorta which is only the part that descends thru the thorax has what branches coming off of it

Back 364

-unpaired A's to gut tube derivitaves: i/e: at least one bronchial A, and 2 or more esophageal arteries
-9 pairs of posterior intercostal A's (top2 are too high for descending and others come off of abdominal aorta)
-1 pair of each of these:
-sup intercostal
-subcostal
-superior phrenic
*it's located to the left of the vert bodies until around t5 and then it goes midline and passes behind the diaphragm

Front 365

what are the L and R vagus nerves closely assd with

Back 365

L common caroted A and the brachiocephalic trunk in the superior mediastinum

Front 366

where does the L recurrent laryngeal N come off of

Back 366

the Left vagus nerve in the superior mediastinum

Front 367

which plexuses does the vagus n contrib to

Back 367

cardiac plexuz, esophageal plexus- where it dissapates and can later recombine to for the ant and post vagal trunks which mis the R and L vagal N's

Front 368

venous drainage of the esophagus in the thorax goes into the

Back 368

azygos system

Front 369

where does the thoracic duct drain into

Back 369

the left brachiocephalic vein in the root of the neck

Front 370

though the azygos V is always present and usually on the r side of teh thorax below T4, what are the two optional veins that can drain into it, which one is more common and which vein connects them if theya re there

Back 370

accessory hemiazygos vein
-hemiazygos vein-below, more common
transverse communicating veins drain either or both of these into the azygos vein

Front 371

what is the largest lympatic vessel in the body

Back 371

thoracic duct- drains all lymph except ruight upper limb and right side of head

Front 372

which two mediastinum is the thoracic duct located in and what big structures is it usually between in the one and what is it assd with in the other

Back 372

posterior- bet aorta and esophagus usually
superior-behind and in close assn with the brachiocephalic vein