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184 Cards in this Set
- Front
- Back
Which ribs are true, false, floating?
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true: 1-7
false::8-10 floating:11-12 |
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Where do true ribs attach?
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vertebrae to sternum
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What do the false ribs attach to?
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cartilages of ribs superior
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What rib cartilages are joined to form the infrasternal angle?
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7-10
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What is the superior throasic aperture bounded by?
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1st thorasic vertebra, 1st pair of ribs, supreior border of manubrium
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What closes the inferior throasic aperture
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the diaphragm
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What does the head of the rib articulate with?
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inferior and superior costal facets of adj thorasic vertebrae
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What does the tubercle of the rib articulate with?
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the costal facet of transverse process of the vertebra of the same number.
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What does the sternal end of the rib connect to?
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the cartilage and then sternum
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What is the costal groove developed from?
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the pull of intercostal muscle fibers
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In older people, what can fuse and form a synostosis?
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manubriosternal and xiphisternal joints.
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What is the sternal foramen?
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failure of fusion between halves of the sternal bars
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Where do ribs rotate?
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1-7 costotransverse joints
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Where do ribs glide?
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8-10 costotransverse joints
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What ribs do not articulae with transverse processes?
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11 and 12
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What are costochondral joints?
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primary carilaginous joints - no mvmt
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What are interchondral joints?
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plane synovial joints (btwn costal cartilages 6-9)
provide indirect anchorage to sternum lower true ribs and upper false (7-10) |
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What are sternocostal joints?
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between upper 7 costal cartilage and sternum
1st joint is cartilaginous 2-7 are synovial plane joints. |
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What is the bucket handle mvmt?
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lateral most part of ribs are elevated and transverse diameter of thorax increases
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What causes the increase in the A-P diameter?
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ribs elevated at the neck (esp 2-6) - pump handle
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What direction do the external intercostal muscles run?
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inferior medial direction
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What do the external intercostal muscles do?
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elevate ribs during inspiration
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Where do the internal intercostal muscles run?
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Only on very anterior most end of vertebra ( depress ribs, right angle to external)
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Where are the innermost intercostal muscles found?
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only on the lateral wall
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What do the scalene muscles do?
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insert on upper 2 ribs and elevate ribs for deep breaths
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Where do the levator costae run?
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transverse process to angle of ribs, elevate during inspiration and support
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What innervates the intermediate layer of back muscles?
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the ventral rami
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What arteries supply the thorasic wall?
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the aorta, posterior intercostal arteries, internal thorasic
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Where do you perform thoracocentesis?
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superior part of rib
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What innerviates the diaphragm?
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2 phrenic nerves
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Where do the phrenic nerves originate?
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branches of the cervial plexus in the neck (arise from anterior rami of C3,C4, C5.)
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What are the superficial extrinsic back muscles?
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trapezius
rhomboids levator scapulae Latissimus dorsi all V rami |
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What are the intermediate extrinsic back muscles?
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serratus (respiratory, v.rami)
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What do the intrinsic back muscles do?
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maintain posture and control mvmts of the vertebral column and head
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What are the intrinsic back muscles?
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splenius
erector spinae transversospinalis minor deep layer dorsal rami |
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Where does the splenius muscle run? What does it do?
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C7-T3 spines and inserts into skull and cervial transverse processes
extends head, ipsilateral bend of head |
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What is the spinalis?
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most medial column of erector spinae, from spines of lower thoracic and upper lumbar to spines of upper thorasic
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Where is longissimus?
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intermediate in erector spinae, transverse process and ribs
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Where is the iliocostalis?
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Most lateral column, run to angles of ribs and cervial transverse processes
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What are the transversospinalis muscles?
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(Intrinsic)
semispinalis multifidus rotators |
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Where do the semispinalis muscles run?
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from thorasic and cervical transverse processes to skull (4-6 v)
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Where do the multifidus run?
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sacrum to spines (2-4 v)
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Where do the rotators run?
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transverse processes to junction of lamina and spine (1-2 v)
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What is the most superior of the neurocostal bundle?
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the veins
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Where do the intercostal nerves come from?
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Ventral ramus from T1-T11
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What pathways run in the intercostal nerves?
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somatic motor (intercostal muscles)
somatic sensory (dermatomes) postgang symp fibers to periphery (only to sweat glands, erector pili, not for respiration) |
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What is carried in the lateral cutaneous branch?
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somatic sensory and sympathetic
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What is carried in the anterior cutaneous branch?
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somatic sensory and sympathetic
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Where is somatic motor?
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only in intercostal nerves for muscles
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Where does the anterior IC artery originate?
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internal thorasic aretery, musculophrenic arteries (only lower spaces)
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Can you survive w/o the diaphragm?
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no
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How does the diaphragm contract?
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by flattening
thorax becomes larger=lower p abdomen is smaller=higher p |
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What are the 2 parts of the diaphragm?
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peripheral muscular part
central tendon |
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What is aponeurotic?
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no contractile forces
central tendon |
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What is the central tendon fused with?
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the inferior surface of the pericardium
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What are the 3 parts of the muscular part of the diaphragm?
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sternal costal lumbar
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Where does the right crus origniate?
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first 3 lumbar vertebra
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Where does the left crus originate?
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first 2 lumbar vertebrae
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What passes over the aorta?
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the median arcuate ligament
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What is constricted during contraction of the diaphragm?
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the esophagus, (also: vagal trunks, esophageal branches of left gastric vessels_
|
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Where is the aortic hiatus?
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posterior to diaphragm, doesn't pierce diaphragm, no effect on blood flow. Also: thorasic duct and azygos vein
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Where is the venal caval foramen?
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central tendon at T8-T9
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Contraction of diaphragm does what to iVC?
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widens the lumen
also: r. phrenic nerve, lymphatic vessels |
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Motor innervation to the diaphragm is...
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Solely via the PRENIC NERVE C3, 4, 5
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Sensory innveration to the diaphragm is...
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via the phrenic nerve to central portions AND intercostal nerves to peripheral parts
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Where is autonomic control of the diaphragm?
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in the brain stem
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What supplies blood to the diaphragm?
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pericardiacophrenic art.
musculophrenic ar. sup phrenic art. inferior phrenic art. |
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What is carried in the phrenic nerves?
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somatic motor, somatic sensory, sympathetics (but does not innerv diaphragm)
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Invagination of what develops lungs?
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pericardioperitoneal canals
|
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What are the two layers of the pleurae (serous sacs investing the lungs)
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parietal layer
visceral layer |
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Which layer of the lungs is somatic (body wall)
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Parietal layer - outer layer
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Which layer of the lungs is autonomic?
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the visceral layer
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Where are the two layers of the lung continuous?
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at the root
|
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What is the pleural cavity?
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potential space
contains thin layer of serous pleural fluid |
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What is the parital pleural derived from?
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embryonic somatopleure (somatic=sharp pain)
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What is the visceral pleura derived from?
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embryonic splanchnopleure (autonomic)
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What holds lungs open?
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surface tension of parietal and visceral layers
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What are the four parts of the parietal pleura?
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costal (body wall adj to ribs)
mediastinal diaphragmatic cervical |
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What are the lines of reflection?
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lines along where the parietal pleura changes direction
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Where are the three lines of reflection?
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sternal
costal vertebral |
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What is the costodiaphragmatic recess?
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potential space
diaphragmatic pleura contacts costal pleura |
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What is the costomediastinal recess?
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potential space
costal pleura contacts mediastinal pleura |
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How big are the lungs when they collapse
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1/3 their normal size
|
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What separates the right and left lungs?
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heart and great vessels (middle mediastinum)
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Are the right and left lungs in the same pleural sac?
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NO they are in different sacs
not like the testes |
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Which lung has 3 lobes?
and 2 fissures? |
right
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Is there a functional relationship between the number of lobes?
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no
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What covers the apex?
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cervical pleura
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Where is the costal surface of the lungs?
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adj to the sternum, costal cartilages, and ribs
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Where is the anterior border of the lungs?
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where costal and mediastinal surfaces meet anteriorly and overlap the heart
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Where is the posterior border of the lungs?
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where costal and mediastinal surfaces meet posteriorly - broad and rounded
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What does the root of the lung refer to?
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structures contained in the pulmonary sleeve and entering the hilum of the lung
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What does the hilum of the lung refer to?
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the area where structures forming the root of the lung actually touch lung tissue
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Where is the pulmonary ligament?
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where the mediastinal pleura passes laterally as a double layer, immediately anterior to the esophagus
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What structures form the root of the lung?
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atery superior
bronchus posterior vein 1 ant, 1 pos |
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What leaves impressions of the left lung?
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thorasic aorta
common carotid esophagus |
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What leaves impressions on the right lung?
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brachiocephalic v
azygos v superior vena cava inferior vena cava esophagus (all veins!) |
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What supports the trach and bronchi?
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C shaped cartilaginous rings
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Which bronchi enters the hila of the lungs?
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main (primary) bronchi
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What does the main bronchi divide into?
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secondary bronchi
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What supplies the bronchopulmonary segments?
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tertiary bronchi
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How are bronchopulmonary segments shaped?
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pyramid - apex toward lung root and base at pleural surface
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What is the largest division of a lob?
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bronchopulmonary segments
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What separates the bronchopulmonary segments?
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CT
|
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What supplies the bronchopulmonary segment?
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segmental bronchus and pulmonary artery (independently)
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What are bronchopulmonary segments named for?
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segmental bronchus
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What drains bronchopulmonary segments?
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intersegmental pulmonary veins (in CT between segments)
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What are surgically resectable?
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bronchopulmonary segments
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Where do pulmonary arteries run?
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parallel to the bronchi, usu on ant aspect of corresponding bronchus
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Where do pulmonary veins run?
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independent courses from arteries and bronchi
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What supplies blood for nutrition to the root, supporting tissues, and visceral pleura of the lung?
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bronchial arteries
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Where do left bronchial arteries arise?
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from the thorasic aorta
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Where do the right bronchial arteries arise?
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either a posterior intercostal a, or left bronchial a
|
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What do bronchial arteries provided branches to?
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the upper esophagus, then follow along posterior aspects of main bronchi
|
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What anastomose in walls of bronchioles
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bronchial a and pulmonary a
|
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What drains blood from bronchial a?
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bronchial veins and pulmonary v
|
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Where does the right bronchial v drain? the left?
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right: azygos
left: hemiazygos |
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What are pulmonary plexuses?
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networks located anterior and posterior to root of lungs
|
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What do pulmonary plexuses contain?
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parasymp fibers from vagus nerve
symp fibers from symp trunks |
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Where are parasympathetic ganglion cells located?
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in plexuses and along branches of the bronchial tree
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Parasympathetics are what to glands of the bronchial tree?
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bronchoconstrictor, vasodilator, secretomotor
Sympathetics are opposite |
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What is the pericardium?
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fibrous sac surrounding the heart and roots of the great vessels
|
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What does the fibrous pericardium fuse with?
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superiorly:
SVC, ascending aorta, pulmonary arteries inferiorly: central tendon |
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What attaches the pericardium to the sternum?
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2 sternocardial ligaments
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What is the pertrachial fascia and where does it go?
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spreads infection
from next, descends to fuse with anterior surface of pericardium |
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Posteriorly where does the pericardium attach?
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tracheal bifurcation and main bronchi (by CT)
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What overlaps the pericardium?
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2 pleural sacs and the lungs
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Where the pleural sacs deviate, where does the pericardium contact?
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the posterior surface of the sternum and 4 and 5 left intercostal spaces
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What does the pericardium contact posteriorly?
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esophagus, descending aorta, main bronchi
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Laterally what happens to the pericardium?
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the mediastinal pleura drapes over with the phrenic nerve and pericardiacophrenic a and v sandwiched between pleura and pericardium
|
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What is the fibrous pericardium?
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outer layer of dense CT of pericardium
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What is the inner serous part include?
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parietal layer and visceral
|
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What is in the form of an enclosed space with a potentail space?
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the serous part
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Where is the potential space?
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between the parietal and visceral layers=
pericardial cavity |
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What is very loosely attached?
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serous, contains fatty layer with blood vessels and myocardium
|
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What is the order of structures surrounding the heart?
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the fibrous pericardium
inner serous layer, includes: parietal pericardial cavity visceral (epicardium) |
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Which layer is inelastic?
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fibrous pericardium
retains, limits If blood fills cavity pressure is put on heart - cardiac temponade- heart can no longer pump |
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What is closely adherent to the fibrous pericardium?
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parietal layer of the serour pericardium
|
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What is aka epicardium?
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the visceral layer of the serous pericardium
|
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What is under the epicardium?
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loose CT with fat and blood vessels
|
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Which area does not have epicardium?
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the posterior between VC and pulmonary v, where myocardium contacts fibrous pericardium
|
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What is the layer w/o epicardium called?
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oblique sinus
|
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Where is the transverse sinus?
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space between arteriole end of heart and venue end. betweem SVC amd pulmonary veins - surgeon can tie off
|
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What gives blood supply to pericardium?
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pericardacophrenic arteries,
musculo phrenic arteries branches of aorta (bronchial, esophageal, sup phrenic) and coronary arteries (to visceral layer only_ |
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Where do the coronary arteries go?
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to the visceral layer only
|
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What supplies the venous drainage of the heart?
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peri cardia co phrenic v
internal thorasic v azygos system |
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What carries somatic sensory innervation to the heart?
|
phrenic nerves
to fibrous and parital layers |
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Where does visceral sensory of the heart go?
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to the epicardium via cardia plexuses (autonomics)
|
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What are the 2 parts of the right atrium?
|
sinus venarum
pectinate muscles |
|
What is the sinus venarum and where is it found?
|
smooth thinwalled posterior part - receives VC and coronary sinus - r. atria
|
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What is the sinus venarum derived from?
|
the embryonic sinus venosus
|
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What divides the sinus venarum from the pectinate muscles?
|
the crista terminalis
|
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Where are the pectinate muscles found?
|
Atria
|
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What divides the right atrium from the left?
|
the interatrial septum
|
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What was the fossa ovalis?
|
used so blood can bypass pulmonary system
|
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What happens if the atrial septal is too large?
|
allows oxygenated blood to go the the right atrium and overloads the pulmonary system, enlarges the right side of heart and pulmonary trunk
|
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Where does the blood in the right ventricle come from?
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the right atrium, through the right atrioventricular orifice : guarded by the tricuspid valve
|
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Where is the tricuspid valve, and what does is guard
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between r atria and ventricle, the r. atrioventricular orifice
|
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What are the trabeculae carneae?
|
irregular muscular elevations on internal surface of ventricles
|
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What are the two parts of the interventricular septum?
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muscular part (toward apex (bottom)), membranous part (superior and posterior)
|
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What is the conus arteriosus?
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cone shaped pouch leads into pulmonary trunk
|
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What is the pulmonary valve?
|
semilunar v guarding p trunk
|
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Where is the pulmonary valve located?
|
right ventricle
|
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What are the cusps of the right atrioventricular valve?
|
ant, pos, septal
|
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What is the function of the atrioventricular valves?
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prevent backflow into atria during ventricular contraction by papillary muscules and chordae tendineae
|
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Where does the left atrium get its blood?
|
from the lungs via the four pulmonary veins
|
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Where are the pectinate muscles in the left atria?
|
in the auricle
|
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Where does blood flow into the left ventricle?
|
from the left atrium through the left atrioventricular orifice
|
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What guards the left atrioventricular orifice?
|
the mitral/bicuspid valve
|
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Where are the trabeculae carneae more numerous and finer?
|
l ventricle
|
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Which wall thickest? Why?
|
the left ventricle (2x as right)
blood pumps to entire body |
|
What shape is the left ventricle?
|
conical
|
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What shape is the right ventricle?
|
crescent shaped
|
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What part of the left ventricle is smooth?
|
the part that leads to the aorta
|
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What guards the ascending aorta?
|
the semilunar aortic valve
|
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How many cusps in mitral valve?
|
2: anterior and posterior
|
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What is the most commonly diseased valve of the heart?
|
the mitral
nodules can form, turbulent flow infections |
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Which valves are tricuspid?
|
the pulmonary and aortic
|
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Which valves are not associated with papillary muscles?
|
the pulmonary and aortic valves
|
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What does each cusp of the semilunar valve have?
|
fibrous nodule (hard midpoint)
lunule (thin CT on either side of nodule) |
|
What happends when the semilunar valves close?
|
the nodules and lunules meet in the center
|
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What do the coronary arteries arise from?
|
the aortic sinuses
|
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When do the coronary sinuses and aortic sinuses fill?
|
following ventricular contraction
|
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What are the 3 vessels in the umbilical cord?
|
2 arteries become medial ligaments of anterior abdominal wall
|