Anatomy Test Three Thorax

Front 1

The first rib has a scalene tubercle and two grooves for?

Back 1

Ventral to dorsal:
groove for the subclavian vein
scalene tubercle
groove for the subclavian artery and brachial plexus

Front 2

what are the single facet ribs/articulate only with their own vertebrae?

These ribs don't have?

Back 2

1st, 11th, 12th

Dont have a costal groove

Front 3

sternal angle is at the level of ____ vertebrae and ______ rib

Back 3

At the level of T4 vert dorsally and the 2nd costosternal joint ventrally

Front 4

Thoracic curvature upon inhalation?

Back 4

Increased kyphosis = more concave anteriorly

Rest = |
Inhalation = (

Front 5

What runs anterior to the anterior scalene?

Back 5

Phrenic n. and subclavian v.

Front 6

scalene muscle innervation

Back 6

ant. and middle = brachial plexus
post. = cervical

Front 7

External intercostals function during

Back 7

forced inspiration

Front 8

internal intercostals - intrachondral part fxn

Back 8

inspiration

Front 9

internal intercostals - intraosseous part fxn

Back 9

expiration

Front 10

the intercostal a. n. and v. are found between

Back 10

between the innermost and internal intercostals

Front 11

subcostalis fxn = ?

transverse thoracis fxn = ?

Back 11

subcostalis fxn = similar to internal intercostals

transverse thoracis fxn = expiratory

Front 12

Which muscles elevate the rib cage for respiration?

Back 12

the scalenes, sternocleidomastoid, intercostals, pec major & minor

Front 13

The internal thoracic artery gives off the musculophrenic a. at the_______

the musculophrenic a. supplies the _____ intercostal spaces

Back 13

6th intercostal space

7-9 anteriorly

Front 14

Skin innervation of the thorax is from

Back 14

the ventral rami of T2-T6

Front 15

epithelium of the nipple?

Back 15

keratinizing stratified squamous

Front 16

sebaceous glands on the areola?

Back 16

montgomary tubercles - oily secretion increases suppleness

Front 17

Layers breast along chest wall from superficial to deep

Back 17

Fat > retromammary space > deep/pectoral facia

Front 18

breast extends into the axillary fossa aka

Back 18

tail of Spence

Front 19

the bands of fibrous tissue that support the breast are the ___________ and extend from the ____ to the _____

Back 19

ligaments of Cooper

from the dermis to the deep facia

Front 20

the glands/alveoli of the breast are lined by ____ epithelium

Back 20

milk-secreting cuboidal epithlium

Front 21

Milk production is via what hormone?

Let down of milk from duct to nipple opening is via what hormone

Back 21

production = prolactin

let down = oxytocin

Front 22

Innervation of the breast?

Back 22

T4-T6

Dermatome of nipple = T4

Front 23

Blood supply to breast is via

Back 23

internal thoracic a., axillary a. (lat. thoracic), and intercostal aa

Front 24

venous drainage of breast?

Back 24

axillary and azygous

Front 25

75% of breast lymphatics is via

Back 25

axillary nodes

Front 26

plexus of vessels under the areola where the lymphatics of other parts of the breast are received?

Back 26

subareolar plexus of Sappay

Front 27

dimpling/orange peel appearance?

Back 27

tumor invasion of the suspensory ligaments/Coopers ligaments

Front 28

Klinefelster's genotype? Notable sign?

Back 28

XXY

gynecomastia

Front 29

Mediastinum superior/inferior border?

Back 29

line through Sternal angle/T4

Front 30

supracardiac mediastinum contains?

Back 30

-great vessels: arch of arota + its 3 branches, the azygous vein, superior vena cava, and R+L brachiocephalic vv
-part of the thymus, trachea, and esophagus
-phrenic nerves and the thoracic duct

Front 31

Inferior mediastinum:
anterior part contains?

Back 31

thymus, fat, lymph nodes

Front 32

Inferior mediastinum:
middle part contains?

Back 32

heart, coronary vessels and great vessels
ascending aorta
autonomic and phrenic nerves

Front 33

Inferior mediastinum:
posterior part contains?

Back 33

esophagus
vagus nerves
thoracic aorta
thoracic duct
azygous veinous system
sympathetic nn
thoracic (greater lesser least) splanchnic nn

Front 34

cervical pleura is reinforced by the?

Back 34

suprapleural membrane aka Simpson's facia

Front 35

inferior to the hilum the duplicate of pleura is called the

Back 35

pulmonary ligament

Front 36

innervation of the pleura

Back 36

parietal: local somatic nerves including the phrenic and intercostal nn

visceral: sensory autonomic nerves - insensitive to inflammatory pain

Front 37

pain due to pleuritis caused by?

Back 37

phrenic or intercostal nn causing sharp pain locally and referred pain to thoracic wall and neck

Front 38

blood supply and drainage of the pleura

Back 38

parietal: intercostal and internal thoracic aa; drainage by corresponding vessels

visceral: vessels of the lungs

Front 39

Intrapleural pressure @

rest = ?
inspiration = ?

Back 39

rest = -3cm H2O

inspiration = -6cm H20

Front 40

Which levels are the inferior border of the lung?

Back 40

midclavicular = 6th rib
midaxillary = 8th rib
scapular = 10th rib

inferior border in children is +1 for above values (7, 9, 11)

Front 41

The oblique fissure extends posteriorly from ______ to the _____ chostachondral joint anteriorly

Back 41

T2

6th costachondral

Front 42

the horizontal fissure runs from the ______ costal cartilage level to the _______ at the midaxillary line

Back 42

4th

oblique fissure @ midaxillary

Front 43

Which lung has
1) cardiac impression anteriorly, groove for brachiocephalic vein and superior vena cava, grove for the arch of the azygos vein,
2) area for ascending and descending aorta, groove for arch of aorta, groove for subclavian a. and a larger cardiac impression

Back 43

1) right lung

2) left lung

Front 44

Trachea is ___ long and ____ wide.
It extends from _____ to carina at _____

Back 44

12cm long and 2cm wide

extends from C6-T4

Front 45

level of the cricoid cartilage/where pharynx merges with esophagus?

Back 45

C6

Front 46

Respiratory component of resp. system?

Back 46

respiratory bronchioles, alveolar ducts, and alveoli

Front 47

Conducting componenet?

Back 47

Everything else:
nasal cavity, pharynx, larynx, trachea, and the bronchial tree all the way down to the terminal broncioles

Front 48

Outter layer of trachea has what type of connective tissue?

Back 48

loose connective tissue

Front 49

connective tissue between cartilages of trachea that allow elongation?

Back 49

fibrous connective tissue - the annular ligament

Front 50

Inner layer of trachea has what type of epithelium?

Back 50

pseudostratified ciliated columnar epithelium

Front 51

mucosa of the bronchioles has what type of epithelium and cells?

Back 51

simple ciliated columnar epithelium with clara and collagen and elastic fibers

Front 52

terminal and respiratory bronchioles have what type of epithelium?

Back 52

simple ciliated cuboidal

Front 53

alveolar ducts have what type of epithelium?

Back 53

simple squamous epithelium

(think of the respiratory epithelium gradually getting simpler and flatter as air moves down)

Front 54

What are clara cells?

Back 54

they can diffrentiate from ciliated cells, secrete glycosaminoglycans, and metabolize airborne toxins

Front 55

thickness of alveolar capillary?

Back 55

0.3-0.7 um

Front 56

Type 1 pneumocytes:
cell type, functions?

Back 56

cell type: simple squamous with tight junctions that dont divide

fxn: gas exchange

Front 57

Type 2 pneumocytes:
cell type, functions?

Back 57

cell type: cuboidal shaped cells that contain microvili and tight junctions; can divide; found near septae

fxn: provide surfactant

Front 58

composition of surfactant and fxn

Back 58

cholesterol, dipalmitoyl phosphatidylcholine and proteins

fxns to reduce surface tension

Front 59

Tidal Volume?

Back 59

inspired/exhaled in normal breathing = 0.5L

Front 60

IRV

Back 60

volume one can inspire in addition to TV = 3L

Front 61

ERV

Back 61

volume one can expire in addition to TV = 1.2 L

Front 62

RV

Back 62

volume of gas remaining after maximal expiration (TV + ERV) = 1.2L (deadspace air)

Front 63

FRC = ?

Back 63

Functional Residual Capacity = ERV + RV = 2.4L

Front 64

VC or FVC

Back 64

Vital capacity or forced vital capacity = TV + IRV + ERV = 4.7L

Front 65

TLC = ?

Back 65

VC + RV = Add up all lung capacities = 5.9L

cant be measured

Front 66

FEV1? normal value =?

Back 66

volume of air that can be forcefully exhaled in the first second

FEV1 = 80% of FVC => FEV1/FVC = 0.8

Front 67

Values in the alveoli:

PO2 = ?
PCO2 = ?

Back 67

Values in the alveoli:

PO2 = 100 mmHg
PCO2 = 40 mmHG

Front 68

Values in the venous blood:

PO2 = ?
PCO2 = ?

Back 68

Values in the venous blood:

PO2 = 40 mmHG
PCO2 = 46 mmHG

Front 69

Innervation of the lung:
vagal efferent?
vagal afferent?

Back 69

vagal efferent (motor) = bronchoconstriction, vasodilation, secretion

vagal afferent (sensory) = mediate the cough reflex, baroreceptors, and chemoreceptors. senses pain from trachea

Front 70

Innervation of the lung:
sympathetic efferent?
sympathetic afferent?

Back 70

sympathetic efferent (motor): bronchodilation, vasocronstriction, decreased secretions

sympathetic afferent (sensory): pain conducting (nociceptive) from visceral pleura and bronchi

Front 71

FEV1/FVC in copd?

Back 71

Decreases (<0.8) because FEV1 decreases (pt can't get rid of air easily)

Front 72

FEV1/FVC in fibrosis/restrictive disease?

Back 72

FEV1/FVC increases or is normal because (= or > 0.8) FEV1 and FVC decrease together or FVC decreases more

Front 73

pancinar emphysema has a deficiency of what enzyme

Back 73

alpha-1-antitrypsin enzyme (protease inhibitor)

Front 74

visceral pericardium aka

Back 74

epicardium

Front 75

pericardial blood supply?

Back 75

mainly pericardiophrenic and musculophrenic arteries from thoracic a. and indirect branches of thoracic aorta

epicardium is also supplied by coronary aa

Front 76

pericardial venous drainage?

Back 76

azygous venous system and pericardiophrenic vv

Front 77

pericardium innervation

Back 77

sympathetic and parasympathetic (vagus)

and phrenic nn

Front 78

ligament of Botallo?

Back 78

aka ligamentum arteriosum

ductus arteriosus during embryological life

Front 79

Borders of the heart?

Back 79

Front 80

BP in aorta?

BP in pulmonary trunk?

Back 80

aorta = 120/80

trunk = 25/10

Front 81

cardiac valves are a duplicature of

Back 81

the endocardium

Front 82

smooth upper part of L ventricle

Back 82

aortic vestibule

Front 83

Rough anterior portion of R atrium?

Back 83

pectinate muscles

Front 84

Smooth posterior part of atrium

Back 84

sinus venarum

Front 85

vertical line on inside of R atrium is called the _________ which corresponds to the ________ on the outside

Back 85

vertical line on inside of R atrium is called the crista terminalis which corresponds to the sulcus terminalis on the outside

Front 86

The opening to the inf. vena cava is partially covered by

Back 86

the sickle shaped valve of Eustachius

Front 87

A valve at the opening of the coronary sinus

Back 87

valve of thebesius

Front 88

upper smooth section of R ventricle

Back 88

infundibulum aka conus arteriosus

Front 89

lower rough section of R ventricle

Back 89

trabeculae carneae

Front 90

AV node aka

Back 90

aschoff-Tawara node

Front 91

Bachman bundle?

Back 91

transmits cardiac impulse from R atrium to L atrium

Front 92

small square on ECG =?

Back 92

0.04s

0.1mV

Front 93

5 small squares on ecg =

Back 93

0.2s

0.5mV

Front 94

_________ surrounds the __________ area and represents the true size of the heart

Back 94

relative cardiac dullness surrounds the absolute dullness area and represents the true size of the heart

Front 95

The first heart sound is heard at the timing of the _______ on ECG and is produced by ____________

Back 95

The first heart sound is heard at the timing of the QRS on ECG and is produced by the closure of the AV valves

Front 96

The second heart sound is produced by the _________ and corresponds to the __________ on ECG

Back 96

The second heart sound is produced by the closure of the semilunar valves and corresponds to the T-wave on ECG

Front 97

Site of auscultation for the aortic valve

Back 97

lateral to sternum at right intercostal space 2

Front 98

Site of auscultation for the pulmonary valve

Back 98

lateral to sternum at left intercostal space 2

Front 99

Site of auscultation for the tricuspid valve

Back 99

over the sternum at left intercostal space 5

Front 100

Site of auscultation for the mitral valve

Back 100

at the apex on the midclavicular line at left intercostal space 5

Front 101

heart sounds picture

Back 101

Front 102

Major branches of RCA

Back 102

SA-nodal artery
right marginal artery
posterior interventricular artery
AV nodal artery

Front 103

SA nodal artery supplies?

Back 103

SA node and pulmonary trunk

Front 104

right marginal artery supplies

Back 104

right ventricle and apex

Front 105

posterior interventricular a supplies

Back 105

both ventricles including post. and inf. left ventricle and post. interventricular spetum

Front 106

AV nodal artery

Back 106

near origin of posterior interventricular a. supplies AV node

Front 107

LCA branches?

Back 107

anterior interventricular artery
circumflex a
left marginal a

Front 108

anterior interventricular a supplies?

Back 108

both ventricles and anterior 2/3 of interventricular septum

Front 109

circumflex supplies?

Back 109

left atrium, left surface of heart, and left ventricle

Front 110

left marginal artery supplies?

Back 110

branch of circumflex supplies left ventricle

Front 111

The main cardiac veins drain into the ______

exception?

Back 111

coronary sinus

exception = anterior cardiac veins on R ventricle usually enter right atrium directly

Front 112

smallest cardiac veins aka?

Back 112

thebesian veins/venae cordis minimae open directly into heart chambers

Front 113

Innervation of heart:
sympathetic nerve originates from intermediolateral gray column of ___________ and synapse in the sympathetic chain including the _____ and _____ ganglia

Back 113

5-6 thoracic nerves

stellate and middle cervical sympathetic ganglia

Front 114

Innervation of heart:
postsynaptic fibers of the sympathetic __________ nerves end on the

Back 114

cardiopulmonary splanchnic nerves end on SA and AV node

Front 115

Innervation of heart:
sensory information is transmitted through ______ whose cell bodies are in the ______

Back 115

T1-T5

DRG

referred pain in shoulder b/c brachial plexus is C5-T1; T1 is common

Front 116

Systole:
Isovolumetric contraction?

Back 116

beginning of systole and all valves are closed.
when intraventricular pressure = aortic pressure the aortic valve opens

Front 117

Systole:
ejection period

Back 117

aortic valve opens and 70mL of blood is ejected.

intraventricular pressure falls below aortic pressure and valves close

Front 118

Diastole:
Isovolumetric relaxation

Back 118

AV and SL valves are closed with residual volume (70mL) causing intraventricular pressure to be less than atrial pressure

Front 119

Diastole:
Filling time

Back 119

AV valve opens and blood enters passively. Atrial contraction then takes place.

Front 120

location of cisterna chyli

Back 120

to the right of L1-L2

Front 121

The esophagus is ____ long and ends in the stomach at ___ below the diaphragm between _____ and_____

Back 121

The esophagus is 25-30cm long and ends in the stomach at cardia below the diaphragm between T10-T12

Front 122

The esophagus passes through the diaphram at ____ accompanied by

Back 122

T10 accompanied by two vagus nerves

Front 123

Three major narrowing points of the esophagus

Back 123

upper sphincter (around cricoid)
aortic narrowing
diaphragmatic narrowing

Front 124

pg 184!

Back 124

!

Front 125

page 185!

Back 125

!

Front 126

Major openings of the diaphragm:
aortic hiatus = ?
esophageal hiatus = ?
foramen for the inferior vena cava = ?

Back 126

aortic hiatus = T12
esophageal hiatus = T10
foramen for the inferior vena cava = T8

Front 127

blood supply to the diaphragm is via

Back 127

inferior phrenic, superior phrenic, musculophrenic, and pericardiophrenic aa

Front 128

Innervation of diaphragm

Back 128

phrenic n. C3-C5
L1-L2 nn
intercostal (sensory) nn

Front 129

Back 129

Front 130

esophageal blood supply

Back 130

upper = inf thyroid a.

middle = esophageal a., bronchal a.

lower = left gastric a, inf. phrenic a.

Front 131

the greater splanchnic nerve is from

Back 131

T5-T9

Front 132

the lesser splanchnic n is from

Back 132

T10-T11

Front 133

The least splanchnic n is from

Back 133

T12