Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
133 Cards in this Set
- Front
- Back
The first rib has a scalene tubercle and two grooves for?
|
Ventral to dorsal:
groove for the subclavian vein scalene tubercle groove for the subclavian artery and brachial plexus |
|
what are the single facet ribs/articulate only with their own vertebrae?
These ribs don't have? |
1st, 11th, 12th
Dont have a costal groove |
|
sternal angle is at the level of ____ vertebrae and ______ rib
|
At the level of T4 vert dorsally and the 2nd costosternal joint ventrally
|
|
Thoracic curvature upon inhalation?
|
Increased kyphosis = more concave anteriorly
Rest = | Inhalation = ( |
|
What runs anterior to the anterior scalene?
|
Phrenic n. and subclavian v.
|
|
scalene muscle innervation
|
ant. and middle = brachial plexus
post. = cervical |
|
External intercostals function during
|
forced inspiration
|
|
internal intercostals - intrachondral part fxn
|
inspiration
|
|
internal intercostals - intraosseous part fxn
|
expiration
|
|
the intercostal a. n. and v. are found between
|
between the innermost and internal intercostals
|
|
subcostalis fxn = ?
transverse thoracis fxn = ? |
subcostalis fxn = similar to internal intercostals
transverse thoracis fxn = expiratory |
|
Which muscles elevate the rib cage for respiration?
|
the scalenes, sternocleidomastoid, intercostals, pec major & minor
|
|
The internal thoracic artery gives off the musculophrenic a. at the_______
the musculophrenic a. supplies the _____ intercostal spaces |
6th intercostal space
7-9 anteriorly |
|
Skin innervation of the thorax is from
|
the ventral rami of T2-T6
|
|
epithelium of the nipple?
|
keratinizing stratified squamous
|
|
sebaceous glands on the areola?
|
montgomary tubercles - oily secretion increases suppleness
|
|
Layers breast along chest wall from superficial to deep
|
Fat > retromammary space > deep/pectoral facia
|
|
breast extends into the axillary fossa aka
|
tail of Spence
|
|
the bands of fibrous tissue that support the breast are the ___________ and extend from the ____ to the _____
|
ligaments of Cooper
from the dermis to the deep facia |
|
the glands/alveoli of the breast are lined by ____ epithelium
|
milk-secreting cuboidal epithlium
|
|
Milk production is via what hormone?
Let down of milk from duct to nipple opening is via what hormone |
production = prolactin
let down = oxytocin |
|
Innervation of the breast?
|
T4-T6
Dermatome of nipple = T4 |
|
Blood supply to breast is via
|
internal thoracic a., axillary a. (lat. thoracic), and intercostal aa
|
|
venous drainage of breast?
|
axillary and azygous
|
|
75% of breast lymphatics is via
|
axillary nodes
|
|
plexus of vessels under the areola where the lymphatics of other parts of the breast are received?
|
subareolar plexus of Sappay
|
|
dimpling/orange peel appearance?
|
tumor invasion of the suspensory ligaments/Coopers ligaments
|
|
Klinefelster's genotype? Notable sign?
|
XXY
gynecomastia |
|
Mediastinum superior/inferior border?
|
line through Sternal angle/T4
|
|
supracardiac mediastinum contains?
|
-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 |
|
Inferior mediastinum:
anterior part contains? |
thymus, fat, lymph nodes
|
|
Inferior mediastinum:
middle part contains? |
heart, coronary vessels and great vessels
ascending aorta autonomic and phrenic nerves |
|
Inferior mediastinum:
posterior part contains? |
esophagus
vagus nerves thoracic aorta thoracic duct azygous veinous system sympathetic nn thoracic (greater lesser least) splanchnic nn |
|
cervical pleura is reinforced by the?
|
suprapleural membrane aka Simpson's facia
|
|
inferior to the hilum the duplicate of pleura is called the
|
pulmonary ligament
|
|
innervation of the pleura
|
parietal: local somatic nerves including the phrenic and intercostal nn
visceral: sensory autonomic nerves - insensitive to inflammatory pain |
|
pain due to pleuritis caused by?
|
phrenic or intercostal nn causing sharp pain locally and referred pain to thoracic wall and neck
|
|
blood supply and drainage of the pleura
|
parietal: intercostal and internal thoracic aa; drainage by corresponding vessels
visceral: vessels of the lungs |
|
Intrapleural pressure @
rest = ? inspiration = ? |
rest = -3cm H2O
inspiration = -6cm H20 |
|
Which levels are the inferior border of the lung?
|
midclavicular = 6th rib
midaxillary = 8th rib scapular = 10th rib inferior border in children is +1 for above values (7, 9, 11) |
|
The oblique fissure extends posteriorly from ______ to the _____ chostachondral joint anteriorly
|
T2
6th costachondral |
|
the horizontal fissure runs from the ______ costal cartilage level to the _______ at the midaxillary line
|
4th
oblique fissure @ midaxillary |
|
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 |
1) right lung
2) left lung |
|
Trachea is ___ long and ____ wide.
It extends from _____ to carina at _____ |
12cm long and 2cm wide
extends from C6-T4 |
|
level of the cricoid cartilage/where pharynx merges with esophagus?
|
C6
|
|
Respiratory component of resp. system?
|
respiratory bronchioles, alveolar ducts, and alveoli
|
|
Conducting componenet?
|
Everything else:
nasal cavity, pharynx, larynx, trachea, and the bronchial tree all the way down to the terminal broncioles |
|
Outter layer of trachea has what type of connective tissue?
|
loose connective tissue
|
|
connective tissue between cartilages of trachea that allow elongation?
|
fibrous connective tissue - the annular ligament
|
|
Inner layer of trachea has what type of epithelium?
|
pseudostratified ciliated columnar epithelium
|
|
mucosa of the bronchioles has what type of epithelium and cells?
|
simple ciliated columnar epithelium with clara and collagen and elastic fibers
|
|
terminal and respiratory bronchioles have what type of epithelium?
|
simple ciliated cuboidal
|
|
alveolar ducts have what type of epithelium?
|
simple squamous epithelium
(think of the respiratory epithelium gradually getting simpler and flatter as air moves down) |
|
What are clara cells?
|
they can diffrentiate from ciliated cells, secrete glycosaminoglycans, and metabolize airborne toxins
|
|
thickness of alveolar capillary?
|
0.3-0.7 um
|
|
Type 1 pneumocytes:
cell type, functions? |
cell type: simple squamous with tight junctions that dont divide
fxn: gas exchange |
|
Type 2 pneumocytes:
cell type, functions? |
cell type: cuboidal shaped cells that contain microvili and tight junctions; can divide; found near septae
fxn: provide surfactant |
|
composition of surfactant and fxn
|
cholesterol, dipalmitoyl phosphatidylcholine and proteins
fxns to reduce surface tension |
|
Tidal Volume?
|
inspired/exhaled in normal breathing = 0.5L
|
|
IRV
|
volume one can inspire in addition to TV = 3L
|
|
ERV
|
volume one can expire in addition to TV = 1.2 L
|
|
RV
|
volume of gas remaining after maximal expiration (TV + ERV) = 1.2L (deadspace air)
|
|
FRC = ?
|
Functional Residual Capacity = ERV + RV = 2.4L
|
|
VC or FVC
|
Vital capacity or forced vital capacity = TV + IRV + ERV = 4.7L
|
|
TLC = ?
|
VC + RV = Add up all lung capacities = 5.9L
cant be measured |
|
FEV1? normal value =?
|
volume of air that can be forcefully exhaled in the first second
FEV1 = 80% of FVC => FEV1/FVC = 0.8 |
|
Values in the alveoli:
PO2 = ? PCO2 = ? |
Values in the alveoli:
PO2 = 100 mmHg PCO2 = 40 mmHG |
|
Values in the venous blood:
PO2 = ? PCO2 = ? |
Values in the venous blood:
PO2 = 40 mmHG PCO2 = 46 mmHG |
|
Innervation of the lung:
vagal efferent? vagal afferent? |
vagal efferent (motor) = bronchoconstriction, vasodilation, secretion
vagal afferent (sensory) = mediate the cough reflex, baroreceptors, and chemoreceptors. senses pain from trachea |
|
Innervation of the lung:
sympathetic efferent? sympathetic afferent? |
sympathetic efferent (motor): bronchodilation, vasocronstriction, decreased secretions
sympathetic afferent (sensory): pain conducting (nociceptive) from visceral pleura and bronchi |
|
FEV1/FVC in copd?
|
Decreases (<0.8) because FEV1 decreases (pt can't get rid of air easily)
|
|
FEV1/FVC in fibrosis/restrictive disease?
|
FEV1/FVC increases or is normal because (= or > 0.8) FEV1 and FVC decrease together or FVC decreases more
|
|
pancinar emphysema has a deficiency of what enzyme
|
alpha-1-antitrypsin enzyme (protease inhibitor)
|
|
visceral pericardium aka
|
epicardium
|
|
pericardial blood supply?
|
mainly pericardiophrenic and musculophrenic arteries from thoracic a. and indirect branches of thoracic aorta
epicardium is also supplied by coronary aa |
|
pericardial venous drainage?
|
azygous venous system and pericardiophrenic vv
|
|
pericardium innervation
|
sympathetic and parasympathetic (vagus)
and phrenic nn |
|
ligament of Botallo?
|
aka ligamentum arteriosum
ductus arteriosus during embryological life |
|
Borders of the heart?
|
|
|
BP in aorta?
BP in pulmonary trunk? |
aorta = 120/80
trunk = 25/10 |
|
cardiac valves are a duplicature of
|
the endocardium
|
|
smooth upper part of L ventricle
|
aortic vestibule
|
|
Rough anterior portion of R atrium?
|
pectinate muscles
|
|
Smooth posterior part of atrium
|
sinus venarum
|
|
vertical line on inside of R atrium is called the _________ which corresponds to the ________ on the outside
|
vertical line on inside of R atrium is called the crista terminalis which corresponds to the sulcus terminalis on the outside
|
|
The opening to the inf. vena cava is partially covered by
|
the sickle shaped valve of Eustachius
|
|
A valve at the opening of the coronary sinus
|
valve of thebesius
|
|
upper smooth section of R ventricle
|
infundibulum aka conus arteriosus
|
|
lower rough section of R ventricle
|
trabeculae carneae
|
|
AV node aka
|
aschoff-Tawara node
|
|
Bachman bundle?
|
transmits cardiac impulse from R atrium to L atrium
|
|
small square on ECG =?
|
0.04s
0.1mV |
|
5 small squares on ecg =
|
0.2s
0.5mV |
|
_________ surrounds the __________ area and represents the true size of the heart
|
relative cardiac dullness surrounds the absolute dullness area and represents the true size of the heart
|
|
The first heart sound is heard at the timing of the _______ on ECG and is produced by ____________
|
The first heart sound is heard at the timing of the QRS on ECG and is produced by the closure of the AV valves
|
|
The second heart sound is produced by the _________ and corresponds to the __________ on ECG
|
The second heart sound is produced by the closure of the semilunar valves and corresponds to the T-wave on ECG
|
|
Site of auscultation for the aortic valve
|
lateral to sternum at right intercostal space 2
|
|
Site of auscultation for the pulmonary valve
|
lateral to sternum at left intercostal space 2
|
|
Site of auscultation for the tricuspid valve
|
over the sternum at left intercostal space 5
|
|
Site of auscultation for the mitral valve
|
at the apex on the midclavicular line at left intercostal space 5
|
|
heart sounds picture
|
|
|
Major branches of RCA
|
SA-nodal artery
right marginal artery posterior interventricular artery AV nodal artery |
|
SA nodal artery supplies?
|
SA node and pulmonary trunk
|
|
right marginal artery supplies
|
right ventricle and apex
|
|
posterior interventricular a supplies
|
both ventricles including post. and inf. left ventricle and post. interventricular spetum
|
|
AV nodal artery
|
near origin of posterior interventricular a. supplies AV node
|
|
LCA branches?
|
anterior interventricular artery
circumflex a left marginal a |
|
anterior interventricular a supplies?
|
both ventricles and anterior 2/3 of interventricular septum
|
|
circumflex supplies?
|
left atrium, left surface of heart, and left ventricle
|
|
left marginal artery supplies?
|
branch of circumflex supplies left ventricle
|
|
The main cardiac veins drain into the ______
exception? |
coronary sinus
exception = anterior cardiac veins on R ventricle usually enter right atrium directly |
|
smallest cardiac veins aka?
|
thebesian veins/venae cordis minimae open directly into heart chambers
|
|
Innervation of heart:
sympathetic nerve originates from intermediolateral gray column of ___________ and synapse in the sympathetic chain including the _____ and _____ ganglia |
5-6 thoracic nerves
stellate and middle cervical sympathetic ganglia |
|
Innervation of heart:
postsynaptic fibers of the sympathetic __________ nerves end on the |
cardiopulmonary splanchnic nerves end on SA and AV node
|
|
Innervation of heart:
sensory information is transmitted through ______ whose cell bodies are in the ______ |
T1-T5
DRG referred pain in shoulder b/c brachial plexus is C5-T1; T1 is common |
|
Systole:
Isovolumetric contraction? |
beginning of systole and all valves are closed.
when intraventricular pressure = aortic pressure the aortic valve opens |
|
Systole:
ejection period |
aortic valve opens and 70mL of blood is ejected.
intraventricular pressure falls below aortic pressure and valves close |
|
Diastole:
Isovolumetric relaxation |
AV and SL valves are closed with residual volume (70mL) causing intraventricular pressure to be less than atrial pressure
|
|
Diastole:
Filling time |
AV valve opens and blood enters passively. Atrial contraction then takes place.
|
|
location of cisterna chyli
|
to the right of L1-L2
|
|
The esophagus is ____ long and ends in the stomach at ___ below the diaphragm between _____ and_____
|
The esophagus is 25-30cm long and ends in the stomach at cardia below the diaphragm between T10-T12
|
|
The esophagus passes through the diaphram at ____ accompanied by
|
T10 accompanied by two vagus nerves
|
|
Three major narrowing points of the esophagus
|
upper sphincter (around cricoid)
aortic narrowing diaphragmatic narrowing |
|
pg 184!
|
!
|
|
page 185!
|
!
|
|
Major openings of the diaphragm:
aortic hiatus = ? esophageal hiatus = ? foramen for the inferior vena cava = ? |
aortic hiatus = T12
esophageal hiatus = T10 foramen for the inferior vena cava = T8 |
|
blood supply to the diaphragm is via
|
inferior phrenic, superior phrenic, musculophrenic, and pericardiophrenic aa
|
|
Innervation of diaphragm
|
phrenic n. C3-C5
L1-L2 nn intercostal (sensory) nn |
|
|
|
|
esophageal blood supply
|
upper = inf thyroid a.
middle = esophageal a., bronchal a. lower = left gastric a, inf. phrenic a. |
|
the greater splanchnic nerve is from
|
T5-T9
|
|
the lesser splanchnic n is from
|
T10-T11
|
|
The least splanchnic n is from
|
T12
|