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154 Cards in this Set
- Front
- Back
Diameter of the trachea at birth? in adults?
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- 3 mm
- 12 mm |
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Length of the trachea
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- 10-12 cm
|
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Where does the trachea begin and end on the vertebrae?
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- begins at CV6
- ends at TV5 |
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Describe the cartilage of the trachea
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- 16-20 C-shaped
- last cartilage: carina - deficient in back (near esophagus) |
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What is the subcarinal angle?
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- 62 degrees
|
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What is the transition angle into the right bronchus? the left bronchus?
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- 25 degrees
- 37 degrees |
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Describe the right primary bronchus and where it enters the right lung
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- wide, short (2.5 cm), more vertical than left
- enters at TV5 |
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Describe the left primary bronchus and where it enters the left lung
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- long (5 cm), narrow, less vertical than right
- enters at TV6 |
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Where does the apex of the lung end?
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above the clavicle but below the neck of the first rib
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What does the base of the lung rest on?
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- diaphragm
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What does the hilus contain?
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- root of each lung, pulmonary ligaments, pulmonary arteries/veins, bronchi, lymph nodes, and bronchial vessels
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How many lobes does the right lung have? Name them
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-3
- upper love - middle lobe - lower lobe |
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What is the name of the bronchi that feed into the individual lobes of the lung?
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- secondary (lobar) bronchi
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How many segments are in the upper lobe of the right lung? Name them
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- 3
- apical, posterior, anterior |
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How many segments are in the middle lobe? Name them
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-2
- lateral and medial |
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How many segments are in the lower lobe? Name them
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- 5
- superior, medial basal, anterior basal, lateral basal, and posterior basal |
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What is the name of the bronchi that feed into the segments of the lobes of the lung?
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- Tertiary (segmental) bronchi
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How many segments are there in the right lung? left lung?
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- 10
-8 to 9 |
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What are the 3 surfaces of the lung called?
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- costal
- mediastinal - diaphragmatic |
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Name the 3 borders of the lung
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- anterior (mediastinal and costal)
- inferior (costal and diaphragmatic) - posterior (mediastinal and costal) |
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What nerve runs anterior to the lung root?
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- phrenic nerve
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What nerve runs posterior the lung root?
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- vagus nerve
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What is the pulmonary ligament?
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- folds of pleura that project from the root to the mediastinum
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How many fissures does the right lung have? Name them
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- 2
- oblique and horizontal |
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What does the oblique fissure separate and where is it located?
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- separates upper/middle lobes from lower lobe
- starts at 5th rib and follows 6th rib to reach diaphragmatic border |
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What does the horizontal fissure separate and where is it located?
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- separates middle from upper lobe
- begins at 6th rib in mid-axillary line and ends at 4th rib behind sternum |
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How many lobes does the left lung have? Name them
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- 2
- upper and lower |
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How many segments does the upper lobe of the left lung have? Name them
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- 4
- apico-posterior, anterior, superior lingular, inferior lingular |
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How many segments does the lower lobe of the left lung have? Name them
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- 5
- superior, medial basal, anterior basal, lateral basal, posterior basal (BUT anterior basal and medial basal may come from same bronchus) |
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What 2 things does a bronchopulmonary segment contian?
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- 1 segmental bronchus (tertiary)
- 1 segmental artery |
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What is the most posterior structure in the hilum?
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- primary bronchi
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What is a bronchopulmonary segment?
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- smallest, functionally independent region
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What are the names of the 3 arteries that supply the lungs?
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- right pulmonary artery
- left pulmonary artery - bronchial arteries |
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Where is the right pulmonary arteries/where does it travel?
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- root of lung
- anterior and inferior to primary bronchus - passes between upper and middle lobe bronchi - ends posterolateral to stem bronchus |
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Where is the left pulmonary artery located and where does it travel?
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- root of lung
- anterior and superior to primary bronchus - passes above upper lobe bronchus - ends posterolateral to stem bronchus |
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How many bronchial arteries are there?
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- 3
- 2 left and 1 right |
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Where does the left bronchial arteries come from?
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- directly off aorta
|
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Where does the right bronchial artery come from?
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- off intercostal OR one of left branches
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What are the names of the 2 left bronchial arteries?
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- superior and inferior
|
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What is the name of the right bronchial artery?
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- Right third intercostal artery
OR - Left superior bronchial artery |
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How many pulmonary veins are there?
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- 2 (superior and inferior) for each lung
- 4 total |
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Where do the pulmonary veins lie?
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- anterior and inferior to other structures within the hilus
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What is the superficial plexus located with or near?
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- visceral pleura
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Does the superficial plexus contains its own nodes? Name them
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- No, empties into hilar nodes
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What are the nodes of the deep plexus?
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- pulmonary nodes
- bronchopulmonary nodes - tracheobronchial nodes - Paratracheal nodes |
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Where are the pulmonary nodes located?
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- bronchopulmonary segments
- interface between lung and bronchi |
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Where are the bronchopulmonary nodes located?
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- near lobar bronchi (where comes of primary bronchi)
|
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Where are Paratracheal nodes located?
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- around the trachea
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What are the 2 types of tracheobronchial nodes?
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- superior
- inferior |
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Where are superior tracheobronchial nodes located?
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- where primary and lobar bronchi meet, closer to primary
|
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Where are inferior tracheobronchial nodes located?
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- under carina cartilage
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Where is the thymus located?
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- in front of great vessels
- behind sternum |
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Where is the left brachiocephalic vein located?
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- in front of arteries
- joins right vein and forms superior vena cava |
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Where is the aortic arch located?
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- begins anteriorly/slightly right
- goes in front of trachea - passes over left primary bronchus - ends posteriorly and left to TV4 body |
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Where do the branches of the aortic arch enter the neck?
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- sides of the trachea
|
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The trachea is in front/behind esophagus
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- in front
|
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Where is the thoracic duct located in relation to the esophagus?
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- left side
|
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What does the left recurrent laryngeal nerve run between on the left side?
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- trachea and esophagus
|
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Where does the esophagus begin and end?
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- CV6 (pharynx)
- to TV11 (abdome at the stomach) |
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Describe the route the esophagus takes until it ends at teh abdomen
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- travels slightly to left of TV1
- slightly right at TV5 - through diaphragm to the left of TV10 |
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What does the anterior portion of the esophagus interact with?
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- trachea and pericardium
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What does the posterior portion of the esophagus interact with?
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- vertebrae and thoracic aorta
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What does the right portion of the esophagus interact with?
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- parietal pleura
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What does the left portion of the esophagus
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- parietal pleura (and aorta in middle)
|
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How many layers of the esophageal wall are there? Name them
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- 4
- tunica adventitia - tunica muscularis - tunica submucosa - tunica mucosa |
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What is associated with the tunica adventita?
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- related to esophageal plexus of nerves
- contains plexus of veins |
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What does the tunica muscularis layer of the esophagus contain?
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- nerve plexus (with sympathetic and parasympathetic fibers as well as postganglionic parasympathetic cell bodies)
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What does the tunica submucosa layer of the esophagus contain?
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- nerve plexus (with sympathetic and parasympathetic fibers as well as postganglionic parasympathetic cell bodies)
- venous plexus |
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What does the tunica mucosa layer of the esophagus contain?
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- stratified squamous epithelium with tunica propria
|
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What is the name of the artery that supplies the upper esophagus?
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- inferior thyroid arteries
|
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What is the name of the arteries that supply the middle esophagus? What structure do they come off of?
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- off of the aorta
- bronchial, esophageal, mediastinal arteries |
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What is the name of the artery that supplies the lower esophagus?
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- esophageal branch of the left gastric artery
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The upper veins of the esophagus drain into ??? via which 3 veins?
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- drain into the superior vena cava
- get to superior vena cava via inferior thyroid vein, azygos veins, and left brachiocephalic vein |
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The lower veins of the esophagus drain into ???? via which branches?
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- drain into portal system
- via esophageal branches of left gastric vein |
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The venous plexus of the middle and lower thirds of the esophagus is part of?
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- the port-caval anastomose
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What is the main nerve supply called for the esophagus?
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- esophageal plexus
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What 2 branches/nerves from the esophageal plexus?
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- vagus nerves
- splanchnic branches from sympathetic trunk |
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What does to vagus nerves contribute to the esophageal plexus?
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- preganglionic parasympathetic fibers
- sensory fibers |
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What do the splanchnic branches from the sympathetic trunk contribute to the esophageal plexus?
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- postganglionic fibers
- sensory fibers |
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What is the path of the thoracic aorta?
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- begins to the left of the body of the TV4
- moves medially as it descends - ends at the mid-line of TV12 - when enters the abdominal cavity through the diaphragm it is called the abdominal aorta |
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What is the left of the thoracic aorta?
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- left lung
|
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What is posterior to the thoracic aorta?
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- superior: connective tissue between vertebral column and lung
- inferior: vertebral column |
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What is to the right of the thoracic aorta?
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- Superior: vertebral column
- Middle: esophagus - Inferior: right lung |
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What is anterior to the thoracic aorta?
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- Superior: root of left lung
- Inferior: esophagus, then diaphragm |
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Which intercostal arteries branch off of the thoracic aorta?
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- 3rd through 11th
|
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How many left bronchial arteries are there? Names?
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- 2
- superior and inferior |
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Name all of the branches off of the thoracic aorta
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- 3rd-11th intercostal
- subcostal - superior and inferior left bronchial - esophageal - mediastinal - pericardial - superior phrenic |
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What usually gives rise to the right bronchial artery? What else may give rise to it?
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- right 3rd intercostal artery
- superior left artery |
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What is the path of the azygos vein proper?
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- begins as right ascending lumbar vein in abdomen
- goes through aortic hiatus (diaphragm hole) goes in front of vertebral column |
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Where does the azygos vein proper empty?
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- goes anterior and superior to right primary bronchus to empty into the superior vena cava
|
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What veins empty into the azygos vein proper?
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- right subcostal (below T12)
- lower 7 or 8 right intercostal - hemiazygos - accessory hemiazygos - several esophageal - several mediastinal - several pericardial - bronchial veins - right superior intercostal veins |
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What is the path of the hemizaygos vein?
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- begins as continuation of left ascending lumbar vein
- enters thorax through left crus of diaphragm (tendons to attach diaphragm to vertebrae) - crosses at TV9 and empties into azygos |
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What veins empty into the hemiazygos vein?
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- left subcostal
- 4 or 5 left posterior intercostal veins - left ascending lumbar vein - several esophageal - several mediastinal |
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Where does the accessory hemiazygos vein cross the vertebrae to empty into the azygos vein?
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- TV8
|
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What empties into the accessory hemiazygos vein?
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- 4th-8th left posterior intercostal
- left bronchial |
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Where does the first intercostal space (veins) drain into?
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- either the brachiocephalic or vertebral vein
|
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Where does the left superior intercostal veins drain?
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- left brachiocephalic vein
|
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What does the left superior intercostal vein cross as it travels to the left brachiocephalic vein?
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- crosses aortic arch
- goes between left phrenic nerve and left vagus nerve |
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Where does the right superior intercostal vein drain?
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- terminal portion of azygos vein
|
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What are the 3 main parietal nodes of the thorax?
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1) sternal/ parasternal/ internal thoracic nodes
2) intercostal nodes 3) phrenic nodes |
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Where are the sternal/parasternal/ internal thoracic nodes located?
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- near internal thoracic vessels
|
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Where are intercostal nodes located?
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- near head and inferior to the neck of the ribs
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Where are phrenic nodes mainly located?
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- on diaphragm
|
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What are the 3 types of phrenic nodes?
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1) anterior nodes
2) lateral/middle nodes 3) posterior nodes |
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Where does the anterior nodes of the phrenic nodes lie?
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- region of xiphoid process
|
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Where do the anterior nodes receive lymph?
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- liver
- diaphragm - anterior abdominal wall - middle phrenic nodes |
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Where do the anterior nodes drain?
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- upward to sternal nodes
|
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Where are the lateral/ middle nodes located?
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- near where the phrenic nerves goe sinto the diaphragm
|
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Where do the lateral/ middle nodes receive lymph?
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- from diaphragm
- on right: from liver |
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Where do most middle/lateral nodes drain? the rest?
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- anterior phrenic nodes
- some to posterior phrenic nodes |
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Where do posterior nodes lie?
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- related to crura of diaphragm near thoracic aorta
|
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Where do posterior nodes receive lymph?
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- diaphragm
- middle phrenic nodes |
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Where do posterior nodes drain?
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- posterior mediastinal nodes
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What are the 3 visceral nodes?
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1) anterior mediastinal lymph nodes
2) tracheobronchial nodes 3) posterior mediastinal lymph nodes |
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Where do the anterior mediastinal lymph nodes lie?
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- near brachiocephalic veins
- within superior mediastinum |
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What types of nodes are included or are joined by in the anterior mediastinal lymph nodes?
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- includes brachiocephalic nodes
- joined by sternal nodes |
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Where are the tracheobronchial nodes located?
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- near where the trachea bifurcates and the hilus
|
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Which vessels enter the tracheobronchial nodes?
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- superficial: paratracheal vessels
- deep: lung vessels |
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Where are the posterior mediastinal lymph nodes located?
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- around esophagus, aorta, soft tissues of posterior mediastinum
|
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Where do the anterior mediastinal lymph nodes, tracheobronchial nodes, and posterior mediastinal lymph nodes drain into?
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- bronchomediastinal lymph trunk
|
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What are the 3 places that the bronchomediastinal lymph trunk drains into?
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- right lymphatic duct
- thoracic duct - into terminal part of subclavian vein |
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Which 2 structures joins the bronchomediastinal lymph trunk?
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- jugular lymph trunk
- subclavian lymph trunk |
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What is the thoracic duct?
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- major lymph vessel
|
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Where does sthe thoracic duct travel?
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- begins in abdominal region as cisterna chyli at LV2 level
- travels superior to right side of aorta through aortic hiatus of diaphragm at TV12 (on vertebral column) - crosses to left at TV6 - arches over subclavian artery - empties into where internal jugular vein and left subclavian vein join OR into subclavian vein |
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What does the thoracic duct drain?
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- lower limbs
- abdominal viscera - pelvic viscera - perineum |
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Where is the thoracic sympathetic trunk?
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- near heads/necks of rib
- extends up to cervical region - extends down to lumbar region |
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Which spinal nerves contribute to the white communicating rami of the thoracic sympathetic trunk?
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- 12 thoracic
- 1st and 2nd lumbar nerves |
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What type of fibers do white communicating rami have?
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- preganglionic neurons
|
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What do the white communicating rami (preganglionic neurons ) do?
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- carry impulses from spinal nerve to the sympathetic trunk
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Which spinal nerves contribute to the gray communicating rami?
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- all spinal nerves
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What type of fibers are in the gray communicating rami?
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- postganglionic sympathetic neurons
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What do the gray communicating rami (postganglionic sympathetic neurons) do?
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- impulses to the smooth muscle and glands
|
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What types of organs/ect do spinal nerves innervate?
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- sweat glands
- smooth muscles - erector pili muscles |
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What do visceral/splanchnic branches come off of?
|
- sympathetic trunk
|
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The first 4 or 5 thoracic segments form what?
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- pulmonary plexus
- cardiac plexus - esophageal plexus |
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What ganglia joins the first 4 or 5 thoracic segments?
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- cervical sympathetic ganglia
|
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What types of fibers do the first 4 or 5 thoracic segments contain?
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- postganglionic sympathetic fibers
|
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What forms the greater splanchnic nerve?
|
- TV5- TV9
|
|
Where does the greater splanchnic nerve travel to?
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- down into abdominal cavity through the crura of the diaphragm
|
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What types of fibers does the greater splanchnic nerve contain?
|
- mainly preganglionic sympathetic
- some postganglionic sympathetic and sensory fibers |
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What branches come off of the greater splanchnic nerve and what types of fibers do they contain?
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- esophageal branches
- postganglionic sympathetic fibers |
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Which segments form the lesser splanchnic nerve?
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- TV10 and TV11
|
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Where does the lesser splanchnic nerve travel?
|
- into abdominal cavity
|
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What forms the least splanchnic nerve?
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- visceral branches from TV12
|
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Where does the right vagus nerve travel?
|
- enters thorax from above
- goes anterior to the subclavian artery - behind lung roots - joins with left to form esophageal plexus - enters abdominal cavity as anterior/posterior vagal trunks |
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Where does the left vagus nerve travel?
|
- enters thorax from above
- anterior to aortic arch - behind lung roots - forms esophageal plexus - enters abdominal cavity as anterior/posterior vagal trunks |
|
Where does the recurrent/inferior laryngeal nerves travel?
|
- under right subclavian artery and aortic arch
- ascends to larynx |
|
What type of branches come off of the recurrent/inferior laryngeal nerves
|
- cardiac branches
|
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What is the pathway of the phrenic nerves? (before they differ)
|
- enter thorax from anterior surface of scalenus anterior muscle
- pass between subclavian artery and vein |
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What structure is the right phrenic nerve related to?
|
- superior and inferior vena cava
|
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What structure is the left phrenic nerve related to?
|
- aortic arch
|
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The phrenic nerves pass anteriorly to what structure?
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- lung roots
|
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Which 2 structures to the phrenic nerves go between?
|
- pericardial and pleural sacs
|
|
What do the phrenic nerves innervated
|
- the diaphragm
|