Week 6- Anatomy Self Study

Front 1

What is the origin of the internal thoracic arteries?

Back 1

Subclavian artery

Front 2

What two areas or structures does the internal thoracic arteries nourish?

Back 2

Intercostal spaces anteriorly via small intercostal branches and from the musculophrenic artery and the rectus abdominis via the superior epigastric aftery

Front 3

What muscles holds the internal thoracic artery to the inside of the chest wall?

Back 3

transverse thoracic

Front 4

What is the sensory innervation to the pleura lining the:
a) thoracic cavity (costal part)?
b) mediastinum?
c) diaphragm?
d) costal and diaphragmatic surface of the lungs?
e) oblique fissures?

Back 4

a) intercostal nerves= thoracic cavity
b) phrenic nerve= mediastinum
c) phrenic (central part) and intercostal nerves (peripheral)= diaphragm
d) costal and diaphragmatic surface of lungs? visceral afferents
e) visceral afferents=0blique fissures

Front 5

In general, by how many ribs higher does the inferior border of the lungs lie than the lowest extent of the parietal pleura?

Back 5

2

Front 6

In the mid axillary line, in mid-inspiration, the lungs cross the _____ rib.

Back 6

8th

Front 7

To drain fluid from the pleural cavity the drain tube is commonly placed in the 8th or 9th intercostal space, mid axillary line. The drain enters what recess?

Back 7

Costodiaphragmatic recess

Front 8

What intercostal muscle layers does the intercostal neurovascular bundle travel between?

Back 8

the innermost intercostal and internal intercostal nerves

Front 9

Developmentally, each lung has how many broncho-pulmonary segments?

Back 9

10

Front 10

Anatomically the superior lobe of the lung lies mostly ____1______, while the inferior lobe lies mostly _____2_____.

Back 10

1) anterior
2) posterior

Front 11

What is the lingual?

Back 11

lower projection off the left upper lobe of lung

Front 12

the lingual is synonymous with what part of the right lung?

Back 12

Middle lobe

Front 13

The apex of each lung lies above the ___1___ and __2___ to extend into the root of the neck.

Back 13

1) clavicle
2) first rib

Front 14

What travels with the segmental bronchi through the middle of the broncho-pulmonary segment?

Back 14

segmental bronchi and artery

Front 15

What is the result of sympathetic innervation to the lung?

Back 15

vasodilation of pulmonary and bronchial vessels, decreased mucus secretion and bronchodilation

(The book differs from my answer in that it states that the sympathetics vasoconstricts the pulmonary and bronchial arteries. Supposedly this increases the pressure, but does not make sense to me so this particular point (vasodilation/vasoconstriction) will not be tested over.)

Front 16

Lymphatic drainage of the lungs is collected by what set of lymph nodes?

Back 16

Pulmonary to hilar

Front 17

Other than pulmonary vessels, what is the blood supply to the lungs and bronchi?

Back 17

Bronchial arteries

Front 18

The lung and viscera pleura are insensitive to somatic-type stimuli, except for __________.

Back 18

Stretch or distension

Front 19

Which primary bronchus is more likely to receive a foreign body and why?

Back 19

Right main bronchus, it is a wider, straighter continuation of the trachea

Front 20

What is another name for the right upper lobar bronchus and why?

Back 20

epiarterial, it lies above the right pulmonary artery

Front 21

At the hilum or the lung, what pulmonary artery structure(s) generally lies most
1) anterior?
2) posterior?
3)superior?

Back 21

1) pulmonary veins
2) bronchus
3) pulmonary artery

Front 22

At what vertebral body level and sternal level does the trachea bifurcate?

Back 22

At the sternal angle, 4th thoracic vertebral body level

Front 23

What is the upward point projection on the inside of the trachea at its bifurcation into primary bronchi?

Back 23

carina

Front 24

What nerve runs anterior to the root of the lung?

Back 24

phrenic nerve

Front 25

What nerve runs just posterior to the root of the lung?

Back 25

Vagus

Front 26

What component of the autonomic nervous system is found on the lateral sides of the vertebral bodies in the thorax?

Back 26

sympathetic chain and greater splanchnic nerve

Front 27

Where is the needle placed to avoid the intercostals neurovascular bundle while removing fluid from the costodiaphragmatic recess?

Back 27

Through the middle of the space, using the superior border of the rib below as a guide

Front 28

In a unilateral sucking or open pneumothorax, what does the mediastinum and inflated lung do during inspiration?

Back 28

They deviate to the side opposite the opening in the thoracic wall

Front 29

In a unilateral tension pneumothorax, what does the mediastinum and inflated lung do upon expiration?

Back 29

They remained deviated to the side opposite the opening in the thoracic wall

Front 30

During inspiration describe the changes in shape and volume of the thoracic cavity.

Back 30

All volumes increase, thus pressure decrease within the thoracic cavity. The ribcage elevates increasing the side-to-side diameter (bucket handle) and the anterior-posterior diameter (pump handle), while the diaphragm contracts and drops, increasing the superior-inferior diameter.

Front 31

What bony landmark divides the superior and inferior mediastina?

Back 31

sternal angle

Front 32

The thymus is found in which division(s) of the mediastinum?

Back 32

superior and anterior

Front 33

What is the primary “artery” found in the posterior mediastinum?

Back 33

descending aorta

Front 34

The middle mediastinum is the “home” for what major structure/organ?

Back 34

heart

Front 35

What structures border the thoracicduct in the posterior mediastinum?

Back 35

aorta, vertebral bodies, esophagus

Front 36

What is the name for the thin membrane which lines the inside of the fibrous pericardium?

Back 36

parietal layer or serous pericardium

Front 37

What is the procedure called when the pericardialsac is tapped with a needle for removal of
fluid?

Back 37

pericardiocenthesis

Front 38

Where on the anterior chest waall is the _____best heard?
1) aortic valve
2) mitral valve

Back 38

1) 2nd intercostal space, right of sternum
2) apex of heart, 5th intercostal space near left mid-clavicular line

Front 39

Where on the anterior chest wall is the apex of the heart projected?

Back 39

5th intercostal space near left mid-clavicular line

Front 40

What valve is heard best at about its anatomicposition as projected onto the anterior chest wall?

Back 40

tricuspid valve

Front 41

What is the name of the external depression on the heart which divides the atria from ventricles?

Back 41

coronary sulcus

Front 42

Auricles are part of which heart chamber(s)?

Back 42

atria

Front 43

The pulmonary trunk carries blood from which chamber of the heart?

Back 43

right ventricle

Front 44

What is the name of the A/V valve that sits between the right atrium and ventricle?

Back 44

tricuspid

Front 45

The “rough” muscular part of the atria walls are termed the ___________ muscles.

Back 45

pectinate

Front 46

What is the function of the papillary/chordae tendenae complexes?

Back 46

prevent AV valve cusps from regurgitating into atria upon ventricular contraction

Front 47

How many pulmonary veins usually enter the left atrium?

Back 47

four

Front 48

What is usual origin for the...
1) left subclavian artery?
2) right subclavian artery?

Back 48

1) aortic arch
2) brachiocephalic trunk

Front 49

The azygos vein arches over the root of the lung to enter what vessel?

Back 49

superior vena cava

Front 50

In general the venous drainage from the heart in collected in what structure before being emptied into the right atrium?

Back 50

coronary sinus

Front 51

In a left dominant coronary artery distribution pattern, which parts of the heart are supplied by branches of the left coronary artery?

Back 51

both interventricular sulci and the posterior surface of the left ventricle

Front 52

The coronary arteries arise from the aortic sinuses of __________.

Back 52

Valsalva

Front 53

The impulse wave from the AV node is transmitted to the ventricles by what bundle?

Back 53

AV bundle of His

Front 54

Which nerve supplies parasympathetic innervation to the thoracic viscera?

Back 54

CN X (Vagus)

Front 55

What affect does sympathetic innervation have on...
1) the heart?
2) lungs?

Back 55

1) increased heart rate and force of contractility, dilation of coronary arteries
2) bronchodilation, decreased mucus secretion, vasodilation or pulmonary vessels

Front 56

Where is the cardiac skeleton located?

Back 56

at the level of the coronary sulcus

Front 57

What is the cardiac skeleton made of in the human?

Back 57

semi-rigid, dense connective tissue

Front 58

Name three functions of the cardiac skeleton:

Back 58

1) attachment for valves
2) attachment for cardiac muscles
3) insulation of ventricles from electrical impulses

Front 59

What is the feature of the right atrium that represents a right to left shunt in fetal life?

Back 59

foramen ovale

Front 60

In fetal life, most of the blood from the pulmonary trunk is shunted to the aorta via the ______________.

Back 60

ductuS arterosuS

Front 61

What does the structure in the question above beome in the adult?

Back 61

ligamentuM arterosuM

Front 62

What chamber of the heart helps form the left heart border on PA plain film radioograph?

Back 62

Mostly left ventricle. The left atrial appendage also forms a tiny part of it.

Front 63

The absence of what feature of the cardiac silhouette indicates the presence of enlarged lymph nodes or masses in the mediastinum?

Back 63

The aorto-pulmonary window or wedge is missing
with enlarged lymph nodes on the left. The right side shows widened mediastinum in the
same region.

Front 64

What is the superior extent of the pleural cavity?

Back 64

about 1 inch above the clavicle/1st rib

Front 65

What is the name of the peritoneal lined space between the body wall and the diaphragm

Back 65

costodiaphragmatic recess

Front 66

A PA chest XRAY should exhibit how many pairs of ribs?

Back 66

at least 8

Front 67

The anterior aspect of each rib is located ___________ to the posterior aspect of the rib.

Back 67

below/inferior

Front 68

In a normal chest XRAY waht radiopaque structure can be seen in the substance of the lung?

Back 68

Pulmonary vessels

Front 69

What forms the majority of the...
1) right heart border?
2) left heart border?

Back 69

1) right atrium (and superior vena cava)
2) left ventricle (and pulmonary trunk and aorta)

Front 70

What is the aortic knob?

Back 70

arch of the aorta on the left mediastinal border

Front 71

what part of the heart lies most anterior in the...
1) thorax?
2) posterior?

Back 71

1) right ventricle
2) left atrium and left ventricle

Front 72

What structure normally makes an impression on the esophagus?

Back 72

aorta-superiorly

Front 73

On inspiration what is the position of the diaphragm?

Back 73

the diaphragm descends

Front 74

Pneumonia of which lobe of the lung obscures the right heart border on PA view?

Back 74

right middle lobe

Front 75

How would free air in the abdominal cavity show up on plain film xray?

Back 75

as a radiolucent (dark) region inferior to the diaphragm

Front 76

How do you describe a PA chest xray of a person with severe emphysema

Back 76

barrel shaped- long and rounded, but low hemi-diaphragm domes

Front 77

Fluid accumulating in the pleura space is referred to as a ________________.

Back 77

Pleural effusion

Front 78

In contrast to pneumonia, how do large pleural effusions affect the organs of the thorax?

Back 78

pneumonias occupy the lung space with little or no displacement, effusions push the lungs and mediastinum to the opposite side - space occupying

Front 79

On a pneumothorax the visceral pleura of the partially deflated lung is seen as a thing _____________.

Back 79

White line

Front 80

Name Five reasons for mediastinal widening that are caused by disease states.

Back 80

1) pulmonary hypertension
2) lung cancer
3) aorta rupture
4) enlarged mediastinal lymph nodes
5) cardiomegaly

Front 81

Cardiomegaly due to mitral valve regurgitation is due mainly to enlargement of the __________.

Back 81

Left atrium

Front 82

Cardiomegaly due to aortic valve regurgitation is due mainly to the enlargement of the _______________.

Back 82

Left ventricle

Front 83

What view is best on aortagram to clearly visualize the three chief supra-aortic brances off the aortic arch?

Back 83

Lateral view