Anatomy Exam 3 (Thorax, Lungs & Heart)

Front 1

What are the symptoms of cervical rib?

Back 1

Cervical Rib (Thoracic Outlet Syndrome)

- ischemia

[lack of blood supply to tissue]

- pain in the medial aspect of arm

[lower brachial plexus affected]

- palpable mass near clavicle

[compression to Subclavian Artery]

Front 2

Which rib contains a costal groove?

Back 2

Rib 1 - the costal groove is where the intercostal arteries/veins/nerve lie.

- found b/w the internal surface & inferior border of Rib1

Front 3

The angle of Louis corresponds to what level?

Back 3

Angle of Louis

(Sternal Angle) = T4

Front 4

What aids movement of the Rib (thoracic) Cage during respiration?

Back 4

1) Movement of the Manubriosternal Joint

2) Elasticity of Costal Cartilage

3) Contraction of the sternocleidomastoid, Scalene and Respiratory Muscles

4) Elevation by Sternum

5) Mobility in Costovertebral Joints

6) Increase of Kyphosis (normal convex curvature of spine) of the Thoracic Column

Front 5

What part of the sternum is used for bone marrow biopsy?

Back 5

Upper 1/3

Front 6

The scalene gap is formed between the ___________ and the _______________.

Back 6

Scalenus Anterior and Scalenus Medius

Front 7

What is found in the Scalene Gap?

Back 7

The Brachial Plexus:

- C5

- C6

- C7

- C8

- T1

Subclavian Artery

Front 8

The Origin of the Inferior Epigastric Artery (IEA) is the _____________.

Back 8

External Iliac Artery [located Anterior]

Front 9

Coarctation of the Aorta is often associated with ____________ ___________________.

Back 9

Turner's Syndrome

- (in Females) is the absence of an entire sex chromosome: X.

- Coarctation of the Aorta is Dilation of:

- Internal Thoracic Artery

- Musculophrenic Artery

- Superior Epigastric Artery

Front 10

The root of the Subcostal Nerve is _______.

Back 10

T12

["Least Splanchnic Nerve"]

Front 11

Intercostal Nerve Block is performed near the _______ border of the rib while Thoracocentesis (Pleural Tap) is performed near the ________ border of the rib.

Back 11

Lower, Upper

- Intercostal Nerve Block is Lower Rib because the nerves, veins and arteries are located there.

- Thoracocentesis/Pleural Tap is Upper Rib because there is nothing above the rib and it avoids damage to the intercostal Vein/Artery/Nerve.

Front 12

Which of the following is not a dermatome of the Thorax?

a) T1

b) T2

c) T3

d) T4

Back 12

T4

Front 13

What hormone is involved in milk production?

Back 13

Prolactin - produces milk & helps in metabolism and regulation of immune system.

Other Hormones & Their Functions:

- Oxytocin (helps release milk from thalamus)

- FSH (growth in pubertal maturation)

- LH (triggers ovulation & corpus luteum development)

Front 14

The nipple dermatome is at the level of ______.

Back 14

T4

Front 15

What 3 arteries make up the blood supply of the breast?

Back 15

Breast Blood Supply

1) Internal Thoracic Artery

2) Axillary Artery (Lateral Thoracic Artery)

3) Intercostal Artery

Front 16

The ____________ lymph nodes directly receive the majority of breast lymphatics from the subareolar plexus of Sappy.

Back 16

Pectoral

---------------------

Pectoral - (breast, lower pect. minor)

Subscapular - (axilla)

Humeral - (humerus)

Apicial - (upper pect. minor)

Front 17

Gyenecomastia is associated with ___________.

Back 17

Klinefelter's Syndrome

Terms:

- Gyenecomastia (endocrine disorder: enlargement of breast tissue in males)

- Klinefelter's Syndrome (XXY, genetic disorder with at least one extra 'X Chromosome')

Front 18

What are examples of content found in the Posterior Mediastinum?

Back 18

Posterior Mediastinum Contents:

- Thoracic part of Descending Aorta

- Azygos Vein

- Hemiazygos Vein

- Vagus Nerve

- Splanchnic Nerves

- Sympathetic Chain

- Esophagus

Front 19

Intrapleural Pressure at rest is ___________.

Back 19

-3 mm water (at rest)

*In contrast, IP when breathing in is -6mm*

Front 20

Thoracocentesis (Pleural Tap) usually is NOT supposed to puncture the _______________.

a) skin

b) fat

c) parietal pleura

d) visceral pleura

Back 20

Visceral Pleura

Front 21

Where is the inferior border of the rib in the midclavicular line in an adult?

Back 21

6th rib

----------------

Other info:

- midaxillary line (8th)

- scapular line (10th)

*it is one rib higher in children*

Front 22

Pseudostratified ciliated columnar epithelium is found in the ______________.

Back 22

Trachea

-----------------------

Stomach - Sim. Colum.

Breast - Adipose CN

Heart - Sim. Squam.

*CN = conn. tissue*

Front 23

The epithelium of the alveoli (sacks in the lungs) is ___________ ______________.

Back 23

Simple Squamous

Front 24

The width of the blood-air barrier is approximately ____________.

Back 24

0.5 micrometers

Front 25

What is found in the Bronchopulmonary Segment?

Back 25

Bronchopulmonary Segment:

1) Pulmonary Vein (tributary)

2) Bronchial Artery

3) Pulmonary Artery

Front 26

Total Lung Capacity is approximately _________.

Back 26

5.9 liters (TLC)

-------------------

Other Info:

- TV = 0.5 liters

- IRV = 3.0 liters

- IRV = 1.2 liters

- RV = 1.2 liters

- FVC = 4.7 liters

Front 27

The erythrocytic (RBC) partial pressure of oxygen is __________.

Back 27

40 mm Hg

--------------------------------

Capillary (blood)

- PO2 = 40 mmHg

- PCO2 = 46 mmHg

Alveoli (tiny air sacs)

- PO2 = 100 mmHg

- PCO2 = 40 mmHg

Front 28

In relation to Lung innervation, what are results of Sympathetic activity?

Back 28

Sympathetic (T1-T4/5) results:

*Efferent* [conducting outward]

- Bronchodilation

- Vasoconstriction

- Inhibitory to Glands

*Afferent* [conducting inward]

- Pain

- Pleura & Bronchi

Front 29

In relation to Lung innervation, what are results of Parasympathetic activity?

Back 29

Parasympathetic (Vagus N.) results:

*Efferent* [conducting outward]

- Bronchoconstriction

- Vasodilation

- Secretomotor (mucus secretion)

*Afferent* [conducting inward]

- Pain (stretch)

- Respiratory Epithelium & Trachea

Front 30

What are the Types of COPD's (Chronic Obstructive Pulmonary Diseases)?

Back 30

COPD = less flow in airways

1) Asthma

- inflammation of bronchial wall

- tightened bronchioles

- Increased of mucus (narrowed lumen)

2) Emhysema [pink puffers]

- Damage to lung tissue (difficulty breathing)

3) Chronic Bronchitis [blue bloaters]

Front 31

"Blue Bloating" is a characteristic of ____________ _______________.

Back 31

Chronic Bronchitis

- Inflammation/ Swelling of bronchial wall

- Increased mucus secretion

- Hypertrophy of seromucous glands

- Scarring of terminal airways

- "Blue Bloaters"

- Coughing

- Chronic Infections

Front 32

In relation to Heart innervation, what are the results of Sympathetic activity in the?

Back 32

Sympathetic (T1-T5) results:

- Increases Heart rate

- Contraction force & Impulse Conduction

- Vasodilation of Coronary Artery

Front 33

In relation to Heart innervation, what are the results of Parasympathetic activity?

Back 33

Parasympathetic (Vagus N.) results:

- Decreases Heart Rate & Force

- Vasoconstriction of Coronary Artery

Front 34

Where is the apex of the Heart found?

Back 34

5th intercostal space @ Midclavicular Line (Mitral Valve)

--------------------------------

- 5th @ Sternum (Tricuspid)

- Left 2nd (Pulmonary)

- Right 2nd (Aortic)

Front 35

The valve of Eustachius covers the opening for the _______.

Back 35

IVC (Inferior Vena Cava)

Front 36

The Valve of Thebesius covers the __________.

Back 36

CS (Coronary Sinus)

Front 37

What are the cusps of the Aortic Valve?

Back 37

Cusps of the Aortic Valve:

1) Left Aortic Cusp

2) Right Aortic Cusp

3) Posterior Aortic Cusp

Front 38

The impulse frequency of the Bundle of His is ______.

Back 38

25-45 ipm (impulses per minute)

-----------------------

Other Info:

- Normal H.R. =

50-60 ipm

- SA Node = 70 ipm

Front 39

What part of an EKG (ECG) represents ventricular depolarization?

Back 39

T-Wave (ventricular repolarization)

------------------

Other Info:

- P Wave (Atrial Repolarization)

- QRS Complex (Ventricular Depolarization)

- ST Segment (isoelectric, ventricular depolarization)

Front 40

What EKG pattern is a characteristic of Prinzmetal (Vasospastic) Angina?

Back 40

ST Elevation

---------------------

- EKG/ECG (monitors electrical activity of Heart)

- P.A (cardiac chest pain at rest)

- cause: vasospasm

Front 41

The Aortic Valve can be heard ____________.

Back 41

Parasternal @ Right 2nd Intercostal Space

-----------------------------------------------------------------------

Other Info:

- Pulmonary (parasternal @ Left 2nd I.S.)

- Tricuspid (Over Sternum @ Left 5th I.S.)

- Mitral (Apex of the Heart on the

Midclavicular Line @ Left 5th I.S.)

Front 42

The right marginal artery supplies the ________.

Back 42

Right Ventricle

and

Apex of the Heart

Front 43

There are NO anastosomes between the coronary arteries.

True or False

Back 43

False

--------------------------------

Anastosome

- cross connection between adjacent channels, fibers, etc...

Front 44

The upper part of the Esophagus is supplied by the _____________.

Back 44

Inferior Thyroid Artery

-------------------------------------------------------------

Blood Supply: (Esophagus)

- Upper (Inf. Thyroid A.)

- Middle (4-5 Esophagus A. & Bronchial A.)

- Lower (Left Gastric A. & Inf. Phrenic A.)

Front 45

What are the roots of the Phrenic Nerve?

Back 45

Phrenic Nerve Roots:

- C3

- C4

- C5

- L1

- L2

- Intercostal (sensory) Nerve

Front 46

The Aortic Hiatus for the thoracic diaphragm is at the level of _______.

Back 46

T12

-------------

Hiatuses of the Thoracic Diaphragm:

1) Aortic: T12

2) Esophageal: T10

3) IVC: T8

Front 47

What are the roots of the Splanchnic Nerve?

Back 47

Greater Splanchnic:

- T5-T9

Lesser Splanchnic:

- T10-T11

Least Splanchnic:

- T12

Front 48

A ______________ ________________ is performed to visualize the coronary vessels by injecting contrast medium into a catheter which is inserted through the femoral artery and or the brachial vein (NOT artery). The contrast can be viewed by an X-Ray.

Back 48

Coronary Angiography

Front 49

Auscultation (listening to heart by stethoscope):

1st sound is the closing of the AV Valves

- _________ Valve = over sternum, left 5th i.s.

- _________ Valve = apex of heart on midclavicular left 5th i.s.

2nd sound is the closing of the SemiLunar Valves

- ___________ Valve = parasternal right 2nd i.s.

- ___________ Valve = parasternal left 2nd i.s.

Back 49

Tricuspid

Mitral or Bicuspid

Aortic

Pulmonary

Front 50

Anterior _________ _____________ ossification can cause restriction to the mobility of the rib cage.

Back 50

Costal Cartilage

Front 51

What intercostal space is Thoracocentesis performed in?

Back 51

9th Intercostal Space (on the MidAxillary Line)

Front 52

___________________ is the presence of more than one nipple on a breast.

Back 52

Polythelia

Front 53

___________________ is the presence of more than 2 breasts.

Back 53

Polymastia

Front 54

A tumor in the ___________ ____________ of the breast may cause an orange peel appearance (dimpling).

Back 54

Cooper's (Suspensory) Ligament