1. Circulatory and Respiratory Organ Systems, Thoracic Cavity Flashcards

Question

Trachea - Anatomy

Answer 1

* beginning: inferior border of cricoid cartilage (C6) * 16-20 incomplete hyaline cartilage * prevent trachea from collapsing * open posteriorly towards esophagus * bifurcates at sternal angle → right and left bronchi * last cartilage: **carina**

Answer 2

* thrachea → bronchi → 1°, 2°, 3° bronchi → bronchioles → terminal bronchioles 1. **right bronchus** * shorter, wider, **steeper** than left one * runs _under_ azygous vein * divides into: 3 secondary (lobar) bronchi (superior, middle, inferior) * each divide into 10 segmental bronchi 2. **left bronchus** * ****inferior through aortic arch (to left side) * divides into: 2 secondary (lobar) bronchi (superior, inferior) * each divide into 8-10 segmental bronchi

Answer 3

* divided into 4 different layers: 1. **Tunica mucosa** * ****Mucous epithelium * pseudostratified columnar ciliated epithelium * Goblet cells (secretion) * Endocrine cells * Lamina propria * Loose connective tissue * Lymphocytes * Plasma cells 2. **Tunica submucosa** * ****loose connective tissue * mucous glands 3. **Tunica fibro•musculo•cartilaginea** * ****hyaline cartilage * annular ligaments 4. **Tunica adventitia** * connective fibres * blood vessels * nerves

Answer 4

→ can be devided into 4 layers * glands and supporting cartilage can be found 1. **Tunica mucosa** * pseudostratified columnar ciliated epithelium * height decreases towards terminal bronchioles 2. **Tunica muscularis** * larger bronchi: smooth muscle layer * smaller bronchi: smooth muscle cells 3. **Cartilage plates ** * decrease in number and size towards terminal bronchioles 4. **Adventitia** * external layer of bronchi * collagen fibres

Answer 5

* NO cartilage, NO glands * ciliated pseudostratified columnar * becomes less ciliated in direction to terminal bronchioles * terminal bronchioles also contain "clara cells" * have secretory granules which secrete proteins protecting bronchiolar lining against pollution

Answer 6

* right lung: 3 lobes * left lung: 2 lobes * enclosed by pleura * visceral + parietal layer → pleural cavity * hilum: root of lungs (medial side) * contains vessels and nerves Borders: * medial: heart in mediastinum * inferior: bases rest on diaphragm * superior: thoracic aperture * lateral: thoracic wall (enclosed by pleura)

Answer 7

* larger, heavier * usually only **1 bronchial artery** * 3 lobes (superior, middle, inferior) * 3 secondary (lobar) bronchi * 10 tertiary (segmental) bronchi * devided by * **oblique** fissure: starts at head of 5th rib, runs along 6th rib * **horizontal** fissure: from upper quarter of oblique fissure to medial side

Answer 8

* upper and lower lobes devided by oblique fissure (along 6th rib) * usually **2 bronchial arteries** * cardiac notch: impression on antero-inferior corner of superior lobe * 2 secondary (lobar) bronchi * 8-10 tertiary (segmental) bronchi

Answer 9

* → pleura constist of * mesothelium (single layer of flat cells) * supporting connective tissue layer 1. _parietal_ pleura * outermost layer, lines thoracic wall * innervated by intercostal and phrenic nerves * sensitive to pain 2. _visceral_ pleura * innermost layer, surrounds the lungs * innervated by vagal nerve endings * sensitive to stretch * → in between: pleural cavity with serous fluid * pleural recess: * space which is not covered by lungs * fluids can collect there * costomediastinal vs. costodiaphragmatic recess

Answer 10

**Parietal pleura** * intercostal nerves **Visceral pleura** * autonomic NS

Answer 11

* Lungs contain non respiratory tissues: * bronchial veins (→ (hemi-)azygous- and pulmonary vein) * bronchial arteries (→ thoracic aorta)

Answer 12

1. **Pulmonary Plexus** * vagus nerve

Answer 13

1. Peribronchial network: * drains lymph from bronchi & most of lungs 2. Subpleural network(smaller): * borders lungs * drains lymph from peripheral lung areas + visceral pleura ⇒ Trachiobroncheal lymph nodes → paratracheal ln → subclavian + internal jugular veins * Parietal pleura : drained by intercostal + parasternal l.n

Answer 14

**Inside lungs: Alveoli** * outpouchings in the wall of bronchioles * side of gas exchange: * epithelial walls of alveoli are extremely thin * Type 1 pneumocytes: gas exchage, flattened * Type 2 pneumocytes: surfactant/film production * a. might be connected by small pores * surrounded by dense CT, which contains anastomosing pulmonary capillary network * blood-air barrier: * alveolar epithelium + capillary endothelium

Answer 15

* from right ventricle * divides into **right + left pulmonary artery** * carry DEoxygenated blood

Answer 16

**Apex** * formed by left ventricle * "tip" of the heart **Base of the heart** * formed by: * left atrium, posterior right atrium * origin of large vessels * opposite to apex **Terminal sulcus (groove)** * ****groove on right atrium * extends from front of SVC to front of IVC * internal: crista terminalis * margin between pectinate muscle and endocardium **Coronary sulcus (groove)** * division between atria and ventricles on sternal surface **Interventricular sulcus (groove)** * separates 2 ventricles **Conus anteriosus** * pouch on anterior surface of right ventricle * continuation: pulmonary trunk

Answer 17

* situated in the middle of the mediastinum * pinecone-shape: broad at the base, thin at the apex * typically size of the fist * mass: 250-300g

Answer 18

**Superior view** * base of the heart * large vessels: ant. to post. * pulmonary trunk (→ arteries) * aorta * SVC * pulmonary veins (2x each side) **Inferior view** * apex of the heart * inferior margin * rests on diaphragm **Lateral view** * right side: * right atrium * superior + inferior VC * right coronary artery * terminal sulcus * left side: * left ventricle **Anterior view** * interior interventricular groove * great cardiac vein * right ventricle **Posterior view** * right ventricle * left atrium * "openings" of great vessels * coronary sinus (veins)

Answer 19

→ fibrous sac enclosing the heart and the roots of great vessels → oblique + transverse (between aorta and SVC) sinus **3 layers + wall of heart: ** 1. fibrous pericardium * dense CT 2. serous percardium * 1. + 2. make up parietal layer 3. pericardiac cavity * filled with few drops serous fluid (lubrication) 4. epicardium (visceral layer) 5. myocardium 6. endocardium

Answer 20

* perichardiophrenic artery * bronchial artery * esophageal artery

Answer 21

* vasomotor and sensory nerve fibres from **phrenic-** and **vagus nerves **and the symphathetic trunks

Answer 22

* receives **oxygenated** blood from 4 pulmonary veins * smaller than right atrium * most posterior of all 4 chambers * smooth walls, except for pectinate muscles in auricle

Answer 23

* on back of the heart * pumps **oxygenated** blood into the aorta * inferior ventricle + superior aortic vestibule * **2** papillary muscles + chordae tendinae * hold back the flaps of **bi**cuspid valve * walls with muscular ridges → trabeculae carnae cordis * 2-3 thicker than right ventricle (higher pressure)

Answer 24

* receives **deoxigentated** blood from: * SVC, IVC * Coronary sinus (collection of coronary veins) * posterior wall is smooth, anterior wall rough (pectinate muscle ridges) * → in between: crista terminalis * fossa ovaries, former opening which closed after birth

Answer 25

* on anterior side of heart * pumps **deoxygenated** blood into pulmonary trunk * **3** papillary muscles + chordae tendinae * hold back the flaps of **tri**cuspid valve * walls with muscular ridges → trabeculae carnae cordis *

Answer 26

→ 4 valves in total, 2 types **caspital valves** * prevent backflow from ventricles into atria during **systole** * anchored by chordae tendineae: * **Tri**cuspid valve: right AV valve * anterior, posterior + septal * **Bi**cuspid valve: left AV valve * anterior + posterior **semilunar valves** * 3 half-moon shaped cusps * aortic valve * left + right + posterior * pulmonary valve * left + right + anterior

Answer 27

**Atria:** * forms during 1st-2nd month of fetal development 1. septum primum * opens when pressure is high in RA 2. septum secundum * has foramen ovale **Ventricles:** * muscular ventricular septum * upper part: membranous VS * separates aortic vestibule from * upper part of right ventricle * lower part of right atrium

Answer 28

→ coronary arteries, arise from ascending aorta **Right coronary artery** * SA nodal artery * Right marginal artery * Posterior interventricular artery * AV nodal artery **Left coronary artery** * Anterior interventricular artery **Circumflex artery** * Left marginal artery **_Veins_** into coronary sinus → right atrium * small cardiac vein * runs with right coronary art. * middle cardiac vein * posterior surface of heart * great cardiac vein * runs with interventricular branch of left coronary art.

Answer 29

→ innervate SA- and AV node and coronary vessels of the heart * Vagus nerve (right and left) * Sensory * Parasymphathetic ( - heartbeat) * Sympathetic nerve (from symp. ganglion) * Sensory * Sympathetic ( + heartbeat)

Answer 30

1. SA node ⇒ cardiac muscle fibers ⇒ atria contract 2. Myogenic conduction ⇒ to AV node 3. AV node ⇒ bundle of His ⇒ AV branches 4. **r****ight**and**left** branches: in interventricular septum 5. at apex: Purkinje fibres innervate ventricle muscle right and left

Answer 31

Cardiomyocytes: * one central nucles * cross striations: quick signal transduction * innervated by autonomic NS → "involuntary striated muscle" * between cells: intercalated discs w/ gap junctions * at the end of fibres: * Fascia adherens * Desmosomes

Answer 32

* **Ascending aorta** * lies in middle mediastinum 1. **Aortic arch** * lies in superior mediastinum * arches over right pulmonary art. * passes downward on left side T4 vertebra 2. **Thoracic aorta** * runs on left side of the vertebral column * passes through aortic hiatus 3. **Abdominal aorta** * ****bifurcates on L4 level into left + right common iliac art.

Answer 33

1. **Aorta: large elastic artery** 1. Tunica intima 2. Subendothelial layer 3. Tunica media * smooth muscle! * collagen fibres * elastic laminae 4. Tunica adventitia * collagen fibres * blood vessels + nerves 2. **Muscular arteries** 1. Tunica intima 2. internal elastic membrane 3. Tunica media 4. External elastic membrane 5. Tunica adventitia

Answer 34

→ venules, small and large veins 1. Tunica intima 2. Tunica media * thin 3. Tunica adventitia * widest layer

Answer 35

* right: from brachiocephalic trunk, inferiorly to clavicle → axillary artery * left: from descending aorta, inferiorly to clavicle → axillary artery

Answer 36

* Vertebral artery * Internal thoracic artery * Thyrocervical trunk * Costocervial trunk * Transverse cervical artery * Dorsal Scapular artery * Axillary artery

Answer 37

→ continuation of descending aorta, becomes abdominal aorta after diaphragm * begins at lower border of T4 vertebra * runs along left side of vertebral column * ends at lower border of T12 vertebra (aortic hiatus) * **posteriorly**: * azygos vein * **anteriorly**: * root of left lung * pericardium * esophagus * diaphragm * **laterally**: * right: hemiazygos vein + thoracic duct * left: pleura + lung

Answer 38

1. **Ascending aorta** * right and left coronary arteries 2. **Aortic arch** * brachiocephalic trunk * left common carotid artery * left subclavian artery 3. **Thoracic aorta** * posterior intercostal arteries * pericardial artery * bronchial arteries 4. **Abdominal aorta** * visceral + parietal branches

Answer 39

* receives blood from all structures superior to diaphragm (exc. heart + lungs) * formed by left and right brachiocephalic vein * receives: * right: azygous vein * left: hemiazygous vein * enters right atrium

Answer 40

* Lumphatic ducts run on right and left side anterior to vertebral column * left lymphatic duct (→ Thoracic duct) drains 75% of body lymph * Lymph nodes and vessels from thoracic cavity drain into **right and left bronchomediastinal trunk** * right bronchomediastinal trunk drains directly into right venous angle * left bronchomediastinal trunk drains into left thoracic duct

Answer 41

* part of the autonomic division of the PNS in posterior mediastinum * two parallel cords, 11 - 12 ganglia, connected to thoracic spinal nerves * Esophagus: * T2-T5→post synaptic axon→esophageal plexus * Trachea & bronchial tree: * post synaptic thoracic branches→pulmonary plexus (bronchial dilation) * Heart: 1. Cervical ganglion: superior,middle,inferior cervical cardiac nerves 2. Thoracic ganglia: thoracic cardiac nerves * make cardiac plexus together

Answer 42

**Recurrent Branches:** * right recurrent laryngeal nerve * left recurrent larnygeal nerve **Branches to the heart:** * superior + inferior cervical cardiac branches * thoracic cardiac branches **Branches to the airways:** * tracheal branches * bronchial branches **Branches to the esophagus:** * esophageal branches * esophageal plexus (ant.+post. vagal trunk)

Answer 43

**Origin: **CN #10, 2x (left + right) **Thoracic inlet: ** * **right**: between right brachiocephalic vein + trunk * **left**: between left brachiocephalic vein + left sublavian artery **(Recurrent laryngeal branches: )** * **right**: below right subclavian artery * **left**: below aortic arch **Posterior Mediastinum:** * behind root of lung → Esophageal plexus **Esophageal hiatus of Diaphragm:** * anterior + posterior vagal trunk

Answer 44

* Superior + Inferior cervical cardiac branches * Thoracic cardiac branches * cardiac branches → cardiac plexus

Answer 45

**Origin:** Cervical plexus, C3-C5, 2x (left + right) **Cervical part:** * anterior to: anterior scalene muscle **Thoracic inlet:** * between: subclavian artery and vein * anterior to: vagus nerve **Thoracic cavity:** * anterior to: root of lung * between: mediastinal pleura and fibrous pericardium * w/ pericardiacophrenic vessels **Sensory terminal branch:** * right phrenicoabdominal branch: Caval opening * left phrenicoabdominal branch: Esophagus hiatus

Answer 46

**sensory:** * fibrous pericardium * mediastinal and diaphragmatic pleura * diaphragm * parietal peritoneum **motor:** * Diaphragm

Answer 47

* external part of nasal cavity * extends nasal c. ventrally, nostrils pointing downwards * vestibule: aperture of each nostril * covered with hairy skin, sebaceous glands, sweat glands → air "filtering" * pyramidal shape, apex in front → consist of cartilage: * lateral processes of septal cartilage (superiorly) * major alar cartilage (antero-inferiorly) * septal cartilage (midline) * 3 - 4 minor alar cartilage (posterio-inferiorly)

Answer 48

* divided in the middle by nasal septum * opens * **anteriorly** through **nostrils** → nose * **posteriorly** through **choanae** → nasopharynx * surrounded by facial bones: * nasal- + frontal bone * ethmoid bone w/ perpendicular plate * maxilla w/ palatine processes * palatine bone * body of sphenoid bone

Answer 49

→ 3 conchae: Formed by ethmoid bone: * superior concha * middle concha Formed by maxilla: * inferior concha → form 4 air channels: * spheno-ethmoidal recess * superior meatus * middle meatus * inferior meatus

Answer 50

1. Ethmoidal sinus (w/ air cells!) * posterior-: → superior nasal meatus * middle-: → middle nasal meatus * anterior-: → middle nasal meatus 2. Frontal sinus * → middle nasal meatus 3. Maxillary sinus * → middle nasal meatus 4. Sphenoid sinus * → sphenoethmoid recess 5. Nasolacrimal duct * → inferior nasal meatus

Answer 51

* lined by **stratified squamous epithelium** * composed of: * olfactory cells * ciliated cells → filtering * goblet cells → mucus secretion * transient immune cells → produce lymphocytes and mast cells * tight junctions between cells prevent materials from entering the tissue!

Answer 52

* organ of voice production * part of respiratory tract between pharyx (Rachen) and trachea (Luftröhre) * acts as sphincter: prevents swallowed material from entering trachea * consists of cartilage, membranes and muslces: * 3 large unpaired cartilages * **Cricoid, Thyroid, Epiglottis** * 3 pairs of smaller cartilages * **Artenoids, Corniculate, Cuneiform**

Answer 53

* hyaline cartilage * right and left lamina * anterior part of larynx (great part) * in men: laryngeal prominence (90°) * superior horn * lateral thyroid ligament - sesamoid cartilage - hyoid bone * inferior horn * cricoid cartilage attached

Answer 54

* elastic cartilage * spoon-shaped, on inferior side * attached to back of thyroid cartilage by thyro•epiglottic ligament

Answer 55

* hyaline cartilage ring * anterior: arch * posterior: lamina * lowest part of larynx IMPORTANT: crico•thyroid ligament → Cricothyrotomy

Answer 56

* elastic + hyaline cartilage * pyramide shape: 1. Apex * cuneiform cartilage * corniculate cartilage 2. Vocal process - anterior * vocal ligament * vocalis muscle 3. Muscular process - posterior * thyro•arytenoid muscle * crico•artenoid muscles

Answer 57

→ attach larynx to the hyoid bone and trachea! 1. Thyro•hyoid membrane, 2. Thyro•hyoid ligament 3. Hyo•epiglottic ligament 4. Thyro•epiglottic ligament 5. Crico•tracheal ligament 6. Crico•thyroid ligament (!) 7. Crico•pharyngeal ligament

Answer 58

→ Divided into 3 parts by **vestibular-** and **vocal folds** 1. **Vestibule** * laryngeal inlet to vestibular folds 2. **Glottis/Rima Glottidis** * vestibular folds to vocal fold 3. **Infraglottic cavity** * part inferior to the vocal fold

Answer 59

* horseshoe-shaped bone * lies in neck on height of C3 vertebrae * consists of body and 2 pairs of greater + lesser horn * attached to thyroid cartilage by thyro•hyoid membrane

Answer 60

* **indirect**: using a mirror, looking down the pharynx * **direct**: head tilted backwards, patient must lie down. Using laryngoscope

Answer 61

1. Crico•thyroid muscle - _superior laryngeal n._ * tightens vocal folds * opens rima glottidis 2. Vocal muscle * tightens vocal folds * closes rima glottidis 3. Thyro•arytenoid muscle * adducts arytenoid cartilages * closes rima glottidis 4. posterior Crico•arytenoideus muscle * adducts vocal folds * **opens** rima glottidis 5. lateral Crico•arytenoideus muscle * adducts vocal folds * closes rima glottidis 6. oblique Arytenoideus muscle

Answer 62

1. from: **Subclavian artery** → * Thyrocervical trunk → * Inferior thyroid artery → * Inferior laryngeal artery 2. from: **External carotid artery** → * Superior thyroid artery → * Superior laryngeal artery

Answer 63

1. from: superior laryngeal vein → * superior/middle thyroid vein → * **internal jugular vein** 2. from: inferior laryngeal vein → * inferior thyroid vein → * **left brachiocephalic vein**

Answer 64

* Nodose-ganglion → Superior laryngeal nerve * **internal** ramus * sensory function * **external** ramus * motor function - cricothyroid muscle * **recurrent** laryngeal nerves * sensory and motor - all muscles * left: under aortic arch * right: under right subclavian artery

Answer 65

* Hyaline cartilge vs. Elastic cartilage (check last semester) * Covering epithilia: * stratified squamous epithelium **without** papillae