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CPR Exam 1 > 8. Thoracic Angiology > Flashcards

8. Thoracic Angiology Flashcards

1
Q

what is the location & path of the aorta

A

located L side of heart

after L ventricle - tracel superiorly as ascending aorta - then turn L and become arch of aorta - then travel inferiorly as descending thoracic aorta thru the thorax - then go thru aortic hiatus on thoracic diaphragm and travel as abdominal aorta

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2
Q

what are the branches of the ascending aorta

A

R & L coronary As

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3
Q

where does the Right coronary A travel

A

travel anteriorly around heart to post aspect in right AV groove

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4
Q

What are the branches of the right coronary a & what do they supply

A
  1. sinuatrial nodal - to SA node
  2. conus branches - to conus arteriosus
  3. atrial branches - to R atrium
  4. post interventricular A -
    1. (interventricular septal branches supply interventricular septum)
  5. right marginal A -(travel along inf border)
  6. atrioventricular nodal - to AV node
  7. R. posterolateral A - to L ventricle
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5
Q

what A supplies most of the conducting system (AV bundle, R/L bundle branches)?

A

anterior interventricular A (from L coronary)

some by post interventricular A (from R coronary)

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6
Q

What are the branches of the L coronary A

A
  1. Anterior interventricular A - to AV bundle/conducting sys
  2. Circumflex A- travel posteriorly around heart
  3. Left Marginal A- travel along left margin
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7
Q

how does the L coronary A travel

A

off of ascending aorta (behind aortic trunk) traveling superiorly around heart to post aspect

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8
Q

what are the branches of the anterior interventricular A

A
  1. conus branch: conus arteriosus
  2. lateral (diagonal) A - descend alond ant heart
  3. interventricular branches: interventricular septum, AV bundle, R/L bundle branches
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9
Q

what are the branches of the circumflex A

A

post L ventricular A

L marginal A

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10
Q

what surgical technique is used for obstruction of the coronary A

A

coronary A bypass graft

great saphenous V used (bc similar sizes) and placed to bypass the blockage

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11
Q

what is the basics of coronary angioplasty

A

insert small balloon catheter into lumen of coronary A

-inflate ballon to flatten obsturcted plaque against wall & increase size of lumen to improve blood flow

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12
Q

what branches off the arch of the aorta

A

subclavian A

L common carotid A

brachiocephalic trunk

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13
Q

where does the internal thoracic A branch from and how does it travel

A

from subclavian A

travel inferiorly to post aspect of anterior chest wall - btn ribs & transverse thoracic M

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14
Q

what are the 4 branches of the internal thoracic A

A

anterior intercostal A

pericardiacophrenic A

Musculophrenic A (terminal)

superior epigastric A (terminal)

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15
Q

what are the sources of mammary As

A
  1. internal thoracic A perforating branches –> medial mammary
  2. lateral thoracic A–> lateral mammary
  3. Post intercostal A lateral cutaneous branch –> lateral mammary
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16
Q

what are the branches of the axillary A (pertaining to thorax)

A

superior thoracic A - supply 1-2 intercostal spaces & superior most serratus ant M

lateral thoracic A- supply pect major/minor Ms, serratus ant M & intercostal Ms (give off lateral mammary A)

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17
Q

what are the 3 vascular planes that the descending aorta is divided into

A
  1. unpaired vascular branches
  2. paired lateral visceral branches
  3. paired segmental parietal branches
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18
Q

what are the unparied visceral branches

A

mediastinal A - LM of post mediastinum

esophageal A - middle 1/3 esophagus

pericardial A - pericardium

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19
Q

what are the bronchial As

A

= paired lateral visceral branches

R = supply strucutres of hilum of R lung

L =supply strucutres of hilum of L lung

supply bronchi!!!!!

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20
Q

what are the paired segmental As

A

posterior intercostal A (1 of 3 branches = lateral cutaneous A)

subcostal A

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21
Q

what are the branches of the posterior intercostal A

A

doral branch: travel w post ramus of spinal Ns

collateral branch: travel along sup edge of rib inferior to intercostal space (thats why inject in middle of spaces!)

lateral cutaneous A: thru intercostal M to supply skin & subcutaneous tissue of lateral trunk (give off lateral mammary branches)

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22
Q

what is the superior phrenic A

A

comes off before aortic hiatus

doesnt fit into 3 vascular categories

supply thoracic diaphragm

23
Q

what are all the As that supply the thoracic diaphragm

A

musculophrenic A (from internal thoracic)

pericardiacophrenic A (from internal thoracic)

superior phrenic A (from descending thoracic aorta)

24
Q

what is the pul trunk

A

exit heart from R ventricle at superior border -travel towards lungs

-produce R & L pul As

25
Q

What are the branches of the R pul A

& what are the segments of the those branches

A

superior lobular A (segmentals = apical, ant & post)

middle lobular A (segmentals = lateral & medial)

inferior lobular A (segmentals = sup, ant basal, lateral basal, medial basal & post basal)

26
Q

what are the branches of the L pul A

& what are the respective segments

A

superior lobular A (segmentals = apical, ant & lingular)

inferior lobular A (segmentals = sup, anteromed basal, lat basal & post basal)

27
Q

what is it called when a pul A is obstructed

A

pulmonary embolism

could be blood clot, fat globule, air bubble

=cant do gas exchange

28
Q

where do pul Vs start and end

A

begin as intersegmental Vs btn bronchiopul segments

end into L atrium

29
Q

what are the branches of the pul Vs

A

R & L superior/inferior Vs

30
Q

what are the cardiac veins associated with the coronary sinus

A

great cardiac V

middle cardiac V

small cardiac V

31
Q

what is the path for the great cardiac V

A

start on ant aspect of heart btn R & L ventricles - then travel anteriorly btn interventricular A then around heart -travel with circumflex A and empty into coronary sinus

* travels with the ant interventricular A & then circumflex A

32
Q

what is the path for the anterior cardiac Vs

A

anterior surface of heart - cross over R AV groove - empty into R atrium directly

33
Q

what does the small cardiac V travel with

A

around inf border of heart & empty into coronary sinus

travels w/ R marginal A

34
Q

how does the middle cardiac V travel

A

travel w post interventricular A along post aspect of heart btn R & L ventricles & dump into coronary sinuses

35
Q

how are smallest cardiac Vs different from others

A

extremely small with NO VALVES

exist in myocardium -communicate w/ internal chambers of the heart directly

36
Q

what makes up the superior vena cava

A

union of R & L brachiocephalic Vs & azygos Vs

37
Q

what forms the inferior vena cava

A

union of R & L common iliac V

-travel thru abd thru vena caval foramen of thoracic diaphragm then into R atrium

38
Q

what is the azygous venous complex

A

3 Vs that fill in the gap that sup & inf vena cava dont cover

  1. azygous V
  2. hemiazygous V
  3. accessory hemiazygous V
39
Q

what does the azygous V drain

A

R post intercostal V (travel with post intercostal A in costal groove & meet w/ sup vena cava)

40
Q

what do the hemiazygous & accessory hemiazygous Vs do?

A

hemiazygous V: drain left lower posterior intercostal V

accessory hemiazygous V: drain left upper post intercostal V

both: communicate w/ azygous V via communicating branches

41
Q

what is the function of the thoracic duct

A

originate as chyle cistern in abd

drain:

  1. LE, Pelvis, Abd
  2. left 1/2 thorax
  3. L UE
  4. L head/neck
  5. in thorax - drains subclavian lymphatic trunk & bronchomedistinal trunk
42
Q

where does the thoracic duct empty

A

venous system at

jxn of L. internal juglaur V

& L . subclavian V

43
Q

what drains the cranial and cervical LNs

A

jugular trunk

44
Q

how does the subclavian trunk drain the UR & axilla

A

via axillary lymphatic plexus

45
Q

what does the lymphatic duct drain

A

subclavian lympathic trunk

bronchomediastinal trunk

-empty into brachocephalic V

46
Q

what does the bronchomediastinal trunk drain

A

LNs:

parasternal

paratracheal

paraesophageal

sup phrenic

brachiocephalic

47
Q

what is the primary lymphoid organ

A

thymus

located in anterior superior mediastinum

gradually replaced by fat after puberty

48
Q

what are the axillary LNs

(associated w/ breast cancer)

A
  1. pectoral
  2. interpectoral
  3. deltopectoral
  4. supraclavicular
  5. inf deep cervical
49
Q

where do axillary LNs empty

A

subclavian lymphatic trunk –> then R lymphatic duct or thoracic duct

50
Q

what does the parasternal LNs drain

A

subareolar lymphatic plexus

parietal pleura

thymus

(empty into bronchomediastinal trunk then R lymphatic trunk/thoracic duct)

51
Q

what do tracheobronchial LNs drain & where do they empty

A

bronchopul LNs

subepicardial lymphatic plexus

empty into bronchomediastinal trunk

52
Q

what doe the bronchopul LNs drain

A

lympathic plexuses of lung

  • superficial - superficial lung & visceral pleura
  • deep - deep lung & bronchi
53
Q

what do anterior mediatinal LNs drain

A

parietal pleura

54
Q

what do post mediastinal LNs drain

A

parietal pleura

esophagus

post. pericardium

thoracic diaphragm

middle post intercostal space

CPR Exam 1 (27 decks)

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