Anatomy 2

Question 1

thoracic aorta direction

Answer 1

L T4-T12 behind root -> approach midline -> push eso to R terminating in aortic hiatus

Question 2

thoracic aorta has 3 plane branches vs 3 exceptions

Answer 2

ant midline eso aa, lat L/R bronchial aa (from aorta/post intercostal aa), posterolat post intercostal aa vs paired supraphrenic aa to diaphragm, unpaired pericardial aa to pericardium, unpaired mediastinal aa to LN & post mediastinum

Question 3

eso direction. 3 constrictions?

Answer 3

L T4 thru post mediastinum to eso hiatus at T10. aortic arch, L main bronchus, diaphragm

Question 4

thoracic duct originates & terminates? accessory vs hemi vs azygos originate & terminate?

Answer 4

cisterna chyli -> aortic sinus. 4/5ICS -> azygos T7/8 vs IVC -> azygos T9 vs IVC -> aortic hiatus

Question 5

accessory vs hemi vs azygos vv drain?

Answer 5

tributaries b/w 4-8ICS vs post intercostal vv, inf eso vv, small mediastinal vv vs back, post thoracoabd wall, post intercostal/mediastinal/eso/bronchial vv

Question 6

pulm cavities vs pleural cavities extend to? where is apex of lung? where is pulm lig?

Answer 6

R1 to diaphragm vs to R12. above R1. inf to root

Question 7

describe location of root of R vs L lung

Answer 7

under aortic arch, behind RA vs behind aortic arch, in front of thoracic aorta

Question 8

blood supply vs innerv of trachea. blood supply of bronchiopulm seg

Answer 8

descending branches inf thyroid a, bronchial aa; inf thyroid vv vs parasymp vagus, thoracic splanchnic nn. pulm aa/vv

Question 9

bronchial aa supplies vs vv drains

Answer 9

; branch of thoracic aorta; visceral pleura, lung connective tissue, bronchial tree vs root -> accessory, azygos, sup intercostal vv

Question 10

R upper vs R middle vs R lower lobe has what seg bronchi? bronchus intermedius? L upper lobe has what seg bronchi?

Answer 10

ant/post, apical vs med/lat vs ant/post, med/lat, sup seg that goes to scapula. R mid/lower lobe bronchi. anteromed, lat, post, sup seg

Question 11

complications of endotracheal tube

Answer 11

tube in eso, R main bronchus, pretracheal tissue; kink in pharynx or outside of body; overinflation, rupture, blocked by secretions; disconnected respirator, air leak -> emphysema, pressure nec -> tracheal sten

Question 12

indic vs absolute CI vs relative CI vs complications of bronchoscopy

Answer 12

tube/stent/balloon, anatomy, toxic/gastric aspiration, histo/cyto, cough/hemoptysis, BAL/PsB, trauma, difficult intub, endoluminal tissue removal vs no consent, not enough staff, can’t oxygenate, bx, hemodynamic instab, unctrlled bronchospasm vs uncooperative pt, pulm HTN, hypercapnia, brain injury, recent MI vs brady/tachy, hypoxemia/hypercapnia, H/oTN, pneumothorax, epistaxis, broncho/laryngospasm -> inc airway resistance, fever, cross-contamination

Question 13

quick pharyngeal arch aa summary: 1 vs 2 vs 3 vs 4 vs 5 vs 6

Answer 13

max a vs stapedial a vs carotids vs R subclavian, L aortic arch vs regress vs pulm aa + ductus arteriosus

Question 14

how does ca spread? think great vessels lecture?

Answer 14

contig spread to adjacent tissue. mets by seeding in serous mem, lymph (most ca) -> sentinel LN bx; hematogenous (most sarcomas) -> venous system -> lung/liver mostly

Question 15

portal systems can be venous or arterial. what are they? examples? explain hep circ

Answer 15

blood flow thru 2 capillary beds before returning to heart; no valves -> flow can reverse if high enough pressure. hep, hypothal-pituitary, kidneys. abd viscera & spleen -> portal v -> liver capillaries/hep v -> IVC

Question 16

watershed areas. anatomic variations occur in what type of vessels? common variations include?

Answer 16

area has dual supply by distal branches of 2 lg aa. lymphatics > vv > aa. duplications, common trunk, split trunk