ANATOMY Flashcards

1
Q

What are the 6 functions of the thorax?

A
  • protection
  • rigidity
  • elasticity
  • locomotion
  • haematopoiesis
  • respiration
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2
Q

Which of the transverse and sagittal diameter of the thorax is the largest?

A

transverse

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3
Q

What makes the rib cage?

A

sternum + 12 pairs of ribs and their costal cartilages + 12 thoracic vertebrae and intervertebral discs

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4
Q

What makes the thoracic wall?

A

thoracic cage
+ skin
+ subcutaneous tissue
+ thoracic muscles (pectoralis major, pectoralis minor, serratus anterior, serratus posterior inferior, serratus posterior superior) and fascia
+ intercostal muscles (external, internal and innermost intercostal muscles)
+ mammary gland and breast tissue

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5
Q

How do thoracic vertebrae limit movement?

A

superior and inferior facets are vertical and face slightly medially –> allow some rotation but no flexion

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6
Q

What are the three kind of ribs and their number?

A

TRUE: 1-7
FALSE: 8-10
FLOATING: 11-12

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7
Q

Which are the typical ribs? What are their features?

A

3-10

  • head with a ridge and two articular half-facets
  • neck
  • tubercle with an articular facet
  • body/shaft
  • costal angle
  • costal groove
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8
Q

What are the features of rib 1?

A
  • scalene tubercle
  • groove for subclavian vein
  • groove for subclavian artery
  • single facet on head (no ridge)
  • no costal groove
  • shortest
  • deep
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9
Q

What is the specificity of rib 2?

A

tuberosity for serratus anterior

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10
Q

What are the features of floating ribs?

A
  • sharp ends
  • only one round head with no ridge
  • no tubercles
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11
Q

Name the three parts of the sternum.

A

manubrium, body, xiphisternum

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12
Q

How does the body of the sternum develop?

A

from 4 pieces of cartilage that ossify

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13
Q

Name 6 structures at the level of the sternal angle.

A
  • 2nd costal cartilage
  • intervertebral disc between T4 and T5
  • proximal and distal boundaries of aortic arch
  • bifurcation of the trachea
  • SVC entering the heart
  • superior limit of the pulmonary trunk
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14
Q

What is the solar plexus region?

A

most anterior part of the T6 dermatome

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15
Q

Describe the costovertebral joints of rib 2. Which rib(s) have the same arrangement?

A

articulates with superior costal facet of its corresponding vertebra and with the inferior facet of the vertebra above

synovial joint with ligaments

rib 3-10

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16
Q

Describe the number of facets for costovertebral joints on the left side of the body of vertebrae 1 to 12.

A

1 –> one full + one half (inferior)
2-9 –> 2 half
10 –> 1 half (superior)
11-12 –> 1 full

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17
Q

Which rib(s) do not have a costotransverse joint?

A

11 and 12

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18
Q

What type of joints are sternochondral joints?

A

synovial

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19
Q

What type of joints are costochondral joints?

A

primary cartilaginous (hyaline)

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20
Q

Which ribs have horizontal costal cartilage?

A

1 to 4

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21
Q

Name the boundaries of the thoracic inlet.

A

T1 vertebra + 1st rib and its costal cartilage + manubrium

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22
Q

What is the level of the most anterior part of the thoracic inlet?

A

T2/T3 intervertebral disc

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23
Q

Name the structures that pass between the thorax and the neck.

A
  • vessels that supply and drain the head and neck
  • trachea
  • oesophagus
  • vagus nerve
  • recurrent laryngeal nerves
  • phrenic nerves
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24
Q

Name the structures that pass between the thorax and the upper limb.

A
  • subclavian vein
  • subclavian artery
  • inferior trunk of the brachial plexus
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25
Q

What are the boundaries of the thoracic outlet?

A
  • T12 vertebra
  • 11th and 12th ribs
  • costal cartilages of ribs 7-10
  • xiphoid process
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26
Q

What are the four main structures to pass from the thorax to the abdomen through the diaphragm?

A
  • aorta
  • inferior vena cava
  • oesophagus
  • phrenic nerve
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27
Q

Define Montgomery glands and tubercles.

A

MONTGOMERY GLANDS
sebaceous glands in the breast

MONTGOMERY TUBERCLES
the visible portions of Montgomery (areolar) glands on the skin surface within the areola

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28
Q

What is the position of the breast in adult females?

A

between the 2nd and the 6th or7th rib

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29
Q

How far could the axillary process of the breast extend to?

A

the apex of the axilla

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30
Q

Which muscles (excluding intercostals) are found underneath the breast?

A
  • pectoralis major
  • serratus anterior
  • external oblique muscles
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31
Q

How do you call the condensations of connective tissue in the breast that connects the deep fascia to the dermis?

A

Cooper’s ligaments = suspensory ligaments of the breast

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32
Q

Define retromammary space.

A

layer of loose connective tissue between the deep layer of superficial fascia and the deep fascia

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33
Q

Which are the two main vessels that provide vascular supply to the breast and how?

A
  • internal thoracic artery (through mammary branches and anterior intercostal arteries)
  • axillary artery (through the lateral thoracic and thoracoacromial branches)
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34
Q

Explain the lymph drainage of the breast.

A

AREOLA + LATERAL QUADRANTS
axillary lymph nodes

MEDIAL QUADRANTS
parasternal lymph nodes and opposite breast

INFERIOR QUADRANTS
inferior phrenic lymph nodes

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35
Q

Which ribs are most commonly fractured?

A

3-10

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36
Q

Name 4 complications of rib fractures.

A
  • haemothorax
  • pneumothorax
  • pulmonary injury
  • splenic injury
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37
Q

In which direction do external intercostal fibers pull? What are the 2 functions of this muscle?

A

pull upwards

  • prevent indrawing of ribs during inspiration
  • aid inspiration
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38
Q

Where would you find the external intercostal membrane?

A

anteriorly

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39
Q

In which direction do internal intercostal fibers pull? What are the 2 functions of this muscle?

A

pull downwards

  • prevent indrawing of ribs during inspiration
  • aids elastic recoil at (forced) expiration
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40
Q

Where would you find the internal intercostal membrane?

A

posteriorly

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41
Q

Name three other intercostal muscles, and give their general function.

A
  • innermost intercostal
  • transversus thoracis
  • subcostalis

aid forced expiration

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42
Q

The rule is that anterior rami of the thoracic spinal nerves do not form nerve plexuses and maintain their segmental orientation to become intercostal nerves. What are the exceptions?

A

T1 and lateral cutaneous branch of T2

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43
Q

What lies in the costal groove, from superior to inferior? Between which muscles are they situated?

A

Intercostal VAN:
Vein
Artery
Nerve

between internal and innermost intercostal muscles

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44
Q

What nerves, other than the intercostal ones, also supply the thoracic wall?

A

supraclavicular nerves (C3-4)

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45
Q

Which intercostal nerve has no cutaneous distribution over the thorax wall? What does it then supply?

A

T1

motor to intercostal muscles and small muscles of the hand

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46
Q

Which nerve is at risk in breast surgery?

A

T2

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47
Q

What else than the thorax wall do T7 to T12 supply?

A

skin and muscles of the abdominal wall

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48
Q

What do the ventral rami of T2-T11 supply in the thoracic wall?

A
  • motor to intercostal muscles
  • sensory to skin and parietal pleura
  • carry sympathetics
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49
Q

At what level do the hemiazygos and accessory hemiazygos veins respectively usually cross?

A

Hemiazygos –> T9

Accessory hemiazygos -> T8

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50
Q

Where is located the beginning of the superior hemiazygos vein?

A

left 4th intercostal space

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51
Q

Which nodes receive lymph from the thorax wall first?

A

anteriorly: parasternal nodes
posteriorly: intercostal nodes

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52
Q

Give the 5 main functions of the cardiovascular system.

A
  • bulk flow of materials
  • temperature regulation
  • homeostasis
  • host defense
  • reproduction
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53
Q

Give two intermediates by which the CNS affects regulation and integration of the cardiovascular system.

A
  • autonomic nerves

- hormones

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54
Q

How much of the blood is respectively found in: the heart, the systemic circulation, and the pulmonary circulation at one time?

A

HEART 7%
SYSTEMIC 84%
PULMONARY 9%

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55
Q

Some vessels are called conductants, and other capacitants. Which are they?

A

conductants - arteries

capacitants - veins

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56
Q

At rest, how much blood is pumped every minute by the heart?

A

5L/min

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57
Q

Give 6 features of blood vessels that can vary, and one common feature to all.

A

VARIES

  • number
  • diameter
  • wall thickness
  • smooth muscle
  • elastic tissue
  • fibrous tissue

COMMON
endothelial lining

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58
Q

Compare the diameter of the aorta, to that of an arteriole, a capillary, a venule and the vena cava.

A
AORTA 25mm
ARTERIOLE 30microns
CAPILLARY 8 microns
VENULE 20 microns
VENA CAVA 30mm
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59
Q

Which of arteries and veins have the most compliance?

A

Veins

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60
Q

What group of organs receives the most blood flow at rest, and which group receives the least?

A

THE MOST: abdominal organs

THE LEAST: heart

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61
Q

What percentage of filling of the ventricle with blood is caused by active contraction of the atrium?

A

20%

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62
Q

What is the role of chordae tendinae?

A

active competence = prevent eversion of the atrioventricular cusps

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63
Q

What types of valves are the aortic and pulmonary valves?

A

tricuspid semilunar valves

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64
Q

Which valve out of the mitral valve and the aortic valve, is the most subject to stress and abrasion? Why?

A

Aortic: smaller opening with higher pressure

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65
Q

What are the respective roles of desmosomes and gap junctions in cardiac muscle?

A
DESMOSOMES
secure adhesion (mechanical)
GAP JUNCTION
electrical connectivity (functional)
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66
Q

Give 4 features of cardiac cells.

A
  • striated
  • connected via intercalated discs
  • electrical connection through gap junctions
  • desmosomes
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67
Q

What are the 4 means of conduction in cardiac muscle?

A
  • functional syncitium
  • conduction network
  • pacemaker activity
  • autonomic innervation
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68
Q

What percentage of cardiac fibers form the excitatory and conductive muscle fibers?

A

1%

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69
Q

What muscles lie on either side of the sternal notch?

A

left and right sternocleidomastoid

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70
Q

At what level does the sternal notch lie? What about the xiphisternal joint?

A

STERNAL NOTCH
T2/T3 intervertebral disc

XIPHISTERNUM
T8/T9 intervertebral disc

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71
Q

Respectively, at which dermatome do each of the sternal angle, the xiphisternal joint, the umbilicus and the suprapubic region lie?

A

STERNAL ANGLE: C5
XIPHISTERNAL JOINT: T6
UMBILICUS: T10
SUPRAPUBIC REGION: T12

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72
Q

What is the name of the membrane that separates the thoracic cavity from the neck? Where does this membrane attach to?

A

suprapleural membrane

attaches to the bones of the thoracic inlet

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73
Q

Name the two muscles that lie on either side of the trachea.

A
  • sternohyoid

- sternothyroid

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74
Q

Which thoracic spinous process is most palpable?

A

T1

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75
Q

What is the point of greatest weakness of the rib?

A

angle of the rib

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76
Q

What are the two parts of a typical rib’s tubercle?

A
  • articular facet for articulation with the transverse process of its corresponding vertebra
  • roughened attachment of the lateral costotransverse ligament
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77
Q

What is the level of the manubrium? What about of the body of the sternum?

A

MANUBRIUM
T3 to T4

BODY OF STERNUM
T5 to T9

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78
Q

Why may the body of the sternum be perforated?

A

It develops as two halves that join together

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79
Q

By what age does the xiphisternum ossify?

A

40 years old

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80
Q

For which rib is the sternal angle a landmark?

A

rib 2

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81
Q

List the 3 major types of blood vessels.

A
  • arteries
  • capillaries
  • veins
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82
Q

Name the 3 layers and 2 partitions of a basic blood vessel.

A
  • tunica intima
  • tunica media
  • tunica adventitia
  • internal elastic lamina
  • external elastic lamina
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83
Q

Highlight the difference in tissue contents between muscular and elastic arteries.

A

ELASTIC ARTERY

  • smooth muscle > elastic tissue > fibrous tissue
  • elastic tissue = ~2/3 smooth muscle tissue
  • fibrous tissue = ~1/3 smooth muscle tissue

MUSCULAR ARTERY

  • smooth muscle > fibrous tissue > elastic tissue
  • elastic tissue = ~1/5 smooth muscle tissue
  • fibrous tissue = ~2/3 smooth muscle tissue
84
Q

Give the internal radius of the aorta, an arteriole, the vena cava and a venule.

A

AORTA 12mm
ARTERIOLE 15 micrometers
VENULE 10 micrometers
VENA CAVA 15mm

85
Q

Which body cavity is not lined by a serous membrane?

A

cranial cavity

86
Q

What is the name of the membrane that lines the pelvic cavity?

A

peritoneum

87
Q

What are the three compartments of the thoracic cavity?

A
  • left pleural cavity
  • right pleural cavity
  • mediastinum
88
Q

What 4 structures is the parietal pleura attached to?

A
  • thorax wall
  • cervical fascia at thoracic inlet
  • fibrous pericardium
  • diaphragm
89
Q

Define mediastinum.

A

space between the two pleural sacs, the sternum and costal cartilages, thoracic vertebrae and diaphragm

90
Q

What 4 structures have movement that would not be possible if the mediastinum didn’t accommodate volume and pressure changes?

A
  • diaphragm
  • ribcage
  • heart
  • major vessels
91
Q

What separates the superior from the inferior mediastinum?

A

angle of Louis

92
Q

What are the structures on the right of the mediastinum? What do they have in common?

A
  • SVC
  • arch of azygos
  • IVC

related to right atrium

93
Q

What are the structures on the left of the mediastinum? What do they have in common?

A
  • left common carotid artery
  • left subclavian artery
  • arch of aorta
  • thoracic aorta

related to left ventricle

94
Q

What are the contents of the middle mediastinum?

A
  • heart
  • pericardium
  • origin of great vessels
  • pulmonary veins
  • phrenic nerve
  • vagus nerve
95
Q

What is the pericardium? Give two functions.

A

fibroserous sac that encloses the heart and the roots of the great vessels

  • anchoring the heart
  • preventing overfiling of the heart
96
Q

Describe the layers of pericardium.

A

EXTERNAL TO INTERNAL

  • fibrous pericardium
  • serous pericardium –> parietal layer and visceral (epicardium) layer
97
Q

What does the fibrous pericardium attach to?

A
  • adventitia of great vessels
  • body of sternum (sternopericardial ligament) + 3rd and 6th costal cartilages
  • 5th and 8th thoracic vertebrae (pericardiovertebral ligaments)
  • central tendon of diaphragm (pericardiophrenic ligament)
98
Q

WHy does the pericardiophrenic ligament halt the descent of the diaphragm during inspiration?

A

If not, diaphragm would pull ribs inside (eversion) and that would disrupt the respiratory biomechanisms

99
Q

How much pericardial fluid is there in the pericardial cavity?

A

10-15mL

100
Q

Give 6 symptoms of pericardial tamponnade.

A
  • tachycardia
  • decreased BP
  • tachypnea
  • distended jugular veins + enlarged cervical veins
  • fear/panic
  • distant heart sounds
101
Q

What are the two sinuses of the heart and what are their clinical significance?

A

TRANSVERSE SINUS
separates arterial and venous ends of the heart tube

OBLIQUE PERICARDIAL SINUS
potential space, no significance

102
Q

Name the 3 nerves that innervate the pericardium.

A
  • phrenic
  • vagus
  • cardiopulmonary splanchnic
103
Q

What are the root values of the phrenic nerve? What does it innervate?

A

C3-5

  • pericardium
  • diaphragm
104
Q

In the middle mediastinum, where would you find the phrenic nerve?

A

between the fibrous pericardium and the parietal pleura

105
Q

Where would the referred pain from the phrenic nerve be found?

A

back of neck, supraclavicular region, shoulder tip

106
Q

What is the other name for the anterior mediastinum?

A

prevascular compartment

107
Q

Give the boundaries, and then the contents, of the anterior mediastinum.

A

BOUNDARIES

  • sternal body and xiphisternum
  • pericardium
  • lungs with pleura
CONTENTS
- thymus
- internal mammary vessels
- lymph nodes
- connective tissues
- fat cell tissue
(- lower pole of thyroid and ectopic parathyroid)
108
Q

Which 8 structures is the thymus related to?

A
  • pericardium
  • SVC
  • aorta
  • left brachiocephalic vein
  • right brachiocephalic vein
  • pleura
  • phrenic nerves
  • trachea
109
Q

Between which two structures can the thymus extend?

A
  • jugular notch

- 4th costal cartilage (sometimes down to aortic arch)

110
Q

What are the 3 planes of the superior mediastinum?

A
  • venous
  • arterial
  • visceral
111
Q

At what level does the pulmonary trunk divide into its branches?

A

intervertebral disc between T4 and T5

112
Q

Give 5 posterior relations to the manubrium.

A

STERNOCLAVICULAR JOINT

  • IJV and subclavian joint to make brachiocephalic vein
  • brachiocephalic trunk divides to its branches on the right side

1st RIGHT COSTAL CARTILAGE
- right and left brachiocephalic veins join to form the SVC

2nd RIGHT COSTAL CARTILAGE
- azygos vein joins SVC

3rd RIGHT COSTAL CARTILAGE
- SVC enters right atrium

113
Q

What level is the aortic hiatus?

A

T12

114
Q

Name 5 types of visceral branches of the thoracic aorta, and one type of parietal branches.

A

PARIETAL
posterior intercostal arteries (3 to 12)

VISCERAL

  • oespohageal
  • bronchial
  • pericardial
  • mediastinal
  • superior phrenic
115
Q

What are the levels between which you may find the carina of the trachea?

A

T4 and T6

116
Q

At what level does the pharynx become the oesophagus? What is the landmark?

A

C6

inferior border of cricoid cartilage

117
Q

To which structure is the oesophagus related in the inferior mediastinum?

A

left atrium

118
Q

At which level does the oespohagus pass through the diaphragm?

A

T10

119
Q

What are the 4 constrictions of the oesophagus?

A
  • upper oesophagus sphincter
  • arch of aorta
  • left main bronchus
  • diaphragm
120
Q

Why can cirrhotic liver lead to oesophageal varices?

A

lower third of oesophagus drains to left gastric vein, which is part of the portal system + anastomoses between lower and middle thirds of oesophagus

cirrhotic liver –> portal hypertension –> varices in oesophagus

121
Q

Where would you find superior and inferior tracheobronchial lymph nodes?

A

around trachea and oesophagus

122
Q

Where does the lymph in the bronchomediastinal lymph trunks come from?

A
  • parasternal lymph nodes
  • paratracheal lymph nodes
  • anterior mediastinal lymph nodes
123
Q

What are the start and end points of the thoracic duct?

A

START cisterna chyli

END Pirogoff’s angle

124
Q

What is the particularity of vertebral bodies T5 and T8?

A

flattened on their left flank by aorta

125
Q

What is the innervation of serratus anterior?

A

C5-C7

126
Q

What can you say about the tips of the floating ribs?

A
  • cartilaginous

- sharp

127
Q

What are the names of the 3 openings through the diaphragm?

A
  • aortic hiatus
  • oesophageal hiatus
  • caval foramen
128
Q

What part of the thoracic vertebra links the body to the laminae?

A

the pedicles

129
Q

Give pulmonary and systemic BP ranges.

A

PULMONARY
12-16mmHg

SYSTEMIC
70-120mmHg

130
Q

Where would you find the apex of the heart in adults?

A

5th intercostal space, 8-10cm of the midline

131
Q

What is the level of the base of the heart? Which chambers/vessels make the base?

A

left atrium + pulmonary veins

T5-T8 or T6-T9

132
Q

What makes the sternocostal and diaphragmatic surfaces of the heart respectively?

A

STERNOCOSTAL
right ventricle + right atrium (+ left ventricle)

DIAPHRAGMATIC
left ventricle + right ventricle

133
Q

What structure separates the base of the heart from its diaphragmatic surface?

A

coronary sinus

134
Q

What respectively makes the right, left and inferior margins of the heart on an X-ray?

A

RIGHT
right atrium

LEFT
left ventricle + left auricle

INFERIOR
right ventricle (+left ventricle)
135
Q

Which structures are contained within the anterior interventricular sulcus?

A
  • great cardiac vein

- anterior interventricular artery

136
Q

To which part of the heart does the apex belong?

A

left ventricle

137
Q

Which structures are contained within the posterior interventricular sulcus?

A
  • middle cardiac vein

- posterior interventricular artery

138
Q

Which structures are contained within the coronary sulcus?

A
  • right coronary artery
  • coronary sinus
  • left circumflex artery
  • left coronary artery
139
Q

Where does the blood in the right atrium come from?

A
  • SVC
  • IVC
  • smallest cardiac veins
  • coronary sinus
140
Q

What are the name of the two regions of the atrium? Which one has smooth walls? What is the name of the boundary?

A
  • sinus of vena cava –> smooth walls
  • right auricle (atrium proper)

boundary: crista terminalis

141
Q

What is the name of the muscles found in the right atrium? What is their function?

A

pectinate muscles

some power of contraction for emptying atrium without thickening the cardiac wall

142
Q

What is the name of the margin of fossa ovalis?

A

limbus fossae ovalis

143
Q

What is the only vessel that opens into the right atrium with a valve?

A

cardiac sinus

144
Q

What is the wall thickness of the right ventricle?

A

3-4cm

145
Q

What is the direction of the bloodflow out of the right ventricle?

A

upwards, backwards and to the left

146
Q

Why is the surface of the right infundibulum smooth?

A

to facilitate laminar flow –> risk of clot if turbulent

147
Q

Name the 3 types of muscles found in the right ventricle? Which one is also found in the atria? Which one is not found in the left ventricle?

A
  • trabecular carnea –> also in atria
  • septomarginal trabecula –> only in right ventricle
  • papillary muscles
148
Q

What is the function of the moderator band?

A

carries right branch of the bundle of His

149
Q

True or false: “chorda tendinea from one papillary muscle attach to more than one cusp”

A

TRUE

150
Q

Name the respective cusps of the tricuspid, pulmonary, mitral and aortic valves.

A

TRICUSPID

  • anterior
  • posterior
  • septal

PULMONARY

  • anterior
  • right
  • left

MITRAL

  • anterior
  • posterior

AORTIC

  • right
  • left
  • posterior
151
Q

Name 2 features of the pulmonary valve cusp

A
  • pulmonary sinus

- nodule on free edge

152
Q

In which direction does the blood flow through the tricuspid valve?

A

forwards and medially

153
Q

In which direction does the blood flow through the mitral valve?

A

anteriorly

154
Q

In which direction does the blood flow through the aortic valve?

A

upwards, backwards and to the right

155
Q

Give the wall thickness of the left ventricle.

A

8-12mm

156
Q

Give one other name for aortic sinuses.

A

sinus valsalvae

157
Q

Describe the fibrous skeleton of the heart.

A
  • 4 fibrous rings with connecting areas

- two trigones

158
Q

Give the 3 functions of the fibrous skeleton of the heart.

A
  • point of attachment for the cusps
  • attachment for atrial and ventricular muscles
  • insulates the atria from the ventricle
159
Q

What are the three layers of the cardiac wall? How is each one supplied with blood?

A

ENDOCARDIUM
blood from the chambers

MYOCARDIUM
EPICARDIUM
blood from the coronary arteries

160
Q

Give the positions of the four corners of the heart.

A
  • right 3rd costal cartilage, 2cm right of the midline
  • right 6th costal cartilage, 2cm right of the midline
  • left 5th costal cartilage, 7-9cm of the midline
  • left 2nd costal cartilage, 3cm left of the midline
161
Q

Give the positions of the surface projections of valves of the heart.

A

TRICUSPID
behind right half of sternum, at 4th intercostal space

MITRAL
posterior to left 4th sternocostal joint

PULMONARY
posterior to left 3rd sternocostal joint

AORTIC
posterior to sternum at level of 3rd intercostal

162
Q

Why would you hear a third heart sound?

A

rapid filling of the ventricle

163
Q

Which nerve innervates both pectoralis major and pectoralis minor?

A

medial pectoral nerve

164
Q

What is the innervation of serratus anterior?

A

long thoracic nerve

165
Q

What is the orientation of external intercostal fibres? Where is its membrane?

A

inferiorly and medially

Anteriorly, medially (hands in front pockets)

166
Q

What are the 2 columns the head sits on?

A
  • neuro-musculo-skeletal column

- visceral column

167
Q

Name the 6 types of fascia found in the neck.

A
  • investing fascia
  • prevertebral fascia
  • carotid sheath
  • alar fascia
  • pretracheal fascia
  • buccopharyngeal fascia
168
Q

Name three muscles of the floor of the mouth that have potential spaces between them.

A
  • genioglossus
  • geniohyoid
  • mylohyoid
169
Q

Name one important potential space responsible for transmission of infection from the larynx to the thorax.

A

retropharyngeal space

170
Q

Which two fascia in the neck enclose the same compartment?

A

buccopharyngeal and pretracheal

171
Q

What is the name of the notch in which the transverse process of the atlas is situated? What structure covers it?

A

Parotid angle

parotid gland

172
Q

What is the name of the foramen cranial nerve go through to leave the cranial cavity?

A

stylomastoid foramen

173
Q

Give the borders of the anterior and posterior triangles of the neck.

A

ANTERIOR
sternal notch, anterior border of sternocleidomastoid, jaw, anterior midline of head

POSTERIOR
- posterior border of sternocleidomastoid, clavicle, anterior border of trapezius

174
Q

Name two categories of muscles attached to the hyoid, that are involved in speech and swallowing.

A
  • suprahyoid

- infrahyoid

175
Q

Give the two functions of the thyroid cartilage.

A
  • muscle attachment

- supports the vocal folds

176
Q

At what level does the common carotid artery bifurcates?

A

superior margin of thyroid cartilage

177
Q

What are the two sensors located near the carotid bifurcation?

A
  • carotid body (chemoreceptor for pCO2)

- carotid sinus (baroreceptor)

178
Q

What region does the internal carotid artery supply?

A

intracranial structures

179
Q

Name the 8 main branches of the external carotid artery, from proximal to distal.

A
  • superior thyroid
  • lingual
  • ascending pharyngeal
  • facial
  • occipital
  • posterior auricular
  • maxillary
  • superficial temporal
180
Q

Name the two veins of the face, 5 veins of the cranium and the 4 cervical veins.

A

FACIAL

  • superficial facial veins
  • deep facial veins

CRANIAL VEINS

  • cerebral veins
  • cerebellar veins
  • dural venous sinuses
  • diploic veins
  • emissary veins

CERVICAL VEINS

  • external jugular veins
  • internal jugular veins
  • anterior jugular veins
  • vertebral veins
181
Q

What is the proximal part of the dural venous sinuses called?

A

sigmoid sinus

182
Q

What is the largest vein of the neck?

A

internal jugular

183
Q

What 3 nervous structures lie in very close proximity to the internal jugular vein?

A
  • brachial plexus
  • phrenic nerve
  • vagus nerve
184
Q

What is the normal upper limit of central venous pressure?

A

8cm H2O

185
Q

What is the level of the jugular venous pulse wave in healthy people?

A

behind sternoclavicular joint

186
Q

Which 3 veins join to make the external jugular vein?

A
  • superficial temporal
  • maxillary vein
  • posterior auricular vein
187
Q

In which category of patients is used for venous access?

A

babies

188
Q

What is the major risk in placing a central line in the external jugular vein?

A

air embolism

189
Q

Which veins join to make the jugular venous arch?

A

left and right anterior jugular veins

190
Q

What is Erb’s point?

A

point at which the cutaneous branches of the cervical plexus emerge posterior to sternocleidomastoid and pass adjacent to the external jugular vein

191
Q

What is the highest centre of the autonomic nervous system?

A

hypothalamus

192
Q

What are the three functions of the ANS?

A
  • to regulate visceral activity
  • to regulate body temperature
  • to provide a path for visceral afferent nerves to follow
193
Q

Which nerve is responsible for parasympathetic innervation of thoracic viscera?

A

vagus ( cranial X)

194
Q

Through which foramen does the vagus nerve exit the cranial cavity?

A

jugular foramen

195
Q

What does the recurrent pharyngeal nerves primarily suppy?

A

laryngeal muscles

196
Q

Where do postganglionic cell bodies of the sympathetic nerves lie?

A
  • paravertebral sympathetic ganglia

- prevertebral sympathetic ganglia

197
Q

Describe the paravertebral ganglia organisation.

A

ON EACH SIDE

1 for C1-C4, 1 for C5-C6, 1 for C7-C8 (sometimes T1 - stellate ganglion), 1 for each vertebra after that

198
Q

What are the 4 pathways a sympathetic neuron can take?

A
  • synapse in ganglion at same level
  • synapse in a cervical ganglion by traveling up the trunk
  • synapse in a lumbar/sacral ganglion by traveling down the trunk
  • pass through trunk without synpasing (splanchnic nerves and sympathetics to adrenal medulla)
199
Q

What are the values of the splanchnic nerves?

A

GREATER T5-9
LESSER T10-T11
LEAST T12

200
Q

Which sympathetics respectively supply the head, the upper limbs, the thoracic/abdominal walls and the lower limbs?

A

HEAD T1-3
UL T4-6
THORAX AND ABDOMEN T1-T12
LL T12-L2

201
Q

What are the 3 visceral autonomic plexuses in the thorax?

A
  • cardiac
  • oesophageal
  • pulmonary
202
Q

Give 4 symptoms of Horner’s syndrome.

A
  • ptosis
  • miosis
  • anhydrosis
  • flushing of face
203
Q

At what respective levels do the oesophagus, IVC and aorta cross the diaphragm?

A

oesophagus: T10
IVC: T8
aorta: T12

204
Q

What structures pass through the aortic hiatus?

A

aorta, azygos vein and thoracic duct

205
Q

Where would you find the sympathetic trunks?

A

in the paravertebral gutters

206
Q

What type of fibers compose the splanchnic nerves?

A

preganglionic sympathetic fibers