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anatomy: cardiorespiratory Flashcards

1
Q

how do you determine the location of specific ribs

A

palpate the jugular notch
move down the sternum until a ridge is felt (sternal angles)
second rib is lateral to sternal angle

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2
Q

how to determine the fourth intercostal space in men

A

location of the nipple is usually in the fourth intercostal space

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3
Q

where does the trachea bifrucates split

A

at the t4/5 vertebral level (in line with the sternal angle)

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4
Q

line coming down from centre of clavical

A

midclavicular line

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5
Q

line coming down from the mid point of the armpit

A

midaxillary line

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6
Q

where is the apex of the heart

A

where the midclavicular line crosses the 5th intercostal space on the LHS

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7
Q

where are aortic valve sounds heard

A

2nd intercostal space at right sternal margin

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8
Q

where are pulmonary valve sounds heard

A

2nd intercostal space at left sternal margin

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9
Q

where are mitral valve sounds heard

A

over heart apex (5th intercostal space) in line with middle of clavical

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10
Q

where are tricuspid valve sounds heard

A

right sternal margin of 5th intercostal space

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11
Q

where are the oblique fissures

A

start at 4th rib at the back
travel deep to the 5th rib
and end at the 6th costal cartilage at the front

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12
Q

what do the oblique fissures do

A

separate the lower lobe from the upper lobe on the left and the lower lobe from the middle and upper lobes on the right

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13
Q

where is the horizontal fissure

A

at the level of the 4th costal cartilage

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14
Q

what does the horizontal fissure do

A

separates the upper from the middle lobe in the right lung

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15
Q

inferior extent of the lungs

A

6th rib anteriorly
8th rib laterally
10th rib posteriorly

{6,8,10- ALPHABETICAL ORDER}

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16
Q

what is the parietal pleura

A

a serous membrane which extends below the lungs and forms the costo-diaphragmatic recesses

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17
Q

extent of recess

A

8th rib anteriorly
10th rib laterally
12th rib posteriorly

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18
Q

why is bronchoconstriction useful when you sleep

A

reduced volume of air in lungs and hence reduces the effort needed to breathe

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19
Q

number of bronchopulmonary segments in each lung

A

right- 10

left- 9-10

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20
Q

what supplies oxygenated blood to the lungs

A

bronchial artery (x1) and pulmonary veins (x4)

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21
Q

what removes deoxygenated blood from the lungs

A

pulmonary arteries (x2) and bronchial veins (x4)

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22
Q

what is the pleural cavity

A

the space between the parietal pleura and the visceral pleura containing a thin layer of serous fluid

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23
Q

what does serous fluid do

A

sticks the surface of the lung to the inside of the chest

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24
Q

term used to describe anterior ends of ribs moving upwards

A

pump handle

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25
Q

term used to describe lateral ends of ribs moving outwards

A

bucket handle

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26
Q

inspiration

A

external intercostals contract
diaphragm contracts
chest wall and lungs expand
expansion of ribs moves sternum up and out

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27
Q

route of right phrenic nerve

A

runs adjacent to the right brachiocephalic vein and superior vena cava, posterior to the root of the right lung

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28
Q

route of left phrenic nerve

A

runs over the arch of the aorta and along the lateral side of the pericardium

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29
Q

position of the phrenic nerves

A

they run inferior to the mediastinal pleura and downwards anterior to the hilum of the lung and pierce the dome of the diaphragm

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30
Q

route of the vagus nerve

A

passes to the left of the aortic arch, posterior to the phrenic nerve and behind the route of the lung, joining to the oesophagus which flows into the abdomen

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31
Q

where does the vagus nerve split

A

over the aortic arch

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32
Q

route of the left recurrent laryngeal nerve

A

it loops under the aortic arch, to the left of ligamentum arteriosum, before continuing its journey to the larynx in the tracheal-oesophageal groove

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33
Q

phrenic nerve roots

A

c3, 4 and 5

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34
Q

where are the brachiocephalic veins

A

deep to the manubrium sternum

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35
Q

where is the right recurrent laryngeal nerve

A

in the neck

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36
Q

which 3 major arteries lie posterior to the brachiocephalic vein

A

brachiocephalic trunk
common carotid arteries
subclavian arteries

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37
Q

what is the inside layer of the pericardium called

A

Visceral pericardium

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38
Q

what is the middle layer of the pericardium?

A

parietal pericardium

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39
Q

what is the outer pericardial layer called

A

fibrous pericardium

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40
Q

if a tumor invades the left recurrent laryngeal nerve, where is it and what effect would it have

A

in the left lung. the muscles of the left vocal cords would be paralyzed leading to a hoarse voice.

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41
Q

painful stimulation of the diaphragm would be felt where?

A

at the c3, 4 and 5 dermatomes- in the side of the neck and the shoulder

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42
Q

effects of fluid build up in the pericardium?

A

ventricular filling will be limited and cardiac output reduced

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43
Q

where is the internal mammary artery

A

deep to the costal cartilage on the deep surface of the thoracic wall

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44
Q

in which direction does the aortic arch run

A

anterior to posterior

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45
Q

which nerve runs anterior to the hilum

A

phrenic nerve

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46
Q

which nerve runs posterior to the hilum

A

vagus nerve

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47
Q

tricuspid valve is on which side

A

right

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48
Q

bicuspid valve is on which side

A

left

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49
Q

atrioventricular groove separates what

A

right auricular appendage and atrium from the right ventricle

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50
Q

what makes up the main part of the anterior side of the heart

A

right ventricle

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51
Q

Where is the right coronary artery

A

In the right ventricular groove

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52
Q

Where is the point of origin of the right coronary artery?

A

Ascending aorta

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53
Q

What does the right coronary artery split into

A

Acute marginal artery, posterior descending artery

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54
Q

What does the left coronary artery split into?

A

Left anterior descending, circumflex (diagonals 1-3/4/5) obtuse marginal

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55
Q

Where does the vagus nerve join the oesophagus?

A

In line with the hilum of the lung

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56
Q

Where does the right vagus nerve pass through the diaphragm?

A

Behind the oesophagus

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57
Q

Where does the left vagus nerve pass through the diaphragm?

A

In front of the oesophagues

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58
Q

What does the thoracic duct do?

A

Drains all the lymph from the of the lower half of the body and bowel back into the blood stream

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59
Q

Where does the thoracic duct drain into?

A

The confluence of the left subclavian vein and internal jugular vein in the left side of the neck

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60
Q

Right intercostal vessels name?

A

Azygos system

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61
Q

Left intercostal vessels name?

A

Hemi-azygous system

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62
Q

What runs across the neck of the ribs?

A

Sympathetic chain (neural cell bodies connected by nerve fibres axons and dendrites)

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63
Q

What are ganglia?

A

Neural cell bodies

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64
Q

How many ganglia in the thorax?

A

12

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65
Q

How many ganglia in the neck?

A

3

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66
Q

What are the origins of the lesser splanchnic nerve?

A

T10>T11

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67
Q

What do the splanchnic nerves supply?

A

The bowel

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68
Q

Origin of greater splanchnic nerve?

A

T5 >T9

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69
Q

What does the greater splanchnic nerve supply?

A

The foregut

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70
Q

What does the lesser splanchnic nerve supply?

A

Mid-gut

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71
Q

Origin of least splenchnic nerve?

A

T12

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72
Q

What does the least splanchnic nerve supply?

A

Hind gut

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73
Q

Where are the intercostal vessels?

A

Intercostal spaces

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74
Q

What is the difference between the right and left main bronchi?

A

Right is wider and more vertical

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75
Q

Hour do you get a clear image of the mitral value?

A

Insert a probe into the oesophagus (trans- oesophageal echo (TOE))

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76
Q

All the sympathetic nerve supply to the head and neck go through which ganglia?

A

Thoracic ganglia 1 (part of sympathetic chain)

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77
Q

What is Horner’s syndrome?

A

Pathology damaging the stellate ganglia (thoracic ganglia 1) causing loss of sympathetic innervation to the eye

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78
Q

Mastoid?

A

Ear

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79
Q

Cleido?

A

Clavicle

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80
Q

sterno?

A

Originates in the sternum

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81
Q

What is the muscle immediately deep to the skin in the anterior side of the neck?

A

Platysma muscle (very thin sheet)

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82
Q

Where is the sernodeidomastoid muscle?

A

In the neck, originating in the sternum and clavicle and inserting into the mastoid process

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83
Q

What is the anterior triangle of the neck?

A

Sternocleidomastoid muscle, midline and lower mandible

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84
Q

What muscles run vertically between the two sternocleidomastoid muscles (in the neck)?

A

Infra-hyoid muscles

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85
Q

What does the sternohyoid muscle attach to?

A

Sternum and hyoid bone

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86
Q

‘omo’?

A

Origins on the scapula

87
Q

Where is the superior belly of the omohyoid (muscle)?

A

Lateral to the sternohyoid attachment to the hyoid

88
Q

What muscles are deep to the sternonyoid muscles?

A

Sternothyroid and thyrohyoid

89
Q

Muscles behind the carotid sheath?

A

Strap muscles

90
Q

What loop of nerves passes 6 the strap muscles (in the neck)?

A

Ansa cervicalis

91
Q

What muscle is superficial to the thyroid gland?

A

Sternothyroid muscle

92
Q

What attaches the two lobes of the thyroid

A

A narrow isthmus

93
Q

In embryos, there is a third lobe of the thyroid. What is this called ? And where is it?

A

The pyramidal lobe, above the left lobe

94
Q

Which blood vessels run at the top of the superior pole? (Thyroid)

A

Superior thyroid artery and vein

95
Q

Which blood vessels run at the bottom of the lower pole? (Thyroid)

A

Inferior artery and vein

96
Q

How many glands are on the surface of the thyroid gland? Name them.

A

4 - a pair of superior and a pair of inferior parathyroid glands

97
Q

What runs in the groove between the trachea and the oesophagus?

A

Recurrent laryngeal nerve

98
Q

What lies on either side of the larynx and trachea?

A

Carotid sheath

99
Q

What is the carotid sheath

A

Tube of fascia containing the carotid artery, jugular vein and vagus nerve( cranial nerve x)

100
Q

What does the common carotid artery bifurcate (split) into?

A

Internal and external carotid arteries

101
Q

Where is the carotid sinus?

A

Distal to the carotid bifurcation

102
Q

What does the carotid sinus do?

A

Baroreceptor (controls blood pressure)

103
Q

Where is the carotid body?

A

In the bifurcation of the common carotid artery

104
Q

What is the carotid body?

A

A chemoreceptor (measures blood pH)

105
Q

Which nerve runs anterior to the subclavian artery?

A

Vagus nerve

106
Q

On how many sides does the thyroid surround the trachea?

A

3 sides

107
Q

Which nerves are at risk of damage during thyroid surgery?

A

Recurrent laryngeal nerves

108
Q

What are the 3 muscles that you can see on the anterior side of the neck? (superficial muscles)

A

Platysma, sternocleidomastoid muscle, sterno-hyoid muscle

109
Q

What is the pharynx made up of?

A

Nasopharynx, bropharynx and laryngeal part (hypopharynx)

110
Q

Where is the nasopharynx?

A

Behind the nasal cavity

111
Q

Where is the oropharynx?

A

Behind the oral cavity

112
Q

Where is the hypopharynx (laryngeal part)?

A

Behind the larynx

113
Q

Where is the origin of the superior constrictor?

A

Medial pterigoid plate and pterygomandibular raphe

114
Q

Where is the pterygomandibular raphe?

A

It extends from the medical pterygoid plate to the mandible

115
Q

Origin of the middle constrictor?

A

Hyoid bone and stylohyoid ligament

116
Q

Where is the origin of the inferior constrictor?

A

Thyroid cartilage and cricoid cartilage

117
Q

Other name for thyroid cartilage?

A

Thyropharangeus

118
Q

What lines the inner aspect of the constrictors?

A

Pharyngobasilar fascia

119
Q

What attaches to the pharyngobasilar fascia?

A

Pharyngeal tubercle, auditory tube and the medial pterygoid plate

120
Q

What does the pharysgobasilar fascia do?

A

Bridges the gap between the superior constrictor and the base of the skull

121
Q

What nerves form the pharyngeal plexus?

A

Vagus nerve (cranial nerve X) and glossopharyngeal nerve (cranial nerve IX)

122
Q

Where is the pharyngeal plexus found?

A

On the back of the pharynx

123
Q

What is killian’s dehiscence

A

The weakest part of the pharyngeal wall

124
Q

Where is killian’s dehiscence?

A

Between the diverging fibres of the thyro-pharyngeal part of the inferior constrictor

125
Q

Where is the cervical sympathetic chain?

A

Running up the neck posterior to the carotid sheath

126
Q

Name the ganglia in the cervical sympathetic chain

A

Superior, middle and inferior

127
Q

The inferior cervical ganglion is often fused with the first thoracic ganglion to form what?

A

Stellate ganglion

128
Q

Where is the stellate ganglion?

A

Between the neck of the first rib and the transverse process of the seventh cervical vertebrae (C7)

129
Q

Which ‘sheath’ is the vagus nerve in?

A

Carotid sheath

130
Q

What is the branch of the vagus nerve that passes down medically?

A

The superior laryngeal nerve

131
Q

What is the internal laryngeal nerve?

A

A sensory nerve to the larynx above the vocal cords

132
Q

What is the external laryngeal nerve?

A

Sensory nerve to the crico-thyroid muscle and crico-pharyngeal part of the inferior constrictor

133
Q

What is the swelling at the origin of the internal carotid artery?

A

The carotid sinus

134
Q

Which nerve runs through the carotid sinus?

A

Glossopharyngeal nerve

135
Q

The glossopharyngeal nerve leaven the skull via???

A

The jugular foramina

136
Q

Which cranial nerve is the glossopharyngeal nerve?

A

Cranial nerve IX

137
Q

What does the glossopharyngeal nerve do?

A

Supplies the posterior 3rd of the tongue (taste and general sensation) as were as the oropharynx (general sensation)

138
Q

What is the name of the branch of the glossopharyngeal nerve?

A

Tympanic branch

139
Q

What does the tympanic branch supply?

A

Middle ear and Eustachian tube (also stylopharyngeus muscle)

140
Q

Origin of the stylopharyngeus muscle?

A

Styloid process (close to the base of the skull)

141
Q

What cranial nerve is the hypoglossal nerve?

A

Cranial nerve XII

142
Q

What does the carotid sinus do?

A

Measures blood pressure

143
Q

What forms the synovial joint?

A

Inferior horn of thyroid cartilage and the cricoid cartilage

144
Q

Where is the submandibular salivary gland?

A

On the floor of the mouth, extending inferior to the mid portion of the ramus of the mandible

145
Q

What is cranial nerve xi?

A

Accessory nerve

146
Q

What does the accessory nerve supply?

A

The sternocleidomastoid muscle

147
Q

What is cranial nerve x?

A

Vagus nerve

148
Q

What influence do the parasympathetic nerves have on blood pressure?

A

No influence

149
Q

What influence do sympathetic nerves have on blood pressure?

A

They cause vasoconstriction and hence increase blood pressure

150
Q

Occlusion of what is most likely to cause a fatal heart attack

A

Left main coronary artery

151
Q

Which nerve innovates the pericardium?

A

Phrenic nerve

152
Q

End diastolic and end systolic volume in a healthy man?

A

EDT - 120mls

ESV - 50 mls

153
Q

How do you work out stroke volume?

A

EDV +ESV= stroke volume

154
Q

Increase in what pressure signifies left heart failure?

A

Left ventricular end-diastolic pressure

155
Q

Increase in what pressure indicates mitral value stenosis?

A

Left atrial end-diastolic pressure

156
Q

What is the purpose of the ductus arteriosus?

A

In the foetus, it allows blood to bypass the hangs by shunting it from the pulmonary artery to the aorta?

157
Q

How do you calculate cardiac output?

A

Heart rate x stroke volume

158
Q

Pulmonary oedema in the presence of a normal central venous pressure is a sign of what?

A

Left heart failure

159
Q

Raised central venous pressure is a sign of what?

A

Right heart failure

160
Q

Severe pulmonary hypertension causes what?

A

Right heart failure

161
Q

What is ascites?

A

Abdominal oedema

162
Q

Symptoms of biventricular failure?

A

Shortness of breath, severe peripheral oedema and ascites after a heart attack

163
Q

What does the right coronary artery supply?

A

The top of the heart including the SAN and AVN

164
Q

What does the left coronary artery supply?

A

The bottom of the heart including the his-purkinge system

165
Q

What are the abdominal was muscles called?

A

aponeuroses

166
Q

What is the function of the aponeuroses?

A

To hold the abdominal viscera within the abdominal cavity

167
Q

What are the vertical muscles on either side of the abdominal midline?

A

rectus abdominis

168
Q

What are the rectus abdominis muscles attached to?

A

Sternum and costal margin superiorly and pubis inferiorly

169
Q

The external obliques in the abdomen run in which direction?

A

Downwards and inwards

170
Q

The internal obliques in the abdomen run in which direction?

A

Upwards + inwards

171
Q

What are the three muscle layers lateral to the rectus sheath?

A

External obliques, internal obliques and transversus abdominis

172
Q

What does the inguinal ligament attach to?

A

Anterior superior iliac spine laterally and pubic tubercle medially

173
Q

What lies just above the inguinal ligament?

A

Inguinal canal

174
Q

What marks the base of the appendix?

A

McBurney’s point

175
Q

Which muscles elevate the ribs?

A

External intercostal, upper 4 and five of internal intercostal, levator costarum

176
Q

Which muscles depress the ribs?

A

Transversus thoracis, intercostal muscles (not upper 4/5), innermost intercostal (similar to intercostals)

177
Q

What forms the anterior axillary fold?

A

Lateral edge of pectoral is major

178
Q

What forms the posterior axillary fold?

A

The lateral edge of the latissimus dorsi and teres major muscles

179
Q

What are the internal mammary arteries a branch of

A

Subclavian artery

180
Q

What do the internal mammary arteries supply?

A

Medial part of the breast

181
Q

Which coronary artery is close to the mammary artery?

A

Left anterior descending

182
Q

Where is the horizontal fissure in the lung?

A

At the level of the 4th costal cartilage

183
Q

what are the articulations of the clavicle?

A

medial- sternoclavicular joint

lateral- acromioclavicular joint

184
Q

what lies deep to the pectoralis minor muscle?

A

axilla

185
Q

the upper outer quadrant of the breast is drained by what?

A

axillary lymph nodes

186
Q

which costal cartilage connects to the sternum at the sternal angle (angle of louis)?

A

2nd costal cartilage

187
Q

which nerve carries sensation from the parietal and visceral pleura

A

T1-T12 (same as thoracic wall)

188
Q

does contraction of the diaphragm increase or decrease intra-thoracic pressure

A

decreases

189
Q

what supplies the diaphragm

A

phrenic nerve (roots C3,4,5)

190
Q

what is the intercostal recession?

A

intercostal muscles get “sucked in” due to very negative pressures in the thorax needed to inhale

191
Q

what is the developmental significance of the ligamentum arteriosum?

A

remnant of a shunt between the pulmonary artery and aorta so the embryonic circulation can bypass the lungs before birth

192
Q

what does the left external carotid artery supply?

A

left side of face and head

193
Q

what does the left internal carotid artery supply?

A

most of the cerebral hemispheres

194
Q

what do the subclavian arteries split into?

A

vertebral, thyro-cervical and axillary arteries

195
Q

what do the thyro-cervical arteries supply?

A

thyroid and neck

196
Q

what do the axillary arteries supply?

A

upper limb

197
Q

what structures (general) are supplied by the vagus nerve?

A

pharync, larynx, heart, lungs, foregut, midgut

198
Q

how many pulmonary veins are there?

A

4 PULMONARY VEINS

199
Q

how many pulmonary arteries are there?

A

one pulmonary artery only!!

200
Q

What connects the aorta to the left pulmonary artery?

A

Ligamentum arteriosus

201
Q

What runs directly below the ligamentum arteriosus?

A

Left recurrent laryngeal nerve

202
Q

What does the vena cava split into?

A

Right and left brachiocephatic veins

203
Q

Which blood vessels branch off the ascending aorta (left to right- anatomically right to left)

A

Brachiocephalic artery, left common carotid artery, left subclavian artery

204
Q

Which blood vessel crosses infront of the aorta?

A

Left brachiocephalic vein

205
Q

Where does the phrenic nerve pierce the diaphragm?

A

At the apex of the heart

206
Q

Which artery appears to separate the right from the left heart ventricle?

A

Left anterior descending

207
Q

Which vessels in the heart lie anterior to the transverse sinus?

A

Aorta and pulmonary artery

208
Q

Which vessels in the heart lie anterior to the transverse sinus?

A

Pulmonary veins (x4) and vena cava (sup and inf)

209
Q

What is the “n-shape” on the posterior side of the heart formed by the pulmonary veins?

A

Oblique sinus

210
Q

Which groove separates the right atrium from the right auricular appendage?

A

Sulcus terminalis

211
Q

The right venous chamber is another word for what?

A

The right atrium

212
Q

What valve lies deep to the atrioventricular groove (right side of the heart)?

A

Tricuspid value

213
Q

What separates the right ventricle from the left ventricle?

A

Inter-ventricular groove

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