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
2
Q
how to determine the fourth intercostal space in men
A
location of the nipple is usually in the fourth intercostal space
3
Q
where does the trachea bifrucates split
A
at the t4/5 vertebral level (in line with the sternal angle)
4
Q
line coming down from centre of clavical
A
midclavicular line
5
Q
line coming down from the mid point of the armpit
A
midaxillary line
6
Q
where is the apex of the heart
A
where the midclavicular line crosses the 5th intercostal space on the LHS
7
Q
where are aortic valve sounds heard
A
2nd intercostal space at right sternal margin
8
Q
where are pulmonary valve sounds heard
A
2nd intercostal space at left sternal margin
9
Q
where are mitral valve sounds heard
A
over heart apex (5th intercostal space) in line with middle of clavical
10
Q
where are tricuspid valve sounds heard
A
right sternal margin of 5th intercostal space
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
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
13
Q
where is the horizontal fissure
A
at the level of the 4th costal cartilage
14
Q
what does the horizontal fissure do
A
separates the upper from the middle lobe in the right lung
15
Q
inferior extent of the lungs
A
6th rib anteriorly
8th rib laterally
10th rib posteriorly
{6,8,10- ALPHABETICAL ORDER}
16
Q
what is the parietal pleura
A
a serous membrane which extends below the lungs and forms the costo-diaphragmatic recesses
17
Q
extent of recess
A
8th rib anteriorly
10th rib laterally
12th rib posteriorly
18
Q
why is bronchoconstriction useful when you sleep
A
reduced volume of air in lungs and hence reduces the effort needed to breathe
19
Q
number of bronchopulmonary segments in each lung
A
right- 10
left- 9-10
20
Q
what supplies oxygenated blood to the lungs
A
bronchial artery (x1) and pulmonary veins (x4)
21
Q
what removes deoxygenated blood from the lungs
A
pulmonary arteries (x2) and bronchial veins (x4)
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
23
Q
what does serous fluid do
A
sticks the surface of the lung to the inside of the chest
24
Q
term used to describe anterior ends of ribs moving upwards
A
pump handle
25
term used to describe lateral ends of ribs moving outwards
bucket handle
26
inspiration
external intercostals contract
diaphragm contracts
chest wall and lungs expand
expansion of ribs moves sternum up and out
27
route of right phrenic nerve
runs adjacent to the right brachiocephalic vein and superior vena cava, posterior to the root of the right lung
28
route of left phrenic nerve
runs over the arch of the aorta and along the lateral side of the pericardium
29
position of the phrenic nerves
they run inferior to the mediastinal pleura and downwards anterior to the hilum of the lung and pierce the dome of the diaphragm
30
route of the vagus nerve
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
31
where does the vagus nerve split
over the aortic arch
32
route of the left recurrent laryngeal nerve
it loops under the aortic arch, to the left of ligamentum arteriosum, before continuing its journey to the larynx in the tracheal-oesophageal groove
33
phrenic nerve roots
c3, 4 and 5
34
where are the brachiocephalic veins
deep to the manubrium sternum
35
where is the right recurrent laryngeal nerve
in the neck
36
which 3 major arteries lie posterior to the brachiocephalic vein
brachiocephalic trunk
common carotid arteries
subclavian arteries
37
what is the inside layer of the pericardium called
Visceral pericardium
38
what is the middle layer of the pericardium?
parietal pericardium
39
what is the outer pericardial layer called
fibrous pericardium
40
if a tumor invades the left recurrent laryngeal nerve, where is it and what effect would it have
in the left lung. the muscles of the left vocal cords would be paralyzed leading to a hoarse voice.
41
painful stimulation of the diaphragm would be felt where?
at the c3, 4 and 5 dermatomes- in the side of the neck and the shoulder
42
effects of fluid build up in the pericardium?
ventricular filling will be limited and cardiac output reduced
43
where is the internal mammary artery
deep to the costal cartilage on the deep surface of the thoracic wall
44
in which direction does the aortic arch run
anterior to posterior
45
which nerve runs anterior to the hilum
phrenic nerve
46
which nerve runs posterior to the hilum
vagus nerve
47
tricuspid valve is on which side
right
48
bicuspid valve is on which side
left
49
atrioventricular groove separates what
right auricular appendage and atrium from the right ventricle
50
what makes up the main part of the anterior side of the heart
right ventricle
51
Where is the right coronary artery
In the right ventricular groove
52
Where is the point of origin of the right coronary artery?
Ascending aorta
53
What does the right coronary artery split into
Acute marginal artery, posterior descending artery
54
What does the left coronary artery split into?
Left anterior descending, circumflex (diagonals 1-3/4/5) obtuse marginal
55
Where does the vagus nerve join the oesophagus?
In line with the hilum of the lung
56
Where does the right vagus nerve pass through the diaphragm?
Behind the oesophagus
57
Where does the left vagus nerve pass through the diaphragm?
In front of the oesophagues
58
What does the thoracic duct do?
Drains all the lymph from the of the lower half of the body and bowel back into the blood stream
59
Where does the thoracic duct drain into?
The confluence of the left subclavian vein and internal jugular vein in the left side of the neck
60
Right intercostal vessels name?
Azygos system
61
Left intercostal vessels name?
Hemi-azygous system
62
What runs across the neck of the ribs?
Sympathetic chain (neural cell bodies connected by nerve fibres axons and dendrites)
63
What are ganglia?
Neural cell bodies
64
How many ganglia in the thorax?
12
65
How many ganglia in the neck?
3
66
What are the origins of the lesser splanchnic nerve?
T10>T11
67
What do the splanchnic nerves supply?
The bowel
68
Origin of greater splanchnic nerve?
T5 >T9
69
What does the greater splanchnic nerve supply?
The foregut
70
What does the lesser splanchnic nerve supply?
Mid-gut
71
Origin of least splenchnic nerve?
T12
72
What does the least splanchnic nerve supply?
Hind gut
73
Where are the intercostal vessels?
Intercostal spaces
74
What is the difference between the right and left main bronchi?
Right is wider and more vertical
75
Hour do you get a clear image of the mitral value?
Insert a probe into the oesophagus (trans- oesophageal echo (TOE))
76
All the sympathetic nerve supply to the head and neck go through which ganglia?
Thoracic ganglia 1 (part of sympathetic chain)
77
What is Horner's syndrome?
Pathology damaging the stellate ganglia (thoracic ganglia 1) causing loss of sympathetic innervation to the eye
78
Mastoid?
Ear
79
Cleido?
Clavicle
80
sterno?
Originates in the sternum
81
What is the muscle immediately deep to the skin in the anterior side of the neck?
Platysma muscle (very thin sheet)
82
Where is the sernodeidomastoid muscle?
In the neck, originating in the sternum and clavicle and inserting into the mastoid process
83
What is the anterior triangle of the neck?
Sternocleidomastoid muscle, midline and lower mandible
84
What muscles run vertically between the two sternocleidomastoid muscles (in the neck)?
Infra-hyoid muscles
85
What does the sternohyoid muscle attach to?
Sternum and hyoid bone
86
'omo'?
Origins on the scapula
87
Where is the superior belly of the omohyoid (muscle)?
Lateral to the sternohyoid attachment to the hyoid
88
What muscles are deep to the sternonyoid muscles?
Sternothyroid and thyrohyoid
89
Muscles behind the carotid sheath?
Strap muscles
90
What loop of nerves passes 6 the strap muscles (in the neck)?
Ansa cervicalis
91
What muscle is superficial to the thyroid gland?
Sternothyroid muscle
92
What attaches the two lobes of the thyroid
A narrow isthmus
93
In embryos, there is a third lobe of the thyroid. What is this called ? And where is it?
The pyramidal lobe, above the left lobe
94
Which blood vessels run at the top of the superior pole? (Thyroid)
Superior thyroid artery and vein
95
Which blood vessels run at the bottom of the lower pole? (Thyroid)
Inferior artery and vein
96
How many glands are on the surface of the thyroid gland? Name them.
4 - a pair of superior and a pair of inferior parathyroid glands
97
What runs in the groove between the trachea and the oesophagus?
Recurrent laryngeal nerve
98
What lies on either side of the larynx and trachea?
Carotid sheath
99
What is the carotid sheath
Tube of fascia containing the carotid artery, jugular vein and vagus nerve( cranial nerve x)
100
What does the common carotid artery bifurcate (split) into?
Internal and external carotid arteries
101
Where is the carotid sinus?
Distal to the carotid bifurcation
102
What does the carotid sinus do?
Baroreceptor (controls blood pressure)
103
Where is the carotid body?
In the bifurcation of the common carotid artery
104
What is the carotid body?
A chemoreceptor (measures blood pH)
105
Which nerve runs anterior to the subclavian artery?
Vagus nerve
106
On how many sides does the thyroid surround the trachea?
3 sides
107
Which nerves are at risk of damage during thyroid surgery?
Recurrent laryngeal nerves
108
What are the 3 muscles that you can see on the anterior side of the neck? (superficial muscles)
Platysma, sternocleidomastoid muscle, sterno-hyoid muscle
109
What is the pharynx made up of?
Nasopharynx, bropharynx and laryngeal part (hypopharynx)
110
Where is the nasopharynx?
Behind the nasal cavity
111
Where is the oropharynx?
Behind the oral cavity
112
Where is the hypopharynx (laryngeal part)?
Behind the larynx
113
Where is the origin of the superior constrictor?
Medial pterigoid plate and pterygomandibular raphe
114
Where is the pterygomandibular raphe?
It extends from the medical pterygoid plate to the mandible
115
Origin of the middle constrictor?
Hyoid bone and stylohyoid ligament
116
Where is the origin of the inferior constrictor?
Thyroid cartilage and cricoid cartilage
117
Other name for thyroid cartilage?
Thyropharangeus
118
What lines the inner aspect of the constrictors?
Pharyngobasilar fascia
119
What attaches to the pharyngobasilar fascia?
Pharyngeal tubercle, auditory tube and the medial pterygoid plate
120
What does the pharysgobasilar fascia do?
Bridges the gap between the superior constrictor and the base of the skull
121
What nerves form the pharyngeal plexus?
Vagus nerve (cranial nerve X) and glossopharyngeal nerve (cranial nerve IX)
122
Where is the pharyngeal plexus found?
On the back of the pharynx
123
What is killian's dehiscence
The weakest part of the pharyngeal wall
124
Where is killian's dehiscence?
Between the diverging fibres of the thyro-pharyngeal part of the inferior constrictor
125
Where is the cervical sympathetic chain?
Running up the neck posterior to the carotid sheath
126
Name the ganglia in the cervical sympathetic chain
Superior, middle and inferior
127
The inferior cervical ganglion is often fused with the first thoracic ganglion to form what?
Stellate ganglion
128
Where is the stellate ganglion?
Between the neck of the first rib and the transverse process of the seventh cervical vertebrae (C7)
129
Which 'sheath' is the vagus nerve in?
Carotid sheath
130
What is the branch of the vagus nerve that passes down medically?
The superior laryngeal nerve
131
What is the internal laryngeal nerve?
A sensory nerve to the larynx above the vocal cords
132
What is the external laryngeal nerve?
Sensory nerve to the crico-thyroid muscle and crico-pharyngeal part of the inferior constrictor
133
What is the swelling at the origin of the internal carotid artery?
The carotid sinus
134
Which nerve runs through the carotid sinus?
Glossopharyngeal nerve
135
The glossopharyngeal nerve leaven the skull via???
The jugular foramina
136
Which cranial nerve is the glossopharyngeal nerve?
Cranial nerve IX
137
What does the glossopharyngeal nerve do?
Supplies the posterior 3rd of the tongue (taste and general sensation) as were as the oropharynx (general sensation)
138
What is the name of the branch of the glossopharyngeal nerve?
Tympanic branch
139
What does the tympanic branch supply?
Middle ear and Eustachian tube (also stylopharyngeus muscle)
140
Origin of the stylopharyngeus muscle?
Styloid process (close to the base of the skull)
141
What cranial nerve is the hypoglossal nerve?
Cranial nerve XII
142
What does the carotid sinus do?
Measures blood pressure
143
What forms the synovial joint?
Inferior horn of thyroid cartilage and the cricoid cartilage
144
Where is the submandibular salivary gland?
On the floor of the mouth, extending inferior to the mid portion of the ramus of the mandible
145
What is cranial nerve xi?
Accessory nerve
146
What does the accessory nerve supply?
The sternocleidomastoid muscle
147
What is cranial nerve x?
Vagus nerve
148
What influence do the parasympathetic nerves have on blood pressure?
No influence
149
What influence do sympathetic nerves have on blood pressure?
They cause vasoconstriction and hence increase blood pressure
150
Occlusion of what is most likely to cause a fatal heart attack
Left main coronary artery
151
Which nerve innovates the pericardium?
Phrenic nerve
152
End diastolic and end systolic volume in a healthy man?
EDT - 120mls
| ESV - 50 mls
153
How do you work out stroke volume?
EDV +ESV= stroke volume
154
Increase in what pressure signifies left heart failure?
Left ventricular end-diastolic pressure
155
Increase in what pressure indicates mitral value stenosis?
Left atrial end-diastolic pressure
156
What is the purpose of the ductus arteriosus?
In the foetus, it allows blood to bypass the hangs by shunting it from the pulmonary artery to the aorta?
157
How do you calculate cardiac output?
Heart rate x stroke volume
158
Pulmonary oedema in the presence of a normal central venous pressure is a sign of what?
Left heart failure
159
Raised central venous pressure is a sign of what?
Right heart failure
160
Severe pulmonary hypertension causes what?
Right heart failure
161
What is ascites?
Abdominal oedema
162
Symptoms of biventricular failure?
Shortness of breath, severe peripheral oedema and ascites after a heart attack
163
What does the right coronary artery supply?
The top of the heart including the SAN and AVN
164
What does the left coronary artery supply?
The bottom of the heart including the his-purkinge system
165
What are the abdominal was muscles called?
aponeuroses
166
What is the function of the aponeuroses?
To hold the abdominal viscera within the abdominal cavity
167
What are the vertical muscles on either side of the abdominal midline?
rectus abdominis
168
What are the rectus abdominis muscles attached to?
Sternum and costal margin superiorly and pubis inferiorly
169
The external obliques in the abdomen run in which direction?
Downwards and inwards
170
The internal obliques in the abdomen run in which direction?
Upwards + inwards
171
What are the three muscle layers lateral to the rectus sheath?
External obliques, internal obliques and transversus abdominis
172
What does the inguinal ligament attach to?
Anterior superior iliac spine laterally and pubic tubercle medially
173
What lies just above the inguinal ligament?
Inguinal canal
174
What marks the base of the appendix?
McBurney's point
175
Which muscles elevate the ribs?
External intercostal, upper 4 and five of internal intercostal, levator costarum
176
Which muscles depress the ribs?
Transversus thoracis, intercostal muscles (not upper 4/5), innermost intercostal (similar to intercostals)
177
What forms the anterior axillary fold?
Lateral edge of pectoral is major
178
What forms the posterior axillary fold?
The lateral edge of the latissimus dorsi and teres major muscles
179
What are the internal mammary arteries a branch of
Subclavian artery
180
What do the internal mammary arteries supply?
Medial part of the breast
181
Which coronary artery is close to the mammary artery?
Left anterior descending
182
Where is the horizontal fissure in the lung?
At the level of the 4th costal cartilage
183
what are the articulations of the clavicle?
medial- sternoclavicular joint
| lateral- acromioclavicular joint
184
what lies deep to the pectoralis minor muscle?
axilla
185
the upper outer quadrant of the breast is drained by what?
axillary lymph nodes
186
which costal cartilage connects to the sternum at the sternal angle (angle of louis)?
2nd costal cartilage
187
which nerve carries sensation from the parietal and visceral pleura
T1-T12 (same as thoracic wall)
188
does contraction of the diaphragm increase or decrease intra-thoracic pressure
decreases
189
what supplies the diaphragm
phrenic nerve (roots C3,4,5)
190
what is the intercostal recession?
intercostal muscles get "sucked in" due to very negative pressures in the thorax needed to inhale
191
what is the developmental significance of the ligamentum arteriosum?
remnant of a shunt between the pulmonary artery and aorta so the embryonic circulation can bypass the lungs before birth
192
what does the left external carotid artery supply?
left side of face and head
193
what does the left internal carotid artery supply?
most of the cerebral hemispheres
194
what do the subclavian arteries split into?
vertebral, thyro-cervical and axillary arteries
195
what do the thyro-cervical arteries supply?
thyroid and neck
196
what do the axillary arteries supply?
upper limb
197
what structures (general) are supplied by the vagus nerve?
pharync, larynx, heart, lungs, foregut, midgut
198
how many pulmonary veins are there?
4 PULMONARY VEINS
199
how many pulmonary arteries are there?
one pulmonary artery only!!
200
What connects the aorta to the left pulmonary artery?
Ligamentum arteriosus
201
What runs directly below the ligamentum arteriosus?
Left recurrent laryngeal nerve
202
What does the vena cava split into?
Right and left brachiocephatic veins
203
Which blood vessels branch off the ascending aorta (left to right- anatomically right to left)
Brachiocephalic artery, left common carotid artery, left subclavian artery
204
Which blood vessel crosses infront of the aorta?
Left brachiocephalic vein
205
Where does the phrenic nerve pierce the diaphragm?
At the apex of the heart
206
Which artery appears to separate the right from the left heart ventricle?
Left anterior descending
207
Which vessels in the heart lie anterior to the transverse sinus?
Aorta and pulmonary artery
208
Which vessels in the heart lie anterior to the transverse sinus?
Pulmonary veins (x4) and vena cava (sup and inf)
209
What is the "n-shape" on the posterior side of the heart formed by the pulmonary veins?
Oblique sinus
210
Which groove separates the right atrium from the right auricular appendage?
Sulcus terminalis
211
The right venous chamber is another word for what?
The right atrium
212
What valve lies deep to the atrioventricular groove (right side of the heart)?
Tricuspid value
213
What separates the right ventricle from the left ventricle?
Inter-ventricular groove
