anatomy of the cardiorespiratory system Flashcards

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1
Q

where does the sternum lie anatomically?

A

anteriorly in the midline of the thoracic cage

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2
Q

what are the three parts to the sternum?

A

manubrium, body and xiphoid process

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3
Q

where in the sternum is the manubrium found

A

the most superior part

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4
Q

what is the name of the notch in the superior part of the sternum?

A

suprasternal (jugular) notch

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5
Q

what does the manubrium articulate with laterally?

A

the clavicle and the first rib

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6
Q

what is the name of the joint where the clavicle and the manubrium ariculate?

A

sternoclavicular joint

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7
Q

what does the sternum articulate with inferiorly?

A

body of the sternum

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8
Q

what is the joint where the manubrium and the sternum articulate called?

A

manubriosternal joint

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9
Q

what is the angle where the manubrium and the body articulate?

A

the sternal angle (angle of Louis)

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10
Q

what does the body articulate with?

A
  1. the manubrium superiorly
  2. xiphoid process inferiorly
  3. ribs 2-7
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11
Q

what does the second rib articulate with?

A

the sternum at the sternal angle

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12
Q

where is the xiphoid process?

A

inferior to the body

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13
Q

where does the seventh rib articulate?

A

inferior part of the body of the sternum and
the superior part of the xiphoid process

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14
Q

identify these on a skeleton

A
  • clavicle (collarbone)
  • manubrium, body, and xiphoid process of the sternum
  • sternoclavicular joints
  • suprasternal notch
  • manubriosternal joint (the sternal angle) and the second rib
  • costal margin.
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15
Q

what is the name of the cartilage found on the anterior part of the ribs?

A

costal cartilage

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16
Q

what is the name of the joint where the ribs articulate with their costal cartilages?

A

costochondral

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17
Q

what costal cartilage articulate directly with the sternum and what is the joint called?

A

ribs 1-7
sternocostal
joints

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18
Q

what costal cartilage join with the seventh costal cartilage?

A

8-10

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19
Q

what do the costal cartilage of ribs 7-10 form?

A

costal margin which is palpable

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20
Q

what is significant about ribs 11 and 12?

A

short and do not articulate with the sternum – they are ‘floating’ ribs

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21
Q

what do the ribs articulate with posteriorly and what is the name of the joint in which they articulate at?

A

thoracic vertebrae
costovertebral joint

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22
Q

how are adjacent ribs connected to eachother?

A

intercostal muscles

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23
Q

what are the two classification of ribs?

A

typical and atypical ribs

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24
Q

what are typical ribs?

A

look similar and share common
anatomical features

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25
Q

what are atypical ribs?

A

look different to typical ribs and / or lack some of the
features of typical ribs

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26
Q

what are the typical ribs? and what makes rhemtypical?

A

ribs 3 - 9 are typical ribs. they have a head, neck, tubercle, and body (shaft).

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27
Q

what are the atypical ribs? and what makes them atypical?

A

ribs 1 - 2 and 10 - 12 are atypical.
ribs 1, 11 and 12
are much shorter than typical ribs

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28
Q

what does the head of the rib articulate with?

A

vertebral body

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29
Q

what does the tubercle of the rib articulate with?

A

transverse process

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30
Q

what is the name of the space created by the manubrium, the first ribs and the first thoracic vertebra?

A

superior thoracic aperture

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31
Q

what is a dermatome?

A

an area of skin innervated by a single spinal nerve

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32
Q

what does each pair of thoracic spinal nerves supply?

A

a ‘strip’ of skin around the chest wall

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33
Q

what do the somatic thoracic spinal fibres innervate?

A

the skeletal muscles of the
thoracic wall

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34
Q

what do the sympathetic thoracic spinal nerves innervate?

A

sweat glands and the smooth muscle of
blood vessels and hair follicles in the skin (arrector pili)

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35
Q

what is the anatomical term for armpit?

A

anterior axilla

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36
Q

what is the part of the breast that is towards the armpit called?

A

axillary tail

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37
Q

what are some components of the breast?

A

● fat - variable amounts.
● glandular / secretory tissue arranged in lobules.
● ducts which converge on the nipple. the areola is the region of pigmented skin
that surrounds the nipple.
● connective tissue and ligaments.
● blood vessels and lymphatics.

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38
Q

what arteries supply the breast?

A
  1. internal thoracic artery (which arises from the subclavian artery)
  2. axillary artery.
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39
Q

where does the internal thoracic arterty go to?

A

the lateral edge of the sternum

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40
Q

what does the internal thoracic cavity give rise to and what does this supply?

A

anterior intercostal arteries
breast and the intercostal spaces

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41
Q

where does venous blood from the anterior intercostal arteries return to?

A

axillary and
internal thoracic veins

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42
Q

what type of nerves and fibres innervate the breasts?

A

somatic nerves and sympathetic fibres via the intercostal nerves

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43
Q

what do somatic sensory fibres innervate in the breast?

A

skin of the breast

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44
Q

what do sympathetic fibres innervate in the breast?

A

smooth muscle in the blood vessel walls and nipple

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45
Q

where does the lymph from the breast drain to?

A

lymph nodes in the axilla

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46
Q

what are the groups of lymph nodes in the axilla?

A

central, pectoral, humeral, subscapular, and apical

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47
Q

what regions fo the lymph nodes in the axilla drain?

A

breast, upper limb, chest wall, scapular region, and the abdominal wall

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47
Q

what is the function of the apical nodes?

A

receive lymph from all other lymph nodes in
the axilla

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48
Q

why are apical nodes often involved in the spread of breast cancer?

A

because they drain most of the lymph from the breast

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49
Q

how many layers of intercostal muscle are there and what are the names?

A

3
1. external intercostal is most superficial.
2. internal intercostal lies deep to the external intercostal.
3. innermost intercostal lies deep to the internal intercostal

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50
Q

what is the pectoralis major and what does it attach to?

A
  1. the most superficial muscle of the anterior chest wall
  2. attaches
    to the upper humerus, the clavicle and the upper six ribs
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51
Q

what is the pectoralis minor and what does it attach to?

A

smaller muscle that lies deep to pectoralis major
attaches to
the scapula (shoulder blade) and ribs 3-5

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52
Q

what is the serratus anterior minor and what does it attach to?

A

superficial muscle that sweeps around the lateral aspect of the
thoracic cage
attaches to the scapula and the upper eight ribs

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53
Q

why is the usage of the prior three muscles a sign of respiratory distress?

A

their main function is to move the upper limb, but they can also move the ribs as they are attached to them and the muscles that are meant to move the ribs are fixed

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54
Q

what is shingles?

A

red, painful, and itchy rash, typically over the chest
or abdomen on one side of the body only

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55
Q

what do shingles affect that explains their stripy appearance?

A

dermatomes

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56
Q

what type of people does shingles affect and how does the infection work?

A

people who have had chickenpox
after an infection with chickenpox, the virus lays dormant in the dorsal root
ganglion. when reactivated, it causes a rash and pain in the dermatome associated with the affected spinal nerve

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57
Q

what is metastatis?

A

spreading (of cancer)

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58
Q

what condition can removing axillary nodes lead to and why?

A

axillary nodes drain lymph from the upper limb, their removal can
lead to fluid accumulation and swelling in the affected upper limb, a condition called
lymphoedema

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59
Q

what are intercostal spaces?

A

the spaces in between the ribs

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60
Q

what do the intercostal spaces contain?

A
  1. three layers of intercostal muscles
  2. the membranes associated with the intercostal muscle
  3. intercostal neurovascular bundle; an intercostal nerve, intercostal artery and an intercostal vein
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61
Q

what are the three types of intercostal muscle?

A
  1. external
  2. internal
  3. innermost
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62
Q

how do the external intercostal muscles run and how is this related to their function?

A

obliquely towards the armpits, where they attach to the rib below them pulling it up and out for inspiration

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63
Q

how do the inner intercostal muscles run and how is this related to their function?

A

obliquely towards the medial line, where they attach to the rib below them pull it down, and in for expiration

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64
Q

how do the innermost intercostal muscles run?

A

same as the inner intercostal muscles

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65
Q

where does the endothoracic facia lie?

A

deep to the innermost intercostal and superficial to the parietal pleura, which surrounds the lung

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66
Q

where do the neurovascular bundles lie within each intercostal space?

A

in the plane between the internal and innermost intercostal muscle.

they lie along the inferior border of the rib superior to the space

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67
Q

what do the neurovascular bundles of the intercostal spaces supply?

A

intercostal muscles, the overlying skin, and the underlying parietal pleura

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68
Q

how can where the neurovascular bundles on the ribs lie be told?

A

on the inferior border of the rib, there is a shallow costal groove

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69
Q

what do the anterior and posterior intercostal arteries supply?

A

the anterior and posterior parts of the intercostal space

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70
Q

where do the anterior intercostal arteries branch from?

A

internal thoracic artery (a
branch of the subclavian artery)

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71
Q

where do the posterior intercostal arteries branch from?

A

descending aorta in the
posterior thorax

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72
Q

where do the anterior intercostal veins drain into?

A

internal thoracic vein

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73
Q

where do the posterior intercostal veins drain into?

A

azygos system of veins

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74
Q

are intercostal nerves somatic or autonomic?

A

somatic, with sympathetic fibers

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75
Q

do intercostal nerves contain motor or sensory fibers or both?

A

both

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76
Q

what do the intercostal nerves innervate?

A

intercostal muscles, the skin of the chest wall and the parietal pleura

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77
Q

what are the two types of pleural membranes and where do they lie?

A
  1. the parietal pleura lines the inside of the thorax.
  2. the visceral pleura covers the surface of the lungs and extends into the fissures.
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78
Q

what is the pleural cavity?

A

the space that lies between the parietal and visceral pleura

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79
Q

which of the parietal or visceral pleura can be seen by naked eye?

A

parietal

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80
Q

what lies within the pleural cavity?

A

pleural fluid made by pleural cells

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81
Q

what are the four parts of the parietal pleura and where do they lie?

A
  1. the cervical pleura covers the apex of the lung.
  2. the costal pleura lies adjacent to the ribs.
  3. the mediastinal pleura lies adjacent to the heart.
  4. the diaphragmatic pleura lies adjacent to the diaphragm
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82
Q

what is the costodiaphragmatic recess?

A

a ‘gutter’ around the periphery of the diaphragm,
where the costal pleura becomes continuous with the diaphragmatic pleura

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83
Q

what is the name of the recess that lies at the junction of the costal and mediastinal pleura?

A

costomediastinal recess

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84
Q

what is the importance of the two recesses?

A

potential spaces that the lungs expand into during deep inspiration

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85
Q

what innervates the parietal pleura, and can injury to it be felt and why?

A
  1. the intercostal nerves that innervate the
    overlying skin of the chest wall
  2. pain can be felt as somatic sensory fibers there carry sensation to the consciousness
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86
Q

what innervates the visceral pleura, and can injury to it be felt and why?

A
  1. autonomic sensory nerves (visceral afferents)
  2. no pain as sensation from visceral afferents do not reach our conscious perception
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87
Q

where does the superior (apex) part of the lung lie?

A

projects into the root of the neck, above the clavicle

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88
Q

where does the base of the lung lie?

A

‘sits’ on the diaphragm

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89
Q

how many lobes are there in the right lung and what are their names?

A

3
a superior (upper), middle, and inferior (lower)
lobe

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90
Q

how many lobes are there in the left lung and what are their names?

A

superior and inferior lobe

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91
Q

which part of the lung extends over the heart?

A

an anterior extension of the superior lobe called the lingula

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92
Q

what is the costal surface of the lungs?

A

adjacent to the ribs

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93
Q

what is the mediastinal surface of the lungs?

A

adjacent to the heart

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94
Q

what is the diaphragmatic surface of the lungs?

A

inferior surface of the lung

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95
Q

what is the anterior border of the lungs in appearance?

A

sharp and tapered

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96
Q

what is the posterior border of the lungs in appearance?

A

thick and rounded

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97
Q

what is the inferior border of the lungs in appearance?

A

sharp and tapered

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98
Q

what is the hilum?

A

region on the mediastinal surface of the lung where the pulmonary artery, pulmonary veins and main bronchus enter and exit the lung

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99
Q

where does the root of each lung lie and what does it consist of?

A
  1. between the heart and the lung
  2. comprises the pulmonary
    artery, pulmonary veins, and main bronchus
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100
Q

what encloses the root of each lung?

A

pleura

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101
Q

where are the positions of the pulmonary artery and the main bronchus at the right lung?

A

at the hilum of the right lung, the pulmonary artery lies anterior to the main bronchus

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102
Q

where are the positions of the pulmonary artery and the main bronchus at the left lung?

A

at the hilum of the left lung, the pulmonary artery lies superior to the main bronchus

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103
Q

where do the pulmonary veins lie in the left and right hila?

A

the two pulmonary veins are usually the most anterior and
inferior vessels

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104
Q

where does the trachea turn into the left and right main bronchi?

A

at the level of the sternal
angle

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105
Q

what is the bifurcation of the trachea marked by?

A

a ridge of cartilage called the
carina

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106
Q

why are foreign bodies more likely to enter the right main bronchus than the left?

A

the right main bronchus is shorter, wider and descends more vertically

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107
Q

what do the main (primary) bronchi divide into and how many are there at each lung?

A
  1. lobar (secondary bronchi)
  2. three in the
    right lung and two in the left lung (one lobar bronchus for each lobe)
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108
Q

what do the lobar (secondary) bronchi divide into and how man are there in each lung?

A
  1. segmental (tertiary) bronchi
  2. approximately ten segmental bronchi in each lung
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109
Q

what is the name of the region that each segmental bronchus suppplies?

A

bronchopulmonary segments

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110
Q

what is the advantage to bronchopulmonary segments?

A

a segment may
be resected (surgically removed) without affecting the rest of the lung as they are supplied by their own segmental bronchus and blood vessels

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111
Q

what do the segmental bronchi divide into?

A

bronchioles, that become smaller with each division

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112
Q

where is the site of gas exchange?

A

alveoli

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113
Q

what do the walls of the trachea and bronchi contain?

A

smooth muscle and cartilage

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114
Q

what do the walls of the bronchioles contain?

A

smooth muscle

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115
Q

what supplies the lungs and where do they come from?

A
  1. bronchial arteries
  2. descending aorta
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116
Q

what do bronchial veins do?

A

return blood to the azygos system of veins

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117
Q

do somatic or autonomic nerves innervate the lungs?

A

autonomic

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118
Q

what do parasympathetic fibers in the lungs do?

A

stimulate:
1. constriction of bronchial smooth muscle (bronchoconstriction)
2. secretion from the glands of the bronchial tree.

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119
Q

what do sympathetic fibers in the lungs do?

A
  1. stimulate relaxation of bronchial smooth muscle (bronchodilation)
  2. inhibit secretion from the glands.
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120
Q

where does lymph from the lungs drain?

A

into the venous system via the thoracic duct or right lymphatic duct

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121
Q

where does the inferior border of the lungs lie?

A
  1. 6th rib anteriorly (midclavicular line)
  2. 8th rib laterally (midaxillary line)
    3.10th rib posteriorly (at the vertebral column).
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122
Q

where does the patietal pleura extend to?

A
  1. 8th rib anteriorly (midclavicular line)
  2. 10th rib laterally (midaxillary line)
  3. 12th rib posteriorly (at the vertebral column).
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123
Q

where do oblique fissures extend to in terms of ribs in the left and right lungs?

A

from the 4th rib posteriorly to the 6th costal cartilage anteriorly; the fissure runs deep to the 5th rib

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124
Q

where does the horiaontal fissure extend to in terms of ribs in the right lung?

A

extends anteriorly from the 4th costal cartilage and
intersects the oblique fissure

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125
Q

what type of muscle is the diaphragm?

A

skeletal muscle

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126
Q

what is the superior (thoracic) surface of the diaphragm adjacent to?

A

parietal pleura

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127
Q

what travels through the apertures of the diaphragm?

A

aorta, inferior vena cava, and oesophagus (structures that pass through the thorax and abdomen)

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128
Q

what is the diaphragm attached to?

A

the xiphoid process, costal margin (and to the tips of the 11th
and 12th ribs) and the lumbar vertebrae

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129
Q

what is special about the central part of the diaphragm?

A

is not muscular, but fibrous - the central tendon

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130
Q

what happens to the diaphragm during inspiration?

A

contracts during inspiration, the muscle fibres of the right and left domes are pulled towards their peripheral attachments, and the domes flatten. this increases the intrathoracic volume for the lungs to expand

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131
Q

what happens to the diaphragm during expiration?

A

diaphragm relaxes and domes superiorly. this decreases the
intrathoracic volume and drives the expiration of air from the lungs

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132
Q

what innervates the diaphragm?

A

right and left phrenic nerves innervate the right and left sides of the diaphragm,
respectively

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133
Q

what type of nerves are phrenic nerves and where are they formed from?

A

somatic nerves, formed in the neck by fibres from the C3, C4 and C5 spinal nerves, and hence contain motor and sensory fibres

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134
Q

what are the three planes in which the thoracic cavity can move during ventilation?

A
  1. vertically - due to the contraction and relaxation of the diaphragm.
  2. laterally - due to contraction of the intercostal muscles which move the ribs.
  3. antero-posteriorly (AP) – due to movement of the sternum secondary to movement of the ribs.
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135
Q

what is the purpose of pleura and pleural fluid?

A

the fluid creates surface
tension between the parietal pleura and the visceral pleura, keeping the lung and thoracic wall ‘together’, so
when the thoracic cavity changes volume, the lung changes volume with it

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136
Q

describe the process of inspiration

A

1.the diaphragm and external intercostal muscles contract, increasing the intrathoracic volume (the external intercostals pull the ribs superiorly and laterally, and the ribs pull the sternum superiorly and anteriorly, increasing the AP and lateral dimensions of the thoracic cavity).
2. the lungs expand (increase in volume) with the thoracic wall (due to surface tension).
3. the pressure in the lungs decreases below atmospheric pressure and air is drawn into the lungs.

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137
Q

describe the process of expiration

A
  1. the diaphragm and external intercostal muscles relax, and the internal intercostals contract, decreasing the intrathoracic volume (the internal intercostals pull the ribs
    inferiorly, and the ribs pull the sternum inferiorly and posteriorly, decreasing the AP and lateral dimensions of the thoracic cavity).
  2. the lungs recoil (decrease in volume).
  3. the pressure in the lungs increases above atmospheric pressure and air is expelled
    from the lungs.
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138
Q

what muscles are involved with normal breathing and which parts are active/passive?

A

inspiration is active and is mainly driven by movement of the diaphragm, but expiration is passive

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139
Q

what muscles are involved with vigorous breathing and is it active/passive?

A

active expiration uses the internal intercostal muscles

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140
Q

what muscles are involved with very vigorous breathing and is it active/passive?

A

active
the accessory muscles of breathing (sternocleidomastoid,
pectoralis major and minor, serratus anterior) contribute to the movement of the ribs and aid ventilation. the anterior abdominal wall muscles contribute to forced expiration

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141
Q

what is pleuritic chest pain and what does it feel like?

A

pain felt from the parietal pleura only, when it becomes inflamed or injured
feels typically sharp, well localised and worse on inspiration

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142
Q

what is pneumothorax?

A

the presence of air in the pleural cavity

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143
Q

what happens when pneumothorax occurs?

A

rapidly increasing volume of air progressively
compresses the lung, heart, great vessels and the opposite lung over to the contralateral side of the thorax, which can be fatal

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144
Q

what is haemothorax?

A

collection of blood in the pleural cavity and occurs secondary to trauma when blood vessels are torn or cut

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145
Q

what is pleural effusion and how is it treated?

A
  1. the presence of excess fluid in the pleural cavity
  2. chest drain is used to remove air and/or fluid from the pleural space
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146
Q

what is primary lung cancer?

A

cancer of the lung tissue or bronchi

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147
Q

what is secondary lung cancer?

A

cancer from
elsewhere that has metastasized to the lungs

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148
Q

what is malignancy of the pleura called?

A

mesothelioma

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149
Q

what is a pulmonary embolism?

A

a blood clot in the pulmonary circulation

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150
Q

how do pulmonary embolisms form?

A

forms in the deep veins in one of the legs and is carried in the venous circulation back to the right side of the heart and into the pulmonary trunk

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151
Q

what is dyspnoea? how does this affect the muscles of ventilation?

A

breathlessness or shortness of breath
accessory muscles of respiration are used

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152
Q

what is the mediastinum? what dos it contain?

A

part of the thoracic cavity that lies between the lungs that contains all the thoracic viscera apart from the lungs

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153
Q

where does the mediastinum extend from?

A
  1. superior thoracic aperture superiorly to the diaphragm inferiorly
  2. sternum anteriorly to the thoracic vertebrae posteriorly
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154
Q

specify the organs and structures within the mediastinum

A
  1. the heart and pericardium (the fibrous sac around the heart)
  2. the great vessels that enter and leave the heart
  3. the veins that drain the chest wall
  4. the trachea and main bronchi
  5. the oesophagus
  6. nerves (somatic and autonomic)
  7. lymphatics
  8. the thymus gland
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155
Q

where is the division for superior and inferior mediastinum?

A

from the sternal angle
anteriorly to the T4/T5 junction posteriorly

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156
Q

where does the inferior anterior mediastinum lie and what does it contain?

A
  1. lies between the posterior aspect of the sternum and the anterior aspect of the pericardial sac
  2. contains the thymus
    gland in children and its remnant in adults
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157
Q

where does the inferior middle mediastinum contain?

A

heart inside the pericardial sac, the pulmonary
trunk, and the ascending aorta

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158
Q

where does the inferior posterior mediastinum lie?

A

between the posterior aspect of the pericardial sac
and the vertebrae

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159
Q

what are the main contents of the superior mediastinum?

A
  1. arch of the aorta and its three branches
  2. superior vena cava and its tributaries - the left and right brachiocephalic veins
  3. trachea
  4. oesophagus
  5. phrenic nerves (left and right) and vagus nerves (left and right)
  6. thoracic duct
  7. thymus gland
160
Q

what parts of the aorta are in the thorax?

A
  1. ascending aorta
  2. arch
  3. descending aorta
161
Q

what does the ascending aorta give rise to?

A

coronary arteries that supply the myocardium

162
Q

where does the arch of the arota lie?

A

in the superior mediastinum

163
Q

where does the descending aorta go?

A

through the posterior mediastinum into the abdomen posterior to the diaphragm

164
Q

what branches from the aortic arch?

A
  1. brachiocephalic trunk
  2. left common carotid
  3. left subclavian
165
Q

what does the braciocephalic trunk split into?

A
  1. right common carotid artery
  2. right subclavian artery
166
Q

what does the right common carotid artery supply blood to?

A

right side of the head neck and the brain

167
Q

what does the right subclavian artery supply blood to?

A

right upper limb

168
Q

what does the left common carotid artery supply blood to?

A

left side of the head,
neck, and brain

169
Q

what does the left subclavian artery supply blood to?

A

the left upper limb

170
Q

where are the chemoreceptors within the aorta located?

A

within the aortic bodies of the aortic arch

171
Q

what do the aortic chemoreceptors do?

A

monitor arterial oxygen and carbon dioxide

172
Q

what is the ligamentum arteriosum?

A

a fibrous, cord-like connection between the pulmonary trunk and the arch of the aorta

173
Q

what is the ligamentum arteriosum remnant of?

A

the ductus arteriosus, a foetal circulatory shunt

174
Q

what does the ductus arteriosus

A

diverts most of the blood entering the pulmonary trunk directly to the aortic arch (only a small amount of blood circulates through the foetal lungs; enough for
them to develop)

175
Q

what are the names of the veins that carry deoxygenated blood into the right atrium?

A

superior and inferior vena cava

176
Q

where does the superior vena cava return blood from?

A

from the head, neck and upper limb

177
Q

where does the superior tributaries cava and its tributaries lie?

A

in the superior mediatstinum

178
Q

what is the superior vena cava formed by the union of?

A

the internal jugular vein (which drains the head and neck) and the subclavian vein (which drains the upper limb)

179
Q

where does the inferior vena cava return blood from?

A

all regions inferior to the
diaphragm (abdomen, pelvis, and lower limbs)

180
Q

where does the inferior vena cava enter the right atrium?

A

as soon as it enters the thorax through the diaphragm

181
Q

what does the trachea do?

A

conducts air to and from the left and right main bronchi

182
Q

why is the trachea semi rigid?

A

due to C-shaped, incomplete rings of cartilage in its walls

183
Q

where does the trachea extend from and to?

A

from the larynx in the midline of the neck into the superior mediastinum and terminated at the level of the sternal angle by bifurcating into the left and right main bronchi

184
Q

where does the oesophagus extend from?

A

the pharynx in the midline of the neck to the stomach in the posterior mediastinum

185
Q

where does the oesophagus lie within the superior mediastinum?

A

the midline of the thorax

186
Q

where does the oesophagus lie compared to the trachea?

A

posterior to the trachea

187
Q

what nerves innervate the diaphragm?

A

left and right phrenic nerves

188
Q

where are phrenic nerves formed from?

A

by fibres from the C3, C4 and C5 spinal nerves

189
Q

what type of nerves are phrenic nerves and what do they contain?

A

somatic nerves and contain motor and sensory fibres

190
Q

where do phrenic nerves pass through to enter the thorax?

A

superior thoracic aperture

191
Q

what do vagus nerves innervate?

A

structures of the thorax and abdomen, in addition to the head and neck

192
Q

where do the vagus nerves arise from?

A

the brainstem

193
Q

what type of nerves do vagus nerves contain?

A

somatic sensory, somatic motor and parasympathetic fibres

194
Q

what do vagus nerves descend through the neck alongside?

A

the internal carotid artery and internal jugular vein and enter the thorax via the superior thoracic aperture

195
Q

what does each vagus nerve give rise to and what does this nerve innervate?

A

recurrent laryngeal nerve (RLN), which ascend back up into the neck to innervate the muscles of the larynx

196
Q

how does the left recurrent laryngeal nerve travel?

A

loops under the arch of the aorta before ascending
back up the left side of the neck (alongside the trachea) to the larynx

197
Q

how does the right recurrent laryngeal nerve travel?

A

descends anterior to the right subclavian artery
and then loops under the inferior border of the artery before ascending back up the
right side of the neck (between the trachea and oesophagus) to the larynx

198
Q

what is the purpose of the thoracic duct?

A

to be a major channel for lymphatic drainage from most regions of the body

199
Q

where does the thoracic duct ascend from?

A

the posterior mediastinum and into the superior mediastinum

200
Q

where does the thoracic duct empty into?

A

the venous system at the union of the left internal jugular vein and left subclavian vein

201
Q

where is the thymus gland?

A

lies anteriorly in the superior mediastinum

202
Q

why is the thymus gland not found within adults?

A

it atrophies with age and eventually becomes fatty

203
Q

what is the pericardium?

A

tough, fibrous sac that encloses the heart like a loose-fitting bag

204
Q

what are the two layers of the pericardium?

A
  1. tough outer fibrous layer that is continous with the great vessels
  2. inner thin serous layer made from a visceral and parietal layer that covers the surface of the heart and the outer layer and are continuous with eachother
205
Q

what is in between the two layers of serous layer of pericardium?

A

a pericardial cavity that contains small amounts of pericardial fluid and low the membranes to slide over each other with the movements of the heart

206
Q

what innervates the fibrous

A

sensory branches that stem from the left and right phrenic nerves

207
Q

what is the ‘base’ surface of the heart?

A

the posterior surface

208
Q

what is the ‘inferior’ surface of the heart?

A

the diaphragmatic surface

209
Q

what is the anterior surface of the heart?

A

faces the ribs and the sternum (also called the sternocostal surface)

210
Q

what is the pulmonary surface of the heart?

A

the left and right sides of the heart that face the lungs

211
Q

what parts of the heart make up the base/posterior surface?

A

left atrium and part of the right atrium

212
Q

what parts of the heart make up the inferior/diaphragmatic surface?

A

left ventricle with part of the right ventricle

213
Q

what parts of the heart make up the anterior/sternocostal surface?

A

right ventricle

214
Q

what parts of the heart make up the left pulmonary surface?

A

left ventricle

215
Q

what parts of the heart make up the right pulmonary surface?

A

right atrium

216
Q

where does the apex of the heart lie?

A

at the 5th intercostal space in the midclavicular line

217
Q

which part of the heart corresponds to the right border?

A

right artium

218
Q

which part of the heart corresponds to the left border?

A

left ventricle

219
Q

which part of the heart corresponds to the inferior border?

A

right ventricle and part of the left ventricle

220
Q

where does the right border of the heart correspond to on the ribs?

A

lies lateral to the right sternal edge, from the right 3rd costal cartilage to
the right 6th costal cartilage

221
Q

where does the left border of the heart correspond to on the ribs?

A

extends from the left 2nd intercostal space to the left 5th intercostal space
in the midclavicular line (i.e. the apex)

222
Q

where does the superior border of the heart correspond to on the ribs?

A

lies along the line connecting the superior extents of the right and left borders (i.e. from the right 3rd costal cartilage to the left 2nd intercostal space)

223
Q

where does the inferior border of the heart correspond to on the ribs?

A

lies along the line connecting the inferior end of the right border with the apex (mostly formed by the right ventricle)

224
Q

what are the auricles?

A

outpouchings from the walls of the right and left atria (look like an ear)

225
Q

what is patent ductus arteriosus (PDA)?

A

the congenital ductus arteriosus does not close, which means blood flows from the aorta through the ductus arteriosus into the pulmonary trunk increasing its pressure (pulmonary hypertension) straining the right side of the heart

226
Q

what is pericardial effusion?

A

an increase in fluid volume in the pericardial space

227
Q

what may cause pericardial effusion?

A
  1. inflammation of the pericardium (pericarditis)
  2. accumulation of blood (due to trauma)
228
Q

why can pericardial efusion be harmful?

A

the fibrous pericardium cannot stretch and so the heart is compressed and unable to fill
properly (called cardiac tamponade)

229
Q

where do arteries lie within the heart?

A

within the grooves onthe eternal surface

230
Q

what are the grooves on the external surface of the heart called?

A

sulci

231
Q

where do the left and right coronary arteries arise from?

A

ascending aorta

232
Q

where do cardiac veins return blood to?

A

the coronary sinus, that enters the right atrium

233
Q

hat supplies blood to the sinatrial and the atrioventricular nodes?

A

branches from the right coronary artery

234
Q

what supplies blood to the inferior border of the heart?

A

right marginal artery

235
Q

what supplies blood to both ventricles of the heart? what is this blood vessel a continuation of?

A

posterior intraventricular arter, which is a continuation of the right coronary artery

236
Q

what does the left coronary artery branch into?

A
  1. anterior interventricular artery (or the left anterior descending; ‘LAD’)
  2. circumflex artery
237
Q

what is the part of the left coronary artery called before it branches off?

A

left main stem

238
Q

where does the anterior interventricular artery run and supply?

A

runs in the anterior interventricular
sulcus towards the apex and supplies both ventricles

239
Q

where does the circumflex artery run and supply?

A

runs around the heart onto the inferior/diaphragmatic left atrium, part of the right ventricle and the left ventricle

240
Q

where does the left marginal artery run and supply?

A

arises from the circumflex and supplies the left ventricle

241
Q

how can a right/left dominant circulation be determined?

A

if the posterior interventricular artery arises from the right coronary, the person has a right dominant circulation

if the posterior interventricular artery arises from the circumflex artery, the person has a left dominant circulation

242
Q

why is left/right dominant circulation important?

A

in someone with a right-dominant circulation,
occlusion of the left main stem would impair blood flow to part of, but not the entire left ventricle. in someone with left-dominant coronary circulation, blockage of the
left main stem occludes blood flow to the entire left ventricle

243
Q

what is the interatrial spetum?

A

separatedthe left anr right atrium

244
Q

what is the fossa ovalis and where is it found?

A

a depression in the right interatrial septumthat is remnant of the foetal foramen ovale

245
Q

what is the foetal foramen ovale?

A

shunts oxygenates blood from the right atrium to the left atrium allowing it to bypassthe lungs

246
Q

what is the crista terminalis?

A

a muscular ridge that separates the smooth-walled posterior part
of the atrium from the anterior part, which has a ridged, muscular wall

247
Q

what is the trabeculae carneae?

A

muscular ridges on the internal wall of the right ventricle

248
Q

what is the papillary muscles?

A

modified regions of trabeculae carneae, which project into the
lumen of the ventricle

249
Q

what is the chordae tendineae?

A

fibrous cords which connect the tips of the papillary muscles to
the tricuspid valve

250
Q

what is the moderator band?

A

a modified region of the trabeculae carneae which connects the
interventricular septum to one of the papillary muscles

250
Q

what does the left ventricle contain?

A
  1. trabeculae carneae
  2. papillary muscles; two in the left ventricle
  3. chordae tendineae that connect the tips of the papillary muscles to the mitral valve
251
Q

what do the papillary muscles and chordae tendineae do?

A

allow the closed valves to resist the pressure generated inside the ventricles during contraction and prevent them from being forced open

252
Q

what are abnormal heart sounds called?

A

murmurs

253
Q

where are the auscultory areas for the heart for each valve?

A
  1. aortic = 2nd intercostal space, just to the right of the sternum.
  2. pulmonary space, just to the left of the sternum.
  3. tricuspid = 5th intercostal space, just to the left of the sternum.
  4. mitral = 5th intercostal space, left midclavicular line.
254
Q

at wutehat rate does the sinoatrial node generate electrical impluses?

A

70 per min

255
Q

what do visceral afferennt fibers do in the heart?

A

convey sensory information from the heart back to the CNS

256
Q

does information from visceral afferent fibers reach conscious perception?

A

no usually, but if the myocardium is ischaemic, it can be relayed to ur conscious perception as pain, burning or tightness

257
Q

what is referred pain?

A

pain that can not be pinpointed

258
Q

what is myocardial infarction?

A

death of a region of myocardium secondary to occlusion (blockage) of the
coronary vessel that supplies it.

259
Q

what is patient foramen ovale and the consequences?

A

when the foramen ovale fails to close after birth, allowing the movement of blood from the right to the left atrium. severity depends on the size

260
Q

what is ventricular septal defects?

A

blood flow from the left to the right ventricle

261
Q

what is cardiomyopathies?

A

diseases of myocardium, and most are inheriteds – some cause the myocardium to thin, whereas others result in the myocardium becoming thick and stiff which reduces the effect of the heart pumping leading to heart failure

262
Q

where is the posterior mediastinum?

A

behind the heart and pericardium

263
Q

where does the aorta descend through?

A

the posterior mediastinum

264
Q

what do the posterior intercostal arteries supply?

A

the intercostal spaces

265
Q

what does the bronchial arteries supply?

A

the lungs

266
Q

what do the oesophageal branches supply?

A

the oesophagus

267
Q

what do the pericardial branches supply?

A

the pericardium

268
Q

what do the phrenic nerves supply?

A

the diaphragm

269
Q

at what level does the aorta pass through the diaphragm?

A

t12

270
Q

what does the aorta branch into?

A
  1. posterior intercostal arteries
  2. bronchial arteries
  3. oesophageal arteries
  4. pericardial arteries
  5. phrenic branches
271
Q

what is the function of azygos veins?

A

drains blood from the posterior thoracic wall and returns it to the superior vena cava

272
Q

how do the azygous veins travel and where do they travel from?

A

arises in the abdomen at the level of L1 / L2 and traverses the diaphragm to enter the posterior mediastinum

273
Q

where do azygos veins lie and what is the system?

A

lies on the bodies of thoracic vertebrae
consists of:
1. azygos vein on the right side of vertebral bodies
2. hemiazygos veins (shorter) on the left side of vertebral bodies
3. one or more veins connecting the veins to eachother

274
Q

where do the sympathetic trunks lie?

A

posterior thoracic wall, either side of the vertebral column and posterior to the parietal pleura

275
Q

what are the sympathetic trunks appearance wise?

A

thin, longitudinal fibre tracts regularly interspersed with ganglia (singular = ganglion)

276
Q

what are ganglia in the sympathetic trunks also called?

A

paravertebral ganglia

277
Q

what does the posterior intercostal space contain?

A
  • intercostal muscles
  • a posterior intercostal artery (a branch of the thoracic aorta)
  • a posterior intercostal vein (which drains to the azygos system)
  • a posterior intercostal nerve
278
Q

what nerves convey sympathetic fibers to thoracic viscera?

A

cardiopulmonary splanchnic nerves

279
Q

what nerves convey parasympathetic fibers to thoracic viscera?

A

vagus nerves

280
Q

what do sympathetic and parasympathetic fibres form?

A

autonomic plexuses

281
Q

what does the cardiac plexus innervate?

A

the sinoatrial node of the heart

282
Q

what does the pulmonary plexus innervate?

A

the bronchi

283
Q

what does the oesophageal plexus innervate?

A

the anterior surface of the oesophagus

284
Q

what does the oesophageal plexus innervate?

A

the anterior surface of the oesophagus

285
Q

what do visceral afferents do?

A

relay sensory information from the thoracic viscera back to the CNS

286
Q

what is referred pain?

A

where pain from one part of the body is felt in another region

287
Q

where is cardiac pain typically felt?

A

central chest, left side of the neck and left arm

288
Q

why does the brain interpret cardiac pain as coming from the chest,neck and arm?

A

somatic sensory information and visceral sensory information (only when the heart is ischaemic) enters the spine at T1-T5

289
Q

what is the hyoid bone?

A

slender bone situated anteriorly in the upper neck, inferior to the
mandible, that keeps the pharynx open

290
Q

what are anterior and posterior triangles?

A

divisions of the neck separated by sternocleidomastoid muscle

291
Q

what are suprahyoid muscles?

A

four paired muscles that lie superior to the hyoid bone and form the floor of the mouth; when they contract, they raise the
hyoid bone and larynx during speech and swallowing

292
Q

what are infrahyoid muscles?

A

lateral to the anterior
midline of the neck that draw the hyoid bone and larynx inferiorly during speech and swallowing

293
Q

what is the function of the thyroid gland?

A

produces hormones which play an important role in the regulation of metabolic processes

294
Q

what regulates hormone secretion from the thyroid
gland?

A

pituitary gland

295
Q

what blood vessles supply the thyroid gland?

A

left and right superior and inferior thyroid arteries

296
Q

what are parathyroid glands?

A

glands that produce parathyroid hormone that plays a role in calcium regulation

297
Q

what are parathyroid glands made from and where are they found?

A

left and right superior and inferior that are located posterior to the thyroid gland

298
Q

where do the common carotid arteries descend?

A

in the left and right sides of the neck

299
Q

what does the common carotid artery bifurcate into?

A

external and internal carotid arteries

300
Q

what does the internal carotid artery do?

A

enters the cranium and supplies the brain

301
Q

what does the external carotid artery do?

A

artery gives rise to several branches that supply the head and neck, including the pharynx, scalp, thyroid gland, tongue, and the face

302
Q

what does the internal jugular vein do?

A

drains blood from the brain
and part of the face

303
Q

what do the left and right brachiocephalic veins unite to form?

A

superior vena cava

304
Q

what separates the triangles of the neck?

A

the sternocleidomastoid muscle

305
Q

how do cervical vertebrae allow for good flexion and extension?

A

small and articulate with each other at facet joints that
are orientated obliquely

306
Q

where do the inferior thyroid arteries come from?

A

right and left subclavian arteries

307
Q

where do the superior thyroid arteries come from?

A

from the front of the external carotid artery

308
Q

what drains the thyroid gland?

A

superior, middle, and inferior thyroid veins

309
Q

what happens at the point of common carotid arteries?

A

a swell of the carotid sinus exists, where baroreceptors monitor arterial blood pressure and relay the information back to the CNS via the glossopharyngeal
nerve to regulate blood pressure

310
Q

what are the walls of the pharynx composed of?

A
  1. outer layer of circular muscle
  2. inner layer of longitudinal muscle
311
Q

what is the external muscle layer of the pharynx composed of?

A

superior, middle and inferior constrictors

312
Q

how does food travel down into the oesophagus?

A
  1. food in the oral cavity is pushed into the oropharynx by the tongue
  2. soft palate rises and closes off the nasopharynx from the oropharynx
  3. food moves down into the laryngopharynx and constriction of the pharyngeal wall moves food into the oesophagus. the epiglottis closes off the laryngeal inlet to prevent food moving into the larynx
313
Q

where is the nasopharynx?

A

posterior to the nasal cavity

314
Q

where is the oropharynx?

A

posterior to the oral cavity

315
Q

what is the laryngopharynx?

A

posterior to the larynx

316
Q

what are tonsils made from and where are they found?

A

lymphoid tissue in the upper parts of the pharynx

317
Q

what tonsils are found in the nasopharynx?

A

pharyngeal and tubal tonsils

318
Q

where is the pharyngeal tonsil?

A

lies in the roof of the nasopharynx

319
Q

where is the tubal tonsil?

A

surrounds the opening of the auditory tube

320
Q

what tonsil lies in the oropharynx?

A

palatine tonsil

321
Q

where does the lingual tonsil lie?

A

on the posterior aspect of the tongue

322
Q

what is the pharynx innervated by?

A

sensory fibres from the glossopharyngeal nerve and motor fibres from the vagus nerve

323
Q

name some nerves that innervate the pharynx?

A
  1. cervical part of the sympathetic trunk
  2. superior laryngeal nerve
  3. hypoglossal nerve
  4. glossopharyngeal nerve
324
Q

how many cartilages is the larynx composed of?

A

9: three unpaired and three paired

325
Q

what are the three unpaired cartilages of the larynx?

A

epiglottis, thyroid cartilage, and the cricoid cartilage

326
Q

what are the three paired cartilages of the pharynx and how do their size compared to the unpaired?

A

much smaller
arytenoids, the cuneiforms and the corniculate

327
Q

what is the structure of the thyroid cartilage?

A

composed of two flat cartilages (laminae) that meet in the anterior midline to form the laryngeal prominence

328
Q

what do the laminae of the thyroid cartilage form posteriorly and what do these articulate with?

A

extensions that project superiorly and inferiorly - the
superior and inferior horns
1. superior horns attach to the hyoid bone
2. inferior horns articulate with the cricoid cartilage below

329
Q

what is the cricothyroid membrane and its significance?

A

connects the inferior border of the thyroid and superior
border of the cricoid that is pierced to create an emergency airway

330
Q

what is the epiglottis attached to?

A

superior aspect of the thyroid cartilage

331
Q

where do arytenoid cartilages lie and what are their importance?

A

sit on the superior surface of the cricoid cartilage
vital for
phonation, as the vocal cords attach to them. movements of the arytenoids move the
vocal cords.

332
Q

what is the internal asoect of the larynx modified for?

A

phonation

333
Q

what are the vestibular folds?

A

two pairs of folds that project superiorly into the cavity of the larynx

334
Q

what are the vocal folds?

A

two pairs of folds that project inferiorly into the cavity of the larynx (true vocal chords)

335
Q

what is the purpose of the vocal folds?

A

protect the vocal
ligaments

336
Q

where do the vocal ligaments attach to?

A

attached anteriorly to the internal aspect of the laryngeal prominence and posteriorly to the arytenoid cartilages

337
Q

what is the space between the true vocal cords called?

A

rima glottidis

338
Q

what is adduction of the rima glottidis?

A

closes the rima glottidis

339
Q

what is abduction of the rima glottidis?

A

opens it

340
Q

what groups of muscles act on the larynx?

A

extrinsic and intrinsic

341
Q

what are the extrinsic muscles of the larynx and their function?

A

suprahyoid and infrahyoid muscles. they do not move the individual cartilages, but rather move the larynx as one with speech and swallowing

342
Q

what are the intrinsic muscles of the larynx and their function?

A

move the laryngeal cartilages which in turn move the vocal
cords

343
Q

what are the intrinsic muscles of the larynx?

A
  1. left and right cricothyroid muscles anteriorly
  2. left and right posterior cricoarytenoids on the posterior surface of the cricoid
  3. transverse arytenoid
344
Q

what nerves inner
vate the larnx and what feaures?

A
345
Q

what separates the left and right nasal cavity and what is this made from?

A

thin midline septum, formed of cartilage and bone

346
Q

what separates the nasal cavity from the oral cavity?

A

the hard palate

347
Q

what separates the nasal cavity from the brain

A

bone

348
Q

what is posterior to the nasal cavity?

A

nasopharynx

349
Q

what sinus is associated with the nasal cavity?

A

the paranasal sinus

350
Q

what is the structure of the septum?

A

formed of cartilage anteriorly and two thin plates of bone
posteriorly

351
Q

what is the structure of the lateral wall of the nasal cavity?

A

three projections of bone, the superior, middle,
and inferior conchae (Latin = shell), or turbinates

352
Q

what is the name of the space that lies inferior to the tubinates?

A

meatuses (superior, middle and inferior which lie inferior to their respective turbinates)

353
Q

what is the purpose of the turbinates and meatuses?

A

inspired air travels through the meatuses it is warmed, humidified, and filtered

354
Q

what is the name of the bone that separates the brain from the nasal cavity, and what is its structure?

A

cribriform plate
delicate section of bone that is perforated with tiny holes (like a sieve)

355
Q

what is significant about the perforations in the cribform plate?

A

olfactory (relating to the sense of smell) nerves of the travel through the perforations to the brain

356
Q

what does the blood supply of the nasal cavity look like?

A

supplied by branches of the maxillary artery which is a terminal branch of the external carotid artery. the branches form networks which is often the site of a nosebleed.

357
Q

what does the nerve supply of the nasal cavity look like?

A

sensory innervation of the nose is via branches of the trigeminal nerve (CN V)

358
Q

what are the four types of paranasal sinuses and where do they lie?

A
  1. frontal sinuses lie within the anterior part of the frontal bone.
  2. ethmoid air cells lie within the ethmoid bone (superior to the nasal cavity and
    medial to the orbits).
  3. sphenoid sinuses lie within the sphenoid bone.
  4. maxillary sinuses lie within the maxillae of the facial skeleton
359
Q

where does the frontal sinus drain into?

A

middle meatus

360
Q

where does the sphenoid sinus drain into?

A

spheno-ethmoidal recess

361
Q

where does the ethmoid air cells drain into?

A

superior and middle meatuses

362
Q

where does the maxillary sinus drain into?

A

middle meatus

363
Q

what does the nasolacrimal duct drain?

A

fluid (‘tears’) that lubricate the anterior surface of the eye

364
Q

what does the nasolacrimal duct drain into?

A

inferior meatus

365
Q

where is the auditory tube?

A

connects the middle ear to the nasopharynx

366
Q

what is the function of the auditory tube?

A

allows air to pass into the middle ear so that the pressure on either
side of the tympanic membrane (eardrum), which lies between the middle and
external ear, is equal. this is important for optimal conduction of soundwaves

367
Q

what is the structure of the palate?

A

anteriorly of bone – the hard palate – and posteriorly of muscle – the soft palate

368
Q

what is the hard palate composed of?

A

palatine processes of the maxillae and the
horizontal plates of the palatine bones

369
Q

what is the function of the hard palate?

A

● it prevents food or fluid entering the nasal cavity.
● we push our tongue up against the hard palate during the first phase of swallowing,
which forces food and fluid backwards into the oropharynx.
● we push our tongue up against the hard palate to articulate certain sounds.

370
Q

what projects from the soft palate?

A

the uvula -‘hangs’ from the posterior border of the soft palate and can be seen at the back of the mouth

371
Q

what is the soft palate innervated by?

A

vagus nerve

372
Q

what is the purpose of the soft palate?

A

the muscles of the soft palate contract during swallowing which elevates the soft palate. the nasopharynx is closed off from the oral cavity, preventing reflux of food and fluid into the
nasal cavity

373
Q

what is the superior surface of the oral cavity?

A

soft tissues and muscles (the floor of the mouth)

374
Q

what is the lateral surface of the oral cavity?

A

the cheeks

375
Q

how many teeth do adults have?

A

32, 16 embedded in the maxilla (upper jaw) and 16 embedded in
the mandible (lower jaw).

376
Q

what type and number of teeth are there?

A

in the upper and lower jaws there are four incisors, two canines, four premolars and six molars

377
Q

what are teeth composed of?

A

● an inner pulp which contains blood vessels and nerves
● dentin which surrounds the pulp
● an outer, hard coating of enamel.

378
Q

what are some functions of the tongue?

A

chewing, swallowing and speech

379
Q

what is found on the surface of the tongue and its function?

A

s papillae on its
superior surface, some of which detect taste (‘taste buds’)

380
Q

what is the space between the posterior tongue and the anterior aspect of the epiglottis called?

A

vallecula

381
Q

what innervates the muscles of the tongue?

A

hypoglossal nerve (CN XII)

382
Q

what types of muscle is found in the tongue, and what is its function?

A
  1. intrinsic muscles lie entirely within the tongue. They are paired bilaterally and fuse in
    the midline. They change the shape of the tongue.
  2. extrinsic muscles are attached to the tongue but originate from outside it (from the
    mandible and hyoid bone). They move the tongue.
383
Q

what innervates the taste found in the anterior two thirds of the tongue?

A

facial nerve (CN VII)

384
Q

what innervates the touch, pain, temperature found in the anterior two thirds of the tongue?

A

trigeminal nerve (CN V)

385
Q

what innervates the touch, pain, temperature and taste found in the posterior third of the tongue?

A

glossopharyngeal nerve (CN IX)

386
Q

what vessels supply the oral cavity and where do they branch from?

A

the lingual, maxillary, and facial arteries, which are
branches of the external carotid artery

387
Q

what innervates the oral cavity?

A

the muscles of the soft palate are innervated by the vagus nerve. the tongue is innervated by four cranial nerves (CNs V, VII, IX and
XII)

388
Q

what and where are the different tonsils?

A

● the pharyngeal tonsil lies in the roof and posterior wall of the nasopharynx
(sometimes called the ‘adenoid’).
● the tubal tonsil surrounds the opening of the auditory tube on the lateral wall of the
nasopharynx.
● the palatine tonsil lies on the lateral wall of the oropharynx. Usually referred to as ‘the tonsils’, they are visible on either side of the oropharynx when the mouth is open.
● the lingual tonsil is a collection of lymphoid tissue in the posterior tongue.

389
Q

what is the name of the three pairs of salivary glands secrete saliva into the oral cavity?

A

the parotid, submandibular and sublingual salivary glands

390
Q

is glandular stimulation sympathetic or parasympathetic?

A

parasympathetic

391
Q

which is the largest of the three paired salivary glands and where does it lie?

A

parotid, overlies the
posterior part of the mandible

392
Q

how does saliva empty into the mouth ?

A

through the parotid duct

393
Q

what stimulates secretion from the parotid gland?

A

glossopharyngeal nerve

394
Q

where are submandibular glands found?

A

lie inferior to the body of the mandible, just anterior to the angle. opens into the
floor of the mouth, under the tongue

395
Q

what stimulates the secretion of saliva in submandibular glands?

A

parasympathetic
fibres in the facial nerve

396
Q

where do sublingual glands lie?

A

in the floor of the mouth

397
Q

what stimulates the secretion of saliva in sublingual glands?

A

parasympathetic fibres in the facial nerve