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CARDIO - RESP BLOCK > Anatomy Of the thorax and circulation > Flashcards

Anatomy Of the thorax and circulation Flashcards

1
Q

What anatomical structures lie behind the sternal angle?

A

RAT PLANT

Rib 2
Aortic arch
Tracheal bifurcation
Pulmonary trunk 
Ligamentum arteriosum 
Azygos vein
Nerves (vagus and sympathetic trunk) 
Thoracic duct
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2
Q

Where is the Suprasternal (suprajugular) notch?

A

Superior border of manubrium

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3
Q

Where is the Sternal angle/ Angle of Louis?

A

Manubriosternal joint (between the manubrium & body of the sternum)

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4
Q

Anterior axillary line

A

Runs through the lateral quarter point of the clavicle

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5
Q

Sternal line (border)

A

Lateral margin of sternum

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6
Q

Parasternal line

A

Between sternal and mid-clavicular lines

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7
Q

Mid-clavicular line

A

Runs through the mid-point of the clavicle

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8
Q

Midline

A

Runs centrally down the sternum

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9
Q

Posterior axillary line

A

Posterior axillary fold

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10
Q

Mid-axillary line

A

Runs at the mid-point between the anterior & posterior axillary lines

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11
Q

Structures of mediastinum

A

Superior- above the heart
Inferior - anterior in front of the pericardium
Inferior - middle containing pericardium
Inferior - posterior behind pericardium

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12
Q

Superior mediastinum

A 
Thymus 
Great vessels
Trachea 
Esophagus 
Thoracic duct
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13
Q

Structures in middle inferior mediastinum

A

Heart
Pericardium
Roots of great vessels

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14
Q

Structures in posterior inferior mediastinum

A

Thoracic aorta
Thoracic duct
Azygous venous system

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15
Q

Thin walled and contain valves

A

Veins

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16
Q

Thick walled
No valves
Contain baroreceptors & chemoreceptors

A

Arteries

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17
Q

Layers of blood vessels

A

Tunica intima

Tunica media

Tunica esterna/Adventia

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18
Q

Tunica intima

A

INNERMOST layer

Lined by endothelium comprised of simple squamous epithelial cells

Basement membrane and subendothelial connective tissue support overlying cells

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19
Q

Tunica media

A

INTERMEDIATE , smooth muscular layer

Contain alpha and beta adrenergic receptors, allowing for sympathetic regulation of blood pressure

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20
Q

Tunica externa/adventitia

A

OUTERMOST layer

Anchors vessels to organs Comprised of type 1 collagen, and elastic connective tissue (in arteries)

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21
Q

Types of arteries

A

Elastic artery

Muscular artery

Arterioles

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22
Q

Elastic artery

A

Aorta, pulmonary trunk

Thick tunica media with abundance of elastic fibres

Contain 2 additional layers : internal and external elastic laminae

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23
Q

Muscular artery

A

Gastro-epiploic artery

More smooth muscle & fewer elastic fibres within intima layer

Most abundant arterial vessel

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24
Q

Arterioles

A

Vasa recta or large intestines

Smallest division of arterial network

Thin tunica interna

Far fewer muscle fibres

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25
Q

What are Capillaries?

A
  • Smallest vascular structures in the body
  • Deliver blood to tissues

• No tunica media or
externa: single layer endothelium plus basement membrane

• Grouped based on the arrangement of the endothelium along the vessel walls

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26
Q

Vessel walls types of capillaries

A
  • Fenestrated
  • Continuous
  • Discontinuous
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27
Q

Fenestrated capillaries

A

Capillary beds are perforated along the endothelial cells

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28
Q

Function of Fenestrated capillaries

A

Facilitates rapid molecular exchange between capillaries and tissues

Example: Bowman’s capsule

29
Q

Discontinuous (sinusoid also) capillaries

A

Tortuous, irregular vessels. Incompletely formed/ absent basement membranes underlie widely spaced endothelial cells.

30
Q

Function of Discontinuous (sinusoidal)

A

Absence of gap junctions allows for direct transportation from the capillary’s lumen to surrounding tissue

Examples: bone marrow, liver, spleen

31
Q

Continuous capillaries

A

Most common type.

Endothelial cells are within close proximity and fitted with gap junctions

32
Q

Function of capillaries

A

Isolate luminal content from interstitial space

Examples:

Skin, connective and nervous tissue, muscle

33
Q

Flow of blood in veins

A

Capillary&raquo_space; post-capillary veins&raquo_space; venules&raquo_space; veins (small> medium>large)

34
Q

When compared to similarly sized arteries, veins have?

A

A thinner tunica media

A wider lumen

A greater abundance (more of them) Valves (except for the venae cava)

35
Q

Location of Baroreceptors

A

Carotid sinus

36
Q

Location of Chemoreceptors

A

Carotid body

37
Q

Carotid sinus

A

Proximal internal carotid artery (near bifurcation of common carotid artery)

38
Q

Carotid body

A

At bifurcation

of common carotid artery

39
Q

Blood supply to head & upper limbs

A

Arch of aorta

40
Q

Blood supply to thorax

A

Thoracic aorta

41
Q

Blood supply to abdomen & GI

A

Abdominal aorta

42
Q

Blood supply to lower limbs and pelvic region

A

Common iliac arteries

43
Q

Ascending aorta

A

From aortic orifice (at base of LV) at the level of 3rd left costal cartilage anteriorly, to 2nd right costal cartilage anteriorly (sternal angle)

44
Q

Aortic arch

A

Begins and ends at the level of the 2nd right costal cartilage anteriorly/ T4-T5 vertebral level posteriorly (i.e level of sternal angle).

Occupies the superior mediastinum

45
Q

Major branch order of the aortic arch

A

ABC’S

Aortic arch gives rise to:

Brachiocephalic trunk

Left Common carotid artery

Left Subclavian artery

46
Q

Thoracic aorta runs from?

A

Arch of aorta ( level TTP) to diaphragm ( vertebral level T12)

47
Q

Where is the Aortic hiatus ?

A

T12

48
Q

Unpaired branches of the thoracic aorta

A

Bronchial arteries

Pericardial arteries

Esophageal arteries

Mediastinal arteries

49
Q

Paired branches of the thoracic aorta

A

Intercostal arteries

Superior phrenic arteries

50
Q

Which branches of thoracic aorta supply diaphragm?

A

Superior phrenic arteries

51
Q

The venous system has two main collecting vessels

A

Superior vena cava

Inferior vena cava

52
Q

Superior vena cava

A

collects from head and upper limbs

53
Q

Inferior vena cava

A

collects from abdomen and lower limbs

54
Q

The RIGHT superior intercostal vein is received by

A

Azygous vein

55
Q

The LEFT superior intercostal drains into the

A

Left brachiocephalic OR the azygos vein.

56
Q

Right azygous vein arises at which level?

A

L1-2

57
Q

Right azygous vein empties at which level?

A

T4 into the SVC

58
Q

What are tributaries of azygous vein ?

A

Right superior intercostal vein, 5th-11th right posterior intercostal veins, the hemiazygos vein, the accessory hemiazygos vein, oesophageal, mediastinal, pericardial and right bronchial veins.

59
Q

Hemiazygos vein (left) arises where?

A

Arises at confluence of L ascending lumbar and subcostal veins or from the L renal vein

60
Q

Hemiazygos vein crossed the midline to enter the azygous run at what level ?

A

T9

61
Q

What are the tributaries of the hemiazygos vein?

A

The lowest 4 or 5 left posterior intercostal veins, oesophageal and mediastinal veins.

62
Q

At what level does the accessory hemiazygos vein (left) descend at the posterior mediastinum?

A

T8, where is crosses the midline to drain into the azygos vein or ends in the hemiazygos vein

63
Q

What are the tributaries of the accessory hemiazygos vein?

A

4th-8th left posterior intercostal veins, sometimes the left bronchial veins.

64
Q

The IVC passes through the diaphragm at?

A

T8

65
Q

What is the lymphatic system?

A

A series of organs, vessels and nodes that collect and filter excess tissue fluid (lymph), before returning it to the venous circulation.

66
Q

Function of lymphatic system

A

• To drain excess interstitial fluid from tissues into the venous system
• To produce and transport immune cells (lymphocytes)
• To mount an immune response against pathogens
• To transport dietary lipids from the GI tract into the
blood

67
Q

Lymphatic flow summary

A
  1. Fluid leaves the blood capillaries (due to hydrostatic pressure) and enters the interstitial space
  2. Fluid enters the lymphatic system through lymphatic capillaries within the interstitial space, which unite to form lymphatic vessels
  3. Lymph flow is slow, one- directional and passes through a series of lymph nodes before draining into lymphatic trunks (collecting vessels)
  4. These trunks converge to form the right lymphatic duct and thoracic duct, which drain into the venous circulation at the subclavian veins (via the right and left venous angles, respectively)
68
Q

What structure collects lymph from left upper quadrant & lower half of body?

A

Thoracic duct - 40 cm long

69
Q

What structure collects lymph from right upper quadrant of the body → head & neck, upper limb, chest & thoracic cavity?

A

Right lymphatic duct- short= 1 cm

CARDIO - RESP BLOCK (13 decks)

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