Cardiorespiratory Flashcards

1
Q

What are the openings of the thoracic cavity called?

A

The superior and inferior thoracic aperture

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2
Q

3 divisions of the thoracic cavity

A
  • Right pleural cavity
  • Left pleural cavity
  • The mediastinum
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3
Q

Describe the main structures of the sternum

A

Most superior is the manubrium with jugular notch at top.
Followed by the body, at junction between manubrium and body is the sternal angle.
Most inferiorly is the xiphoid process.

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4
Q

How many ribs are there?

A

12

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5
Q

Ribs are divided into 3 categories, what are these?

A
  • True ribs (R1-7) vertebrosternal
  • False ribs (R8-10) vertebrochondral
  • Floating ribs (R11-12) vertebral
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6
Q

Describe the true ribs

A

Attach from the vertebra posteriorly and to the sternum anteriorly via costal cartilages

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7
Q

Describe the false ribs

A

Attach posteriorly to the vertebrae, and attach indirectly to sternum via costal cartilages (they attach to the costal cartilage of the superior rib above them)

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8
Q

Describe the floating ribs

A

No attachment on the anterior aspect, no costal cartilages, do attach posteriorly to thoracic vertebrae

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9
Q

Describe the features of typical ribs

A
  • Head (end which articulates posteriorly with thoracic vertebrae)
  • Neck
  • Tubercle (articulates with transverse process of a thoracic vertebra)
  • Body
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10
Q

How many thoracic vertebrae are there?

A

12

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11
Q

Describe the 5 main features of thoracic vertebrae

A
  • Vertebral body
  • Transverse processes (left and right) have facets to articulate with ribs
  • Spinous process (long and slender, central)
  • Pedicle (stub of bone connecting lamina to vertebral body)
  • Lamina (links each transverse process with spinous process)
  • Intervertebral foramen for spinal nerves
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12
Q

Describe the facets present on the thoracic vertebrae

A

Each vertebrae has 6 facets:

  • 2 inferior costal facets for head of rib
  • 2 superior costal facets for head of rib
  • 2 facets for the tubercle of the rib

Summary: rib articulates at 2 points for head and 1 point for tubercle

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13
Q

Name the 5 muscles of the thoracic wall

A
  • External intercostal muscle
  • Internal intercostal muscle
  • Innermost intercostal muscle
  • Transversus thoracis
  • Subcostal muscle
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14
Q

Describe the external intercostal muscle

A

Many slips of muscle that run down the full length of the thoracic wall. Elevate the ribs during inspiration.

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15
Q

Describe the internal intercostal muscle

A

Lies deep to external intercostal muscle, muscle fibres run perpendicular to ext inter muscle fibres.
Run right up to the sternum.
Depresses the ribs in forced expiration.

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16
Q

Describe the innermost intercostal muscle

A

Lies deep to the internal intercostal muscle. Fibres run in the same direction.
Relatively small muscle.
Involved in forced expiration.

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17
Q

Describe the transversus thoracis

A

Fan out from sternum.

Aids internal intercostal muscle in depressing the ribs.

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18
Q

Describe the subcostal muscle

A

A variable muscle- not always present.

Aids expiration.

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19
Q

Where are neurovascular structures located?

A

Between the internal intercostal muscle and the innermost intercostal muscle

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20
Q

In what order do the neurovascular structures lie?

A

Vein superior, artery in the middle, nerve inferior. (V A N)

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21
Q

What is the collateral neurovascular bundle?

A

A smaller bundle of neurovascular structures which runs at the inferior border of the thoracic space- order of structures is opposite to normal (N A V)

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22
Q

Describe the blood supply and drainage of the thoracic cavity

A

Internal thoracic artery and internal thoracic vein are the main collection of vessels and travel down either side of the sternum.
Intercostal veins drain into internal thoracic vein.
Intercostal arteries branch from the internal thoracic artery.

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23
Q

Describe the diaphragm

A

A flat muscle (musculotendinous sheet) dividing the thoracic cavity from the abdominal cavity.

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24
Q

Describe the innervation of the diaphragm

A

Diaphragm is innervated by the Phrenic nerve.
Root values for Phrenic nerve- C3, C4,C5

“C3, C4, C5 keep the diaphragm alive”

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25
Q

Which 3 major structures pass through the diaphragm?

A
  • The aorta (T12)
  • The inferior vena cava (T10)
  • The oesophagus (T8)
26
Q

Describe the pleura present in the thoracic cavity

A

The pleura is a continuous membrane lining the lungs and thoracic wall.

  • Visceral pleura lines the lungs
  • Parietal pleura lines inner aspect of pleural cavity

Space between 2 pleura = pleural cavity

27
Q

3 differences between the left and right lung

A
  • Left has cardiac notch
  • Left has a lingula (on superior lobe)
  • Left lung has 2 lobes, right lung has 3 lobes
28
Q

Left lung structure

A
  • 2 lobes (inferior and superior)

- Lobes separated by oblique fissure

29
Q

Right lung structure

A
  • 3 lobes (inferior, middle and superior)
  • SL and ML separated by horizontal fissure
  • ML and IL separated by oblique fissure
30
Q

What is the hilum?

A

A triangular section where vessels and nerves enter and exit the lungs

31
Q

Vasculature of the left vs right lung

A

Left: 1 pulmonary artery, 1 pulmonary vein
Right: 1 pulmonary artery, 2 pulmonary veins

32
Q

3 main surface landmarks of the thorax

A
  • Midclavicular lines: midway of clavicle and straight down
  • Midaxillary lines: line down the lateral aspect from the axilla (armpit)
  • Midscapular lines: down from middle of scapular
33
Q

Shortcut to remember position of lungs and associated pleura

A

A, 2, 4, 6, 8, 10, 12

A- apex of lung, pleura lies in neck
2- 2nd costal cartilage (CC) pleura meet at midline
4- 4th CC left pleura moves away from midline
6- 6th CC right pleura moves away from midline
8- 8th CC most inferior point of pleura anteriorly
10- 10th CC most inferior point of pleura laterally
12- 12th CC most inferior point of pleura posteriorly

34
Q

What are the 2 main phases of respiration?

A

Inspiration
Expiration

(NB: there’s also forced inspiration and expiration which commonly occur during exercise and utilise additional muscles)

35
Q

Diaphragm during respiration

A

Contracts

36
Q

Pleura during respiration

A

Facilitates frictionless movement, lungs can move smoothly against thoracic wall

37
Q

Bony and cartilaginous skeleton during respiration

A

Movable and flexible to allow for expansion of thoracic cavity

38
Q

Lungs during respiration

A

Inherently elastic organs

39
Q

What is the mediastinum and its contents?

A

The space in the thorax between the lungs.

  • Heart and pericardium
  • Trachea
  • Oesophagus
  • Vagus nerves
  • Lymphatics
  • The great vessels
40
Q

The mediastinum is divided into ….

A

The superior mediastinum

The inferior mediastinum (middle, anterior and posterior)

41
Q

Describe the superior mediastinum

A

Lies inferior to the superior thoracic aperture.

Runs from sternal angle to the transverse thoracic plane (line between T4 and T5)

42
Q

Describe the 3 components of the inferior mediastinum

A
  1. Anterior mediastinum: small, fat filled space, contains thymus gland in children
  2. Middle mediastinum: contains heart and pericardium, sits behind body of sternum
  3. Posterior mediastinum: occupies region posterior to middle mediastinum
43
Q

Route of blood in right side of the heart

A

Receives deoxygenated blood from the superior and inferior vena cava, blood leaves via pulmonary artery to the lungs

44
Q

Route of blood in the left side of the heart

A

Recieves oxygenated blood from the pulmonary veins, blood leaves via the aorta to the rest of the body

45
Q

Alternative terms for the left and right sides of the heart

A
Right heart (pulmonary)
Left heart (systemic)
46
Q

Which chambers of the heart are thicker walled?

A

The ventricles as they must act as powerful pumps.

The atria are thinner walled.

47
Q

Describe the 2 valves in the right side of the heart

A
  1. Atrio-ventricular valve between the atrium and ventricle- tricuspid valve, bases of 3 cusps are anchored to a tendinous ring, free edges of cusps attached to chordae tendineae.
  2. Pulmonary valve
48
Q

Describe the 2 valves in the left side of the heart

A
  1. Atrio-ventricular valve- bicuspid valve/mitral valve

2. Aortic valve

49
Q

Describe the pericardium

A

Fibrous sac enclosing the heart and the great vessels
Has 2 layers:
1. Outer fibrous layer (superficial)
2. Inner serous membrane (deep)

50
Q

Describe the right atrium of the heart

A
  • Relatively thin walled
  • Has pectinate muscles on anterior wall
  • Has a vertical ridge separating rough anterior wall and smooth posterior wall called the crista terminalis
51
Q

Describe the right ventricle of the heart

A
  • Thicker walled pumping chamber

- Has muscular ridges on inner wall called trabeculae carneae

52
Q

Describe the left atrium of the heart

A
  • Has pectinate muscles

- Recieves oxygenated blood from 4 pulmonary veins

53
Q

Describe the left ventricle of the heart

A
  • Wall is thicker and tougher than right ventricle wall

- Has ridges of cardiac muscle on inner wall called trabeculae carneae

54
Q

What is the function of the coronary arteries?

A

Coronary arteries supply the heart with blood

55
Q

Describe the anatomy of the left and right coronary arteries

A

Left and right coronary artery arise from the aorta, just above the aortic valve.
Left coronary artery bifurcates into the circumflex branch (runs posterior) and the anterior interventricular branch (runs anterior)

56
Q

Describe the venous drainage of the heart

A

The great cardiac vein receives venous blood.

All cardiac veins drain into the coronary sinus- coronary sinus empties into the right atrium of the heart.

57
Q

Contents of the superior mediastinum

A
  • The great vessels
  • Vagus nerve
  • Lymphatics (thoracic duct)
  • Trachea
  • Oesophagus
58
Q

What are the great vessels?

A
  • Superior vena cava
  • Inferior vena cava
  • Aorta
  • Pulmonary arteries
  • ## Pulmonary veins
59
Q

Contents of the posterior mediastinum

A
  • Thoracic aorta
  • Lymphatics (thoracic duct)
  • Oesophagus
  • Azygos and hemiazygos veins
60
Q

What is the azygos and hemiazygos system of veins?

A

Blood from intercostal veins drain into the azygos vein and hemiazygos veins.
Azygos vein then drains into superior vena cava.
Hemiazygos drains into azygos vein. Then into vena cava.