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ExPhys > CH 1 RCQ > Flashcards

CH 1 RCQ Flashcards

1
Q

importance of sternal angle

A

2nd Rib and 2nd ICS anteriorly, T4,5 vertebrae posteriorly, bifurcation of the trachea, right atrium of the heart

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2
Q

what makes rib 1 different

A

shortest and most curved of all the ribs with a small head and rounded shape allows for only one facet for articulation with the body of the first thoracic vertebrae

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3
Q

what makes rib 2 different

A

similarly curved to rib 1, slightly longer, but not twisted and has a short costal groove on the internal surface posteriorly

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4
Q

what makes ribs 10-12 different

A

one articular facet on their heads. 11 and 12 are floating ribs without necks or tubercles and are narrowed at their free anterior ends. Often times rib 12 is shorter than rib 1.

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5
Q

What are all of the functions of the respiratory system?

A

Gas and fluid exchange, maintenance of relatively low volume blood reservoir, filtration and metabolism.

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6
Q

primary muscles of ventilation

A

Diaphragm
External Intercostals
Abdominals
Internal Intercostals

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7
Q

accessory muscles of ventilation

A

SCM
Scalenes
Upper Trapezius
Pectoralis Major/Minor
Serratus Anterior and Rhomboids
Latissimus Dorsi
Serratus Posterior Superior
Thoracic Erector Spinae

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8
Q

structure of the diaphragm? what does it form? how is it set up?

A

musculotendinous dome
creates the floor of the thorax and separates the thoracic and abdominal cavities.

right and left hemidiaphragm
– each being composed of sternal, costal, and lumbar portions that converge into the central tendon.

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9
Q

What is the structure and function of the central tendon?

A

aponeurosis situated anteriorly and immediately below the pericardium.

central tendon is pulled down and forward during inspiration

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10
Q

bucket handle motion

A

Costal fibers of the diaphragm contract and pull the lower ribs up and out

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11
Q

pump handle motion

A

suprasternal notch elevating and posteriorly rotating

xiphoid process elevates and moves anteriorly during inspiration

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12
Q

supine positioning and the resting position of the diaphragm? how does this affect volume of lungs?

A

level of the diaphragm rises and allows for a relatively greater excursion of the diaphragm

This in turn decreases the volumes of the lungs due to elevated position of the abdominal organs in the thoracic cavity.

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13
Q

upright position and the resting position of the diaphragm? how does this affect volume of the lungs?

A

dome of the diaphragm is lowered due to gravity, decreasing respiratory excursion and increasing lung volumes

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14
Q

side lying position and the resting position of the diaphragm? how does this affect the volume of the lungs?

A

the uppermost side drops and has less excursion where as the lowermost side rises higher and has greater excursion when compared to sitting.

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15
Q

explain the events of inspiration

A

diaphragm contracts
– increase of volume in the thoracic cavity

increase volume until it hits the abdominal viscera
– bucket handle motion of the ribs to occur due to costal fibers of the diaphragm contracting.

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16
Q

explain pressure differences that allow for inspiration

A

intrathoracic pressure decreases below the air pressure outside of the body

air to rush into the lungs to normalize this difference.

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17
Q

explain passive expiration

A

elastic reoil of the lung and relaxation of external intercostals and the diaphragm

ribs drop and diaphragm rises drop to their original positions

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18
Q

what muscles are used in forced expiration

A

abdominals and internal intercostals

19
Q

pleural pain refers to

A

pleura innervated by intercostal nerve refers pain to thoracic / abdominal walls

phrenic innervated refers pain to lower neck and shoulder

20
Q

what is pleural effusion

A

build up of fluid in pleural space, typically blood

21
Q

what is a pneumothorax

A

air build up in the pleural space due to a collapsed lung

22
Q

what is an empyema

A

bacterial infection with resultant pus build up in pleural space

23
Q

what does the inferior border of the lung separate

A

base of the lung from costal surface

24
Q

what does posterior border of the lungs separate

A

costal surface from the vertebral aspect of mediastinal surface

25
Q

what does the anterior border of the lung overlap

A

front of pericardium

26
Q

what structures pass through the hila?

A

principal bronchus
pulmonary artery/veins
bronchial arteries/veins
pulmonary nerve plexus
lymph vessels

27
Q

right vs left mainstem bronchus

A

right mainstem bronchus is wider and shorter with a 25° angle of divergence from the trachea

left mainstem bronchus diverges at an angle of 40-60°

28
Q

importance of difference between right and left mainstem bronchus

A

aspiration is much more common in the right lung

29
Q

type 2 pneumocytes

A

granular pneumocyte that are thick and cuboidal
cover 7% of alveolar surface
produce surfactant

30
Q

type 1 pneuomcytes

A

squamous pneumocytes that cover about 93% of alveolar surface

31
Q

What is mediastinal shift and what causes it?

A

A shift of structures in the mediastinum

pneumothorax or pneumonectomy.

32
Q

tell me bout the pericardium

A

outermost layer that is a double-walled sac
– parietal and visceral

33
Q

compare parietal vs visceral pericardium

A

parietal - dense, irregular fibrous CT

visceral - thin, moist serous layer

34
Q

tell me bout the myocardium

A

contractile elements of the heart
– pumping of the heart caused by mechanical and conductive cells

35
Q

what are mechanical vs conductive cells

A

mechanical - contain actin and myosin, carry out the action of pumping

conductive - contain and deliver electrical impulses that initiate mechanical action

36
Q

tell me about the endocardium

A

innermost layer made of squamous endothelium overlying a thin areolar tissue

continuous with tissue of valves and blood vessels

37
Q

what nerve determines PSNS control of the heart? stimulation of it causes

A

from R and L vagus to cardiac plexus

inhibitory of CV system
– decreased HR, blood pressure

38
Q

what neurohormone is most involved in PSNS stimulation of the heart

A

Acetylcholine

39
Q

SNS control of the heart and its resultant outcome

A

from sympathetic trunk in the neck at the level of upper 4/5 thoracic ganglia

to cardiac plexus

excitation of CV system
– increased HR, BP, contractility and decreased time of conduction through the AV node

40
Q

main neurohormone involved in the SNS control of the heart

A

catecholamines

41
Q

what makes up arteries?

A

elastic and fibrous CT as well as smooth muscle

42
Q

difference between elastic and muscular arteries

A

elastic - thick tunica media with more elastic fibers

muscular - more smooth muscle in middle tunica media and are more able to vasodilate/constrict

43
Q

how do veins compare to arteries

A

thinner walls
larger diameter
less elastic tissue
valves that control unidirectional flow of blood to heart
– need muscle contraction to move blood against gravity

ExPhys (9 decks)

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