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2 - CR/MET > CR anatomy > Flashcards

CR anatomy Flashcards

1
Q

Sternal angle level

A

T4

2nd rib

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2
Q

Pectoralis major attachments

A

Intertuberculular sulcus of humerus

–> sternum and clavicle

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3
Q

Pectoralis major innervation

A

Sternal head = medial pectoral nerve (C7-T1)

Clavicular head = lateral pectoral nerve (C5-C6)

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4
Q

Serratus anterior attachments

A

Ribs 2-8 –> scapula

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5
Q

Serratus anterior innervation

A

Long thoracic nerve

C5-C7

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6
Q

Pectoralis minor attachments

A

Scapula –> ribs 3-5

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7
Q

Pectoralis minor innervation

A

Medal pectoral nerve (C7-T1)

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8
Q

Intercostal bundle content from superior to inferior

A

Vein
Artery
Nerve

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9
Q

Where does the intercostal bundle lie?

A

Inferior to the superior rib

Between internal and innermost intercostals

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10
Q

Parts of internal intercostals and their role

A 
Interosseous = forced expiration 
Interchondral = inspiration
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11
Q

Where is a thoracocentesis performed?

A

9th IC space

Mid-axillary line

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12
Q

Where is a chest drain places?

A

5th IC space

Mid-axillary line

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13
Q

What passes through the diaphragm at T12?

A

Aorta
Thoracic duct
Azygous vein

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14
Q

Where does the hemiazygous cross the midline?

A

T7/8

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15
Q

Referred pain of the pleura

A

Costal –> intercostal strip

Mediastinum surface –> C4-5 around shoulders

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16
Q

Oblique fissure surface markings

A

C2 vertebrae –> 6th rib at mid-clavicular line

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17
Q

Transverse fissure surface markings

A

Midline of oblique fosse (or where crosses mid-axillary line) –> midsternal line at the level of the 4th costal cartilage

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18
Q

Order of structures in the lung hilum

A 
Superior = arteries 
Middle = bronchi 
Inferior = veins
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19
Q

What is the Stellate ganglion?

A

Fusion of inferior cervical and first thoracic sympathetic ganglion

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20
Q

Referred pain of the heart

A

T1-4 for chest, neck and arm pain

Inferior = T5-9 for epigastric pain

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21
Q

Arterial supply to heart nodes

A

RCA = SAN
PD = AVN
Bundle branches = LAD

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22
Q

Lateral ECG leads

A

V5, V6, I, aVL

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23
Q

Inferior ECG leads

A

II, III, aVF

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24
Q

Causes of concentric vs eccentric hypertrophy

A 
Concentric = pressure overload 
Eccentric = volume overload
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25
Q

S3 heart sound

A

Large volume of blood striking overly compliant LV

= systolic heart failure

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26
Q

S4 heart sound

A

Atrial contraction forcing blood into a non-compliant LV

= diastolic heart failure

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27
Q

CXR signs of pulmonary oedema

A 
Alveolar oedema 
Kerley B lines 
Cardiomegaly 
Upper lobe diversions 
Pleural effusions
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28
Q

CXR signs of COPD

A

Hyper-inflated lungs (>6 anterior >10 posterior ribs)

Flattened hemidiaphragms –> blunted costophrenic angled

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29
Q

What forms the valve over the foramen ovale?

A

Septum primum

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30
Q

What does the bulbis cordis become?

A

Right ventricle

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31
Q

What does the sinus venosus become?

A

Inflow tracts to the heart

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32
Q

What does the truncus arteriosus become?

A

Aorta and pulmonary trunk

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33
Q

When does the septum primum appear?

A

Day 28

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34
Q

When do the heart tubes fuse?

A

Day 21

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35
Q

When does the heart begin to beat?

A

Day 22

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36
Q

Lesions in tetralogy of Fallot

A

Overriding aorta
VSD
Narrow RV outflow
RVH

37
Q

Features of persistent truncus arteriosus

A

Cyanotic lesion
Outflow tracts not fully divided
VSD

38
Q

ASD features

A

Patent foramen ovale or defect in septum primum/secundum

39
Q

Where is VSD most common

A

90% membranous

10% muscular

40
Q

What does patent ductus arteriosus increase the risk of?

A

Bacterial endocarditis

41
Q

How can patent ductus arteriosus be treated?

A

PG inhibitor such as ibuprofen

42
Q

What drains to the superior meatus?

A

Posterior ethmoidal sinuses

43
Q

What drains to the middle meatus (semi-lunar hiatus)?

A

Anterior ethmoidal, maxillary and frontal sinuses

44
Q

What drains to the ethmoid bulla?

A

Middle ethmoidal sinuses

45
Q

What drains to the inferior meatus?

A

Nasolacrimal duct

46
Q

What drains to posterior nasal wall?

A

Sphenoid sinus

47
Q

What drains to the nasopharynx?

A

Pharyngotympanic tube

48
Q

Blood supply to the nasal cavity

A

External carotid
Sphenopalatine artery (maxillary)
Greater palatine artery (maxillary)
Septal branch of superior label (facial)

Internal carotid
Anterior ethmoidal arteries (ophthalmic)
Posterior ethmoidal arteries (ophthalmic)

49
Q

Where are the tonsils found?

A

Palatine = between arches
Adenoids (pharyngeal) = nasopharynx roof
Lingual = back of the tongue
Tubal = laterally where the Eustachian tube opens out

50
Q

Which muscle forms the UOS

A

Cricopharyngeus

51
Q

What is the innervation of the pharyngeal muscles?

A

CN X

Except stylopharyngeus = CN IX

52
Q

Sensory nerve supply to the pharynx

A 
Naso = V2 
Oro = V3 
Laryngo = CN X
53
Q

Level of hyoid bone

54
Q

Level of cricoid cartilage

55
Q

Intrinsic laryngeal muscles

A

Relaxers (thyroarytenoid) = lower pitch

Tensors (cricothyroid) = raise pitch

56
Q

Laryngeal muscle innervation

A

Recurrent laryngeal = all except cricothyroid

Cricothyroid = external laryngeal nerve

57
Q

Sensation to the larynx

A

Above vocal cords = internal laryngeal nerve

Below vocal cords = recurrent laryngeal

58
Q

Superior laryngeal nerve injury

A

Loss of chocking reflex

Monotonous voice

59
Q

Recurrent laryngeal nerve injury

A

Hoarseness

Aphonia

60
Q

Facilitation of lymph transport

A 
Low pressure conducts 
Milking action of skeletal muscle 
Pulsation of arteries alongside 
Valves 
Thoracic pressure changes 
Smooth muscle in walls
61
Q

Lymph node cortex vs medulla

A 
Cortex = T cells, B cells, dendritic cells 
Medulla = B cells, plasma cells, macrophages
62
Q

Afferent vs efferent vessels in lymph nodes

A

Afferent enter around the edge

Efferent leave via hilum

63
Q

Where does the superficial cervical chain lie?

A

Over SCM

Along EJV

64
Q

Where does the deep cervical chain lie?

A

Deep to SCM

Along IJV

65
Q

Walls of the axilla

A 
Anterior = pec major 
Posterior = lat dorsi 
Medial = ribcage
66
Q

Axillary nodes

A 
Anterior = pectoral 
Posterior = sub scapular 
Lateral = humeral
67
Q

Path of drainage from axillary nodes

A

Pectoral, sub scapular, humeral

  • -> central
  • -> apical
  • -> supra clavicular
  • -> subclavian lymph trunk
68
Q

Groups of inguinal lymph nodes

A 
Horizontal = along inguinal ligament 
Vertical = along great saphenous
69
Q

What drains to the horizontal inguinal lymph nodes?

A 
Anterior abdominal wall 
Perineum 
External genitalia (except testes)
70
Q

What drains to the vertical inguinal lymph nodes?

A

Superficial lymphatics of the leg

71
Q

Where do the superficial inguinal nodes drain to?

A

Deep inguinal nodes
3 nodes in the femoral canal
Drain to lumbar trunks

72
Q

Where are the lymph nodes of the lung found?

A

Intrapulmonary within the lung
Bronchopulmonary at the lung hilum
Tracheopulmonary around the carina
Tracheal along the trachea

73
Q

Where does lymph from the lungs drain to?

A

Bronchomediastinal trunks

–> SCV or thoracic/right lymphatic duct

74
Q

What do the lumbar trunks drain?

A

Structures of the pelvis
Lower limbs
Kidneys

75
Q

What does the intestinal trunk drain?

A

Abdominal organs

76
Q

Where is the cisterna chyle found?

77
Q

Parts of the spleen?

A

White pulp = T and B lymphocytes

Red pulp = blood

78
Q

Carotid sheath contents

A 
CCA
ICA
IJV
CN X 
Deep cervical lymph nodes 
CN IV, XI, XII
Ansa cervicalis
79
Q

Where does the phrenic nerve travel in the neck?

A

Anterior to anterior scalene

Just lateral to carotid sheath

80
Q

Where does recurrent laryngeal nerve travel in the neck?

A

Between the trachea and oesophagus

81
Q

What does the LAD supply?

A

RV, LV, IV septum, bundle branches

82
Q

What does the left marginal supply?

83
Q

What does the LCx supply?

84
Q

Whats does the RCA supply?

A

RA, RV, SAN

85
Q

What does the right marginal supply?

A

RV and apex

86
Q

What does the PD supply?

A

RV, LV, IV septum, AVN

87
Q

Extent of trachea

A

C6 –> T4

88
Q

Number of bronchopulmonary segments

A

8 in left

10 in right

89
Q

Pulmonary plexus

A

T1-5 of sympathetic trunk

Vagus nerve

2 - CR/MET (8 decks)

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