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CV > CV1 > Flashcards

CV1 Flashcards

1
Q

true ribs
false ribs
floating ribs

A

1-7
8-10
11 and 12

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2
Q

flail chest

A

multiple broken ribs in 2 or more places

thoracic wall moves in during inspiration and out during expiration

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3
Q

xiphoid process level of rib and dermatome

A

7th rib but T6 dermatome

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4
Q

transverse thoracic plane

A

sternal angle-disc bw TV4-5

seperation bw sup and inf mediastinum

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5
Q

sternocostal joint

A

1st one is synchondrosis-impt for respiation
2-7 are plane
dislocations

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6
Q

costochondral

A

synchondrosis

seperation

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7
Q

rib dislocation
rib seperation
rib fracture

A

sternocostal
costochondral
usually angle (and usually middle ribs)

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8
Q

external intercostal

A

*only one that elevates ribs (inspiration)
A:maintain intercostal space during respiration by elevating ribs during inspiration

N: intercostal nn

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9
Q

internal intercostals

A

A:maintain intercostal space during respiration by depressing ribs during expiration

N: intercostal nn

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10
Q

innermost intercostals

A

*lat
A:maintain intercostal space during respiration by depressing ribs during expiration

N: intercostal nn

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11
Q

subcostal

A

*post and spans more than one rib level
A: depress ribs during expiration

N: intercostal nn

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12
Q

transversus thoracis

A

*ant
A: depress ribs during expiration

N: intercostal nn 2-6

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13
Q

endothoracic fascia

A

deep thoracic fascia
top part is sibsons
adheres parietal pleura to thoracic wall

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14
Q

pump handle

A

increase A-P

why the first rib is a synchodrosis

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15
Q

bucket handle

A

increase transverse

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16
Q

musculophrenic and superior epigastric

A

musculophrenic is lateral

superior epigastric is medial

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17
Q

intercostal nn

A

ventral rami of spinal nn

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18
Q

superior mediastinum Ant to post

A

thymus,
brachicephalic vv-formed by int. jugular and subclavian
Aortic arch and branches-starts and ends at TTP
brachiocephalic trunk, L common coratid, L subclav a
SVC-formed by 2 brachiocephalic vv
trachea
esophagus

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19
Q

phrenic n course into thorax

A

passes ant to subclavian a

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20
Q

vagus n course and branches

A

larygeal, cardiac, pulmonary, and esophageal branches

lat border of common carotid and passes post to root of lung and in the post mediastinum on esophagus
left becomes the anterior vagal trunk
right becomes post vagal trunk

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21
Q

recurrent larageal nn

A

branches of vagus n

left-under arch or aorta, lat to lig arteriosum and then goes up

right-around r. subclavian a

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22
Q

post mediastinum

A

portion of inf medistinum

esophagus and decending aorta azygous vv, splancnic nn, thoracic duct

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23
Q

esophagus

A

starts at C6

in sup media its post and left of trachea and then in midline in post media

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24
Q

esophageal constriction

A

C6-pharyngoesophageal
TTP-aortabronchial
T10-diaphragmatic

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25
Q

esophagus innervation

A

symp-travel with CP splancnic and pain can feel like an MI

PS-vagus

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26
Q

azygous v

A

formed by right ascending lumbar and right subcostal vv.

at T4 goes ant over root of right lung to enter SVC

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27
Q

hemiazygous

A

formed by left ascending lumbar and left subcostal vv

gets 9-11 intercostal vv then cross at T9 to go to azygous

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28
Q

accessory hemiazygous

A

drains 5-8 and crosses at T8 into azygous

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29
Q

left 1-4 intercostal vv aka left superior intercostal v

A

drain directly into left brachicephalic v

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30
Q

right superior intercostal v (2-4 intercostal v)

A

drain into azygous

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31
Q

thoracic duct

A

starts at L2 at the cisterna chyli and travels post to esophagus. At T5 crosses to the left of esophagus and enters the venous angle

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32
Q

thoracic splancnic nn

A

preganglionic sympathetic axons to preaortic (paravertebral ganglia)
greatest T5-T9
Lesser T10 and 11
Least T12

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33
Q

hiatal hernia

A

abdominal viscera through esophageal hiatus

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34
Q

UR tract

LR tract

A

Upper- nose, pharynx, larynx

Lower- trachea, bronchi, lungs

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35
Q

trachea

A

starts at C6 and divides into primary bronchi which the right one is wider shorter and vertical so things get stuck

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36
Q

lung pleura

A 
serosal membrane (only thing in pleural space)
viceral and parital
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37
Q

lung parital pleura

A

costal, diaphragmatic, mediastinal, and cervical surfaces

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38
Q

mediastinal surface of lung parital pleura

A

continuous with the visceral, together with visceral pleura forms pulmonary ligamnet

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39
Q

pulmonary lig

A

point of fixation for the lung

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40
Q

cervical extension of the lung parital pleura

A

reinforced by sibsons (suprapleral) of endothoracic fascia

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41
Q

pneumothorax

A

collapsed lung DT puncture of pleura (either one)

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42
Q

pluritis of the lung

A

inflammaed pleura and don’t slide over one another
pain from
parietal pleura which has sensory fibers from phrenic and intercostal nn so refered pain is C345

visceral pleura has sensory that travel with autonomic fibers

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43
Q

bare area of heart

A

rib space 5/6

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44
Q

Tension pneumothorax

A

*parietal
DT trauma, emhysema, lung cancer, COPD
signs are distended neck veins and hypoTN from low CO
caused by loss of integrity of pleura (either one) resulting in air getting in but unable to leave so there is an increase in intrathoracic pressure and you have mediastinal shift to contralateral side and comprimises venous return

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45
Q

spontaneous pneumo

A

*viceral

in tall lanky males

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46
Q

right lung

A

oblique and horizontal fissure=3 lobes sup, middle (4-6 ribs), inf
art is ant to bronchus

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47
Q

left lung

A

oblique fissure=2 lobes sup and inf
cardiac notch and lingula
art is sup to bronchus

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48
Q

pulm veins location

A

usually ant and inf

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49
Q

bronchi location

A

usually post

50
Q

viceral pleura and lung paranchema lymph

A

bronchopulmonary node -> sup and inf tracheaobronchiol nodes-> bronchomediastinal trunk

51
Q

bronchomediastinal trunk left and right drainage

A

left into the toracic duct

right into the right lymphatic duct

52
Q

bronchi and bronchioles lymph drainage

A

pulmonary nodes-> bronchopulmonary nodes-> tracheobronchiole nodes-> bronchomediastinal trunk

53
Q

lung paritel pleura lymph drainage

A

to thoracic wall aka intercostal nodes

54
Q

which recesses are only occupied during deep inspiration?

A

costomediastinal and costodiaphragmatic

55
Q

which recess would you find a pleural effusion in xray?

A

costodiaphragmatic

56
Q

fibrous pericardium where and innervation

A

anchors heart and prevents overfilling

phrenic

57
Q

serous pericardium where

A

visceral and parietal layers

58
Q

parietal pericardium where and innervation

A

underside of fibrous pericardium

phrenic

59
Q

visceral pericardium where and innervation

A

on the heart itself also called epicardium

cardiac plexus but no pain fibers here

60
Q

pericardial sac

A

potential space

61
Q

cardiac temponade

A

when the pericardial sac is filled with fluid and the heart cant fill to capacity

62
Q

transverse pericardial sinus

A

*where you clamp during bypass and cardiac surgery

behind aorta and pulm trunk but in front of SVC and pulm veins

63
Q

oblique pericardial sinus

A

blind caul de sac bw pulm veins and IVC

64
Q

pericardial refered pain (pericardidtis)

A

C345

65
Q

fibrous skeleton of heart

A

structural support for valves

insulates against impulse propagation from A to V

66
Q

RA structures (6)

A

sinus venarum, auricle, crista terminalis, fossa ovalus, SA and AV nodes

67
Q

sinus venarum

A

smooth part of RA where IVC SVC and coronary veins enter

68
Q

auricle

A

in atria has pectinate muscles

69
Q

crista terminalis

A

divides sinus venarum and auricle in RA

70
Q

SA and AV locations

A

SA-subepicardium near SVC

AV-subendocardium near coronary sinus opening

71
Q

RV structures (5 main 10 total)

A

trabelcula carnae (moderator band), conus arteriousus, tricuspid (chordae tendinae and papilary mm) interventricular septum (membranous and muscular) pulmonary semilunar valve

72
Q

trabeculae carnae

A

vent mm finer but more in left

73
Q

moderator band (septomarginal)

A

specialized trabecular carnae in RV m from intervent spetum to ant pap m

74
Q

conus arteriosus

A

smooth part of RV where the pulm a starts

75
Q

mitral and tricuspid valve and structures

A

chordae tendinae connect valve to pap mm

76
Q

interventricular septum parts

A

membranus-short and sup

muscular-long and thick

77
Q

LA structures (3)

A

gets 4 pulmonary vv, auricle, mitral

78
Q

LV structures (4 main 6 total)

A

trabecular carnae, aortic vestibule, mitral (CT and pap mm), aortic semilunar valve

79
Q

aortic vestibule

A

smooth part of LV leading to aorta

80
Q

regurg

A

valve insufficiency can cause a murmur along with stenosis

81
Q

sites for auscultation

A

A-2nd ICS on right
P-2nd ICS on left
T-4th ICS on left
M-4th or 5th ICS left MCL

82
Q

CAD

A

atherosclerosis leads to less blood in heart

83
Q

Ischemia

A

below MI threshold leads to angina

84
Q

what travels with what

A

Great CV with LAD
Middle CV with PDA
Small CV with right marginal a

85
Q

heart lymph drainage

A

RCA->ant. mediatinal LN->left bronchomediastinal trunk

LCA->inf. tracheobronchiole N->R. bronchomediastinal trunk

86
Q

cardiac plexus

A

postgang symp (T1-T4) (lung is T2-T6) and pregang PS
superficial-under AA
deep-on trachea

87
Q

cardiopulmonic splancnic nn

A

postganglionic sympathetic nerve processes

88
Q

refered pain of MI

A

pain fibers (GVA) follow sympathetic (GVE) to T1-4

89
Q

plexus has what fibers in it?

A

symp, PS, and GVA

90
Q

4 parts of the fetal heart from cranial to caudal

A

bulbis cordis, ventricle, atrium, sinus venosus

91
Q

what comes from the bulbus cordis

A

truncus arteriosus=pulmonary trunk and aorta
conus cordis=RV-conus arteriosus LV=aortic vestibule
caudal portion=trabecula carnae of RV

92
Q

what comes from the ventricle

A

trabecula carnae of LV

93
Q

what comes from the atrium

A

left and right auricles

94
Q

what comes from the sinus venosus

A

right horn=sinus venarum of RA

left horn=coronary sinus

95
Q

what makes the interatrial septum

A

septum secundum

96
Q

what makes the valve of FO

A

septum primium

97
Q

what makes the AV seperation

A

endocardial cushions (NC cells)

98
Q

ASD

A

Can cause a stroke
hole in atrial septum DT ostium secundum defect either bc septum primeum regresses too much or septum secundum doesnt form

99
Q

VSD

A

hole in V septum and L-R shunt

100
Q

what causes L to R shunt (late cyanosis)

A

VSD, ASD, PDA

101
Q

endocardial cushion defect

A

ASD

102
Q

pulmonary or aortic stenosis

A

semilunar valve malformation results in Patent FO and PDA

103
Q

tetralogy of Fallot

A 
unequal division of TA by conotruncal ridges
PROVE
Pulmonary stenosis
RVH-(boot shaped heart on CX)
Overiding aorta
VSD
104
Q

Transposition of GV

A 
Very bad!
conotruncal ridges fail to spiral
aorta from RV and pulmonary from LV
have to have patent FO and PDA to be compatible with life
newborn cyanosis
105
Q

persistent TA

A

conotruncal ridges dont form
undivided TA gets blood from both Vs
cyanosis of newborn

106
Q

DiGeorge

A 
CATCH 22
Cleft palate
Abnormal facies
Thymic aplasia
Cardiac defects
HypoCa
107
Q

Retroesophageal R subclavian a

A

right 4th regresses and so forms on the left of Left subclavian and has to bend back to the right behind esophagus and can cause dysphagia

108
Q

PDA

A

L to R shunt results in increase pulmonary flow and decreased systemic flow

109
Q

Coarctication of aorta

A

aortic constriction
preductal-at birth id collateral circulation didnt happen
postductal-early adolescence and huge intercostal aa

110
Q

double aortic arch

A

right dorsal aorta persists and fuses with left and forms ring around trachea and esophagus and causes dysphagia

111
Q

course of vagus

A

right-behing ascending aorta

left-in front of arch

112
Q

course of recurrent larengeal nn

A

right-loops under subclavian

left-under AA and Lig Art

113
Q

umbilical vein

A

ligamentum teres hepatis

114
Q

ductus venosus

A

bypass liver to IVC

becomes ligamentum venosum

115
Q

umbilical aa

A

medial umbilical ligs

116
Q

absent IVC

A

to azygous

117
Q

Left SVC

A

r common cardinal degenerates but left persists

blood goes to coronary sinus to RA

118
Q

double SVC

A

both persists and drain as said before

119
Q

R- L shunt (cyanosis of the newborn)

A

transposition, TOF, PTA

120
Q

conotruncal ridges
unequal division-
fail to spiral
fail to form

A

unequal division-TOF
fail to spiral-TGV
fail to form-PTA

121
Q

pleural effusion

A 
Becks triad
DDD
Distended ext jugular
Distant heart sounds
Decreased blood pressure

CV (1 decks)

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