Dr. Olingers Flashcards
Difference between bronchi and bronchiole
Bronchioles dont have cartilage
Typical ribs
Atypical ribs
Typical : 3-9
Atypical 1-2, 10-12
True ribs
False ribs
1-7
8-10
Superior facet of the rib
Inferior costal facet of vertebra
Superior mediastinum
Just has aorta and pulmonary a
Epicardium
Visceral serous pericardium
Agina Pecteris
Shooting referred pain from the heart having a problem (usually ischemia to myocardium)
4 circles above the heart
2 at bottom = SVC and IVC (A and V orifices)
One in middle = ascending aorta
One on top = Pulmonary a
Superior facet on head of rib
Inferior costal facet on vertebrae
Tubercle of rib
Transverse process of vertebrae (SAME VERT)
1st rib has what
Scalene tubercle for anterior scalene muscle
Simple vs complicated rib fracture
Simple = costoverterbral dislocation Complicated = trauma to the pleura of the lung, lung can collapse
Types of fibrous joints
Syndesmosis
Schindylesis
Gomphosis
Suture
Types of Cartilagenous joints
Primary = Synchondrosis Secondary = Symphsis
Manubriosternal joint
Xiphisternal joint
Secondary cartilaginous = Symphysis
Primary cartilaginous = Synchondrosis
1st sternocostal joint
Primary cartilaginous = Synchondrosis
Anterior L
Radiate L
Sternocostal L
2-7th sternocostal joints
Planar Synovial joint
Anterior L
Radiate L
Sternocostal L
Costovertibral joints
Planar synovial joint
Intraaricular L
Radiate L
Costotransverse joints
Planar synovial
Superior Costotransverse L (from TP one level up)
Lateral Costotransverse L (from TP same as rib level)
Movement of ribs during breathing
Lateral part
Anterior part
Like a bucket handle
Like a pump
Costochondral joints
Primary cartilaginous joint = Synchondrosis
Dislocation
Separation
Costosternal joint
Costochondral joint
Intervertebral joints
Zygopophyseal joints
Secondary cartilaginous = symphysis
Planar synovial
Internal intercostal M
External intercostal M
Depression, also becomes posterior intercostal M
Elevation , also becomes anterior intercostal M
Thoracentesis
Needle to drain fluid around pleural cavity
Needle is inferior (under) intercostal nerve bundle
+ superior (above) collateral branches
* between 9th and 10th rib
Chest tube insertion
To remove a large amount of fluid, air, blood from pleural cavity
Between 5th and 6th intercostal space
Thoroscopy
Visualize and biopsy of the pleural cavity
Smooth of atrium
Smooth of atrium = sinus venarum
PECTINATE = rough of atrium
Sinus venarum
Smooth of atrium
Internal separation of smooth and rough
External separation
Crista terminalis
Sulcus terminalis
Rough and smooth of ventricle
Rough = trabecula carnae Smooth = conus arteriosus
What 2 things loop around the LIGAMENTUM arteriosum and the aortic arch where it attaches
Left Recurrent Laryngeal N + Vagus N
Cardiac catheterization
Insert catheter into femoral vein ——> to the IVC = to visualize the RA, RV, Pulmonary trunk, Pulmonary A.s
Aortic valve
Semilunar valve
Artificial Cardiac Pacemaker (how do you insert it and where does it go)
Makes electrical impulses to Ventricles by an electrode inserted at a large V ——> SVC —> RA, tricuspid valves —> ENDOCARDIUM of TRABECULA CARNAE (RV)
Atrial Fibrillation
Irregular twitching of the atrial cardiac muscle fibers, circulation is satisfactory
Ventricular fibrillation
Rapid twitching of ventricles, heart is unable to pump blood
* Electrical shock administration by electrodes can cease all cardiac movement = defibrillation, so the heart may begin beating regularly after a period of time
Cardiac Referred pain
Visceral pain due to ischemia
Upper limb + superior lateral chest wall
Where is anginal pain felt
Due to left medial bronchial cutaneous n —>
- left substernal area
- left pectoral area
- medial part of left upper limbs
Reason surgeons do surgery on the Transverse Pericardial Sinus
Allows access posterior to aorta and pulmonary trunk = clamp or insert tubes for a bypass machine into these large vessels
Pericarditis
Pericardial inflammation making it rough and increase friction, hear by stethoscope
Need to Tx to prevent calcification
Pericardial Effusion
Pericardial inflammation causing fluid or pus acculturation in pericardial sac = compresses heart (CARDIAC TAMPONADE)
Pericardiocentesis
Draining blood, fluid, pus form pericardial sac = to release cardiac tamponade
* needle 15 degrees above skin in para iPhone area
What supplies the conduction system of the heart
The interventricular As (anterior-left coronary and posterior-right coronary)
Coronary Artery Bypass Graft
use great saphenous vein or the radial artery to bypass an obstruction of a coronary a or branch
Coronary Angioplasty
insert a balloon into coronary artery to increase size or artery where plaque was
pulmonary embolism
blood clot or obstruction (air, fat) of a pulmonary artery usually coming from the right side of the heart
the medial mammary A comes off the
internal thoracic branching the perforating branches which makes the medial mammary branch
the lateral mammary a comes off the
lateral thoracic artery + posterior intercostal arteries
collateral branches come off the
posterior intercostal arteries
3 parts of the phrenic A and where they come from
- Musculophrenic (internal thoracic a)
- Pericardiacophrinic (internal thoracic a)
- Superior Phrenic (from descending thoracic aorta)
great cardiac vein travels with
Middle Cardiac Vein travels with
small cardiac vein travels with
ANT : Anterior interventricular artery
POST : Circumflex A (before dumping into the coronary sinus)
Posterior interventricular artery
Right marginal artery
2 veins dumping into the coronary sinus
great cardiac vein + small cardiac vein
the phrenic nerve runs between what
the fibrus pericardium and the mediastinum parietal pleura
typical nerves
3-6
sympathetic truck has 3 branches or parts
greater, lesser, least
vagus nerve has 5 branches
also left and right go where
Superior Cardiac -neck Middle Cardiac - neck Inferior Cardiac - thorax * Pulmonary * Esophageal * left vagus --> anterior trunk right vagus --> posterior trunk
Pulmonary plexus
SYMPA: pulmonary splanchnic
PARA: pulmonary br
Superficial + Deep Cardiac Plexus
SYMPA: cardiac splanchnic
PARA: superior, middle, inferior cardiac br
Aortic plexus
SYMPA: continuous with superficial cardiac plexus
PARA: continuous with superficial cardiac plexus
Esophageal plexus
SYMPA: Greater splanchnic
PARA: esophageal br
THORACIC AORTA:
- unpaired
- paired lateral visceral
- paired segmental parietal
- Mediastinal, esophageal, pericardial
- bronchial (to lung tissue)
- Posterior intercostal + subcostal
