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CV > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

Scapular line

A

Passes through inferior angle of scapula

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2
Q

Thoracic vertebrae with only one costal facet

A

TV1, 10, 11, 12

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3
Q

Type of attachment between 1st rib and sternum

A

Synchondrosis

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4
Q

True ribs

A

Attach directly to sternum

Ribs 1-7

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5
Q

False ribs

A

Attach to sternum via costal margin

Ribs 8-10

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6
Q

Floating ribs

A

Don’t attach to sternum

Ribs 11 and 12

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7
Q

Atypical ribs

A

Have the number 1 or 2 in them

Ribs 1, 2, 10, 11, 12

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8
Q

Attachment of anterior scalene m

A

Attaches to superior surface of 1st rib.

Subclavian v passes anterior to m, subclavian a passes posterior to m

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9
Q

Which rib attaches at sternal angle?

A

2nd rib

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10
Q

Which rib attaches at xyphi-sternal joint?

A

7th rib

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11
Q

Transverse thoracic plane

A

Line from sternal angle to disc between TV4 and 5

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12
Q

Most common site of rib fx

A

Angle of rib

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13
Q

Most common site of rib separation

A

Costochondral joint

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14
Q

What type of joints are sternocostal joints?

A

Synovial joints

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15
Q

Course of intercostal V/A/N

A

Between internal and innermost intercostal mm, on inferor aspect of rib through costal groove.

Superior to inferior: V→A→N

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16
Q

Endothoracic fascia

A

Lines inside of chest cavity

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17
Q

T4 dermatome

A

Found around the level of where the nipples should be

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18
Q

T10 dermatome

A

Found around the umbilicus region

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19
Q

Intercostobrachial n

A

Comes from T2

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20
Q

Internal thoracic a branches

A

Bifurcates at about the level of 6th rib

Forms superior epigastric a and musculophrenic a

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21
Q

Superior epigastric a

A

Supplies mm of rectus abdominis

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22
Q

Musculophrenic a

A

Supplies anterior intercostal aa to lower intercostal spaces

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23
Q

What forms intercostal nn?

A

Ventral rami of spinal nn

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24
Q

Structures found at the transverse thoracic plane

A

Ligamentum arteriosum

Concavity of aortic arch

Bifurcation of pulmonary trunk

Vagus n becomes plexiform

Bifurcation of trachea at carina

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25
Q

What vessels join behind the 1st rib?

A

R and L brachiocephalic vv

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26
Q

Length of superior vena cava

A

Extends from level of 1st rib to 3rd rib

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27
Q

Cord levels of phrenic n

A

Arises from C3, 4, 5

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28
Q

Anterior mediastinum contents

A

Fat, lymph nodes, connective tissue, thymus remnants

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29
Q

What plane does the esophagus begin at?

A

C6

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30
Q

Course of the esophagus

A

Begins off to the left, then curves to the right in middle thorax because of the aorta, then back to the left to pierce the diaphragm and join the stomach.

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31
Q

Level of pharyngoesophageal constriction

A

C6

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32
Q

Level of thoracic constriction of esophagus

A

T4/5

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33
Q

Level of diaphragmatic constriction of esophagus

A

T10

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34
Q

Formation of azygous v

A

R ascending lumbar vein joins R subcostal v to form azygous v on R side of body

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35
Q

Formation of hemiazygous v

A

L ascending lumbar v joins L subcostal v to form hemiazygous v on L side of body. Drains 9th-11th intercostal vv and subcostal v on L side. Will cross midline to drain into azygous v.

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36
Q

Formation of accessory hemiazygous v

A

5th-8th intercostal vv on L side of body join to form accessory hemiazygous v. Will cross midline to drain into azygous v

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37
Q

Cisterna chyle

A

Origin of thoracic duct at LV2. Collects lymph from R and L lower extremities, pelvis, and abdomen

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38
Q

What does the thoracic duct drain?

A

Both lower extremities, pelvis, abdomen, L upper extremity, L half of thorax, L half of head and neck

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39
Q

Contents of greater splanchnic n

A

Preganglionic sympathetic nn fibers from T5-9

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40
Q

Contents of lesser splanchnic n

A

Preganglionic sympathetic nn fibers from T10 and 11

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41
Q

Contents of least splanchnic n

A

Preganglionic sympathetic nn fibers from T12

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42
Q

Where do greater/lesser/least splanchnic nn synapse

A

In pre-aortic ganglia in abdomen

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43
Q

R main bronchus vs L main bronchus

A

R main bronchus is shorter, wider, and directed more straight downward than L main bronchus

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44
Q

Costomediastinal recess

A

Medial edge of parietal pleura

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45
Q

Costodiaphragmatic recess

A

Space at base of lungs

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46
Q

Pulmonary ligament

A

Point at which visceral pleura reflects to become parietal pleura; serves to anchor lung

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47
Q

Innervation of pleura

A

Phrenic n

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48
Q

Pleurisy

A

Inflammation of pleural lining

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49
Q

Orientation of A/V/ Bronchi in L lung

A

A will be superior, V will be anterior and inferior, bronchi will be more posterior

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50
Q

Orientation of A/V/Bronchi in R lung

A

A is most anterior, V is in middle, bronchus is posterior

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51
Q

Pulmonary lymph nodes

A

Found within lung tissue

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52
Q

Bronchopulmonary lymph nodes

A

Found at hilum (junction of bronchus and lung tissue)

53
Q

Trachiobronchial lymph nodes

A

2 sets: superior and inferior.

Inferior sit below carina, also called carinal lymph nodes

54
Q

Paratracheal lymph nodes

A

Sit beside trachea

55
Q

Pancoast tumor

A

Found in superior lobe of lung. Can affect brachial plexus and cervical sympathetic ganglia

56
Q

Sx of Pancoast Syndrome

A

Pain in shoulder radiating towards axilla and scapula, pain along ulnar aspect of hand, atrophy of hand and arm mm, Horner’s Syndrome (ptosis, miosis, anhydrosis)

57
Q

Virchow’s node

A

Abnormally enlarged L supraclavicular lymph node. Sometimes called “seat of the devil”

58
Q

Components of pericardium

A

Fibrous component and serous component

59
Q

Sulcus terminalis

A

Sulcus between superior/inferior vena cava and R atrium

60
Q

Function of the fibrous skeleton of heart

A
  1. Keeps the 4 valve orifices patent
  2. Site of valve attachment/anchoring
  3. Site of muscle attachment
  4. Electrically insulates atria from ventricles
  5. Provides a tunnel for the AV bundle
61
Q

Ratio of thickness of atrial wall : R ventricular wall : L ventricular wall

A

1:3:9

62
Q

Where do you find preganglionic sympathetic nerve cell bodies?

A

Intermediolateral cell column of grey from T1-L2

63
Q

Sympathetic innervation of heart

A

7 pairs of cardiopulmonary splanchnic nn, carrying postganglionic sympathetic fibers

64
Q

Parasympathetic innervation of heart

A

6 pairs of vagal cardiopulmonary nn carrying preganglionic parasympathetic fibers

65
Q

Average diameter of RBC

A

~7µm

66
Q

Blood capillaries vs lymphatics

A

Blood capillaries tend to have uniform diameter

Lymphatic capillaries have variable diameters and incomplete basement membranes

67
Q

Pericyte

A

Accessory cells that sit on top of blood vessels. Seem to be a precursor cell of sorts; often differentiate into smooth muscle cells

68
Q

3 types of capillaries

A

Continuous capillaries

Fenestrated capillaries

Discontinuous capillaries

69
Q

Discontinuous capillaries

A

Much larger than other types of capillaries. Found in locations where large amounts of exchange of materials is needed, i.e. liver, spleen, pancreas.

70
Q

Inner elastic lamina

A

Deepest portion of tunica intima. Not visible in smaller arteries, but in larger ones it can be seen. Composed of mostly elastic fibers.

71
Q

Number of layers of smooth muscle in an arteriole

A

No more than ~5 layers of smooth muscle

72
Q

Subendocardial connective tissue

A

Found within the endocardium. Purkinje fibers found here.

73
Q

Mesothelium

A

part of the visceral covering of the heart

74
Q

Lacteal

A

Lymph collecting channel found in periphery, immediately juxtaposed with capillary beds.

75
Q

What part of the embryo gives rise to the heart?

A

The mesoderm of the early cardiogenic field

76
Q

Sinus venosus

A

Initially receives common cardinal v, umbilical v, and vitelline v. Will eventually become sinus venarium of R atrium.

77
Q

Primitive atrium

A

Forms the portion of atria that contains pectinate mm, called auricles

78
Q

Primitive ventricle

A

Develop trabeculae carnae of the L ventricle

79
Q

Bulbus cordis

A

Consists of three parts.

First part will form trabeculated portion of R ventricle

Second part will form outflow tracts of both ventricles: aortic vestibule of L ventricle and conus arteriosus of R ventricle

Third part, the truncus arteriosus, will form the ascending aorta and pulmonary trunk

80
Q

Partitioning of atria

A

Step 1: Septum primum forms

Step 2: Osteum primum forms, is the initial blood shunt from R to L. Very short lived.

Step 3: Osteum primum closes

Step 4: As osteum primum closes, osteum secundum forms from region of apoptosis in septum primum

Step 5: Septum secundum forms in R atrium

Step 6: septum primum is incomplete; contains opening called foramen ovale

Septum primum now called valve of foramen ovale

81
Q

Partitioning of atrioventricular canals

A

Bulboventricular flange regresses and atrioventricular canal opens. Neural crest cells migrate in and form endocardial cushion around AV canal. Superior and inferior endocardial cushions grow towards each other and fuse.

82
Q

What are heart valves derived from?

A

Neural crest cells

83
Q

Intraventricular septum parts

A

2 parts: muscular and membranous.

Muscular part derived from muscle of ventricle wall

Membranous portion derived from endocardial cushions

84
Q

Conotruncal ridges

A

Derived from neural crest cells. Will divide the conus cordis and truncus arteriosus. Also called aorticopulmonary septum and spiral septum.

85
Q

Ventricular septal defects

A

Most common congenital anomaly

86
Q

Endocardial cushion defects

A

Neural crest in origin.

87
Q

Tetralogy of Fallot

A

Caused by unequal division of truncus arteriosus by conotruncal ridges. Has four components:

Pulmonary stenosis

Overriding aorta

Interventricular septal defect

R ventricular hypertrophy

88
Q

Transposition of great vessels

A

Caused by failure of conotruncal ridges to spiral.

Blood from R heart goes into aorta, blood from L heart goes into pulmonary circuit. Mixing occurs via patent ductus arteriosus

89
Q

Persistent truncus arteriosus

A

Caused by failure of conotruncal ridges to form

90
Q

DiGeorge Syndrome

A

CATCH-22

Deletion on chromosome 22 causes neural crest disorder

Cardiac defects (endocardial cushions and conotruncal ridges)

Abnormal facial development

Thymic aplasia

Cleft palate

Hypocalcemia (parathyroid deficiency)

91
Q

Vasculogenesis

A

de novo synthesis of new vessels. Mostly a prenatal process.

92
Q

Angiogenesis

A

Sprouting of vessels from existing vessels. Occurs postnatally.

93
Q

Development of arterial system from aortic arches

A

1st and 2nd aortic arches regress

Dorsal aorta that connected 3rd and 4th arches regresses BIL

Connection at bottom also regresses

5th aortc arch regresses

94
Q

What embryonic artery does the common carotid artery arise from?

A

3rd aortic arch artery

95
Q

What embryonic artery does the arch of the aorta form from?

A

L 4th aortic arch artery

96
Q

What embryonic artery does the right subclavian artery arise from?

A

R 4th aortic arch artery

97
Q

What embryonic artery forms the ductus arteriosus?

A

L 6th aortic arch artery

98
Q

Coarctation of the aorta

A

Results from a constriction of part of the aorta. 2 types: preductal and postductal.

99
Q

Cardiac rate and rhythm are reproducible due to what?

A

Automaticity (no neural input required)

Conduction system

Functional syncytium

100
Q

How is Ca++ removed from cardiomyocytes?

A

3Na+/1Ca++ antiporter on sarcolemma

Ca++ pump on sarcolemma

Smooth Endoplasmic Reticulum Calcium ATPase (SERCA)

101
Q

Early afterdepolarization

A

Occurs in late phase 2 or early phase 3 of cardiac cycle. More likely when AP duration is prolonged. Reentry is more likely to occur than with delayed afterdepolarizations

102
Q

Long QT Syndrome

A

Mutation in channels that results in prolonged AP in cardiac tissue. Associated with development of Torsades de Pointes

103
Q

Delayed afterdepolarizations

A

AP generated during phase 4 of cycle, but before a normal AP would occur. Associated with increased [Ca++]i

104
Q

Factors promoting reentry

A
  1. Lengthened conduction pathway
  2. Decreased conduction velocity
  3. Reduced refractory period
105
Q

EKG indication of RVH

A

Tall R wave in V1 followed by decreasing amplitude through precordial leads

106
Q

EKG indication of LVH

A

S in V1 + R in V5 is more than 35mm

107
Q

Which circulatory segment does the greatest pressure drop occur across?

A

Arterioles

108
Q

What is the driving force for blood flow?

A

Mean arterial pressure

109
Q

Mean arterial pressure equation

A

At rest: MAP = DBP + 1/3(SBP - DBP)

During exercise: MAP = DBP + 1/2(SBP - DBP)

110
Q

Fick Principle

A

Cardiac output = oxygen consumption / arterial - venous O2difference

Q = VO2 / (A-V) O2 Difference

111
Q

Causes of increased turbulent flow

A

Increase in velocity

Increase in diameter

Decrease in viscosity

112
Q

What is compliance?

A

Measure of vessel distensibility.

Compliance = change in vol / change in pressure

113
Q

Ohm’s Law applied to blood flow

A

Flow = change in pressure / vessel resistance

114
Q

Relationship between CO, MAP, and TPR

A

CO = MAP / TPR

115
Q

Extrinsic control of vascular resistance

A

Neural (mediated by sympathetic nervous system and alpha1 receptors)

Endocrine

116
Q

Intrinsic control of vascular resistance

A

Autoregulated: flow is independent of blood pressure, proportional to tissue metabolism

Examples: cerebral circ, coronary circ, skeletal musc. during exercise, renal circ

117
Q

Starling Forces

A

Pc: Capillary hydrostatic pressure

Pi: Interstitial fluid hydrostatic pressure

πc: Capillary colloid osmotic pressure

πi: Interstitial colloid osmotic pressure

118
Q

What are the most important factors influencing filtration/reabsorption?

A

Capillary hydrostatic pressure

Plasma colloid osmotic pressure

119
Q

Factors that promote edema

A

Increased capillary pressure

Increased capillary permeability

Decreased plasma oncotic pressure

Lymphatic blockage

120
Q

During contraction, on which part of the heart are coronary vessels more likely to be compressed? Least likely?

A

Most likely: Left ventricle

Least likely: Right ventricle

121
Q

Coronary Steal

A

If a vessel is stenosed, tissue downstream has decreased flow. If vasodilators are given, because the stenosed vessel is maximally dilated, dilation of other vessels will decrease flow to the stenosed vessel. This will decrease available supply to the area downstream of the stenosis.

122
Q

Contents of esophageal plexus

A

Postganglionic sympathetic fibers and preganglionic parasympathetic fibers

123
Q

Which embryonic vessel forms the superior vena cava?

A

R common cardinal v

124
Q

Which embryonic vessel forms the inferior vena cava?

A

R subcardinal v

125
Q

What is the mechanism of absent inferior vena cava?

A

R subcardinal v fails to make a connection with the hepatic part of inferior vena cava. Results in the caudal portion of the body being drained by the azygous venous system.

126
Q

What is the mechanism of a left superior vena cava?

A

L common cardinal v persists, forming a L superior vena cava. This causes R common cardinal v to regress. L superior vena cava drains to R atrium via coronary sinus.

127
Q

What is the mechanism of double superior vena cava?

A

R and L common cardinal vv persist, forming R and L superior venae cava. R superior vena cava drains into R atrium as per normal. L superior vena cava drains into R atrium via coronary sinus.

128
Q

What becomes of the umbilical v postnatally?

A

Forms ligamentum teres hepatis

CV (4 decks)

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