Exam 2 Flashcards
Right Carotid Artery Supplies…
Supplies right side of head, neck, and brain
Right Subclavian Artery Supplies…
Supplies right upper extremity, some to brain and branch to heart
Left Carotid Artery Supplies…
Supplies left side of head, neck, and brain
Left Subclavian Supplies…
Supplies left upper extremity, some to brain, and branch to heart
Where does Subclavian artery become axillary artery?
1st rib
2 branches of the Subclavian artery
Vertebral Artery- 1st part of subclavian
Thyrocervical Trunk- short trunk
Common carotid arteries 2 branches
Internal Carotid Arteries
External Carotid Arteries
Internal Carotid Arteries supplies…
Anterior and middle brain, orbit, and scalp
External Carotid Arteries supplies…
Neck and face
Phrenic Nerve
C3-C5 nerves
Supplies diaphragm
If injured, paralysis of diaphragm on that side
4 parts of the brain
Cerebrum
Cerebellum
Diencephalon
Brain Stem
Cerebrum
controls thought
Control center for perception, communication, understanding and memory
Fold
gyri or convolutions
Deep grooves
fissures
Shallower grooves
Sulci
Longitudinal Fissures
separates the cerebrum into right and left halves called Cerebral Hemispheres
Corpus Callosum
connect hemispheres
4 Lobes of the brain
frontal, parietal, temporal, occipital
Central Sulcus
Separates frontal and parietal lobes
Pre-central Gyrus
anterior to the central sulcus; primary motor area
Post-central Gyrus
Posterior to the central sulcus; primary somatosensory area
Vertebral Artery Supplies….
Posterior Brain
Internal Carotid Artery Branches
Anterior Cerebral
Middle Cerebral
Anterior Communicating
Vertebral Artery Branches
Basilar Artery
Posterior Cerebral
Posterior Communicating
What makes up the Circle of Willis?
Anterior Cerebral
Anterior Communicating
Middle Cerebral
Posterior Communicating
Where does anterior cerebral Artery go after circle of willis?
Superior and then posteriorly along corpus callosum
Where does middle cerebral artery go after circle of willis?
Between parietal and temporal lobes
What does posterior communicating arteries (2) connect?
internal carotid to basilar artery
Anterior Circulation of Circle of Willis
Two Internal Carotid Arteries
Internal Carotid Arteries branches into…
Anterior Cerebral Artery
Middle Cerebral Artery
Internal Carotid Arteries Function
Majority of cerebral circulation
Obstruction: contralateral motor and sensory deficit
Collateral Circulation: Circle of Willis
Anterior Communicating Artery
Posterior Communicating Arteries (2)
Posterior Circulation of Circle of Willis
Two Vertebral Arteries
Vertebral arteries combine to form…
basilar artery
Basilar Artery divides to form…
posterior cerebral arteries
Two Vertebral Artery Function
Supplies cerebrum, brain stem, cerebellum
Obstruction: Vision loss and vertigo
Anterior Circulation Supply to Brain
Majority of Cerebral Circulation
Obstruction will result in contralateral motor and sensory deficit
Posterior Circulation Supply to Brain
Provides flow to cerebrum, brain stem, and cerebellum
Obstruction will result in vision loss and vertigo
Left Dominant Hemisphere Stroke (dont memorize)
Aphasia Right Hemiparesis Right-sided sensory loss Right visual field defect Poor right conjugate gaze Dysarthria Difficulty reading, writing, or calculating
Right Non-Dominant Hemisphere Stroke (don’t memorize)
Neglect of left visual field Extinction of left-sided stimuli Left hemiparesis Left-sided sensory loss Left visual field defect Poor left conjugate gaze Dysarthria Spatial disorientation
Most common cause of ischemic brain infarcts (strokes)
Thromboemboli
Most common: vessel wall embolus
Vessel Wall Embolus
Carotid artery most often the source
Related to thrombus formation distal to stenosis
Ischemic Brain Infarct Causes
Vessel Wall Embolus
Cardiac source (Hemispheric attack > 60 minutes)
Other vascular Sources
Cardiac Source (Hemispheric Attach > 60 min)
A Fib Mitral valve stenosis Mitral valve prolapse Calcified mitral annulus Ventricular aneurysm or dyskinesia Atrial or ventricular clot Valvular vegetation ASD
Other Vascular Sources of Stroke
Intracranial artery thrombus (esp. blacks)
Aortic arch atherosclerotic Plaque
Transient hypotension w. Carotid Stenosis >75%
Ulnar artery
Supplies medial muscles of anterior forearm
Terminated as deep and superficial ulnar palmar arches
Radial artery
runs along cubital fossa along lateral side of forearm
supplies lateral forearm muscles
Vena Comitantes
Deep veins
2 or more veins that wrap around an accompanying artery
Superficial Veins in Arm
Basilic Vein
Cephalic Vein
Median Cubital Vein
Basilic Vein
medial side of arm
becomes axillary vein
superficial vein
Cephalic Vein
lateral side of arm
joins axillary vein in the shoulder
superficial vein
Medial Cubital Vein
at elbow
connection between 2 superficial veins
used for blood draws
superficial vein
Common Iliac Artery Divides into…
External Iliac
Internal Iliac
External Iliac
Supplies blood to remained of lower limbs
Becomes femoral artery
Internal Iliac
Primarily supplies blood to pelvic and gluteal regions
Divides into: superior gluteal artery, inferior gluteal artery, obturator artery
Anterior Tibial Artery
aka. Dorsalis Pedis Artery
Supplies anterior compartment of the leg
Continues as Dorsalis Pedis Artery at ankle
Dorsalis Pedia Artery Branches
Anterior Lateral Malleolar Artery
Anterior Medial Malleolar Artery
Anterior Lateral Malleolar Artery
eventually joins fibular artery
Anterior Medial Malleolar ARtery
eventually joins the tibial artery
Posterior Tibial Artery
Supplies the posterior compartment of the leg and foot
Gives rise to the fibular artery (runs along the medial side of the fibula)
Splits: Lateral Plantar Artery (deep plantar arch) joins deep plantar artery
& Medial Plantar Artery
Fibular Artery Branches into….
Medial Plantar Artery
Lateral Plantar Artery
Dorsalis Pedis Artery (Anterior Tibial Artery) branches into…
medial tarsal artery
lateral tarsal artery (supplies tarsals/ toes)
Courses to the base of metatarsals 1 and 2 then splits:
First Dorsal Metatarsal Artery (1st metatarsal/great toe)
Deep Plantar Artery (plantar surface of foot)
Respiratory System is comprised of
Nose Pharynx (Throat) Larynx (Voice Box) Trachea (windpipe) Bronchi Lungs
Upper Respiratory System
Nose, nasal cavity, pharynx, larynx, associated structures
Lower Respiratory System
Trachea
Bronchi
Lungs
Conducting Zone
Cavities and tubes outside and within the lungs
Ex. Nose, nasal cavity, pharynx, larynx, trachea, bronchi, bronchioles, terminal bronchioles
Function: Filter, warm and moisten the air and conduct to the lungs
Respiratory Zone
Tubes and tissues within the lungs where gas exchange occurs
Respiratory Bronchioles, alveolar ducts, alveolar sacs, alveoli
Function: site of gas exchange
Nose Function
Warm air (via capillaries) Moisten air (via mucous) Filter incoming air Detect olfactory stimuli Modify speech vibrations as they pass through large hollow resonating chambers
Pharynx
Funnel Shaped Tube
5’’ long
Starts at internal nares and extends to level of cricoid cartilage
Wall composed of skeletal muscle
Lined with mucous membrane
Relaxed, skeletal muscle keeps pharynx patent
Contract, skeletal muscle assists in swallowing
Passageway for air and food
Pharynx 3 Regions
Nasopharynx
Oropharynx
Laryngopharynx
Nasopharynx
Nasal cavity to soft palate
Oropharynx
Soft palate inferior to hyoid bone
Opening of the mouth is in here
Common passageway for air and food
Laryngopharynx
Hyoid bone inferior to esophagus (posteriorly) and larynx (anteriorly)
Larynx
Short passageway that connects the largopharynx with the trachea
Composed of 9 pieces of cartilage
3 single pieces: thyroid, epiglottis, cricoid
3 paired pieces
Thyroid Cartilage
Adam’s Apple
2 fused plates of hyaline cartilage that form an anterior wall of the larynx and give it a triangular shape
Present in males and females, more prominent in males
Epiglottis
Large leaf-shaped piece of elastic cartilage that is covered by epithelium; covers larynx during swallowing and after swallowing opens back up to allow air to enter larynx and trachea
Stem- attached to anterior rim of thyroid cartilage and hyoid bone
Leaf- unattached, free to move up and down like a trap door
Swallowing
Pharynx and larynx rise.
Elevation of pharynx widens it to receive food and drink
Elevation of the larynx causes the epiglottis to move down and form a lid over the vocal cords: keep food out of larynx and guides it into esophagus
Trachea
Aka. Windpipe
Tubular passageway for air
5’’ long and 1’’ in diameter
Located anterior to esophagus
Extends form larynx to superior border of 5th thoracic vertebrae
Divides into right and left primary bronchi
Contain incomplete rings of cartilage
Layers of the Tracheal Wall (inside to out)
Mucosa
Submucosa
Hyaline cartilage
Adventitia
16-20 incomplete hyaline cartilage rings stacked horizontally: interconnected via dense connective tissue; can be palpated through the skin inferior to the larynx, provides semi-rigid support to maintain patency so the trachea doesn’t collapse
Right Primary Bronchus vs Left
Right Primary bronchus is more vertical, wider, and shallower than the left; aspirated objects more likely to lodge here
Epi
over
Glottis
tongue
Carina
point where trachea divides, internal ridge; mucous membranes here are one of the most sensitive areas of the entire larynx and trachea for triggering cough reflex
Secondary Bronchi AKA…
Lobar
How many lobes in each lung?
3 on the right
2 on the left
Tertiary Bronchi AKA…
segmental
Terminal Bronchioles
End of conducting zone
How does smooth muscle maintain patency of airway?
Muscle spasms can close off airways (Asthma)
Exercise increase release Epi/NE by SNS causes smooth muscle relaxation, airway dilation, increase vent.
PNS and allergic rxns; histamine, contract bronchiolar smooth muscle and constricts airway
Histology: Bronchi vs. Bronchioles
Presence of cartilage in bronchus which allows larger diameter of the airway and prevent collapse
Lung Hilum
Bronchi, pulmonary blood vessels, lymphatic vessels, and nerves enter and exit
Vagus nerve, epi, and norepi
Vagus Nerve
parasympathetic innervation (Ach) causes bronchial smooth muscle constriction
Epi & Norepi
bronchial dilation
Parietal Pleura
Adherant to chest wall
Highly sensitive to pain
Visceral Pleura
Adherant to surface of the lungs
No pain sensation
Pleural Cavity
Space between the two pleura
Small amount serous fluid is useful to lubricate lung surface during respiration (acculumate large amt of fluid and compress lung)
provides surface tension for the lungs to remain adherant to chest wall during respiration and movement of chest muscles: lung expand
Left Lung
Contains concavity (cardiac notch)
Apex of the heart sits there (cardiac notch)
10% smaller than the right due to space occupied by heart
Oblique fissure separates the superior and inferior lobes
Right Lung
thicker, broader, shorter than left lungs because diaphragm is higher on the right side to accomodate the liver Oblique fissure (superior)-separates the superior lobe from the inferior lobe. The inferior part separates the inferior lobe from the middle lobe Horizontal fissure- separates the superior and middle lobes
What divides lobes of the lungs?
1-2 fissures
How many tertiary (segmental bronchi) in each lung?
10 in each lung
Bronchopulmonary segment
Tertiary bronchi go to this segment of lung tissue
Lobules
Each bronchopulmonary segment has many small compartments called lobules
Have lymphatic vessels, arteriole, a venule, branch of terminal bronchus
Surrounded by elastic connective tissue
Respiratory Bronchioles
have alveoli budding from walls where gas exchange occurs
respiratory bronchioles start the respiratory zone of respiratory system
Respiratory bronchioles lead to alveolar ducts
Alveolar sacs
2 or more alveoli that share a common opening
How many alveoli in lungs?
300 million alveoli
What is the surface area of alevoli?
70m^2
Surfactant
secreted by alevoli phospholipids and lipoproteins lowers the surface tension of alveolar fluid reduces tendency for alveoli to collapse maintains patency
Respiratory membrane contains…
Alveolar Wall (2 types of cells)
Epithelial basement membrane
Capilary basement membrane (fused to epithelial basement membrane)
Capillary endothelium
How big is the respiratory membrane?
0.5 micrometers
How do pulmonary blood vessels respond to hypoxia?
They constrict (all other body tissues dilate to increase blood flow)
Vasocontriction diverts pulmonary blood flow to better ventilated areas of the lung where gas exchange is better
(Ventilation-perfusion coupling)
2 blood supplies of the lungs
Pulmonary circulation
Bronchial circulation- supply terminal bronchioles, outer walls pulmonary vessels, supporting tissues
