Exam 2 Flashcards by Kurtis Siemsen

What connects the lower part of the pharynx to the trachea?

The Larynx

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What are the functions of the larynx?

It prevents the passage of food into the airway during swallowing.
It regulates the flow of air into the lungs.
It functions in vocalization.

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How long is the adult larynx?

5 cm long

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What vertebrae does the larynx lie between?

C3 and C6

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What is the thyroid cartilage primarily made of?

Hyaline cartilage

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The thyroid cartilage is a single cartilage which presents what features?

Superior Thyroid Notch
Inferior Thyroid Notch (less defined)
Laryngeal Prominence (anterior median elevation)
Superior Horn (attached to greater horn of hyoid)
Inferior Horn (articulates with cricoid cartilage)
Laminae (lateral walls)
Oblique Line (on external surface of the lamina, provides attachment for inferior constrictor, sternothyroid, and thyrohyoid)

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What feature of the thyroid cartilage is also known as the “adam’s apple”?

Laryngeal Prominence

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What feature of the thyroid cartilage is more pronounced in males due to a longer vocal cord?

Laryngeal Prominence

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What does the Greek word Krikos mean?

Ring

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What cartilage of the larynx is a single cartilage which is shaped like a signet ring consisting of a narrow anterior arch and a broad, posterior lamina?

Cricoid cartilage

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What is the most inferior of the laryngeal cartilages?

Cricoid cartilage

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What cartilage of the larynx is a single cartilage which is shaped like a spoon and lies behind the root of the tongue and body of the hyoid bone?

Epiglottic cartilage

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What cartilage of the larynx has a lower end that is attached to the back of the laryngeal prominence of the thyroid cartilage by the thyroepiglottic ligament?

Epiglottic cartilage

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What cartilages of the larynx make a cricoarytenoid joint?

Arytenoid cartilages

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What cartilages of the larynx are paired cartilages which are pyramidal in shape?

Arytenoid cartilages

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What cartilages of the larynx have bases that articulate with the cricoid cartilage?

Arytenoid cartilages

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What two features does each arytenoid cartilage present?

Vocal process

2. Muscular process

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What feature of the arytenoid cartilage gives attachment to the vocal ligament?

Vocal process

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What feature of the arytenoid cartilage gives attachment to intrinsic muscles of the larynx?

Muscular process

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What cartilages of the larynx are paired cartilages which lie on the apices of the arytenoid cartilages and are closed within the aryepiglottic folds?

Corniculate cartilages

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What cartilages of the larynx may ossify in some individuals and look like a fracture when looking at x-ray?

Corniculate and Cuneiform cartilages

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What cartilages are paired cartilages which lie in the aryepiglottic folds anterior to the corniculate cartilages?

Cuneiform cartilages

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What joint of the larynx is a synovial joint between the side of the cricoid cartilage and the inferior horn of the thyroid cartilage and permits rotation of the thyroid cartilage around a horizontal axis?

Cricothyroid joint

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What joint of the larynx is a synovial joint between the upper border of the cricoid cartilage and the base of the arytenoid cartilage and permits gliding and rotation of the arytenoid cartilage on the cricoid cartilage?

Cricoarytenoid joint

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What ligament of the larynx extends from the thyroid cartilage to the hyoid bone and is pierced on each side by the internal laryngeal nerve and the superior laryngeal vessels?

Thyrohyoid Membrane

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What ligament of the larynx extends from the arch of the cricoid cartilage to the thyroid cartilage?

Median Cricothyroid Ligament

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What ligament of the larynx extends from the thyroid cartilage in front to the vocal process of the arytenoid cartilage behind?

Vocal Ligament

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What ligament of the larynx is a fibroelastic membrane which extends upward from the cricoid cartilage to the vocal ligament and has a free edge that is formed by the vocal ligament?

Conus Elasticus (Cricovocal Membrane, Lateral Cricothyroid Ligament)

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What ligament of the larynx connects the epiglottic cartilage to the arytenoid cartilage on each side?

Quadrangular Membrane

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What margin of the Quadrangular forms the aryepiglottic ligament within the aryepiglottic fold?

Superior margin

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Whar margin of the Quadrangular forms the vestibular ligament within the vestibular fold?

Inferior margin

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What two pairs of folds does that larynx contain?

Vestibular Folds (False Vocal Cords)

2. Vocal Folds (True Vocal Cords)

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Which of the two pairs of folds that the larynx contains does not vibrate but is protective in function and initiates the cough reflex?

Vestibular Folds

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Which of the two pairs of folds that the larynx contains vibrates and is located inferior and medial to the False vocal cords?

Vocal Folds

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What do vocal folds contain?

The vocal ligament and vocalis muscle

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What is the space between the vestibular folds termed?

Rima Vestibuli

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What is the space between the vocal folds and is the narrowest part of the laryngeal cavity?

Rima Glottidis

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What space is where people usually choke and need assistance?

Rim Glottidis

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What includes the rima glottidis and vocal folds and is a sound producing apparatus?

Glottis

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What is the larynx divided into three cavities by?

The vestibular and vocal folds

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What 3 cavities is the larynx divided into?

Laryngeal Vestibule
Laryngeal Ventricles
Infraglottic Cavity

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What cavity of of the larynx extends from the laryngeal inlet to the vestibular folds?

Laryngeal Vestibule

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What cavity of the larynx lies between the vestibular folds and vocal folds?

Laryngeal Ventricles

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What cavity extends from the vocal folds to the inferior border of the cricoid cartilage and is the lowest cavity of the larynx?

Infraglottic Cavity

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What is the term used for inflammation of the vocal cords?

Laryngitis

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What is the small diverticulum within the laryngeal ventricle?

Laryngeal Saccule

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What contains glands which lubricate the vocal folds and has been called the “oil can” of the vocal folds?

Laryngeal Saccule

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With hoarseness due to excessive speaking or singing what happens to the lubricant from the saccule?

It is temporarily depleted

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What muscles are those which move the larynx as a whole?

Extrinsic muscles of the larynx

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What two groups can extrinsic muscles be divided into?

elevators and depressors

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Which of the extrinsic muscles of the larynx are elevators?

Thyrohyoid
Stylohyoid
Mylohyoid
Digastric
Stylopharyngeus
Palatopharyngeus

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Which of the extrinsic muscles of the larynx are depressors?

Omohyoid
Sternohyoid
Sternothyroid

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What are the names of the intrinsic muscles of the larynx?

Cricothyroid
Posterior Cricoarytenoid
Lateral Cricoarytenoid
Transverse Arytenoid
Oblique Arytenoid
Aryepiglottic
Thyroepiglottic
Thyroarytenoid
Vocalis

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When contracted, what intrinsic muscle of the larynx increases pitch?

Cricothyroid

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What muscle originates at the cricoid cartilage and inserts on the inferior horn and lower lamina of the thyroid cartilage?

Cricothyroid

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What is the innervation of the Cricothyroid muscle?

External Laryngeal Nerve

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What is the function of the Cricothyroid muscle?

Tilts the thyroid cartilage downward or cricoid cartilage upward thereby tensing the vocal cords

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What muscle originates at the posterior surface of the lamina of the cricoid cartilage and inserts on the muscular process of the arytenoid cartilage?

Posterior Cricoarytenoid

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What is the innervation of the Posterior Cricoarytenoid muscle?

Recurrent Laryngeal Nerve

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What is the function of the Posterior Cricoarytenoid muscle?

Abducts the vocal cords

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What position of the vocal cords is considered to be neutral and reduces the risk of suffocation?

When they are partially abducted

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What muscle originates at the arch of the cricoid cartilage and inserts on the muscular process of the arytenoid cartilage?

Lateral Cricoarytenoid

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What is the innervation of the Lateral Cricoarytenoid muscle?

Recurrent Laryngeal Nerve

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What is the function of the Lateral Cricoarytenoid muscle?

Adducts the vocal folds

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What muscle originates at the posterior surface of the arytenoid cartilage and inserts on the posterior surface of the opposite arytenoid cartilage?

Transverse Arytenoid

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What is the innervation of the Transverse Arytenoid muscle?

Recurrent Laryngeal Nerve

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What is the function of the Transverse Arytenoid muscle?

Adducts the vocal folds

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What two muscles act together to perform the action of “coughing”?

Transverse Arytenoid

2. Oblique Arytenoid

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What muscle originates at the muscular process of the arytenoid cartilage and inserts at the apex of opposite arytenoid cartilage?

Oblique Arytenoid

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What is the innervation of the Oblique Arytenoid muscle?

Recurrent Laryngeal Nerve

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What is the function of the Oblique Arytenoid muscle?

Adducts the vocal folds

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What muscle originates at the apex of the arytenoid cartilage and inserts on the side of the epiglottic cartilage?

Aryepiglottic

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What is the innervation of the Aryepiglottic muscle?

Recurrent Laryngeal Nerve

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What is the function of the Aryepiglottic muscle?

Closes the laryngeal inlet (swallowing)

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What muscle is a continuation of the Oblique Arytenoid and lies within the aryepiglottic fold?

Aryepiglottic

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What muscle originates at the inner surface of the thyroid lamina and inserts at the lateral margin of the epiglottis?

Thyroepiglottic

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What is the innervation of the Thyroepiglottic muscle?

Recurrent Laryngeal Nerve

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What is the function of the Thyroepiglottic muscle?

Opens the laryngeal inlet (end of swallowing)

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What muscle originates at the inner surface of the thyroid lamina and inserts at the arytenoid cartilage?

Thyroarytenoid

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What is the innervation of the Thyroarytenoid muscle?

Recurrent Laryngeal Nerve

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What is the function of the Thyroarytenoid muscle?

Shortens and relaxes vocal folds by drawing the arytenoid cartilages forward

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What happens when the Thyroarytenoid muscle takes tension off of the vocal folds?

A lower voice is produced

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What muscles originates at the inner surface of the thyroid lamina and inserts at the vocal process of the arytenoid cartilage?

Vocalis

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What is the innervation of the Vocalis muscle?

Recurrent Laryngeal Nerve

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What is the function of the Vocalis muscle?

Adjusts the tension on the vocal cords during phonation

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What are important in phonation because they control the stream of air passing through the rima glottidis?

Vocal folds

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The size and shape of what is altered during phonation and respiration by movements of the arytenoid cartilages?

Rima glottidis

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The movements of what alters the size and shape of the rima glottidis during phonation and respiration?

Arytenoid cartilages

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The rima glottidis is ___ during inspiration, and ___ and ___ during expiration and phonation.

Wide
Narrow
Wedge-shaped

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What aspect of the vocal folds determines the pitch (frequency) of the sound produced?

Degree of Tension

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To raise the pitch (frequency) of the sound produced, tension is increased by what muscle(s)?

Cricothyroid muscle

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To lower the pitch (frequency) of the sound produced, tension is decreased by what muscle(s)?

Thyroarytenoid and Vocalis muscles

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What 3 things is voice dimorphism determined by?

Length of the Vocal Cords
Size of the Resonating Chamber (Pharynx, Larynx, etc.)
Thickness of the Vocal Cords

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Does the vocal ligament have androgen receptors on it?

Yes

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What nerves innervate the larynx?

Recurrent Laryngeal Nerve
Internal Laryngeal Nerve
External Laryngeal Nerve

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What nerve is motor to all of the intrinsic muscles of the larynx except the cricothyroid?

Recurrent Laryngeal Nerve

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What nerve is sensory to the mucosa of the larynx below the vocal fold?

Recurrent Laryngeal Nerve

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What nerve(s) is/are a branch of the superior laryngeal nerve?

Internal Laryngeal Nerve

2. External Laryngeal Nerve

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What nerve is sensory to the mucosa of the larynx above the vocal folds?

Internal Laryngeal Nerve

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What nerve pierces the thyrohyoid membrane to enter the larynx along with the superior laryngeal artery?

Internal Laryngeal Nerve

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What nerve is motor to the cricothyroid and inferior constrictor muscles?

External Laryngeal Nerve

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What blood vessel supplies blood to the larynx from the superior thyroid artery?

Superior Laryngeal Artery

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What blood vessel supplies blood to the larynx from the inferior thyroid artery?

Inferior Laryngeal Artery

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Which of the nerves that innervate the larynx is the most important?

Recurrent Laryngeal Nerve

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What are the 3 main functions of the lymphatic system?

Picks up protein molecules from tissue fluid which are too large to pass through capillaries and transports them to the bloodstream.
Returns excess tissue fluid to the bloodstream.
It produces lymphocytes.

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What type of tissue do lymph nodes contain?

Reticular tissue

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What moves lymph?

Skeletal Muscle Contraction

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What are examples of lymph being moved by skeletal muscle contraction?

Exercise clears toxins from tissues.

2. Health benefits of massage.

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What are swellings found along the lymphatic system called?

Lymph Nodes

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What are the functions of lymph nodes?

Produce lymphocytes.

2. Act as filters for the lymph, preventing foreign bodies from entering the bloodstream.

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What do afferent lymph vessels do?

Drain lymph to a node

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What do efferent lymph vessels do?

Drain lymph from a node

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What are the superficial lymph nodes of the head?

Occipital
Mastoid
Parotid

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What are the superficial lymph nodes of the neck?

Submandibular
Submental
Anterior Cervical
Superficial Cervical

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What superficial node of the neck is located on the external surface of the sternocleidomastoid muscle following the external jugular vein?

Superficial Cervical

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Where do all lymphatics of the head and neck eventually drain directly or indirectly into?

Deep Cervical Nodes

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Where are deep cervical nodes located?

Located within the carotid sheath and follows the course of the internal jugular vein

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What are the two largest deep cervical nodes?

Jugulodigastric Node

2. Jugulo-omohyoid Node

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What does the Jugulodigastric Node drain?

The tongue and the palatine tonsils

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Where is the Jugulodigastric Node found?

Near the posterior belly of the digastric muscle.

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What node is enlarged by Tonsilitis?

Jugulodigastric Node

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What does the Jugulo-omohyoid Node drain?

The tongue

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Where is the Jugulo-omohyoid Node found?

Near the intermediate tendon of the omohyoid

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What forms the right and left jugular trunks?

Efferents of the deep cervical nodes

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Where does the right jugular trunk drain into?

The junction between the internal jugular and subclavian veins

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Where does the left jugular trunk drain into?

The thoracic duct

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What is very important for tracking the spread of cancer cells?

The lymphatic system

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Afferents of what nodes drain the central portions of the lower lip, the floor of the mouth, and the tip of the tongue?

Submental Nodes

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Afferents of what nodes drain the cheek, the side of the nose, the upper lip, the lateral part of the lower lip, the gums, and the margin of the tongue?

Submandibular Nodes

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What lymphatics are followed by the spread of cancer?

The lymphatics which drain the affected region

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Will cancer of the central part of the lip follow a different path than cancer of the lateral part of the lip?

Yes

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Will cancer of the central part of the lip follow the same path than cancer of the lateral part of the lip?

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What term is used to describe the spread of cancer via the lymphatic system?

Lymphogenous Metastasis

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What is an enlarged supraclavicular node that is usually located on the left side?

Signal (Sentinel) Node

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What is often the first indication of a visceral tumor of the thorax or abdomen?

Signal (Sentinel) Node

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What is a primary tumor of the lymph nodes called?

Lymphoma

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What is Hodgkin’s disease a type of?

Lymphoma

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What is a type of lymphoma that has a poorer prognosis than Hodgkin’s disease?

Non-Hodgkin’s Lymphoma

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In diagnosis, what does an enlarged lymph node which is tender or painful indicate?

Infection

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In diagnosis, what does an enlarged lymph node which is hard and painless indicate?

Cyst development or cancer

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What is a parasital infection of the lymph nodes consisting of worms?

Filarasis

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What is an epidermally derived structure that consists of mammary glands, fat, and fibrous tissue?

The breast

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What does the breast consist of?

mammary glands
fat
fibrous tissue

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Where is the breast located?

Between the second and sixth ribs and between the sternum and the midaxillary line

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What is a vertical line dividing the armpit into anterior and posterior halves?

Midaxillary Line

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Where is the nipple usually located?

At the level of the fourth intercostal space

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What is the ring of pigmented skin which surrounds the nipple called?

Areola

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What is the portion of the breast which extends back into the armpit?

Axillary Process (Tail)

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Is the axillary process (tail) a frequent site for cancer?

Yes

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What are the strong fibrous septa which support the breast and which run through the breast from the skin to the deep layer of superficial fascia called?

Suspensory Ligaments of the Breast

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What is a modified sweat gland that is located in the superficial fascia and has 15 to 20 lobes of glandular tissue?

Mammary Gland

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Where does each lobe of glandular tissue of a mammary gland open onto?

Onto the tip of the nipple through the lactiferous duct

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What is an expansion of the lactiferous duct which serves as a reservoir for milk during lactation?

Lactiferous Sinus

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What blood vessels supply blood to the breast?

Internal Thoracic Artery
Thoracoacromial Artery
Lateral Thoracic Artery
Intercostal Arteries

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What are the lobes of glandular tissue made up of?

Histological features called lobules

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What lymphatic structures drain the breast?

Axillary Nodes
Parasternal Nodes
Nodes of the Opposite Breast
Nodes of the Anterior Abdominal Wall

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Why are there lots of lymphatics around the breasts?

Immune response protecting the infant

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What is the most important lymphatic that drains the breast?

Axillary Nodes

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Where are parasternal nodes located?

Inside of the Sternum

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Seventy-five percent of the lymph from the breast drains to what nodes?

Axillary Nodes

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What is the most common cancer in women?

Breast Cancer

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Where does breast cancer spread to first before entering the bloodstream?

Lymphatics

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Following entrance into the bloodstream where does breast cancer first spread to?

Axilla

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Where does the posterior intercostal veins brain cancer drain to?

Azygos and Hemiazygos systems

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Where do connections to the vertebral venous plexus allow the spread of breast cancer to?

The vertebral column and brain

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What are the 3 clinical signs of breast cancer?

Dimpling due to invasion of the suspensory ligament.
Inverted nipple (due to invasion of the lactiferous duct).
Leathery thickening of skin (like an orange).

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What is one cause of mid-thoracic back pain in females?

Breast Cancer

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What is the sternum a major site for?

Red Blood Cell production

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What is the widest and thickest part of the sternum?

Manubrium

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What structure’s upper border forms the jugular notch?

Manubrium

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What part of the sternum articulates with the second to seventh costal cartilages?

Body

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What joint does the costal cartilage of the second rib articulate directly with?

Manubriosternal Joint

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What part of the sternum is cartilaginous at birth, but slowly ossifies throughout life?

Xiphoid Process

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Can the Xiphoid process of the sternum be bifid?

Yes

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What part of the sternum is often broken during CPR?

Xiphoid Process

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What does the articulation of the manubrium with the body of the sternum form?

The Sternal Angle

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Where is the sternal angle found at?

The level of the intervertebral disc between T.V.4 and T.V.5

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What is the superior opening of the thoracic cage called?

Superior Thoracic Aperture (Thoracic Inlet)

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What is the Superior Thoracic Aperture (Thoracic Inlet) bounded by?

Manubrium
First Rib
First Thoracic Vertebra

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What may barrel chest suggest?

COPD (Emphysema)

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What is the inferior opening of the thoracic cage called?

Inferior Thoracic Aperture (Thoracic Outlet)

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What is the shape of the Inferior Thoracic Aperture (Thoracic Outlet)?

Kidney-shaped

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What is the Inferior Thoracic Aperture (Thoracic Outlet) bounded by?

Xiphoid Process
Costal Margin
Twelfth Rib
Distal End of the Eleventh Rib
Twelfth Thoracic Vertebra

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How many ribs are there?

24 (12 pairs)

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What two types of ribs are there based on their patterns of articulation?

True Ribs

2. False Ribs

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What type of ribs are ribs 1 to 7?

True Ribs

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What type of ribs articulate with the sternum directly through their own costal cartilages?

True Ribs

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What ribs are classified as “True Ribs”?

Ribs 1 to 7

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What types of ribs are ribs 8 to 12?

False Ribs

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What “False Ribs” articulate with the sternum indirectly by attaching to the costal cartilage of the rib above?

Ribs 8 to 10

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What “False Ribs” are not connected to the sternum at all and are often referred to as floating ribs?

Ribs 11 & 12

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What two types of ribs are there based on morphology?

Typical Ribs

2. Atypical Ribs

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What ribs are classified as “Typical Ribs”?

Ribs 3 to 9 which share similar morphology

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What ribs are classified as “Atypical Ribs”?

Ribs 1, 2, 10, 11, and 12, each of which is unique

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What morphological features are found on a typical rib?

Head
Neck
Tubercle
Angle
Shaft
Costal Groove

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What are the functions of the thoracic cage?

Protection of thoracic and upper abdominal organs.
Muscle attachments.
Respiration.

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Do the ribs move with respiration?

Yes

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What muscle originates at the lower border of ribs 1 to 11 and inserts at the upper border of ribs 2 to 12?

External Intercostal

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What is the innervation of the external intercostal muscle?

Corresponding intercostal nerve

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What is the function of the external intercostal muscle?

Elevates the ribs in inspiration

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Where on the rib do the external intercostal muscles begin and end?

They begin at the tubercle of the rib and end at the costochondral joint

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What are the external intercostal muscles replaced by at the costochondral joint?

External intercostal membrane

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What direction do the fibers of the external intercostal muscles run?

Downward and Forward

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What muscle originates at the upper border of ribs 2 to 12 and inserts at the lower border of ribs 1 to 11?

Internal Intercostal

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What is the innervation of the internal intercostal muscles?

Corresponding intercostal nerve

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What is the function of the internal intercostal muscles?

Depresses the ribs in fored expiration

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Where on the rib do the internal intercostal muscles begin and end?

They begin at the sternum and end at the angle of the ribs

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What replaces the internal intercostal muscles?

Internal Intercostal Membrane

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What direction do the fibers of the internal intercostal muscles run?

Downward and Backward

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What muscle originates at the upper border of ribs 2 to 12 and inserts at the lower border of ribs 1 to 11?

Innermost Intercostal

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What is the innervation of the Innermost Intercostal muscle?

Corresponding Intercostal Nerve

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What is the function of the Innermost Intercostal muscle?

Depresses the ribs in forced expiration

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What direction do the fibers of the innermost intercostal muscles run?

Downward and Backward

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What do all intercostal muscles function to do?

To prevent the pushing in or drawing out of the intercostal spaces during respiration

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What muscle originates at the inner surface of ribs near their angles, travels across a rib without inserting, and then inserts into the rib above that?

Subcostalis

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What is the innervation of the subcostalis muscle?

Intercostal Nerve

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What is the function of the subcostalis muscle?

Depresses the ribs in forced expiration

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What muscle originates at the posterior surface of the lower sternal body and xiphoid process and inserts at the inner surface of costal cartilages 2 to 6?

Transversus Thoracis

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What is the innervation of the transversus thoracis?

Intercostal Nerve

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What is the function of the transversus thoracis?

Depresses the ribs in forced expiration

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What do anastomoses allow?

Collateral Articulation

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What is the anterior aspect of the thoracic wall supplied by?

The Internal Thoracic Artery and its branches

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What are the branches of the internal thoracic artery (from the subclavian)?

Pericardiacophrenic Artery
Anterior Intercostal Arteries
Musculophrenic Artery
Superior Epigastric Artery

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What branch of the internal thoracic artery accompanies the phrenic nerve and supplies the pleura, pericardium, and diaphragm?

Pericardiacophrenic Artery

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What branch of the internal thoracic artery supplies the upper 6 intercostal spaces and anastomose with the posterior intercostal arteries?

Anterior Intercostal Arteries

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What branch of the internal thoracic artery is the lateral terminal branch?

Musculophrenic Artery

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What branch of the internal thoracic artery is the medial terminal branch?

Superior Epigastric Artery

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What blood vessels supply the posterior aspect of the thoracic wall?

Supreme (Superior) Intercostal Artery
Third through Eleventh Posterior Intercostal Arteries
Subcostal Artery

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What side is the thoracic branch of the aorta located on?

Left

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Where does the Supreme (Superior) Intercostal Artery come from?

Costocervical Trunk

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What does the Supreme (Superior) Intercostal Artery branch into?

The first and second posterior intercostal arteries

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Where do the third through eleventh posterior intercostal arteries arise from?

Directly from the thoracic aorta

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Where does the subcostal artery come from?

Thoracic Aorta

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Where does the subcostal artery lie?

Below the 12th rib

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What is the anterior aspect of the thoracic wall drained by?

Internal Thoracic Vein

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What does the internal thoracic vein drain into?

The brachiocephalic vein

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What is the posterior aspect of the thoracic wall drained by?

The azygos system of veins

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Is the Azygos System unpaired and bilaterally asymmetrical?

Yes

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Is the Azygos System paired and non-bilaterally asymmetrical?

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On the right side, where does the first posterior intercostal vein drain into?

The brachiocephalic vein

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On the right side, what do the second and third posterior intercostal veins join together to form?

The Superior Intercostal Vein

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On the right side, what does the superior intercostal vein drain into?

The azygos vein

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On the right side, what do the fourth through eleventh posterior intercostal veins and the subcostal vein drain into?

The azygos vein

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On the left side, what does the first posterior intercostal vein drain into?

The Brachiocephalic Vein

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On the left side, what do the second and third posterior intercostal veins join together to form?

The Superior Intercostal Vein

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On the left side, what does the superior intercostal vein drain into?

The Left Brachiocephaic Vein

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On the left side, what do the fourth through eighth posterior intercostal veins join together to form?

The Accessory Hemiazygos Vein

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On the left side, what does the hemiazygos vein drain into?

The Azygos Vein

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On the left side, what do the ninth through eleventh posterior intercostal veins join to form?

The Hemiazygos Vein

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What do the azygos and hemiazygos veins represent?

The thoracic continuation of the right and left ascending lumbar veins

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What are the anterior primary rami of the first 11 thoracic spinal nerves?

Intercostal Nerves

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What is the anterior primary ramus of the 12th thoracic spinal nerve?

Subcostal Nerve

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What is the function of the endothoracic fascia?

To prevent the innermost intercostal muscle from rubbing against the parietal pleura

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What is the thickening of the fascia over the apex of the lung called?

Suprapleural Membrane

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What does the typical intercostal space contain?

Intercostal Vein
Intercostal Artery
Intercostal Nerve

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What structure found in the typical intercostal space hangs below the costal groove and is not protected like its corresponding artery and vein?

Intercostal nerve

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What structures lie within the costal groove on the lower, internal surface of each rib and are sandwiched between the internal and innermost intercostal muscles?

Intercostal Vein
Intercostal Artery
Intercostal Nerve

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What three smaller cavities is the thoracic cavity subdivided into?

Mediastinum

2. 2 Pleural Cavities

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What is the name of the cavity that surrounds the lung?

Pleural Cavity (2)

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What is the area between the two pleural cavities which contains the heart, great vessels, trachea, esophagus, etc. called?

Mediastinum

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What is a thin membrane which lines the inner surface of the thoracic cavity and covers the surface of the lung?

Pleura

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What two types of pleura are there?

Parietal Pleura

2. Visceral Pleura

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What type of pleura lines the inner surface of the thorax?

Parietal Pleura

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What type of pleura intimately invests the lung?

Visceral Pleura

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What is a potential space between the parietal and visceral pleurae?

Pleural Cavity

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What lubricates the pleurae to minimize friction between the parietal and visceral layers, facilitating movement of the lungs?

Pleural Fluid

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What 4 parts does the parietal pleura consist of?

Costal Pleura
Mediastinal Pleura
Diaphragmatic Pleura
Cervical Pleura (portion which overlies the apex of the lung)

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What are spaces found between two folds of parietal pleura called?

Pleural Recesses

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What do pleural recesses allow for?

The expansion of the lung during inspiration

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What is the space formed where the costal and diaphragmatic pleurae meet?

Costodiaphragmatic Recess

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Where is the costodiaphragmatic recess located?

At the midaxillary line

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What is the space formed where the costal and mediastinal pleurae meet?

Costomediastinal Recess

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What tends to accumulate in the costodiaphragmatic recess but can be removed by thoracentesis done at intercostal space 9 during expiration?

Fluid

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What blood vessel(s) supply the parietal pleura?

Intercostal Arteries
Internal Thoracic Artery
Superior Phrenic Artery

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What blood vessel(s) supply the visceral pleura?

Bronchial Artery

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What innervates the parietal pleura?

Intercostal Nerves
Subcostal Nerve
Phrenic Nerve

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Is the parietal pleura highly sensitive to pain?

Yes

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Is the visceral pleura highly sensitive to pain?

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Is the parietal pleura insensitive to pain?

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Is the visceral pleura insensitive to pain?

Yes

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What innervates the visceral pleura?

Nothing. It has no sensory innervation

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With what condition do the pleural cavities fill with air?

Pneumothorax

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What are the causes of pneumothorax?

Trauma (“sucking chest wound”)
Disease (Lung tumor, chronic bronchitis, foreign object, etc.)
Congenital weak spot (More common in tall people due do a difference in the growing rates)

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What term is used when discussing a condition of pneumothorax in which air comes from the lung itself through rupture?

Positive Pressure Pneumothorax

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With what type of pneumothorax would there be a flap instead of a hole present on the visceral pleura allowing the lung to expand, but then it closes with breathe out and pushes against the heart potentially causing collapse?

Tension Pneumothorax

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What condition is caused when air enters the pleural cavity on inspiration but cannot exit upon expiration?

Pneumothorax

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With what condition does the pleural cavity inflate like an intertube pushing the mediastinum to the opposite side and compressing the other lung?

Pneumothorax

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With what condition does the pleural cavity fill with blood?

Hemothorax

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When both Pneumothorax and Hemothorax are present what is this condition called?

Hemopneumothorax

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What is the term used interchangeably with lung collapse?

Atelectasis

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What term is used to describe cancer of the pleura?

Mesothelioma

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What condition consists of inflammation of the pleurae which leads to adhesions between parietal and visceral pleurae?

Pleuritis

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What condition is painful due to the sensory innervation of the parietal pleura?

Pleuritis

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With what condition is pain often referred to the shoulder via the phrenic nerve (C3,4,5)?

Pleuritis

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With what condition does pain radiate along the distribution of the supraclavicular nerves (C3,4)?

Pleuritis

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What condition produces a sand known as a pleural friction rub, which can be heard with auscultation?

Pleuritis

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What is the space between the pleural cavities called?

Mediastinum

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What space contains all of the structures of the thorax except the lungs and pleurae?

Mediastinum

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What divides the mediastinum into the superior mediastinum above and the inferior mediastinum below?

An imaginary plane that passes from the sternal angle through the intervertebral disk between T.V. 4 and T.V. 5

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Topographically, what structures does the sternal angle act as an important landmark to indicate the level of?

Boundary between the superior and inferior mediastinum.
Articulation of the second rib with the sternum.
Aortic arch.
Bifurcation of the trachea into the left and right main bronchi.
Upper border of the pulmonary trunk.

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What are the contents of the Superior Mediastinum?

Superior Vena Cava
Brachiocephalic Veins
Arch of the Aorta (and its branches)
Thoracic Duct
Trachea
Esophagus
Thymus
Vagus Nerve
Left recurrent laryngeal nerve
Phrenic Nerve

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What three compartments is the inferior mediastinum further subdivided into?

Anterior Mediastinum
Middle Mediastinum
Posterior Mediastinum

Where does the anterior mediastinum lie?

Anterior to the pericadial sac and posterior to the sternum

What are the contents of the anterior mediastinum?

Thymus
Lymph Nodes
Sternopericardial Ligaments

What is the middle mediastinum bounded by?

The Pericardial Sac

What are the contents of the middle mediastinum?

Heart
Pericardium
Roots of the Great Vessels
Main Bronchi
Phrenic Nerve

Where does the posterior mediastinum lie?

Posterior to the pericardial sac and anterior to thoracic vertebrae 5 through 12

What are the contents of the posterior mediastinum?

Esophagus
Thoracic Aorta
Azygos Vein
Hemiazygos Vein
Thoracic Duct
Vagus Nerve
Splanchnic Nerves (from sympathetic trunk)

Where does the trachea begin?

At the inferior border of the cricoid cartilage (C.V.6)

How many C-shaped cartilaginous rings does the trachea consist of?

15 to 20

Which direction do the C-shaped cartilaginous rings of the trachea open?

Posteriorly

What is the function of the C-shaped cartilaginous rings of the trachea?

Prevent the trachea from collapsing

What band of smooth muscle spans the posterior gap of the trachea?

Trachealis muscle

How long is the trachea?

9 to 15 cm in length

At the level of the sternal angle what happens to the trachea?

It bifurcates into the left and right main bronchi

What is the prominent ridge located within the trachea at its bifurcation that separates the openings of the right and left main bronchi called?

Carina

Where does the trachea lie?

Anterior to the esophagus and posterior to the arch of the aorta

In its path, where does the trachea deviate to just before its bifurcation at the sternal angle?

To the Right

Which of the main bronchi is shorter, wider and more vertical?

Right Main Bronchus

Which of the main bronchi passes under the arch of the azygos vein and gives off the superior lobar bronchus before entering the hilum of the lung?

Right Main Bronchus

Which of the main bronchi divides into the middle and inferior lobar bronchi within the hilum?

Right Main Bronchus

How many lobar bronchi are there coming from the right main bronchus?

What do the 3 lobar bronchi of the right main bronchi divide into?

10 segmental bronchi

Which of the main bronchi is longer, narrower, and more horizontal?

Left Main Bronchus

Which of the main bronchi passes anterior to the esophagus and divides into superior and inferior lobar bronchi within the hilum of the lung?

Left Main Bronchus

How many lobar bronchi are there coming from the left main bronchus?

What do the 2 lobar bronchi of the left main bronchi divide into?

10 segmental bronchi

Is it common for a child to aspirate a small object such as a peanut or a button?

Yes

During Aspiration, where do foreign objects usually enter due to its wide, short and vertical arrangement?

Right Main Bronchus

What is the carina covered with?

Sensitive Mucous Membrane

What represents the lowest point in the tracheobronchial tree where the cough reflex is mechanically initieated?

Carina

Once the carina is passed, coughing stops and what ensues?

Chemical Bronchitis and Atelectasis

What blood vessel(s) supply blood to the trachea?

Inferior Thyroid Artery

2. Bronchial Arteries

What nerve(s) innervate the trachea?

Vagus Nerve (parasympathetic and pain fibers)

2. Sympathetic Trunk

Do both the left and right lungs have an apex and a base?

Yes

What surfaces are present on both lungs?

Costal
Mediastinal
Diaphragmatic

What borders are present on both lungs?

Anterior
Posterior
Inferior

What surface of the lungs is the hilum present on?

Mediastinal Surface

What is the opening of the lung through which the vessels, nerves, and bronchi pass?

Hilum

What is formed by the structures which pass through the hilum?

Root of the Lung

What does the root of the lung connect?

The lung to the heart and trachea

What structures form the root of the lung?

Bronchi (posterior)
Pulmonary Arteries (superior)
Pulmonary Veins (anterior and inferior)
Bronchial Vessels
Nerves
Lymphatics

What is the root of the lung covered with?

Pleura, which is prolonged downward as a double layered membrane called the pulmonary ligament

How many bronchopulmonary segments does each lung have?

What fissure(s) are present on the right lung?

Oblique Fissure

2. Horizontal Fissure

What lobes are present on the right lung?

Superior Lobe
Middle Lobe
Inferior Lobe

Where is the superior lobe of the right lung located?

Above the horizontal fissure

Where is the middle lobe of the right lung located?

Between the horizontal and oblique fissures

Where is the inferior lobe of the right lung located?

Below the oblique fissure

What supplies each lobe?

A corresponding lobar bronchus

Following the division of each lobar bronchus into segmental bronchi, what do each of these segmental bronchi supply?

A bronchopulmonary segment

What features are characteristic of the right lung?

Groove for the Azygos Vein
Groove for the Esophagus
Cardiac Impression (shallow)
Groove for the Superior Vena Cava
Groove for the Brachiocephalic Vein

What fissure(s) are present on the left lung?

Oblique Fissure

What lobes are present on the left lung?

Superior Lobe

2. Inferior Lobe

Where is the superior lobe of the left lung located?

Above the Oblique Fissure

Where is the inferior lobe of the left lung located?

Below the Oblique Fissure

What features are characteristic of the left lung?

Lingula
Cardiac Notch
Cardiac Impression (deep)
Groove for the Aorta
Groove for the Left Subclavian Artery

What are the functional units of the lung?

Bronchopulmonary Segments

What does each bronchopulmonary segment consist of?

Segmental Bronchus
Branch of the Pulmonary Artery
Segment of Lung tissue
Surronding Septum

What structures are clinically important as they can be surgically removed without affecting the functioning of adjacent structures?

Bronchopulmonary Segments

What blood vessels supply the lungs with blood from the thoracic aorta?

Bronchial Arteries

What blood vessels of the lungs take blood to the azygos and accessory hemiazygos veins?

Bronchial Veins

In order, what structures make up the Tracheobronchial Tree?

Trachea
Main Bronchi
Lobar Bronchi
Segmental Bronchi
Bronchioles
Alveoli

What is the primary structure of the trachea?

Cartilaginous Rings

What is the primary structure of the main bronchi?

Cartilaginous Rings

What is the primary structure of the lobar bronchi?

Cartilaginous Plates

What is the primary structure of the segmental bronchi?

Smooth Muscle

What is the primary structure of the bronchioles?

Only Smooth Muscle

What is the primary structure of the alveoli?

Membrane (Squamous Cells)

What does inflammation of the segmental bronchi cause?

Bronchitis

What does inflammation of the bronchioles cause?

Bronchiolitis

What does inflammation of the alveoli cause?

Pneumonia

Where do the anterior and posterior pulmonary plexuses lie?

In front of and behind the root of the lung

The anterior and posterior pulmonary plexuses are formed by fibers from where?

Vagus Nerve (parasympathetic and sensory)

2. Sympathetic Trunk (T2 to T5, sympathetic and sensory)

What does sympathetic activation of the lungs produce?

Bronchial Dilation

2. Vasoconstriction

What does parasympathetic activation of the lungs produce?

Bronchial Constriction

2. Vasodilation

Does sympathetic activation decrease glandular secretion?

Yes

Does parasympathetic activation decrease glandular secretion?

Does sympathetic activation increase glandular secretion?

Does parasympathetic activation increase glandular secretion?

Yes

What condition is an obstructive airway disease characterized by coughing, wheezing, and difficulty breathing?

Asthma

What condition is caused by spasms of smooth muscle which lie in the segmental bronchi and bronchioles?

Asthma

What condition is accompanied by excessive secretion of mucus?

Asthma

What are the two types of Asthma?

Extrinsic Asthma

2. Intrinsic Asthma

What type of asthma is triggered by allergens?

Extrinsic Asthma

What type of asthma is triggered by non-allergy stimuli such as stress, cold or exercise?

Intrinsic Asthma

What have chiropractic clinicians noted about asthma?

Often associated with upper thoracic subluxation

What often brings relief to patients with asthma?

Adjustments

What does impingement of the sympathetics that originate from T2 to T5 allow?

Parasympathetic activation to dominate

What supplies the adrenal medulla, which secretes epinephrine, a potent bronchodilator?

Lower Thoracics (T9 to T11)

Smoke damage to the cilia tesults in what?

Smokers cough

Where does lymph from the lungs drain into?

The pulmonary and bronchopulmonary nodes located in the hilum

Where do the pulmonary and bronchopulmonary nodes located in the hilum drain into?

Tracheobronchial Nodes

Is respiratory Epithelium ciliated?

Yes

What does mucosiliated clearance move?

Mucus and dirt up and out of the larynx

What are the lungs and tracheobronchial tree rich in?

Lymphatics

What is a primary tumor of the bronchus?

Bronchogenic Carcinoma

What condition is directly related to cigarette smoking and air pollution?

Bronchogenic Carcinoma

What condition is highly metastic and spread quickly to the lymph nodes and enters the bloodstream by eroding a venule and traveling via the pulmonary veins to the heart and systemic circulation?

Bronchogenic Carcinoma

What condition often causes enlargement of a sentinel node?

Bronchogenic Carcinoma

How may lung cancer affect the phrenic nerve?

Results in paralysis of half of the diaphragm

How may lung cancer affect the recurrent laryngeal nerve?

Results in the paralysis of half of the larynx

Interthoracic disease such as bronchogenic carcinoma or lung infections may refer pain to where?

Upper or Middle Thoracic cord segment

Do both sympathetic and vagal branches of the lungs contain sensory fibers?

Yes

What seperates the thorax from the abdomen?

Diaphragm

What is a fibromuscular dome-shaped structure with right and left domes?

Diaphragm

Is the right or left dome of the diaphragm slightly higher?

Right Dome

Why is the right dome of the diaphragm slightly higher?

It overlies the liver

What two parts does the diaphragm consist of?

Muscular Part (lies around the periphery)

2 Central Tendon

What part of the diaphragm takes origin from a number of bony sources, and inserts into the central tendon?

Muscular Part

What are the 3 points of origin of the muscular part of the diaphragm?

Sternal
Costal
Lumbar

Where does the sternal point of origin of the muscular part of the diaphragm come from?

The Xiphoid Process

Where does the costal point of origin of the muscular part of the diaphragm come from?

The lower 6 costal cartilages

Where does the lumbar point of origin of the muscular part of the diaphragm come from?

The bodies of Lumbar vertebrae 1-3 and the medial and lateral arcuate ligaments

What are the openings in the diaphragm?

Caval Opening (Foramen)
Esophageal Hiatus
Aortic Hiatus

What opening of the diaphragm is located at T.V.8 within the central tendon and transmits the inferior vena cava and the right phrenic nerve?

Caval Opening (Foramen)

What opening of the diaphragm is located at T.V.10 and transmits the esophagus and the anterior and posterior vagal trunks?

Esophageal Hiatus

What opening of the diaphragm is located at T.V.12 and transmits the aorta, thoracic duct, and azygos vein?

Aortic Hiatus

What is the lowest part of the mediastinum?

T.V.12

What blood vessels supply blood to the diaphragm?

Musculophrenic Artery
Pericardiacophrenic Artery
Superior Phrenic Artery
Inferior Phrenic Artery

Where is the musculophrenic artery derived from?

Internal Thoracic Artery

Where is the pericardiacophrenic artery derived from?

Interna Thoracic Artery

Where is the superior phrenic artery derived from

Aorta

Where is the inferior phrenic artery derived from?

Aorta

What nerve(s) innervate the diaphragm?

Phrenic Nerve (C3,4,5)

2. Intercostal Nerves

What nerve supplies motor innervation to the diaphragm as a whole and supplies sensory innervation to the central part of the diaphragm?

Phrenic Nerve (C3,4,5)

What nerve supplies sensory innervation to the peripheral part of the diaphragm?

Intercostal Nerves

What condition is due to weakness in the diaphragmatic wall around the esophageal hiatus?

Hiatal Hernia

What condition involves the upper part of the stomach sliding up into the thoracic cavity through an opening?

Hiatal Hernia

When does a hiatal hernia usually occur?

After age 50

What condition is a major cause of gastroesophageal reflux?

Hiatal Hernia

What condition may be involved when the symptoms of a patient include belching and epigastric pain?

Hiatal Hernia

What type of chiropractic adjustment may be used in treatment of a hiatal hernia?

S.O.T. technique diagnose with X-ray

During what action do three major movements take place within the thorax which result in an increase in intrathoracic volume and a decrease in intrathoracic pressure?

Inspiration

What three movements take place within the thorax during inspiration?

Piston Movement
Bucket Handle Movement
Pump Handle Movement

During what movement that takes place within the thorax during inspiration, does the diaphragm contract, pulling the domes inferiorly into the abdomen resulting in an increase in the vertical diameter of the thorax?

Piston Movement

During what movement that takes place within the thorax during inspiration, does an elevation of the lower ribs (7 to 10) occur about an anteroposterior axis resulting in an increase in the transverse diameter of the thorax?

Bucket Handle Movement

During what movement that takes place within the thorax during inspiration, does an elevation of the upper ribs (2 to 6) occur about a transverse axis resulting in an increase in the antero-posterior diameter of the thorax?

Pump Handle Movement

What is the elevation of the ribs in both the bucket handle and pump handle movements due to?

Contraction of the external intercostal muscles

What do movements of inspiration result in?

A negative pressure within the thoracic cavity and the entrance of air into the lungs

During what type of expiration do the diaphragm and external intercostal muscles relax and air is expelled passively?

Normal Expiration

During what type of expiration do the internal intercostals, innermost intercostals, and the muscles of the anterior abdominal wall contract?

Forced Expiration

During Inspiration what happens to the interthoracic volume and pressure?

Volume Increases

- Pressure Decreases

During expiration what happens to interthoracic volume and pressure?

Volume Decreases

- Pressure Increases

Does contraction of the diaphragm during inspiration have the same or opposite effect on the abdomen that it has has on the thorax?

Opposite Effect

During inspiration what happens to the intra-abdominal volume and pressure?

Volume Decreases

- Pressure Increases

What is an important factor in the occurrence of inguinal hernias?

Contraction of the diaphragm during inspiration has the opposite effect on the abdomen that it has on the thorax

What are the result of a spasmodic contraction of the diaphragm?

Hiccups

What are some morbid underlying causes of hiccups?

Brain lesions
Pleuritis
Pericarditis
Peritonitis

What is a fibroserous sac that occupies the middle mediastinum and forms its borders and encloses the heart and great vessels?

Pericardium

What types of pericardium are found around the hear?

Fibrous Pericardium

2. Serous Pericardium

What is the strong, dense outer part of the pericardium?

Fibrous Pericardium

What blends with the central tendon of the diaphragm and with the walls of the great vessels which pierce it?

Fibrous Pericardium

What part of the pericardium is continuous with the pretracheal fascia above?

Fibrous Pericardium

What is connected to the back of the sternum by two variable fibrous strands called sternopericardial ligaments?

Fibrous Pericardium

What are the three parts of the serous pericardium?

Parietal Layer
Pericardial Cavity
Visceral Layer

What part of the serous pericardium lines the inner surface of the fibrous pericardium?

Parietal Layer

What part of the serous pericardium is a potential space between the parietal and visceral layers of the serous pericardium and contains serous fluid?

Pericardial Cavity

What part of the serous pericardium is closely adherent to the outer surface of the heart and is also known as the epicardium?

Visceral Layer

What are the 4 layers of the heart?

Epicardium
Myocardium
Endocardium
Chambers

What part of the heart is equivalent to the visceral layer of the serous pericardium?

Epicardium

What part of the heart is composed mainly of cardiac muscle fibers arranged in a spiral?

Myocardium

What part of the heart is the smooth endothelium which lines the inside of the heart?

Endocardium

How many chambers are there in the human heart?

With what condition is the fibrous pericardium very unyielding (“tough” or “doesn’t stretch well”)?

Cardiac Tamponade

With what condition, if fluid leaks rapidly into the pericardial cavity (pericardial-effusion), the heart may be compressed and venous return may be impeded because veins are flatter and can be compressed more easily?

Cardiac Tamponade

In Cardiac Tamponade, what is particularly vulnerable?

Superior Vena Cava

With what condition can the external jugular vein become prominent and eventually all veins of the face and neck can become engorged?

Cardiac Tamponade

What are the names of the pericardial sinuses?

Transverse Pericardial Sinus

2. Oblique Pericardial Sinus

Which pericardial sinus is a subdivision of the pericardial sac which lies posterior to the aorta and pulmonary trunk as well as anterior to the superior vena cava and left atrium?

Transverse Pericardial Sinus

Which pericardial sinus is a subdivision of the pericardial sac which lies posterior to the heart and is surrounds by the left and right pulmonary veins and the inferior vena cava?

Oblique Pericardial Sinus

What blood vessel(s) supply blood to the pericardium?

Pericardiacophrenic Artery
Bronchial Artery
Esophageal Artery
Coronary Arteries (supply visceral layer of serous pericardium only)

What nerve(s) innervate the pericardium?

Phrenic Nerve (Sensory)
Sympathetic Trunk (Vasomotor)
Vagus Nerve

Where does the phrenic nerve pass in relation to the pericardium?

Between the parietal pleura and fibrous pericardium

Where is pericardial pain felt diffusely?

Behind the sternum

What is less sensitive to pain? (Pericardium or Pleura)

Pericardium

What is inflammation of the membrane of the lung which is not serious but painful?

Pleuritis

What is inflammation of the pericardium which is serious and can be life-threatening but not really painful?

Pericarditis

Describe the Pericardial Friction Rub test.

Have patient hold their breath
Examine the patient for friction by auscultation
Distinguish between pleural friction and pericardial friction

During the Pericardial Friction Rub test, if the rubbing stop what is indicated?

Pleural Friction

During the Pericardial Friction Rub test, if the rubbing continues what is indicated?

Pericardial Friction

Where does the heart lie?

Within the pericardial sac in the middle mediastinum

What is the heart divided into left and right halves by?

A Septal Wall

What does each half of the heart consist of?

Two Chambers (Atrium & Ventricle)

What is the thickest chamber of the heart?

Left Ventricle

What is the 2nd thickest chamber of the heart?

Right Ventricle

What is the 3rd thickest chamber of the heart?

Left Atrium

What is the thinnest chamber of the heart?

Right Atrium

In order according to thickness, list the chambers of the heart.

Left Ventricle
Right Ventricle
Left Atrium
Right Atrium

What are the only arteries to carry de-oxygenated blood?

Pulmonary Arteries

What are the only veins to carry oxygenated blood?

Pulmonary Veins

How much thicker is the Left Ventricle than the Right Ventricle?

2 to 3 times thicker

What condition is an obstruction of a pulmonary artery by a blood clot?

Pulmonary Embolism

In relation to a pulmonary embolism, where does the blood clot form?

In the systemic venous system (a leg for example)

Describe the pathway of a blood clot to becoming a pulmonary embolism.

Forms in the systemic venous system
Passes through the inferior or superior venae cavae to the right atrium
Passes from the right atrium to the right ventricle
Passes from the right ventricle to the pulmonary trunk
Passes from the pulmonary trunk into the pulmonary arteries
Embolus blocks a pulmonary artery or one of its branches blocking blood to the lung

What does a pulmonary embolism result in?

Acute Respiratory Distress

What condition leads to the dilation of the right ventricle and right atrium resulting in heart failure?

Pulmonary Embolism

How fast can a Pulmonary Embolism cause death?

In minutes (More common in the young)

What are the two types of semilunar valves?

Aortic

2. Pulmonary

What controls the flow of blood through the heart?

Valves

What does each valve consist of?

Valve Orifice
Fibrous Ring (Anulus)
Cusps

Structurally, what surrounds the valve orifice of a valve?

Fibrous Ring (Anulus)

Structurally, what is attached to the fibrous ring of a valve and are flaps which close the valve?

Cusps

What are the four major valves in the human heart?

Pulmonary Valve
Aortic Valve
Mitral (Bicuspid) Valve
Tricuspid Valve

Which of the four major valves of the heart connects the right ventricle and pulmonary trunk?

Pulmonary Valve

How many cusps does the pulmonary valve have?

3 (Anterior, Left, Right)

Which of the four major valves of the heart connects the left ventricle and the aorta?

Aortic Valve

How many cusps does the aortic valve have?

3 (Left, Right, Posterior)

Which of the four major valves of the heart connects the left atrium and left ventricle?

Mitral (Bicuspid) Valve

How many cusps does the mitral (bicuspid) valve have?

2 (Anterior, Posterior)

Which of the four major valves of the heart connects the right atrium and right ventricle?

Tricuspid Valve

How many cusps does the tricuspid have?

3 (Anterior, Posterior, Septal)

What is the other name used for the Mitral (Bicuspid) Valve?

Left Atrioventricular Valve

What is the other name used for the Bicuspid Valve?

Right Atrioventricular Valve

What produces a two-stroke beat (“Lub-Dup”) which represents the blood carrying sound in the direction of its flow?

Heart

What is produced by contraction of the ventricles and closure of the tricuspid and mitral valves?

Lub Sound

What is produced by the closure of the pulmonary and aortic valves?

Dup Sound

Where is the Pulmonary Valve located?

Behind the medial end of the third left costal cartilage

Where is the Pulmonary Valve most audible?

Over the left second intercostal space

Where is the Aortic Valve located?

Behind the left half of the sternum medial to the third intercostal space

Where is the Aortic Valve most audible?

Over the right second intercostal space

Where is the Mitral (Bicuspid) Valve located?

Behind the left half of the sternum medial to the fourth costal cartilage

Where is the Mitral (Bicuspid) Valve most audible?

Over the left fifth intercostal space at the midclavicular line

What is the most frequently diseased valve of the heart due to the high pressure produced by the left ventricle which results in micro-abrasions of the valve cusps?

Mitral (Bicuspid) Valve

Where is the Tricuspid Valve located?

Behind the right half of the sternum medial to the fourth intercostal space

Where is the Tricuspid Valve most audible?

Over the left fifth intercostal space at it border with the sternum

In the thorax, what is the orientation of the heart?

It lies obliquely, running forward, downward and to the left from base to apex

What is the base of the heart formed by?

The left and the right atria

What is the apex of the heart formed by?

The left ventricle

Where does the apex of the heart lie?

In the left fifth intercostal space

What surfaces are found on the heart?

Anterior (Sternocostal)
Diaphragmatic
Left Pulmonary
Right Pulmonary

What is the anterior (sternocostal) surface of the heart mostly formed by?

The Right Ventricle

What is the diaphragmatic surface of the heart mostly formed by?

The Right and Left Ventricles

What is the left pulmonary surface of the heart mostly formed by?

The Left Ventricle

What is the right pulmonary surface of the heart mostly formed by?

The Right Atrium

What structure located within the right atrium is an ear-like appendage from the superior aspect of the right atrium?

Right Auricle

What structures located within the right atrium are prominent parallel ridges located in the anterior atrial wall?

Pectinate Muscles (Musculi Pectinati)

What structure located within the right atrium is a vertical muscular ridge which runs from the opening of the superior vena cava to that of the inferior vena cava?

Crista Terminalis

What structure located within the right atrium marks the termination of the pectinate muscles and separates the right atrium from the sinus of venae cavae?

Crista Terminalis

What structure is a vertical groove which marks the crista terminalis externally?

Sulcus Terminalis

What structure located within the right atrium is the smooth-walled area located posteriorly to the crista terminalis?

Sinus of Venae Cavae (Sinus Venarum)

What structure located within the right atrium represents the embryonic sinus venosus and receives the openings of the superior vena cava, inferior vena cava, coronary sinus, and anterior veins of the right ventricle?

Sinus of Venae Cavae (Sinus Venarum)

What structure located within the right atrium is a depression which is the remnant of the foramen ovale (oval foramen), an opening between the right and left atrium which closes at birth?

Fossa Ovalis (Oval Fossa)

What is the sharp border of the fossa ovalis called?

Limbus Fossa Ovalis

What condition that occurs in 25% of adults, does the foramen ovale persist as a small opening in the superior part of the fossa ovalis?

Atrial Septal Defect

When an Atrial Septal Defect is small what is it called?

Probe Patent Foramen Ovale

Is a probe patent foramen ovale clinically significant?

In most cases no

When an Atrial Septal Defect is larger what is it called?

Clinical Atrial Septal Defect

With an atrial septal defect, blood is shunned from the left atrium to the right, what does this cause dilation of?

Right Atrium
Right Ventricle
Pulmonary Trunk

What openings are present in the Right Atrium?

Superior Vena Cava (has no valve)
Inferior Vena Cava (has a rudimentary valve)
Coronary Sinus (has a rudimentary valve)
Anterior Veins of the Right Ventricle
Right Ventricle (through the Tricuspid Valve

What structures located within the right ventricle are interconnecting muscular ridges located in the ventricular wall?

Trabeculae Carneae

What structures located within the right ventricle are cone-shaped muscles which originate from the ventricular wall?

Papillary Muscles

What structures located within the right ventricle have apices that are connected to the chordae tendineae?

Papillary Muscles

What are the three papillary muscles of the ventricle?

Anterior (largest)
Posterior
Septal

Can papillary muscles often be bifid, trifid, or multiple?

Yes

What structures located within the right ventricle attach the papillary muscles to the borders of the cusps of the tricuspid valve?

Chordae Tendineae (Tendinous Cords)

What structures located within the right ventricle prevent eversion of the tricuspid valve during ventricular contraction?

Chordae Tendineae (Tendinous Cords)

What structure located within the right ventricle is the upper portion of the right ventricle which ends in the pulmonary trunk?

Conus Arteriosus

What structure located within the right ventricle is a thick, muscular ridge which separates the conus arteriosus from the rest of the right ventricle?

Supraventricular Crest

What structure located within the right ventricle is a large trabecula which extends from the interventricular septum to the base of the anterior papillary muscle?

Septomarginal Trabecula (Moderator Band)

What structure located within the right ventricle transmits the right bundle branch of the conduction system?

Septomarginal Trabecula (Moderator Band)

What openings are found within the right ventricle?

To Right Atrium (through the tricuspid valve)

2. To Pulmonary Trunk (through the mitral valve)

Where does oxygenated blood enter the heart?

Left Atrium

What structure located within the left atrium is an ear-like appendage of the left atrium?

Left Auricle

What structures located within the left atrium consist of a few that are found in the auricle, but mostly the left atrium is smooth?

Pectinate muscles

What openings are found within the left atrium?

Pulmonary Veins

2. To Left Ventricle (through the Mitral Valve)

How many pulmonary veins usually open into the left atrium?

Usually 4

What structures located within the left ventricle are finer and more numerous interconnecting muscular ridges located in the ventricular wall than that of the right ventricle?

Trabeculae Carneae

What structures located within the left ventricle are cone-shaped muscles which originate from the ventricular wall?

Papillary Muscles

How many papillary muscles are found within the left ventricle?

2 (Anterio, Posterior)

What structures of the left ventricle are attached from the papillary muscles to the borders of the cusps of the mitral valve?

Chordae Tendineae (Tendinous Cords)

What structure of the left ventricle is a smooth-walled portion below the cusps of the aortic valve?

Aortic Vestibule

What openings are found within the left ventricle?

To left atrium (through the Mitral Valve)

2. To aorta (through the aortic valve)

What 4 parts does the septal wall that divides the heart into right and left halves consist of?

Interatrial Septum
Atrioventricular Septum
Membranous Interventricular Septum
Muscular Interventricular Septum

What part of the septal wall lies between the two atria?

Interatrial Septum

What part of the septal wall is a small portion above the septal cusp of the tricuspid valve and below the anterior cusp of the mitral valve?

Atrioventricular Septum

What part of the septal wall is thin, smooth, and fibrous in structure?

Membranous Interventricular Septum

What part of the septal wall is very thick?

Muscular Interventricular Septum

What two ways can an enlargement of the heart occur?

Muscular Hypertrophy

2. Dilation of a Chamber

With what type of enlargement of the heart is the elasticity of the blood vessels lost with age, particularly with atherosclerosis and/or hypertension?

Muscular Hypertrophy

With what type of enlargement of the heart is more force required to push blood through the arteries?

Muscular Hypertrophy

With what type of enlargement of the heart do the walls of the heart grow thicker due to enlargement of cardiac muscle fibers?

Muscular Hypertrophy

What type of enlargement of the heart may be due to septal defects or valve incompetency?

Dilation of a Chamber

When there is an incompetent mitral valve, there is regurgitation of blood from the left ventricle into the left atrium, the left atrium may dilate to accomodate extra blood. What is the response to?

Valve Incompetency

Do the Mitral and Tricuspid valves have chordae tendineae and papillary muscles?

Yes

Do the Pulmonary and Aortic valves have chordae tendineae and papillary muscles?

Which valves close due to ventricular contraction?

Mitral and Tricuspid valves

Which valves open due to ventricular contraction?

Pulmonary and Aortic valves

Structurally, both the pulmonary and aortic valves consist of three semilunar cusps which have what features?

Nodules
Lunules
Pulmonary and Aortic Sinuses

What are the small central thickenings on the free edge of each cusp of the pulmonary and aortic valves?

Nodules

What is the thin, crescentic part of the cusps of pulmonary and aortic valves?

Lunules

What are the spaces of the pulmonary and aortic valves between the cusps and the walls of the vessel, located superiorly?

Pulmonary and Aortic Sinuses

What are the pulmonary and aortic valces sometimes referred to as?

Semilunar valves

What is the connective tissue framework of the heart?

The Fibrous Skeleton

What is the fibrous skeleton composed of?

Fibrous Rings
Left and Right Fibrous Trigones
Membranous Part of the Septal Wall

What structures of the fibrous skeleton form the foundation of each of the heart valves (tricuspid, mitral, pulmonary, and aortic)?

Fibrous Rings (Anuli)

What structures of the fibrous skeleton connect the fibrous rings together, and represent the strongest part of the fibrous skeleton?

Left and Right Fibrous Trigones

What structure of the fibrous skeleton consists of the interatrial, atrioventricular, and membranous interventricular septa?

Membranous Part of the Septal Wall

What are the functions of the fibrous skeleton of the Heart?

To provide a structural framework for the valves.
To insulate the electrical impulses of the conduction system within the atrial wall from those within the ventricular wall.

Does the fibrous skeleton resist dilation?

Yes

Where do the right and left coronary arteries arise from?

The aorta just superior to the aortic valve (within the right and left aortic sinuses, respectively

What does coronary mean?

“Crown”

What do the right and left coronary arteries travel within?

The coronary sulcus

What are the branches of the right coronary artery?

Sinuatrial Nodal Artery
Right Marginal Artery
Posterior Interventricular Artery

What branch of the right coronary artery runs along the right lower margin of the heart?

Right Marginal Artery

What branch of the right coronary artery lies within the posterior interventricular sulcus?

Posterior Interventricular Artery

What branch of the right coronary artery passes posteriorly around the superior vena cava to the sinuatrial node?

Sinuatrial Nodal Artery

What are the branches of the left coronary artery?

Anterior Interventricular Artery
Circumflex Artery
Left Marginal Artery

What branch of the left coronary artery lies within the anterior inteventricular sulcus?

Anterior Interventricular Artery

What branch of the left coronary artery passes posteriorly to anastomose with the right coronary artery?

Circumflex Artery

What branch of the left coronary artery, that actually comes off of the circumflex artery runs along the left margin of the heart and supplies the left ventricle?

Left Marginal Artery

Where does the left coronary artery lie?

Deep to the Epicardium

What term refers to which coronary artery gives rise to the posterior interventricular artery?

Coronary Artery Dominance

What percentage of individuals present with right coronary dominance?

70%

What percentage of individuals present with left coronary dominance?

30%

What does the right coronary artery usually supply?

Right Atrium
Most of the Right Ventricle
Diaphragmatic Surface of the Left Ventricle
Posterior 1/3 of the Interventricular Septum
Conduction system to proximal parts of the right and left bundle branches

What does the left coronary artery usually supply?

Left Atrium
Most of the Left Ventricle
Part of the Right Ventricle
Anterior 2/3 of the Interventricular Septum

Which coronary artery always supplies the greatest portion of the heart’s tissue?

Left Coronary Artery

Branches of what arteries are generally considered to be end arteries?

Coronary Arteries

Where do (coronary artery) anastomoses occur between?

Right Coronary and Circumflex Arteries

2. Anterior and Posterior Interventricular Arteries

What is the largest vein of the heart?

Coronary Sinus

What structure lies within the coronary sulcus and drains into the right atrium?

Coronary Sinus

Does the Coronary Sinus have a valve?

Yes, a rudimentary valve

What 5 tributries does the Coronary Sinus receive?

Great Cardiac Vein
Middle Cardiac Vein
Small Cardiac Vein
Posterior Vein of the Left Ventricle
Oblique Vein of the Right Ventricle

What tributary accompanies the Anterior Interventricular Artery?

Great Cardiac Vein

What tributary accompanies the Posterior Interventricular Artery?

Middle Cardiac Vein

What tributary accompanies the Right Coronary Artery near the right lower margin of the heart?

Small Cardiac Vein

What tributary is located to the left of the middle cardiac vein?

Posterior Vein of the Left Atrium

What veins drain directly into the right atrium?

Anterior Veins of the Right Ventricle

What are the smallest veins of the heart?

Venae Cordis Minimae

What veins run within the walls of the heart and drain primarily primarily into the right atrium?

Venae Cordis Minimae

What condition is the deposition of lipid plaques on the inner walls of arteries resulting in a narrowing of the lumen?

Atherosclerosis

What condition is a substernal chest pain that occurs upon exertion due to insufficient blood flow to heart tissue (ischemia)?

Angina Pectoris

What is a symptom of Angina Pectoris?

Occlusion of the Coronary Artery Bronchus

What condition occurs when a coronary artery branch become occluded?

Myocardial Infarction

What condition results in the portion of the heart supplied by the artery that is occluded, dies (necrosis) and is converted into fibrous scar tissue?

Myocardial Infarction

Are men or women more likely to die from heart attacks?

Women

What are the most common sites of a myocardial infarction?

Anterior Interventricular (40 to 50%)
Right Coronary Artery (30 to 40%)
Circumflex Artery (15 to 20%)

What common site for a myocardial infarction is sometimes referred to as the widow maker because it is usually lethal?

Anterior Interventricular Artery

Where does the Subepicardial Plexus drain lymph into?

Tracheobronchial Node

What structure has its own contractile mechanism (the conduction system) and does not require a nerve supply to beat rhythmically?

The Heart

What is necessary to alter the rate of beating of the heart?

A nerve

What increases the heart rate and strength of contraction and dilates the coronary arteries?

Sympathetic Activation

What decreases the heart rate and strength of contraction and constricts the coronary arteries?

Parasympathetic Activation

What is innervation of the heart?

The Cardiac Plexus

What is the cardiac plexus divisible into?

Superficial Cardiac Plexus

2. Deep Cardiac Plexus

Where is the superficial cardiac plexus located?

Beneath the arch of the aorta, anterior to the pulmonary trunk

Where is the deep cardiac plexus located?

Posterior to the arch of the aorta

Where does sympathetic innervation of the heart come from?

The cervical and thoracic cardiac nerves from the sympathetic trunk (T1-T4)

Where does parasympathetic innervation of the heart come from?

The Vagus Nerve

Where do sensory fibers of the heart travel?

With both the sympathetic branches and the vagus

What are subluxations and related soft tissue changes restricted to T1-T4 frequently associated with and what is the hypothesis behind this?

Myocardial Infarctions and other heart problems;
Impingement on sympathetics could allow parasympathetic activation to dominate, leading to constriction of coronary arteries

What stops valves from everting and allowing the backflow of blood?

Papillary muscles

What is controlled by specialized cardiac muscle fibers which are collectively known as the conduction system?

The rhytmic beating of the heart

What are the parts of the conduction system?

Sinuatrial Node
Atrioventricular Node
Atrioventricular Bundle
Subendocardial Plexus of Conduction Cells (Purkinje Fibers)

What part of the conduction system is the natural pacemaker of the heart?

Sinuatrial Node

What part of the conduction system is located at the upper end of the crista terminalis, near the junction of the right atrium with the superior vena cava?

Sinuatrial Node

What part of the conduction system is located in the septal wall, above the opening for the coronary sinus in the right atrium?

Atrioventricular Node

What part of the conduction system is located within the septal wall and divides into a right and left bundle branch?

Atrioventricular Bundle

What two branches does the atrioventricular bundle divide into?

Right Bundle Branch

2. Left Bundle Branch

What branch of the atrioventricular bundle enters the septomarginal trabecula of the right ventricle?

Right Bundle Branch

What branch of the atrioventricular bundle enters the papillary muscles of the left ventricle?

Left Bundle Branch

What part of the conduction system is joined by branches of the left and right bundle branches?

Subendocardial Plexus of Conduction Cells (Purkinje Fibers)

Where does the conduction impulse begin?

The sinuatrial node

Describe the path of the conduction impulse.

Begins in the sinuatrial node.
Spreads through the atrial wall until it reaches the atrioventricular node.
Travels through the atrioventricular bundle and its two bundle branches to the subendocardial plexus of conduction cells.
Travels through the myocardium of the ventricles

What type of arteries are the aorta and pulmonary trunk and their branches?

Elastic Arteries

What great vessels exit the heart?

Aorta (from left ventricle)

2. Pulmonary Trunk (from right ventricel)

What are the branches of the Pulmonary Trunk?

Left Pulmonary Artery

2. Right Pulmonary Artery

What great vessels enter the heart?

Pulmonary Veins (to left atrium)
Superior Vena Cava (to right atrium)
Inferior Vena Cava (to right atrium)

Where do the pulmonary veins drain blood to the left atrium from?

Behind the heart (lungs)

Where does the superior vena cava drain blood to the right atrium from?

Anything above the heart

Where does the inferior vena cava drain blood to the right atrium from?

Anything below the heart

What is the remnant of the embryonic ductus arteriosus?

Ligamentum arteriosum

What connects the arch of the aorta to the left pulmonary artery or pulmonary trunk?

Ligamentum arteriosum

Where is the ligamentum arteriosum located at?

The level of the sternal angle

In the embryo, what shunts blood from the pulmonary trunk to the aorta?

Ductus Arterisosus

What is prone to aneurysms in the aortic arch?

Ligamentum arteriosum

What nerve hooks under the aortic arch posterior to the ligamentum arteriosum?

Left Recurrent Laryngeal Nerve

What nerve hooks under the right subclavian artery?

Right Recurrent Laryngeal Nerve

What is the muscular tube through which food passes to the stomach?

Esophagus

What does the esophagus consist of?

An upper 1/3 composed of striated muscle
A middle 1/3 composed of mixed striated and smooth muscle
A lower 1/3 composed of smooth muscle

What three parts make up the esophagus?

Cervical Part
Thoracic Part
Abdominal Part

Which part of the esophagus is the longest?

The thoracic part

Where does the esophagus begin?

At the laryngopharynx at C.V.6

What is a median structure which enters the thorax posterior to the trachea?

Esophagus

Where does the esophagus enter the abdomen?

Through the esophageal hiatus at T.V.10

Where does the esophagus join the stomach?

At the cardioesophageal junction

What sphincters are found in the esophagus?

Superior Esophageal Sphincter

2. Inferior Esophageal Sphincter

What sphincter is formed by the lower part of the inferior constrictor?

Superior Esophageal Sphincter

What sphincter is sometimes referred to as the cricopharyngeus?

Superior Esophageal Sphincter

What sphincter is formed by encircling fibers of the diaphragm at the esophageal hiatus?

Inferior Esophageal Sphincter

Is the esophagus distensible?

Yes

What blood vessels supply blood to the esophagus?

Inferior Thyroid Artery
Bronchial Artery
Esophageal Artery
Left Gastric Artery
Inferior Phrenic Artery

What blood vessels drain blood from the esophagus?

Esophageal Veins (into adjacent systemic veins)

2. Left Gastric Gastric Vein (into the portal vein)

What nerves innervate the esophagus?

Vagus Nerve
Sympathetic fibers from thoracic cord levels
Pain fibers carried in the sympathetic trunk

What nerve contains special motor fibers which supply the striated muscle portion of the esophagus (upper 1/3 and striated part of the mixed middle 1/3)?

Vagus Nerve

What nerve contains parasympathetic fibers which supply the smooth muscle portion of the esophagus (lower 1/3 and smooth muscle part of the mixed middle 1/3)?

Vagus Nerve

What are the parts of the Aorta?

Ascending Aorta
Aortic Arch
Descending Aorta

Where is the ascending aorta located?

In the middle mediastinum

Where is the aortic arch located?

In the superior mediastinum

What are the parts of the descending aorta?

Thoracic Aorta

2. Abdominal Aorta

Where is the thoracic aorta located?

In the posterior mediastinum

Where is the abdominal aorta located?

In the abdomen

Where does the thoracic aorta begin?

At the level of T.V.4

Where does the thoracic aorta lie?

Posterior to the esophagus

What begins its descent to the left of the vertebral column, but slants toward the midline of the body and ends directly anterior to the vertebral column?

Thoracic Aorta

What passes through the aortic hiatus at the level of T.V.12 to become the abdominal aorta?

Thoracic Aorta

What two types of branches come from the thoracic aorta?

Parietal Branches

2. Visceral Branches

What do the parietal branches of the thoracic aorta supply?

The Body Wall

What do the visceral branches of the thoracic aorta supply?

Thoracic Viscera

What are the parietal branches of the thoracic aorta?

3rd through 11th Intercostal Arteries
Subcostal Arteries
Superior Phrenic Arteries

What are the visceral branches of the thoracic aorta?

Bronchial Arteries (1 right and 2 left)
Pericardial Arteries
Mediastinal Arteries
Esophageal Arteries

Where do important anastomoses of the thoracic aorta occur?

Between the anterior and posterior intercostal arteries

2. Between the superior and inferior epigastric arteries

What does most of the lymph of the body reach the venous system through?

The thoracic duct

What begins in the abdomen as a dilation at the junction of three abdominal trunks (intestinal, lumbar, descending intercostal) called the cisterna chyli?

The thoracic duct

What passes through the aortic hiatus of the diaphragm and travels upward through the posterior mediastinum between the aorta and the azygos vein?

The thoracic duct

What level does the thoracic duct cross over to the left?

T.V.5 or T.V.6

What passes posterior to the left subclavian vein, forms an arch, and empties into the junction of the left internal jugular and subclavian veins?

The thoracic duct

The thoracic duct drains the lymph of the entire body except for the what?

Right upper extremity
Right thoracic cavity
Right side of the head and neck

What nerve enters the thorax after passing down the anterior surface of the scalenus anterior muscle?

Phrenic Nerve

What nerve descends between the mediastinal pleura and fibrous pericardium and is accompanied throughout its length by the pericardiacophrenic artery?

Phrenic Nerve

What nerve passes anterior to the root of the lung?

Phrenic Nerve

What are the functional components of the phrenic nerve?

Motor (to diaphragm)
Sensory (pain fibers from the diaphragm, pericardium, pleura, and peritoneum)
Sympathetic

What is a variation which arises from C5 and which is a branch of the nerve to subclavius?

Accessory Phrenic Nerve

When what nerve is present, sectioning of the phrenic nerve will not completely paralyze the corresponding half of the diaphragm?

Accessory Phrenic Nerve

What extends from the base of the skull to the coccyx on either side of the vertebral column and is located anterior to the neck of the ribs?

Sympathetic Trunk

What is the sympathetic trunk connected to the thoracic spinal nerves by?

Gray and white rami communicantes

What type of communicantes contain postganglionic sympathetic fibers and are connected to every spinal nerve?

Gray Rami Communicantes

What type of communicantes contain preganglionic sympathetic fibers and are limited to spinal cord segments T1 to L2?

White Rami Communicantes

What type of communicantes have nerve cell bodies that are located in the sympathetic trunk?

Gray Rami Communicantes

What type of communicantes have nerve cell bodies that are located in the lateral horn (intermediolateral cell column) of the spinal cord?

White Rami Communicantes

What passes from the thorax to the abdomen behind the medial arcuate ligament or through the crura of the diaphragm?

The sympathetic trunk

What is formed by the fusion of the inferior cervical with the first thoracic ganglion?

The cervicothoracic (stellate) ganglion

Within the thorax, the sympathetic trunk gives off what branches?

Cardiac
Pulmonary
Mediastinal
Splanchnic

What are the major visceral branches of the sympathetic trunk which supply abdominal viscera?

Splanchnic Nerves

What are the splanchnic nerves?

Greater Splanchnic Nerve (T5-T9)
Lesser Splanchnic Nerve (T10-T11)
Least Splanchnic Nerve (T12)

How do all three splanchnic nerves reach the abdomen?

By piercing the crura of the diaphragm, and end in abdominal ganglia

Aside from sympathetic fibers, the sympathetic trunk also carries sensory (pain) fibers from where?

Thoracic, Abdominal, and Pelvic Viscera

Where does the right vagus nerve enter the thorax?

Anterior to the right subclavian artery

Where does the left vagus nerve enter the thorax?

Between the left common carotid and left subclavian arteries

Within the thorax, what nerve gives off the recurrent laryngeal nerves and branches to the autonomic plexuses of the thorax?

Vagus Nerve

What nerve hooks around the right subclavian artery and ascends into the neck between the trachea and the esophagus?

Right recurrent laryngeal nerve

What nerve hooks around the arch of the aorta posterior to the ligamentum arteriosum and ascends into the neck between the trachea and the esophagus?

Left recurrent laryngeal nerve

What nerve passes posterior to the root of the lung?

Vagus nerve

What forms the esophageal plexus along the esophagus?

Vagus nerve

What comes together to form the anterior and posterior vagal trunks near the esophageal hiatus?

Esophageal Plexus

What are the functional components of the vagus nerve?

Motor (to muscles of the pharynx and larynx only - not to thorax)
Sensory (to thoracic and abdominal viscera)
Parasympathetic (to thoracic and abdominal viscera)

What are the autonomic plexuses?

Cardiac Plexus
Pulmonary Plexus
Esophageal Plexus
Thoracic Aortic Plexus

What autonomic plexus is related to the arch of the aorta and controls heart rate and is subdivided into superficial and deep parts?

Cardiac Plexus

What autonomic plexus is related to the root of the lung?

Pulmonary Plexus

What autonomic plexus is formed along the esophagus?

Esophageal Plexus

What autonomic plexus is a delicate network of nerves along the thoracic aorta and its branches?

Thoracic Aortic Plexus

Where do each of the autonomic plexuses of the thorax receive sympathetic fibers from?

The sympathetic trunk and parasympathetic fibers from the vagus

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