Exam 2 COPY Flashcards
Where is the frontal lobe of the brain?
Most anterior lobe
extends from the anterior portion to the central sulcus
Where is the Median nerve located in the upper limb?
Middle of M and runs anterior to the brachial artery
What does the primary somatosensory do?
Interpret stimuli
Each sensory area has an association area.
What does the hypothalamus control?
emotions
autonomic functions (body temp, thirst, hunger, sex drive)
hormone production
Origin-Great Cardiac Vein
Apex of the heart
Where is the radial artery located in the upper limb?
Posterior to the brachial artery
Where does the right coronary artery run?
To the right side of the heart
Origin-Radial Nerve
Posterior cord of the brachial plexus
Where do the anterior cardiac veins drain into?
the small cardiac vein
What are gyri?
Folds of cerebrum to increase surface area for processing
What does the upper subscapular nerve supply?
upper part of the subscapularis
Describe the flow of csf in the brain
- Lat. Ventricles (both sides)
- Medial through interventricular foramen (both sides)
- 3rd ventricle
- cerebral aquaduct
- 4th ventricle
- lateral (2) and median (1) aperatures
- subarachanoid space
- spinal cord and arachanoid villi
What is the other name for right AV valve?
Tricuspid Valve
What are the four locations of the choroid plexus in the brain?
- One on side of the lateral ventricles
- 3rd Ventricle
- 4th Ventricle
How is the brachial plexus formed?
From the fusion of spinal roots C5-T1
Where does the long thoracic nerve sit in the axilla?
Deep
What are the great vessels?
The vessels coming off the most superior portion of the heart
Insertion of pectoralis major
Lateral lip of intertubcular sulcus
Origin- Small Cardiac Vein
right margin of the heart
What does the Right AV (Tricuspid) Valve open into?
The right ventricle
How do the cerebral hemispheres work?
Receive sensory information and generates motor commands to the opposite sides of the body.
Also generates sensory commands
What is the function of the primary somatosenory association area?
Interpretation of stimuli
Where does the left coronary artery run?
To the left side of the heart
Where is the temporal lobe of the cerebrum?
most anterior part of the inferior half
What structure is affected by parkingson’s?
the substanchia nigra, Parkingsons can’t initiate motor programs
Where does the Great Cardiac Vein Run?
Starts at the apex of the heart and takes blood through interventricular surface where it then travels posteriorly to the coronary sinus
What blood vessels take blood into the heart?
Superior vena cava
inferior vena cava and the coronary sinus
Name the trunks of the brachial plexus
Upper
middle
lower
What are the problems with a slash injury to the axilla?
- Severing the axillary artery and bleeding out
- Sever brachial plexus where entire arm is then paralyzed
- Sever the axilary vein where an air bubble can be sucked in
- Server the thoracodorsal nerve and long thoracic nerve and serratus anterior is paralyzed
In which direction do the association fibers run in the brain?
Front and back
What does the radial artery innervate?
Muscles of the posterior arm and forearm and dorsum on the 1st, 2nd, 3rd and half of the 4th digit
What major nerves are found within the axilla?
Brachial Plexus Median Ulnar Long Thoracic Thoracodorsal Lower Subscapular
What comes off of the posterior cord of the brachial plexus?
upper subscapular nerve Thoracodorsal nerve Lower subscapular nerve Axillary nerve radial nerve
Where does the coronary sinus receive blood from?
Great, middle and small cardiac veins
Action of Biceps Brachaii
Strong forearm Flexor and in a pronated state you can supinate the forearm
Origin of the medial pectoral nerve
Medial cord of the brachial plexus (C8-T1)
Where does the inferior vena cava attach to?
to the right atrium posteriorly
What is hydrocephalus?
CSF will not drain and circulation is impaired. Babies bones are not yet fused. Head enlarges
Where is the hypo thalamus located?
It is the pointed part of the brainstem
What does the axillary nerve innervate?
Deltoid
Teres minor
Where does the median nerve run in relation to the brachial artery and ulnar nerve?
More anterior
What secretes the CSF?
Coroid plexus
What does the musculocutaneous nerve run?
Most of the elbow flexors (Biceps Brachaii, Brachialis, coracobrachialis
Where is the midbrain located
Most superior portion of the brain stem
Where is the 4th ventricle located?
Anterior to the pons and cerebellum
What does the postcentral gyrus contain?
Contains the primary somatosensory area for skin and muscle
Insertion of pectoralis minor
Coracoid process of the scapula
What does the median nerve innervate in the hand?
2nd and 3rd digits and half of 4th digit
Where does the middle trunk of the bracial plexus come off?
C7
Occipital Lobe Function
Visual Cortex
Conscious perception of visual stimuli
What muscles are the anterior forearm flexors?
Pronator Teres Flexor carpi radialis palmaris longus flexor digitorum superficialis flexor pollicis longus flexor digitorum profundus
Origin of the pectoralis major
Medial half of the clavicle, sternum and costal cartilages (1-7)
Which side of the heart pumps more blood
Neither!
Where does the lateral pectoral nerve run?
Across the axillary artery and vein to innervate pectoralis major and sometimes pectoralis minor
What does the medial pectoral nerve supply ?
Pectoralis major and minor
What lung is bigger?
Right lung-to accomodate heart
What does the lower subscapular nerve innervate?
Teres major (inferior to scapula)
How are the cords in the brachial plexus named?
According to arterial supply
What does the heart lay in?
Mediastinum
What is the most anterior great vessel?
Pulmonary trunk
Where does the blood have low oxygen in the heart?
Leaving the heart via the pulmonary arteries(in blue)
Innervation of Coracobrachialis
Musculocutaneous Nerve
What does the ulnar nerve run in the forearm?
Flexor carpi ulnaris
What is a nerve compression injury?
Nerve is comprssed and there is a mechanical problem where nerves can’t communicate. Example is arm falling asleep
What action does pectoralis major perform?
Medially rotates, flexes and adducts shoulder
What arteries comes off the left coronary artery?
On the anterior side-the anterior interventricular artery
2nd branch -left marginal artery
What is the function of projection fibers in the brain?
They send information anteriorly and posteriorly in the white matter
Connect cerebral cortex to diencephlan, brain stem, cerebellum and spinal cord
What does the posterior axillary fold contain?
Teres major and latissimus dorsi and subscapularis
Parietal Lobe Function
Primary sensory coretx
Conscious perception of touch, pressure, vibration, pain, temperature and taste
What does the hypothalamus coordinate?
nervous and endochrine functions
What comes off the medial cord of the brachial plexus?
Medial root of the median nerve
Medial pectoral nerve
Ulnar nerve
(medial antebrachial nerve and medial brachial cutaneous nerves are sensory)
What vessel is to the right of the aorta?
Superior vena cava
What is the M formed by?
Lateral and medial cords of the brachial plexus
Where is the primary somatosensory area?
postcentral gyrus of the parietal lobe
Where does the blood go from the pulmonary veins?
Into the left atrium of the heart
What great vessel is posterior to the pulmonary trunk?
the aorta
Origin of Long thoracic nerve
Brachial plexus
Where is the ulnar nerve located in the upper limb?
Medial to the median nerve and runs posterior to brachial artery
What does the left AV valve(bicuspid, mitral) open into?
left ventricle
Action of coracobrachalis
Adducts and Flexes humerus (shoulder)
What does the lateral pectoral artery supply blood to?
Serratus Interior and sometimes pectoralis major
What are arachanoid villiin the brain?
reabsorb csf and puts back into venous blood supply.
What is the function of coronary circulation?
get rid of waste and bring oxygen and nutrients to the heart
Where does blood go from the pulmonary semilunar valve?
Pulmonary trunk
Insertion of coracobrachialis
Medial side of shaft of humerus
What do the R and L coronary arteries feed?
The respective side of the heart
What is a motor program?
A storage of muscle actions and when to use certain muscles (muscle patterns)
How does the blood brain barrier protect the brain?
Chemical Protection
- Capillaries have tight junctions
- Lipid soluable (non polar) stuff can pass
- CO2 can pass
- Drugs like caffiene, nicoteine and anesthetics can pass
What is the function of the medulla oblongota?
o Relays sensory information to thalamus and to other portions of the brain stem
o Autonomic centers for regulation of visceral function (Cardio, respiratory and GI activity)
what does the left coronary artery branch into?
Left marginal artery and posterior left ventricular artery
Which side of the heart has a thicker myocardium?
left thus left is stronger
Where is the transverse fissure in the brain?
Seperates the cerebellum from the cerebrum
Where does the median nerve dive into the forearm?
at the pit of the elbow
What is the function of the pons?
- Relays sensory information to the cerebellum and thalmus
- Subconscious somatic and visceral motor centers
- Helps to regulate respiration (back seat driver), modifies it
- To help coordinate involuntary skeletal muscle movements and tone
What are the 3 cords of the brachial plexus?
Lateral
Medial
Posterior
What does the lateral pectoral nerve supply?
Pectoralis Major
Where does the upper trunk of the brachial plexus come off?
C5-C6
Describe Huntingtons Disease and What it affects
o Begins in Basal Nucleui o Manifests by 40 years o Autosomal dominant (1 parent 50/50 chance) of getting it o 20 years to kill o Initial signs-dropping things o Miss grabbing things o Continual degeneration o Later-everything is moving o Moves to whole brain-loses motor functions to swallow or breathe
Where does the ulnar nerve sit in the arm?
between the medial epicondyle and olecranon process
What sits in the posterior interventricular sulcus?
The middle cardiac vein and the posterior interventricular artery
Where does the aortic semilunar valve open into?
Aorta
Where does the medial pectoral nerve run and what does it innervate?
It travels between the axillary artery and vein to innervate the Pectoralis Minor and Sternal area of pectoralis major
What are the five major brachial plexus nerves?
Musculocutaneous Median Ulnar Axillary Radial
What is shoulder dystocia?
Stretching the brachial plexus
Infants- shoulder trapped behind pubic bone
Adults-Falling off a horse
Where does the long thoracic nerve run?
Posterior to the brachial plexus to innervate the serratus anterior
Origin of Lateral pectoral nerve
Lateral cord of the brachial plexus
Where are the lateral ventricles located?
One in each cerebral hemisphere
What comes off the lateral cord of the brachial plexus?
Lateral pectoral nerve
musculocutaneous nerve
lateral root of the median nerve
What are the first branches to come off the aorta in the heart?
The coronary arteries
Where does blood go from the left ventricle?
aortic semilunar valve
What are the problems with a slash injury to the axilla?
- Severing the axillary artery and bleeding out
- Sever brachial plexus where entire arm is then paralyzed
- Sever the axillary vein where an air bubble can be sucked in
- Server the thoracodorsal nerve and long thoracic nerve and serratus anterior is paralyzed
Innervation of the Brachialis
Musculocutaneous Nerve
What does the profundus brachii artery come off of?
Brachial Artery
What does the anterior axillary fold contain?
Pectoralis major
Part of pectoralis minor
Clavipectoral fashia
Where does the thoracoacromial artery branch off the axillary artery in the axillary region?
The first part of axillary artery artery between the lateral border of 1st rib and medial border of pectoralis minor.
What does the great Cardiac Vein supply blood to?
coronary sinus
List four ways the brain is protected
- Fused Bones of the skull
- Cranial meniges
- CSF
- Blood Brain Barrier
What is the precentral Gyrus?
Receives input from the premotor area and the upper motor neurons live there
Orientation of the Brachialis Muscle
More lateral
What does the blood exit the right atrium into and through?
Tricuspid or Right AV valve
What is another name for the left AV valve?
Bicuspid or mitral
Name the Three parts of the basal nucleui
o Caudate Nucleus (medial)
o Putamen (more lateral)
o Globus Pallidus (more inferior)
Where is the thalamus located?
Lateral to the 3rd ventricle
Where is the occipital lobe of the cerebrum?
The most posterior lobe
Which great vessel do you not see on the superior portion of the heart?
inferior vena cava
Where is the brachial plexus located in the upper limb?
Lateral to the brachial artery and lateral to median nerve
What does the lower subscapular nerve innervates?
teres major
lower part of the subscapularis
What does the thoracodorsal nerve innervate?
latissimus dorsi
Describe the blood flow from the lungs to the heart
- Blood enters a pair of pulmonary veins from each lung(4)
- left atrium
- Left AV valve (Bicuspid or mitral)
- Left ventricle
- Aortic semilunar valve
- Aorta
7.
What does the anterior cardiac vein supply blood to?
The small cardiac vein
What does the right coronary artery branch into?
right marginal artery and posterior interventricular artery
Describe the pathway of the blood through the heart
Sup. and Inf Vena Cava and coronary Sinus
- Right Atrium
- Right AV (Tricuspid) Valve
- Right Ventricle
- pulmonary semilunar valve
- Pulmonary Trunk
- Right and LEft Pulmonary Arteries
Where does the post circumflex anterior and posterior artery branch off the axillary artery?
between the lateral border of pectoralis minor to inferior border of teres major.
Describe the blood flow from the lungs to the heart
- Blood enters a pair of pulmonary veins from each lung(4)
- left atrium
- Left AV valve (Bicuspid or mitral)
- Left ventricle
- Aortic semilunar valve
- Aorta
- Rest of body
Where is Brocas Area located?
Inferior anterior area of the premotor area
What is located within the basal nuclei?
Nerve cell bodies
What is the function of the corpora quadrigegemina?
- Must have four to qualify
* Startle reflexes
What is the great cardiac artery paired with
anterior interventricular artery
Where is the thoracodorsal nerve in the axilla?
Lateral to the long thoracic in the deep axilla
Describe the pathway of the blood through the heart
Sup. and Inf Vena Cava and coronary Sinus
- Right Atrium
- Right AV (Tricuspid) Valve
- Right Ventricle
- pulmonary semilunar valve
Where is the pons?
First part of the brainstem
Where does the musculocutateous nerve run?
Between the biceps brachaii and brachialis muscles
What are the branches of the thoraactomial artery?
Acromial (comes off deltoid branch), clavicular, deltoid and pectoral branch
What is the function of the premotor are in the brain?
Planning motor movements (complex muscle actions)
Motor programs storage area (muscle memory)
What is the function of the primary motor cortex?
Area that moves skeletal muscle
Insertion of the Brachialis
Tuberosity of the Ulna
Where does the median nerve run in the axillary region?
Between the border of the biceps and brachialis
What is the function of the commissures of the brain?
They run left to right and transport information between white matter of the hemispheres
Interconnect lobes of different hemispheres
Origin of the Biceps Bracii
Radial Tuberosity
Origin of the brachialis
Anterior aspect of the humerus
What do the association areas do?
Interpretation and where you learn
Where is the parietal lobe of the cerebrum?
Posterior to frontal lobe and superior to the temporal lobe (its the middle one)
Function of the frontal lobe
Primary motor cortex
conscious control of skeletal muscles
Where is the Primary Motor Cortex?
Located in the precentral gyrus
What arteries are found within the axilla?
Axillary
Subclavian
Subscapular (Deep)
What is the function of the superior colliculi?
Visual startle reflex
What part of the brain is affected when you get heatstroke?
Hypothalamus-you don’t want to drink cause you don’t feel thirsty in the later stages
What are the branches of the thoraactomial artery?
Acromial (comes off deltoid branch), clavicular(Main branch), deltoid and pectoral branch
What does the lower subscapular nerve innervate?
teres major
lower part of the subscapularis
Location of the axillary nerve in the upper arm
Runs deep and lateral to the brachial artery
What veins are found within the axilla?
Axillary vein
Where does blood go from the right ventricle?
pulmonary semilunar valve
What is a fissure in the brain?
Deep groove
Where is the central sulcus of the brain?
It seperates the frontal and pareital lobes
Starts at the longitudinal fissure down to the temporal lobe.
It usually starts posterior and moves anterior
The left and right sides may be different
Straightest line possible
What runs through the dectopectoral groove?
The cephalic vein
What is the function of the subclavis muscle>
Depresses clavicle ans stabilizes the sternocovicular joint
Where is the pons located?
• Located in the brainstem (Belly of the seahorse)
What does the cerebellum coordinate?
Coordinates complex somatic motor patterns
What is the Substanchia Nigra?
Basal ganglia structure in the midbrain that is associated with the basal nuclei
What i is the role of the white matter in the brain?
Transport of information
What is the function of the diencephalon?
- Connects cerebrum to brain stem both structurally and functionally
- Connect higher (brainstem) brain centers to lower brain centers
- Almost all subconscious activity
What supplies blood to the deep axilla?
Subscapular artery which provides blood supply to many muscles.
Describe the pathway of the blood through the heart
Sup. and Inf Vena Cava and coronary Sinus
- Right Atrium
- Right AV (Tricuspid) Valve
- Right Ventricle
- pulmonary semilunar valve
- Pulmonary Trunk
- Right and Left Pulmonary Arteries
- Lungs
What does the thoracodorsal nerve innervate?
Lattisimus dorsi
What does the vermis do?
o Connects two hemoispheres of the cerebellum
Origin-Median nerve
Comes off from the union of medial and lateral cords of the brachial plexus
What are sulci?
Shallow grooves in the brain
What does the pulmonary trunk split into?
Right and Left pulmonary arteries
Where does the subclavian artery and vein change names are what are they?
Axilally (pass clavicle)
Overall Function of the cerebrum
Conscious thought processes and intellectual functions
Memory storage and processing
Conscious and subconscious regulation of muscle contractions
If you look up whether left or right what cranial nerve do you use?
III-Oculomotor
What is the function of the basal nuclei in the brain?
Controls starting, stopping and intensity of motor movements
Inhibits antagonistic muscles during movement
What is the Corpus Callosum?
The largest commissure of the brain
Temporal Lobe Function
Auditory and olfactory cortex
Conscious perception of olfactory and auditory stimuli
What is the origin of the right and left coronary arteries?
ascending aorta
Explain how you differentiate between the anterior and posterior sides of the heart.
The posterior side has more openings (pulmonary veins)
Anterior side you can see the auricles better
Where is the Deltopectoral groove?
Between the Deltoid (superior) and pectoralis major muscles
What makes up the diencephalon?
Hypothalamus and thalamus
What blood vessels take blood into the heart?
Superior vena cava
inferior vena cava and the coronary sinus into the right artrium
Origin-Axillary nerve
Posterior cord of the brachial plexus
What does the lateral sulcus seperate?
temporal and frontal lobes
What arteries comes off the left coronary artery?
On the anterior side-the anterior interventricular artery
2nd branch -left marginal artery
Where does the subclavian artery and vein change names are what are they?
Axilally (pass clavicle)
Brachial (past lateral border of scapula)
Innervation of pectoralis minor
Medial pectoral nerve
Where is the Jugular Fossa?
Between the sternoclediomastoid muscles
Where do the pulmonary arteries go?
To each lung
What is the function of Brocas area?
Planning Area for speech (usually only on left side)
Part of a motor program (speech takes lots of coordination of muscles)
What is the function of the Thalamus?
• Relay and processing centers for sensory information
Where is the lower subscapular nerve in the axilla?
Lateral to the thoracodorsal nerve in the deep axilla
What does the middle cardiac vein run next to?
posterior interventricular artery
Where is the posterior interventricular artery?
Within the posterior interventricular sulcus
when can you see the thymus?
Only in younger people
Origin of the posterior interventricular artery
right coronary artery
Where does the ulnar nerve run in relation to the median nerve?
Runs slightly posterior to it and runs with it.
How many pulmonary veins are there?
4 (2 from each lung)
What is the function of the inferior colliculi?
Auditory startle reflex
What does the coronary sinus drain into?
The right atrium
What nerves are parasympathetic?
4,
Where is the longitudal fissure?
It splits down the middle and seperates right and left hemispheres
What are the three functions of the CSF?
- Mechanical Protection (Shock absorption)
- Provides Nutrients (Metabolically active brain)
- Gets rid of waste products (pH and CO2)
Action of pectoralis Minor
Anteriorly tilts and depresses scapula
Where do the left and right marginal arteries run?
On the border of the heart
Origin of the pectoralis minor
Ribs 3-5
What does the long thoracic nerve innervate?
serratus interior
Origin of Long Thoracic Nerve
Brachal Plexus (C5-C7)
Where is the 3rd ventricle located?
Midline within the diencephalon medial to the thalamus
Origin of coracobrachialis
Coracoid process of the scapula
Orgin-Ulnar nerve
Medial cord of the brachial plexus
What nerve innervates Biceps Brachii?
Musculocutaneous
Medulla oblongota-Location
o Physically connects brain with spinal cord
o Most inferior portion of brainstem
What is the function of the midbrain?
- Processing of visual and auditory data
- Generation of reflexive somatic motor responses
- Maintenance of consciousness
What does the median nerve innervate in the arm?
runs anterior forearm flexors
What does the musculocutaneous nerve control?
Biceps Brachii, Coracobrachialis, and brachiliais
Innervation of the pectoralis major
Medial and Lateral pectoral nerves
Where do the pulmonary veins come in and then connect?
Come in posteriorly and then connect to the left side of the heart
Where does the ulnar nerve run in relation to the brachial artery?
posterior
What do the cardiac veins do?
Take lower oxygenated blood away from the heart muscle and giving it back to the general circulation
Origin -musculocutaneous nerve
Lateral cord of the brachial plexus
What is the function of the association fibers in the brain?
Facilitate communication between the anterior and posterior brain
interconnect cortical areas within the same hemisphere
Where is the cerebellum located?
o Posteriorly and inferiorly to cerebrum
o Bi-lobed
What does the blood from the left atrium go through?
Left AV valve (Bicuspid)
What does the basal nuclei communicate with?
Premotor and motor cortex
When numbering cranial nerves, what direction are they numbered?
anterior to posterior
Cranial Nerve I is….
Olfactory
What cranial nerves are the special sensory nerves?
I (Olfactory), II (Optic), VIII (Vestibulocochlear)
What cranial nerves have both sensory and mixed function?
V (Trigeminal), (VII)Facial, IX (Glossopharengeal), and X (Vagus)
Which cranial nerves are motor nerves?
III (Oculomotor), IV (Trochlear), VI (Abducens), XI (Accessory), XII (hypoglossal)
Function of the Olfactory nerve (I)
Smell
Origin of the olfactory nerve (I)
Receptors of the olfactory epithelium (smells are created with chemoreceptors). There is an association area in the brain
What does the olfactory nerve pass through?
Cribiform plate of the ethmoid bone
Destination of the olfactory nerve (I)
Olfactory bulbs
How do you test the olfactory nerve for function?
Occlude each nostril and ask the patient to identify odors
What is Cranial nerve II?
Optic nerve
What is the function of cranial nerve II (Optic)?
Vision
Origin of CN II (Optic nerve)
Retina
What does the Optic Nerve (II) pass through
optic canal of sphenoid
What is the destination of the optic nerve?
Through the optic chiasm to diencephalon
What is CN III?
Oculomotor
What is the function of CN III (Oculomotor)
Runs 4 of the 6 extraocular muscles
What is the origin of CN III (Oculomotor)?
Mesencephalon
What does CN III (Oculomotor) pass through?
Superior orbital fissure of the sphenoid bone
Where does CN III (Oculomotor) run to?
Intrinsic eye muscles
How would you test CN II Optic nerve?
Test for visual acuity using the snellan chart (both distance and near)
Also color perception and pupillary response
How would you test cranial nerve III (optic), IV (Trochlear), VI(Abducens)
Ask patient to follow a moving target to all 4 quadrants. Check pupillary response for briskness and symmetry and size in a dimly lit room. Check for drooping eyelids
If you ask a patient to look straight ahead, what cranial nerve and what muscle are you testing?
CN III (Oculomotor) Superior Rectus Muscle which elevates the eye to look straight
If you ask a patient to cross their eyes (Abduction) and keep the eye straight, what muscle and what cranial nerve are you testing?
Medial Rectus Muscle and CN III
If you ask a patient to look left and right (Right Abduction and left adduction and left a and right abduction and right adduction)t and you are looking at the most lateral eye, what muscle and CN are you testing?
The lateral rectus muscle and CN VI (Abducens)
If you ask a patient to look up and to the left (Elevation), and are looking at the right eye (adduction), what muscle and what cranial nerve are you testing?
The superior Rectus Muscle-CN III
If you ask a patient to look up and to the right(Elevation), and are looking at the left eye (adduction), what muscle and what cranial nerve are you testing?
Superior Rectus Muscle and CN III
If you ask a patient to look up and to the right(Elevation), and are looking at the abducted eye right eye, what muscle and what cranial nerve are you testing?
inferior oblique muscle and CN III (Oculomotor)
If you ask a patient to look up and to the left(Elevation), and are looking at the abducted left eye, what muscle and what cranial nerve are you testing?
inferior oblique muscle and CN III (Oculomotor)
If you ask someone to cross their eyes and look up, what cranial nerve and muscle are you testing?
Adduction of the eye using the superior rectus muscle and CN III
What can you ask someone to do to test CN III (Oculomotor)?
Elevate to the right and left and straight
Adduct the eye
Depress the eye while Adducting
Depress the eye
What extraocular movements test the Trochlear nerve (CN IV)
Depressing the Eye and Depressing while adducting the eye (superior oblique muscle)
What extraocular movements test the abducens (CN VI)?
Looking right and left while abducting
CN IV
Trochlear
What is the primary function of the trochlear nerve (CN IV)?
Eye Movements-Motor nerve
What does the CN IV (Trochlear) nerve pass through?
Superior Orbital Fissure of Sphenoid Bone
What muscle does the Trochlear (CN IV) Nerve Run
Superior Oblique muscle of the eye
Origin of the Troclear Nerve (CN IV)
Troclear nucleus of the midbrain
What nerve is the Trigeminal Nerve?
CN V
Name the three branches of the Trigeminal nerve
Opthalmic branch
Maxillary branch
Mandibular branch
What is the trigeminal nerves sensory function?
Anterior face
What Cranial nerve operates the chewing muscles?
CN V -Trigeminal
What action do the pterygoid muscles perform?
Moving the jaw side to side
What are the chewing muscles?
masseter and pterygoids
Where does the opthalmic branch of the trigemial nerve run?
To the top of the optic nerve and innervates the front of the face. (Forehead, lacrimal glands,upper eyelids, ciliary bodies and sides of nose)
Where does the maxillary branch of the trigeminal nerve run?
Maxillary bone (Sensory information from mucosa of nose, palate, pharynx, upper teeth, upper lip and lower eyelids)
Where does the Mandibular branch of the trigeminal nerve run?
Mandible
What does the opthalamic branch of the trigeminal nerve go through?
Superior orbital fissure of the sphenoid bone
Origin of the Trigeminal Nerve
Nuclei in the pons
What does the maxillary branches of the Trigeminal nerve pass through?
Foremina rotunda of the sphenoid bone
What do the mandibular branches of CN V (Trigeminal) ne go through to exit the brain?
Foramen Ovale of the sphenoid bone
What is the sensory function of the mandibular branch of the trigeminal nerve?
Anterior portion of the tongue (touch, temp and pressure) NOT TASTE
Cranial Nerve VI
Abducent
What cranial nerve controls the Lateral Rectus muscle?
CN VI (Abducent)
What does the abducent nerve pass through?
Superior orbital fissure of sphenoid bone
CN VII
Facial Nerve
What type of nerve is CN VII
A Mixed Nerve
What is the sensory function of the facial nerve?
Anterior 2/3 of the tongue (taste not motor)
What is the motor function of the facial nerve?
Salivary Glands (submandibular and sublingual under the tongue), Tear Ducts (moves tear medially in the eye to the lacrimal canal to come out nose), Facial expression
What does the facial nerve pass through?
Internal acoustic meatus of the temporal bone
Where does the facial nerve run?
Along the facial canal to reach the stylomastoid foramen
if you palpate anterior and up it will hurt.
How would you test the function of the facial nerve?
Unequal facial expressions, test each side of the tongue with different tastes.
Which Cranial nerve is Vestibulocochlear?
VIII (8)
What is the primary function of the vestibulocochlear nerve (CN VIII)
Vestibular branch-Balance and equlibrium
Cochlear branch = hearing
What is the Origin of CN VIII (Vestibulocochlear)
Receptors of the inner ear (vestibule and cochlea)
CN IX
Glossopharangeal
What is the sensory function of the glossopharengeal nerve?
Taste (posterior 1/3) and drooling
Which cranial nerve displaces the pharynx and moves glottis to swallow?
IX -Glossopharengeal
What is the visceral motor function of the glossopharengeal nerve (CN IX)?
Parotid Salivary Gland (Anterior to ear and largest pair)
CN X
Vagus
What is the most important cranial nerve?
Vagus
Destination on the Glossopharegeal Nerve (CN IX)
Tongue (posterior 1/3), Pharengeal muscles, parotid salivary
How many branches doe the vagus nerve have?
Three
What is the motor function of the vagus nerve?
parasympathetic(HR, breathing, sweating, some swallowing
What is the sensory function of the vagus nerve?
Stomache, ta
Origin of the Vagus nerve
Medulla Oblongota
Where does the vagus nerve exit the skull?
Jugular foramen
Where do the sensory fibers of the vagus nerve go to?
Sensory nucleui and autonomic centers of the medulla
Where do the Somatic Motor fibers of the Vagus nerve go to?
Muscles of the palatte and pharynx
Where do the visceral motor of the vagus nerve go to?
Cardiovascular, respiratory, and digestive organs in the thoracic and abdominal cavities
CN XI
Accessory
What does the external branch of CN XI (11) Control?
Sternocleidomastoid and trapezius muscles
Where does the Accessory nerve enter the skull?
Foramen magnum
Where does the accesory nerve exit the skull?
Jugular foramen
How would you test CN XI (Acessory)
Shrug shoulders and press down or to test sternocledi mastoid- Turn head and press on jaw.
CN XII
Hypoglossal
What is the function of the Hypoglossal nerve?
Moving the tongue to manipulate food
How Could you test the hypoglossal nerve (CN XII)
Muscle atrophy of the tongue, movement of the tongue
What three brain arteries arise from the internal carotid arteries?
- Anterior cerebral
- Anterior Communicating
- Middle Cerebral
What three brain arteries arise from the vertebral arteries?
- Basilar
- Posterior cerebral
- Posterior communicating
What does the common carotid artery come off of?
Aortic Arch
What does the common carotid artery split into?
Internal and External Carotid
What does the external carotid artery supply blood to?
Facial Muscles of the Skin
Where does the internal carotid artery run?
Stays deep and runs to the circle of willis
Origin of the Vertebral Arteries
Subclavian
Describe the pathway of the vertebral arteries
- Come off the subclavian arteries
- Ascend through the foramen in the transverse processes C1-C6.
- Enter skull through foramen magnum
- unite to form basilar at the lower border of pons
- Basilar divides into rt and left posterior cerebral arteries
- Connected to the middle cerebral arteries by posterior communicating arteries.
Describe the pathway of the Internal carotid arterys
- Common carotid at upper border of thyroid cartilage
- carotid canal in petrous portion of temporal bone( anterior to transverse processes of C1-C3)
- Branch into opthalmic and anterior choroidal
- Terminate in middle cerebral and anterior cerebral segments
Define an aneurysm
A weakened arterial wall that can balloon out
Where is the hyoid bone?
Anterior side of the neck and makes up superior border of the larynx
Function of the hyoid bone
Anchor for superior portion of the larynx
What bone is fractured during strangulation?
Hyoid
Borders of the anterior triangle (Carotid Triangle) of the neck
Anterior-Sternohyoid
Superior-Mandible
Posterior-Sternocleidomastoid
Borders of the Posterior Triangle (Occipital) of the Neck
Anterior-Sternocleidomastoid
Posterior-Trapezius
Inferior-Clavicle
Superior attachment of the platysma
inferior border of the mandible
Inferior attachment of the platysma
Superior part of the pectoralis major
What nerve innervates the platysma?
Facial nerve (VII)
Action of the platysma
Tenses skin of neck
Assists depression of mandible or opening the mouth
Superior attachment of the sternocleidomastoid muscle
Mastoid process of the skull
Inferior attachment of the Sternocleidomastoid muscle
Sternal head- anterior surface of the manubrium of sternum
Clavicular head: Superior surface of the medial 3rd of the clavicle
What nerve innervates the Sternoclediomastoid muscle?
Accessory nerve (XI)
Action of the sternocleidomastoid
Deep respiration
Right turns head left and left turns head right
Flexion of neck in supine positon
Extend atlantooccipital joint
What is the clinical relevance of the cricothyroid ligament?
You would make a verticle incison in the skin and then a horizontal incison in the membrane Divit between cricoid cartilage and
What is found in the larynx
Vocal cords, epiglottis, thyroid cartilage, cricoid cartilage,
Why is the adams apples (Thyroid cartilage) larger in males?
Size is affected by testosterone during puberty
There is change to the motor program as well causing voice cracking
What is the epiglottis?
A fold of cartilage that can save your life when you swallow covering the trachea
What nerve innervates the mylohyoid muscle?
Nerve to mylohyoid which is a branch of the inferior alveolar nerve coming off the 3rd branch of the trigeminal nerve.
What nerve innervates the Geniohyoid muscle?
C1 via hypoglossal nerve (CN XII)
What nerve innervates the anterior belly of the digastric muscle?
Nerve to mylohyoid (Branch of alveolar nerve)
What nerve innervates the posterior belly of the digastric muscle?
Digastric branch of the facial nerve (CN VII)
What nerve innervates the stylohyoid muscle
Stylohyoid branch of the facial nerve
What is the function of the mylohyoid, geniohyoid, and stylohyoid muscles?
elevate hyoid to swallow and fold over the epiglottis
Action of the Digastric muscle
Depresses the hyoid
Where are the infrahyoid muscles located?
Below the hyoid bone
Origin of the sternohyoid
Manubrium of the sterum and medial end of the clavicle
Insertion of the sternohyoid
Body of the hyoid bone
What nerve innervates the sternohyoid muscle?
C1-C3 by a branch of the ansa cervicalis
Action of the sternohyoid muscle
Depresses hyoid after elevation during swallowing
Origin (Superior) Attachment of the Omohyoid Muscle
Superior border of scapula near suprascapular notch
Insertion (Lateral) attachment of omohyoid muscle
inferior border of hyoid
What nerve innervates Omohyoid muscle?
C1-C3 by a branch of the ansa cervicalis
Origin (Superior) Attachment of the Sternothyroid muscle
Posterior surface of the manubrium of the sternum
Insertion of Sternothyroid muscle
Oblique line of thyroid cartilage
What nerve innervate sternothyroid muscle?
C2-C3 by a branch of the ansa cervicalis
What action does the Omohyoid muscle do?
Depresses retracts and steadies hyoid
What action does the sternothyroid muscle perform?
Depresses hyoid and Larynx
Where is the thyrohyoid muscle located?
Deep to the sternohyoid
Insertion of thyrohyoid muscle
Inferior border of body and greater horn of the hyoid bone
Origin of the Thyrohyoid
Oblique line of the thyroid cartilage (Inferior border)
What nerve innervates the thyrohyoid muscle?
C1 via hypoglossal nerve (CN XII)
What action does the thryohyoid muscle perform?
Depresses hyiod and elevates larynx
Origin of the anterior and middle scalene muscles
Cervical transverse processes
Insertion of the Anterior and middle scalene muscles
1st and 2nd ribs
Action of the anterior and middle scalene muscles
Elevates 1st and 2nd ribs
Lateral neck flexion
Orientation of the internal jugular vein
Larger
Runs within the carotid sheath
Deep to sernoclediomastoid
Where is the external jugular vein located?
More superficially
External to the sternocleidomastoid muscle
What does the external jugular vein branch into?
Supply the superficial areas on the head
Where does the external jugular vein drain blood to?
into the subclavian veins
Where is the spinal accessory nerve located?
Immediatly posterior to the sternocleidomastoid
Where is the great auricular nerve located?
Comes up next to the external jugular and goes straight to the ear
What does the great auricular nerve do?
Provides sensation to the ears
Where are the transverse cervical nerves?
Deep to the external jugular but superficial to sternoclediomastoid muscle
Branch off the facial nerve
What do the transverse cervical nerves innervate?
operates the superficial neck muscles
What lies within the carotid sheath?
Internal jugular, common carotid, vagus and phrenic nerves
Which side does the brachiocephalic artery come off the aortic arch?
Right
what does the brachiocephalic trunk divide into?
Right subclavian and right common carotid
On the right side what is the first branch of the subclavian artery?
Vertebral Artery
On the left side, what comes off the aortic arch?
Left common carotid and Left subclavian arteries
Explain arterial circulation in the neck
- Left Ventricle
2. Ascending Aorta
what do the vertebral arteries branch off of?
Subclavian
what does the external carotid feed blood to?
To the face
What are the branches of the thryocervical trunks?
Suprascapular
Ascending
Inferior Thyroid
Transverse Cervical
What does the right vagus nerve innervate?
The larynx
Where does the vagus nerve run?
The right vagus nerve hooks underneath subclavian artery
Where is the spinal accessory nerve?
Posterior to the trapezius
What are the thoracic cavity bones designed to do?
Protect the mediastinum and pleural cavities
What is the tradeoff to the protective design of the osteology of the thorax?
Limited movement
How do you distingush between a true and false rib?
False ribs do not have a direct connection
How many pairs of true ribs are there?
7
How many pairs of false ribs are there?
5
What are floating ribs and how many are there?
Two and they lack costal cartilages
Which costal cartilages fuse?
8,9,10 and they connect with costal cartilage 7
How do ribs articulate with thoracic vertebrae?
Via costovertebral joints
Where does the thoracic vertebrae articulate with the rib?
Rib facet-Body
Tubercle of rib - transverse process
Head of rib-body of vertebrae
What happens when the costovertebral joints become arthritic?
Can’t inhale as deep as normal
Orientation of the external intercostal muscles
They start medial and move lateral (fibers)
Origin of the external intercostal muscles
Inferior border of the rib above
What is the most anterior great vessel of the heart?
pulmonary trunk
What is to the right of the aorta?
Superior vena cava
Where do the pulmonary veins of the heart come in?
Posteriorly but connect to left side of the heart
Where does the inferior vena cava attach to?
Right atrium inferiorly
Where do the pulmonary veins come from?
1 pair from the left lung and one pair from the right lung
How does the left ventricle differ from the right?
Thinner myocardium
What do the papillary muscles connect to in the heart?
Chordae Tendinea
What do the Chordae tendinae in the heart connect to?
The cusps of the AV valves
What is the function of chordae tendinae and papillary muscles?
To prevent valve prolapse. Papillary muscles contract when valves shut and chordae acts as a rope
Which valves have chordae tendinae?
AV valves
What are the beats of the heart?
Shutting of the valves
What is valve prolapse?
When a valve gets blown backwards and then blood can leak backwards and you would have to repump it
What way to AV valves open?
Atria to ventricle
What way do semilunar valves open?
Ventricle to vessel
When do the papillary muscles contract?
When ventricle muscles contract
What are trabeculae Carnea?
Wrinkled pattern on the wall if ventricle
What is the Septomarginal trabecula or moderator?
Connects wall of ventricles of the heart (interventricular septum) with the lateral wall of the right atrium
what is the function of the septomarginal trabecula or moderator?
part of the conduction system of the heart, send signals quickly to right side of heart so contracts works as 1 muscle
How many muscles does the heart have?
36
What side does the septomarginal trabecula occur at?
right
Can you function without auricles?
yes
Ductus arteriorsus
Ligamentum arteriosum
Oval Foreman
Oval Fossa
Ductus Venosus
Ligamentum venosum
Umbilical Vein
Round ligament of the liver (ligamentum teres)
Umbilical artery
medial umbilical ligament
What does the ductus arteriosus connect?
pulmonary trunk to aorta, you can bypass the lungs in utero-you get all your oxygen from mom
What is another word for open ductus arteriosus
Patent ductus
What is the foramen ovale?
A hole between the walls of the atria that can bypass lungs
What is the umbilical vein?
Originates in the placenta and allows exchange between mom’s blood and fetuses via diffusion
What is the umbilical artery?
How we get rid of our lower oxygenated blood
Explain the path of fetal heart circulation from placenta to the heart
Oxygenated blood 1. placenta 2. umbilical vein 3. branches into inferior vena cava and hepatic portal vein 4. From hepatic portal vein to liver back to inferior vena cava 5. inferior vena cava to right atrium
Does the umbilical vein have oxygen?
Yes (red on diagram)
What is the advantage to taking blood to the liver in fetal circulation via the hepatic portal vein?
Process some of fetal foodstuff
early start on metalbolism
filters blood
Path of fetal circulation in the heart coming from inferior vena cava
- Inferior Vena Cava to right atrium
- Some blood from the right atrium goes through the foramen ovale to the left atrium to bypass the lungs and some goes out the pulmonary trunk
Pathway of fetal blood from the superior vena cava
- superior vena cava
- right atrium
- Some blood through foramen ovale to left atrium and some out pulmonary trunk
Pathway of fetal blood from the left atrium out the pulmonary trunk
- Left atrium to pulmonary trunk
- Pulmonary arteries to lungs
- Pulmonary artery to aorta (Another bypass of lungs)
What are the lung bypasses in fetal circulation?
Foramen ovale and pulmonary trunk into aorta
Is there still oxygen in venous blood?
yes
Why do you do compressions for CPR?
keep blood moving so brain gets oxygen and there is still oxygen left
Pathway of fetal blood from aorta
- Mixed blood goes from aorta to umbilical arteries back to placenta to remove waste and pick up oxygen and then back to umbilical vein. (There is still blood going to body)
What happens when the umbilical cord is severed at birth?
Umbilical vein becomes round ligament of liver
What happens when the umbilical cord is severed at birth?
- Umbilical vein becomes round ligament of liver
- internal illiac veins shrink
- Ductus arteriorsus become ligamentum arteriosum
What are the 4 problems of Tetralogy of fallot?
- Right ventricle hypertrophy-no room for blood
- Ventricular septal defect-Blood would be mixed (low oxygen and high oxygen blood)
- pulmonary valve stenosis (Thicker wall and it is hard to get blood out- overworking ventricle and its getting thicker)
- narrowed pulmonary trunk (will need more pressure)
* Requires surgical intervention
What is main theme in congenital heart defects?
Blood leaving the aorta is not fully oxygenated (can affect many thing)
What is a patent ovale foramen?
open ovale foramen
What is a ventricular septal defect?
A hole in the septum (Hole in the heart)
Does location really matter when there is a hole in the heart?
no its the size that is important
Ventricular hypertrophy
Ventricle is getting too large -not as much blood to pump.
Stenosis is present
Why would you want to correct a defect in utero?
Once born they can die, they also heal really quick
What is lymph?
when intersticial fluid enters lymph vessels
what is intersticial derived from?
capillaries
What does the thoracic duct do?
collects lymph from most of the body except right side above waist
what does the right lymphatic duct collect lymph from?
right side
1/2 of head,
shoulder,,
waist and right arm
Where is the thoracic duct?
- Inbetween the hemiazygous and azygous vein
- Retract esophagus to see a line to the left of the azygous vein
- Hooks behind
What is the cistern chyle?
Collecting vessel from lower body (rt lumbar trunk, intestinal trunk, left lumber trunk
What does the thoracic duct collect lymph from?
Left jugular trunk
left subclavian trunk
Thoracic duct entering left subclavian vein
Left bronchomediastinal trunk
What is the right lymphatic duct formed from?
Right jugular vein
Right subclavian trunk
right lympatic duct entering right subclavian vein
right bronchomediastinal trunk
What does the thoracic duct dump into?
hooks behind left internal jugular vein and hooks around to drain into the left subclavian vein
Where does the right lymphatic duct dump into?
Right subclavian vein
How much lymph do you replace in 24 hours?
2 liters
Why is the tetralogy of fallot bad?
The defects cause the hypertrophy due to the pressure in the ventricle
What are five causes of azygous vein enlargement?
- Pregnancy
- Overhydration
- Congestive heart failure
- portal hypertension
- Tricuspid insufficiency
What are the two types of Left ventricle hypertrophy?
- Concentric
2. Eccentric
If you have a really damaged oculomotor nerve what would not work?
You couldn’t look up
If vagus is damaged what would you see?
increased heart rate
Describe Concentric Left Ventricle hypertrophy?
- Maladaptive
- Hypertension, congenital heart defects, stenosis causes it
In concentric heart hypertrophy there is an _______ in muscle mass but a ______in vasculature
Increase,
decrease
Describe eccentric hyperatrophy?
“Athlete’s heart”
- Results from increased physical activity
- risks are associated with dramatic hypertrophy
Describe dialated cardiomyopathy
- The thinning ventricular wall decreases stroke volume
- Organ perfusion becomes more difficult
What can heart fibrosis affect?
Heart muscle and/or heart valves
What is the general term for a collapsed lung?
atelectasis
What valve is usually affected by heart fibrosis?
Tricuspid valve (heart murmurs)
What are the causes of coronary artery disease?
- Smoking
- Hypertension
- High Chlolesterol
- Diabetes/insulin resistance
- Sedentary lifestyle
What are risk factors for coronary heart disease?
- Age
- Sex
- Family History
- Obesity
- High Stress
- Poor Diet
Describe a Myocardial Infarcation
Heart Attack
What layer of the heart is affected by a heart attack and why?
inner
Orientation of internal intercostal ribs
Run lateral to medial
Origin of internal intercostal ribs
Inferior to rib above
Insertion of intercostal ribs
Superior border of rib above
What nerve innervates the internal, external and innermost internal intercostal ribs?
intercostal nerves
Action of the internal and innermost internal intercostal ribs
Depresses the rib above (Exhale)
Orientation of the intercostal nerves
run just inferior to ribs in the intercostal grooves
Origin of the intercostal nerves
Arise from the ventral ramus (after the ganglion) of the thoracic spinal nerves (Mixed) nerves
How would you get from the internal thoracic arteries to the external iliac arteries?
- Thoracic aorta
- Travels downward on each side of sterum
- Branches out to ribs (1 on each side)
- Branches travel on the superior and posterior surface of the rib.
- Anastomoste
6 Once you pass costal cartilages called superior epigastric
What is the difference between the right and left sides of venous supply in the thorax
Azygous system
From right side- come over and anastomose with azygous vein
From the left go into hemiazygous
Hemiazygous and azgous combine
Where does the azygous vein go?
posterior side of the superior vena cava
Where do the intercostal veins go?
Can take blood to azygous system
Where do the internal thoracic veins go?
To subclavian veins
What is the superior border of the medistinum?
Superior wall of thoracic cavity
What is the anterior border of the mediastinum?
Sternum
What is the posterior border of the mediastinum?
Spine
What is the interior border of the mediastinum?
Diaphram
What is the Lateral border of the mediastinum?
Lungs
What is found in the anterior mediastinum?
Fat on the chest plate
What is found in the posterior mediastinum?
Esophagus, Air passageways TRachae Bronchii Azygous system Arteries and veins into the heart
What is found in the superior mediastnum?
Esophagus
Trachae
Great vessels of the heart
What is the function of the trachae?
Windpipe, takes air to both lungs
What does the trachae break into?
Two primary bronchi
Where are the primary bronchi?
1st branch off trachea
What is the function of the primary bronchi?
Take air to each lung
Where are the secondary bronchi?
2nd branch off aorta
How many secondary bronchi are on the right
3
How many secondary bronchi on the left?
2
Where so the secondary bronchii take air to?
each lobe
What happens if one of the secondary bronchi is obstructed?
Better than if theprimary bronchi are
Only one lobe won’t function
What is the difference between the right and left lungs?
Right has 3 lobes and two fissures
Left has 2 lobes and one fissure
Name the location of the three lobes of the right lungs
superior, middle, and inferior (goes down to the base)
Name the fissures of the right lung
Horizontal and oblique
What does the horizontal fissure of the right lung seperate?
superior and inferior lobes
What does the oblique fissure of the right lung seperate?
inferior and middle
Name the two lobes of the left lung
superior inferior
What is the fissure of the left lung called?
oblique
How can you distinguish Bronchi in the lungs?
They are thicker
How do you remember arteries in the lungs?
RALS (Right anterior, left superior) (if looking at it medially)
What color are lung arteries on diagrams and why?
Blue and because they are low oxygen
What is pleura?
A double walled sac that forms a pleural space with pleural fluid
What is the function of the pleura?
Reduce friction,
keep lungs inflated (they have a tendency to want to collapse
Which layer is the parietal pleura?
outside
What is the pleura covering the wall of the lungs called?
visceral pleura
What is the difference between the right and left primary bronchi?
Right-Anterior to arteries and Primary Bronchus is larger with a steeper descent
Left-Bronchi are superior to arteries
Which primary bronchus would food enter if it went down the trachae?
The right, because it has a bigger diameter
What is the carina?
The area where the primary bronchi split
Where are the cartilage rings located on the trachae and why?
Anterior side because esophagus sits posteriorly
What is the function of the trachalis muscle?
Constricts during a cough decreasing the diameter so air can move faster and expel contaminant out
How does the pleura maintain a negative pressure and prevent collapse of the lung?
It opposes the cohesive nature of fluid in the lungs
Since the fluid is made mostly of water it has the tendency to form micelles pulling of the walls of the lungs. This pressure will decrease the volume and pull inwards but the pleura opposes this.
What is a pneumothorax?
Air in the pleura space
What is the term for a collapsed lung?
Atelectasis
What is a closed pneumothorax?
Air in the pleural cavity without a penetrating injury or external cause.
Pleural cavity pressure is less than atmospheric
Describe an open pneumothorax
There is a penetrating injury (you will see blood soap bubbles)
Person can still breath
Can seal it with cellophane
Pleural cavity = atm
What is a tension pneumothorax?
The most fatal
Pleural cavity pressure is greater than atm
Can displace blood vessels
Person tries to breath deeper. In the field you make a second wound to let air out
What is valsalva’s maneuver?
Compression of the abdominal muscles and closing glottis increases pressure in the ventral cavity.
Volume decreases.
People have a voice change during the manuever
Initiates vagal response and HR decreases.
Danger is that the inferior vena cava is low pressure and it could flatten and get less air out to the heart.
To avoid, exhale during exertion
Why does pregnancy increase the diameter of the azygous vein?
Larger blood volume
Why is the azygous vein larger with portal hypertention?
Refers to hepatic portal vein. Too much blood in portal system (Cirrosis)
Blood builds up behind venous and now you have high BP in azygous
Hypertrophy
Increased muscle mass
Why is concentric hytpertrophy so bad?
Heart has to contract much harder at rest
Why is eccentric hypertrophy better?
We can increase muscle but still keep the same amount of volume. It can protect against heart attacks.
Also can occur during pregnancy
Athletes can get too much hypertrophy
what can dilated cardiomyopathy lead to?
pulmonary edema
Causes of cardio myopathy?
High BP- cap-stretching muscle leads to
Coronary heart disease
Aortic valve problems
Symptoms of cardio myopathy?
fluid accumulation in lungs because blood is not leaving ventrical and fluid leaves blood to lungs
Renal failure- cannot regulat potassium
Effect of a slow relaxing heart
cannot contract heart all the way, heart works harder
What is the cause of heart fibrosis
sedentary lifestyle
aging-valve get stiffer
What is coronary heart disease
arterosclorsis- hardening
athroscolosis-plugging
what is a heart attack?
killing heart cells