Exam 2: Learning Objectives Flashcards
boundaries of thoracic cavity
anterior = sternum posterior = spine inferior = diaphragm superior = superior thoracic aperture
compartments of thoracic cavity
right pleural cavity - right lung
left pleural cavity - left lung
inferior mediastinum - heart
superior mediastinum
components of thoracic WALL
- skin
- subcutaneous tissue
- ribs
- intercostal muscles
functions of thoracic WALL
- protection
- muscle attachments
- respiration
three types of ribs and their unique feature
- true ribs: ribs 1-7, direct cartilage attachment to sternum
- false ribs: ribs 8-10, indirect cartilage attachment to sternum via coalescent cartilage
- floating ribs: ribs 11 and 12, no attachment to sternum
general structure of rib
head of rib - articulates with body of vertebra
NECK of rib
costal tubercle - articulates with transverse process of vertebra
costal angle - sharp change in rib direction
shaft of rib
three rib joints and their synovial classification
- costotransverse: costal tubercle of rib and transverse process of vertebra
- sternocostal: costal cartilage and sternum
- costovertebral: head of rib and body of vertebra
SYNOVIAL CLASSIFICATION FOR ALL 3: PLANE/GLIDE
first rib unique landmarks
- scalene tubercle - boundary between two grooves of first rib
- groove for subclavian artery (posterior to scalene tubercle)
- groove for subclavian vein (anterior to scalene tubercle)
sternal angle
fusion between manubrium and body of sternum, also at same lcoation where second rib attaches
medial/lateral dimension of diaphgram
inspiration: ribs elevate, mid-shaft moves lateral
expiration: ribs depress, mid-shaft moves medial
rib movement is comparable to bucket handle movement
anterior/posterior dimension of diaphragm movement
inspiration: ribs elevate, sternum moves up and forward
expiration: ribs depress, sternum moves down and back
rib and sternum movement comparable to pump handle movement
vertical dimension of diaphragm
contraction/inhalation = diaphragm flattens - inferior displacement (makes sense because thoracic cavity is getting bigger with more air and pushing diaphragm down)
relaxation/exhalation = diaphragm is dome shaped (thoracic cavity gets small and diaphragm comes back up in dome size)
name of nerves for T1-T6
intercostal nerves or upper intercostal nerves
name of nerves for T7-T11
thoracoabdominal nerves, lower intercostal nerves
name of nerve for T12
subcostal nerve
T4 landmark of innervation
includes nipples
T6 landmark of innervation
xiphoid process of sternum
T10 landmark of innervation
includes umbilicus
what are the four parietal nodes?
parasternal, intercostal, posterior mediastinal, diaphragmatic
what are four visceral nodes?
pulmonary, bronchopulmonary, tracheobronchial, paratracheal
people bring the party ;) !!
branching of bronchial tree
primary/main bronchii = right and left lung
secondary/lobar bronchii = towards lobes of each lung
tertiary/segmental bronchii = towards bronchopulmonary segments
medial surfaces of right lung
esophagus
heart impression
veins: superior vena cava, azygos vein
medial surfaces of left lung
esophagus
heart impression
arteries = thoracic aorta, aortic arch
lung root is comprised of
pulmonary veins, pulmonary artery, primary bronchii
structure of right lung root
[RA]
Right lung: pulmonary artery is ANTERIOR to primary bronchus
structure of left lung root
[LS]
Left lung: pulmonary artery is SUPERIOR to primary bronchus
pleural coverings of lung
parietal = covers wall of lung, goes down to cover superior border of diaphragm visceral = covers lung
4 regions of parietal pleura
cervical
costal
diaphragmatic
mediastinal
recesses of lungs
costodiaphragmatic and costomediastinal
layers of pericardium, from superficial to deep
FPV ME fibrous pericardium parietal pericardium* **visceral pericardium (aka epicardium)* **myocardium **endocardium
- makes up serous membranes
- *on/within the heart directly
surface features of heart
apex of heart (bottom tip) right atrium and auricle right ventricle left atrium and auricle left ventricle
sulci: coronary sulcus (coronary sinus vein lies here) anterior interventricular sulcus
featured vessels: SVC ascending and arch of aorta pulmonary trunk and arteries pulmonary veins
internal features of right atrium
crista terminalis (ridge between pectinate m. and interatrial septum pectinate muscles (interior walls) interatrial septum fossa ovalis!!!!! remnant shallow depression from foramen ovale
orifices:
valve orifice of coronary sinus
valve orifice of inferior vena cava
R AV orifice with AV valve - opening for right ventricle
internal features of right ventricle
trabeculae carneae R AV/tricuspid valve chordinea tendinae anterior papillary muscles posterior papillary muscles septal papillary muscles interventricular septum **septomarginal trabecula/moderator band **conus arteriosus **supraventricular crest **valve of pulmonary trunk
what is the septomarginal trabecula
aka moderator band
sx: band of cardiac muscle with a transversal orientation, connects septum to right marginal wall of heart
fxn: helps with R side conduction system by allowing rapid diffusion of electrical impulse from interventricular septum to right marginal wall = proper timing of RV contraction
internal features of left atrium
crista terminalis
pectinate muscles
valve of foramen ovale
interatrial septum
internal features of left ventricle
trabeculae carneae of interventricular septum chordinae tendinae anterior papillary muscles posterior papillary muscles bicuspid/mitral/L AV valve
explain arrangement between chordae tendineae and heart valves
@ atrial contraction:
blood is flowing from atrium to ventricle (follows high to low pressure), valves are open
@ ventricular contraction:
ventricles = high pressure, atrium = low pressure. blood wants to flow from high to low, aka backwards flow from ventricle to atrium. But is prohibited by closure of valves via chordinae tendineae. papillary muscles stabilize chordinae tendineae.
set-up is analogous to someone skydiving with parachute
valves = parachute
chordinae tendinae = strings of parachute
papillary muscles = human
cardiac auscultation site for semilunar valves
intercostal space of 2nd rib
cardiac auscultation site for AV valves
5th rib intercostal space
pulmonary circulation review
from right ventricle, deoxygenated blood flows out via pulmonary semilunar valve —> pulmonary trunk —> R/L pulmonary arteries —> R/L lungs —> exchange CO2 with O2 —> oxygenated blood flows back to heart via pulmonary veins —> left atrium
arterial anastomoses of heart
are these anastomoses actually useful?
right coronary artery —<>— circumflex artery (LCA)
anterior interventricular artery (LCA) —<>— posterior interventricualr artery (RCA)
useful? NO - heart is too metabolically active that anastomoses wouldn’t be able to supply enough blood that the heart needs to survive
location of SA node, AV node, atrioventricular bundle
SA node: superior aspect of right atrium
AV node: inferior aspect of right atrium
atrioventricular bundle: interventricular septum
anatomy of cardiac referred pain
myocardium has pain receptors - these visceral afferent axons share their cell bodies in the same dorsal root ganglion with the general somatic axons.
because cell bodies of somatic and visceral axons are shared, it results into the body feeling pain of the skin when the heart feels pain.
what areas of skin specifically? L side of shoulder, pec, and medial UE
FOSSA OVALIS:
where is it found
what is it a remnant of
what was its location of shunted blood
found in: right atrium
remnant of: foramen ovale
shunted blood: between R and L atrium
LIGAMENTUM ARTERIOSUM
where is it found
what is it a remnant of
structures of shunted blood
found: ligament between aortic arch and pulmonary trunk, at superficial layer, anterior to L recurrent laryngeal nerve
remnant of: ductus arteriosus
structures: pulmonary trunk to aortic arch — this was because during fetal stage, lungs are basically non-functioning so pulmonary circulation was skipped. blood from R ventricle went into pulmonary trunk and straight into aortic arch.
pulmonary circulation at fetal stage
lungs non-functioning!!! so pulmonary circulation was essentially non-existent - pulmonary arteries and veins had very little blood flow. blood from R ventricle went into pulmonary trunk and straight into aortic arch instead of going to lungs.
deep cervical fascia layers
investing fascia (superficial) “deep fascia of extremities”
pretracheal
prevertebral
carotid sheath
contents of deep cervical fascia: investing layer
completely encircles: neck, trapezius, sternocleidomastoid
contents of deep cervical fascia: pretracheal fascia
trachea, esophagus, thyroid cartilage
columnar structure as it goes down trachea and esophagus
contents of deep cervical fascia: prevertebral fascia
vertebral disc
spinal cord
relative location and contents of deep cervical fascia: carotid sheath
contents:
internal jugular vein (lateral)
common carotid artery (medial)
vagus nerve (posterior and between IJV and CCA)
location: medial to SCM
suprahyoid muscles of anterior neck (4 total)
geniohyoid
anterior digastric AND posterior digastric
mylohyoid
stylohyoid
infrahyoid muscles of anterior neck
sternohyoid
sternothyroid
thyrohyoid
superior omohyoid AND inferior omohyoid
posterior triangles of neck
occipital triangle
supraclavicular triangle
anterior triangles of the neck
submental
submandibular
carotid
muscular
borders of anterior triangle
mandible, midline of neck, SCM
borders of posterior triangle
anterior border of trapezius, SCM, clavicle
borders and contents of: occipital triangle
borders:
trapezius
SCM
inferior belly of omohyoid m.
content:
trunks of branchial plexus
accessory nerve (CN XI)
borders and contents of: supraclavicular triangle
borders:
SCM
inferior belly of omojhyoid m
clavicle
contents: subclavian artery thyrocervical trunk suprascapular artery transverse cervical artery
borders and contents of: submandibular triangle
borders:
mandible
posterior belly of digastric m.
anterior belly of digastric m.
contents:
lymph nodes
(possibly external and internal carotid artery)
borders and contents of: submental triangle
borders:
anterior belly of digastric muscle
hyoid bone
midline neck
contents:
lymph nodes
borders and contents of: carotid triangle
borders:
SCM
superior belly of omohyoid m.
posterior belly of digastric m.
contents:
common carotid artery
borders and contents of: muscular triangle
borders:
midline neck
SCM
superior belly of omohyoid m.
contents:
infrahyoid muscles of anterior neck
what ensues branchial motor axon function, and what’s their relation to cranial nerve
if the muscles they innervate derive from pharyngeal arches
relation to cranial nerves: some of the muscles that branchial motor axons innervate are by cranial nerves
pharyngeal arch #1
- name
- muscles
- nerve
name: mandibular
muscles:
mastication
anterior belly of digastric
mylohyoid
nerve: trigeminal n (V3)
pharyngeal arch #2
- name
- muscles
- nerve
name: hyoid
muscles:
posterior belly of digastric
facial expression
stylohyoid
nerve: facial nerve (CNVII)
pharyngeal arch #3
- name
- muscles
- nerve
name: third
muscle: stylopharyngeus
nerve: glossopharyngeal n. (CN IX)
pharyngeal arch #4
- name
- muscles
- nerve
name: fourth
muscles:
cricothyroid
inferior pharyngeal constrictor
nerve:
vagus nerve (CN X)
superior laryngeal n.
pharyngeal arch #6
- name
- muscles
- nerve
name: sixth
muscle: intrinsic laryngeal
nerve:
vagus nerve (CN X)
recurrent laryngeal n.
unique features of cervical vertebrae
bifid spinous processes
transverse foramina - holes of transverse process that allow vertebral artery to pass through
unique features of Atlas (C1)
anterior arch
>anterior tubercle
posterior arch
>posterior tubercle
>groove for verterbral a. of posterior arch - fxN; houses vertebral a. and v. and suboccipital n.
lateral masses
>superior facet - fxn: articulates with occipital condyles
>inferior facet - fxn: articulates with axis
unique features of Axis (C2)
body
> superior articular facet - fxn: articulates with atlas
dens
vertebral arch
> pedicle
» vertebral notch - fxn: trasmits C3 spinal n.
spinous process
4 suboccipital muscles of neck
- superior oblique
- inferior oblique
- rectus capitis posterior minor
- rectus capitis posterior major
name the 4 sinus cavities of skull
frontal sinus
ethmoid sinus
maxillary sinus
sphenoid sinus
bones that form roof of orbit
frontal bone
lesser wing of sphenoid
bones that form medial wall of orbit
lacrimal bone
ethmoid bone
bones that form floor of orbit
maxilla
zygomatic bone
bones that form lateral wall of orbit
zygomatic bone
greater wing of sphenoid
muscle that compresses cheek when blowing
buccinator muscle
name muscle for frown, sadness
depressor anguli oris
name muscle for pouting and sadness
depressor labii inferioris
name muscle for surprise or curiosity (elevation of eyebrows/nose)
frontalis
muscle showing sadness
levator labii superioris
muscle for flaring nostrils when angry or exerted
nasalis
muscle for closing mouth or kissing
orbicularis oris
muscle for conveying tension or stress
platysma
muscle for smiling/happiness
zygomaticus major
