Exam 3 Flashcards

1
Q

Ribs 1-10 Articulate With

A

Sternum

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2
Q

Ribs 1-7 Articulate Via

A

Costal Cartilages

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3
Q

Ribes 8-10 Articulate Via

A

Cartilage from 7th Rib

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4
Q

Ribs 11-12

A

Floating Ribs/No Connection

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5
Q

Parts of Ribs

A

Head, Neck, Body, Tubercle

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6
Q

Head of Rib Articulates With

A

Bodies of Vertebrae and Intervertebral Disc; Costovertebral Joint

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7
Q

Tubercle of Rib Articulates With

A

Transverse Process of the Thoracic Vertebrae; Costotransverse Joint

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8
Q

Ribs that Articulate with only their own Vertebrae:

A

1st, 11th, 12th

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9
Q

Sternal End of Rib Articulates With

A

Costal Cartilage and the Sternum

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10
Q

First Rib

A

Scalene Tubercle on its Superior Surface, 2 grooves for Subclavian Artery, lower Brachial Plexus and Subclavian Vein, rarely fractured, would be dangerous for vessels

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11
Q

Cervical Rib

A

Remnant or development of a costal process on the C7 vertebra

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12
Q

Cervical Rib Problems

A

Thoracic Outlet Syndrome, compression of the subclavian artery and ischemic pain, lower brachial plexus compression and muscle weakness/pain, palpable mass in lower neck

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13
Q

Middle Rib Fractures

A

Most Common

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14
Q

Lower Rib Fractures

A

Damage the Pleura and Abdominal Viscera and even the kidney, liver, spleen

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15
Q

Flail Chest

A
Caused by multiple ribs fracture, thoracic wall
moves freely (paradoxical), very painful with impaired ventilation
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16
Q

Parts of Sternum

A

Manubrium, Xiphoid Process, Body, Jugular Notch, Clavicular Notch, (8-9cm)

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17
Q

Sternal Angle

A

Angle of Louis, T4 vertebra level, manubiosternal joint

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18
Q

Sternal Puncture

A

Upper third of sternal body in the midline, bone marrow needle biopsy for bone marrow transfer or cytologic analysis

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19
Q

Median Sternotomy

A

Cut through the bone, procedure done to access the heart in coronary bypass or open heart surgery

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20
Q

Movements of Thorax

A

Widening for Inspiration and normal size for Expiration

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21
Q

How Thorax Moves:

A

Mobility in costovertebral joints, elevation of the sternum, mobility at manubrio-sternal joint, elasticity of costal cartilages, increased kyphosis of the thoracic column

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22
Q

Age Effect on Thorax Movement

A

Calcification of costal cartilage leads to loss of thoracic cage elasticity which restricts respiratory movements

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23
Q

Muscles that Elevate Thoracic Cage

A

Scalene Muscles, Sternocleidomastoid, Pectoralis Major/Minor

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24
Q

Scalene Muscles Function

A

Life upper ribs to move Thoracic Cage

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25
Q

Scalene Gap Contents

A

Subclavian Artery and Brachial Plexus

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26
Q

Intercostal Muscle Function

A

Elevate and Depress Ribs

Innervation: intercostal nerves

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27
Q

External Intercostal Muscle

A

Running obliquely, function during forced inspiration

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28
Q

Internal Intercostal Muscle

A

Running vertically, function both as expiratory and inspiratory muscles

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29
Q

Innermost Intercostal Muscles

A

May be missing, intercostal nerve, artery and vein are found between these muscles

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30
Q

Subcostalis Muscles

A

Fibers of the internal intercostal muscles that extend over several segments, function similarly to internal intercostals
Innervation: 4-11 intercostal nerves

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31
Q

Transversus Thoracis

A

Expiratory muscles from xiphoid process to the ribs on each side
Innervation: upper intercostal nerves

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32
Q

Muscles on Outside of Chest Wall

A

Pectorals Major/Minor, Serratus Anterior, REctus Abdominus, External/Internal Abdominal Obliques, Latissimus Dorsi, Trapezius

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33
Q

Internal Thoracic Artery

A

(IMA) Mammary Artery, origin is subclavian artery on each side, supplies thoracic wall, skin or region and back

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34
Q

Musculophrenic Artery

A

Starts in the sixth intercostal space, provides blood fro intercostal spaces 7, 8, 9

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35
Q

Superior Epigastric Artery

A

Originates from the Musculophrenic Artery, in the rectus sheath between the abdominal muscles

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36
Q

Inferior Epigastric Artery

A

Branch of the external iliac artery in the lower abdominal wall

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37
Q

Coarctation of the Aorta

A

Narrowing in the arch of the aorta compromising blood supply to thoracic, abdominal, and lower limb structures, arteries are dilated

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38
Q

Posterior Intercostal Arteries

A

Originate from thoracic artery, run in intercostal spaces

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39
Q

Thoracic Wall Veins

A

Posterior/Anterior Intercostal Viens drained by Azygos and Hemiazygous Viens drained into the Superior Vena Cava

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40
Q

Anterior and Posterior Intercostal Vessels

A

Internal thoracic Artery to Musculophrenic Artery,

Internal Thoracic Artery to Superior Epigastric Artery

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41
Q

Subcostal Nerve

A

Located in the intercostal space originates from T12, primary ventral rami of spinal nerves

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42
Q

Reasons to Enter Intercostal Spaces

A

Fractures of the ribs or Shingles

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43
Q

Procedure to Enter Intercostal Spaces

A

Intercostal nerve block, needle into lower border of rib, extreme care not to sever vessels and nerves

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44
Q

Tube Thoracotomy/Thoracocentesis

A

Draining pathologic air/gas from pleural cavity, entering needle close to upper border of rib, all layers pf pleura are punctured except for visceral pleura

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45
Q

Breast

A

Extends vertically from 2nd to 6th rib and transversely from sternum to the mid-axillary line, it extends into axilla where high percentage of tumors occur
Function: lactation

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46
Q

Tissue of Breast

A

Glandular tissue and Adipose tissue (contour and size)

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47
Q

Nipple Cell Type

A

Connective Tissue and Keratinizing Stratified Squamous Epithelium

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48
Q

Nipple at Puberty

A

Darkens due to melanin production and pigmentation

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49
Q

Internal Structure of Breast

A

Mammary Glands in adipose tide, ligaments of fibrous bands of tissue and superficial and deep fasciae for support

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50
Q

Suspensory Ligaments (of Cooper)

A

Extend from the skin to deep fascia and support the breast, tumor here may cause dimpling of skin.

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51
Q

Retromammary Space

A

Between breast and the deep fascia, tumor here may contract the pectoralis major and the breast may move superiorly

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52
Q

Mammary Glands

A

Exocrine and Apocrine glands, modified sweat glands, secreting part is the alveoli, each lobule is drained by a lactiferous duct which opens into the nipple

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53
Q

Alveoli

A

Lined with milk secreting cuboidal epithelium, controlled by hypothalamus

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54
Q

Innervation of Breast

A

Intercostal nerves, T4-T6

Dermatome of nipple is T4

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55
Q

Blood Supply of Breast

A

Internal thoracic, axillary and intercostal artery

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56
Q

Venous Drainage of Breast

A

End up with draining by axillary and azygous veins

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57
Q

Lymphatic Drainage of Breast

A

Axillary lymph nodes receive 75% of lymphatics, some in central group as well

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58
Q

Axillary Lymph Node Groups

A

Pectoral (medial), Lateral (humeral), Apical, Subscapular (posterior), Central

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59
Q

Left Side Lymphatics

A

Final drainage is Thoracic Duct

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60
Q

Right Side Lymphatics

A

Final drainage is larger veins at the venous angle

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61
Q

Progesterone

A

For the development of milk secreting lobules

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62
Q

Breast Cancer Sign

A

Dimpling (invagination) and thickening of skin especially if the lymphatic system is blocked, looks like an orange peel

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63
Q

Mastectomy

A

Removes breast completely, danger is in injury to long thoracic nerve

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64
Q

Lumpectomy

A

Surgery to remove cancer or other abnormal tissue from your breast

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65
Q

Gynecomastia

A

AKA Klinefelter’s Syndrome, men have one extra X chromosome, abnormally large breast in males, puberty and old age is when sign appear

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66
Q

Axillary Region Structures

A

Brachial Plexus, Axillary Artery, Vein, Lymph Nodes

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67
Q

Ultrasound Guided Infraclavicular Nerve Block

A

Anesthesia for surgery of the arm, forearm or hand, can be used for pain here as well (axillary region)

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68
Q

Mediastinum

A

The space between the right and left lungs: 1. Superior Mediastinum (supracardiac) 2. Inferior Mediastinum (anterior, middle and posterior)

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69
Q

Supracardiac Mediastinum

A

5 layers of structures.

  1. Thymus
  2. Great veins related to heart, the phrenic nerves, the thoracic duct and lymphatic trunks
  3. Arch of Aorta including its branches and the vagus nerves, sympathetic and parasympathetic nerves to the heart (cardiac plexus)
  4. Trachea and its bifurcation
  5. Esophagus, the recurrent laryngeal nerves
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70
Q

Pleura

A

Double layered membrane, serous membrane, produces serous fluid

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71
Q

Layers of Pleura

A

Visceral (inner) and Parietal (outer)

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72
Q

Other parts of Pleura

A

Costal, Cervical, Mediastinal, Diaphragmatic

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73
Q

Pleural Cavity

A

Serous fluid here serves as lubrication, no friction between lungs

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74
Q

Plural Cavity becomes wider near Diaphragm/Mediastinum

A

Costodiaphragmatic and Costomediastinal Recesses

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75
Q

Innervation of Pleura (Parietal Layer)

A

Somatic nerves, intercostal nerves, phrenic nerve

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76
Q

Innervation of Pleura (Visceral Layer)

A

Sensory autonomic nerves

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77
Q

Blood Supply of Parietal Layer

A

Intercostal and internal thoracic arteries, drained by same name veins

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78
Q

Lymphatics of Parietal Layer

A

Nodes of the internal aspect of the thoracic wall

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79
Q

Blood Supply of Visceral Layer

A

Lungs supply the blood here

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80
Q

Lymphatics of Visceral Layer

A

Follows the lungs, nodes in hilum of lungs

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81
Q

Significance of Intrapleural Pressure

A

Breathing Cycle = -3 cm H2O at rest, -6 cm H2O at inspiration, increase in both and elastic recoil strength of the lungs

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82
Q

Intrapleural Pressure is Disturbed

A

Interferes with respiration

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83
Q

Pneumothorax

A

Air is getting into the pleural cavity due to injury, pulmonary disease which leads to rupture of the visceral pleura, now positive pressure, which will collapse the lung and can be fatal

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84
Q

Puncturing the Intercostal Space Warnings

A

Always go superior to the inferior rib, not below the 9th intercostal space (danger to injure the liver on the right side)

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85
Q

Sucking Pneumothorax

A

Air enters and leaves the pleural cavity, mediastinal flutter which is the mediastinum shifted toward the normal side in inspiration and shifted to the injured side in expiration

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86
Q

Tension Pneumothorax

A

Air enters the pleural cavity and does not leave, increased intrathoracic pressures, patient now has dyspnea and/or cyanosis, seen by hyper-resonant percussion tone in radiolucent area in lung, in radiography.

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87
Q

Pneumothorax Surgical Procedure

A

Chest tube at -10cm H2O to reduce pneumothorax inserted anteriorly in 2nd intercostal space or if fluid is also present, in 5th-6th space (near posterior axillary line)

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88
Q

Inadvertent Damage to Pleura

A

Catheterization of the subclavian vein and brachial plexus block, injuries in the neck over the clavicle or during kidney surgery

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89
Q

Pleural Effusion

A

Excess fluid in the pleural cavity

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90
Q

Types of Pleural Effusion

A

Hydrothorax (eg: congestive heart failure)
Pyothorax (infection)
Chylothorax (injury to thoracic duct)
Hemothorax (blood in pleural cavity)

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91
Q

Pleuritis

A

Inflammation of the pleura, pain only if parietal pleura is involved, not the visceral layer

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92
Q

Respiratory System

A

Gaseous Exchange, blood pH, Blood Pressure, Protecting the Heart

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93
Q

Pharynx

A

Both respiratory and the digestive tract, merges into the esophagus at the level of the cricoid cartilage

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94
Q

3 Parts of Pharynx

A

Nasopharynx, Oropharynx and Hypopharynx (Laryngopharynx).

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95
Q

Lungs

A

Organs of respiration

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96
Q

Surfaces of Lung

A

Costal, Diaphragmatic, Mediastinal

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97
Q

Inferior Border of the Lungs

A

6th rib in midclavicular line, 8th rib in the midaxillary line, 10th rib in the scapular line
Children: one rib higher

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98
Q

Right Lung

A

3 lobes, larger and shorter

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99
Q

Left Lung

A

2 Lobes, upper lobe contains the cardiac notch and lingula is below the cardiac notch

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100
Q

Fissures of the Lungs

A

Oblique: T2 to 6th costochondral joint
Horizontal: from 4th costal cartilage level to the oblique fissure

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101
Q

Structures of the Hilum

A

Main bronchus, lobar bronchi, lower lobe brunches, pulmonary artery and veins, bronchial vessels, pulmonary plexus, lymph vessels, broncho pulmonary lymph node

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102
Q

Trachea

A

12 cm long and 2 cm wide, from C6 to T4, contains C-shaped cartilage rings, posteriorly has muscle layer covered by mucus membrane

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103
Q

Trachea Divides

A

Main Bronchi –> Lobar Bronchi –> Segmental Bronchi

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104
Q

Right Main Bronchus

A

Shorter (2.5 cm), wider and more vertical

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105
Q

Left Main Bronchus

A

Longer (5 cm), less steep

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106
Q

Bronchopulmonary Segments

A

10 in each lung, segments of bronchi branches

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107
Q

Bronchopulmonary Segments Contains

A

Segmental bronchus, branch of pulmonary artery and branch of bronchial artery run together

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108
Q

Right Lung Superior

A

Apical, Posterior, Anterior segments

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109
Q

Right Lung Middle

A

Lateral, Medial segments

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110
Q

Right Lung Inferior

A

Superior, Anterior Basal, Medial Basal, Lateral Basal, Posterior Basal segments

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111
Q

Left Lung Superior

A

Apical, Posterior, Anterior, Superior, Inferior segments

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112
Q

Left Lung Inferior

A

Superior, Anterior Basal, Medial Basal, Lateral Basal, Posterior Basal segments

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113
Q

Clinical Function of Bronchopulmonary Segments

A

Tributaries of the pulmonary vein, used as surgical markers

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114
Q

Blood Air Barrier

A

Thin membrane between capillaries and alveoli, gas exchange takes place here

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115
Q

Histology of Bronchioles

A

Simple ciliated columnar epithelium with goblet cells

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116
Q

Histology of Trachea

A

Pseudostratified ciliated columnar epithelium with goblet cells

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117
Q

Histology of Alveolar Ducts

A

Simple Squamous

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118
Q

Tidal Volume

A

.5 Liters

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119
Q

Inspiratory Reserve Volume

A

3 Liters

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120
Q

Expiratory Reserve Volume

A

1.2 Liters

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121
Q

Residual Volume

A

1.2 Liters

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122
Q

Vital Capacity or Forced Vital Capacity

A

4.7 Liters

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123
Q

Total Lung Capacity

A

5.9 Liters

124
Q

FEV1 Equals about

A

80% of the Forced Vital Capacity

125
Q

Lung Blood Supply

A

Pulmonary Arteries bring deoxygenated blood and Bronchial Arteries from intercostal arteries

126
Q

Venous Drainage of Lung

A

Azygous System

127
Q

Parasympathetic Nerve Supply To Lungs

A

Vagus Nerve (CN 10)

128
Q

Sympathetic Nerve Supply To Lungs

A

T1-T5

129
Q

Vague Efferent Nerve Supply To Lungs

A

Bronchoconstriction, Vasodilator, Secretomotor

130
Q

Vagal Afferent Nerve Supply To Lungs

A

Sensory in respiratory epithelium(p)

131
Q

Sympathetic Efferent Nerve Supply To Lungs

A

Bronchodilator, Vasoconstrictor, Inhibitory to glands in bronchial tree

132
Q

Respiratory Structures in Respiratory Diseases

A

Involve airways, parenchyma of the lung, pulmonary vessels, pleura, nerves and muscles of respiration

133
Q

Structural/Pathophysiological changes in COPD’s

A

Less air flows in and out of airways because the elastic quality of the airways is lost, narrowing go lumen

134
Q

Asthma

A

Inflammation and edema of the bronchial wall, tightened bronchi an bronchioles and increased mucus production, constriction and narrowing of the lumen

135
Q

Emphysema

A

Enlargement of distal air paces and damage to the lung and alveolar tissue, destruction of the alveolar walls, pink puffers, heave breathing and pink discoloration, difficult exhaling, barrel shaped chest

136
Q

Chronic Bronchitis

A

Inflammation and swelling of the bronchial wall, mucous secretion, narrowing of small airways, blue bloaters, cigarette smoking or inhalation of chemicals as cause, often coughing, sputum production, chronic bacterial infection

137
Q

Pulmonary Thromboembolis

A

Blood clots in the lung originating mainly from veins of the lower limb

138
Q

Bronchiolar Carcinoma

A

(Lung Cancer) From epithelium of the bronchial tree

139
Q

Pancoast’s Tumor

A

Apical lung tumor

140
Q

Atelectasis

A

Collapse of alveoli due to infection or tumor or surfactant deficiency

141
Q

Blood From the Heart Tissues Returns to

A

Coronary Sinus via Coronary Veins

142
Q

Cardiac Output

A

Amount of blood pumped into the aorta and pulmonary trunk by the heart

143
Q

Blood Pressures is Higher

A

Higher in Arteries than Veins

144
Q

Serous Pericardium

A

Double layer thin sac of serous membrane

145
Q

Parietal Pericardium

A

Outer membrane of the Serous Pericardium

146
Q

Visceral Pericardium

A

Inner membrane of the Serous Pericardium (epicardium)

147
Q

Pericardial Cavity

A

Space between the two layers of the serous membrane, contains pericardial fluid which serves as lubrication

148
Q

Fibrous Pericardium

A

External cover of Serous Pericardium, dense connective tissue membrane, like a badd from the outside

149
Q

Function of Pericardium

A

Keeps the heart inn the thoracic cavity, protects the heart against sudden overfilling when blood volume increases

150
Q

Pericardial Sinuses

A

Seen when the fibrous and parietal serous pericardium are both opened, oblique and transverse pericardial sinuses

151
Q

Transverse Sinus

A

Space posterior to ascending aorta and pulmonary trunk, anterior to superior vena cava, finger can pass through

152
Q

Oblique Sinus

A

U shape blind recess posterior to heart., hand can pass through

153
Q

Blood Supply of the Pericardium

A

Pericardiacophreic and Musculophrenic arteries

154
Q

Venous Drainage of the Pericardium

A

Azygous Venous system and Pericardiacophrenic veins

155
Q

Innervation of Pericardium

A

Sympathetic and Parasympathetic (vagus) nerves, phrenic nerve

156
Q

Pericarditis

A

Inflammation of the serous pericardium, due to cardiac or systemic disabuses, increased amounts of pericardial fluid, compress and restrict hearts movements, friction rubbing, severe pain behind and above sternum

157
Q

Pericardiocentesis

A

Removal of excess fluid from pericardial cavity, entering at 5th or 6th left intercostal space near sternum

158
Q

Pericardial Effusion

A

Abnormal accumulation of fluid in the pericardial cavity, eads to an increased intrapericardial pressure which can negatively affect heart function

159
Q

Cardiac Tamponade

A

Pressure on the heart that occurs when blood or fluid builds up in the space between the heart muscle (myocardium) and the outer covering sac of the heart (pericardium)

160
Q

Heart Tissue Is

A

Myocardium

161
Q

Myocardium is Covered By

A

Epicardium

162
Q

Endocardium

A

Thin layer covering the inner surface of the heart

163
Q

Ligamentum Arteriosum

A

Remnant of Ductus Arteriosus, goal was to stop blood from going to the pulmonaries

164
Q

Right Superior Border of The Heart

A

Third Costal Cartilage

165
Q

Left Superior Border of The Heart

A

Second Intercostal Space

166
Q

Right Inferior Border of The Heart

A

Sixth Costal Cartilage

167
Q

Left Inferior Border of The Heart

A

Fifth Intercostal Space

168
Q

Heart Size

A

Child a relatively larger, lies higher, transversely located compared to the heart of adult

169
Q

Atria Separated by

A

Atrial Septum

170
Q

Ventricles Separated By

A

Interventricular Septum

171
Q

Left Wall Ventricle

A

2-3 times thicker than the right ventricle

172
Q

Blood Pressure Aorta

A

120/80 mmHg

173
Q

Blood Pressure Pulmonary Artery

A

25/10 mmHg

174
Q

Interventricular Septum

A

Thick as the wall of the left ventricle, consists of a lower muscular portion and upper membranous portion

175
Q

Ventricular Septal Defect

A

Most common heart defects whose cause is unknown, genetic factors, excessive fatigue during exertion, pulmonary hypertension, thickening of these arteries and arterioles leads to increased pulmonary resistance in systemic circulation, Eisenmenger’s Syndrome

176
Q

Mitral/Bicuspid/Left Atrioventricular Valve

A

Two leaflets, connected to papillary muscles by tendinous cords

177
Q

Aortic Valve

A

Outflow of the left ventricle at the beginning of the aorta and consists of three semilunar cusps, Posterior, Left and Right

178
Q

Aortic Sinus

A

Dilated portion of aorta that prevents the cusps from sticking to the wall during the closure of the valve

179
Q

Right Atrium

A

Receives blood from the superior vena cava, inferior vena cava and coronary sinus

180
Q

Atrial Septum

A

Double layered is membrane formed during gestation that divided the right and left atria from one another

181
Q

Foramen Ovale

A

Turns into Fossa Ovais, fetal structure to stop blood from entering the lungs

182
Q

Premature Closure of Foramen Ovali

A

Leads to right heart hypertrophy and left side under development

183
Q

Atrial Septal Defect

A

Congenital malformation that presents as an opening between the atria, blood from left side goes to right side causing heart enlargement and a higher volume of blood to the lungs, larger detect could need cardiac catherization or open heart surgery

184
Q

Septomarginal Trabeculae

A

Moderator Band, muscle bundle extending from the interventricle septum to anterior papillary muscle part of conductive system

185
Q

Tricuspid Valve

A

Between right atrium and ventricle, anterior, posterior, and septal cusps

186
Q

Pulmonary Valve

A

Anterior, Left and Right valves

187
Q

Pathology of Valves

A

Inflammation or infections of cusps may lead to scar formation and narrowing of the valve orifice (stenosis)

188
Q

Incompetency/Insufficiency of Valves

A

Occurs when valve is unable to close properly

189
Q

Rheumatic Fever and Cardiac Function

A

Acute inflammation as a result of complication of chronic tonsillitis, pharyngitis (etc), by Streptococcus infection characterized by arthritis, chorea, skin involvement (erythema), subcutaneous nodules and carditis, nodules on the valve cause irregular blood flow, valvular incompetence (blood regurgitation) causing murmur, may cause stenosis

190
Q

Skeleton of Heart

A

Fibrocartilaginous tissue the muscles and valves are built on this system

191
Q

Conduction System of the Heart

A

Specialized muscle tissue (the impulse-conducting system), which spontaneously generates rhythmical impulses to stimulate the rest of the heart muscle to contract.

192
Q

Sinus (Sinoatrial) Node

A

Keith Flack, pacemaker, 70 impulses per minute

193
Q

Atrioventricular (Aschoff-Tamara) Node

A

Ventricular side of orifice of coronary sinus, 50-60 impulses per minute

194
Q

Bundle of His (Atrioventricular Bundle)

A

Pierces the cardiac skeleton, left and right bundles, 45-25 impulses per minute

195
Q

Right Bundle of His

A

Section passes through the mdoerator band

196
Q

Left Bundle of His

A

Has 6 branches and stimulates inter ventricular septum, anterior and posture papillae muscles and left ventricle

197
Q

Purkinje Fibers

A

Terminal ends of bundles, merge with cardiac muscles on the walls of ventricles

198
Q

Innervation of Conduction System Sympathetic

A

5-6 upper thoracic segments, postsynaptic fibers end on SA and AV nodes, increases heart rate and contraction force

199
Q

Innervation of Conduction System Parasympathetic

A

Vagus nerve terminates on many small ganglia on the heart, decreases heart rate and force

200
Q

Electrocardiography

A

Test recording electrical activity of heart

201
Q

P Wave

A

Represents atrial depolarization

202
Q

QRS Complex

A

Represents depolarization of ventricles

203
Q

T Wave

A

Represents ventricular repolarization

204
Q

P-R Interval

A

Normally equal to less than 0.2 seconds

205
Q

ST Segment

A

Isoelectric and indicated that ventricles are depolarized

206
Q

Normal ECG

A

25 mm/s

207
Q

Detect Abnormal Heart Rate/Rhythm

A

Look on ECG

208
Q

Atrial Flutter

A

Supreventrivcular arrhythmias characterized by rapid atrial waves, AV node is unable to respond to all waves it is receiving, saw toothed baseline appearance, may lead to heart failure

209
Q

Atrial Fibrillation

A

400-700 a minute, wavy baseline, absence of recognizable P wave, can develop congestive heart failure and syncope

210
Q

Ventricular Tachycardia

A

Three or more ectopic beats of ventricular origin, greater than 100 beats per minute, life threatening, coronary artery disease

211
Q

Ventricular Fibrillation

A

Most serious cardiac arrhythmias, potentially leading to cardiac rest, electrical activity is disordered, leading to rapid and unsynchronized contraction of ventricles, use of defibrillator

212
Q

ECG Changes During Myocardial Ischemia

A

Critical during exercise or high metabolic energy demand reveals S-T segment depression

213
Q

S-T Segment Elevated in Conditions:

A

Transmural Myocardial Infarction, Vasospastic Angina, Pericarditis

214
Q

Auscultation

A

Listening to the sounds of the heart

215
Q

First Heart Sound

A

QRS complex, closure of atrioventricular valves

216
Q

Second Heart Sound

A

T wave, closure of semilunar valves

217
Q

Third Heart Sound

A

In children due to rapid ventricular filing

218
Q

Fourth Heart Sound

A

Due to atrial systole

219
Q

Sites of Auscultation

A

Aortic Valve (right 2nd intercostal space), Pulmonary Valve (left 2nd intercostal space), Tricuspid Valve (left 5th rib, at sternal junction), Mitral Valve (left 5th intercostal space in midclavicular line)

220
Q

Blood Supply of Heart

A

Right and Left coronary arteries, functional end arteries

221
Q

Right Coronary Artery Branches

A

SA Nodal Artery, Right Marginal Artery, Posterior Interventricular Artery, AV Nodal Artery

222
Q

Right Coronary Artery Supplies

A

Right Atrium, SA Node, AV node, posterior parts of inter ventricular septum

223
Q

Left Coronary Artery Branches

A

Anterior Interventricular Artery, Circumflex Branch, Left Marginal Artery

224
Q

Left Coronary Artery Supplies

A

Left Atrium, left ventricle, inter ventricular septum, AV bundles, SA Node

225
Q

Blockage of Coronary Arteries Results

A

No alternative blood supply, myocardial infarction and death, heart attacks due to blockage of smaller arteries

226
Q

Veins of Heart Drain To

A

Coronary Sinus to Right Atrium

227
Q

Veins of the Heart

A

Great Cardiac, Middle Cardiac, Small Cardiac, Left Posterior Ventricular, Left Marginal, Oblique Vein of the Left atrium, Anterior Cardiac, Smallest Cardiac

228
Q

Thesbian Valve

A

Valve on coronary sinus and right atrium

229
Q

Atherosclerotic Plaque

A

Calcification or hemorrhage, blockage and narrowing of vessels, coronary angiography (contrast medium), femoral or brachial artery to heart, balloon at tip of needle to push fluid towards and widen the lumen and restore blood supply

230
Q

Sympathetic Nerve

A

Increases heart rate, contraction force and impulse conduct of the heart

231
Q

Sensory Information From Heart

A

Transmitted through sympathetic neves (T1-T5)

232
Q

Parasympathetic Nerve

A

Decreases the heart rate and force, vasoconstrictor to the coronary arteries

233
Q

Lymphatic Drainage of Heart

A

Drained by subperiardial plexus which eventually drained onto the left venous angle

234
Q

Two Phases of Cardiac Cycle

A

Systole and Diastole

235
Q

Systole Goal

A

Contraction, emptying of blood filled ventricles

236
Q

Diastole Goal

A

Relaxation, ventricles filled with blood

237
Q

Systole Stages

A

Isovolumetric Contraction and Ejection Period

238
Q

Diastole Stages

A

Isovolumetric Relaxation and Filling Time

239
Q

Structures of the Posterior Mediastinum

A

Esophagus, Esophageal plexus, thoracic aorta and branches, thoracic duct coming from the cisterns chill, azygos venous system, thoracic splanchnic nerves

240
Q

Esophagus

A

Muscular Tube to Digestive tract

241
Q

Blood Supply to Esophagus (Upper)

A

Inferior thyroid artery

242
Q

Blood Supply to Esophagus (Middle)

A

4-5 esophageal arteries and bronchial arteries

243
Q

Blood Supply to Esophagus (Lower)

A

Left gastric artery and inferior phrenic artery

244
Q

Venous Drainage of Esophagus

A

By the inferior thyroid vein, azygous, hemiazygous, gastric veins

245
Q

Innervation of Esophagus

A

Sympathetic and parasympathetic (vagus) nerves

246
Q

Cardia

A

Where esophagus enters the stomach

247
Q

3 Narrowings of the Esophagus

A

Upper Sphincter, Aortic, Diaphragmatic

248
Q

Azygous Venous System Contains

A

Azygous, Hemiazygous, Ascending Lumbar, Accessory Hemiazygous

249
Q

Sympathetic Chain

A

Visceral organs of the trunk are innervated by the autonomic nervous system

250
Q

Route of Sympathetic Step 1

A

Myelinated preganglionic axons of the lateral horn neurons leave the spinal core through the ventral root

251
Q

Route of Sympathetic Step 2

A

Passing through the white commenting rams to teach the sympathetic ganglion of the sympathetic chain

252
Q

Route of Sympathetic Pathway 1

A

Axons synapse in the ganglion and leave to innervate

253
Q

Route of Sympathetic Pathway 2

A

Other group of postganglionic fibers reach visceral organs in thorax

254
Q

Route of Sympathetic Pathway 3

A

Another group of fibers reaching the ganglion don’t synapse and move on to synapse at other location

255
Q

Route of Sympathetic Pathway 4

A

Another group of fibers leave the ganglia without surpassing and go pre vertebral ganglia

256
Q

Lymphatic System

A

Lymphatic vessels collect lymph (excess tissue fluid and blood proteins from loose connective tissue) and carry this fluid (lymph) to the great veins in the neck, fluid flows only toward the heart

257
Q

Thoracic Diaphragm

A

Dome shaped, musculotendinous structure separating the thoracic and abdominal cavities

258
Q

Parts of Thoracic Diaphragm

A

Central tendon and muscular part (sternal, costal, lumbar)

259
Q

Openings in Thoracic Diaphragm

A

Aortic hiatus (T12) , Esophageal hiatus (T10), Foramen for the inferior vena cava (T8)

260
Q

Thoracic Diaphragm Function

A

Chief muscle of inspiration

261
Q

Blood Supply of Thoracic Diaphragm

A

Inferior phrenic, superior phrenic, musculophrenic and pericardiophrenic arteries

262
Q

Innervation of Thoracic Diaphragm

A

Phrenic nerve: C3, C4, C5 and L1-L2 nerves and intercostals (sensory)

263
Q

Epithelial Tissue

A

Covers external and Internal surfaces and involved in protection absorption and secretion, can regernate

264
Q

Junctions of Epithelial Tissue

A

tight, adhering, desmosomes, gap

265
Q

Tight Junctions

A

Prevent molecules from passing between the cells, encircles the cell to secure it to neighboring cells

266
Q

Adhering Junctions

A

All around the cell where microfilaments extend, supports the cell like a belt close to the neighboring cells

267
Q

Desmosomes

A

Disc saved plaques connected across the intercellular space, contact with cytoskeleton to support the cell, only at points where cell has mechanical stress

268
Q

Gap Junctions

A

Specialized channels called connecons, six subunits and allow ions to flow rapidly between cells

269
Q

Classifications of Epithelial Cells

A

Squamous (flat), Cuboidal (cube), Columnar (tall and rod like) –> Simple (one layer), Stratified (multiple layers)

270
Q

Simple Squamous Epithelium

A

Air Sacs of Lungs, Kidney Corpuscles

271
Q

Simple Cuboidal Epithelium

A

Kidney Tubules, Thyroid Gland

272
Q

Simple Columnar Epithelium

A

GI Tract, goblet cells

273
Q

Ciliated Simple Columnar Epithelium

A

Uterine tube, cilia moves contents

274
Q

Pseudo Cilitated Columnar Epithelium

A

Respiratory airways, goblet cells

275
Q

Non Keratinized Stratified Squamous Epithelium

A

Esophagus, Vagina

276
Q

Stratified Keratinizing Epithelium

A

Skin, five layers

277
Q

Five Layers of Stratified Keratinizing Epithelium

A

Stratum basale, stratum spinosum, stratum granulosum, stratum lucid, stratum corneum

278
Q

Dead Layer of Skin

A

Stratum corneum

279
Q

Stratified Columnar Epithelium

A

Urethra and large ducts of glands

280
Q

Stratified Cuboidal Epithelium

A

Ducts of salivary and mammary glands

281
Q

Transitional Epithelium

A

Ureter, urinary blasser, urethra

282
Q

Connective Tissue

A

Supports and connects the tissue

283
Q

Loose Areolar Connective Tissue

A

Most widespread, cushion organs and under epithelial tissue

284
Q

Adipose Connective Tissue

A

Matrix of fat cells, breast and kidneys

285
Q

Reticular Connective Tissue

A

Reticular fibers and cells, spleen, bone marrow, lymph nodes

286
Q

Dense Irregular Connective Tissue

A

Irregularly arranged fibers, fibrous joint capsule, dermis, submucosa

287
Q

Dense Regular Connective Tissue

A

Parallel fibers, rows, ligaments and tendons

288
Q

Cartilage

A

Firm, compressible, flexible structure, contains lots of water

289
Q

Types of Cartilage

A

Hyaline, Elastic, Fibrocartilage

290
Q

Hyaline Cartilage

A

Strong tissue, rich inc collagen fivers, row and column, surrounded by a capsule, joint surfaces, epiphyseal plates and embryonic skeleton

291
Q

Elastic Cartilage

A

Matrix rich in elastic fibers, yellowish color, ear, epiglottis, larynx

292
Q

Fibrocartilage

A

Matrix with collagen fibers, symphysis pubis and intervertebral discs

293
Q

Scurvy

A

Vitamin C deficiency, due to inadequate college cross linking, leads to rupture of blood vessels and bleeding gums

294
Q

Muscle Tissue

A

Responsible for movement of the body and contraction of the internal organs

295
Q

Skeletal

A

Voluntarily controlled, 40% of body weight, long, multinuclear, striated cells

296
Q

Cardiac

A

Branching, uninuclear, striated, walls of heart

297
Q

Smooth

A

Spindle shaped, one nucleus, lack striation, propel content of organs

298
Q

Nerve Tissue

A

Command center that controls the body function, contains excitable neurons

299
Q

Glands

A

Specialized unicellular or multicellular structures that prices and secrete products via exocytosis

300
Q

Types of Glands

A

Exocrine and Endocrine

301
Q

Exocrine Secrete

A

Product through a duct

302
Q

Endocrine Secrete

A

Product into circulation

303
Q

Classification of Exocrine Glands

A

Apocrine, Holocrine, Merocrine

304
Q

Apocrine Gland

A

Secretion, salivary, gastric, part of pancreas glands

305
Q

Holocrine Gland

A

Pinched off portion of cell and secretion, mammary gland

306
Q

Merocrine Gland

A

Disintegrating cell and secretion, sebaceous gland

307
Q

Blood Tissue Types

A

Red Blood, Lymphocyte, Basophil, Monocyte, Eosinophil, Platelets, Neutrophil