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Anatomy > Exam 3 Lungs,Heart > Flashcards

Exam 3 Lungs,Heart Flashcards

0
Q

components of lower respiratory tract

A
  1. trachea
  2. primary bronchi
  3. lungs
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1
Q

Components of upper respiratory tract

A
  1. nasal cavity
  2. pharynx
  3. larynx
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2
Q

4 surfaces of the lung

A
  1. Apex
    - T1
    - project 3cm above medial clavicle
    - Subclavian A & V pass over apex of lung –>superior thoracic aperture
  2. costal surface: spine to sternum (follows curvature of ribs)
  3. diaphragmatic surface: follows curvature of diaphragm
    - anterior more cranial than posterior
    - inferior border @ rest: mid-clavicle = 6th rib; 8th rib = mid-axilla; T10 posteriorly
  4. Medial surface:faces heart
    - Hilus:where pulmonary arteries, veins, bronchi enter medial surface
    - Root of lung:conduit of pulmonary arteries, veins, bronchi entering hilus
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3
Q

Pleura

A
  • 2 very thin layer of cells
  • visceral: surface of lung
  • parietal: inner wall of thoracic cavity
  • pleural cavity: synovial fluid, lubricant
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4
Q

4 regions of parietal pleura

A
  1. costal pleura: lines ant, lateral, post walls of rib cage
  2. diaphragmatic pleura: cranial surface of diaphragm, floor of pleural cavity
  3. mediastinal pleura: medial surface of lungs
    - continuous c costal/diaphragmatic pleura, copula
    - @ root: surrounds pulmonary vessels, bronchi
    - inferior to root: fuses c visceral pleura–>2 layered Pulmonary Lig.
  4. Copula (dome): covers apex
    - extends into superior thoracic aperture
    - superior to posterior surface of mid clavicle, 1st rib
    - continuous c costal, mediastinal pleura
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5
Q

pleural recesses

A

spaces within pleural cavity not filled entirely by lungs

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6
Q

Costodiaphragmatic recess

A

-formed inferiorly where costal pleura becomes continuous w/ diaphragmatic pleura

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7
Q

costomediastinal recess

A
  • lies anteriorly @ ventral margin of 4th&5th intercostal space
  • where costal pleura meets mediastinal pleura
  • left recess bigger than right (due to cardiac notch)
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8
Q

Right lung

A
  • 3 lobes: upper, middle, lower
  • oblique fissure: runs down/forward, approximates 6th rib; separates middle/lower lobe
  • posterior to mid-axillary line: no middle lobe –>oblique fissure separates upper/lower lobes
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9
Q

left lung

A
  • 2 lobes: upper, lower separated by oblique fissure (approximates course of 7th rib)
  • cardiac notch: indentation along medial surface of upper lobe
  • lingula: tongue like protrusion below cardiac notch
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10
Q

bronchopulmonary segments

A
  • lobes divided into bronchopulmonary segments
  • BP segments anterior to oblique fissure differ between upper lobes
    • R lung (upper & middle lobe anterior to fissure)
    • L lung (only upper lobe anterior to fissure)
    • Upper lobe-R lung: apical, ant, post BPS
    • Upper lobe-L lung: apical, ant, post BPS
      - And superior & inferior lingular segments
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11
Q

bronchial tree (descending order)

A
  1. Trachea
  2. Primary Bronchi
    - Right
    - Left
  3. Secondary Bronchi (Lobar Bronchi)
    - Right (3)
    - Left (2)
  4. Tertiary Bronchi (Segmental Bronchi)
    - Right (3)
    - Left (2)
  5. Each tertiary bronchi goes to one of the BPS (named for that segment it enters)
  6. terminal bronchioles
  7. respiratory bronchioles
  8. alveolar ducts
  9. alveolar sacs
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12
Q

Describe organization of cartilage as bronchi divide-

A

-decrease cartilage as bronchi divide

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13
Q

cells found in alveoli

A
  1. type I pneumocytes (epithelial)

2. type II (cuboidal):surfactant

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14
Q

Postural drainage

A
  • Helps clear mucoid congestion
  • gravity assists
    • move mucous from BP segment–>primary bronchus
    • tap chest over segment
    • coughing: mucous goes from bronchi–>oral cavity for removal
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15
Q

Level of lungs

A

Inferior border:

  • T10 (posterior)
  • Rib 8 (mix-axillary line)
  • Rib 6 (mid-clavicular)
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16
Q

super mediastinum

A

border:
- ant: sternal angle (T4,5 disc), top of manubrium
- post: C7/T1 disc, T4,5 disc
- superior: superior thoracic aperture (first ribs)
- lies above heart
- overlaps ant, middle, post mediastinum

planes (ant to post)

  1. glandular
  2. venous
  3. arterial-venous
  4. visceral
  5. lymphatic
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17
Q

glandular plane of superior mediastinum

A

thymus gland

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18
Q

venous plane of superior mediastinum

A
  • 2nd plane (ant–>post)
  • L,R brachiocephalic V
  • superior vena cava
  • arch of Azygos V
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19
Q

arterial-nervous plane of superior mediastinum

A
  • 3rd plane
  • Aortic arch & branches: brachiocephalic trunk, L common carotid A, L subclavian A

Nerves:

  • L,R vagus
  • L,R phrenic
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20
Q

visceral plane of superior mediastinum

A
  • 4th plane
  • trachea
  • esophagus
  • L recurrent laryngeal N
  • thoracic duct
21
Q

pericardium

A

deep to superficial:

  1. visceral serous pericardium
  2. pericardial cavity
  3. parietal serous pericardium
  4. fibrous pericardium
22
Q

Anterior surface of heart

A 
5th-8th thoracic vert
Sup/Inf vena cava
R auricle
ascending aorta
aortic arch
pulmonary trunk
R/L ventricles
L auricle
23
Q

Coronary sulcus

A

Between atria & ventricles

  • circumflex branch of L Coronary A
  • Coronary Sinus
  • R Coronary A
24
Q

Lines of reference for lungs

A
  • midline
  • lateral sternal line
  • midclavicular line
  • anterior axillary line
  • middle axillary line
  • posterior axillary line
25
Q

Posterior view of heart

A
  • small cardiac v (runs with R coronary A)
  • posterior interventricular A (posterior branch of R coronary A)
  • middle cardiac v (post interventricular A)
  • great cardiac v (ant interventricular A, circumflex A)
  • coronary sinus (small, middle, great anastomose)
26
Q

vessels that enter Right Atrium

A
  • sup vena cava
  • inf vena cava
  • coronary sinus
27
Q

Right ventricle

A
  • tricuspid valve (R AV valve)
    • chordae tendineae attach to papillary muscles
  • pulmonary trunk
    • pulmonary valve (semilunar valve)
28
Q

L Atrium

A
  • most posterior portion of heart
  • sup & inf pulmonary veins (4 total)
  • biscuspid/mitral valve
    - chordae tendineae attach to papillary muscles
29
Q

L Ventricle

A
  • most muscular
  • aortic valve (3 semilunar cusps)
    • concave superiorly–>form aortic sinus
  • R,L coronary A
    • superior to R/L cusps @ level of aortic sinus
    • blood pooling in sinus fills coronary arteries when valves close
30
Q

Ohm’s law

A

flow:
- directly proportional to pressure difference
- inversely proportional to resistance

31
Q

METs

THR

A

Metabolic Equivalent System

  • desk work: 1.5-2
  • walk 2mph: 2.5
  • jog 5mph: 7-8

Target heart rate:
(220-age0.65).65 (lower end range)
(220-age0.65).85 (upper end range)

32
Q

congestive heart failure

A
  • inability of heart (left ventricle) to eject all blood it receives
  • pooling of blood in ventricles reduces amount of blood it can receive from pulm circulation
  • ->restriction of blood flow out of lung–>pulm edema
    • decreases elasticity of lungs
    • pushes fluid into alveoli, decreased respiration
33
Q

structures that L coronary A supplies

A
  • L atrium
  • L ventricle
  • interventricular septum
  • ant part of R ventricle
  • interventricular bundle of His
  • branches into Ant Interventricular A & Circumflex A (curves posterior)
  • Circumflex A–>L marginal A (supplies L ventricle)
34
Q

structures that R coronary A supplies

A
  • large part of R atrium, ventricle
  • less of L ventricle
  • least of L atrium
  • interventricular septum
  • interatrial septum
  • SA,AV nodes
  • branches:
  • Sinoatrial A : SA node
  • R marginal branch
  • posterior interventricular A (meets w/ ant IVA @ apex)
  • ends by anastomose w/ circumflex A
35
Q

Coronary Artery Disease

A

decreased diameter coronary A–>ischemia–>decreased O2 to heart –>chest pain (angina pectoris)
*severe decrease–>myocardial infarction

36
Q

Cardiac Veins

A
  • venous blood from R,L ventricles & L atrium into coronary sinus
  • coronary sinus lies in coronary sulcus
    • empties into lower R atrium near inf vena cava
    • receives blood from:
      • great cardiac v
      • middle cardiac v
      • L,R marginal v
      • small cardiac v
37
Q

structure of arteries and veins

A

3 layers:

  • intima: simple squamous epithelium i.e. endothelial cells
  • middle: “media”, smooth muscle, collagen, elastic fibers
  • adventitia: outermost layer, collagen
38
Q

3 divisions of Arteries

A
  1. large elastic (aorta, pulmonary trunk)
    - intima: thick, layer of elastic fibers
    - media: smooth mm, elastic fibers
    - adventitia: thin, collagen
  2. medium size A (muscular A)
    - intima: elastic fibers
    - media: thick smooth muscle
    - adventitia: thick, mostly collagen, some elastic
  3. small A (arterioles)
    - few elastic fibers in intima, only few layers of smooth mm in media
    - adventitia thin, mostly collagen
39
Q

structure of veins

A
  • large: thin intima & media, thick advent
  • medium size: thin intima & media, distinct advent
  • small; thin intima & media
40
Q

structure of capillaries

A
  • single layer of endothelial cells
  • continuous: no pores
  • fenestrated:thin porous regions (fenestra)
41
Q

congenital heart defects

A
  1. interventricular septal defect
    - hole in IV septum
    - more common in superior (membranous)
    - loss of pressure in L ventricle during contraction–>decreases flow
    - push blood back into R ventricle
    • increase pulmonary flow, may cause CHF
  2. tetralogy of fallot
    - IV septal defect
    - infundibular pulmonary stenosis (narrow opening of pulmonary trunk)
    - overriding aorta (receives blood from R & L ventricles due to IV septal defect)
    - R ventricular hypertrophy
42
Q

contents of superior mediastinum

A
  • continuous inferiorly w/ ant, mid, post mediastina
  • thymus
  • R,L brachiocephalic V, superior vena cava
  • arch of aorta
    • brachiocephalic trunk: R subclavian A, R common carotid A
    • L common carotid A
    • L subclavian A
  • R,L vagus N (lie in sup, mid, post mediastina)
    • run w common carotid A, int jug V
    • give off recurrent laryngeal N
  • phrenic N (superior and middle mediastina)
  • trachea
  • esophagus
  • thoracic duct
  • sympathetic trunks (chains) (neck - sacrum)
    • through sup & post mediastina

note:
aortic arch in sup mediastinum
ascending aorta: middle mediastinum
descending aorta: posterior mediastinum

43
Q

super mediastinum contents (ant–>post)

A

1.thymus
2.R,L brachiocephalic V, superior vena cava
3.Arch of Aorta
*brachiocephalic trunk: R subclavian A, R common carotid A
*L common carotid A
*L subclavian A
R,L vagus nerves
*run w/ common carotid A and int jug V
*give off branch to recurrent laryngeal N
R,L phrenic N (sup & mid mediastinum)
Sympathetic Trunks
4.Trachea, esophagus
5.thoracic duct

44
Q

posterior mediastinum contents

A
  • posterior to pericardium, T4-5 disc to vertebral margin of diaphragm
    1. thoracic aorta
    • post intercostal A
    • esophageal A
    • bronchial A
    • subcostal A
    • arteries to pericardium, diaphragm
      2. esophagus
      3. vagus N, ant & post vagal trunks (continuations of R,L vagus N)
      4. azygos V
      5. hemiazygos V(T12-T9,formed by L subcostal & ascending lumbar V)
      6. accessory hemiazygos V (T8-T4, blood from L intercostal V)
      7. sympathetic trunks
    • splanchnic Nerves (3):Greater (T5-9),Lesser(T9-10),Least(T11)
      8. thoracic duct
    • begins @ cisterna chyli (ENLARGED SAC-ventral to T12)
    • lymph drainage from abdomen, pelvis, lower extrem
    • empties into L brachiocephalic V
45
Q 
Diaphragm apertures
(Come Enter Abdomen Please)
A

Ant –>post:

  1. vena caval: T8
  2. esophageal: T10
  3. Aortic hiatus: T12
  4. Psoas: T12
46
Q

posterior mediastinum (4 birds)

A
  • esophaGOOSE (esophagus)
  • vaGOOSE (vagus N)
  • azyGOOSE (azygos V)
  • thoracic DUCK (thoracic duct)
47
Q

sympathetic trunks

A
  • Neck to sacrum
  • superior mediastinum
  • posterior mediastinum
    • greater splanchnic N (ganglia T5-9)
    • lesser (ganglia T9-10)
    • least (ganglia T11, sometimes T12)
48
Q

accessory hemiazygos V

A

T8-4

blood from L intercostal V

49
Q

hemiazygos V

A

T12-9

formed by L subcostal V & ascending lumbar V

50
Q

R lymphatic duct

A

drains into R internal jugular V / R brachiocephalic V

Anatomy (10 decks)

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